In addition to addiction, I have a fairly intense interest in HIV and other communicable diseases. I have my reasons.
In the early eighties I was involved in writing policy for several law enforcement organizations regarding their dealings with situations where members might be exposed to blood and blood-borne pathogens. During that time I became familiar with the early AIDS hysteria in considerable detail. Public Safety people were afraid to arrest and/or otherwise deal physically with gays (who, along with Haitians, were at that time the only well-publicized victims of AIDS.) Paramedics were concerned about treating people at accident scenes. Law enforcement personnel called into emergency rooms were refusing, in some cases, to deal with patients or visitors if it involved physical contact. All the misinformation and panic of the general population was concentrated and often exaggerated in the folks who were supposed to be protecting it.
Well, the writing got done, and in the process I had become a sort of de facto “expert” on AIDS–not because I was medically qualified (I wasn’t) but simply because in those days anyone who wasn’t educated by street gossip pretty-much was the local expert most of the time. I got to know a number of folks in the HIV/AIDS community over the years, and when I got into recovery from my own addictions I met a great many more. I became quite close to some of them. And then they died.
I got pretty pissed at this disease that was stealing away not only my friends but some of the best and brightest people in the community. I eventually became aware that, tragic as it is, the HIV problem in this country is barely a drop in the global bucket. Sub-Saharan Africa, for example, has lost an entire generation of its population, with long-term effects that can be only guessed at. But the reason that I’m interested in all common communicable diseases is that they are uncomfortably frequent in the recovering people I relate to.
Let’s face it: addiction, at least in the beginning, is about mood-altering in order to feel better. Later the “feel better” part is a matter of conjecture. “Feel normal” would hit closer to home were it not for the fact that, by then, most addicts and alcoholics scarcely remember what normal felt like. But to begin with we mess up our minds because we enjoy the results. Mood altering means altering the ability to make well-considered decisions. We know, from extensive testing, that even seasoned drinkers have a reduced capacity for critical thinking after only one drink. (If this seems to be at odds with your own experience, remember that the ability to evaluate such things is altered as well.)
Folks who can’t think critically make bad choices. The likelihood increases with further intoxication, whether from alcohol or some other drug. The old saw about everyone in the bar being beautiful at 3:00 AM is not all that much of a joke. Some of the undesirable results of such altered behavior are bad choices like sharing needles, trading sexual favors for drugs or companionship, and so forth.
Sexually-transmitted diseases (STD’s) are diseases of behavior. People who don’t take chances sexually and hygienically don’t catch them unless their partners are careless. What? You’re sure your partner is 100% faithful? And has been for the past twenty years? Bet your life on it, would you? Sure you would. You already are.
Unsafe sex is the result of uneducated or impaired choices in behavior. Sharing needles, ditto. Living in unhygienic conditions with people who carry diseases such as TB is a common result of the downhill slide into severe addiction. In this country, most of the people suffering from HIV, AIDS, Hepatitis C, Syphilis, Gonorrhea, TB, and the several other chronically endemic communicable diseases are folks who were either impaired when they were exposed or associated with folks who were. (This is not the case in most of the world, however, where the primary factors are lack of education, poor understanding of hygiene, and consorting with prostitutes or with people who do so.)
These are daunting problems, nationally and especially globally. EDUCATION IS THE ANSWER. Vaccines, if they are ever practical, will not save uneducated people who don’t even realize they need them.
Please don’t let the fact that AIDS and HIV are making fewer headlines nowadays lull you into a sense of false security.
Thanks for the post.
from what I could read it is based on many years of experience in the field, and you wrap it up by stating that sometimes people have a false sense of security because HIV/AIDS is not splashed all over the front pages. Do you think that this also contributes to the fact there are medications out there to prolong lives? that people think, “oh, I can just take a few pills a day, and continue my life?
That’s an interesting question, Mike.
Humans tend to absorb information in the brain, but make decisions with their gut. That’s why, in the face of simple instructions on how to be healthy, we still tend to overeat, get too little exercise, and die of completely unnecessary causes at too early an age. The empirical knowledge just doesn’t get translated into behavioral changes — we don’t “internalize” it, to use shrinkspeak.
There is no doubt that if we watched every clinically-obese person we know die before age 40, we would take some action. That there are so many unhealthy but living folks at advanced ages makes it easy to say to ourselves that we have plenty of time, or that it won’t matter.
That may well be the case with HIV. The infection rate in Western society is on the rise again, after a drop for some years. Notably, it is in less educated groups primarily, but an alarming number of well-educated folks who should certainly know better are practicing unsafely as well. Possibly it is because they lack the experience of having seen their friends wither and die in their prime. It may well be the the additional denial afforded by the presence of effective drugs that has caused it. But I also believe it is simply due to familiarity. Early on, it was a mysterious plague, then a death sentence, now it’s more on the order of an inconvenience, so far as our denial system is concerned.
Thanks for the thought-provoking question.