Is drug use really a “health” problem?

You hear it a lot these days:

We have to stop thinking of people struggling with drugs as “criminals,” recognize them for the “sick people” they are, and get them into treatment!

To be clear, I agree.

I’d much prefer to say that somebody struggling with drugs is “sick,” as opposed to “bad.” But, at the same time, I think the struggle a lot of people go through in breaking their drug habit is bigger than simply battling an “illness.”

Yes, there’s a physiological component of shooting heroin every day, but it takes more than doctors and nurses and pills and hospitals to turn a person’s life around. Most people struggling with drugs aren’t just “sick.” There’s usually a whole slew of things – physical dependency, emotional pain, broken social relationships, checkered employment prospects – all going wrong at once. And real recovery is about all of that. To get their lives to a good place, people who’ve been using drugs excessively need safe housing, a job where they’ll be respected, support from their communities, all on an ongoing basis, hopefully for the rest of their lives. Not just a 30-day medical treatment, like a foot fungus.

Another problem with framing drug use as simply being a “health” issue is that if you treat people like they’re “sick,” they start thinking of themselves that way, and that’s not always the most conducive mindset for changing how you live your life. When you’re sick, you usually can’t work. You have to stay home and rest. You’re a patient, a client, a passive consumer of medical services. You’re off the hook.

When a person is first detoxing off of hard drugs, in a lot of ways, they really aren’t all that different than any other medical patient in the early stages of recovery from a trauma, like a car accident or a stroke. But very quickly, that begins to change, and once it does, an inevitable question emerges – sure I was sick, but when will I be well again? Can I ever really be genuinely healthy? Can I ever actually be normal?

When I was first getting sober, I wrestled with that sort of thing a lot. A few times, those questions were even enough for me to drink over. If, no matter what I did, on some level, I was always going to be sick, then what was the point of even trying to get well?

These days, I’ve been sober for more than a few 24 hours, and many things in my life are going wonderfully. I’m getting married. I’m starting a business and helping with several other organizations. An alarming number of people in our community seem to respect me, and, when I’m lucky, they even trust me. I’m not sure what flipped in me, but the truth is that I no longer feel like a sick person.

Sure, I’ve had to come to terms with the fact that I have a mental health condition that, in retrospect, I think may have contributed in a number of ways to my drinking and drug use. But, today, I treat that through a mix of daily psych meds and monthly talk therapy. It’s one thing about my life, but when I’ve got it under control, and I usually do, it isn’t even a very big thing.

For me, being sober is about a lot more than that. It’s about how I live in the day to day. It’s about my relationships, my home, my work, my family, my overall health, my spirituality.

And, today, when I think about what was going on with me back when I was inebriated so much of the time, that too seems more complicated than just having a “disorder.” Sure I was sick, both physically and emotionally, sometimes intensely, but I feel like it’s equally true to say that, for a lot of that time, I was just a lonely person who behaved antisocially and self-destructively. I’m not sure why, but sometimes looking straight at my life, without filtering everything through the lens of sickness, just feels better to me. It’s simpler and less pitiful. My life hangs less heavily on my shoulders when I don’t try to cram everything in my past into a diagnosis.

That’s where I think the word “dignity” comes in.

As I see it, the problem with treating somebody with a substance use disorder like a “criminal” and putting them in jail is not just that they’re actually a “sick person” who should be in a medical facility instead. No. The problem is that they’re an actual “person,” and they deserve to be treated like one.

I once went to an organizing workshop taught by a guy who was an African-American community organizer from Brooklyn who said, if you ask the government to shelter the homeless, best case scenario, they’ll shelter the homeless. But if what you want is actual housing for the people you’re serving, you have to ask the government to help people get real homes. Likewise here, if we always talk about the struggles that people are having with drugs as “health” problems, best case scenario, we’ll get the folks struggling with drugs better access to health care.

If we want them to be able to live full lives, however, in all aspects of their lives, we have to demand that. All of that.

Rob Korobkin

About Rob Korobkin

Rob is a software engineer, community organizer, teacher and musician. He can often be found at Peloton Labs, staring at his laptop, drafting diatribes and programming software late into the night.