Addiction is like an iceberg: most of the harms are below the surface
A visualization of the direct and downstream effects of addiction.
Even with all the attention that addiction receives in press and culture, I still believe that the scale of the social harms is under-appreciated. As devastating as addiction is for the people who have a substance use disorder, most of the damage happens outside of direct medical harms: the trauma to family members, lost employment, crime, incarceration, and more.
I think of addiction as an iceberg: above the water are the medical harms (overdose, injury, cancer, heart disease) and below the water is everything else.
I built a visualization last week to capture the economics dimensions of this iceberg, with help from some coding tools. I spent way too much time making it look pretty, so please check it out:
The comparison to cancer is perhaps the most telling and applies to families as well as society as a whole. When someone has cancer, their family unites in support. But when someone has a serious addiction, it tears families apart, causing trauma that is often passed down through generations.
I believe a core reason that there’s so little patient and family advocacy for better addiction treatments (unlike for cancer, HIV, Alzheimer’s, etc) is that when you are close to someone who is addicted, all your focus and energy is going into arguing, pleading, and coping with the damage. It’s hard to step outside the blast radius to demand better medicine.
Screenshots of the icebergs are below, but it’s much better when viewed at the link above.
