Grieving Out Loud: A Mother Coping with Loss in the Opioid Epidemic

New research points to addiction as a disability, not a disease

November 08, 2023 Angela Kennecke/Dr. John Maier Season 5 Episode 137
New research points to addiction as a disability, not a disease
Grieving Out Loud: A Mother Coping with Loss in the Opioid Epidemic
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Grieving Out Loud: A Mother Coping with Loss in the Opioid Epidemic
New research points to addiction as a disability, not a disease
Nov 08, 2023 Season 5 Episode 137
Angela Kennecke/Dr. John Maier

Is addiction a disease or a disability, and why does it matter?

Dr. John Maier, a distinguished researcher, therapist, and philosopher, is writing a groundbreaking book championing the concept of addiction as a disability rather than a disease. In this enlightening episode of Grieving Out Loud, we delve into Maier's perspective and explore why this distinction holds such significance. We hope that this episode has left you feeling more informed and empowered, ready to make a positive impact in today's world.

Maier would like to hear from people struggling with substance use disorder about how they think it should be classified. Don't hesitate to contact him by email or on Twitter.


Support the Show.

For more episodes and to read Angela's blog, just go to our website, Emilyshope.charity
Wishing you faith, hope and courage!

Podcast producers:
Casey Wonnenberg & Anna Fey

Show Notes Transcript

Is addiction a disease or a disability, and why does it matter?

Dr. John Maier, a distinguished researcher, therapist, and philosopher, is writing a groundbreaking book championing the concept of addiction as a disability rather than a disease. In this enlightening episode of Grieving Out Loud, we delve into Maier's perspective and explore why this distinction holds such significance. We hope that this episode has left you feeling more informed and empowered, ready to make a positive impact in today's world.

Maier would like to hear from people struggling with substance use disorder about how they think it should be classified. Don't hesitate to contact him by email or on Twitter.


Support the Show.

For more episodes and to read Angela's blog, just go to our website, Emilyshope.charity
Wishing you faith, hope and courage!

Podcast producers:
Casey Wonnenberg & Anna Fey

[00:00:00] Jessica Pfau: I know somewhere deep down that I'm better than this, but at the same time, when my addiction takes hold of me, I don't care about anything but that addiction, and I feel like I should be the mother that I know I can be, the wife that I know I can be, the daughter and sister that I know I can be, 

[00:00:18] Chris Herren: I was 11 years old and I promised mom that I never, ever drink. And of everything we've been through, and I remember at 13 years old first time all about please don't let my mom smell my father's Miller Light's on my breath. You know, because I, I knew what that would do to her. 

[00:00:38] Harold Noriega: Sometimes fitting in that box is challenging for kids. And I see other kids now in my neighborhood where they don't fit into that box and they struggle and they internalize it. And what they all want to do is they want to have somebody to talk to about it. and they don't know how to ask for that because mental health is regarded as a stigma.

 (MUSIC UP) 

[00:00:57] Angela Kennecke: These are just a few of more than 100 people who we've interviewed on Grieving Out Loud. They'll tell you substance use disorder is complicated, and there's no doubt it's leaving a trail of destruction all over the country. Drug overdoses and fentanyl poisonings are the number one killer of Americans under age 50, and let's not forget about the countless broken relationships, heartbreak, and unrealized potential all due to addiction.

It is a real crisis.

[00:01:35] John Maier: Addiction of course, is a topic that lives very much at the intersection of, philosophy and therapy. 

So 

[00:01:41] Angela Kennecke: On this episode of Grieving Out Loud, I'm sitting down with therapist, philosopher, and author, Dr. John Maier. Maier is coming out with a new book explaining his view that addiction is a disability instead of a disease. 

[00:01:57] John Maier: Human psychology I think has pretty much been the same, at least for the last few thousand years. But addiction and especially really tragic outcomes that we see as a result of addiction, those are kind of new as we, as we, know. And so well, what's changed? Well, not brains. Brains are kind of similar to the way they were 2000 years ago. Something else has changed and it's the environment that's changed, 

[00:02:15] Angela Kennecke: I'm Angela Kenecke, your host of Grieving Out Loud. I hope this episode leaves you both enlightened and empowered, ready to make a positive impact on today's world.

 (MUSIC UP) 

Well, John, it is an honor to have you on grieving out loud. Thank you so much for being here.

[00:02:38] John Maier: It's a pleasure. Thanks for having me.

[00:02:40] Angela Kennecke: Let's start off a little bit by talking about, I think your title is so interesting to me, therapist slash philosopher, and maybe there's just a lot of philosophy in therapy anyway, , but I just kinda wanna know how you arrived at that combination and why you're doing what you do.

[00:02:56] John Maier: Yeah, definitely. Uh, by training I'm an, I'm like a philosophy professor. I got a PhD in philosophy. And taught philosophy at various places for about a decade. I love that work and I kind continue to do that work. I gradually got more interested in psychology and therapy and the idea of, doing therapy. so a years ago I've made a bit of a shift and I've now I. You know, kind of retrained as a therapist. So now I primarily work as a therapist, primarily working with patients with psychosis and early psychosis. then I also do a lot of philosophy writing teaching. And addiction of course, is a topic that lives very much at the intersection of, philosophy and therapy. So that's one reason why I've been so interested in it. 

[00:03:35] Angela Kennecke: I was gonna ask you if there's a relation between psychosis and addiction.

[00:03:40] John Maier: It's interesting. I don't personally work on it that much. it's a really interesting subject and people do self-medicate certain psychiatric conditions and so are relationships. I think one, one thing that's notable is people with a diagnosis of schizophrenia typically have a. Higher rate of nicotine use than other people. And there are various hypotheses for why that might be so, so there are all these sort of interesting connections, the two. But I, personally haven't worked on it, but I'm kind of fascinated by it.

[00:04:07] Angela Kennecke: I am fascinated by it too. Just the mental health addiction connection and, and what comes first, right? Did the mental health issue come ? Before the addiction, the addiction is a way to self-medicate or does substance use cause mental health problems that we see.

[00:04:23] John Maier: Yeah, and I think sometimes it goes one way, sometimes it goes the other way. Sometimes there's no connection at all. Sometimes someone has a mental health condition and they have an addiction, and so I think all three can.

 (MUSIC UP) 

[00:04:31] Angela Kennecke: Maier has been studying substance use disorder, not only as part of his profession, but also as research for a new book, which is slated to come out in early to mid 2024. This book takes a deep dive into the concept of addiction as a form of a disability; covering a wide range of topics spanning moral, psychological, bioethics, and public policy.

 (MUSIC UP) 

[00:05:04] John Maier: I've learned a huge amount. about addiction. I think one thing I've learned is just people's experiences of addiction and how diverse they are and how people understand their own addictions. 'cause the book puts forward a very particular view of what addiction is. And I'll talk about that in a bit. But I often go to people with addictions and be like, how does that sound to you? And some people like it, some people really don't like it, some people aren't sure. have their own narratives around addiction a large part of the project is trying to respect that and saying, here's a story about addiction. Whether it's true or not, it's really not up to me. It's up to the people who have lived experience of addiction and what they, in the end think is true.

[00:05:41] Angela Kennecke: As you've done your research on this topic, what do you think is the biggest misconception about addiction?

[00:05:48] John Maier: for me, the big, big misconception is that addiction, there's something wrong with a person. Someone who has an addiction is in some way. Defective, whether that's a disease or a disorder, that there's something wrong. So one, big theme of the book is that's just not true. People with addictions are different, people who don't have addictions and they're discriminated against and exploited in certain ways. But the idea that there's something wrong with addiction, which a lot of like, it's not just people, you know, a lot of, well-meaning physicians, a lot of well-meaning family members. A lot of people with addictions themselves have this belief. So I don't think it's an unreasonable belief, but I think it's ultimately one that we should reject. We should think addiction's. Just a difference.

[00:06:28] Angela Kennecke: A difference. Not that it's a bad thing necessarily, not that you are bad, right? I mean, I think that's the person is not the addiction. It's something extra that they sort of carry around. That's how I look at it.

 

[00:06:40] John Maier: Yeah, I think the person's not bad and the bad things. 'cause there are of course addiction. I don't wanna deny. Addiction is associated with quite tragic outcomes. Um, most people have been infected in one way or another by these. picture is, that's largely the product of kind of social circumstances, of drug markets, of various kinds, of, various forms of exploitation rather than of something wrong with the addicted person herself.

[00:07:05] Angela Kennecke: So how did you arrive to the idea of addiction as a disability? Because before I started reading up on you and researching, I had never heard it classified as a disability before.

[00:07:18] John Maier: Yeah, so in some ways, so the view disability, well, Under the Americans with Disabilities Act, which is now like several decades old, alcohol use disorder, and certain sorts of other substance use disorders are recognized disabilities. So this is like a longstanding fact in American law. people outside the law though rarely talk about this, physicians, psychologists, it doesn't really come up. So I think you're right. 

Most people, including myself, haven't really considered it. think the way I came to it, there's a. Medical and philosophical literature on the idea that addiction is a disease, some sort brain disease.

that always kinda seemed wrong to me. I couldn't quite put my finger on why it seemed wrong to me, but something that seemed off about that. so I was kind of thinking, well, what is it, if not a disease? And then I started learning more about disability, the law and among disability activists. And that started to seem more and more like a better and more like Charitable model of what's going on with addiction rather than seeing it as a disease.

So that's really kind of how I came personally.

[00:08:20] Angela Kennecke: What do you see as the difference between disability and disease?

[00:08:25] John Maier: Yeah, and are theories of this, you know, within philosophy, within psychology, and so it gets quite complicated. But basically I Think of some core disease. Think of Covid 19. So that's a disease. I guess that's the virus that causes the disease.

But you got, you got the idea of the flu, covid, things like that. Those are diseases. They're bad things that happen to us. we go to doctors, and doctors give us medicine, if we're lucky, the medicines fix is the problem. things like that. Is addiction, something like that? Or think of like blindness and deafness. So blind people need to go to doctors and they often, they need the help of doctors, so to the deaf people, but blindness and deafness aren't like medical conditions, and they're not medical conditions that need to be fixed by doctors. They're just different ways of being so blindness and deafness. At least a lot of people in the disability community think they're different ways of being. Being blind doesn't make you worse off in of itself. Discrimination makes you worse off, but being blind in itself is just a difference. So, I try to not get too caught up in words like disease and disability. I think is addiction something like covid or is addiction something like blindness and I think it's much more like blindness than it is like covid. That's the general picture.

[00:09:30] Angela Kennecke: What do you think makes it more like blindness then? Can you elaborate on that? 

[00:09:34] John Maier: Yeah.

I I think the first thing to notice is that addiction, Doesn't behave like typical diseases in a number of ways. One thing is that it often gets better or changes without medical intervention. So people with addictions at one point in their life. I mean, some people do go to rehab or go to other sort of facilities and get medical attention, but a lot of people without medical attention go from having an alcohol use disorder at one point in their life to not having an alcohol use disorder at the other point of their life. so that's, something that you don't typically see with diseases, at least not the sort of chronic diseases. So people often analogize alcoholism, for example, to diabetes. Diabetes doesn't just get better on its own. but addiction does seem to change sort of on its own. So one thought is addiction doesn't seem to require medical event intervention in the way that canonical diseases do. 

 (MUSIC UP) 

[00:10:25] Angela Kennecke: And recent research from the U. S. Department of Health and Human Services reveals 94 percent of people aged 12 and older with a substance use disorder do not receive any treatment. An overwhelming majority of these people who forego treatment believe they don't need it. But is that really true? Many experts in addiction care agree that a significant portion of those grappling with addiction are not receiving the necessary help.

This could be because of a lack of access to care and screening, the cost of treatment, and the stigma surrounding substance use disorder.

[00:11:06] Hannah Statz DeVries: It can take, weeks, months, years, really, before someone's back functioning where they were before everything happened. Years, years. And that's something that we call post acute or protracted withdrawal.

[00:11:18] Angela Kennecke: That was addiction medicine doctor Hannah Statz DeVries. She's also a valuable member of the Emily's Hope Board of Directors.

[00:11:32] Hannah Statz DeVries: It's physical, it's mental, and that's that disease piece where the addiction has started to wreak havoc on your dopamine pathways and release abnormally large amounts of dopamine in your brain. And that's your pleasure center. That's your survival center.

If drugs take over your survival center, it goes from wanting drugs to saying, gosh, I don't just want it. I feel like I need it and I need it to survive. What a scary thing. 

[00:11:58] Angela Kennecke: Dr. Matt Stanley, who is recognized as a leading authority in the field of addiction medicine, also sits on our nonprofit's board. He was on a previous episode of Grieving Out Loud, explaining why most medical associations, including the American Medical Association and the American Society of Addiction Medicine, categorize substance use disorder as a disease.

[00:12:24] Matthew Stanley: So addiction, much like diabetes, which is a disease we often use as a comparator. Addiction is genetically driven. Physiologic changes occur at the receptor level. We have a bunch of neurochemicals in the brain that are affected. It really is the physiology of the body that begins to dictate the addiction. I think where people get really hung up is they feel like this is a disease of choice.

A moral failing. A moral failing and that and we've heard that repeatedly and we get I think because we often like many illnesses We as people who care about the people with addictions get really frustrated get really angry And I think sometimes that anger is expressed by saying, you know You need to control this.

This is a moral problem. This is a weakness of character. But on the other hand, if you look again at that dia that diagnosis of diabetes, many of much of that is developed through lifestyle, exercise, but it's very genetic, it's very powerful, and there are changes you have to commit to to be able to manage that.

It's not different in most aspects when you start to compare them between addictions and and diseases like diabetes that we call chronic medical illnesses. I think some of the problem that some people have is that with diabetes the choice may be eating the wrong food, where with addiction the choice may be using an illegal drug.

So this is something people are like, well why did you ever use that in the first place? Or once you used it, why did you keep using it? Right, and again I think it's understanding that with our genetics and and the power of neurochemicals. One exposure can really just flip a switch that's almost, I won't say impossible, because many, many people have overcome tremendously difficult addictions.

I don't know how to describe when addicts tell you when the light goes on, the first time they have this, how they feel. It's just like everything in the world is right, all of a sudden I know it's been missing. It's a powerful, powerful neurochemical reaction 

[00:14:21] Angela Kennecke: Still, Maier argues that addiction is more like blindness instead of diabetes.

 (MUSIC UP) 

[00:14:37] John Maier: why is it more like blindness? then I really start to think of, thinking of the experience of blind people. It's this thing that's people Think is inherently bad, but then when you look more carefully at it, you say, aha. Actually, the badness comes from the environment. We live in a world that's built for sighted people, so of course you're gonna have a tough life if you can't see in the way that typical people do, statistically, typical people do, then say, oh, it's, it's addiction like that. Maybe we just think addiction's a disease because we think that there's something wrong with it. Actually what we're seeing are the effects of discrimination and exploitation. So that's kind of how it goes. First you think, oh, it's not really like an ordinary disease, and then you think, oh, maybe it's not a disease at all. Maybe there's nothing wrong with addiction at all. Maybe it's coming more from discrimination. that's kinda how the line of thought goes.

[00:15:26] Angela Kennecke: It seems like many of our brains, or maybe all of our brains are wired in some way for addiction. You could say we're all addicted to our phones, right? , we're all addicted certain things that we, do habit. I dunno if that's a habit or an addiction, but, and then some people with a substance definitely have a different reaction than others to that substance, right?

[00:15:47] John Maier: so, I think that's definitely true. So I think, we all tend to revise our intentions. Sometimes I intend to go to the gym. and I decide not to. I change my mind for no good reason. It's a perfectly nice day, but I'm like, I'm not not gonna go to the gym today. we revise our intentions. We form plans. No stick to them. We think I'm not gonna have a second piece of cake, and then we have it. the wheel has many forms, as we all know, as human beings. The will takes many forms 

on my picture. Addiction's a certain sort of tendency of the will. It's like a certain sort of tendency to revise intentions, so it's, I think of it almost like a. bell curve, like people with addictions are just occupying a certain space on the bell curve. We all tend to revise intentions. with addictions tend to do it more than most of us with respect to a certain sort of activity, but it's just part of normal. Human psychology. What's not part of normal human psychology is the forces of exploitation. You know, then people design opioids that are, meant to target people or gambling. Addiction I think is especially like this. So gambling addiction is sort of a harmless tend, tendency in of itself is just a tendency to place betts. But then we get these apps that, exploit gambling addiction or these substances. Exploit people's, fondness for opiates. And that's to me, the source of the tragedy rather than the, atypical psychology itself.

[00:17:05] Angela Kennecke: Yeah, that makes complete sense to me. If we didn't have these powerful opioids out there, we wouldn't have this problem. Right. If they hadn't been designed or manufactured and elaborate. We know there's some natural, obviously, heroin and things like that, but they still still has to be refined before it can be, utilized in that way.

[00:17:21] John Maier: Yeah, and that's a nice way to put it. I mean, human psychology I think has pretty much been the same, at least for the last few thousand years. But addiction and especially the, outcomes that we see as a result of addiction, those are kind of new as we, as we, know. And so well, what's changed?

Well, not brains. Brains are kind of similar to the way they were 2000 years ago. Something else has changed and it's the environment that's changed, and so that, in my view is the source of the, the sort of bad aspects of addiction.

[00:17:44] Angela Kennecke: And when You think of addiction as a disability, it, brought something home to me. we at Emily's Hope offer partial treatment scholarships at a treatment, facility one affiliated with the medical system. And recently I just spoke to two young women who were their jobs temporarily to go into treatment and both. Were fired because they went into treatment and our scholarships actually helped cover their Cobra, their insurance so that they could stay in treatment. 

And I don't think either one of them was surprised that they were fired, but if they had looked at their addiction as a disability, they may have thought maybe they had more legal rights.

[00:18:22] John Maier: Yeah, and it's a great question and I'm should. 

[00:18:26] Angela Kennecke: I know you're Yeah.

[00:18:27] John Maier: But I would consult, you know, encourage, I think this is the sort of thing to, ask an attorney about. 'cause people, with addictions do have certain rights under the Americans with Disabilities Act. It's quite complicated what those rights are and what context they apply.

And so I really do mean, you really worth consulting an attorney on these sort of, on these sort of legal questions as they arise in the United States. speaking more philosophically or ethically, like, uh, so stepping outside of the law, That feels wrong to me. And basically it feels to me like a form of discrimination. There's a certain sort of person and you say, I don't, you know, approve of this sort of person or this sort of activity, and you fire them on those grounds. So not speaking to the legal question on the moral grounds, that seems wrong and that seems the sort of discrimination to which people addictions are constantly subject

and that we tolerate in a way that we wouldn't, I mean, obviously there's still a lot of racial. And religious discrimination and other forms of discrimination in the us but it's, at least most people now think, well when they see it, they say that's terrible. discrimination against people with addictions. It's still kind of widespread and still sort of accepted in a lot of contexts. that's remarkable to me. But it's something that people with addictions live with every day.

[00:19:32] Angela Kennecke: right. And people would be outraged if someone was getting help for another disability as a maybe a physical. Disability. They're in a wheelchair or something and they were fired because they were getting with that disability. would be outraged. But when it comes to addiction, you're right. There's that stigma attached and it's so prevalent through all, society.

[00:19:51] John Maier: that's a great point. Yeah. I think with other disabilities, people would be more understanding, but with addiction, it's still bit of a mental block for people.

[00:19:58] Angela Kennecke: And I know you have this book coming out. You've been working on it for quite a while. What do you hope to accomplish with the book?

[00:20:05] John Maier: Yeah. So, yeah, I like that way of framing it. 'cause the book is, really meant to accomplish something in particular. The book is meant to just, so I think there's a, view that addiction as a disability has, I think a lot of people who are interested in the topic, of addiction they're kind of, surprised by it, I guess. so more than, I think the of the book is to get the view out there to describe what the view is, why you might think addiction is disability what implications this would have. And leave it to people to like, I don't know, like I, I guess I do personally think it's true. But the, the purpose of the book is not to convince everyone that it's true. It's to be, if you're interested in addiction, here's a view of addiction that I think would have really beneficial consequences. you know, people might not agree with it for one reason or another. So it's just to get the view out there in a sort of clear, understandable form.

Then leave it to people whether they want to accept it and I would hope not just accept it, but if they do accept it, act on it in various legal or political ways.

[00:20:58] Angela Kennecke: Well, and so that was my next question for we would all see addiction as a disability or even, you know, a disease, which, you know, we can, we whether it's a disease or a disability, but if people would see it as a disability ultimately, what do you think could change or could happen that would benefit people? Our society in general.

[00:21:17] John Maier: Yeah, . I think it would, in principle, if people took it seriously, would radically. Benefit society in a way that would benefit everyone, not just people with addictions. I think recognizing people with addictions as a. class of people with certain rights, radically think about how we think about harm reduction, how we think about substance use policy, how we think about providing goods, you know, how we think of even providing, goods to people who are not employed or, or in need of services. I all that could be changed, and I should say. But one nice thing in the disability rights movement is they've found that often things that are done for people with disabilities benefit everyone. For example, those little, ramps on curbs like city streets where they're, so, I. Those were created in Berkeley, California. Like in the late sixties, somebody just got frustrated. Someone in a wheelchair just got frustrated and blew up a curb.

so he could, he could, he could ride his wheelchair to his classroom. then people find, oh, you know, it's not just for people with wheelchairs, it's for parents with strollers, it's for people on bikes, for kids, on scooters, this, that and the other thing. And so I think making these changes to society can benefit everyone. So I think Taken seriously, the thought that addictions disability would make society a more beneficial place for people with addictions and for people without addictions.

[00:22:30] Angela Kennecke: And no doubt everyone has been touched by addiction in one way or the other, so just having that. Mind shift and having that, approach change would definitely change everyone's lives and, be incredibly stigma reducing.

[00:22:44] John Maier: Yeah, that's a great point too, especially something I haven't talked about much, but a lot of people may not have an addiction themselves, may have loved ones in their. That can be a very challenging experience. and so this framing of understanding addiction as a disability can hopefully lead to more understandings both sides of that relationship.

[00:23:03] Angela Kennecke: And I am sure people with other disabilities would say there are never enough resources. Right. But when it comes to addiction and understanding addiction and addiction treatment or treating the entire family, finding those resources can be very difficult for people.

[00:23:18] John Maier: Yeah, I think that's right. And I think a lot of people in, addiction recovery started talking about this idea of recovery capital. So this idea that that recovery is not just a matter of, having meetings to go to or of having medical care, although it's partly that, but of having sort of resources that you can build on. to build and sustain recovery. And the disability model kind of lines up nicely with that. The idea of recovery capital. that's, we should be providing people with recovery capital, the things that they need abstain from use if they so choose or to mod moderate their use if they so choose. Um, to provide people with the capital, they need for recovery.

[00:23:53] Angela Kennecke: Do you foresee or have you experienced any pushback from people with addictions who don't want it to be classified as a disability? I.

[00:24:02] John Maier: Yeah. I have, and I, it very seriously 'cause I, as I say, the point of the view book is here's something for people with addictions to. Decide whether or not they accept.

And when people with addictions tell me they don't accept the view, I, I take that very seriously. So I have heard this frequently. I think disability itself has a sort of negative connotation

[00:24:21] Angela Kennecke: Right. There's some stigma there too, right? There's some stigma surrounding that. 

Yes. 

[00:24:25] John Maier: So it's partly that it's like, I don't want to be I don't want to be disabled. I think when I compare it more directly to particular disabilities, like blindness or deafness, I find that more helpful. The word disability, I feel kind of sets off alarm bells for people.

And so that word can sometimes be a bit triggering for people. but, But I think there are lots of reasons for people have pushed back and I think I'm, I'm just kinda interested to find out.

I think this view hasn't really been out there yet in the recovery community. And 

[00:24:51] Angela Kennecke: I mean, I talk to so many people on this podcast and outside of this podcast, and I have not heard it framed in this way, which is why I was anxious to talk to you because I wanted to understand it better. 

[00:25:01] John Maier: Yeah, that's the, the, point of talking about it and the point of the book really is like putting this out there and the jury's still out. I think, on reflection, like reading the book or hearing this interview or what have you, people can say, oh, especially people with addictions who I'm most concerned with, they can say, oh, is this of 

Is this an accurate. And they might say yes, or they might say, no, it's not. But I think, yeah, I'd say the jury is still out. Some people buy it, some don't, and we'll see.

[00:25:24] Angela Kennecke: Well, and I think any way that we can stigma, reduce or shift blame, the first time somebody uses a substance, whatever that might be, is a choice. But after a while, it, it is not a choice any longer. And, um, such a great point about the substances that are available now that, you know, were never available, that that isn't someone's fault.

 

[00:25:45] John Maier: Yeah. Choice is a tricky, notion and where, you know, as you say, where does choice begin and where does choice leave off? But, to the credit of the disease model is I think people were so excited about the disease model. 'cause once you see addiction as disease, well diseases aren't people's fault. we shouldn't blame them for it. And I think a, that was a useful from disease model. And I think way with disability. but I think the disease model's, right, to think it's. we shouldn't be thinking in terms of blame or punishment. That's totally the wrong way of about addiction in the same way we wouldn't think of blindness and deafness terms of blame. 

[00:26:17] Angela Kennecke: Yeah, I think maybe 50 years from now we'll look back on some of the ways that we've treated addiction and people who are addicted, and the behaviors that go along with that. And it will seem very barbaric, right? we have a complete understanding of it in a different way.

[00:26:35] John Maier: I think that's totally right and I think that's what happens when you expand the sphere of moral concern. I mean, when you recognize that, you know, people of different races or people of, you know, different gender presentations, oh, you know, they should be treated equally. Then you look back and say, oh, remarkable. You know how, how bad things were just 50 years ago. my thought is that, addictions sort of in that transitional phase that we're beginning to recognize people with addictions as, not to be blamed or criticized, but just, you know, citizens who are a bit different. Um, so that's my hope that, that our current practices will look objectionable, the near future.

[00:27:08] Angela Kennecke: let's hope that's the case. 

And I are starting to shift. I think they are, but it just changes sometimes slow as well. 

 (MUSIC UP) 

[00:27:15] Angela Kennecke: Maier believes that this shift must involve society at large, but he emphasizes the importance of including input from those battling substance use disorder because afterall, they're the ones with the lived experience. They need to voice their thoughts...and how they view their experience with addiction.

[00:27:34] John Maier: (MUSIC UP) I think people addictions, I would encourage them to like reflect on this view for themselves. I've read a lot of stuff about addiction in the past couple years, and a lot of it has a very, my way or the highway sort of tone to it. And I think especially people who are maybe early in recovery listening to this podcast might not know yet how they think of their own addiction. And so I'd encourage people to hear all this, like with With an open mind and an open spirit and be like, oh, that's an interesting view of addiction. does it actually fit my experience? And maybe it doesn't, maybe this view in the end isn't, doesn't describe people's, experience. To me it feels like the right view, but I'm really more than interested, having people reflect on and hearing what they think. 

[00:28:10] Angela Kennecke: Well, thank you. Thank you so much for, um, sharing these ideas with us today.

[00:28:14] John Maier: It's been an honor and a pleasure. I've really enjoyed it.

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[00:28:16] Angela Kennecke: If you'd like to get in touch with Dr. Maier and share your thoughts on addiction and whether it should be considered a disability, you can find his contact information in our show notes. We'd also greatly appreciate it if you could take a moment to rate, review, and share this podcast with your friends and family.

Your support helps us in our mission to reduce the stigma surrounding substance use disorder, raise awareness about our nation's devastating drug epidemic, and ensure more people get the help they desperately need. Thank you so much for listening. Until next time, wishing you faith, hope, and courage.

This podcast is produced by Casey Wonnenberg King and Anna Fey.

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