Holly Richardson: Professionals recognize addiction as a ‘disease of despair’

Randall Carlisle

Randall Carlisle retired last year after 50 years in broadcasting. He is well known and highly recognized across the state as the former lead news anchor at ABC4. He was awarded three Emmys during his career and covered many major news stories. He was also an addict.

Carlisle began drinking at age 14 and continued as a “functional alcoholic” for decades. He has been sober for the last six years and is now the media and community affairs specialist for Odyssey House of Utah, the state’s largest addiction treatment center. He is also the keynote speaker for the 2019 Utah Valley University Conference on Addiction being held this Friday.

Addiction comes in many forms. It may involve substances like alcohol, opioids, nicotine, inhalants, caffeine, cocaine or other forms. It may involve behaviors such as gambling, shopping, overeating or pornography use. It may be a digital addiction to gaming, smart phones and social media.

It can affect any family, cut across any socio-economic strata and is never “victimless.” According to Psychology Today, we know that both substances and behaviors share a “key neurobiological feature — they intensely activate brain pathways of reward and reinforcement.” Dopamine and other pleasure hormones are released in the brain. Addictions can also become “habits,” which can explain why treatment programs that don’t include a change in the environment and routines you were accustomed to engaging in while in your addition often fail.

Addiction can be defined broadly as using more/doing more of something than you would like and continuing despite negative consequences. To be considered an addiction, it must meet at least three of the following criteria, based on the American Psychiatric Association and the World Health Organization.

  • You develop a level of tolerance, needing more and more to get “the fix” you crave.

  • You experience physical or emotional withdrawal when you stop using.

  • You seem to have limited or no control over your usage.

  • You continue to use in spite of negative consequences.

  • You neglect or postpone social, recreational, work, family or household activities because of your addiction.

  • You spend significant amounts of time thinking about, planning, using, concealing, minimizing and creating cover stories to hide your usage.

  • You want to cut down your use and may have tried, unsuccessfully, to do so on your own.

Beyond these definitions, many professionals are now recognizing addiction as a “disease of despair.” Alice Miller, psychologist and expert on child abuse, said: “What is addiction, really? It is a sign, a signal, a symptom of distress. It is a language that tells us about a plight that must be understood.” Some posit that, “The opposite of addiction is not sobriety but connection.” Two of the sessions at Friday’s conference will be looking at the connection between trauma and addiction.

Utahns are not immune to addiction. More people die of prescription opioid overdoses here than all other drugs combined. The rate of overdose deaths in Utah is higher than car accidents and firearm deaths. We also have the nation’s highest rate of drug overdose deaths for our veterans.

Looking specifically at Utah women, we also see some disturbing trends. From 2013-2015, 776 Utah women died from a drug overdose. Utah also has the highest rate in the nation of opioid use among pregnant women and a 2014 study of women on Medicaid showed that Utah moms were prescribed opiates at almost double the national rate: an astounding 41.6 percent compared to a national average of 22.8 percent. Those numbers beg the question: What doctors are prescribing opiates to 4 in 10 of their pregnant patients on Medicaid? Opioid overdoses were also the leading cause of pregnancy-associated deaths in Utah in 2015/2016, with 80 percent occurring during the postpartum period.

There is hope! The Psychology Today article mentioned above notes that “research documents that recovery is the rule rather than the exception.” Friday’s conference is focused on the addict and his or her recovery and is designed for professionals, community members and anyone interested in learning more about recovering from addiction.

(Photo Courtesy Holly Richardson)

Holly Richardson is a regular columnist for the Salt Lake Tribune.