Contrary to popular belief, addiction is NOT a brain disease – addiction is a learned behaviour, and a behaviour of choice! Informed by considerable experience dealing with drug addicts, I can assure you that addiction is a personality disorder just the same as selfishness or narcissism.
From the mid to late 1980’s, I took on several clients who were heroin addicts. I offered this service free of charge because I genuinely thought that hypnosis could contribute something to addict’s recovery. I have lost count of how many hours I spent talking to them, trying to understand why they would want to throw away their lives for a gramme of powder on a piece of tinfoil. But I did come to some conclusions.
The first, and the most surprising was that addicts who volunteered to talk to me didn’t want to be helped! Yes… they claimed they would do anything to come off the drug, but I eventually realised that despite their protestations, anything didn’t include not actually taking it anymore. I know this sounds crazy, but that’s the way it is with addicts – their minds simply don’t operate the same way as everyone else’s.
I tried some pain management techniques to help with withdrawal. I have seen addicts go through withdrawal, so I know what I’m talking about. Withdrawal starts within a few hours of the last ‘fix’ and includes stomach cramps, inability to sleep properly and flu-like symptoms. Withdrawal lasts only for three or four days and after that, the body, and more important, the chemical imbalance in the brain return to their physically normal state.
The second and even more shocking discovery was that once withdrawal was over, feeling ‘normal’ was worse than continuing to take the drug! Without the ritual of getting money to ‘score,’ which usually involves committing some kind of crime, meeting up with the dealer, who is notoriously unreliable, finding a place to take the drug, and then somewhere to ‘chill’ for a few hours, leaves a huge void in the addict’s lives. There is literally nothing to do! So what is there to fill the void, where time drags on and there’s nowhere to go?
Addicts have lived outside society for so long, they are unable to cope with the real world. The sense of false confidence heroin once gave them has gone, and adjusting to normal life is a bigger challenge for the ex-addict than most people realise.
It’s difficult to get a job without references and even more so if there is any kind of criminal record. Potential employers are understandably reluctant to take on staff with a record of theft. Ex-addicts seldom know anyone outside their circle of fellow users so there’s no one that can help point them in the right direction. So addicts very quickly return to the comfortable and familiar life they once knew… and prefer.
The National Institutes for Drug Addiction (US) defines addiction as ‘a chronic and continually relapsing brain disease’ but that really is a flawed concept. Of course there’s a humanistic desire to help and treat addicts, but failure to see addiction for what it actually is, is not helpful, in fact it sidesteps the real problem because it provides an excuse for bad and anti-social behaviour.
American presidential hopeful Bernie Sanders recently described addiction as a ‘disease, not a criminal activity.’ I disagree, and so do many of my colleagues who have experience dealing with druggies, some of whom are psychiatrists and psychologists.
The idiotic Hillary Clinton has laid out a plan on her website on how to fight the epidemic. Her definition of addiction as a ‘chronic disease that affects the brain’ is as simplistic as it is blinkered. I believe that addiction is a matter of choice, a view supported by psychologists Gene Heyman and Marc Lewis, both of whom are experts in the field and their views are supported by many other international experts and academics.
To refer to addiction as a kind of brain disease is to suggest that addiction is involuntary, but anyone who has had any dealings with drug addicts will tell you that it comes down to something much more simple – choice! In other words, addiction is a personality problem. I will go one step further and say that addiction could be treated as a criminal act in itself, one for which the punishment should be a period of re-education and enforced abstinence.
The problem with that rather perfect solution however, is two-fold. First and most obvious, is that drugs are readily available in prisons, and second, the funding for such a large-scale project will never be affordable, given there are nearly 150,000 registered drug addicts in the UK.
There is no doubt that both brain structure and function is altered by drug, and alcohol addiction – repeated abuse of heroin, cocaine, alcohol, nicotine and even compulsive and ruinous gambling change the circuitry of the brain involved in memory, anticipation and pleasure.
It is correct to assume that addictions to substances or certain activities do assuage pain and elevate mood, which is why people form a strong attachment to them. Synaptic connections strengthen to form pleasant associations. Smoking cigarettes for example is associated with other pleasurable activities, usually social in nature. But do changes in brain structure and function stymie the normal mechanisms of self-control and conscience? There is a considerable body of evidence that suggests this may indeed be the case, but actual damage to the relevant areas of the brain only becomes visible after years of addiction.
Addiction is not beyond the control of an addict in the same way the symptoms of Alzheimer’s or dementia are beyond the control of the sufferer. No amount of reinforcement or punishment can alter the course of an entirely autonomous biological condition. Addicts on the other hand can and often do respond to the principles consequence and reward.
Professionals such as doctors who have succumbed to drug addiction are often suspended for a period of time but are usually allowed to return to work under strict supervision. If they don’t comply with set rules, they have a lot more to lose than just their jobs; their income, social status, their homes and children’s school fees might disappear. It should come as no surprise then that their recovery rates are high. Of course it might also be because professionals are generally a bit more intelligent than your common or garden poorly educated smack-head, but it bears consideration. Addicts who are required to routinely undergo drug testing and who face sanction for failure are more able to stay on the straight and narrow than those left to their own devices.
Addiction is the triumph of instant gratification, often the result of a need to quell psychological discomfort or regulate mood set against the risk of long-term consequences. People don’t use addictive substances because they want to be addicted – people take addictive substances because they want immediate relief.
Addiction always follows a familiar pattern: enjoyment of the effects of the drug increases whilst at the same time, once-rewarding activities such as relationships, hobbies and family time recede in value.
Before very long, the appeal of taking the drug starts to fade as consequences pile up – spending too much money, disappointing loved ones, attracting suspicion at work – but the drug still retains value because it makes psychological pain disappear, at least in the short term. The drug also continues to suppress withdrawal symptoms not to mention the intense craving that goes with withdrawal. Substitutes such as Methadone (for heroin) are rarely as satisfying as the drug they are supposed to replace – hence prescription Methadone is often traded for heroin on the street.
Motivation is an essential component of change. Counselling and therapy may well help, but it’s a long road. The important thing is for both therapist and client to understand the role choice will play in treatment – that, and self-control.
The addict must take steps to distance themselves from their so-called ‘friends’ and that includes their best friend, the dealer. This is also a choice, and a difficult one. Comfortable familiarity is a real problem because addicts all too often find it easier to return to their old stamping grounds than try a new lifestyle. After all, the drug den is the one place they will always be accepted and feel truly welcome. Maybe it is a battle of intelligence after all. A change of environment would also be a good move, but this is not always possible.
In short, life is full of tough decisions. Making that decision is not only the best, but probably the only way out of addiction.
There’s been growing acceptance of mental illness over the last few years – even the younger Royals are championing the cause – and this is no bad thing. People who are genuinely mentally ill deserve and are entitled to help, but there are some who invoke mental illness as an excuse for unacceptable behaviour.
The pattern is by now familiar – they get drunk, take drugs, indulge in antisocial behaviour, then appear before the cameras to make contrite apologies and excuses for their ‘addictions.’ Then they check themselves into an exclusive and comfortable clinic where they will be pampered and reassured by therapists who will reinforce the belief that it’s not their fault. Even when they haven’t publicly made a fool of themselves, the self-serving announcement they are going into rehab offers a short cut to free publicity. The poor tortured soul – I don’t mind if you think I’m pathetic, just don’t blame – or ignore – me. With celebrities, the desire for fame can also be an uncontrollable addiction.
Taking drugs is not a medical condition. Getting drunk and lashing out at photographers is not a medical condition. Making racist comments or sexually assaulting women are not signs of mental illness, although both these can be career killers. But remember – no one will criticise you if you’re unwell. That’s how it works when the perpetrator magically transforms into the victim. How very clever. How very cynical.
Going into rehab has become the traditional, PR-managed response to any indiscretion, no matter how appalling, committed by the rich and famous. The rich and famous go to rehab – the poor and insignificant go to jail.
Believe it or not, alcoholism and drug addiction are not clinical conditions recognised in either of the psychiatric diagnostic manuals used by professionals. Addiction is an invented condition, created to abdicate responsibility. Addiction is now a convenient excuse for bad behaviour by selfish, self-centred, inconsiderate people who have no respect for what others might want or expect. Once something is given a medical-sounding label, any criticism seems cruel and uncaring in our caring sharing society.
The idea that addiction is an illness is a fallacy first promoted the late 1990’s in America. The pharmaceutical companies were delighted of course because they were suddenly presented with an opportunity to sell replacements such as methadone – expensive and profitable. It wasn’t long before the idea found its way to the UK where it was embraced with enthusiasm by psychotherapists and publicity agents.
But it’s time to face an inconvenient truth. The abuse of alcohol and drugs is voluntary. Most doctors reject the idea that alcoholism and drug addiction are diseases. Calling addiction a disease or an illness is counter-productive because it removes any sense of responsibility or ownership. It also flies in the face of much of the psychological work that has been done with addicts and it definitely does not help the addict.
A review published in the medical journal The Lancet Psychiatry confirms that the research into addiction supports this view. In short, addiction is caused by poor coping strategies for emotional pain and psychological distress. Addicts use alcohol or drugs, or food, or whatever, as a crutch.
Addicts consciously choose to drink alcohol and take drugs. Whatever you may think about addiction, whatever you have been told about addiction is probably wrong. Substance abuse is an active decision that users make each and every day. Pretending otherwise only serves to rob them of the chance to choose a different path.
The process of recovering from addiction involves taking responsibility for one’s own life – realising, accepting, understanding and facing up to the fact that you are the architect of your own misery. It’s time to man up!
As if this isn’t enough, young people who regularly consume energy drinks are significantly more likely to use cocaine in later life. Dr Amelia Arria from the University of Maryland, says that energy drink users might be at heightened risk of other substance use – particularly stimulants.
It is unclear why energy drink consumption is linked to illegal drug use, but it does warrant more investigation. More than likely, teenagers get used to the energy ‘buzz’ that these drinks provide and as they get older, go out more and stay up later, they will be tempted by something a little stronger. Cocaine is the obvious choice given its availability and the fact that it’s easy to take and the effects are pretty well the same, though much stronger. Future studies should focus on younger people, because they are the main consumers of high-energy drinks.
In the United States, high-energy drinks are unregulated by the Federal Drug Administration and manufacturers are not required to list their specific caffeine content.
The Maryland researchers analysed 1,099 college students who were first assessed at 21 years old and then annually until they reached 25, specifically in relation to caffeine consumption and substance use.
The data [Published in the journal Drug and Alcohol Dependence] revealed that young people who regularly consumed highly-caffeinated energy drinks were significantly more likely to use cocaine, take prescription drugs for non-medical reasons and have alcohol problems at 25. The risk was greatest among those who consistently increased their energy drink consumption year-on-year – they made up 51.4% of the study’s participants.
Copyright Andrew Newton 2016. All rights reserved.