Is Addiction A Failure Of Willpower, Or Is It A Physical Disease?

Medicine Is Beginning to Recognize Addiction as a Disease of the Brain

Fifty-two year old Jacques Harvey (a pseudonym) has spent most of the last five years living in a tent in a very grassy field right behind a church in Austin, Texas. While he was once a very successful nuclear power technician located in California, Harvey's world began to completely unravel when, he believed that an alien or robot-like presence levitated straight into his apartment and abducted his wife. Completely terrified of the thought of returning to the site of his "abduction," Harvey decided to begin drifting across the country. He never wanted to spend another night indoors even if there was really bad weather, he dealt with his fear by always sleeping outside and never going indoors.

At first Harvey's friends were more than happy to offer him a place to stay for a while, but he was only able to extinguish his complete terror with alcohol. He started to become ashamed of his behavior when he was drunk. As an atonement and walked all the way from the San Francisco Bay Area to his native state Texas to leave this shame he was suffering—and the extraterrestrials.

When Harvey lives outdoors, he is completely sober. Harvey does not ask for any money, but instead offers to wash other peoples's windows of stopped cars at an intersection near an on-ramp to an interstate highway. After a man in a similar mental state froze to death in 2010, people in his neighborhood were kind and would often stop to bring him food and blankets or even some ice, depending on what the weather was like. Harvey did not receive any institutional services, however. About every month or so, a kindly neighbor offered to take him to the Veterans Administration Hospital for psychiatric help, but Harvey always declined the offer.

Fifty-three year old Randy Jansen (again, a pseudonym) was struck by a car while he was crossing an intersection in late 2009. He was shown to suffer 22 broken bones and had to undergo seven surgeries. Jansen was finally released from an Austin, Texas hospital only to confirm the fact that the reason he had not seen his wife or son recently was that they had left him to find work in New Jersey. Previously diagnosed as an alcoholic and suffering from bipolar disorder, Jansen dealt with his problems by assuming the lifestyle of the classic drunk in the gutter.

Jansen found another street person's stash of Vicodin (hydrocodone), it was enough to keep himself on pain medication. When the Vicodin ran out, Jansen started developing the very common "explosive" diarrhea associated with withdrawal, right in the middle of a very busy street, and was run over yet again a second time.

Though this might seem extremely unlucky, for Jansen, however, getting run over a second time was actually an enormous stroke of luck. After the accident, he was sent to a psychiatric facility and offered a relatively new medication called Suboxone. Also known by its chemical name buprenorphine, this medication acts on the same receptors in the brain that respond to hydrocodone, oxycodone, heroin, and opium-derived drugs. Coming off Suboxone also causes withdrawal symptoms, but they are much less severe than those associated with withdrawal from other drugs like it.

The US government places tight regulation on the use of Suboxone. Only psychiatrists who do group therapy are allowed to prescribe the drug to anyone at all, and only recently have they been allowed to treat up to 100 patients at a time. (The previous limitation on the number of patients any one doctor could treat with the drug was only 10.) Randy Jansen, however, chanced to be examined by a psychiatrist who had room on his roster to treat him, and after  a whole six months of treatment from a half-way house, Jansen overcame his addictions to both alcohol and Vicodin and got a job working for a dry cleaner. You may be wondering , could he not have overcome his addiction just by willpower? Can't we all?