ADDICTS' DISEASE NOT A WEAKNESS

Without clarification, Frank Wooten's Aug. 5 commentary "Addiction is still
a weakness" undermines decades of scientific research.

Tragically, his column will also feed feelings of personal failure that
often prevent alcoholics and addicts from trying to get help. Without an
understanding of the relationship between personal responsibility and
disease, his column can easily be nailed to the chests of many suffering
addicts by their equally suffering significant others. This does not lead
to the "compassionate care" and avoidance of "dehumanizing stigmatization"
that Mr. Wooten calls for in his article and must be addressed strongly.
Hardly anyone in the scientific community doubts any more that alcoholism
and drug addictions are diseases in every sense of the word. The research
documentation is easily available and does not need to be rehashed here.
Addiction is not a weakness.

It is a disease, and weakness is a symptom of the disease.

Weakness is symptomatic to most diseases.

From the flu to brain tumors, people with significant physical impairment
seldom retain great physical or emotional strength.

Weakness is a result of addiction, not a cause. Mr. Wooten writes: "Beating
your habit is a direct measure of your will power, despite experts'
protests to the contrary." Many experts would agree that will power plays a
role in recovery but probably not in the way Mr. Wooten expects. "Just say
no!" didn't work 15 years ago and it doesn't work now. There is always an
exception here and there, but the vast majority of addicts cannot simply
control their intake and walk away no matter how much will power they have.
This is because of compulsion. Over two decades of research has shown that,
for alcohol and for many other drugs, the biochemistry of the addict is
different from the non-addict. More recently, brain scans have shown
dramatic differences in addict and non-addict responses to alcohol and drugs.

Compulsion is the inability to stop drinking or using, and it is directly
related to altered brain function.

Using will power to beat a biochemical compulsion is like using will power
to stop a physical allergic reaction. Experts would agree with Mr. Wooten,
however, that will power is important in getting treatment and sticking to
treatment recommendations. People can and do recover from alcohol and drug
addiction every day. They start getting well just like any other patient
with any other disease.

To recover, they attend therapy sessions.

They change their lifestyle. Some take prescription medications. Most
attend Alcoholics Anonymous or Narcotics Anonymous. Those who don't
exercise a personal responsibility to follow clinical advice often relapse.

But addicts have no monopoly on relapse.

Heart patients who don't exercise and change their diets often have second
or third heart attacks.

University of Pennsylvania research has shown that compliance with
treatment advice given to addicted patients is comparable to compliance
with treatment recommendations given to patients with asthma, hypertension,
or diabetes. Failure to comply with doctors' recommendations -
prescriptions, diets, exercise programs, etc. - is common throughout
medicine. So to all you suffering alcoholics and addicts out there - don't
let Mr. Wooten discourage you. You have no reason to feel ashamed.

But if you think you have the disease, you do have a responsibility to
yourself and the people who care about you to get professional help. And
treatment almost always works if you comply with the recommendations. Just
like any other illness.

Mark Cowell is the director and Jack Emmel, M.D., is the medical director
of the Charleston Center of the Charleston County Department of Alcohol and
Other Drug Abuse Services.