The Roads to Addiction
According to experts, there’s a range of bio-psychosocial factors that increase a person’s chances of becoming addicted to alcohol or other drugs. For example, if an identical twin with an alcoholic parent develops alcoholism, an amazing 60 per cent of their identical twins will also develop alcoholism, even if raised by non-alcoholic adoptive parents.
Brain chemicals occur in different proportions in different people, causing alcohol to affect people differently. For example, some people experience higher levels of anxiety, which alcohol seemingly normalises. Consequently, alcohol’s calming effect gives people an incentive to drink again. But continued use eventually leads to tolerance. In time the person requires more alcohol to achieve the same effect, leading to a downward spiral into addictive behaviour.
Sons of alcoholic fathers are actually less affected by alcohol compared with sons of non-alcoholic fathers. Give both groups the same amount of alcohol, and those with alcoholic fathers feel less of a buzz.
Not one single gene but many contribute to addictive tendencies. Even if you have them all, you won’t necessarily become alcoholic—biology is not destiny. Knowing you have a tendency, you can choose never to drink, even socially, and avoid the problem. But remember to be aware of addictive tendencies in other areas, such as gambling, sex, work, eating and even shopping.
On the psychological side, certain psychological events can make it easier to become dependent on chemicals.
“I’ve always felt different, and when I had my first drink, I felt as though that invisible wall between myself and others had miraculously disappeared. I was ashamed of the light-coloured patches on my skin, but after drinking, it didn’t seem to matter anymore,” a patient said.
A nurse, who drank from age 10, had endured sexual abuse, so to her it made perfect sense to start drinking to numb the fear, anguish and pain. Many soldiers use alcohol or drugs to numb memories.
“I drank in order to get to sleep. I couldn’t sleep because I was terrified of what God would do to me in order to punish me for what I did during the war,” one former soldier told me. His face told of the reality he felt.
Some are easily bored, always have to try something new, stir up some trouble or check out trouble brewing. Punishments don’t faze them and rewards don’t have much influence. This is the type of person most apt to experiment with alcohol or drugs—and also to become addicted.
No-one is immune to social influences. Research shows that as cigarette prices increase, fewer teens take up smoking. It’s apparent that the drugs that cause the most problems are the drugs that are the most available and cheapest–alcohol and tobacco. And they cause more than 25 per cent of all deaths in Western countries, more than any illicit drug.
That some drugs are illegal doesn’t prevent everyone using them, but it does prevent some. More people use legal drugs and, as a result, if they have genetic tendencies, they will then become addicted to them.
If a teenager can avoid smoking up to age 18, the chance of their ever using drugs or becoming addicted to drugs is very small. On the other hand, using alcohol or smoking cigarettes or marijuana doesn’t always mean going onto cocaine or heroin. But most who use amphetamines, cocaine and heroin began with legal drugs.
Attitudes toward social drinking also influence how many become addicted. What some do under the influence may be humorous, but it is also tragic. There aren’t many jokes about those with diabetes or cancer, but we make jokes about alcoholics. This reveals permissiveness to the problem. Instead of laughing at the results of excessive drinking, we need to recognise it for what it is: a person in need of help.
No-one becomes alcoholic intentionally. Everyone rationalises the process in the early stages. “I’m just having a little.” “It’s just enough to feel good.” “I’m just having some fun!” “Oh, just this once. Just to be friendly.” Yet I7 per cent of the population will end up having regrettable and often uncontrollable problems as a result.
So why is it easy to become addicted? The affected area of the brain controls what is called the reward system. Often, special cells in the brain are activated when you feel pleasure. Addictive drugs activate these brain cells and pathways.
But normal, healthy behaviours can activate these same areas too. For example, if you receive a good grade on a test after hard study, you feel a surge of pleasure. This helps you remember what it took to feel good, and you’ll study hard for the next test. If you act unselfishly toward someone you love and they respond in a way that makes you feel good, you unconsciously say to yourself, I’m going to act unselfishly again in the future, since I like feeling this way.
Unfortunately, if you take a short cut and use a drug to obtain this same feeling, you will more likely remember the short cut and repeat the act to feel good again. This causes a surge of feeling to become the goal rather than the process and eventually you become addicted to the short cut.
Early signs of addiction aren’t hard to spot, but it’s easier for the onlooker to detect than the addicted person. Initially there’s a feeling of embarrassment, followed by guilt. Next there’s a tendency to minimise or avoid the topic, to blame something or someone else. Because admitting the truth would cause an addicted person to feel terrible, they often describe their lives as overwhelmed by stress, fatigue, a lousy job, a nagging spouse, bad luck or judgmental friends.
If avoiding the topic doesn’t work and others continue to remind them of their drinking, the addicted person may turn to anger in order to frighten off their friends. Then the alcoholic and the family become isolated, dropping out of the social scene, even avoiding family gatherings or social activities.
Outrageous techniques are used to hide substance abuse. One of my patients would pour alcohol into a hose. Telling his wife he was going to work in the yard, he would then make multiple trips to the hose to get “a drink of water.” Another patient, an elderly grandmother, would drink alcohol only from a thermos so her family would think it was coffee.
Eventually, financial problems begin to develop, with more money being spent on the addictions and not enough on life’s necessities. Additional money is spent on the resulting problems—accidents and drink-driving violations. A spouse may have to assume more responsibilities, which eventually cause fatigue, depression, insomnia, hypertension or headaches and backaches.
To avoid embarrassing, unpredictable encounters, children don’t bring friends home. Eventually problems develop on the job and in the physical health of the substance user. Not all doctors or counsellors are comfortable confronting the problem, so the problem can persist until it can no longer be ignored. This often results in serious medical problems, divorce or death.
Family members become trapped to the same degree that the chemical traps their loved ones.
“My son is using heroin, and he won’t stop,” said one woman. I turned to the son, but he wasn’t sure why his mother was so upset.
“Yes, he lives at home with me still,” she said. “He won’t take care of himself, so I end up doing the cooking for him and cleaning his clothes. Sometimes I find myself lending him money, knowing he will use it to buy drugs. I’ve even found myself driving him to where he can buy. I know I shouldn’t, and I promise myself it will be only this once, but it isn’t. I’m hoping he will see how much I love him when I make these sacrifices and that seeing this love will motivate him to change.”
It wasn’t working, and she needed help to practise tough love, not permissive love. She needed new ways of thinking, just as the patient did.
It was once believed that an addict had to “hit bottom” before being willing to receive help. Hitting bottom meant losing self-respect, friends, family, home, money, job and health. We now know that it needn’t become this severe if the right techniques are applied early enough.
It’s unusual for the patient to wake up one day and say, “Today I will get help.” Generally it takes external pressure from the family, concerned colleagues at work, a doctor or the legal system before one chooses to make changes.
Just as a diabetic or someone with hypertension is not able to “think” their way to health, so a person with alcohol- or drug-related problems needs to follow directions and a plan of recovery to achieve success. It’s usually an ongoing process that requires vigilance, new ways of thinking, spiritual renewal and guidance from experienced helpers.
Even for those not willing to receive help, there are caring and supportive ways to encourage them. For professionals such as doctors, dentists, nurses and pharmacists there are programs of help referred to as “diversion.” And a person doesn’t have to be an in-patient in a program; there are many effective outpatient programs. Some will need to stay in a recovery home if they are homeless or jobless. Self-help groups abound for all forms of addiction.
Humans will always be prone to addiction. The good news is that recovery is possible. I see it every week. I’ve seen lives changed from hopelessness to hopefulness.
So if you’re concerned about someone with an apparent addiction, don’t delay seeking help. You may be the one to begin the process of healing for a friend or loved one.
Adapted, with permission, from Vibrant Life.
reality checklist
To determine whether or not you may have an alcohol or drug problem, check off any of the following that apply to you:
Preoccupation with the use of a chemical between periods of use.
Development of tolerance to the chemical in question.
Legal problems resulting from substance use.
Limitation of social, occupational, or recreational activities in favour of further substance use.
Withdrawal symptoms from the chemical.
Use of the chemical to avoid withdrawal symptoms.
Repeated and unsuccessful efforts to cut back or stop the drug use.
Affected by the chemical at inappropriate times (such as at work) or when it impacts daily functioning (such as a hangover making a person too sick for work).
Use of more of the chemical than had been anticipated.
Continued substance use in spite of having suffered social, emotional, professional or physical problems related to the use.
Blackouts and failure to remember all or parts of a day/evening while using the substance.
Poor decision making as a result of substance use.
Missed work (if employed) or lower grades (if in school).
Neglect of obligations to family, friends, work, school etc.
Concerns and complaints expressed by family, friends or employer concerning substance use.
Use of the substance to relax, sleep, socialise etc.
Answering yes to three or more indicates an addiction or dependence. It means you should seek help. You’re the only one who can correct the problem.
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This is an extract from June 2003
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