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Tuesday, January 26, 2010

A Personal Guide to Addiction

My intention here is to bring a personal perspective to topics of mental illness and substance abuse. I have had a lot experience with both, and my goal is to act as a kind of "apologist" to help others understand what these things are like to go through.
Please note! I hold no certifications or specialized training in the fields of psychotherapy or addiction counseling. These entries are for informational purposes only. My hope is to provide insight drawn from personal experience, rather than clinical study; as such, some information may very well be incorrect. If you find yourself struggling with any of these issues, your best course of action is to consult a physician. He or she can direct you to the help you need.
The simplest and most direct format I can come up with is Question & Answer. It has the advantage of allowing people to skip down to topics that interest them, instead of wading through a long diatribe.

"My 'name' is Michael St. John, and I'm an addict..."
I first abused drugs when I was 16 years old. I had just flunked my driver's license test, and I was bummed out and dreading all of the teasing I would get from my friends. (Ironically, they never said a word.) Then I remembered the Percodans my dentist prescribed for my wisdom teeth. I stole one out of my mother's medicine cabinet and took it. Once it kicked in, I felt so calm and delightful. All of my problems melted away. Problems were an impossibility. That's how I began my career as an addict.

Over the next decade and a half, I got my hands on narcotics any way I could. I didn't use all of the time, but I never went more than several months without getting a new supply. After I'd exhausted all of the pills in my parent's house, I started stealing from the homes of others. It got to the point where any time I was in another house, I would make an excuse to use the restroom and search it for pills. I went to ridiculous lengths to search every bathroom in the house. It's amazing to me that I only got caught a few times, but those times were humiliating enough, though never enough to stop me.

It wasn't until 2002, when I was thirty-two, that I actually had a dealer. A clerk at a store I frequented had a dentist friend who would prescribe her thirty Vicodin a month as a favor. She liked them all right, but liked the money I would pay her for them better. For the longest time I went through a monthly cycle where I would devour the thirty pills over the course of a few days, and then spend most of the rest of the month withdrawing. Luckily for me, the dentist eventually wised up and stopped prescribing to her. (I can't imagine what he was thinking in the first place!)

I binge drank in college on the weekends like a lot of students. But I never really had much interest in alcohol because I've never liked the taste, and it was a chore to get it down. Then, again in my thirties, I started to drink to mask the persistent anxiety I was feeling. My life was going nowhere, and I didn't know what to do with myself. I found that beer would calm me down. Eventually I started to drink regularly until I finally became a binge drinker, someone who always drinks until drunk. For the past three to five years (I've lost count) I have been drinking almost every single night. I finally worked up to six malt liquors and three hard ciders a day, closer to twelve on weekends.
And so I drank one which became four
And when I fell on the floor, I drank more
{The Smiths, "Stop Me if You Think You've Heard This One Before"}
So that brings me up to where I am now: a recovering addict 18 days sober.

What is an addict?
I think the defining characteristic of an addict is a powerlessness when it comes to their drug(s) of choice. Any behavior can become addictive. That's why you hear about gambling addicts, sex addicts or even video game addicts. Something about the pleasure feedback loop becomes distorted. One simply can't get enough. I think science has determined that some people are simply wired differently, and they can't properly regulate their behavior when it comes to their drug(s) of choice.

I had friends in college who smoked pot like a chimney, a particularly busy chimney, at that. But after they graduated, they decided they were done with it and were able to leave it behind without much difficulty. They enjoyed it but were never addicted to it. I tried narcotics once and ended up being hooked for life. That's one of the biggest dangers with "experimenting" with drugs. You never know if it's going to wind up ruling your life. It's best simply to avoid the possibility. My sister is one of the smartest and most together people I know. One indication of this is that she looks at the history of addiction in our family and says, "Forget it! I'm not even going to start."

What exactly is "drug(s) of choice"?Addiction is quite personalized. A substance or behavior that one addict struggles against so desperately can mean nothing to another addict. I don't think that I could ever become addicted to gambling because I find it boring. For others, it has totally ruined their lives. Some people drink or even do drugs socially but are never in any danger of becoming addicts, yet they can never manage to stop smoking. I smoke when I use, but when I'm not using, I have no temptation to pick up a cigarette.

How does one become an addict?
There's no set pattern. For some, the process is very quick, for others it develops over time. I was pretty much hooked on narcotics the first time that I abused them as a teenager. I didn't become an alcoholic until twenty years later. Again, the best course of action is to avoid the potential. Don't try illegal drugs. If you find yourself unable to wait until you have the opportunity to do a certain activity such as gambling, avoid that activity completely. If you drink socially, make a habit of being the designated driver. If you find this difficult, then you might have a problem.

Why can't an addict just stop?
That's the million-dollar question, isn't it? Addicts will fully acknowledge the self-destructive nature of their addiction, even its potential for fatality, and yet be unable to break the cycle. There is an entire branch of science devoted to this subject, but I don't know enough to relate the latest scientific thinking. All I can tell you is that it is damn hard for an addict to stop. I would wake up every morning hung over and swearing that I would never drink again. By the time the afternoon was rolling around, I was planning my binge for that evening. I think a big part of it has to do with an inability to delay instant gratification with subtler long-term goals. I wasted literally *years* of my life telling myself, "Just one more night..."
Time and again I tell myself
"I'll stay clean tonight..."
{David Bowie, "Ashes to Ashes"}
Furthermore, the temptation can be overpowering. When it comes to narcotics, the differential between dealing with my anxiety and depression and the allure to being able to forget all of my cares is too great. Not every addict deals with the psychological problems that I deal with (although a statistically significant number of them do!). But the differential between dealing with their cravings and the allure of temporarily satisfying them is too great in of itself. When it comes to me and alcohol, I couldn't stop even though I didn't find the actual drinking pleasurable. It was still a crutch to keep me from having to confront my problems. I do well at my job. (Thank heavens! Or I would've been fired years ago!) But I simply didn't know what to do with myself from the time I got home until it was time to go to sleep. I didn't have the strength to try and make positive changes that would ultimately improve my life, and I feared I would be too agitated to fall asleep and be ready for the challenges of work the next day. I would drink until I passed out in bed, creating a vicious cycle in the process.

What does "jonesing" refer to?
This may sound like a quaint or hip term, but it actually refers to an utterly awful sensation, probably the primary answer to the question above. "Jonesing" is the restless agitation an addict feels when his or her drug(s) of choice wears off. It's a terrible craving that is maddening to resist. It hijacks your brain, and all you can think about is how you're going to get high again. If you've ever seen someone with heroin addiction jonesing, you wouldn't soon forget it!

What is a "trigger"?
Triggers are the situations and behaviors that lead an addict to use. They're slippery slopes. A lot of them are learned. My pattern of use for my alcoholism became very established and well-defined. On the way home from work, I would stop at my local video store and pick out a movie or two to watch. Then I would walk across the street to the market and pick up my beer and cigarettes. I followed this exact same routine for years. It got to the point to where, if I went to the grocery store and didn't buy alcohol, a lot of the clerks would ask me, "Where's your Mickey's?" Often I would be determined not to drink one night, but once I got to the video store to return last night's movie, I would be triggered to drink anyway. Other addicts are triggered by particular nightclubs, or days of the week, or even certain people. Whatever they associate with their ingrained pattern of use.

What is withdrawal like?A nightmare, plain and simple. My use has altered the way my brain processes certain substances. Only last month I had an outbreak of oral herpes, something I've never had before, and it hurt like hell! I eventually got prescribed some pain pills, rationalizing that I truly needed them and only had a small supply. It was enough, though. After only forty pills (not a large amount given the fact that my tolerance forces me to take at least 6-8 of them to start a buzz going), I spent four days of misery unable to do anything but lie in bed and contemplate suicide. I was lucky this happened to fall during a four-day New Year's break from work, so I didn't get myself into trouble. Now a single night of binge drinking spikes my anxiety off the charts. My brain can no longer process these substances "normally," and they always produce terrible withdrawal.

Should I not drink (smoke pot, snort coke, etc.) around my addict friend?
Definitely, unless he or she tells you that it is all right AND you have confidence that you're being told the truth. People are often uncomfortable drinking around me because I'm an alcoholic. But it honestly doesn't bother me. My pattern of use was to binge drink alone in my apartment. Watching other people drink simply isn't a trigger for me. However, if someone was taking narcotics recreationally (or even medicinally) around me, I could not help myself but to make every effort to score some.

Have you ever been to Alcoholics Anonymous or Narcotics Anonymous?
I'm hesitant to go into my experiences with these 12-Step Programs because they are *good* programs and work for a lot of people. I went through an outpatient rehab program at the Matrix Institute that was very helpful, but I've had little involvement with either A.A. or N.A. Frankly, I've kinda been a snob about it. I didn't like the rigidity, and one of the meetings I went to was full of court-ordered individuals who resented being there. Once I move in the next couple of month to wherever I'm going to be living, I'm determined to pursue A.A. as a way to expand my support system. I would encourage anyone struggling with addiction to try a local "Anonymous" program for support.

Where can I get more information?
Wikipedia's entry on Addiction
Matrix Institute
Alcoholics Anonymous
Narcotics Anonymous
Cocaine Anonymous
Meth Anonymous