I’m usually pretty good with the empathy thing, but for the life of me I can’t seem to understand addiction. In my case, I can take or leave alcohol and tobacco. Can go for months/years without the stuff, consume fairly regularly, even heavily, for weeks or a couple months and then just switch it off with no ill effects. Desire just fades and the consumption goes away.
I am given to understand the desire in an addict just fails to go away. Is that correct? Further, an addict who has been clean for a period of time (always? sometimes? with daily craving) can relapse. How does that work? Alcoholic does a good job staying dry for a couple years, decides they have enough composure to take just one shot and magically they are back to square one and hammered all the time? Is that necessarily the case or can they sometimes “get away with it”?
I’m sorry the above isn’t all that coherent. I simply have no idea how to ask about something I seem to be immune to.
I am an alcoholic. I have been sober for over twenty years. Before that, I was sober for six years, until I decided I should try alcohol-free beer. That was my trigger, and before long, I was back where I was. It took me three years to realize I can’t handle it.
I believe the reason is because I feel different from other people when I drink. I don’t just feel good, I feel fucking great. If you felt the way I feel when you drink, you would be an alcoholic too.
I think Leo McGarry from the West Wing said it best:
When an addict relapses, there are different outcomes. Some fall back into addiction immediately. Some are able to control it for a while and it gradually gets worse. And some previous addicts are able to moderate.
I have read accounts and talked with alcoholics and some of what they describe is what I go through with a bag of potato chips and other junk food. I have to buy only a small bag at a time because I will eat the whole damn thing. If I put it away in the kitchen… I will obsess on those chips until I go and get them and eat them. I will eat them until my stomach hurts and my mouth hurts. I have dinner in front of me and have a bag of chips… I will eat the chips. I crave them all of the time. If I indulge in a small bag then it seems to increase my cravings.
My mother commented that she couldn’t understand people who get addicted to pain pills. as she hates the way they make her feel. I pointed out she smoked cigarettes for decades even though they smelled horrible, caused her health issues, tasted terrible etc and I said I had a hard time understanding how anyone could take a second puff. She did not appreciate my comments. My dad pointed out there was a lot of peer pressure to smoke and the bad affects were not as well known.
So bottom line, most people have something that they are addicted to. Some are more socially acceptable than others.
Seems to me that it’s down to brain mechanics. Some people are just wired in a way that the pleasure/reward response is too strong to be easily controlled by executive function.
Some people “eat their emotions”. I wonder if that’s a similar cause/effect response in those with a chemical addiction.
This is the analogy that was used to explain it in a pharmacology class I took:
Hold your breath. You can do it for a few seconds no problem, then after a few more you want to take a breath, and sometime after that you need to take a breath, and soon taking a breath becomes the most important thing in your life, and you can’t think of anything else. With breathing that all happens in a minute or two.
The point of the analogy is to remove the prejudice that addiction has to do with will power or character. Regardless of your will power, you will take a breath. This can be difficult for some people to understand, because satisfying an addiction can require a complex series of behaviors. Get money, find a dealer, buy the drug, etc.
There is a great deal of individual difference in how prone people are to addiction, and this can vary by substance and activity. There are also individual differences in how easily people kick an addiction.
So this is a little tangential but I always felt it was in the same vein. When I was a teenager I would cut (self-harm). I’ve heard that cutting operates very similarly to other addictions but its difference to other addictions may help clarify a little. Anyway, I was depressed, anxious, and felt like I was living every day in hell back then. There were two ways I got to the cutting stage. The first was to feel so overwhelmed by my mental distress that I felt I needed to stop it by any means necessary. The second was to feel so separated from what constituted a normal life that I felt I needed to bring myself back before I stopped living entirely. At those times I would cut and cause pain. And the thing is: it works. The brain releases a chemical that works much like a natural opioid. The fact that it worked is what creates that addictive behavior. Eventually you do start daydreaming about it, you spend your every spare thought ruminating on it, you look forward to it for the whole day, you basically wind yourself up unintentionally, waiting for the release you will get later. And it will reinforce itself because it will feel so good when it gets there. And it doesn’t even matter that you will feel pain and it will be a detriment to you because you are so focused on the feeling you get after that you simply don’t care. Your brain puts two and two together “cutting = feeling better, finally, for once, thank god” and continues the loop. I quit it after a few years, but in times of extreme distress my brain would snap right back to it. I would crave the feeling and think about it for years after quitting. But eventually, my life got better enough that I didn’t need it to feel happy enough day-to-day. My experience mirrors that mouse study they did where happy mice are much less likely to use addictive substances, while unhappy mice would use the drugs all day long to try and escape. Due to my experiences with cutting I knew I didn’t have the fortitude to handle much more “acceptable” vices so I never did drugs, I never smoked, I never drank. I could probably handle drinking now, but I’m so far into never drinking that I’ve decided I might as well continue this way.
So unlike addictions like alcohol where initially going in there’s no pain hurdle to get over, people expect you to try it, you just drink some stuff, my addiction was so severe that I was willing to go through lengths of pain and having to hide it from everybody to arrive where I wanted to be: high, and not giving a shit any more. Sometimes you don’t even realize how unhappy you are before you’ve fallen down the hole, and by then you’re so obsessed by the “I feel like shit/I finally feel better” loop that you don’t have the mental fortitude to self examine: What are you doing? Why are you doing it? You live every day one by one without the capability of looking long-term at the effects it will have on you even one week into the future. Every day is: get through today. Then you’ll have to get through tomorrow. Then the day after that. What do I see myself doing in 5 years? Are you nuts? That’s the mindset. And it has that shimmer even now because it promises stasis, a world without change, a world where you don’t have to plan ahead or prepare for disaster because there’s only today. Unlike a rational adult life where you plan for things and mitigate costs that lifestyle has just one day that you need to think about. Anyway, I’m no doctor so: grain of salt.
I have smoked off and on since I was probably about 13 years old (I’m 54 now). I’ve quit several times for extended periods of time (sometimes years). When I’ve relapsed, it usually happens something like this: I haven’t smoked in a while and will get the urge. I convince myself that I will only buy one pack and stop again. And I do. A week later, I get the urge again and tell myself that I can buy just one pack and quit again, you know, like I did a week ago. And I do. Then six days later, I get the urge, then five, then four, etc…until I’m back to smoking every day. I tell myself that it’s OK, I quit before after smoking a pack a day. I can do it again. But it’s never like that. I struggle and struggle until I can get out from under it again (Chantix was a godsend), and man does it suck. Wednesday will be my 34th week without a cigarette on this last go round, and God willing, I’ll never go back. Shout out to the State of Rhode Island for taxing the shit out of cigarettes, providing me with more incentive to be clean.
Not all addicts are the same. One of my friends was an alcoholic back when he was in college (before I met him). You’d never know it to meet him now. Nowadays, he does drink, but he really does do it only in moderation: I’ve never seen him have more than two drinks in an evening, and usually zero. And he did this basically on his own, because he himself realized that he was ruining his life, and he didn’t want his life ruined.
Would that work for everyone? Probably not. But for some people, it’s possible.
Very relevant in my case. Just retrieved my daughter from rehab (dual diagnosis w/ alcohol withdrawal). She has a hell of a history of cutting, it’s hard to find a patch on her arms, legs, or belly that isn’t a scar. I’ve never understood it as a coping mechanism, and nobody has been able to adequately explain it to me, but your post came close. Her main demon I think is anxiety. She was drinking because she was trying to get away from the cutting and needed a shortcut to unconsciousness. And it got out of hand. I suspect the actual broken thing in her is anxiety–but given how deep she got into the bottle I wonder if she hasn’t added that specific addiction to her problem list, or if it’s still just A means of managing the underlying anxiety.
Sounds like a self-developed form of CBT. That’s how I eventually got my brain under control (imperfectly so, but it’s not ruing my life anymore so…)
I don’t understand this. I feel great when I drink too. But I don’t feel great waking up at 5:30 am. And I can’t be drunk or drink at work. And I can’t drive when I’m drunk. And I can’t do school work while drunk. And I can’t take care of my kids when I’m drunk. How can “feeling great while drunk” overcome all those things?
Purely as a mental exercise for Inigo, I find it helpful in understanding “addiction” to drugs and such by comparing it to our relationship and thoughts about food.
We all eat food, we all need to eat food, we all know the feeling of needing to eat food, we go through elaborate activities in order to eat food. One could say we are addicted to food. In your mind, substitute all of these thoughts about eating food with thoughts about X (X being any thing, alcohol, cigarettes, drugs, etc.) Strip away any thoughts about societal judgements on X, just think about the feeling of need.
For me, using imagination, that is a starting point for understanding addiction.
Clearly the metaphor is not 100% because, yes, humans need nutrition to live. But setting that aside and considering the feeling of need, I feel is illustrative.
Also, it seems to me the word “addiction” has two levels of usage, a “hard” usage and a “soft” usage. I have always felt we use the word “addiction” in its full force when it is about something some find objectionable. Whereas we don’t use the word in its full force when it is applied to a subject we don’t find objectionable as a general populace. In those cases we use the word in a somewhat joking way, “I’m addicted to video games.” “I’m addicted to TV.” “I’m addicted to shopping.” “I’m addicted to exercise.” However, I suspect that the neurological operation is the same.
Addiction to things like sex and food are, IMO, the most sinister of all addictions. This is because both things, sex and food, are critical components to a (healthy) life. You can’t go without food and you shouldn’t go without sex. So it’s not as if you can just “quit” your substance of abuse like you can with drugs or alcohol. You have to learn to change your entire relationship from a wholly dysfunctional, abusive one to a healthy, positive one. That is no easy task. Imagine asking a drug addict to learn how to develop a positive relationship and habit with their drug of choice. I’d say that is on the precipice of nary impossible (exceptions exist for most anything).
Imagine yourself on a torture chair. You know the safe word, but saying it would kill someone you are very close too. And then you break. And you have to live with this. Then you break again.
Only solution is to try and have it under control, not saying the word, and hope not to break. Ever. Again.
The best book I’ve ever read to explain addiction, and specifically alcoholism, is Drinking: A Love Story by Caroline Knapp. I have recommended it before both on this board and elsewhere for people who are struggling to understand what someone they care about is going through, and they have often found it useful. You might want to give it a look.
I find addiction to gambling is so hard to understand. I had a Uncle who lost fortunes. He died of a heart attack at the racetrack. I might have thought it humorous if he was winning. But, alas it was not be. My Aunt was still paying off junk when she died. I know its a legitimate addiction but, I don’t see how his logical mind couldn’t tell him to stop. He wasn’t dumb. I don’t get it. I get substance abuse, that changes your awareness and your thinking. I think I understand sex addiction and food addiction. It’s about feeling good. But, gambling, nah I don’t understand.
I’m by no means an expert but I believe the areas of the brain that are activated in drug/food/sex addicts are the same or similar in gambling addicts. The rush, the dopamine, etc. The feel good neurotransmitters, chemicals, etc. It’s the same effect on your brain, you’re just using a different tool to achieve it.
Shitty the next day.