Thus far, I have explored the topic of addiction and broken it down into (hopefully!) understandable stages, Fun and Fun with Problems. In the final post of my addiction series I will review the stage I like to call, Just Problems.
When the only thing you can count on is trouble it might be time to pay closer attention and take stock of your circumstances. When the fun stops, the end is nigh.
Mission: Possible
The occasional headaches resulting from problematic substance use are controllable. Given enough rope though an individual with a substance use disorder will cross that invisible line into addiction. And to survive, she will circumscribe her world into ever smaller and unhealthy compartments.
As a result, individuals in the throes of substance abuse lose things that are known to contribute to a fulfilling life: friends, family, freedom, meaning, economic security, physical health, self-respect.
These losses are mourned, but easily rationalized away. “I never liked that job anyway.” “He didn’t love me the way I wanted him to.” “Everyone in my family has liver problems.” “I needed to lose some weight anyway.”
However, and this is part of the insidious nature of substance abuse, as losses mount there is always a panacea to offset them. Addiction is an infinity loop that veers wildly between extreme highs and lows. When you’re in it though, it’s hard to see any other reality.
To an outside observer this is crazy. Just say no! But to an addict the mission is simple, straightforward, and obtainable: get high no matter what.
What Problem?
At this stage of the game, as discussed in an earlier post, an individual’s substance use is no longer simply a conscious choice. The brain’s short-cut, it’s “chunk” of time- and energy-saving efficiency is in full control: I don’t like how I feel…When I don’t like how I feel, I use…When I use I feel better… Problem solved!
An addict’s “better,” of course, is a relative term that describes only feeling different than she did when her craving was cued. And craving is triggered by just about any cue, good or bad, at this stage. If gone unchecked, the once perfect solution, the once unassailable resolution to any uncertainty or conflict delivers the addict further into the final stage of addiction and for too many people, closer to death.
What starts out as a novel way to kill time and hang out with friends becomes a means to address something else entirely, an unquenchable craving that appears to have only one answer: more! The paradox of addiction is that this reward-seeking behavior, a once rational attempt to change how we feel, can kill us if gone unchecked.
For those who enter this late stage of addiction life is unbearable, both for the addict and those around her. Nothing goes right. Everything is wrong. The losses outnumber the wins, but the brain is focused only on earning its reward and easing the pain associated with not using.
Addiction in its final stage is like Kevin Bacon’s character in the film Animal House trying to reassure the panicked homecoming parade attendees that all is well. No matter how sincere is our attempt to put on a game face, sometimes we’re just gonna to be flattened.
Why does this happen?
Addiction in my experience is iatrogenic in nature, an illness caused by the treatment of another affliction. Iatrogenic addiction normally refers only to that caused by healthcare professionals. The classic example being opioid addiction resulting from pain management.
In my experience, however, only in rare instances is substance abuse disorder the sole presenting issue. It more often than not is comorbid with another mental health concern such as anxiety, depression, traumatic stress, unresolved grief, schizophrenia, etc.
Individuals who find relief of some kind through substance use are not just looking for a good time. They are self-medicating.
Substances that once introduced you to awesome experiences and saved you from unacknowledged demons could be the thing that kills you in the end. This is dramatic language, but struggling with an untreated mental health issue can be unbearable even before adding drugs and alcohol into the mix.
Substance use might allow you to bear it for a brief time, but the cost is steep and the payback fleeting. Surprisingly, the causes of addiction are not germane to the brute phenomenon that is addiction. Origin stories are interesting, sure, and also pointless when helping someone regain control of their life.
Here’s what is important to know: substance use patterns and the ability to control usage change over time. Cues to use creep from conscious choice to something more ingrained, involuntary, and unconscious. Life becomes smaller and less enjoyable. The only thing that provides escape is the very thing that might be killing you.
Recovery From a Hopeless State of Mind and Body
How then do you address the intractable state of being that is addiction? Recovery from a hopeless state of mind and body should be a no-brainer, right? If only that were true.
For those of us with personal experience of it, addiction is a killer, yes, and it's also a pain in the ass. Relapse, manipulation, illness, chaos, loneliness: it’s messy and recovery rates are abysmal.
Despite this reality, recovery is possible. In fact, if an individual is willing to be honest with herself recovery is entirely probable.
There are many recovery paths, from abstinence to harm reduction/moderation management. For anyone who has entered the final stage of addiction I personally believe that abstinence is the best choice. For those not as advanced in their addiction, harm reduction can be a plausible and logical approach.
For now, suffice it to say that there is a solution for everyone, even if that solution is different for everyone. Two necessary threads that characterize successful recovery of any type are honesty and connection with others. Humans, after all, are social creatures.
In order to heal from a condition that isolates us and lies to us it’s necessary to replace separation with relation. White-knuckling it alone at home is not worth the trouble. It’s one reason why too many in recovery return to substance use.
Recovery cannot be focused solely on losing a relationship with a substance though. Recovery must be about living life to the fullest. It must be about tolerating the stress of daily life and paying attention to what really matters to us. It must be about accepting ourselves and others, no matter what.
To highlight the seductive power of addiction I’ll leave you with the song, “Golden Brown,” by The Stranglers, a song that sweeps you away however you interpret it.