What Drives Addiction?

I am beginning to wonder if drugs are already the leading cause of death, to include alcohol and tobacco, along with all pharmaceutical and street drugs. The notion is not far-fetched when you consider this takes in all accidental overdoses, accidents related to impaired judgement, violence relating to drugs, hospital drug errors, adverse reactions, and drug incompatibilities when a person has a chemical soup of drugs within their system.

The only reason I have an understanding of addiction, is because of my own background and family history. I do understand what the cycle of addiction is, and how it can be shuffled onto a different circuit.

For some people, especially those from very stable backgrounds, addiction is difficult to understand. There does seem to be a genetic trend. Most of all, there is a trauma trend within the family of origin. Addiction is escapism. It is an attempt to elevate the mood, and block out pain.

When opiates were given out en masse, such as when Oxycontin was first introduced, and Tylenol #3’s were handed out like candy, it was known that opiates are addictive. Alcohol seems to be more insidious. But regardless, the cycle of addiction is one of shame and escapism.

If there is a strong sense of familial judgement and rejection, or a loss of sense of self, a person struggles to cope. The only way to cope in a world that you don’t seem to belong in, is to try and find ways to escape it. Of course, that’s not the logical and healthy way to deal with things, but you don’t realize it until you are in too deep.

Addiction is kind of like wading or swimming in crocodile infested waters. Some are oblivious to the danger that lurks below. Some can go swimming hundreds of times and never encounter a croc. Others get grabbed, rolled and spit back out. If they wade back in, what is going through their mind?

Addiction grabs certain people and drags them under in no time flat. For others, they might be able to manage their addiction for years, but if they are faced with trying circumstances, like family breakdown or an accident, they become vulnerable.

Addiction in my opinion, is driven by fear, trauma, escapism, and a cycle of shame. Even for those who are addicted to power and wealth – it is a quest to elevate oneself out of that cycle of shame.

Addiction, in all of its forms, does lead to illness and multiple co-morbidities. It robs quality of life. It destroys the family lives of millions of innocent children. It ostracizes and excludes, which increases the alienation and downward spiral.

Yet paradoxically, some of the most brilliant and creative minds were also the most addicted. Just look at all the great musicians who succumbed to addiction. Or probably one of the most incredible dichotomies is that of comedian and actor Robin Williams. His brilliance and wit was a polarized diversion, and self distraction from the pain within. He is probably the most profound example of the two faces in Greek theatre – one comic, the other tragic. He was honest about his alcohol addiction, and as a result, his humanity and compassion deepened.

Going through addiction is life altering. The addiction itself becomes the biggest threat to survival. Once addicted, it is not only the family of origin, rejection, grief, and inner demons that caused you to seek out the escape route in the first place. You keep all those things filed away, and find yourself in a bigger snare than ever. The substance, or whatever is feeding the addiction has to be stopped before the central cause can be addressed.

In many cases, addictions are simply substituted for something equally addictive or even worse. The alcoholic might get prescriptions for benzodiazepines. The opiate addict might get a prescription for methadone. The tobacco addict might start smoking the occasional cigar. We are all capable of creating a dizzying game of spin the bottle – to point us to another option, that leads to the same conclusion.

Although everyone has a different journey in life, and addiction is a soul journey more than anything, my opinion is just one of many. But, through it all – I believe the only viable option is to quit. Don’t necessarily quit cold turkey, since many drugs must be tapered to avoid severe and sometimes dangerous withdrawal symptoms.

But first and foremost, the addict has to contemplate, and then make a firm decision to quit. Then we must reconcile the fact it is not quitting alone that is going to save us. The solution is in quitting, and never starting again. I realize it goes against the grain of those who advocate for compassion and acceptance of failures and relapses. By all means, shake the failures off and carry on – but never lose sight of the fact that quitting is the only path to recovery, to feeling better, to getting over the past, and to overall healing.

From a neurochemistry perspective, addiction is tied to dopamine and adrenalin. If you take the adrenalin cycle involved in family trauma, is it any wonder people develop escapist methods of coping? Adrenalin is meant to prepare people for flight or fight. But if you are in a family dynamic, or a situation where you can do neither, the natural inclination will be to find other methods of escapism.

It also helps to explain why some people have to deal with a significant amount of suppressed anger, as part of the recovery process. If you have never been permitted to assert yourself, it is like braking out of chains at first. Geographical cures might work for awhile, especially if you have to physically distance from an abuser or an untenable situation. However, the monkey on your back might stick to you no matter what.

In a sense, we have to develop a lightening rod to ground ourselves during times of hurt feelings, and the whole flight or fight chaos within. The adrenalin component, once settled down to a more normal neurochemistry, will still be triggered. Peace of mind increases with faith. Faith is knowing that eventually there will be justice.

Every facet of health care has to deal with addiction. In maternity, you see addicted moms and babies going through withdrawal. In the emergency departments you see people who are referred to as frequent flyers, who are there to get drugs for chronic pain. In liver clinics, there is liver failure and hepatitis from drug or alcohol abuse. In surgical units you see people go into detox when they are admitted without staff knowing what they are addicted to. In geriatrics you see the falls, disorientation and cognitive decline related to alcohol, sleeping pills, and other prescription drugs.

In fact, addiction is so pervasive and so common, it is the proverbial elephant in the room. It is inappropriate to accuse someone of drug seeking. What about the person who has chronic pain or is still requesting opiates for surgery they had three months ago? Somewhere along the line, someone needs to warn them. Not with judgemental shaming, but with an open conversation about what to expect if the drug is continued. People need to learn about the physiological effects of addiction. They need to correlate it with gut health, liver health, brain health and evaluate how it is affecting them, before they get to the point they cannot even read.

The more unwilling we are to learn about addiction, the more denial there is surrounding it. There are so many tragic stories. The parents of young people who overdose often don’t realize the extent of the addiction until it is too late. We have to keep in mind that contrary to what many people believe, addiction is prevalent among high achievers.

What do we have to quit? We can’t quit food. We can’t quit making money. We can’t quit where we came from, our genetic markers, past trauma etc. But we can quit whatever has plunged us into a toxic cycle of self-destructive abuse. Some things are far more damaging and gripping than other things.

Any substance that causes withdrawal when you try to quit should be a big red flag. Harm reduction involves self care, in particular good nutrition and an alert mind. There are spiritual forces greater than we are – that can grab us, and drive us back into the abyss. We have to find ways to resist.

The relapse rate following rehab is over 90% What does that tell us? Quitting doesn’t last, so what is the point? Or does it tell us we are going about things the wrong way? I watched one program where a thirty something year old person was describing her addictions. She had been to rehab seventeen times, and did not think the programs were tailored to her specific needs and personality. Forget that. It is obviously not working anyway.

Instead, people need support during detox from a medical and physical perspective. After that, the process of rehab should not require long stints in a facility. If it does, the facility should be on a farm out in the boonies somewhere. Rehab involves a multi-layered approach, with family at the centre of the support system. If not family, a community network supporting job skills and talk therapy. There is no point in going through rehab only to return to the same environment you came out of. The paradigm has to shift. Most reasonably healthy people can go through detox to get past the acute phase, followed by a focused recovery plan and change in old habits.

Addiction is about worthlessness. Our society has taught us that we are worthwhile based on image, wealth, jobs, education, and what we own. If we have nothing, we are far closer to being worthless than if we have a nice house and fancy car. But what many learn, is that addiction can be hiding behind the closed mansion doors, just as easily as it can be on the streets.

If we try to elevate our worth by accumulating stuff, it makes for distraction, but it does not really work to elevate self worth. If we try to look good, we feel fake. If we try to do good, it seems futile. If we try to belong, we get rejected.

What does that leave us with? And who is driving our destiny? I have come to believe that addiction is a spiritual journey. The most valuable lesson on a personal level, is if you are vulnerable – don’t go near the croc infested waters. If you get grabbed and rolled, and make it out alive – thank God, and do not wade back in.

Every addict is an extension of their family. It is not a matter of seeking who to blame – but how to offer love, acceptance, and understanding for the original and authentic person. Rather than focus on the bad behaviour or shame associated with the addiction, people need positive affirmations. They need to know they are not ALL bad.

At the same time, we all need to take responsibility for our own lives, and possible contributions to either enabling, or to the shaming and rejection that exacerbates addiction and family breakdown. Adults with dominating traits need to listen to the other members of the family, and stop trying to control them. The intimidating sense of disapproval, combined with being crafted into someone else’s plot, is dehumanizing and oppressive. It is designed to push a person into escapism since reality takes away your freedoms.

Family breakdown is central to addiction, and is responsible for intergenerational patterns. The weak and vulnerable in such situations do not survive. Or sometimes it is the rebel who becomes the family outcast. There is a circuitry of love within a family, like an electric current. If there is a broken or outcast link or connection, it contributes to a broken family.

There will always be conflicts in life. But a stable family remains intact, and every individual is forced to examine themselves without revolving around a set power structure. Individuals need to be heard in order to be empowered. Some people actually are mentally ill. Some are character disordered, or addicted, or whatever. But if a family is tormented, there will be much more addiction, and intergenerational patterns of addiction.

It is important to find ways to resolve our differences without dehumanizing another member of the family, or trying to get rid of a family member. To do so breaks the family bonds. It shows a lack of responsibility and a lack of vision. The patterns have to be identified and broken – instead of repeating the patterns, and breaking the family.

Addiction robs people of who they are. We only see the scrappy tent and pile of garbage, without seeing the person inside. Every addict was once a child. Every child and every human being deserves love. Love is the rock to climb onto if you fall out of the boat in dangerous waters.

For those who love their own lives too much, they will lose it. For those who love others, we will gain the spiritual reckoning that saves us.