Beyond Addiction:

Stumbling Into Addiction Why does a person use mood-altering substances? The answer is basic and simple. Because it is fun and it often makes a person feel good. It is an extremely fast and effective way to feel either more relaxed, more euphoric, or simply to relieve any pain or discomfort. It seemingly appears to be a perfect solution for the problems of life, at least initially. In some respects a person who is suffering from an addictive disorder is no different than a ten-year-old child who has not eaten all day. If at the end of the day, two things are placed in front of that ten year old, a bowl of ice cream and a bowl of green beans, which one is the ten year old going to choose? The child is going to choose the ice cream. Why? The child has an overwhelming need for immediate gratification for what is going to feel good. In a ten-year old, this overwhelming need will almost always prevail. So, too, with the person suffering from an addiction. Similarly, in addictive disorders, like the ten year old, the brain does not take into account what is going to be the better selection. It just reacts impulsively for immediate gratification. However, unlike the ten year old who lacks the foresight and knowledge of what is the better choice, the person who suffers from an addictive disorder is actually experiencing a malfunctioning of the brain. It may be surprising to learn that people often unknowingly stumble into the addictive process. They do this through learned and repetitive behaviors that occur developmentally over time with family, friends, and general life experiences. Although it is true that some people may become addicted to a substance right from the very beginning due to their genetic make-up, for others it often takes years and sometimes decades before a person actually falls victim to the addictive process. Research has demonstrated that behaviors, particularly repetitive behaviors over time, can activate dormant genes (Siegel, 2012). This may explain why certain people who start off as recreational or social users become full-blown addicts in later years. Often, people simply train themselves into becoming addicted. Neurobiology and Addiction Much has been written in recent years regarding the science of addiction. Recent research, particularly in the field of neurobiology and the neurosciences, has delineated quite conclusively the neurobiological underpinnings of chemical dependency and addiction (Koob, G.F. and Volkow, N.D.,2010). Researchers have been able to show that addiction is not simply a matter of a “loss of will power” but a neurobiological process that literally hijacks the brain of a person. If untreated, the dysregulation in the brain of the addicted person will almost surely lead to certain death. Hence, addiction must be understood as a “brain disease.” These findings have significant ramifications to understanding addiction. Even more importantly, these findings have great significance for understanding the science of recovery. In the previous chapter the focus of addiction was on the neurobiology of the brain. However, neurobiology and genetics alone do not fully explain the addictive process. A person born with the genetic predisposition to addiction does not necessarily become an addict. Similarly, a person free of a genetic predisposition is not immune from the addictive process. As the previous chapter made clear, everyone has the potential to become addicted. The difference in the length of time it takes a person to become addicted, genetics notwithstanding, is directly related to how effectively that person has learned to adapt to the surrounding environment and how they have developed certain functioning areas of their life. Personal behavior, regardless of genetics and the neurobiology involved, plays a critical role in the addictive process. If a person consistently perceives a situation as being one of helplessness and hopelessness, there is a greater likelihood that serotonin levels, as well as the levels of other neurotransmitters, will be affected. The resultant symptoms force the person to adapt to a specific pattern of behavior in order to cope with these symptoms. The specific coping mechanisms that a person develops to compensate for this dysregulation, for example seeing a therapist as opposed to taking a drink, will in turn affect their neurochemistry. As a result of these reciprocal influences, the process of neuro-adaptation begins to take place. Siegel (1999; 2012) discusses how specific behaviors and coping mechanisms play a critical role in how neurons are wired together, and ultimately have a significant impact on the neurochemistry and the behavior of a person. What must be emphasized is that just as our behavior influences neurochemistry, neurochemistry can and does influence our behavior. So what else is it that influences the addictive process? Behavior, life experiences, and how the person has developed certain levels of functioning areas in their life play a critical role. Level of Functioning and Well-Being The level of functioning areas refers to key specific developmental areas of a person’s life. These developmental areas include the intrapersonal, interpersonal, social, familial, vocational, physical, and spiritual make-up of a person. It is believed that how a person functions in these specific areas plays a major role in how effectively that person maintains a healthy and productive lifestyle regardless of their genetic make-up. It is also believed that these particular areas play an instrumental role in both the addictive and the recovery processes. From the perspective of the addictive process, most of the stress that is produced emanates from one or more of these areas. As a person begins to negotiate the developmental life cycle, each of these areas presents new and evolving challenges. Whether it is transitioning from childhood to adolescence, leaving home to attend college, getting married or divorced, relocation, or simply raising children, there is always going to be a challenge, and the subsequent stress of that challenge is always confronting the person. This is not to say that these challenges are bad. Often, these challenges are what make a person grow and feel a sense of self worth. However, these challenges also bring a degree of stress. As a result of this stress, a person is subject to the potential dysregulation in the neurochemistry of the brain. The resultant symptoms that may occur, which may even be “normal feelings” such as feeling sad and angry due to the loss of a job, can trigger a person to seek relief. For many, the use of substances is that viable relief, which can also be the beginning of a learned behavior that initiates the addictive process. The implication of this reciprocal relationship alters significantly how one needs to view the recovery process. Although the advancement in pharmacology and the use of medications to assist in the recovery process have been effective, these are simply not enough. Use of opiate blockers, anti-craving medications, mood stabilizers, anti-depressants, serotonin re-uptake inhibitors, and anti-anxiety medications have all played a vital role in recalibrating a person’s neurochemistry. However, these medications and other pharmacological interventions have done very little in influencing a person’s behavior. Just because a person’s neurochemistry is stabilized does not necessarily mean that a person knows how to adapt to the prevailing environment differently. The contention, here, is that if a person is not able to demonstratively change their behaviors, their old adaptive behaviors will eventually neutralize and subvert the positive effects of pharmacological interventions. Changing one’s behavior is at the essence of the recovery process.