NY Magazine shares a jarring photo essay. (Trigger warning, the images are pretty graphic.)
Most documentary projects about addiction expose someone else’s self-destructive behavior, but Graham MacIndoe took a very different approach: He photographed himself during the years he was addicted to drugs. He’d place a cheap digital camera on a table or bookshelf, set the self-timer to take a photo every so often, then turn his attention to the rituals of his habit: filling a crack pipe, cooking heroin, shooting up. Over time, he became more deliberate about lighting and composition, but the point was not to glamorize what had become a solitary existence, the monotonous repetition of an addict’s daily life.
These images offer important perspective in light of the recent discussion about treatment and responses to addiction. There’s been a lot of discussion about natural recovery. I think it’s important to distinguish between problem drinking or drug use and addiction.
People with drug and alcohol problems, even serious problems, stop all the time without help. For them, the drug is just a drug. It may feel really good. It may have a pretty strong pull. But, they’ll quit once they have a good enough reason—a child, incarceration, loss of a job, divorce, etc.
This looks like addiction, where the drug is no longer just a drug—it’s survival. The brain of the addict treats the drug as it’s most basic survival need. It’s not a learned behavior. It’s not a lifestyle choice. It’s not secondary to a crappy environment. Few addicts will be able to initiate and maintain recovery without help. (There’s no doubt that, historically, treatment providers have done a lousy job differentiating between addicts and problem users.)
The good news is that Graham is in recovery now.
I posted about tough love earlier this week. Here are his thoughts on tough love:
People need to be nurtured out of addiction. That tough-love thing of turning a blind eye because you think you can do nothing is really destructive. Because you’re getting somebody at the lowest ebb of their life who just needs something, and they don’t know how to do it.
recoveryreview.blog 
I’m with you on many of your points, but I wonder if addiction is a switch: you cross a line and you are in a different place with no return, or if it is more complex than that. I’m not sure that there is no ‘natural’ recovery from addiction though i suspect that when you examine what happens, many of the determinants and catalysts of recovery that we commonly recognise could be traced in the history.
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I hear you.
I chose the words “few” and “help” carefully. I don’t doubt that it happens and I didn’t want to imply that everyone needs professional treatment.
This was in response to the frequently cited research that most people resolve alcohol and drug problems without any help. However, this usually gets communicated not as, “resolve drug and alcohol problems”, and rather as, “recovered from addiction.”
The research is based on surveys that ask questions like, “Did you once have a problem with drugs and alcohol but no longer do?”
This failure to distinguish between problem use and addiction is being used to challenge the disease model and addiction.
This was a attempt to assert that distinction, though it may have been clumsy and lacking in context.
Thanks for the comment. I miss your writing on the topic!
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