Since news broke yesterday of the tragic death of actor Philip Seymour Hoffman, I’ve watched conversations slowly spring up on social media, mainstream media and in real life around the circumstances of his death. People are talking about the fact he overdosed on heroin and that he left behind three small children under 10.
Had Hoffman died in a car accident or of cancer, the reaction would have been more straightforward. A tragedy, A waste. A shock. Those words are being used about Hoffman’s death too, but bubbling up in certain places has been another emotion: anger.
Anger that he died with a needle in his arm surrounded by bags of heroin. “Selfish” some have claimed. “Self-indulgent.” It seems there’s something about a drug overdose that, for some, partly cancels out the sympathy and empathy they’d normally feel when someone dies.
Fellow actor Jared Padalecki hit Twitter to say what many others were thinking:
Padalecki was resoundingly slammed by people calling him insensitive and he quickly expanded on his initial tweet:
Other celebrities and commentators may not have said it on social media but judging by the number of re-tweets and favourites on Padalecki’s statements, and the numerous times I’ve heard people expressing similar sentiments in the past 24 hours, anger and a lack of sympathy is not an uncommon reaction to a drug overdose.
Then there was this:
The backlash against that online headline was as fast and loud as it should have been.
Generally though, when it comes to the manner in which Philip Seymour Hoffman died, opinion seems to be split broadly into two schools of thought.
1. Those who believe drug addiction is a disease and that people who battle it can’t be held responsible for their actions or the consequences of them.
They say: “He was an addict. He had a horrible disease that he tried to manage as best as he could. He spent time in rehab recently after being clean for 23 years, because addiction is something that never goes away. We have to look at their choices in the context of their disease. If stopping was easy, there would be no drug addicts in the world. Hoffman had access to the best resources and treatment available, and he still ended up dead. It’s not a choice; some people just aren’t strong enough to live with this disease.”
2. Those who reject the term ‘disease’ when referring to drug and alcohol addiction.
They say: “But there is an element of choice to drug addiction. It’s not like cancer. With an actual disease, you have no choices. With drugs, you do. Nobody holds you down and forces you to take heroin repeatedly over the course of years and decades. To refer to it as a disease absolves the user from responsibility in their own life and in this case, death. And frankly, it’s insensitive to those battling actual diseases like cancer or schizophrenia.”
These are important, uncomfortable conversations to have.
The question of drug addiction is one that many families will grapple with in their lifetime. We reached out to drug and alcohol councellor Nicola Cowling from ANEX for some more information to help us understand how to frame this complex conversation.
Q: Is addiction really a disease?
A: Unfortunately the jury is still out on this definition. I think it is fair to say that addiction is, in many ways, like a disease. It is a chronic, relapsing condition. Advances in brain imaging suggest long term, heavy drug use causes significant changes in how the brain works. And without some sort of intervention, drug addiction can worsen with potentially devastating results.
Certainly addiction is recognised by the World Health Organisation (as dependence syndrome). And the disease definition has allowed addiction to be regarded as a health issue rather than a moral or criminal one, and rightly so. Improving access to treatment and support services is far more beneficial, and more cost effective, then incarceration and other punitive measures.
Q. By calling it a disease, does it absolve addicts of personal responsibility?
A: I think if we can understand addiction as a health issue, recognising there are changes in how the brain is working, it’s easier to understand an individual’s continued use isn’t due to a lack of will power. In addiction, continued drug use becomes less about seeking euphoria and more about just trying to feel normal. It’s about keeping withdrawal symptoms, such as depression and anxiety, at bay.
It can also be about self-medicating physical or psychological pain. In addiction, the individual continues to use despite any negative physical, psychological and social effects. This is because the effects of being without the drug are more difficult to face. Methamphetamine use, for example, greatly increases the availability of feel good or “reward” chemicals like dopamine. But it doesn’t give the individual more of these chemicals, rather it makes them use more than their normal share in a short period of time.
This results in extreme confidence, energy and euphoria. When they stop using, they go from having an excess of these feel good chemicals to a deficiency. They go from feeling on top of the world to significant depression, apathy and amotivation.
With regular, high dose use, the brain can alter, adjusting to these excess levels of feel good chemicals. This means the more they use, the greater the deficiency of feel good chemicals and the worse the individual
feels. Because these symptoms can last for weeks or months, it is very common for individuals addicted to methamphetamine to relapse during efforts to stop using.
This can explain, to some extent, the sense of powerlessness experienced in addiction. The individual develops a tolerance to the more desirable effects of be drug. They must use increasingly more, therefore, in an effort to achieve these effects. As their physical and psychological dependence grows, the negative effects begin to outweigh the positive. The drug use simply allows the individual to function. Without it they face debilitating symptoms of withdrawal.
Though drug addiction effects a broad spectrum of individuals, it is much harder to address when there are other contributing factors. Individuals with a history of mental illness, trauma or significant social disadvantage are particularly vulnerable to the effects of addiction.
How have you reacted to the news of Philip Seymour Hoffman’s death? Does the way he died change the way you feel about it?