The Scarlet Letter Revisited

As a teenager I read  Nathaniel Hawthorne’s novel, The Scarlet Letter. For those of us that haven’t read it, the book chronicles the trials and tribulations of Hester Pyrnne, a young woman living in a New England Puritan community during the 18th century. Hawthorne describes a scene where Hester, who has been accused of adultery, is led from the prison carrying her infant daughter borne of her affair. A scarlet rag, shaped in the letter “A”, is noticeable against the breast of her gown. It is the symbol of her sin of adultery — her badge of shame.

This story came flooding back into my mind when my husband, Ed, and I were at a neighborhood barbeque. At the time, our son Alex was in an inpatient rehab program. One of our neighbors, I’ll call him Joe, cornered me to ask how Alex was doing.  I didn’t know Joe well, but my general impression was that he was a gossiper. I had heard from another neighbor that Joe was looking for juicy details about Alex’s drug use and his incident with the police.

I began to describe the rehab facility and our recent visit in as little detail as I could with guarded politeness. In not so many words, Joe responded by telling me that if we had been more involved in Alex’s life, this never would have happened.  I was speechless – we had been involved in our son’s life on every front – meals together, family outings, coaching sports… We kept tabs on his school work, were involved with the Home and School Association, Boy Scouts, CCD, etc. 

In that moment, I felt like I was wearing my own scarlet letter – that the “A” for addiction was emblazoned on my forehead and would be my mark to bear for as long as I lived. I was embarrassed and ashamed about our situation, not knowing how to begin to respond to Joe’s assertion that we had failed our son. I vaguely remembered mumbling something to Joe, searched for Ed, and told him that I had had enough of the party and wanted to go home. 

It’s been six years since that party.  With a great deal of education, I realize that I had succumbed to what is often referred to in the literature as the “moral” theory of drug addiction. This theory posits that if a person could just muster up a little more will power he or she could overcome the attraction of any addictive substance.

Advances in neuroscience support the fact that substance dependence is a disorder of the brain, just as with any other psychiatric or mental illness. Among other reputable organizations, both the American Medical Association  and the World Health Organization endorse this position. Simply put, some brains are chemically wired differently than others and are far more susceptible to drug abuse. 

In Dirk Hanson’s book entitled, The Chemical Carousel, he describes the work of Dr. Lee Robins of Washington University, who was investigating heroin use by service personnel in Vietnam. Dr. Robins found that nearly half of all soldiers had used either opium or heroin during their tour of duty, with 20 percent reporting that they had been addicted. Upon their return to the United States, only 5 percent of the men who stated that they were addicted in Vietnam relapsed within ten months and 12 percent relapsed within three years. So why is it that with nearly half of the service men using, the majority were able to stop without interventions? Could it be that their brains were structured differently than those who could not kick it?

When I am trying to explain this phenomenon to my friends, I use the analogy of corrected vision. Suppose as a child you don’t have 20/20 vision, but you don’t know it because blurry vision is what’s normal for you. Then one day, an optometrist checks your eye sight and gives you corrective lenses. A whole new world opens up for you with distinct shapes – it’s an “ah-ha” moment as you realize that this is what everyone else sees.

Now imagine that similar to someone who is sight impaired, your brain is “impaired” and short on dopamine or serotonin – the feel good chemicals in the brain, so that day in and day out, you feel down or blah. This feeling is your normal. One day someone offers you a drink or a drug and suddenly you feel great – it’s your “ah-ha” moment that this is how the rest of the world feels.  

You feel that this substance is the best thing since sliced bread and you keep using. The only problem is that the brain is smart and compensates for the chemicals you use by decreasing the natural “feel good” chemicals the brain produces. So, you have to use more to feel the same happy feeling you felt the last time you used. And the cycle continues…

I am not trying to say that there are no environmental influences at play in addiction. I just want to make the point that one’s genetics and biology are significant factors in the whole picture. It is not just a matter of will power.

So thinking back to my scarlet letter “A” for addiction, I have redefined mine to be the letter “A” for advocacy. I want others to understand that substance abuse and addiction are not just a matter of will power — we cannot just will this away.  As a parent, I challenge you to learn as much as you can about this disease. Join me in not only advocating for our loved ones, but also advocating for more research and a cure for substance dependence and addiction, just as one would for any other disease.

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    Tom at Recovery Helpdesk

    October 10, 2010 at 12:56 AM

    I like the Scarlet Letter analogy. I think it’s right on point. And I agree that parents need to learn about addiction, treatment and recovery if they hope to support their son or daughter in making informed decisions.

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    Pat Aussem

    September 15, 2010 at 1:29 AM

    Thanks Ron. My husband and I used to lament that if our child had cancer, people would be hosting fundraisers for treatment, but with substances, they look the other way. We have to help people understand that children (and adults for that matter) don’t chose addiction, just like people don’t chose to have cancer. Just as with cancer, there can be lifestyle choices that are detrimental, but nevertheless, they need our help, not our judgments.

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    Ron Grover

    September 14, 2010 at 5:28 PM

    Good article, there are way to many “Joe’s” out there that can make us feel small with only one comment.

    The only way to change “Joe” is for all of us to stand up and talk about addiction. We need to understand that it is truly a disease in the brain. For too long it was thought of as just a weakness of character. I myself am guilty of that mentality. Unfortunately I had to live the experience of addiction with my son to experience an awakening of what addiction really is and does to a person and family.

    Keep writing, and keep speaking to others about this problem. Wear your Scarlet Letter A proudly. Advocay is nothing to be ashamed of when it comes to dealing with addiction.

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