Generally the term ‘drug addiction’ refers to ‘recreational’ drugs, most of which are illegal. This is unfortunate because it gives the impression that other mood-altering substances, which come in different categories, and are not of great concern to drug addicts. In fact any substance that has the capacity to alter the mood will be potentially addictive to drug addicts and therefore liable to lead them back to using their usual drugs. In this way alcohol, nicotine, caffeine, antidepressants, tranquillisers, sleeping tablets, painkillers and many other substances are risky for addicts who want to stay clean. For example, cigarette smokers have double the relapse rate of non-smokers. Therefore the concern for cigarette smokers is not solely for their health but also for their risk of relapse.
The thinking side of the brain knows the difference between these various substances but the feeling part of the brain does not. The feeling part of the brain simply knows whether something ‘works’ or not. It soon recognises that potatoes have no mood-altering effect until they are distilled into whisky. It may know that rhubarb affects the bowel but it isn’t interested in that. Cannabis, another plant, is altogether a different matter. Irrespective of its legality or illegality it has a mood-altering effect on addicts and therefore they will often use it for that purpose.
Addicts will often have one particular ‘drug of choice’. Heroin addicts and cocaine addicts often see themselves as belonging to different groups when in fact they are all addicts – and will sometimes use the other drug when they cannot get their own particular favourite. Some addicts will regularly use both – or even a cocktail of drugs.
Not all users of a drug are addicted to it. For example, not all people who drink alcohol are alcoholic. Obviously not. The same is less obviously true for other drugs. Many smokers of cigarettes are not addicted to them. Nor are all users of cannabis or even cocaine. The crucial issue is not what is used or how much or when but WHY these substances are used. If they are used primarily to alter the mood then the user is probably an addict. The problem is that many addicts believe that they are not in fact addicts – and they go to immense lengths to ‘prove’ that. People who are genuinely not addicts have no need to come up with such elaborate proof.
Addicts are probably born rather than made. Their problems may be made worse by their home circumstances or other environmental factors but the prime cause is probably genetic. Addiction in one form or another may come down through the generations – not always in the same form – and it may skip a generation. Some addictions, such as eating disorders (other than anorexia) and prescription drug addiction are easily overlooked when searching the family tree.
In the long term the only safe way of getting free from addiction is to be totally abstinent from all mood-altering substances (and mood-altering processes such as gambling and sex addiction – which destroys all pleasure) and to work The Twelve Step Programme of Narcotics Anonymous on a continuing basis.
Dr Lefever has over 26 years’ experience in the diagnosis, treatment and rehab of drug addicts. Please contact him if you are concerned about yours or a loved one’s drug use.