Hooked

Yesterday, in the comments, Milan chided me for misrepresenting the nature of addiction in my Get Poor Quick post. He said, in part:

In short, I don’t think addictions are something that people stumble into because they are careless or stupid. Rather, they are serious afflictions that affect many people and don’t necessarily indicate immorality or a lack of will.

I hope  most people understood that because of the satiric nature of the post, I was not trivializing actual addictions or the people who suffer from them. I was rather, trying to make a point about factors that contribute to poverty.

However, Milan’s comment did get me thinking about the nature of addictions and how very prevalent they seem to be these days. Are there any celebrities left who have not been in rehab? Even Robert Munsch recently confessed his problems with alcohol and cocaine.  Guys caught cheating on their spouses suddenly all seem to be “sex addicts”. Stars with weight problems are “food addicts”. Victoria Beckham is a “shopaholic”. Which prompts me to ask – is there a difference between addictions to substances like drugs and alchohol and addictions that are behaviour-based like sex, shopping, gambling, eating, exercise, staying with a toxic partner,  etc.?

From what I understand, the thought processes, the reward/letdown cycle, the consequences and recovery process for both substance and behavioural addictions are very similar.

I can see when you’re altering your brain chemistry with a substance that this would increase your chances of becoming dependent on that substance. Does brain chemistry get similarly altered when you gamble compulsively or consistently over-eat? Or does lumping substance addictions with behavioural compulsions somehow trivialize “real” addictions?

Is there such a thing then as an “addictive personality”? Are some people more likely to become addicted to both dangerous substances and dangerous behaviours than others and why?

There is a link between genetics and addiction vulnerability. Research has pretty much determined that addiction is approximately 50% genetics. In fact some say that we all have the genetic predisposition for addiction because there is an evolutionary advantage to addictive behaviour. For instance, in the wild, it’s safe and advantageous to return again and again to a good food source. So, the potential for addiction is probably hardwired into our brains.

Whether or not this predisposition manifests as addiction seems to depend on various factors including environment, physical/psychological trauma, and coping skills.

I admit I don’t understand addiction at all. All the reading I’ve done on it and all the people I’ve talked to who have suffered from addictions, haven’t really helped me to understand it.

I want to understand it, but the idea of consistently consuming something or engaging in a behaviour that is self-destructive – long past the point where you hate yourself for doing it and long past the point where it’s destroying all the other areas of your life – makes no sense to me.

I mean, sure, we’ve all engaged in self-destructive behaviours at times, but it mostly doesn’t result in an addiction. For instance, I smoked for many years and they tell me nicotine is addictive, yet when I decided it was time to quit – I quit. I’ve known a lot of people who were almost compulsively promiscuous for years, but when they got married were faithful spouses. I’ve even known people who’ve had some pretty serious issues with alcohol to the extent that anyone who knew them would say they were alcoholics, and yet they were able to cut back their consumption to one or two drinks a week with no problems; no binging; no transference to another addiction.

And yet, some people take their first drink at maybe 14 or 15 and are instantly alcoholics. Some people have had a cancerous lung removed and still can’t quit smoking. And some people keep packing on the pounds year after year even though they haven’t been able to bear to look at themselves in the mirror for ages.

I knew a man who gambled away his family home, all their savings, his RRSPs his kids’ RESPs – he maxed out all their credit cards and then went and borrowed money from a loan shark and gambled that away. His wife finally figured out what was going on; divorce was threatened; counseling was undertaken and his access to money was severely restricted so that his paycheque went directly to the wife. They lost their house and pretty much everything else they owned of any value to pay off their debts. And still, he found a way to continue gambling.

Why can’t they stop? Especially when they have every reason in the world to stop? Especially when they’ve been offered all the help they could possible want or need to stop? People often ask: Are they weak? Selfish? Lack self-control? Are some so-called addictions just an excuse for bad behaviour?

It’s mind-boggling isn’t it? The only thing I can think is that whatever pain an addict is trying to obliterate with his/her addiction has to be so much worse than whatever the addiction is doing to them.

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16 responses to “Hooked

  1. I think that when one is truly addicted to something, it takes an extreme amount of will power to stop whatever it is that is addicting.

    I don’t think that those of us who have never suffered an addiction can ever really understand what it is to be addicted. It just doesn’t make sense.

    I started smoking in 1967. I quit in 1969, 1971, 1973, ’74, ’76, ’78, ’79, ’80 and 1981 — and, in several of those years, I quit more than once.

    Was I addicted?

    I don’t know, but it sure was hard to quit. I tried all kinds of different ways over the years. However, cigarettes were always available. There was always someone I could bum a smoke from. There were cigarette machines in almost every business. Sometimes, I lasted a couple of months, but, then, I’d bum a smoke or buy a pack.

    The last time I quit was in February, 1982.

    Since then, I often buy a pack of cigarettes, but it lasts for days at time and never does me any harm.

    You see, the only time I smoke now is in my dreams…, the only time I’ve smoked since February, 1982…., just in my dreams.

    Except for that rotten tasting cigar in San Juan, Puerto Rico, in June 1996. 😉

  2. I’m really surprised XUP — you’re completely right. Your post shows quite clearly that you don’t understand addiction at all, and it actually underscores your (no offense meant at ALL) lack of insight into the subject. It’s not your fault — you’ve never been a drug user!

    I would love to help you understand addiction (which is different from substance dependance) but it’s a big effort to get it across to someone. Societal policy is driven so deeply into our minds that it can be really hard to actually get the message across to someone — because their automatic response is what they’ve been trained by society to do — stigmatize, other, and reject.

    But I will answer your questions: addiction to food, sex, gambling, and drugs are all the same. [I don’t differentiate between drugs and alcohol — alcohol IS a drug and splitting the two words reinforces the myth that alcohol is somehow safer than other drugs, because the government supports it and it’s not a ‘drug’] One of the many amazing counsellors in Ottawa, Jean-Francois of the Sandy Hill Community Health Centre, counsels people no matter what they’re addicted to. Porn, sex, shopping, anything. He makes no distinction between substance and non-substance; he tells me the behaviour and chemical changes are identical to those of an illicit drug user.

    I truly believe the only way to understand any addiction is to have been an addict. As you know, I’m an active drug user, and I differentiate between chaotic and non-chaotic drug use. Because there IS a way to safely use any drug, regardless of how the government arbitrarily divides them into ‘schedules’. And the whole arguement of drugs make people commit crime is ridiculous — but that’s an argument for MY blog 😉

    I would encourage you to read not only my blog, but blogs like JunkE Life (http://opiated.wordpress.com/) and DeQuinceyJynxie (http://dequinceyjynxie.blogspot.com/); although DeQuinceyJynxie is mostly heroin ‘reviews’, it’s a cool blog nonetheless. There’s tons of other blogs about addiction and drug use, look them up and read them!

    And remember — not all drug use is destructive, even though the media portrays it that way. Don’t buy into stigma and discrimination — and don’t hate drug users; we’re people too, with rights and feelings and all the other things everyone else has. We’re your brothers, sisters, mothers, fathers, cousins and partners. If you want to read something really cool, read this:

    http://www.soros.org/initiatives/health/focus/ihrd/articles_publications/publications/nothingaboutus_20080603/Intl%20Manifesto%20Nothing%20About%20Us%20(May%202008).pdf

    VERY, VERY cool manifesto that explains drug users a lot better, and what we’re trying to achieve. At least the non-chaotic users.

  3. Dr. Monkey – Right on, dude!

    Mike – A lot of people I see out at work smoking every day don’t seem at all happy to be doing it. They saying they have to quit. They feel like crap all the time. They have young kids at home and don’t want them to know. Cigarettes cost a small fortune. So many good reasons to quit and yet they can’t. When I decided to quit it was something that had been brewing in the back of my mind for some time. I was sick and tired of the whole smoking thing yet still enjoyed doing it, then one night just thought “enough”. It was the worst possible time to quit because I was in a very stressful situation at the time and the first few days were very unpleasant, then it got easier. After a year I couldn’t stand the smell of them anymore. Cigarette smoke still makes me sick. That’s my pathetic story. So you’re right, someone like me, who has never been addicted to anything can never really understand.

    JunkieMonkey – I was hoping you’d provide your perspective on this. And I’m not offended at all that you think I understand nothing about addiction. I don’t. I’m here to try. So you call yourself an “active drug user”, which means, I assume that you do not consider yourself an addict or “substance dependent”? You are happy with your life? Would you consider your drug use in the same way as the average suburbanite considers his/her alcohol consumption? (Wine with dinner, a martini or two at the end of the day to unwind, maybe a small scotch before bed, a couple of beers on the weekend, etc.) What’s the difference between being substance dependent and being an addict? I totally agree that drugs should be decriminalized. This whole “war on drugs” thing is just a big political hobby horse and a huge waste of police resources and tax payer money. And the only people who are being attacked in this war are the ones that are the easiest targets. If we can sell alcohol in a relatively controlled manner, why not drugs? Then we can totally eliminate the middle man – the criminals – from the whole business. Anyway, that’s not the topic of this post, as you say. I have no arguments with the manifesto you link to. It seems like common sense to me. I would like to understand the chaotic vs unchaotic drug user. I guess chaotic is what we are used to seeing portrayed in the media? The one who is out of control, will do anything for his next fix, will take anything to get high? And non-chaotic would be you and your peer bloggers? I’ve never met you, but I know people who have and I understand you certainly don’t fit that stereotype. I’m going to go read the other blogs you link to now.

  4. Despite being an active area of research for a long time, the academic literature on addicitions remains self-contradictory and uncertain in many cases.

    Why can’t they stop?

    My personal hypothesis is that serious addictions are deeply connected to the central parts of somebody’s personality. The same impulses and responses that drive them to make the other major decisions in their lives are uniquely affected by the drug or activity to which they are addicted. As such, it will never lose its allure, no matter how many harmful consequences it generates, and it requires an enormous amount of will and assistance to overcome.

    On a side note, things are definitely better for those whose addictions are to legal substances. It is difficult enough to wrestle with the cravings and consequences of addiction to a legal drug. Imagine the extent to which the situation becomes worse if the quality and concentration of the substance is unknown, due to being unregulated, and the production and distribution of the substance is bound up with organized criminal groups.

  5. Pingback: The nature of addiction

  6. I agree with Junkie_Monkey about all addictions being essentially the same, whether it’s to a substance or to an activity like computer games or porn or sex or gambling or whatever. It’s about getting one’s needs met. It’s hard to give up something that is meeting a critical need.

    Is there such a thing as an addictive personality? Certain drugs have addictive potential, but not all people are equally at risk for addiction to those drugs. Bruce Alexander did some fascinating studies on this (see Rat Park: http://en.wikipedia.org/wiki/Rat_Park). Subjects whose needs were being met were far less vulnerable to addiction.

  7. I have also read about studies involving animals that live in social hierarchies, such as monkeys.

    From what I recall, while all the monkeys would use drugs like cocaine if they were available, those high in the social order would generally not become dependent or suffer from withdrawal symptoms when they were taken away, while those lower down had those problems more often.

    I read this a while ago, so cannot comment on the quality of the methodology or analysis behind the study.

  8. I’m not addicted to drugs but let’s talk about chocolate. I just can’t say no to that and can’t keep it in the house or I can’t stop eating it. I just love to eat. It’s so much fun to shop and cook and then eat. Am I a food addict? I don’t know. I think about food alot and it consumes a lot of my life. Except for weight gain, I’m not too worried about it.

  9. I think it might all be a question of degree. I think there might be a continuum of addiction, from one extreme to the other, with many many levels in between. That being said, I do think some people really are “addictive personalities”. They seem to be wired somehow to be unable to control whatever it is (sex, drugs, alcohol, cigarettes, you-name-it) that they do/use. We all know people like that. I also know some people who can, say, nibble one small piece of chocolate and really enjoy it – and then put the rest away for another day. I don’t like those people.

    BTW, there’s an award for you over at my place.

  10. Milan – Very true. Being a regular heroine user, I would think would create some biological issues, but the biggest danger would come from trying to buy the stuff, being involved with criminals, finding clean gear and places to inject, trying not to get caught by the police/jailed/living with a criminal record, and just finding safe places to hang out after. The whole illegality of this baffles me. What is the reasoning behind keeping recreational drugs illegal anyway? To protect citizens and keep them safe? (Also, interesting about the monkeys. I’m going to try and track that down)

    Zoom – I’m interested in the concept of chaotic and non-chaotic as JM discusses. That might help me to understand. With substance abuse, part of rehabilitation is to never touch that substance again yet a sex addict or food addict or shopping addict just learns to modify his/her behaviour. And many seem to be successful whereas there are not many alcoholics who can go to becoming social drinkers. There have to be some differences in behavioural and substance-based addictions. I can see how the drivers behind them would probably be the same (unmet needs, for instance), but the process seems to be somewhat different as is the treatment to a certain extent.

    Linda – Well, you’re in the right country for a food addiction. At least you’re getting the very best. Your problem would be worse if you had to indulge your habit on Kit Kat bars instead of fine French chocolate. I think about food a lot too. Sometimes when I wake up in the morning, if I have something special in the fridge for breakfast, it’s actually the #1 that makes me eager to face the day. Sad, eh?

    Pinklea – A continuum, eh? I don’t know. Can you be a little bit addicted to something? The person who nibbles the chocolate and then puts it away isn’t addicted. If you have a couple of cups of coffee every morning are you addicted? How do you decide? Can you go a day without coffee? What happens? Does the thought of not having coffee make you anxious, physically ill, unable to cope? Will you be late for work, skip your shower, whatever it takes so you have time to have coffee? Then I’d say you’re addicted. If it just makes you grumpy not to have coffee then you’re not. Where am I going with this? I don’t know. Just goes to show you once again that I don’t have a clue what addiction is all about.

  11. But with substance abuse the answer is not always to never touch the stuff again. For some it’s replacing the illicit drug with a maintenance dose of methadone, or in places that support it, replacing the street drugs with a maintenance dose of the same drug (heroin users can do this through their medical clinic in the Netherlands for example. They can lead perfectly ordinary lives with this kind of bias free support. Drug addiction does not have to have any more social stigma than an addiction to chocolate, or bejewelled.

  12. I’m with Junkie-Monkey on this.

    I think as a society we tend to make light of addiction as a serious mental health disorder — and of mental health diseases in general. (This post proves it.) But it is a disease, even once an addict stops using, he is still an addict. (Hopefully, one who has had some sort of support to stop.)

    There are physiological changes that occur in the brain that occurs when people are addicted, just like there are physiological changes that happen in people who get Parkinson’s or Alzheimer’s. Yet, still, people feel compelled to link addiction to some sort of character flaw. Frustrating really.

  13. Mudmama – Maybe one of the reasons why drug addiction is such a stigma is because it’s illegal?

    Nat – I’m sorry you feel that I was making light of addiction or mental health diseases. That’s not where I was coming from at all. The topic was raised in my last post and I decided it might be good to discuss it further. I admit I know next to nothing about addiction even after everything I’ve read about it. So, I thought I’d ask some questions. Maybe the questions sound ignorant or superficial to you and I’m sorry for that, but I’m coming from a place of ignorance and superficiality when it comes to this topic. But then perhaps this isn’t a topic people can be educated on. Perhaps only those who have experienced really know what it’s all about and the rest of us should just not even attempt to understand it because we never will and we’ll only appear foolish by trying.

    Zoom – Me too. I don’t even know the right questions to ask, apparently.