Substance Use Disorder is a disease process like no other. It does not fit neatly inside a box labeled "Diseases people can get."

When a person has a cold[1], that person has symptoms of that disease process.  That person will probably take some medicine that will reduce or completely wipe out whatever is going on inside them.  The cold gets neutralized in some way by the medicine and the person feels better. 

Almost always, the person is instructed to take their medicine once every four hours.  If they don't follow the instructions to take their medicine this way, the cold starts to take over again and those horrible symptoms come back making the patient feel crappy.  The virus that is causing the cold is present in the body of the patient and the medicine alleviates the discomfort and eventually evicts or kills the virus.  The absence of medicine allows the virus to build back up and continue creating symptoms.  

Substance Use Disorder is similar and yet completely backward from this model of disease.  In the absence of their 'medicine,' the person dealing with Substance Use Disorder will have horrible symptoms.  They take their 'medicine' approximately every four hours (at a minimum) so as to avoid these symptoms.  In this sense, Substance Use Disorder has the characteristics of a cold.

The presence of Substance Use Disorder in a person is not the same as the presence of a virus that causes a cold.  There is no virus that causes Substance Use Disorder and yet to not take one's 'medicine' is to, without exception, invite withdraw symptoms to come back and create discomfort beyond the wildest imaginations of those of us who have never experienced them.

With Substance Use Disorder, it is not the presence of the virus that causes the discomfort that is eliminated by the consumption of the medicine.

With Substance Use Disorder, it is the absence of the medicine that causes the discomfort that is eliminated by the consumption of the medicine.

But wait…

Maybe, just maybe…  

Is it possible that the "virus" does exist but not within the standard definition of virus[2]?  Could it be that the "virus" in the Substance Use Disorder patient IS:

• the generational continuance that is often seen
• the agony to the soul created by that family member who knew this patient in their childhood in a way that no adult should ever know a child?
• the family tragedy that pushed this person to find an emotional pain killer.
• Etc…

If we as a larger society could begin to see the consumption of their 'medicine' by the person with Substance Use Disorder as exactly that - consuming their medicine so as to eliminate the symptoms of their virus - and stop adding stigma, then maybe, just maybe we could open our hearts, honor our Hippocratic Oaths and find the solutions to eliminate this outside the box virus from the patient and bring healing once and for all.

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For the record, I am not a medical expert by any means.  This blog is my humble interpretation of observations I've made during my few years of serving to the best of my ability on the streets of Kensington (a community in Philadelphia, Pennsylvania).

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[1] a viral infection of the nose, throat, and bronchial tubes, characterized by sneezing, nasal congestion, coughing, and headaches

[2] a submicroscopic parasitic particle of a nucleic acid surrounded by a protein that can only replicate within a host cell. Viruses are not considered to be independent living organisms.