Addiction and Personal Responsibility: Who’s Problem Is It?


The definition of personal responsibility is the idea that human beings choose, instigate or otherwise cause their own actions. A corollary idea is that because we cause our actions, we can be held morally accountable or legally liable.

There are also various types of responsibility. Some are obvious types and others that are more subtle to identify. This includes the following, however this list isn’t exhaustive and other forms of responsibility also exist, however for the benefit of this topic, we have only included those that are most relevant for this article.


Personal Responsibility

The responsibility to do positive things with your abilities, talents and resources.


Agency

Agency is your ability to influence what happens to you. Individuals with a strong sense of agency are more likely to take responsibility for their successes and failures as opposed to blaming external factors such as systems, circumstances, bad luck or other people.

An individual who completely and truly lacks agency is not responsible for themselves. For example, a very young child has no agency.

Personal Agency

The ability of a person to act to represent their best interests. Generally speaking, competent adults have a great deal of agency over their lives. However, constraints imposed by a society or system may restrict this agency.

The question of how much agency an individual enjoys in a particular system is often a matter of intensive debate. For example, an economic theory may assume that individuals are powerless victims of a system while an alternative theory may look at the decisions and behaviour of individuals acting within a system to explain economic outcomes.

Moral Agency

The ability to determine right from wrong and act to do the right thing. For example, an employee who knows that their employer is illegally dumping a toxic waste into a river that is a source of drinking water for a community may be reasonably and morally expected to report this to the authorities.

Accountability

Accountability is agency that is based on formal authority. If you are the CEO of a firm, you have the power to represent the interests of stakeholders in the firm including communities, investors, employees and partners.

As such, you are accountable for everything the firm does unless a rogue employee does something unpredictable that was completely beyond your capacity to prevent.


Responsibility

Responsibility is the duty to act based on your role. For example, the responsibility of an employee to do their job with diligence and the responsibility of a parent or guardian to protect, nurture and support the happiness and development of their child.


Moral Responsibility

The duty to do good and to do no harm. For example, the responsibility of the strong to help the weak.


Norms

Norms are responsibilities that are expected in a culture without being enforced by written rules. This respects people’s intelligence and allows for some flexibility.


Social Role

Responsibilities based on your position in a social system. For example, the responsibilities of parents, children and spouses.


Social Responsibility

A responsibility not to harm people or planet on the path to your goals.


Where Does The Buck Stop In Addiction & Recovery?

In previous articles, we explained we lack certainty as to the precise cause of addiction. It follows there is a lack of consensus about the most effective approach to treatment as well.

However, our discussion about the causes of addiction would not be complete without a discussion of personal responsibility. This issue of personal responsibility leads to a great deal of controversy about addictions.

The role people apply to their situation and who’s ultimate responsibility often changes depending upon their role within the constantly changing dynamic relationship as follows (this will vary from person to person):

Addicts still using or drinking – It’s everyone else’s fault

Addicts in recovery – It was my fault

Family members of addicts who still use or drink – it’s the fault of care services who are failing the addict OR it’s the fault of the addict who is failing to comply with treatment services

Treatment services – it’s the role of the addict to take responsibility

This issue of personal responsibility is not unique to addictive disorders. People who develop hypertension, heart disease or other medical conditions because of obesity face similar difficulties.

So do cancer patients who smoke cigarettes. What each of these have in common is some part of the illness is due to life-style choices and things we have control over. Other parts of these illnesses have to with genetics, things we don’t have control over. This creates a problem with respect to personality responsibility.


So… Who caused the problem & Who should fix it?

With addiction and recovery in mind, this then leads on to ask two fundamental questions:

  1. Who is responsible for creating a problem?
  2. Moreover, who is responsible for solving it?

These two questions yield four possibilities with respect to responsibility for personal problems:

  1. The Moral Model: People are responsible for creating and solving their own problems.
  2. The Medical Model: People are not responsible for creating or solving their own problems due to genetics and mental health ect.
  3. The Enlightenment Model: People are responsible for creating, but not solving their own problems.
  4. The Compensatory Model: People are responsible for solving, but not creating their own problems.

The table below summarises these four possibilities:

The Moral Model:

  • “I’m responsible for creating the problem and I’m responsible for solving it.”
  • What do I need to solve this problem? Proper motivation
  • Someone else might say: “It’s your own fault, so I’m not going to help you. You need to solve this problem on yourself.”
  • Extreme, exaggerated version of this model: Faulty and distorted thinking such as “Everything that happens to me is my own fault.” OR “I can solve all my own problems, I don’t need anyone.”
  • Healthy recovery application: “I decided to start drinking and now I’m deciding to stop.”

Medical Model:

  • “I’m not responsible for creating the problem but I’m not responsible for solving it.”
  • What do I need to solve the problem? Treatment, experts, therapies ect.
  • Someone else might say: “You are ill. You need help.”
  • Extreme, exaggerated versions of model: Becoming helpless and completely dependent upon others.
  • Healthy recovery application: “I didn’t plan on having these problems and I have no idea how to get rid of them. I should follow the advice and suggestions of the experts who are trying to help me.”

Enlightenment model:

  • “I’m responsible for creating the problem but I’m not responsible for solving it.”
  • What do I need to solve the problem? Self-discipline.
  • Someone else might say: “It’s clear you don’t understand the true nature of your problems, so let me explain it to you.”
  • Extreme, exaggerated versions of model: Becoming crippled and ineffective because of extreme guilt and self-loathing; complete submission to authority and blindly following others.
  • Healthy recovery application: “Looking back, I see what I did to cause my addiction and I’ve learned from my mistakes. Now I’m going to follow the guidance and direction of a greater authority that can show me how to change my life (completely if necessary).”

Compensatory model:

  • “I’m not responsible for creating the problem but I am responsible for solving it”
  • What do I need to solve the problem? Knowledge, skills ect.
  • Someone else might say: “I respect you for your efforts. Let me know if you need any help.”
  • Extreme, exaggerated versions of model: Failing to recognise one’s own limitations, grandiosity, stubbornly refusing help of any sort from others.
  • Healthy recovery application: “I sure wish I didn’t have these problems. However, since I do, I’m going to figure out how to resolve them. I’ll get some help if I need it.”

Prescription Medications & Responsibility

Chronic addiction to drugs, alcohol and other addictive behaviours are an issue for many people locally, nationally and internationally. Addiction to prescription drugs is an ever increasing trend that can, has and will lead to the use of other drugs or addictive behaviours once a prescription has run out.

When approaching the constantly worsening opioid crisis from the standpoint of someone who struggles with addiction, many questions surface, including the following:

The 2017 National Survey on Drug Use and Health conducted by the Substance Abuse and Mental Health Services Administration reports that 11.1 million people used opioids (age 12 and older) within the year surveyed.

The National Institute on Drug Abuse explains that, in 2016, substance use costs $740 billion in the form of crime, health care and lost productivity in the USA.

Figures for the UK in the case period.

Experts explain that there are a variety of contributing factors to addiction, including the following:

  • Mental health issues & associated conditions and disorders
  • Physical health conditions and disorders
  • Genetic predisposition toward addiction and addictive behaviours
  • Social, environmental or familial factors

Excessive drug or alcohol use typically begins as experimentation, recreational use or as a consequence of becoming addicted to prescribed medications which then escalate to harder/stronger prescribed medications or illegal substances.

Continued use can result in developing a substance/alcohol use disorder. Prolonged substance use can cause financial, criminal, mental, physical and social problems. However, when prescription medications are the misused drug, there are other factors to consider.

Prescription drug misuse often begins with a legitimate prescription following surgery, an injury or health condition. The most commonly misused prescription drugs are opioids and benzodiazepines.

The National Survey on Drug Use and Health recorded 2 million new instances in which people abused prescription pain medications (opioids) in 2017 across the USA.

According to the NHS Business Services Authority, 12.8% of the adult population in England were prescribed opioids in 2017/18.

Of the 114,752 people starting treatment in Great Britain during 2018, 50% reported primary use of opioids. The UK has one of the largest opioid treatment populations in Europe. In 2017, there were 57,430 people who started treatment in the UK who said they had a primary problem with opioids.

Prescriptions for these drugs have risen in the last five years, with one in every 11 NHS patients regularly taking a potentially addictive substance.

People also frequently misuse tranquilizers and sedatives. Opioids are particularly susceptible to misuse because they activate the reward system in the brain, providing pain relief and feelings of euphoria. When people begin to rely on the drug for the pleasurable feelings it elicits, it may create a cycle of addiction.

Several new laws are being enacted in various states that limit how long opioids can be prescribed for, from seven days to only three days. Electronic registries for opioid prescriptions and other systems are being tested to limit patient access and regulate prescriber practices.

Despite these measures, many people today live with addictions that started with legal prescriptions. Whether or not a prescription continues, the addiction may remain. These practises are designed to help the user to make accessing prescribed opioids more difficult for those who misuse them, this is then supposed to help users to make better informed decisions and to take more responsibility for their actions and behaviours.


A Patient’s Response To Overprescribing

According to the Centers for Disease Control and Prevention, 17.4% of people in the United States received an opioid prescription in 2018. This number is reflected in the clinical findings in the UK for the same year, with 24 million prescriptions were written in 2018.

While prescription rates have decreased significantly over the past few years, the impacts of past prescribing practices still impact millions of people everyday worldwide.

There are many ways in which experts now believe that addiction is significantly related to genetic predisposition or neurological factors. In other words, people who struggle with substance use are compelled by forces outside of their control. This goes back to our original question, who is responsible in addiction and treatment?

Much blame has been rightfully assigned to the role of overprescribing in the opioid epidemic. Because opioids are highly addictive, the risk of prescribing them to patients who have had surgery or are in chronic pain may not have been weighed heavily enough by doctors. 

There are some ways that patients may respond to this process that can circumvent drug use. Patients can take more responsibility for their own care as they have the right to the following:

  • Ask for opioid alternatives for pain treatment
  • Request drug specific information
  • Ask for the lowest possible dose
  • Schedule regular check-ups while on opioids
  • Be open and honest with your Doctor or healthcare professional if you feel you may be becoming addicted to the medications you are prescribed
  • Keep a written log of your medication use so that you can see if you are beginning to take them more frequently, at a stronger dose or needing another repeat prescription more frequently
  • Try to use other pain management techniques or coping strategies such as meditation, mindfulness and relaxation techniques BEFORE you take your prescribed medications as you may be able to avoid taking a dose of your symptoms can be managed without needing to take medications
  • Try using alternatives such as using TENS machines, hot/cold packs, NSAIDS (paracetamol or ibuprofen among others)
  • Use healing therapies such as counselling, hypnotherapy or auricular acupuncture

The Power of Perception: A Thought Experiment

Imagine that you have two friends. 

The first friend has had a hard life. Growing up, his parents emphasised harsh, rigid rules instead of emotional connection and his siblings teased him mercilessly. In school, he started doing drugs and decided to drop out before graduation. His health and happiness deteriorated, and now he’s struggling to stop using.

The second friend is incredibly gifted. He’s an amazing musician, always creating new melodies on his guitar. He has performed in several showcases and has had steady work teaching others to play. He feels things deeply and when you talk to him, he really listens. He has issues with drug use, but he’s working hard to recover.

Here’s the thing: these two hypothetical friends are one and the same. 

Does this guy have hope for recovery? 

It depends on your perspective, on what story you choose to tell.


The Difficulty of Dual Diagnosis

Dual-Diagnosis

If you’re struggling with a dual diagnosis – a substance addiction combined with a mental health condition such as depression, bipolar disorder, borderline personality disorder or anxiety – you may feel as though your life is out of control and going at a million miles an hour.

And we’ll be the first to affirm that your struggles are real and genuine.

You can decide to despair, or you can believe that your unresolved issues are opportunities for spiritual, physical and mental growth. You can choose to abdicate personal responsibility or you can step up to the plate.

It’s not easy to cope an addiction, never mind adding a mental health condition on top too. But the good news is, you’re the author of your story and you have a responsibility to take stock of your situation and make the right decisions to improve your life, with the help of professionals and others.

Taking personal responsibility doesn’t mean that you have to do it on your own. It simply means that you must acknowledge your predicament and apply positive coping strategies, healing therapies and knowledge to remove the negative aspects of your situation and combat it with positive, healthier ones.

Everyone has all of resources that they need to heal within themselves, those around them and in the resources around them, such as therapy, rehab, detox, fellowship, MAT Programs and others.


What Does It Mean to Take Accountability in Addiction Recovery?

First, here’s what taking accountability and personal responsibility does NOT mean.

It does not mean that you caused or “deserved” the hard or bad things that happened to you in your life.

It also does not mean that you assume a heavy weight of guilt, blame or shame, because you “should have known better.”

“I did then what I knew how to do. Now that I know better, I do better.”

Maya Angelou

Here’s what taking accountability and personal responsibility DOES mean

  • Deciding that you are going to lead your own life, determine your experience of the world and create your own reality from here on out
  • Offering yourself forgiveness for the times when you didn’t take responsibility in the past
  • Releasing your judgments and limiting beliefs and utilising the power of positive affirmations
  • Practicing techniques which can help you heal and cope with the difficult aspects of life such as meditation, mindfulness and relaxation
  • Making the choice to heal every day

How Taking Personal Responsibility in Addiction Recovery Empowers Us

No matter what happened before now, you get to choose what you do next and that’s the fun part, you can try anything to find out what you like or don’t like. Experiment and try as many new positive opportunities as possible.

Will you isolate yourself and continue the downward spiral? Or, will you reach out, get help and do the work you need to do in order to heal? The answer you give makes all the difference!…

Want To Take The First Step In Taking Responsibility For Your Addiction?

Reaching out is the first and often biggest step in overcoming your addiction or addictive behaviours. You can find contact information for a wide range of groups, charities and organisations who can help. You can find contact information for them on our help and support page here.


Want More Like This?…

Published by Drink ’n’ Drugs

Providing useful, relevant, up to date information and support for those suffering from active addiction or those who are in recovery.

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