Where Do Values Fit In Addiction Treatment?

I’d wager that for most people there is an intuitive understanding that values and drug and alcohol addiction are somehow linked. The Oxford dictionary defines values as “Principles or standards of behaviour; one’s judgment of what is important in life.” Values are the ideas and ideals that each of us holds that drive the decisions and choices we make, which in turn determine a lot about the course our lives and relationships take. To some degree values are chosen for us, by our families, teachers and communities, but to a large extent are capable of choosing our values for ourselves—exactly how much we choose versus have chosen for us is one of life’s mysteries, but what is certain is that there is a close relationship between living according to our highest values, and living a fulfilling happy life.

Mainstream understandings of addiction tend to portray active addiction as being synonymous with an abandonment or failure of living according to one’s values. This portrayal is deeply embedded in our culture- from early media representations of addiction like Reefer Madness (1936) and Days of Wine and Roses (1962), to more modern films like Blow (2001) and Winter’s Bone (2010)—the cliché story of value abandonment is everywhere and likely familiar to everyone. In this understanding of the link between values and addiction, as a person becomes more enmeshed with a life of addiction they slowly but surely abandon their values, ultimately becoming a lying, cheating, stealing pariah whose only hope, according to this understanding, is a psychological and spiritual reawakening to a life of living in conjunction with one’s values.

I’d like to question this understanding of drug and alcohol addiction as a separation from a person’s values and as something that defines the realm of active addiction as a life without values. Instead I want to express the idea that active addiction represents a misguided pursuit of essentially positive values, though they are often exaggerated and misapplied. It’s an important distinction and I’ll explain why a little bit later, but don’t get me wrong here- I don’t want to say that addiction doesn’t cause people to do harmful and horrible things that they would never ordinarily do otherwise. What I’m saying is that the belief that addiction is synonymous with or even leads to an abandonment of values is backwards- it’s incorrect and, in an addiction treatment setting, potentially very harmful.

The truth is that the choices people make in times of active addiction are very often based on positive values such as community, ambition, attachment, honor, loyalty, selflessness, courage, family, and even honesty. Unfortunately, in active addiction, when healthy biological, social, and psychological functioning are impaired, these positive and honorable values often become expressed in shortsighted ways that are ultimately counter-productive to the long term goals and interests of the addicted person and their loved ones. For example, values such as community, loyalty and attachment can lead to involvement in criminal activity, gang culture and street-entrenchment. Ambition can lead to violence. Otherwise positive values also frequently work against rather than in conjunction with each other when people are in active addiction, leading to a fracturing of consistent reality and a loss of connection with self and others.

Making the distinction between viewing active addiction as a valueless state verses a state where values are present but shortsighted and in conflict with one another is more than just a semantic exercise. When addiction is seen as a valueless state of being, rather than a state where values are present but misguided, it moves addiction from the physical realm of psychology and biology—maladaptation, sickness and an overarching biopsychosocial view—to the moralistic and punitive realm of good versus bad. Addicted people without values are rationally defined as “bad” in need of becoming “good” rather than as people like you or I, who are in simply in need of becoming healthier.

From a treatment perspective it’s very important to recognize how values played a role in people’s active addiction. At the root of virtually all addiction is a history of trauma and sense of guilt and shame—experiences and feelings that the moral, addiction-as-valueless perspective perpetuates and even exaggerates. By examining addictive behaviours as, ultimately, misguided attempts to express what are actually positive and healthy values it becomes possible to both counteract some of the guilt and shame inherent in addiction, and to find the basis for creating a realistic, achievable strength based, client-lead recovery and aftercare plan. After all, recovery and treatment aren’t about making a bad person good, they are about supporting and guiding a wounded person toward health, community and happiness—addicted people don’t need to find or create values, they just need to be shown they had them all along.