–by Gary McLeod

I am addicted to crack. That first hit of numbing confidence in my throat was wonderful. The second one too. I did it more and more, wanting more and more. I built a tolerance, a resistance. Months and years went by. The Hollywood level rocks I was eventually doing every day all day were very expensive. I became a shell of my former self, malnourished, bad teeth, very unhealthy in general. I had to do something. It was a do or die proposition. I went to my doctor’s office for help. 

Doctor: “What can I do for you?”

Me: “I love crack but look at me. I am a mess. I only feel good when I snort or smoke. Help!”

Doctor: “No worries, I see this all the time. Here is the plan. You have to try your best to simply cut your use in half. I am going to put you on crack sensitization medication. That should help you lower the dose but you should really just tough out using less. Quit smoking tobacco, that will help. Exercise should help. Eventually you are going to need bigger and bigger doses. Then you die. There is no cure for this as it is a progressive chronic addiction.”

Me: “So I can maintain my addiction to the lovely yellow rocks? Sounds like a plan doc. Sign me up.”

Years go by. The medication worked well but now it doesn’t. I seem to need more and more. Craving all the time. Back to the Doctor I went.

Me: “Meds don’t work no more Doc.”

Doctor: “You should really get off the crack and use cocaine instead. It is much healthier. But in the mean time, we will just have to up your dose. Go talk to the pharmacist. Here is a prescription for a month supply.”  

I am not really addicted to crack or it’s “relatively” healthier sister cocaine. Would it not be ultra unethical for a Doctor to treat addiction this way? What does all this have to do with diabetes you ask? Lets look at that scenario again but with a few of the words changed around.

I am addicted to sweets. That first taste of sweet on my tongue was wonderful. The second one too. I did it more and more, wanting more and more. I built a tolerance, a resistance. Months and years went by. The family size bag of pastries and assorted goodies I was eating every day all day were very expensive. I became a blob of my former self, malnourished, bad teeth, very unhealthy in general. My vision blurred after a doughnut. I had to do something. It was a do or die proposition. I went to my doctor’s office for help. 

Doctor: “What can I do for you?”

Me: “I love sweets but look at me. I am a mess. I only feel good when I eat sugar or drink pop. Help!”

Doctor: “No worries, I see this all the time. You are insulin resistant, also known as diabetic. Here is the plan. You have to try your best to simply cut your calories in half. I am going to put you on blood sugar lowering medication. That should help you but you should really just tough it out and cut the calories. Half the food portions you are currently consuming. No more fat and salt, that should help. Exercise should help. Eventually you are going to need insulin injections with progressively bigger and bigger doses. Then you die. There is no cure for this as it is a progressive chronic condition.”

Me: “So I can maintain my sweet tooth to the lovely baked goods? Sounds like a plan doc. Sign me up.”

Years go by. The medication worked well but now it doesn’t. I seem to need more and more. Craving all the time. Blurred vision came back. Back to the Doctor I went.

Me: “Meds don’t work no more Doc.”

Doctor: “You should really get off the sugar and switch to complex sugars instead. It is much healthier. But in the mean time, we will just have to start you on insulin. Go talk to the pharmacist. Here is a prescription for a month supply.”

Standard of practice for diabetic care. Ethical. Right?