Substance Abuse is a Brain Disease: George Bortnick, Psychology

George Bortnick is an assistant professor of psychology at New England College. He has worked for Keystone Hall, a nonprofit that offers residential and outpatient treatment and support services in New Hampshire, as a substance abuse counselor in the drug court and prison programs. He discusses why substance abuse counselors are needed, why students want to enter the field, the challenges of funding and other topics.  

George Bortnick
George Bortnick teaches psychology at NEC and has worked for Keystone Hall, a nonprofit offering substance abuse treatment services.

Why is there a growing need for substance abuse counselors?

If you truly look at the statistics of addiction, it’s always about 10% through the history of time – 10% of people have addictive personalities or get addicted.

The issue now is the drugs are people getting addicted to. Forty years ago, it was alcohol, which can take a long time to destroy the body, whereas meth or opioids can destroy the body much quicker.

Where do substance abuse counselors work?

They can work in a variety of settings – it can be very intense, or it can be just sort of like checking in. They work with the individual directly or in groups. It could be rehab, it could be outpatient facilities, it could be a methadone clinic.

Based on your experience, why do students want to enter this field?

For most people entering the addiction field, there is an underlying reason why they want to get in the field. When I teach an addiction class, I’d say out of 30 students, two to four would admit to having their own personal addictions, and another two to four would admit to having a family member (with a substance abuse problem).

What can students expect to learn?

What I like for people to come away with, especially in an addiction class, is understanding that addicts are human beings first. I think the one thing to get people to understand is that it’s a brain disease. We need to approach it from a medical or biological or emotional sort of an issue, as opposed to a selfish sort of issue.

How do we reduce the stigma related to substance abuse?

The more you know individuals, the more you interact, the more you come across people who are dealing with it, the more you understand it. If it’s a friend or a family member, you wouldn’t be mad at them for being an addict – you know who they are. If you don’t look at them, it’s just a statistic. But when you only look at statistics, whatever the issue is, you don’t necessarily know their story or know the struggle.

Until I started working in the field, as far as I knew, I never knew anyone who did heroin, I never knew anyone who did methamphetamine.

What is the status of funding for substance abuse programs?

The tough part is always the funding aspect of it. I understand both sides – we don’t want to pay too many taxes, but at the same time, if we don’t end up doing anything, the problem ends up making us spend more on it and we end up building more prisons and locking people up.

For now, the outlook is positive. But with any movement, the American people have about three to five years of patience when you’re spending their money. If they don’t see progress, they don’t think it’s gotten any better. That’s why I worry, because both political parties manipulate statistics and numbers. Neither side gives an accurate representation of how something is working or not working. It’s less about who’s the president – it’s more about the attitude.

Is there a difference between people who are entering treatment voluntarily and those who are mandated to do so?

Attitude can be a big problem. A lot of times, when you force something, they don’t want to do it or they just do the bare minimum. Then the struggle comes in. People might agree to it because they don’t want to go to jail, but it’s not that they really want to stop using.

What can we learn from other parts of the world?

In Portugal, they decriminalized all drug offenses. Obviously, it was still illegal, but you didn’t go to jail for it. The use of substances went slightly up – there was an increase in people using it, but there’s not an increase in people abusing it.

Criminalization does not work. We’ve known that for 80 years and haven’t reduced the problem.

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