I think it's a big challenge of culture. Substance abuse is a problem that becomes a symptom. Part of the issue I think is cultural ideas about mental health. American culture is strongly focused on good and bad, strength of will and weakness, and where to place blame. Both the person with the addiction and the rest of society are affected by this culture.

When you become addicted to a substance, it's like it becomes revealed to society that you're a weak person. Like weakness is part of your identity. A good person is strong, a good person has the strength of will to not abuse substances. You're not a good person.

When you look back at your life, you see the same faults and have the same regrets. You think of yourself as a weak person.

The problem with those sorts of ideas is they reinforce the behavior that leads to things like substance abuse. They isolate you, they make you lose motivation, they make you act in a self destructive manner because you think you are the kind of person who should.

These are cultural elements that are present everywhere but relatively stronger in American culture. It really likes to put people into boxes, quite literally. People who commit a crime are considered criminals. The crime can be pretty minor, but maybe it sends you to jail. Criminals are bad, and people who go to jail are bad. Good people won't interact with bad people. You can lose your job, you can lose the ability to find another, you can lose your home, you can lose your ability to find another. But good people don't care, bad people go to jail. Bad people need to be punished. Bad people don't deserve our attention. Bad people don't deserve our money.

Other cultures are a bit less polarized. The need to brand someone good or bad isn't as strong. If you commit a crime, you go to jail, but you're treated like a person, you're given opportunities to correct some of the issues that sent you there, you're released in a manner that tries to help integrate you into the rest of society. American culture sees things like this and gets very angry. How dare you spend MY tax dollars on feeding THOSE bad people nice food, and give them comfortable beds!? How dare you help bad people fix their problems when good people fix their problems themselves?

A person who abuses substances needs to be helped. It's a problem that is self-reinforcing and really need some external support to break. The issue is that to ask for help identifies you as weak. It lets out the "secret" that you're not good enough, you don't have that imaginary "indomitable will" that good people have that keep them from doing bad things. The person feels this and is afraid to ask, and society feels this and will punish you for doing so.

It's like how mental health issues, like suicide attempts can go into your police file and keep you from being allowed to cross the border. These sorts of cultural impacts cause people to be afraid to look for help, and not just be afraid, but be punished for looking for help.

I think for the person in that situation, there's very little you can do to change the rest of society. But I think you can change your own mind, and I don't mean you can buck up and use that indomitable will to shrug off your addiction. I mean, you can recognize that you aren't a bad person or a weak person. You're not significantly different than your neighbor, it's just that you had a different set of circumstances 30-40 years ago and ended up learning a different set of habits and coping behavior. Had they been exposed to the same things and presented the same circumstances, they could be in your shoes.

You can identify the small things in life that are important, and you can look towards what is needed to make your life a bit more like that. It doesn't even have to be getting rid of your addiction, it could be that you want to keep your home tidy, it could be that you want to eat breakfast in the morning, it could be that you want to get in shape, it could be that you like to read Stephen King novels, it could be that you want to spend time with a friend. And you can do little things to move that forward. You can throw a couple of things off the counter into the garbage, you can get a dozen eggs for breakfast tomorrow, you could take a walk around the block, you could read a chapter, you could chat with a friend for a few minutes.

It's a matter of not believing the lie that you're any better or worse. You're a person who does some things. You've done some hurtful things, but at this point you can only do things now. You aren't a bad person, you aren't a good person. You're a person who can do things. And while society can limit their interactions with you because of their own mindset, you still have a lot of latitude to do many things despite that.

You're judged by your lifestyle. Yeah, that's unfortunate. But you can still clean your house, get up early and go for a run, eat some breakfast, read your favorite books and chat with your friends after work. The unfortunate part is that even if you "get your life back together" people's mindset might never change and think about the fact that people aren't strictly good or bad. It's more likely they'll just think you've changed and now you're good.

But maybe you will have learned that, and that's something.