Chronic vs. Acute
I first heard it on a Dr. Drew podcast and it whizzed over my head. I read it elsewhere weeks later and took note. Then yesterday while walking my dogs I was listening to this podcast (Sober Conversations with Dr. Harry Bell: Guest Joe Schrank) and there it was again:
If alcoholism and addiction are chronic conditions, why do we treat them as acute illnesses?
Alcohol addiction grows over time and the brain changes remain permanently (i.e. a chronic condition), so why is it only considered worth treating once it reaches crisis (i.e. acute illness)? Why watch the problem escalate to dangerous levels but then only treat it with episodic care? Do we do this for any other health issues?
How many of us ignored our growing drinking problem for years because it “wasn’t that bad” in our own opinion? How many had some idea in mind of what behaviour or consequence would be “bad enough” to require change? Isn’t this the opposite of how we have been taught to care for ourselves?
We check our moles for change and our breasts for lumps, rushing in for assessment at the first sign of trouble. No doctor ever says, “Yep, that looks bad buuuuut let’s wait until your life is threatened before we treat it.” The idea is preposterous, but that is how we think about getting help for addiction: wait until it is the worst that a person can tolerate before getting help. And by the way, the help available is 30-90 days of treatment generally, and though the care may be excellent, shouldn’t the medical system then follow patients for a lifetime if they have a life-long condition susceptible to relapse? My sister had cancer and she received routine scans for 20 years after her treatment.
I’ve always felt a bit apologetic about getting sober pre-crisis. I used to feel pressure to explain that even thought my situation wasn’t “that bad”, the process was clearly well underway and needed curtailing. I’ve since discovered that most people in recovery don’t need to hear this justification – they understand that all of us follow a similar trajectory and our differences are really just “yets”. By that I mean we can take all the things we didn’t do (I didn’t lose my license, I didn’t publicly humiliate myself, I didn’t blackout) and tack the word “yet” onto those statements, because if we kept drinking they likely would have happened to us.
I hadn’t lost my license, yet
I hadn’t publicly humiliated myself, yet.
I wasn’t blacking out, yet.
The “yet” is a reminder that I stopped before those problems arose, but they were certainly as possible for me as for anyone if I continued to drink.
Like myself, many readers of this blog have stopped drinking before their condition reached an acute stage. This can leave us wondering if we over-reacted, over-compensated, over-corrected. It can mean that those around us are not as supportive or understanding because they were not personally impacted by our behaviours…yet.
It is simply wrong to think that help is only necessary for the worst cases. I suspect that recovery care providers would LOVE the opportunity to work with people earlier in their addiction, but so many of us have been conditioned to think that we are not worthy of help unless we have had a horrendous “rock-bottom” experience.
Even though this whole blog is about how I self-managed my recovery, I hope one day it is easier for everyone to talk about this and ask for help. Shame and stigma kept me hidden and sick for far too long. I was lucky it didn’t kill me, and I am glad it didn’t kill you either.
Perhaps the real obstacle is public perception. Funding, legislation, and treatment protocol all respond to societal demands and until Joe Average starts to understand the “Chronic vs Acute” issue, there is no outcry against the system, no support for proposed changes, no money for tv campaigns with catchy jingles.
Maybe there are a lot of us in recovery who need to understand it better ourselves before we can hope anyone else will.
Note: shout out Bubble Hour co-host Catherine for introducing me to the concept of “yet”. We all learn together.