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Guest Opinion
On
Patrick Kennedy and calls for his resignation
By Robyn Leary, President, Recovery Network
Foundation
The headlights on Patrick J. Kennedy's Mustang illuminated
more than just steel barricades at the pre-dawn hour when the
Rhode Island congressman crashed his car within blocks of the
nation's capitol May 4. They also flashed a spotlight on the
concrete wall of prejudice and stigma that many in this nation
have held against people in recovery from addiction and mental
illness since its founding.
Laudably, Congressman Kennedy, who is now out of rehab and
back to work on Capitol Hill, has made mental health reform to
eradicate that stigma one of the highest priorities of his
legislative career, calling the stigma and the discrimination
major civil rights issues. Kennedy is the lead Democratic
cosponsor of the Paul Wellstone Equitable Treatment Act, which
would end insurance discrimination against the mentally ill -
only one of the many ways that he has worked in his six terms
on Capitol Hill to end the double-stigma of mental illness and
addiction from which he suffers himself.
In the last session of Congress, Reps. Kennedy and Jim
Ramstad (R-MN), a recovering alcoholic, formed the
groundbreaking bi-partisan Caucus on Addiction, Treatment and
Recovery to promote awareness about chemical addiction and
promote access to treatment and recovery.
From personal experience, Kennedy realizes that blaming the
chemically dependent for their illness and believing that it's
a matter of choice or moral weakness are anachronisms that
linger despite a growing body of science documenting that
addiction is a disease: "It is a brain disease but not just a
brain disease," wrote Dr. Alan Leshner, former director of the
National Institute on Drug Abuse. "Addiction is the result of
prolonged drug use that changes the brain. It is a biological
disorder in that the brains of addicts are different from
those of non-addicts."
We also know that addiction is a disease from which people
and families can recover, that recovery, in fact, is
treatment's expected outcome, that millions of addicts are
living a life free from alcohol and drug use. We know, too,
that not everyone can become chemically dependent and that the
biggest risk factor is genetic (40 percent environmental
factors). New thinking and paradigm shifts in research also
indicate that relapse is not a sign of failure if it occurs in
the context of progress toward stable, long-term recovery. And
we know, finally, that treatment innovations have made it
possible for millions of Americans with mental illness to live
healthy, productive lives.
Why, then, did The Providence Journal's
Bob Kerr suggest in a column published shortly after the
incident that it's time for Kennedy to end his congressional
career? And why have two-thirds of the Journal's
readers agreed with that assessment in a continuing
online poll? According to the latest results, more than 63
percent of those responding believe Kennedy should return to
private life.
From the tenor of most responders' comments, one would
think that all we have learned about the neurochemistry of
addiction and the efficacy of treatment for the mentally ill
never happened. There's only one word for these reactions and
that word is stigma - a stigma that keeps people from seeking
the help they need, leads to discriminatory practices and one
that affects millions of people not named Kennedy.
According to the latest statistics compiled by the federal
Substance Abuse and Mental Health Services Administration
(SAMHSA), an estimated 22.2 million people (9.3 percent of the
total population) are in need of treatment for an alcohol or
other drug problem. Of these, an estimated 1.9 million
received treatment. However, only a very few, like Kennedy,
can afford the Mayo Clinic. In 2003, 20.3 million persons who
needed treatment didn't get it.
Meanwhile, this country continues to criminalize addiction.
We are building more prisons than ever before and filling them
with people who suffer from substance use disorders. In most
cases, they receive no treatment while in prison. Kennedy,
according to his critics, managed to escape criminalization
only because of his name. Of course, his behavior may very
well not have warranted any criminal charges but the same may
be said of millions of others who did get charged.
Like Kennedy, who suffers from what is known as a
"co-occurring disorder" (bipolar depression and addiction),
about 26.2 percent of Americans - one in four adults - suffer
from a mental disorder. When applied to 2004 U.S. census, that
figure translates to 57.7 million people. According to
SAMHSA's National Household Survey on Drug Abuse, four million
Americans had both serious mental illness and a substance
abuse disorder. Of the approximately 668,000 male hospital
admissions in the 29 states covered by the SAMHSA survey,
103,000 (15 percent) had co-occurring problems.
Science has documented that alcoholism and addiction to
other drugs is a progressive disease. At least six years ago,
we began discovering that our understanding of addiction is
flawed, so the way we treat it is also flawed and in many
cases actually causes failure and relapse. According to an
article in the October 2000 issue of the Journal of
the American Medical Association, the effect of
drug dependence on social systems has shaped the generally
held view that drug dependence is a social and not a health
problem.
As a result, medical approaches to prevention and treatment
are sorely lacking, we fill up our prisons and virtually
nothing is known about recovery. The authors compared the
diagnoses of drug dependencies to diabetes, hypertension and
asthma. While drug dependence has been generally treated as an
acute episode, the article suggests that "longterm care
strategies of medication management and continued monitoring
produce lasting benefits."
Consequently, drug dependence should be insured, treated
and evaluated like other chronic illnesses. If a member of
Congress (or anyone else for that matter) failed to end an
affair with contraband like French fries and red meat
following cardiac double-bypass surgery, would the second
heart attack due to these diet infractions be considered a
relapse, not covered by insurance and grounds for resignation?
In a recent study published in The Journal of
Nervous and Mental Disease, two Duke University
psychiatrists reviewed the biographical material of the 37
U.S. presidents from Washington to Nixon and concluded that
almost half were likely to have suffered from various
psychological ailments, including bipolar disorder, depression
and alcoholism.
Whose interest does stigma serve? After all, if you're not
personally in recovery from alcohol or addiction to other
drugs or from mental illness or both, statistics confirm that
someone you love is.
I, for one, am happy to see that Rep. Kennedy has returned
to continue his vital work as a legislator who advocates for
this stigmatized class of people who have so few true
advocates.
Robyn Leary is president of the Recovery
Network Foundation in Scarborough, NY
(www.recoverynetworkfoundation. org) and
host and coproducer of "Recovery Talk," a
weekly public affairs presentation of WDFH
90.3-FM, in the lower Hudson valley.
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