In Part 1 we learned how we are all vulnerable to addiction when we choose unhealthy strategies to meet valid needs, and how habituation, tolerance, and withdrawal reinforce behaviors that we otherwise should know to avoid. But why don’t we know better? It’s because many addictions actually do help us meet our needs in the short term and therefore seem “good.” It’s also because many addictive drugs directly affect our ability to make accurate assessments and so despite the harmfulness and cost of these otherwise “effective” strategies, we have a harder time seeing how “bad” the consequences are.
In most situations, it is the primary effects of the drug that directly affects our better judgment. But with different effects of different drugs, the specific reason why reliable insight and decision making suffers can vary. Let’s see how this happens in the most common drugs of abuse:
Alcohol – This is due to the dulling of our higher order brain functioning which is more vulnerable to the effects of alcohol than the more rigid but simpler parts of our mind. We become less aware of our surroundings, our ability to read social cues is impaired, our ability to regulate anxiety and anger is diminished, we have less impulse control, and we can’t use our critical thinking or problem solving skills quite as well. At higher levels, alcohol dulls the functions of all parts of the brain. The more intoxicated, the worse this gets.
Stimulants – With stimulants like cocaine or methamphetamine, overstimulation causes the brain to make associations that aren’t really there potentially creating false insights or paranoia. Because of an intensity of focus on certain things, relevant details outside the scope of immediate attention get missed. Euphoria can also make a person overestimate their abilities. High levels of anxiety can also be triggered, which tends to make simplified but less than accurate snap judgments and prioritizes short term needs over long term ones.
Marijuana – When cannabinoid receptors are activated all experiences are enhanced. This is because the primary molecule that our body produces naturally to bind to these receptors, anandamide, is typically released when we have true moments of significance. The root word anand in Sanskrit means “bliss.” It’s thought that this enhancement makes these unique moments more memorable. When these receptors are artificially flooded with the active metabolites of marijuana, the uniqueness is lost. What happens instead is that the dull gets enhanced to seem interesting, so reruns are funny again. The average gets enhanced to become exceptional, so McDonald’s tastes really good. The intense can become overwhelming – feeling a little paranoid? As a result of these generalized changes, the normal emotional responses that would typically motivate a person to make improvements in their circumstances don’t get triggered because things seem better than they actually are. As motivation is tied to emotion, drive and purposefulness can be impaired with long term marijuana use. When things don’t seem like a problem, you don’t tend to be motivated to fix problems. When things seem pretty good, you don’t tend to be motivated to make them better.
Opiates – With natural opioids, the desensitization to danger and harm is intentional when our bodies release these chemicals when faced with a severely painful injury. The purpose of this temporary sense of calm and semidelusional belief in the viability of a good outcome is so that a person may improve their chance to actually escape a life threatening situation. Let’s say you are a caveman that gets ambushed by a saber-toothed tiger. It may be helpful to have a sense of calm and optimism so that you could possibly poke it in the eye and crawl to a hiding spot. Unlikely, but maybe. But when these receptors are artificially activated by synthetic opiates like heroin, Vicodin, or Oxycontin – there is also an appealing sense of “everything is good, everything is going to be alright.” However, it also dulls our sense of danger, including the very real dangers of opiate use. With prescription pain medication abuse, people may gradually increase their use to very high levels before truly being aware of how dependent they have become. Heroin use can be fatal with an “accidental” overdose, usually because a person misjudges the high level of drug in their system already.
Other than the direct effects of these drugs, another reason why we stay in these patterns of addiction is related to the fact that despite the potential harm, on some level, our addictions are partially successful in meeting our needs. With alcohol, marijuana, opiates, and benzodiazepines there are real anti-anxiety and mood elevating effects, so if you are feeling chronically stressed or miserable, these drugs will make you feel better. If our need is for connection and we’re feeling lonely, compulsively checking our Facebook feed creates some sense of connectedness as you read the status updates of your friends, even though in reality you’ve not made real contact with anyone. If the need is to have some fun, then just the right amount of alcohol, pot, or Vicodin may do the trick. The positive emotion associated with these strategies reinforces that on some level, these coping mechanisms are “good.” Also, as the typical unpleasant feelings associated with unmet needs goes away with these strategies, the determination and motivation to find better ways to find fulfillment goes away. Sort of like when we stop feeling thirsty the moment we have something to drink, even if that drink is highly caffeinated and is likely to make us even more dehydrated later. In addition, with certain drugs or behaviors, the level of positive emotion experienced can be more immediate and more intense – an even better than the real thing kind of experience, creating a hierarchy in your mind of what is the “best” way to solve a need based on a pleasure scale, rather than a healthy one.
These “pretty good,” “not so bad,” “that hit the spot,” experiences in our mind create a kind of ambivalent emotional experience, which over time also creates an ambivalence towards change, and habits start to settle in. Over time, if we habituate certain behaviors with certain needs, our minds may get confused regarding the natural solutions for our needs and more strongly associate genuine needs with inauthentic solutions. Feeling thirsty may create a craving for soda, not water. Feeling anxious may be more strongly connected with having a cocktail than solving a problem. Feeling lonely may be connected to watching pornography rather than spending time with people. Feeling disappointment may be connected with compulsive shopping or gambling. And again, despite these behaviors having other costs, in the immediate sense they “work” and the cycle of ongoing negative behavior continues.
In a previous series on personal growth, I’ve talked about how change is initiated by meaningful insight. Ideally this insight can be achieved through help, support, and experience. Unfortunately, what is sometimes required to get a person out of this chronic state of ambivalence to their “a ha!” moment is an abrupt and intense negative experience. Hopefully this experience is “bad enough” but not to the point of “rock bottom,” because hitting “rock bottom” is a terrible strategy, and I wouldn’t ever encourage hastening a person dealing with an addiction to such a place. Because if a person is truly in a place where things couldn’t get worse, then in order for them to get to a place of healthiness, in addition to growing past their addictive behaviors that person is also going to have to find a way out of the deep hole that was dug on the way down. That’s asking a lot from a person who’s already got an addiction to deal with who probably doesn’t have the tools or help to do either.
So what do we do instead to help ourselves or to help those that we know that are struggling with addiction? The goal is healthiness and not just abstinence. We must learn how to refamiliarize ourselves with the feelings and behaviors that most naturally reinforce feeling good. To not just learn to manage our addictive tendencies, but grow beyond them. And it must be done in the context of relationships. In Part 3, we’ll finish this series by discussing the details of his health-focused solution to addiction.