Addiction is a bio-psycho-social illness that disrupts the lives not only of the person who is addicted but also their family, friends, co-workers and neighbors. Addiction is an illness because it has definite signs and symptoms, is progressive, can cause other illnesses, is treatable, and if untreated, can be fatal. In going forward we must understand that people can be addicted to drugs (alcohol, opiates, benzodiazepines, nicotine, cannabis), actions
(gambling, shopping, internet, sex, work) and people can be addicted to more than one of the aforementioned.
Many of my clients come to treatment with the perspective that his or her drug of choice is the only issue and believe all they need to do is stop using it and life will miraculously get better. Unfortunately, recovery does not work that way and people in early recovery still have to deal with all the issues that he or she left behind. The inability to cope with problems or the void left by the loss of drugs and/or alcohol can lead to relapse into other addictive behaviors or back to his or her drug of choice. I had an addict once tell me that using drugs was the solution to his problems but it was no longer working so he needed to find new solutions.
Addiction is a biological, psychological, sociological and spiritual disease in which all affected areas must be treated and complete abstinence is vital.
My Problem is Opiates
A young opiate addicted client came into my office due to family pressure, which I noted as his primary motivation for treatment. He was a 20-year-old college student who admitted to opiate addiction and was willing to work on it. However, he did not believe that alcohol or marijuana were a problem. He told me that he had no intention of stopping drinking or smoking pot. “I am turning 21 in two months and all my friends drink and smoke pot” he stated when we explored the idea of complete sobriety. “Plus, I never had any problems with alcohol and I can function on pot.” “I actually work better when I am high,” he added. Unfortunately, many of my clients have had this initial prospective over the years – this is especially true for my 20 somethings. To compound the issue, his or her family members may have a similar view of the problem. It is not uncommon for a family member to believe that drinking and pot are okay as long as their son or daughter has stopped using heroin and other opiates. The fact is that all addictive drugs including alcohol trigger the pleasure center of the brain leading the addicted person back to maladaptive uncontrolled behavior. The addict’s brain through the abuse of his or her drug of choice becomes wired for addiction making the use of any additive drug a major risk. There is an old saying in AA that I think describes this concept perfectly, “once you become a pickle, you can’t go back to being a cucumber.”
A Drug Is a Drug
Cross addiction is a term used for addicts who had one drug of choice and became addicted or replaced it with another. You simply cannot be in recovery from one substance while using another. Cross addiction is not limited to opiates and alcohol, as all addictive substances and even actions are subject to this occurrence and could result in relapse. We must consider that complete sobriety is an extremely frightening prospect for an addicted person, as using drugs or alcohol is their primary coping skill. I had one young addict refer to using drugs as his solution and when he got sober, he needed to find new solutions for his problems. From my experience, an addict who attempts substitution usually ends up back on his or her drug of choice within a short time. They can also switch drugs and become addicted to a completely new drug, which I refer to as, “Changing seats on the titanic.” The ship is going down and the absolute best way it could end is back in treatment.
Gambling, Sex, Food, and Shopping.
When a person puts down his or her drug, they often seek to replace it with something else. Unfortunately, they can easily find themselves in the same place, unable to control or regulate compulsive behavior. Process addictions such as gambling, shopping, food and sex are risk factors and may lead to a completely new addiction or a relapse back to an individuals drug of choice. A client who was an alcoholic and had a couple years sober decided to start gambling despite warnings from his sponsor and others in the program. He thought it was not a problem for him and began going to Atlantic City about once a month. He started gambling increasingly more often eventually making several trips per week and gambling online when he could not make time for the trip. He eventually found himself in a worse situation than years earlier with his alcohol addiction, spending his children’s college money, mortgage payments, and borrowing large amounts of money to satisfy his gambling losses.
Addiction is complex and transferable in that one who has the disease and crossed that line can become addicted to many things. Balance is the key to maintaining sobriety; however, this can be difficult for an individual in early recovery. The following is some advice for creating balance and avoiding cross addiction.
1. Fill the void caused by the loss of drugs or alcohol with new positive activities. Activities like exercising, meditation, sculpting, playing an instrument, painting, reading, etc., stimulate neurobiological activity in a positive way increasing the rate of the healing.
2. Cut out toxic relationships from your life and surround yourself with positive influences. If you don’t want to slip, stay away from slippery people, places and things. You are who your friends are.
3. Do not take unnecessary risks by using other recreational drugs or alcohol.
4. Inform your physicians about your addiction and be sure to research any prescription before taking it.
5. Be humble; one can make many mistakes and stay sober but I do not believe one can lack humility and maintain recovery.
6. Forgive yourself and others, don’t harbor resentments as they can only hurt you.
7. You are not the exception to the rule or unique- many addicts have died from terminal uniqueness. Using drugs or alcohol is not an option.
Steven J. Drzewoszewski is the Intensive Outpatient Coordinator at Carrier Clinic, a psychiatric hospital in New Jersey. He has worked in behavioral health for the past 10 plus years and specializes in the disease of addiction. He is also a recovering addict with many
years in recovery so his writings, lectures and presentations are often from both sides of the coin. Being in recovery and having the clinical perspective helps Steven reach clients and their families as a professional and someone who’s been there.