Curing One of Our Society’s Greatest Ills: Addiction

Why you should care

Because opioid abuse is rampant.

The authors are professors at Dartmouth College and Public Voices fellows with the OpEd Project.

The dramatic rise in the use of opioids and associated deaths has created a new sense of urgency nationwide, and with it, widespread bipartisan support among legislators (who otherwise can barely agree that the sky is blue) for measures to address the problem. Yet every day it becomes clearer that legislation alone cannot stem the tide. Although opioids are the current villains in the long history of abused substances, the underlying problem is not a particular drug. It is addiction itself.

But how to tackle it?

Here in New Hampshire, where drug deaths are now at an all-time high, a remarkable program is achieving palpable results. Telling My Story is the 20-year-old brainchild of the amazingly energetic Chilean activist and artist Pati Hernández. The venues change — from rehab facilities to jails — but the story is the same. Every week for two months, patients in rehab facilities or inmates in local jails come together with students at Dartmouth College and work toward a public presentation. These collaborations, staged at the end of each cycle, use theater, music and dance to bridge the chasm and build commonality between the haves and the have-nots. The performances also wrestle with the social isolation and hopelessness that often accompany addiction.

A final performance typically opens by staging fictionalized episodes in the lives of addicts. It can be difficult in these short, sometimes humorous skits to parse recovering addicts from Ivy League students. Interspersed among the performances are moving personal testimonies. Though the gaps in privilege between students and addicts remain, it is clear that the empathy that develops between the two groups is empowering for both.

Students who have entered the program wanting to “help,” with that word’s connotations of superiority, leave wanting to collaborate, recognizing how alike we all are under the skin. For patients and inmates, a wide gap remains between them and the students, who can walk out of the facility each night free from condemnatory labels. But for many, the ability to share their experiences publicly under the protection that role-playing affords allows them to make connections — with both other performers and a sympathetic audience. It’s an important step toward replacing addiction with the rewards of a meaningful social network.

Their work stands as a testament to the power of art to build bridges, and in doing so points to what may be a crucial tool against addiction. It remains one of our society’s most entrenched medical problems. Consider one of our oldest addictions: alcohol. Excessive drinking was characterized as a disease over two millennia ago by the Roman medical writer Celsus. If only the picture had changed since then. It has not. In 2013, 7 percent of adults 18 years or older had an alcohol-use disorder. That translates to nearly 17 million people, and approximately 1.3 million of them required treatment at a specialized facility that year.

With the right support, the act of abstaining might substitute for the drug and become the reward itself.

 

A wealth of information on the genetics and neurobiology of addiction has underscored that the cause of addictions like alcoholism cannot easily be traced to a gene or molecule, despite some high-profile recent commentaries that simplistically suggest this may be so. Rather, we now know that biological and genetic predispositions interact with the environment to make some individuals more susceptible to addiction than others. It is the addition of so many complex cultural and social factors that makes addiction resistant to the quick fix of a pill or a shot.

Yet this awareness may also provide an avenue to address addiction. We know that part of the process of addiction involves learning, changing the processing in the parts of our brains that drive motivation and our sense of reward. But the neural systems involved are malleable, suggesting that environmental factors could also be manipulated to rewire them. With the right support, the act of abstaining might substitute for the drug and become the reward itself. Which is where programs like Telling My Story come in. Programs like this offer something that may be just as important as other forms of treatment: a way for diverse groups to see and feel beyond their differences, to combat the disabling stigma of addiction and to build a supportive community for sufferers.

Indeed, the healing power of the arts for those with addictions, and those who care for them, has received national recognition through programs such as the National Institutes of Health’s Addiction Performance Project. Dramatization offers addicts and their families an avenue to make sense of the world through imagination — exploring lives that may be at several removes from theirs but that still echo something of their own lived reality. In engaging within the safety of fictional people, this program builds the empathy, sympathy and mindfulness that have come to the fore in both the scientific and popular press as a promising cognitive behavioral approach to address addiction.

As states across the country consider legislation to address each new epidemic of addiction — whether to opiates, crack, oxy or alcohol — and the ranks of three-strike minor offenders crush our prison systems, we need all the resources at our command to address a problem that, in one way or another, belongs to all of us. Though it will likely not replace the solutions to be found in clinics and laboratories, Telling My Story points compellingly to another, perhaps unexpected, place where support is to be found: in the theater and the arts.

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