Addiction is now defined as “Substance Use Disorder”. This new term implied that the substance in question is used to the extent that it causes problems.
So rephrase the question… “Has the substance I am using led to any problems, is it causing a problem right now or can it potentially lead to a problem?”
By asking the question this way, not only do obvious drugs or alcohol fall into this category, but also behaviors like playing video games, a relationship, eating certain foods or even exercising.
For example the young female with a body image disorder who thinks she’s overweight despite weighing less than a 100 pounds and still exercises 2-3 hours per day which has led to her having brittle bones and no menstrual cycles. Yes her exercising is causing obvious problems.
The father who works a 9 to 5 and goes to the gym to work out another 2-3 hours and gets home tired and falls asleep, all while his kids are wondering why their super hero dad not making time for them? Yes, he is working out too much.
The diabetic who continues to eat sugar. Someone with high blood pressure who continues to eat salt. The gambler who is waiting in the dim light at the ATM outside the Casino for their paycheck to come in at midnight while their electricity at home is turned off. The teenager who gets a perfect score in his video game yet fails in school.
These are all examples of a type of substance use or behavior causing problems.
So there you have it. Humans encounter many problems in their lives, some are extraneous that happen by chance like the job market going down, the lack of rain for the farmer, catching a cold etc. These problems need to simply be overcome with continued effort. Then there are the self produced problems that are based in decisions made by the person themselves. These also have to be overcome but instead by meer choice.
Is that the answer to addiction, simply choosing to stop? No, the true addict cannot choose to stop. They CAN choose to seek help, read a book, talk to a friend, attend a 12-step meeting, see a doctor, talk to their family etc. These actions are in their control and by continued effort they may achieve abstinence.
A crucial part to recovery for the isolated addict is human connection. The kind found in a supporting spouse, family member, counselor, medical professional or in their 12-step group.
Accepting addiction as a problem that needs treatment infers that it is a disease. Some people still argue against this idea, because it implies that it’s not just due to choice but an actual physiological change. When performing an activity like learning to ride a bike, the brain undergoes physiological change. New neuronal connections are formed that deals with riding a bike. The same happens in addiction. The brain forms stronger and stronger connections to ensure continued use of a harmful substance or activity despite problems emerging. This seeking behavior overrides logical reasoning. The same happens in type 2 diabetes, the eater gains weight and a tolerance to sugar, the excess unused sugar causes damage to the body and the disease develops. Of diabetes started with excess substance use, in this case sugar, and led to a disease state, so does addiction to any other substance or activity.
The new understanding of addiction goes like this.
The disease of addiction is present from an early age, possibly infancy. The person with the disease encounter a substance at some point in their life that reveals the disease. The disease may in part be genetic, but it has largely to do with what that individual experienced in their lives. People with addicted parents may grow up in an “abnormal” household with certain stressors not encountered in the non addicted families. These stressors contribute to shaping the disease of addiction.
More obvious examples of stressors are things such as parents fighting, parents divorcing, a parent dying, a parents or other family member being emotionally distant or abusive, a father or mother who works 24/7, a family who constantly moves to new cities and schools, physical, sexual or emotional abuse, being bullied, being shamed, hyper religious families, a severe accident, concussions, going to prison, going to war etc.
These are referred to as ACE events or “Adverse Childhood Events.” A famous study was done which showed a correlation between the number of these events and the risk of addiction and other health related issues like high blood pressure, obesity and depression.
If you have any of these events in your past, you are at high risk of worsening addiction.
If you are already using a substance on a daily basis with any ACE events consider finding an addiction doctor, intensive outpatient therapy in your area, a 12-step group, SMART recovery online or simply starting the conversation with your closest friend or family member. You are not different or a bad person, you simply need a little help.
Thanks for reading. Dr Z.