5 Things I’ve Learned About Addiction

I have been in the addiction and recovery arena in one way or another for almost 30 years.  About half of that time was spent battling addiction personally, in and out of treatment centers and detoxes, with fleeting stints of sobriety. The other roughly half of that time has been in continuous, sustained recovery.  During my time in recovery, I’ve been able to see things from the eyes of someone who struggles with addiction, someone who has his own recovery path and someone who has spent time as a substance abuse counselor.  My attitudes and biases have naturally changed as I have grown and gained knowledge, which seems to be a requirement if one is to defeat an enemy who is constantly at the gate.  Here are five things I have learned about addiction.

ADDICTION IS ONE OF THE MOST MISUNDERSTOOD ILLNESSES ON THE PLANET. There is an old saying that has to do with alcoholics being around since man first learned to crush grapes.  If you believe that as I do, that covers many centuries. In more recent times, Alcoholics Anonymous was founded somewhere around 1935, and the American Medical Association declared alcohol addiction an illness 1956.  If my math is right, that is 85 years and 64 years ago, respectively.  One would think that with all of the technological, scientific and sociological advances made during that time, we would have a better handle on the symptoms, causes, treatments and recovery paths for something so destructive.  And we would have a better view of the illness as an illness, and not a punch line, a head shake or an opportunity for horrible advice.
Yet, addiction is still widely misunderstood, even in 2020.  Doctors prescribe treatment they believe will help, yet medical professionals have over prescribed opiates to the point of being one of the catalysts to an epidemic.  The War on Drugs has gone on for over 45 years and has cost well over a trillion dollars, with really no meaningful, positive change.  In fact, the War On Drugs has been called an abject failure, but that is another post for another day. I promise.
Family members, friends and coworkers close to someone with a substance use disorder are often heard saying, “I wish they’d just quit this nonsense,” or “If they would just stick to beer.”  Movies portray addicts in ways that seem to exaggerate the symptoms to make a point.  Even the news media is involved.  It is not uncommon (in my area is it very common) for the local news to report on a burglary, high speed chase, standoff, or some other crime where charges result in, among other things, possession of heroin, methamphetamine and/or THC. These are just a few examples, and I’m not picking on anyone.

In modern society, we fix things with pills, when often pills are what get us into trouble in the first place.  (Don’t believe me?  Two words: television commercials.)  Family members, friends and coworkers also mean well, and often travel to the ends of the earth, and to the edge of sanity and well passed exhaustion, to help.  But, despite the best efforts of everyone involved, sometimes we contribute to the muddying of the waters and don’t do well to separate the myth from the truth concerning addiction, treatment and recovery.
All too often, if something is said enough times, if we see it in the news or on social media enough, even if it is completely wrong, it somehow becomes truth (see: politics). Stigma is a huge issue that perpetuates the myths concerning addiction.  Underfunding by our national, state and local governments is another barrier in the understanding of addiction, the reduction of stigma and the availability of treatment for those who struggle.  We can do better.

ADDICTION COSTS A LOT.  According to the National Institute on Drug Abuse (NIDA), substance abuse in the U.S. to alcohol and drugs costs over $520 billion annually. Let me say that again. FIVE HUNDRED-TWENTY BILLION DOLLARS per year.  The Institute includes crime, lost work productivity and healthcare costs in its numbers, while the healthcare numbers alone are $27 billion for alcohol and roughly $11 billion for illicit (illegal) drugs and $26 billion for prescription opiates.  (The cost concerning opiates will surely go up as new data is processed and becomes available.)  To put that into perspective, the cost of the effects of tobacco use and addiction in the U.S. costs roughly $300 billion a year, with over half of that ($168 billion) being healthcare costs.  Not only is addiction and its consequences costly for the person who struggles and for those close to that person, it is also a huge drain on our economy. Imagine if we spent anywhere near that on education, intervention and treatment accessibility and availability. And what if we spent money to develop prevention programs that work?

ADDICTION IS NOT A CHOICE.  I grew up in a small town in a neat neighborhood. My sister and I had lots of friends within a few blocks and the neighborhood was always alive with activity. Some of us wanted to be doctors when we grew up. Others wanted to be cowboys. Princesses. Astronauts. Dirt bike riders. Mechanics. Nurses.  Sometimes our future career choices depended on the popular TV shows or movies of the day. At the risk of dating myself, I’ll stay clear of listing those here.  But, of all the kids in my the neighborhood where I grew up, not once did anyone ever say they wanted to grow up to be an addict.
Addiction is a primary, progressive illness. It can travel alone or, as it often does, it can occur with other conditions like depression, anxiety disorder and so on.  It’s also impossible to predict with certainty who will become addicted to alcohol or other drugs or when it might occur. But there are some risk factors including genetics, age of onset (use), a preceding mental illness and trauma.
People make the choice to abuse, that is, to use a substance to gain a desired affect. People choose to binge drink. People choose to take pills or take a various array of other chemicals in many ways to gain or lose something in their lives, even temporarily, and I’m sure you’ve heard some of these reasons. To lose boredom. To gain excitement. To gain energy. To lose sadness. To lose stress. To gain camaraderie. To gain concentration. To lose weight. We could go on and on. But people choose, whether it is drinking to access, or to double a prescription dose, or to smoke, sniff or inject a substance. Obviously, we all make choices, and sometimes those choices have far reaching consequences. However, to make the connection that since one chooses to abuse, one then also chooses addiction, is irresponsible and really lazy. We choose to abuse. But we don’t choose to become addicts.

ADDICTION IS TERMINAL IF LEFT UNTREATED.  The American Medical Association classifies addiction as a disease and follows a disease model, much the way it classifies diabetes, heart disease and cancer.  The AMA also says that causes are sometimes determined by biological, environmental and behavioral factors. There is much debate about addiction as a disease or an illness, and a quick Google search can open up all sorts of thoughts and ideas on what addiction is to different people and organizations.  Here is where I usually ask people to do all the research they can. Ask questions, reach out. Find credible sources. Think critically.
This July will mark 18 years of continuous long term recovery from alcohol and drugs for me, but I believe truly and completely that I am only in remission.  One drink or drug will surely activate my illness.  You may ask how I know that. I gained valuable yet costly, first-hand experience on relapse personally before I gained long term recovery, and I’ve watched countless others do the same.
NIDA defines addiction as, “a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.”
There are other definitions that echo this idea, some are quite long and more in depth.  For simplicity’s sake, I like to use this definition, and it describes my own addiction, and the addictions of the countless others I have met over the years, perfectly: “Addiction is chronic, and as such will get worse and never better over time if left untreated.”
According to the National Institutes of Health, approximately 88,000 people in the U.S. die each year from alcohol-related causes.  The CDC estimated that in 2017, there were over 72,000 opiate overdose deaths, which included both prescription and illicit drugs. To put that number in some sort of perspective, that was 197 people per day, every day, in 2017, from opiates alone.

ADDICTION IS BEATABLE.  Now that we have all that other stuff out of the way, we can get to the good stuff. Addiction is treatable, it is beatable, and you or someone you love can get their lives back. There are millions of people around the world who celebrate long term recovery. For all the data involving the negative aspects of addiction, there is also data on recovery. There are many pathways to recovery, and each path is as unique as the individual who makes the journey, and there have never been more pathways to recovery than in years past.  Recovery from addiction is possible, and there are millions of us who are proof of that, and there is plenty of room for millions more.
One of the most basic keys to recovery is that it is self-directed, meaning that the person recovering is in charge of determining the path he or she will follow.  Of course, there is much help out there to help guide along the path, or even to help one make the decision of which path to follow. The intervention someone who struggles with a substance use disorder receives, meaning the interruption of behavior, whether family, law enforcement contact, medical, or self-directed, can come in many forms.  Whatever form that intervention comes in, considering consequences, can be the foundation for an effective plan for recovery.
This is certainly not an unabridged, comprehensive reference guide on addiction. These are merely a few things I have learned along the way. There are many resources available online to learn more about addiction treatment, recovery groups, detoxification when needed, and often a medical professional can assist in finding the best option and level of care

5 Things I’ve Learned About Relapse

You or someone you know had a few weeks or months, or even years of recovery. Things appeared to be going well. Lives were getting back in order. The past was becoming just that. Things were good, or better than good. Then it came seemingly out of nowhere. Relapse. The hope, the ability to breathe easy -the overall feeling that things were getting better- were torn away. It seems that all the effort put into getting help and working hard to gain recovery was all for nothing.

But does relapse erase any previous growth or success? Here are five things I’ve learned about relapse from being around addiction in one way or another for 30 years.

Relapse Sucks. For the person struggling with addiction, relapse sucks. For the people around him or her, relapse also sucks. Rebuilt trust crumbles, restful nights once again turn sleepless. Every time the phone rings, it brings with it a dose of panic. These things are common for a spouse or significant other, friends and family members, clergy, counseling professionals, coworkers, neighbors or anyone else involved with the wellbeing of someone who struggles with substance use disorder. But, as someone who survived more than one relapse before I found long term recovery, there are some things to consider.

Relapse Doesn’t Mean You Suck. My experience with relapse came with a boat load of shame. Because I relapsed, I was not only defective, I was broken. Bad. I believed somehow that I deserved addiction and therefore didn’t deserve recovery. Shame is toxic, devoid of any constructive use whatsoever, and in my case, shame prolonged my active addiction and complicated recovery efforts. Shame, quite simply, kills.
Early on, I hadn’t come to grips with the idea that I was battling an illness or disease. What I believed was that because I couldn’t control my drinking or drug use and kept using even in the face of worsening negative consequences, there was something unfixable within me. Today I know that to be false. I didn’t choose to be an addict. No one does. Not you, not your parent, not your husband, daughter, cousin or the guy down the street. I’ve been around this stuff for a long time and I’ve never heard anyone once say that their life’s dream was to become an addict.

Relapse Isn’t a Spur of the Moment Thing. Regarding drinking and drug use, we’ve all heard about people who “slipped,” or “fell off the wagon,” after some time without using chemicals. Along my winding path to sustained abstinence and long term recovery, I used the same language to describe my relapses, usually to my own benefit, to explain to others that I got drunk out of no where after some clean time. In reality what I was doing was trying somehow to magically reduce my responsibility in the whole matter. I was doing great. Then, all of a sudden, I drank! I know, weird, right?

Looking back, I never “slipped.” It never came out of no where. I was never blind sided by a return to using. Instead, there were always doors I had left open or things I hadn’t done, whether intentionally or not, to make it easier to return to using. I kept old friends and relationships. I kept going to parties and bars under the guise of being a “designated driver.” I thought I could handle it. I wasn’t always honest with myself about how serious my addiction was. I daydreamed about using again and thought usually of only positive consequences. When I did think about the negative possibilities, I often minimized, rationalized or denied them. What I was doing was setting myself up for relapse.

Hearing relapse stories, studying relapse, surviving my own relapses and working with others through theirs, experience says that what seems to be a “slip” can usually (if not always) be traced back to something done, or left undone, during early recovery.

Relapse… Happens. Data shows that people with substance use disorders relapse at a rate comparable to people with other chronic illnesses like diabetes, asthma or hypertension, according to the National Institute of Health.

Relapse Can Be A Good Recovery Tool. I would never, ever, never, ever advocate for someone to relapse back to using or anything close to that. Some people don’t make it back from relapse and we face an illness with often heavy negative consequences.
But a point to make about relapse is the idea that it doesn’t always mean using, if you believe relapse is a process, just as recovery is. More often than not, however, the act of using or drinking is what is talked about, because that is when relapse is most easily identifiable. For example, if someone in recovery would stop doing the things they did to get sober, say, if they were to quit going to therapy or meetings, that would be something to look at and find answers for. If he or she were to go back to doing some of the same things they did while in active addiction -hang out in bars, hang out with old using friends, spend a lot of time thinking about the “old days”- they may be areas to highlight as well. A new or reestablished negative outlook (they used to call it “stinkin’ thinkin’), money being spent, whereabouts being unaccounted for… These are just a few quick examples, and when identified and corrected, can help establish a new, improved plan of attack in recovery.

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This, of course, is in no way a comprehensive list of ideas regarding relapse. It is merely a quick sketch of things I have picked up along the way. There are many things to learn from relapse that can help forge a path to long term recovery. Recovery is a journey and relapse can be part of that journey, but it doesn’t have to be the end of it.