Substance Abuse and Addiction

The ultimate causes of drug addiction have been widely theorized in the past as genetic, bad environment and even moral choice.

The ‘moral choice’ theory went away a long time ago and addiction was seen more as a disease.  A new theory by Heyman (his book, “Addiction; A Disorder of Choice”) is once again labeling addiction as a series of bad choices.

He believes that many addictions are overcome once the real life consequences of addictive behavior are realized making addiction a response to an out-of-control life.

Heyman further believes that labeling addiction as a disease will provide a crutch for many addicts to lean on and not give up the addiction.

That is a simple explanation and not all inclusive so to see more look up this author and book if you are interested.

This is a short story about Jerry, a person with a co-occurring disorder meaning substance abuse with a mental disability.  Did the mental disability cause the substance abuse or did the substance abuse result in the mental disability?  We will never know…  Here is a history of Jerry:

Jerry began drinking constantly shortly after he had what the doctors back then termed, “a break with reality”.  He had lived alone with his mother who drank all day and Jerry would buy her the alcohol.

It wasn’t long before Jerry began drinking himself, all day every day.  He would sit in the apartment with his mother, drinking and chain-smoking, talking to invisible people while his mother slept.

As the years passed, Jerry who was now in his late teens began losing his tenuous grasp of reality and with it went any social skills including self-care skills.

Food rotted in the refrigerator, neither mother nor son ever washed and soon it became too much for Jerry to travel to the bathroom in the middle of the night when the urge hit – the corner of the room now sufficed.

His mother’s social security kept them both in booze and Jerry drank and smoked every waking minute.  When rent was not being paid the landlord stepped in followed by state authorities which landed Jerry in a residential setting for the mentally disturbed and his mother in a convalesent home.

Jerry had no problem with this at all until he discovered that he would not be drinking anymore…

A nasty detox was followed by some heavy duty medications and Jerry has been sober for quite a few years now, more or less.  His last remaining vice is smoking, but his cigarettes are held by staff and apportioned to him at no more than 2 per hour.

Jerry is physically clean and has been through self help training to educate him in his ADL’s (activities of daily living).  Even Jerry’s money, the disability he gets each month, is held by staff.

But Jerry still saves his pennies by not returning all the change for a bought item and conveniently losing the receipt.  When he has enough pennies he hightails it to the bar up the street to down a few quick beers.

Fortunately, Jerry’s case manager suspects when this will happen and usually catches and stops him going into the bar before he can buy a drink.

Jerry’s life is now smoking and thinking about drinking… Fortunately his meds are designed to reduce his cravings for alcohol.

Jerry will eventually attend an AA group, is going to individual counseling and will hopefully venture out on his own and in better control of himself someday…  He is working on it…

As I sit here writing this, I realize I spend an inordinate amount of time on the Internet.  Am I addicted to the websites and blogs I maintain?

Maybe I’m addicted to the massive MMORPG’s (massively multiplayer on-line role playing game) that I play or have played.  I finished playing ‘Eve Online’ and currently I’m playing ‘Anarchy Online’ while waiting patiently for StarTrekOnline.com to launch it’s game so I can jump in and cruise the galaxy as an Andorian.

Maybe I’m addicted to work…spending 40 hours a week in the pursuit of 1 activity cannot be healthy… and I’m positively reinforced to keep working by being paid a salary and negatively reinforced to keep working for fear of losing what I have.

I maintain 4 websites including this one and it takes up a lot of my free time.  Is it addiction or love?  Speaking of love, I’ve been married to the same person for 27 years…love, habit, addiction?

When I think of all the time I spend in the pursuit of food, whether shopping, preparing or eating, it’s downright scary.  I generally eat more than needed to survive, much more in fact.  Compulsion, food abuse or addiction?  Maybe a little of all 3.

Seriously though, compulsion to perform a behavior over and over is certainly an element of addiction.  And the amount of time spent on an activity can make the difference between a healthy pursuit of something and an unhealthy pursuit.

But the one big difference between substance abuse and addiction is whether the pursuit of the ‘addiction’ is seriously and negatively affecting your life and you are still pursuing the addiction in spite of this…