Every fiber within me was screaming out for relief. I was so uncomfortable in my own skin and overwhelmed by my own thoughts. I felt as if I was going insane. I literally found myself in the room I had grown up in slouched on the floor against the wall and banging my head against it as if this act would distract me from my current state. I had this insane idea that if I could create more physical pain unrelated to my withdrawals I would distract myself from my emotional anguish and the obsessive hunger to get high. The physical pain of it all was always the least of my worries, I had always had a high tolerance for pain, but the flip side of that is the slightest bit of mental or emotional discomfort and I would begin to break. Emotional pain had always been a poison to me and alcohol and drugs my antidote.
So, there I was in my parents’ home in the room I grew up in acutely aware of my condition and the consequences my addiction had delivered like an apocalypse into my life. I knew something was not right with me, but was confused to what or how to make it stop. The room seemed so much smaller then I had remembered, and I felt claustrophobic as if the memory of my childhood and the addict I became had merged and was now suffocating me. I needed some relief to this madness. I thought why did I agree with my parents that I would stop using and go to treatment again? I needed to use. There was no way I could live with out it. They just didn’t understand my pain and if they did they would see I was justified in my using. But what was I thinking, I knew I couldn’t use. It had destroyed everything good about me. With no empathy and no remorse like a sociopathic killer it lay waste to everything in my life leaving a path of destruction and carnage. “STOP! STOP! I can’t take this anymore!” I wanted to stop! I had wanted to stop 3 years prior and was confused with how I continued to make a “choice” to go back to the insanity of using. I thought, I truly must be the evil I felt. While my parents frantically called around to get me into a treatment center out of state, as I had burned through every program in the state I lived. I pulled myself up off my bedroom floor and went into my parent’s upstairs bathroom where I knew a bottle of Listerine sat patiently for me below the dual sink of my parents’ master bath. I noticed before I even began to drink from the half full bottle of the green elixir, that I could feel a comfort and calm wash over my body and my mind.
This story would play out repeatedly in my life. Where I would be assuredly done with my using, enrolling my parents for help over and over again; only to drain every ounce of hope in their being time and time again. No one was more confused then I was, the shame in believing something with my character was flawed and weak; only perpetuated my drinking and drug use. I would hear family members or acquaintances I worked with make statements like, “Why don’t you just stop” or “I used to have a problem like you when I was younger, but I just made a decision to put it down.” What I know today that I did not know then, was that those people were nothing like me, nor did they understand the disease of addiction.
Culturally we still look at addiction as choice, a moral failing or weakness in one’s own character. We have made some progress, but it is truly amazing the ignorance the public still has around addiction. Which in turn affects how those suffering from the early onset of addiction keep it hidden to avoid the shame that accompanies substance use disorders. Hell, the American Medical Association recognized Alcoholism as a disease in 1956. Let that sink in for a second, and I’ll repeat it. The American Medical Association recognized Alcoholism as a disease in 1956. The American Society of Addiction Medicine (ASAM) defines it as such, “addiction is a primary, chronic, disease of brain reward, motivation, memory and related circuitry.” Yet here we are in 2018 still debating the topic, but such is the pride and Ego of a culture that believes it is the most intellectual and evolved in all of history, but I digress.
No individual signs up to become an addict or alcoholic. I didn’t aspire to hurt the people closest to me, to be consumed in thought and action with getting high, to be robbed of anything else I had once found pleasurable, and to ultimately resign to a constant state of despair and misery; plagued with suicidal thoughts almost daily. Who chooses that!
The disease of addiction hijacks the brain and the pathways of communication between the limbic and executive (parent) part of the brain. The limbic system is where the reward center of the brain is located, it is also responsible for our own emotional regulation, arousal and our memories. Hmmm, sounds like if addiction could have chosen a place to live, it couldn’t have found a more perfect place to sustain its own existence, then that of the limbic system. You see the brain operates on a reward system for our own survival. The brain produces dopamine in order to signal to the brain that an action is pleasurable so that we continue to do it. Depending on the amount of dopamine produced is how the brain prioritizes which act is most important to our own survival hierarchy. All this happening in the limbic system, so eating food produces dopamine, having sex produces dopamine so on and so forth. We need food for our own survival and we need to reproduce as a species, so we do not become extinct. The limbic system and the executive part of the brain, which I call the rational parent brain, working seamlessly together is a beautiful thing. When I get hungry and I have no money on me because I left my wallet at home and the primitive self tells me to go steal food at a local grocery store across the street from my work or to steal my co-workers lunch, the executive part of my brain keeps me in check and rationally offers up thoughts to control my actions. Like “Stealing is not the answer. People go to jail for stealing, you can wait to eat when you get home” etc. So, the executive part of the brain is in charge and keeps those primitive impulses in check. So, lets go back to the explanation of dopamine as a reward chemical for a minute. The brain at anyone time only wants to handle about 300 units of dopamine, don’t ask me what a unit of dopamine is measured in I have no idea. So, food, sex, being around friends, exercising etc. will produce dopamine that keeps us right in that 300 ball park. Now lets add in addictive chemicals to the brain and I’ll show you how it entirely hijacks the whole system. Alcohol and opiates produce about 500-700 units of dopamine, methamphetamine produces about 1,200 units of dopamine. Insane, right? So hopefully you’ve been able to follow up to this point. Remember how the brain prioritizes what is the most important thing for our survival based upon the amount of dopamine an act produces. Well as you can see addictive chemicals produce a greater amount of dopamine then the brain was ever meant to handle, and it tricks the brain into thinking those chemicals are essential to the addict’s own survival. Over time, introducing these chemicals into your body more frequently, a rewiring of the communication between the limbic system and the executive function occurs. No longer is the executive part of the brain in charge, the now primitive limbic system is in charge. The very emotional and arousal-based part of the brain is now calling the shots. The addicts executive part of the brain is still offering up thoughts like why do you keep doing this, you’re going to lose your family, you’re going to be arrested again, but it is no match for the limbic system who ultimately believes it is pushing you to get high because it believes that is what you need to survive, when in reality it is pushing you to your death. There in lies that battle the addict is faced with every day. Knowing logically what they are doing is not in their best interest, however the executive part of the brain is in an unwinnable war with a part of the brain that believes if you don’t use you will die. I don’t know about you other addicts out there, but when I was unable to get high the anxiety I felt was very much like feeling my life was in jeopardy. That’s why I would practically compromise everything about myself and go to any lengths to get high, as if my life depended upon it. I would even at times contemplate engaging in high risk situations or put my life in jeopardy to get high (refer to my blog last week). As that’s exactly what my brain was telling me, “If you don’t use you will die anyway.” Nothing felt more real to me in my using then that threatening thought. So, I existed in a terrified state daily, unsure of why I continued to “choose” this way of living for myself. A great video to watch for a more in-depth explanation of the choice argument, and explanation of the disease model of addiction is ‘Pleasure Unwoven’, by Dr. Kevin McCauley. I encourage anyone directly or indirectly dealing with addiction to watch this video.
So, to the question, ‘Is Addiction a disease and does it matter?’ I would say that we know medically, yes, it is a disease and recognized and classified as such. The argument should end there. To the part, ‘does it matter?’ I would say yes and no. It matters for the individual struggling with addiction to be explained this by a medical professional. To allow the aspect of shame to be removed from the equation. Addiction at its core is a very shamed based disease and anything to perpetuate that and not alleviate shame is harmful to the individual. Where it doesn’t matter is whether those not suffering from the disease of addiction acknowledge it as such. Ignorance will always be present as long as man exists. So, the key is to not allow another’s view to define you or determine your outcomes. Part of being in recovery is to not only be free of the crippling grip substances has had over one’s life, but to also no longer live as a victim to circumstance or to other opinions and views. Where addiction can be a horrible disease that has claimed a lot of lives and destroyed a lot of families and relationships, rest assured there is a solution to this disease. No longer do we have to be a victim to it, no longer do we have to live a double life mired in shame. Where I used to believe being an alcoholic and an addict at 23 was the worst thing to happen to me in my life. I have now grown to see that it was the best thing to ever happen to me. As it forced me to find a solution to fix the problem of the drink and the drug, but in turn it became the solution to everything in my life and connected me to a massive power without end.
“Counselor, give me some advice. Tell me how hard will I fall if I live a double life…Doctor, can you help me ‘cause I don’t feel right? Better make it fast before I change my mind.” – Cage the Elephant