ADRIFT IN A WORLD OF TEMPTATION

WHEN it comes to addiction there are two types of people in the world. There
are those who accept addiction and there are those who will argue that
addiction is the greatest con job played on the modern world, that it is an
international conspiracy between weak and selfish people to excuse their
weakness and selfishness.

The latter reject the idea that addiction is a medical condition and claim
that it merely provides an alibi for irresponsible behaviour. As more and
more seemingly ludicrous addictions have entered public consciousness (sex,
shopping, video games), they have served to downgrade the legitimacy of
addiction as a disease, portraying it rather as the folly of the
irresponsible. Just as the prevalence of Prozac in the US made light of
depression, Michael Douglas and his ilk have made light of addiction.

To dismiss the idea of addiction as an illness which needs treatment is to
dismiss two important aspects of the abuse of drink, drugs, food, or
whatever. Firstly, that addiction causes tremendous misery and health
problems, and secondly, that it can be cured.

As long as these two factors hold true, then it is perhaps helpful whatever
your philosophical difficulties with addiction to regard it as an illness.

Not only is addiction an illness, but it is one of the major illnesses of
the latter days of the 20th century.

More worryingly still, it is a disease that is increasingly affecting young
people in this country. While the increasing availability of more and varied
types of drugs is one contributory factor to this increase (a 50 per cent
increase in addictions in people under 25 in the past 10 years), there are
others.

Maura Russell is the director of the Rutland Centre, a residential centre on
the outskirts of Dublin which has been treating addictions in a
non-psychiatric environment for 21 years. Russell believes that addiction is
as much a symptom of a problem as a problem in itself.

Those who spend time in the Rutland Centre will inevitably have difficulties
in coping with life and relationships. They will often live in fear of
social situations and will generally have a low self-opinion. These are not
just addicts, they are people who are hurting a lot.

Those young people who succumb to addiction are probably not coping with
life. According to Russell, this usually means that they never learned
social or life skills, neither at home nor school. She feels it is wrong
that children are getting an ever more academic education without being
instructed in the basic building blocks of life.

THE absence of this basic education can lead to car accidents, suicides, a
downward spiral into an emotional hell for families, and a whole host of
physical illnesses. In the case of the Rutland Centre, it can lead to young
people being admitted for addiction while still in their late teens.

Given how long full-blown addiction takes to develop, it means these
children began drinking or drugging in their early teens and perhaps
younger. In other words, children are getting involved in drink and drug
abuse before they are old enough to make halfway mature decisions.

Maura Russell is clearly used to explaining the mechanics of addiction and
is patient with my mild scepticism as she explains how use becomes abuse,
and enjoyment becomes obsession.

Addiction, she points out, is based on the very human principle of trying to
minimise pain and maximise pleasure. It occurs when this natural inclination
backfires, when people lose control over themselves and their lives because
of their addiction.

And, to ensure we sympathise with addiction, this is the crucial thing to
remember: addicts cannot give up. They are powerless in the face of their
addiction. Not that most of them will bring themselves to admit this.

The Rutland Centre works on the basis of family motivation and intervention.
This means that it will often be the family of an addict that makes the
first approach. Having gathered evidence from the family, the Centre will
then arrange an intervention meeting between the addict and the family. The
family will present the addict with the facts of their addiction and the
addict will then be assessed, diagnosed and recommended for treatment.

Given that addiction revolves heavily around denial, addicts will often
decline the treatment and decide to kick on their own. Maura Russell smiles
as she recounts that they generally return some time later, saying, `I've
tried it on my own and it's got worse.'

When someone does agree to the six-week treatment programme, they join a
community of 25 or so addicts at various stages of recovery. More
specifically, they join a group of eight within the 25. For the next six
weeks, they share twice-daily group therapy sessions with this group as each
member tries to overcome his own problem and facilitate others in dealing
with theirs.

Tuesday is the worst day in group. Tuesday is family day when addicts are
confronted by their families, confronted with their behaviour and how it
affects their families. The other members of the group will be present for
this. This is important, Maura says, as people may be back into denial by
Thursday and it will take other group members to remind them of how bad they
actually were. All of this is punctuated by lectures, duties in the
community and individual therapy, as well as AA, NA and GA meetings. The
fellowships are important to the Centre. When it was first set up 21 years
ago, it was based on various American models that had grown out of the AA
12-step programme, specifically the Minnesota model.

AFTER the six weeks, the addict will leave residential care and embark on a
further year of aftercare. At the end of this year, the addict will
hopefully be one of the 70 per cent or so who are still sober. Maura Russell
uses the term ``sober'', but in fact the range of addictions dealt with at
the Rutland is growing all the time. The Rutland was one of the first places
in this country to treat gambling as an addiction, and these days, apart
from drug addicts, the Centre also deals with an increasing number of people
with eating disorders.

Maura Russell wishes that more people could avail of treatment centres like
the Rutland. It is ironic, she says, that it is those who can least afford
treatment usually need it most.

The Rutland Centre takes a certain number of people on the medical card, as
well as private patients (who pay about pounds 4,000 for treatment) and VHI
or work-sponsored patients. Still, with a turnover of little over 200
patients a year, it is only scratching the surface of this growing problem.

* This week, to mark its 21 years in existence, the Rutland Centre, together
with various other treatment centres around the country, is holding
Addiction Awareness Week. There is a Helpline set up for Thursday, Sept 23,
9am to 5pm, at 1-800-432313