This view is completely at odds with research demonstrating
that these disorders are indeed a brain disease. A documentary called “The
Anonymous People” features personal narratives that call for a fundamental
reframing of the national conversation about alcohol and substance-use
disorders and recovery.
“It is important for scientists to have a good sense of what
alcohol-use disorders look like in the real world,” said George F. Koob, Ph.D.,
NIAAA director.
“It is an ‘equal opportunity’ disease that cuts across
economic, occupational, racial/ethnic, and gender lines. It is a disease that
is profoundly devastating at the personal and societal level. It is a disease
that, to this day, is shrouded in stigma and shame.”
Koob was part of the panel that discusses this documentary
after its screening at the 39th Annual Research Society on Alcoholism in New
Orleans June 25-29, 2016.
“The recovery community is undergoing a transformation,” added
Robert Huebner, Ph.D., director of the NIAAA Division of Treatment and Recovery
Research.
“In the past, it focused on anonymity and consisted primarily
of small groups meeting in church basements. Now we see a very assertive
recovery community that is not shy about talking about recovery in public, is
organized on a national level, and is politically active at the state,
regional, and national level.”
He added that NIAAA, and the addiction-research field, grew
out of multiple historical currents, including the rise of Alcoholics
Anonymous, organizations like the National Council on Alcoholism and the
Society of Americans for Recovery, and the leadership and courage of Senator
Harold Hughes (D-Iowa).
“This documentary represents a very different way of talking
about people with alcohol-use disorders and their recovery,” said Lorenzo
Leggio, M.D., Ph.D., M.Sc., CPN Section Chief, NIAAA and NIDA. “The people in
this documentary make a strong case for rejecting common stereotypes and
terminology when describing individuals with alcohol- and other drug-use
disorders.
They argue for bringing their stories of recovery out of the
shadows and talking about recovery in positive rather than negative terms.
Individuals describe themselves as being ‘in long-term recovery, without using
alcohol or drugs since a certain date.’ This sounds very different from
traditional characterizations of personal recovery which declare first and
foremost that one is an alcoholic or addict.”
This focus on deliberately reframing one’s recovery echoes the
call by Senator Hughes for people in recovery to start saying that they have
“gotten well” rather than referring to themselves as a “recovering alcoholic,”
added Leggio.
“Moreover, this
documentary significantly seeks to characterize an alcohol-use disorder as a
health problem, rather than a moral issue. Furthermore, this film challenges
the field of alcohol research to address the issue of long-term recovery, given
that the focus of much of our clinical research has been on acute care. We need
more research on the complex set of factors that support long-term recovery and
effective interventions to support it. Patients who achieve long-term
abstinence can, especially in stressful situations, relapse after years of
abstinence. This documentary reminds physicians and other health-care providers
to follow their patients with alcohol-use disorders beyond acute care. In this
regard, the long-term relationships between physicians, patients, and their
families can play a key role in helping a patient's recovery efforts.”
Language is fundamentally important, agreed Koob and Huebner.
“We need to get away from using terms like ‘alcoholic’ and ‘addict’ and frame
this disorder as we would any other health problem,” said Koob.
“People who suffer from alcohol-use disorders or whose loved
ones suffer from this disease need to feel comfortable about seeking help from
their doctors.”
“Practitioners need to see people who suffer from alcohol-use
disorders as patients for whom appropriate clinical care and treatment can and
should be provided – no different from patients suffering from other health
problems such as cancer or infectious diseases,” added Huebner.
“The community at large needs to see alcohol-use disorders as
a serious medical problem that can be treated via shared efforts. Indeed, this
documentary shows that recovery from alcohol- and other drug-use disorders is
possible. The personal narratives demonstrate this very well and complement the
findings of NIAAA-supported research on the prevention and treatment of
alcohol-use disorders.”
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