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tweet by Johann Hari: The core of addiction is not wanting to be present in life, because pour life is too painful a place to be. This is why imposing more pain or punishment on a person with an addiction problem actually makes their addiction worse.
I appreciate your response and hope you're well.
The language keeps evolving, but this is also described as the difference between substance use/abuse/dependance. Anyone that falls into any of those categories could identify as having an addiction, but each have different issues to be addressed when seeking recovery.
I've worked in substance use disorder treatment and have some challenges of my own but anecdotally, I think the starting point is almost always escapism whether it's the persons circumstances or mental health. Occasionally it's living a certain lifestyle or use being normalized by key people in a person's life. Dependence comes later, and adds extra layers of things to overcome, as you described.
IMO one of the worst aspects of the punishment is when people who are in the stages of use/abuse are punished (whether criminally or otherwise), and after the punishment their circumstances are even worse.
Those who weren't dependent before are headed right into the revolving door of hospitalization, jail, rehab, outpatient so on and so on.
We should do better.