Addiction Is Not “Just Like Cancer”

The death of a celebrity with the involvement of drugs or alcohol is unfortunately happening often enough that a frustrating pattern in the public reaction can be discerned.  It happened with Heath Ledger, Cory Monteith, variations on the theme with both Michael Jackson and Whitney Houston and most recently this weekend with the death of Philip Seymour Hoffman.  The extremes in the reactions seem directly proportional to the general level of respect for the celebrity and their work, and with Mr. Hoffman’s passing the conversation exploded.

The reactions, completely over-generalized for the sake of further discussion, go something like this.

• News organization: Celebrity dies. Drugs and alcohol likely involved.
• General Public: WOW, it’s newsworthy, I should say something.
• Group A: What a loss, I loved this person/their work.
• Group B: This is sad, I feel bad for the friends and family.
• Group C: This is an absolute tragedy, addiction is terrible.
• Group D: They did this to themselves, a tragedy is troops dying in war.
• Group C: No one chooses to be an addict.
• Group D: They had the choice to do drugs or not every time they did it.
• Group C: You’re uneducated, it’s a disease!  Just like cancer.

Obviously there are subtle shadings to each version of this, but the theme of this oversimplified conversation has played out repeatedly when this kind of death occurs, and it usually devolves quickly from there.  The unsympathetic will call the subject “stupid” or “selfish” and some with personal experience with addiction will translate that to their own lost loved one being called those things and it becomes a screaming match about “not blaming the victim” versus “personal responsibility” and the opportunity to educate others about addiction is lost in a battle of semantics and comparison, the importance of understanding completely lost.

The thing is, addiction is not just like cancer.  There is an obvious appeal to the ability to draw the comparisons that are typically used to help those uneducated regarding addiction understand its seriousness and complexity.  Remission is like being sober, relapse is a possibility no matter how long it has been, it’s an ongoing struggle, it dramatically changes the individual and has an enormous impact on their loved ones and the way they operate in the world.  And more basically, it’s just truly awful.  For those who have intimate experience with addiction either as an addict, a health professional or the friends and family of an addict, the comparison seems to serve well in relating the severity and ongoing struggle of addiction.

Unfortunately, when using it in an argument with someone who does not understand addiction, or has little or no experience with it, the comparison is useless because it shifts their mindset immediately to presenting you with all of the ways that addiction is not like cancer.  Not only are you not getting them to understand the devastating nature of addiction, they aren’t actually thinking about addiction at all.  They’re now thinking about cancer.  They often inevitably first respond with the “choice” objection.  No one chooses cancer. Lung cancer from smoking can be volleyed back, and the various elements of the nature of addiction that remove choice from the equation can be explained, but the problem with all of this is that this apples and oranges conversation is now an exercise in defending the cancer comparison instead of educating the uninformed about the complexity of addiction.

Ultimately, it’s just a terrible argument, no matter how well intended.  When it is said, and I’ve watched it said repeatedly just in the last twenty-four hours, it’s often thrown down like a trump card.  The speaker wants the opposition to understand that addiction is a truly terrible and insidious disease.  This is an important conversation and is absolutely true.  Addiction is terrible.  For the addict and for those who love them.  The more we collectively talk about the disease of addiction, the more we remove the stigma from those who suffer with it and provide the opportunities they need to ask for help, work toward healing and learn to live a life fighting against it in the way that works best for them.

Almost everyone has an addiction story, whether personal or in their friends and family circles.  While there are threads that run similarly through many, each individual addict’s journey is unique.  This compounds the challenge of explaining it to those who do not understand it.  Despite general traits in common, when you can be addicted to anything from gambling to meth, it’s hard to explain it quickly.  The combination of the biological and genetic components, life circumstances and personality traits that makeup each addict is different, and this makes dealing with it unique to each person’s circumstances.  The desire to help those who are addicts, the will to educate those who are uniformed and the understanding that the more we talk about it the easier it is for it to be addressed are all incredibly important to fighting this disease.  Because it is unique.  And despite similarities, it is not “just like cancer.”

It is a disservice to those who have been lost to this disease, those who are in the throes of it now, those who struggle to keep it at bay on a daily basis and to those who love or have loved and lost an addict to lose ourselves in an argument of semantics about what addiction is not with someone who is uninformed instead of using that time and energy to focus on educating them about all of terrible, challenging and complex things that addiction actually is.

Unless, of course, you know an addict with cancer who says they are exactly the same, and then they can say it as often and as loudly as they want.