Andrey Nailor, M.D.·Published 27 September 2008·7 min read
Key points
You may have begun to use alcohol or drugs because of the temporary relief you got from emotional discomfort.
What has happened is that your brain has learned that the drug produces pleasure.
As your main interest in life becomes supporting the addiction, other activities become less important.
Typically you will not see the ways in which your drinking or drug use interferes with relationships.
You may have begun to use alcohol or drugs because of the temporary relief you got from emotional discomfort. But there comes a point when the drug takes over and through its effects on the brain becomes its own motivation for continuing use. At this point, addiction - with the associated changes in brain functioning - has occurred. There is no way to tell exactly when this happens, but once it does the addict has another dilemma. What used to be a handy tool now becomes a heavy burden. One cocaine addict put it this way: "I was spending a hundred dollars just to feel nervous for fifteen minutes. But I couldn't stop." The drug wasn't doing what it was supposed to do any more, but not using was no longer a choice. The inner drive to use has little to do with the reason you started.
What has happened is that your brain has learned that the drug produces pleasure. The pleasure center in the brain sends strong signals to other parts of the brain and motivates you to use again. Once this has occurred, your choices about drug use become more and more irrational. This powerful effect reinforces the denial mechanism. The personality starts to change as your basic goal in life becomes supporting and continuing the addiction.
You become more and more self-centered. As your main interest in life becomes supporting the addiction, other activities become less important. You might skip social events if they don't provide an opportunity to drink or get high. You begin to choose friends based on whether or not they drink or use drugs. If you're hung over on a Monday morning, you might call in sick to work.
Typically you will not see the ways in which your drinking or drug use interferes with relationships. When arguments occur about your behavior, you defensively blame the other person instead of looking at yourself. When you're intoxicated, you are more likely to act on feelings of resentment, which leads to fights. The emotional needs of the people around you become less important, and you may find your-self resenting your spouse or children because they seem demanding. Having given the addiction the highest priority, you have no problem with diverting funds to support it, regardless of other necessities. This leads to more fights and more resentment.
Some people are able to maintain a modicum of functioning while continuing their addiction. You might control your behavior just enough so that you can avoid some consequences. For example, you might be able to keep your job and avoid legal difficulties. But it is likely that your relationships are suffering and that you are not realizing your potential for achievement. You are also risking the physical complications of your addiction, such as cirrhosis with alcohol or lung damage with marijuana.
While all this is going on, the spiritual life is suffering as well. A person's relationship with God goes on the back burner along with all other relationships. Religious teachings and moral imperatives become relative rather than absolute.This allows the addict to continue without experiencing guilt.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.
Many people develop resentments toward God. This might be because of something terrible that happened or it might be the consequence of a consistent turning away from God.
In any case, by the time the addiction is full blown you are spiritually bankrupt.
A moral deterioration also occurs while the addiction is progressing. This can be striking in the case of strongly addictive drugs like crack cocaine. People find themselves selling cherished personal belongings, going through savings accounts, stealing from family members, shoplifting, trading sex for drugs, or becoming entrenched in a criminal underground.
You become caught in a cycle of denial, rationalization, and justification. You might have a bit of insight; in quiet moments, you might suspect that the addiction is not worth the price. But when the motivation to use again kicks in, this voice is stilled. Everyone else becomes the enemy - the angry spouse or parent, the "narcs," the straight-laced church people, the unreasonable boss. The addiction has created an illusory world in which it is the number-one priority. The reason you started using has disappeared, and the temporary relief the substance gave you has long since diminished. {pagebreak}
You are stuck with whatever the original problem was - shyness, anxiety, depression, abuse - and now you have more problems piling up as your world collides with reality. Relationships break down, jobs are lost, financial problems build, and you may have trouble with the law as well as physical problems caused by the addictive substance.
A housewife who started drinking at night to get to sleep finds that she cannot sleep at all, despite drinking continuously all evening. A trucker who began using amphetamines to stay awake during long hauls finds that he can't keep his weight up, that he is paranoid and restless, and that his skin is breaking out in sores. A college student who started using marijuana to relax at parties finds that he can't get through the day without smoking, that he is coughing all the time, and that he is failing in school.
During the time that this downward spiral is occurring, you are probably making some attempts to control it. You might adopt various rules - no hard liquor, only beer. No drinking before five p.m. on workdays. Drinking only on the weekends. No more crack, only marijuana. No more than fifty dollars per week on drugs.
{embed="ref/stat-menu-addiction3"}
You might even stop drinking or using for prolonged periods of time. But because you haven't addressed the other issues, this attempt will eventually fail. You are attacking the symptom - the use of the substance - without looking at the cause, which is the addictive disease itself with all its different aspects.
A "dry drunk" is an alcoholic who has stopped drinking because of the negative consequences but has never looked at the damage that has occurred to relationships, personality, and morals. If you're in this situation, you are probably miserable. Addiction professionals call this "white knuckling," because it's as though you're holding on so hard to keep yourself from using that your knuckles get white. And eventually you get tired. It's at this point that addicts often switch their drug of choice, from alcohol to marijuana or benzodiazepines, from opiates to alcohol, from cocaine to crystal meth, and so on.
If you manage to stay dry and not relapse or switch substances, you still suffer from the distortions in thinking and the damage to relationships that developed as the addiction progressed. You probably continue to place blame elsewhere for your shortcomings and to be self-centered and insensitive to the needs of others. Your self-esteem and sense of realistic effectiveness have been damaged by the addiction. As one recovering alcoholic put it, "I'm not going to be a dry drunk, because I can be just as unhappy drinking."
Where is this spiral leading? Remember the lab rats who are given a choice between food pellets and cocaine. They will press the lever for the cocaine, despite their need for food, until they collapse and die. Even self-preservation takes a backseat to the addiction. "I knew that I was either going to stay messed up, get locked up, or get covered up," said one woman at a treatment center. That is the truth about addiction. You might be able to continue to control environment and consequences for a while, but eventually your quality of life suffers, and the outcome may even be death.
In some ways people with more destructive addictions are fortunate, because consequences are severe and obvious and the dreadful possibilities are laid out before them over and over again. People who experience less dramatic consequences might continue using or drinking all their lives without ever facing the need to recover. But their relationships wither and their spiritual life fades away.
The choice is this: recovery or death. Addictive disease is a fatal illness, with no cure. There is a chance for a reprieve.
Addiction can be brought into remission, and the addict can begin repairing the damage and rebuilding his or her life.
But addiction is the only fatal illness I know of that contains an element of will. The addict is the one who chooses the outcome. Addicts in recovery choose their outcome every day, and so do active addicts. With every day that goes by, you have the choice: addiction or recovery.
Recovering addicts describe this as an elevator going down.
The bottom floor is death. You can get off the elevator at any floor you choose, or you can ride it all the way down.
News
News
News
