Addiction - a brief insight

Addiction, substance use disorder, dependency. However you define it personally or professionally, it is a major issue and one that extends across all social and economic demographics.

Stigmas, stereotypes, and misunderstandings around addiction are understandable at times, but without speaking transparently about it to build awareness, provide education, and dismantle these stigmas, nothing can change.

When a person is ready to accept, and they are coming out of denial about having an addiction issue, the crucial part is having immediate support and intervention available, as well as that person's want and desire to change. Even if they do not know how to change, the key is that they want to. Hope starts when the desperation to change starts to overtake the desperation to use and self-harm.

Fear and being close to death is not always the obvious motivator. In my experience this can be an inhibitor to recovery, when the addicted person’s belief (some name it the 'addict ego') of their invincibility is enhanced by having such a close shave, yet surviving.

Asking for help and being signposted to the correct support can be confusing, difficult, and scary. There is immense shame and fear around admitting to a professional about a substance issue, especially with the concern that this could risk misjudgement, or have legal or safeguarding implications potentially jeopardising employment, education, or the individual's home life.

Help is not always immediately available or easily accessible, and it can be expensive - extra tricky financially when the money has gone on the drug use.

Joy, heartbreak, frustration, fear, curiosity, anger, regret, humour, sadness, resentment, hope, and confusion are all typical experiences of being around addiction, personally and professionally, as it’s a multi-complex arena to be in.

From my years of addiction work, I am aware that there is no one-way route into recovery, as addiction is so complex and has contributing factors that can include;

• social (recreational/pleasurable use gone wrong, social pressure)
• environmental (homelessness, abuse, work)
• cultural (trending, being normalised, being accepted by peers, belief systems)
• genetic
• family history / learnt behaviour (normalised)
• life events, thought processes, belief systems, and behaviours as a consequence of exposure to trauma and abuse, depression, grief and loss (childhood and adulthood)
• other mental health issues, including ADHD and physical health issues (self-medication and abuse of prescription medication)
• low self-esteem and confidence issues

This is a non-exhaustive list.

Where do you get help?

From 12-step programmes, SMART recovery, outreach and community projects, specialised therapists, and other support groups - getting in touch with any of them (see the list at the end of this article) is a great start.

There is a need for more education in schools and the workplace, and for all of us to be more compassionate and understand that addiction in its many forms is a psychological problem that has physical, social, and economic consequences.

Patching up with a detox can be a mere temporary sticking plaster; it's the pathways into the disorder that will need to be explored and supported.

Occasionally, I encounter people that have managed recovery without support, however, like many mental health issues, addiction is debilitating and isolating. Long term, sustained recovery is appearing to have better efficacy by not dealing with the problem solely, but connecting with people that understand and can help/educate on a safer way to live.

If your drug of choice is a chemical (alcohol, cocaine, heroin, cannabis, etc), please seek professional medical advice - going 'cold turkey' may be extremely dangerous, leading to a serious risk to your health and possibly even your life.

Here are some of the more common behavioural symptoms that suggest there is a drug dependency issue. Drug means the abuse/abnormal use of a substance that is causing harm to self and/or others; alcohol, recreational and prescription drugs, gambling, gaming, sex, pornography, shopping, etc.

Are you;

• continuously taking the drug in spite of and despite any negative consequences (e.g. health, financial, relationships, education, work, or recreation)?
• using in physically hazardous situations (e.g. when driving or working)?
• continuing to use despite the harmful consequences to self and others?
• getting defensive if challenged on how you are presenting and what you may be doing?
• having to use more and take more risks as your tolerance levels to your initial using have increased?
• having to be secret and dishonest about it? Including lying about what you are doing, your finances, your whereabouts, etc?
• finding that spending time obtaining, hiding, using, and recovering from your drug is becoming more than you ever intended?
• making excuses and justifying why you are doing it (e.g. "if you were as stressed as me...")?
• having cravings and/or withdrawal effects, maybe having to cross to another drug to manage this?
• missing out or screwing up social, family, work or education time because of it?
• finding that time with family, friends, work, and daily life gets irritating as it's getting in the way of you using?
• telling yourself that everybody does it?
• attempting to control or stop but always going back to it or replacing it with another drug?

An addictive person also can present certain personality and behavioural traits;

• agitation, anger, and low tolerance to people and things
• apathy and low mood, depression, anhedonia
• emotional disconnection
• being hyper or manic
• manipulation, deceitfulness, deviousness
• feeling anxious or fearful
• consistently making excuses about behaviour, location, money
• being a perfectionist - expecting too much of self or others
• being a people pleaser
• selfishness or controlling behaviour
• being forgetful
• being obsessive
• getting easily overwhelmed

To have an addiction or dependency issue, you do not have to use every day or in the morning, and it’s not about the strength of what you use (that’s important for a doctor to know to check any physical health risks that may result from using). A person may still present as functioning (to a degree); holding down a job, socialising, running the home, looking presentable, etc, thus convincing self and others that there is not a problem.

Our brain is an organ and, like all organs, it can malfunction. Addiction is a disorder of the brain (in very basic, non-scientific speak!) which is producing the wrong neural pathways and faulty emotional regulation. The prefrontal cortex allowing reason is affected, and there is a deficiency in mood balancing hormones - often creating too much dopamine - as well as developmental issues from childhood.

There are so many reasons why such a complicated piece of kit goes wrong, and thanks to scientific research we keep discovering more. Apart from the external factors, we have a major organ that as an engine is malfunctioning, yet because the effects of addiction can have selfish, harmful, hurtful, threatening, and devastating consequences, we may understandably react in an emotive manner. Not to mention the financial costs to self, family, the taxpayer, the NHS, society, and the great expense to everyone’s health and well-being, so it’s understandably difficult to step back and be objective when you are harmed in any way by addiction.

Recovery is about learning the following;

• how to have emotional honesty - asking for help
• how to cope with feelings and life events without a substance or behaviour to manage that feeling
• adaptive behaviours as opposed to harmful ones
• how to break from the physical dependency and the emotional and psychological dependency that has consumed you
• self-care and self-respect
• how to shed fear and ego
• how to build healthy, nurturing relationships with self and others
• structure and support

A safely managed chemical detox may be necessary, but the drug use is the consequence, and we need to focus on what led to that and how to not keep repeating the same path of destruction.

Recovery takes time, courage, patience, and nurture, with the good news being that it is possible just by admitting there is a problem, not minimising it and seeking help. If you are affected by addiction, there can be hope and help for the user and their loved ones.

Telling someone with an addiction or dependency to "pull themselves together" and "have some willpower" is as ineffective and misguided as telling someone with clinical depression to "watch a comedy and cheer up". The drive to keep using/harming despite the consequences takes immense willpower. This is not always about applying logic; if it was there would be no problem to resolve.

With gratitude for you taking the time to read this, remember that if you have a problem and are affected in any way the first step can be hard, but it is simple. All you need to do is talk.

Where to start seeking help

Many organisations may be able to help. If you are worried about your own, or someone else's health - mental or physically - please visit your GP for advice, Talk to Frank for support and information about addiction and drug use, or visit Happiful's Where to Get Help page for helplines and further resources.