62 Years An Addict
Let’s start off with full transparency: I’m a 62-year-old white, male, addict. I have been an addict my whole life. Some gay people say they knew from the very beginning that they were gay. Well, I knew I was an addict.
The first manifestation of my addiction happened when I was 8. I was sick enough that there was the threat of my missing the life-shatteringly important class trip to the airport (gasp!). My pediatrician gave me meds. They made me feel better; I might be able to go! Take more!
Somehow Mom found out. She wasn’t happy.
What’s the problem, Mom? One made me feel better, two will make me feel even better and…I’ll be able to go! Makes perfect sense!
Yeah. Only to an addict.
So, by 8 I was already exhibiting symptoms of addiction. Whether or not that particular event really is an early sign of addiction, what it reveals (to me, at least) is the thinking-feeling of an addict. At 8. Yep, it has been there all my life.
Along with the depression, anxiety, low self-esteem, and dysthymia (what my therapist calls my moodiness these days) that still lurk in my emotional landscape. And that emotional palette seems to play a role in most addict’s stories. What’s the connection?
The other thing to know about my addiction is that I have always been an edge case. An outlier. What, in the rehabilitation industry (yes, there is one, we’ll get to that), they call a “high functioning addict.” The point here being that my experiences may be outside the norm and, as I have recently learned in data science class, the importance of outliers is they often point to unexpected insights that are important to the larger population.
So…my story. I hope that it’s helpful, instructive, or beneficial in some way.
Addiction from an addict’s viewpoint
What is it? There is a profusion of definitions. At best, some of them are partially right. At worst, they are dangerous, inhumane, and simply crazy.
After living it and watching other people live with it for a long time, it’s clear to me that addiction is a genetic disease. That disease has multiple components: Spiritual, Physiological, and Social.
Social? Yes, social. Addiction is a disease that responds to its environment. There are epigenetic components to it. It’s a disease that happens beyond a single body. It is amplified in certain social contexts and is a master at abusing love and care, so it carries families and friendships along with it.
Let’s look at each of these components, starting with the easy one — the physiological. As complex as that is, it might be the simplest of the three.
Physiology; is it the answer?
Medical science has come so far in its understanding of the brain that we now have a pretty good idea what’s happening in the brain of an addict. It’s a complex interplay of neurotransmitters, reward systems, the brain’s plasticity (ability to change, adapt to its environment), and our survival instinct; one of the deepest we have.
And, as deeply and granularly we understand the physiology of addiction, it really tells us little about how it starts in the first place, why some people are more susceptible than others or why, if it’s mechanism is so clear, it’s so hard to interrupt.
Part of that might be uniquely American (there’s the Social component, popping its head up again). Other places in the world are starting to see success interrupting the addictive processes through medicines that reduce the sensitivity of our endorphin systems. But Americans think that treating the medical problem of addiction with pills is insane. Why? We prescribe pills for just about everything else.
Part of the physiology is, of course, genetic. For me to show signs of addiction at 8, there’s no question (to me, some scientists disagree) that genetics play a critical role in addiction. Given the high rates of other mental health issues amongst addicts, the question to me isn’t “are genetics a suspect in addiction?”, but “which genes express themselves in addiction and depression?” Genetics and mood — the interplay of genes and emotions — turns out to be a very interesting avenue to explore (more on that below).
And, the bottom line here seems to be that, in order to “cure” addiction, some kind of physiological treatment is likely to be needed, at least until we can successfully edit the genes involved. So, the answer to the opening question of this section is: partially. But, until we actually have treatments that get to the actual causes of addiction and depression, that’s the best anyone can offer.
The inner life of an addict (or a depressive) is a vortex of evil. That’s really the best description of it that I have come up with. The spiritual-emotional axis of this disease (these diseases?) makes life really difficult, for the addict (of course) and for everyone around them. Depression alone is more readily hidden; addiction can be a black hole that sucks lives into it. But, the inner lives are very similar.
The emotional life of an (untreated) addict is fear-filled, anxious, self-defeating, and hopeless. Persistently. Sounds like depression, doesn’t it? If addiction progresses far enough, the object of the addiction (heroin, alcohol, whatever) becomes the only thing that brings joy…no, not really joy, but comfort. The “I’m OK” feeling. Almost serenity, but not quite.
Addict-depressives also have the extreme highs and lows of addiction thrown into the emotional palette. The addiction feeds the depression and the depression fuels the addiction, in a hard-to-break positive feedback loop that can become an endless dance. Our brains get used to it and it becomes the norm. From the inside? It sucks. A lot.
It’s a life that no one, no one would knowingly choose to live. But it is the life that many of us find ourselves in.
This emotional state pushes right to the edges of our understanding of our own selves. Why are some people like this and others not? We just don’t know yet. But, I can tell you the ramifications of it from an addict’s viewpoint: once one is identified as an addict, the response is mostly cookie-cutter, automatic (read “thoughtless”), sternly stereotyped, and permanent. With only two outcomes: complete lifelong sobriety or permanent thrall to the addiction.
The reality for the addict is very different. During my search for solutions I was placed into programs with hardcore, active addicts. One guy was there because he has snorted an eighth-ounce of cocaine on a Friday night and ended up in the ER the next morning.
I have to ask: why did it make any sense at all for me to be there? Yes, I was an addict just like that gentleman, but…under what model does it make sense to treat all addicts the same? We don’t treat cancer patients all the same, but under the current addiction model once you’re identified as an addict there is the AA model and not much else.
In a recent article, I point out that the world is not binary. Neither is addiction (or depression). We should stop treating it that way. But, the unfortunate answer to the question, “why did it make any sense at all for me to be there?”, is that it’s about all there was.
In order to even attempt to treat my addiction, I was force-fit into a treatment model that is as unscientific is it is cruel. Yeah, sorry AA and all of the “recovery” industry, what you did to me was cruel and I expect that you’re doing it to a whole lot of other people right now. Perhaps it’s time to question your assumptions?
In my case that made treating my addiction much harder. The current monolithic model of addiction is doing a huge disservice to many, many people who may be on the addiction spectrum, but who don’t need the rigors of AA to “recover.”
Almost every story of “recovery” has the addict having to change social circles. From my own experience, I know that quitting anything required that I completely change my friends. My entire social circle was dedicated to that activity. Friends help with the emotional underpinnings of addiction and depression, as do drugs, and together they can just about make us feel better.
The social components of alcohol are alarmingly obvious. One of the reasons that it’s so hard to quit is that it’s everywhere. As the one accepted drug in the country, it is enormously popular. Part of almost every ritual, gathering, night out, you name it.
Why is a good question. Why does this one drug have such power? Why does any drug have such power? The answer is as simple as it is surprising. The evidence is clear, we just have to acknowledge it.
Getting high is a survival trait. Evolution has selected for it for some part of the population.
Fermentation is one of the earliest industrial processes. Cannabis is one of the earliest examples of agriculture. Before we were human we were eating fermented berries for the effect.
Getting high is part of our DNA and ancestry from prehistoric times. And certainly consciousness seems to come with a desire to alter itself.
The desire to make ourselves feel different inside seems to be deeply ingrained in our genetics. In some cases it expresses itself strongly from early in life (like me); in others it gets turned on later in life by something in its environment.
Which brings us to epigenetics and the social component of addiction. Early exposure to intoxicants makes for a much higher likelihood of later addiction. Peer pressure. Death. Job loss. All make substance abuse more likely. And for some part of that population, the drinking/using binge will trigger that magic combination of genes to turn on the addiction.
There are several other indications of the social component of addiction: the fact that when addicts quit being addicts they frequently have to completely change their social circle. I had to. I know how it goes. The other proof point is AA, the organization imputed to have the most success in keep people sober, and a strong component of their “cure” is having a strong community.
From my experiences, it is perfectly clear that all three of these components — physiological, spiritual, and social — need to be addressed in order for any “recovery” to happen.
What IS a cure?
As part of my own addiction management, I take part in a weekly men’s group. Recently a group-brother expressed what his experience of life was like: fear-filled, anxious, self-defeating, and hopeless (just as above). Yet, he’s been sober for over 30 years.
So, the question: was he cured of his addiction? Clearly, not. He may no longer have been an active alcoholic, but he was most certainly still an addict.
Are we, is the rehab industry, willing to accept that as an answer? As “that’s as good as we can do?” I hope not, and, that attitude might be slowly changing (see below).
Part of the issue is how we define “cured.” The recovery industry seems to use only one definition: total abstinence for life. Period. And yet, as we’ve seen, even that definition doesn’t really fit; my group-brother is clearly not cured, he just has enough support — physiological, spiritual, and social support — to keep from drinking. The underlying issue, pathology, syndrome, whatever-you-want-to-call-it, is still quite firmly in place.
Perhaps part of the answer is defining “cure” much more inclusively. Again, I think my scenario is instructive: I was a medium-level coke addict for a few years and stopped on my own. After that, the medical industry was kindly giving out opiates like lollipops, and I really liked those. Thank god for my wife who intervened and saved my life. Then it was alcohol (drinking vodka at 2pm at my worst moments), which I was able to taper off through a combination of therapy (general and addiction), meditation, cannabis, and my men’s group.
Today I manage my depression with cannabis and Effexor. I don’t know if I would call my addiction “cured,” but here’s what I do know: I have an on-going prescription for Xanax, one of the most addictive drugs on the market, and I never abuse it. I can have one beer and be satisfied, or a half glass of wine and walk away, or not drink at all at a party where just about everyone else is drinking and not feel weird about it (until everyone starts getting really drunk), 0 cravings, and have stopped even tracking when I drink because I do it so rarely. I think I am cured of alcoholism (I can hear the cries of “denial!” from here), even while still being an addict.
Some people, especially those in the recovery industry, will say that I am just allowing my addiction with a lesser harm drug. My question back is, “why is that a problem?” The cure I have found keeps my depression at bay, allows me to focus and able to work and be productive consistently, be kind first (#bkf), improves my memory, and helps me have better relationships.
Don’t tell me that that’s not a cure. We still haven’t gotten to the real basis of the disease; my genes, but, I am in a place where I think I might be if we had turned off those genes in the first place.
AA and the origins of addiction
AA’s success rate (and any program founded on their method), are highly debated, but it’s somewhere between 10% and 70%. Whichever end of the spectrum you believe, it’s clear that it does work for some people some of the time. IMHO that’s because they do cover the three areas of addiction with sponsors, higher power, and meetings. Whether or not they “cure” anyone is open to interpretation.
Where did addiction come from in the first place? Because it’s a genetic disease with epigenetic components, it’s difficult to determine. But…it’s clear it’s been with us for a long time. And, recent evidence has shown that trauma can be carried down generations through genes, and can get turned on by epigenetic responses to the environment. Perhaps trauma is more common in the ancestry of addicts?
Either way, it’s clear that a high percentage of those prone to addiction have underlying emotional issues (WD?) that the drugs help to salve. That’s what allows the disease to implant itself in people.
And, when we open our definition of “cured” or “recovered,” we see that it’s not black and white. Nor should it be. Addicts come in multiple flavors, sizes, shapes, and colors. Just like people.
A New Hope
While this binary paradigm of addiction is pretty well integrated into the medical and rehab industries, there are signs that it is beginning to crack and allow some of the light of reality in. The 2015 article by The Atlantic (cited below) wasn’t the first to question AA’s model, and they presented a fact-driven approach to the treatment of addiction, depression, and addiction-depression.
And then there is Alltyr. An approach I dearly wish had been available 30 years ago. From this addict’s viewpoint, they are much closer to what I see as an effective approach or, at least, something that would have worked for me.
For anyone who is suffering with addiction, please contact them. For anyone who loves someone who’s an addict, contact them. It doesn’t have to be so terrible.
The author has no affiliation with Alltyr or any of its staff. The first I have learned of them was doing research for this article, and I make no guarantees regarding the efficacy of their treatment. OK, I think that covers me legally.
I refer, above, to the “rehab industry” several times and I know that that is going to encounter some friction, especially from those within it. For those of you that do care to argue, please stop it, you’re only denying the incredibly obvious.
And to all the addicts still suffering; may you find your peace.
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