Literary Review

Literary Review

The Silent Killer: Addiction

By: Elisabeth French

We can always hope it is not too late, but sometimes it is. For Tom Macher, it was almost too late. Addiction had consumed his entire life. One’s personal perceptions about addiction have been constructed by their own individual involvements with the disease. Macher, author of Halfway: A Memoir, details the trials and tribulations he faced as he tried to stand up on his own two feet after battling alcohol addiction in his new memoir, to be released this upcoming February. Addiction often goes by unnoticed, or at least society tends to ignore it and turn a blind eye. However, we all know about it. People die from it every day. Everyone probably knows someone who has been affected by addiction or still is affected by addiction. They could be suffering silently or not. It takes over their entire life. It clouds their judgment. It makes them reliant. Macher reveals his raw accounts struggling with addiction and illustrates his quest for hope, community, and ultimately sobriety in his darkest hour. Macher grew up in a broken family. His estranged father was suffering with AIDS, and to get away from his terribly lonely reality, he became reliant on alcohol as his means of escape. Mancher, like many other struggling addicts, began with a “gateway” substance and spiraled from there.

Macher was kicked out of school, then out of his mother’s house and sent to a boys’ home in Montana; it was later that he entered into a halfway house in Louisiana. Macher’s struggle with his alcohol addiction is like much of America’s addicts. Addiction is a complex disease of the brain and body. It involves the habitual use of one or more substances despite the serious health and social consequences. Addiction disrupts areas of the brain that are accountable for reward, motivation, learning, judgment and memory. It is known to damage numerous body systems, as well as relationships with family, work, school and neighborhoods. In Macher’s memoir, he showcases just that. He develops strained relationships between his family and destroys his ties to school due to his addiction.

However, in Macher’s circumstance, he came close to overdosing, but ultimately sought treatment. The halfway house in Louisiana presented him with a community of like-minded men, struggling to survive as they ran from their pasts. It was here, among the memorable characters he meets—like the former child actor, teen with schizophrenia, tough-love counselor and more—that he finds loyal friends who help him carve his path towards salvation. In his new memoir, he is able to capture the tests of sobriety—suicide, death, and recovery—while building bonds with other struggling addicts. While many addicts do not get a second chance and cease to the trap that addiction presents, for Macher, the halfway house was the second chance he needed in his quest for salvation.

Macher presents addiction candidly and through his experience creates a space of interest to investigate the reality that this silent killer, addiction, has on America. Addiction like cancer, heart disease and diabetes, is caused by a combination of behavioral, environmental, and biological factors. Half of the chances that an individual will develop addiction rest solely on their genetics. While an addict makes the initial decision to use substances, it is out of their control how their brain and body respond. Much like the satisfaction people feel when a basic need such as hunger is fulfilled, that same feeling of satisfaction corresponds with the pleasure felt when under the influence of a substance. Typically, when the feelings of pleasure are fulfilled, certain chemicals are triggered in the brain. The same chemicals released to satisfy basic needs, according to the National Institute on Drug Abuse reports, are again released by most addictive substances, creating the association between the substance and the feeling of fulfillment and pleasure.

The continued release of these chemicals over time alters the brain’s system involving rewards, motivation and memory. A dependency begins to form for the use of a substance and eventually becomes something an individual needs to feel normal. In many cases, addicts continue to use the substance despite the known detrimental and threatening consequences. Addiction can be a chronic disease. About 25% to 50% of people with substance abuse have a severe, chronic disorder. In light of the detrimental effects of addiction, it has been found that even in addiction’s most severe and chronic form, the disorder can be manageable and reversible, usually needing long-term treatment with monitoring and support throughout their recovery.

Addiction is more common than most people realize, which is why it is deemed a silent killer. In 2011, there were an approximate 20.6 million people in the United States over the age of 12 with an addiction—which makes it evident that not nearly enough people are getting the treatment they need. It was reported that there were just over 3 million people in 2011 that received treatment for their addiction. That is nearly 15% of all the reported people suffering receiving some attention and treatment for their addiction. Macher’s story provides hope for people facing addiction and also serves to educate those who might not struggle themselves, but know of someone who is. His story offers an inside look at these struggles. He decodes the stigma that if an addict tries hard enough they can just stop.

Education and tolerance are necessary for all people to understand what addiction really is like to live with, especially if the American community is ready and willing to silence this silent killer. 100 people die from drug overdoses everyday. In the past 20 years, this rate has tripled. The numbers circulating about addiction are devastating. Addiction hijacks the brain. Tolerance is key; being intolerant to those who suffer from addiction does no good. For some individuals, addiction is a chemical imbalance in their brain, but for others it is a curse of their genetics or psychological predisposition. Or even, it is a result of a traumatic occurrence as young person that has lured them in. The battle of addiction that many struggle with around us is real. While it may not be a disease that inflicts your personal health, the number of people affected has been ever increasing.

Studies done by the National Survey on Drug Use and Health report that children are already using drugs at age 12 and 13, which leads them to believe that some begin even earlier. Macher’s story verifies this finding. It was during his early teens that his home life drove him to drinking. He became one of the 16.6 million people with alcoholism. It has been found that 95% of alcoholics who need treatment do not feel they need treatment. However, for Macher getting kicked out of school and his house was enough to lead him to get the help he needed. It was the struggling young men around him who motivated him to achieve his sobriety and salvation. The people a part of his life at the halfway house portray a fraction of the world of recovering alcoholics and how at their worst, these men are able to form the bond of a family.

Macher’s memoir serves to educate and bring attention to the battle of addiction to prevent other Americans from struggling what he has experienced. While his experience with addiction was bound by alcohol consumption, no struggle with addiction is the same. Addiction holds no single story. Addiction comes in all shapes and forms. While in Macher’s case, he struggles with alcoholism; others struggle with drugs and some are even addicted to multiple substances at once. 2.6 million people with addictions struggle with a dependency on both alcohol and illicit drugs.

Addiction has proven to be the most neglected disease. In a study conducted by Columbia University, “40 million Americans ages 12 and over meet the clinical criteria for addiction involving nicotine, alcohol or other drugs.” That represents more Americans affected by addiction than those with heart disease, cancer, and diabetes, all of which are illnesses that are covered more often and openly talked about than addiction. Additionally, there are another estimated 80 million people who are “risky substance users,” which implies that they are not addicted, yet “use tobacco, alcohol and other drugs in ways that threaten public health and safety.” When will the devastating impact of addiction grasp the public eye? Over 38,000 people died of drug overdoses in 2010 in the U.S. alone. That is greater than the deaths caused by motor vehicle accidents, homicides, and suicides. Among the accounted for deaths due to drugs, overdose deaths from opioids are representative of the fastest growing drug problem across America.

Addiction pulls at people’s lives not only in terms of their health, but also leads to: financial and legal problems, domestic violence and child abuse, unplanned pregnancies and motor vehicle accidents. Entire families are forced to struggle on the basis of a single family member’s addiction. The burden of addiction causes other aspects of the addict’s life to crumble and make their addiction feel like a tunnel with no light at the end—when, in reality, if they seek out and receive the right treatment, they could get on a path to recovery. Therefore, that they receive the professional help to find salvation, like Macher, for themselves and their families sake, becomes essential.

It is troubling to accept the reality that only 1 in 10 individuals struggling with addiction to alcohol and/or drugs report having received any treatment at all. In comparison, there is an approximated 70% of people with diabetes who have received treatment. The typical route suggested for treatment directs the addicts to programs like Alcoholics Anonymous (AA), Narcotics Anonymous or 12-step recovery programs. However, such treatments take a spiritual approach to recovery, and while this has proven effective for some, a 2006 study by Cochrane Review examined AA and 12-step programs. They concluded that “no experimental studies unequivocally demonstrated the effectiveness of AA” in treating alcoholism. A 2015 issue of The Atlantic reports a finding that AA to only work for 5 to 8 percent of those who went to meetings.

America has turned a blind eye to this silent killer, leaving no wonder why so many addicts walk the fine line between their addiction struggle and salvation. The criminal justice approach towards cracking down on alcohol and drugs has proven ineffective, as well as the use of programs like AA. Now it is time for America to take a new approach and no longer turn a blind eye to the millions of suffering addicts. It is time to give a newer form of treatment a chance and incorporate a medical model and psychological approaches, which could surpass the effectiveness of traditional spiritual recovery. Americans continue to die from this silent killer daily. They shatter the lives of their families and communities surrounding them, leaving them to pick up the pieces and live with regrets forever. While Macher is not the first memoirist to account for his struggles with addiction, his soon to be released memoir will surely serve to keep the conversation circulating, as he stands victorious to the demons of addiction.



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