businessman drinking alcohol

Early on in my career, I had the privilege of working with a variety of addicts and addictive behaviors. As a therapist, I soon discovered that there is a distinct difference between an “out-of-control” addict and a “highly functioning” addict.

The life of an “out-of-control” addict often resembles an amusement ride. Even as a therapist, you must decide whether or not you are willing to board this addict’s rollercoaster ride. Our society commonly associates addiction and addictive behaviors with this personality type. Our minds may conjure up an assortment of images related to addiction, but the reality is there is no absolute personality type or characteristic. It is not uncommon for the “out-of-control’ addict to be involved in criminal behaviors (e.g. including driving impaired, selling narcotics); abusive and broken relationships; abandonment and neglect of children; an inability to maintain regular employment or friendships. According to research by Raheleh Rafaiee, el al, “there is a close relationship between drug abuse and crime. Drug abusers commit crimes to pay for their drugs and this inflicts damages to the society. Moreover, many criminals are under the influence of drugs while committing crimes.” As a society, our perceptions are not without merit. The influence of drugs and their direct relationship on criminal behavior is significant. In fact, “According to (Rafaiee’s) research in the United States, 70% of male prisoners were drug abusers which is significant to the 11.2% rate of drug abuse in the entire male population.”

While drugs are related to criminal behavior, there is no absolute certainty that an addict will become a criminal. Interestingly enough, not all criminals, traffickers or manufactures of narcotics are going to be users either. However, according to the U.S. Department of Justice, “The evidence indicates (and is clear) that drug users are more likely than nonusers to commit crimes, that arrestees and inmates were often under the influence of a drug at the time they committed their offense, and that drug trafficking generates violence.” It is understandable why violence perpetuates violence and why the trafficking of drugs and other substances equates to a higher rate of criminal behavior.

Naturally, it is easy to associate addiction with an individual who has lost control, but it is a greater challenge to associate addiction with an individual who has an appearance of control. Highly functioning addicts seldom appear to be affected by the addiction. These individuals often have an appearance of normalcy and they are capable of functioning on a day-to-day basis. Yet, the highly functioning addict is not much different from their counterpart. Fundamentally, an addict is an addict and declaring a specific universal characteristic or personality type is impossible. For after all, addicts come in an array of personalities, temperaments, and backgrounds. There really is no such thing as an addictive personality, because anyone, at any time, can be challenged with an addictive issue. Rather, there are specific characteristics and traits that are common amongst addicts. Nevertheless, personal behaviors, traits, and styles are not a guarantee, or an indicator, that someone is susceptible to developing an addictive issue.

Author Maia Szalavitz tries to debunk many of the misnomers and myths surrounding the addiction model through her article The Addictive Personality Isn’t What You Think It Is published in Scientific American. “Fundamentally, the idea of a general addictive personality is a myth. Research finds no universal character traits that are common to all addicted people.” If this is the case, why then are we continuing to pursue the idea of an addictive personality?

Why is it then, that there are some individuals who are addicted the very moment that they try a particular substance, drug, or alcoholic beverage? Why is it that some individuals have an ability to abstain; while others are perceivably incapable of abstaining?

My argument is that there is a biopsychosocial relationship related to someone developing an addictive habit. Moreover, there is a direct relationship to an individual’s personal temperament and psychological background. Furthermore, the evidence is clear that chemical dependency occurs and is likely to develop the longer that an individual is exposed and using any substance.What is it that causes an individual to become an addict? Are they more susceptible to becoming an addict if there is a history of psychological instability? Are they more susceptible to becoming an
addict the longer that they use a substance? Or is it, that there is a perfect storm that sweeps through the life of an individual making them more vulnerable to the addictive issue?

What is the possibility of preventing an addictive issue? My argument is that we can prevent addictive issues by establishing boundaries and preventive measures. As a therapist, I firmly believe that many of the addictive habits develop after being exposed to years of abuse, neglect and maltreatment. Please understand that this is not to say that an individual cannot develop an addictive habit having come from a good home. However, I firmly believe that an individual has a greater propensity of developing an addictive habit if there has a been an extensive psychological history. After all, we have an inclination or natural tendency to behave in a particular way the more that we are exposed to abusive or unstable environments.

According Dr. George Koob, director of NIH’s National Institutes of Health on Alcohol Abuse and Alcoholism; “scientist do not yet understand why some people become addicted while others do not. Addiction tends to run in families, and certain types of genes have been linked to different forms of addiction. But not all members of an affected family are necessarily prone to addiction. As with heart disease or diabetes, there’s no one gene that makes you vulnerable.”

My argument is that we must prevent an individual from ever having a reason to seek-out drugs, alcohol and other substances. As a clinician, I have worked with addicts who have been raised in the ideal home; reported never experiencing any form of abuse; and having never been exposed to a substance until they began using. There is no absolute guarantee that an individual raised in a perfect home will be insulated from addictive habits; nor will an individual who has been exposed to a variety of psychological challenges develop an addictive habit.

The key to preventing an addictive habit is not only by establishing safeguards, but in having a clearer understanding what measures to take to prevent the possibility of someone becoming susceptible. We are capable of helping those struggling with addiction by helping them to establish healthy boundaries; by having a clearer understanding of the effects of the substance; by creating healthy relationships; and by finding a professional with which they may engage. Early intervention is essential to overcoming an addictive habit.

Moreover, it is vitally important that an addict have an understanding why they sought out the addictive substance in the first place. What was it about the substance that offered them a sense of pleasure and reassurance? How do they feel when using the substance? What does it feel like when they are incapable of using?

As a clinician, I am determined to help those that I treat to develop a healthier mindset and perspective on life. It is essential that they gain a comprehensive understanding of the addictive vice. Likewise, I am interested in learning more about the dominant players in this individual’s life; because they too can help this individual through the process of recovery. Finally, it is important to help the individual to discover his or her “why”? Why is it that they began using the substance and what will help them continue a life of sobriety?

Dr. Asa Don Brown, Ph.D., C.C.C., D.N.C.C.M., F.A.A.E.T.S.