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Comment by trentnix | Hacker News Reader

While we're at it, let's de-stigmatize the abuse of substances and treat it like a real mental health issue.

Literally everyone involved in the treatment and support of substance abuse does that, whether it's treatment facilities or social groups like AA and Al-Anon. As they should. Every family I know has been affected in one way or another by drug or alcohol addiction and has firsthand knowledge that substance abuse must be treated like an illness and to forgive (but not forget) the damage it causes. So I'm not exactly sure your statement reflects reality.

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Have 1000 people tell their boss they need a month of paid leave to deal with an acute cancer treatment or recover from a kidney transplant.

Have 1000 people tell their boss they need a month of paid leave to deal with alcohol addiction.

Measure the immediate reactions and future performance review and employment outcomes of the two groups. Do you expect them to be the same as each other? I don’t and I think it comes down to “I or a family member could get cancer or kidney failure” vs “alcohol addiction is a choice” thinking.

Apples and bowling balls. As I said in another comment:

While substance abuse is an illness and should be treated as such, it's not leukemia or muscular dystrophy. It requires an active participant to make a concerted effort to obtain and abuse an addictive, destructive substance. So it's no surprise that substance abuse might not be given the same level of sympathy.

I think many managers would prefer the latter because getting sober should have mainly positive effects on my employee's health and performance whereas an organ transplant or cancer seems much more likely to come with longterm disability and accommodation needs...

"Literally everyone involved in the treatment and support of substance abuse" is a small percentage of the population as a whole, and a very, very small percentage of the people who make policy and resourcing decisions related to how substance abuse is handled.

You may be in a particular microcosm that handles this well, but that is definitely not the universal experience (not by a long shot). I'd also dispute the "literally everyone" part of your comment, as I can think of countless examples of attempts at substance abuse treatment and support being actively harmful to the person struggling with addiction.

It's not treated that way by society at large.

Treat here not in the "provide medical care for" sense but in the "interpretation" sense, as in, "I know it's a polka, but I'm going to treat it like a waltz."

Once again, I think that's a fun thing to see because it's always nice to dunk on the broader culture, but that's genuinely not been my experience. People are generally very understanding and considerate of substance abuse situations and the carnage that surrounds it.

And it should be noted that while substance abuse is an illness and should be treated as such, it's not leukemia or muscular dystrophy. It requires an active participant to make a concerted effort to obtain and abuse an addictive, destructive substance. So it's no surprise that substance abuse might not be given the same level of sympathy.

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