HJNO Sep/Oct 2022

24 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS   health disorders among every population as well as an increase in substance use and addiction. Substance use and addiction are nearly universally accepted empirically as a brain disease or mental illness, and the science continues to be sound in declaring that addiction is a disease. 2 This is coun- ter intuitive to long held philosophies that substance use was merely an indication of weakness in the character of the user. In the third article, “Opening the Pandora Box”from the July/August 2022 issue, Julio Olaya, MD, made the case that pain was the major contributing factor in the beginning of the opioid epidemic in the U.S. Pain is a marker of an underlying illness that can be treated and remedied. 3 As discussed in the first article, “Historical and cultural aspects of man’s relationship with addictive drugs” from the March/April 2022, opioids have been a primary ingredient in pain relief cocktails since antiquity, and the beginning of the opioid epidemic in the U.S. was a chapter of near innocence with doctors aim- ing to bring relief to their clientele. But the gifts of pandoras box got in the way. Greed set the course for overprescribing, and fear combined with lies disabled the ship from righting its way. While the second article of this series, “Addiction as a brain disease revised: why it still matters, and the need for consilience” from the May/June 2022 issue, makes a strong case for the scientific basis of the argument that addiction is a disease, it does not completely debunk the long- observed truth that many individuals with “risky substance use behaviors” can, with their own strength of will, right their own path before substance use disorder or addiction take hold. While that argument is not wholly debunked, it is not wholly substanti- ated either. However, it is worth not- ing that hope is not an active emotion. Hope is a passive emotion that exists as a possible motivator and cannot be a prescribed fix for a client suffer- ing from extreme addiction. Hope- lessness, another passive emotion, is often a close companion to addicts as the drug of choice has a stronger hold on them than their own will. Hopelessness is also a com- panion to those in relationship — personal, family, work, or otherwise — with an addict, as only the addict can make the choices that can enable them to recover. As noted in all the articles of this series, addiction is rampant throughout the world with continued rises in deaths, overdoses, and what appears to be a never-ending war Pandora opened the box and into the world flooded all human illnesses and suf- fering. 1 Frightened as she was by the evil flowing into the world, Pandora tried des- perately to close the box to no avail. When all evil had forced its way into the world, Pandora looked into the box to see what remained in there. Hope, so easily seen in that moment as a beacon of light, alone remained. While the common perception of hope is a joyful and motivating one, it must not be forgotten that hope was in the box with all the other sources of human suffering and pain. Since the story of Pandora was first shared, the question has remained: was hope a gift, or was it a curse? As discussed in the previous three articles of this four-part series “His- torical and cultural aspects of man’s relationship with addictive drugs” from the March/April 2022 issue, “Addiction as a brain disease revised: why it still matters, and the need for consilience”from the May/June 2022 issue, and “Opening the Pandora Box” from the July/August 2022 issue, addiction is rampant throughout the world and dev- astatingly deadly in the United States. With new and more potent substances entering the market of prescribed and street drugs, there is a continual rise in deaths, overdoses, and what appears to be a never-ending war on substance use and addiction. With the COVID-19 pandemic and its forced isolation as well as the fears of the many unknowns caused by its worldwide disrup- tions, there has been an increase in mental ABSTRACT Acknowledging that addiction is a brain disease has continuously been a debate by many people as well as widely criticized as being too limiting and allowing for a certain scientific lens in which many other factors such as social, behavioral, and genetic makeup can be dismissed. The definition of disease is a disorder of structure of function in a human, animal, or plant, especially one that produces specific signs or symptoms or that affects a specific location and is not a direct result of injury. According to the Centers for Disease Control (CDC), addiction is a chronic disease due to prolonged substance use in which the brain’s reward system is altered leading to changes within the brain’s reward system as well as causing the prefrontal cortex to perceive the world pertaining to impulse control and judgement. When working with recovery from addiction, and if addiction is a disease, is there any hope of recovery, or are efforts futile? This article will propose that recovery is possible and that hope is possible for the person working with recovery as well as the provider who is able to walk the path of recovery with their patient and possibly … for themselves. ADDICTION, RECOVERY, AND HOPE