The Physical Dependence Chapter One continued

This is the section that will need some updating.  Much more research is available now, particularly with the mesolimbic dopamine system.  At some point, I will try to write an update for those who are interested.  This MDS will clarify why one can be addicted to anything.

In the section entitled, “The Doctors Opinion” of the Alcoholics Anonymous book, it reads, “that the body of the alcoholic is quite as abnormal as his mind. It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.” (1) From the beginning, we seem to know that there was more to our powerlessness over our substances than just what we have discussed in the previous chapter. The older AA guys described this “something physical” as an allergy. They believed that alcoholics had some type of allergy that caused them to continue drinking despite all that was falling apart around them. I used to tell people that I was allergic to drugs and alcohol. When I drink it, I break out in felonies! Setting the humor of that remark aside, those of us who have struggled with moderate use have come to the conclusion that moderation is not in our make-up. When we use, we use to “get the job done.” To use to a point of extreme intoxication. The very idea of moderate use makes no sense to us. What is the point? If we are going to use, then let’s do it! If not, then we are just wasting good substances. Not only do we live by this motto, but it becomes the pattern of our use. Namely, that when I start, I can’t stop. In fact, the very idea of stopping is absolute lunacy to me. Once I take that first drink, I will continue to use until I’m completely wasted. What we are trying to say, in this section, is that this mindset with its subsequent action, has a physical, if not genetic root. That’s right, it has to do with the way that our bodies process drugs as opposed to the way that non-addicts process those same substances. It came as a welcome relief to me to find out this had to do with my genetic makeup and not my own lack of will power or weakness. It was physiological. Again, the Doctors Opinion, “We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.” (2) It would be a mistake to only limit the discussion to alcohol, all of the intoxicating substances seem to have a very similar biochemical response in the bodies of those prone to these issues. Let’s review some of the science on the matter.

From his book, “The Science of Addiction”, Carlton Erickson writes, “New research has found that genes for two neurotransmitter receptors are probably involved in the causes of alcohols dependence. These two receptors, GABA-A, and a form of the gene that codes for the serotonin transporter (SERT, also known as 5-HTT), may produce abnormalities in the mesolimbic dopamine system that cause people to be unable to stop drinking. Other neurotransmitter receptors have also been implicated.” (3) Everybody got that! Clear as mud! I‘ll offer a humble explanation. What this means is that alcohol, and probably other substances as well, trigger two brain receptors to release GABA-A and SERT 5. These are little do-dads (parts of cells called receptors) in the brain that trigger the brain to release more of the “I feel like the greatest person alive” chemical called Dopamine. Dopamine is what triggers that wonderful and great feeling, we like to call “a buzz.” It is what I was experiencing with “Cool Don” at the arcade. This release of Dopamine is so wonderful that we begin to crave more of it. Well, how did we get this release of dopamine in the first place? By using! Hence, in order to get more of the feeling, we continue to use and the idea of stopping, is goofy to say the least. This is what we call the phenomena of craving. It never happens when drugs are outside of your body. It happens as soon as we put that substance into our bodies. That is when the craving begins and drinking/using in moderation is not within our scope of practice. This is a biochemical response triggered by our genetic make-up. In other words, you can’t help it, you are powerless to the way your body process substances.

Here is a little more on Dopamine, “We believe that some people who are born with lower D2 (dopamine receptor) levels are more vulnerable to alcohol or drug abuse,” A team led by Dr. Panayotis K. Thanos of Brookhaven National Laboratory (news – web sites) in Upton, New York, reports the findings in the current issue of the Journal of Neurochemistry. Dopamine is part of the brain’s “reward system,” playing what is thought to be a key role in mood and motivation. Previous research has suggested that people who are vulnerable to addiction may have fewer-than-normal brain receptors for dopamine. The theory is that this pushes them to make up the difference by using substances–including alcohol and other drugs–that elevate dopamine levels in the body. In the new study, researchers used gene therapy in rats to show that the level of dopamine receptors in the brain determined the animals’ motivation for getting alcohol. The rats drank far less alcohol after scientists increased their dopamine receptor levels by injecting the gene for the dopamine D2 receptor into the animals’ brains. This gene delivery allowed the rats’ brain cells to churn out more D2 receptors in the nucleus acumens, a brain structure known to be involved in feelings of pleasure.” (4) The supposition put forth here is that addicts are born with “less than normal” amounts of the “thing” that releases Dopamine in our brains. Because our levels of Dopamine are too low, when we use substances, the level of Dopamine increases which makes us “feel better.” Even good old weed, which is only an herb and doesn’t hurt you. Yeah right! (see chapter six for details) has a similar response.

Again, Dr. Erickson, “These people (referring to folks who chronically stay in trouble regarding the amount of weed they smoke) have a dysregualtion of endocannabinoids or cannabis receptors in their mesolimbic 1 A system (Maldonado, Valverde and Berrenderro, 2006) (5, parenthetical note mine for clarification) Everybody got that! Of course, your average everyday pothead would understand this with absolute clarity and certainty. Just Joking. What is being said is that even weed triggers a very similar response, it makes those who smoke it crave more of it after they have experienced the effects on their brains.

We could go on and on quoting scientific journals, studies, and articles which reiterate the same thing. First, that this is a genetic response. It can’t be helped. It is the bodies biochemical, neurological, neurophysiologic reaction to the ingestion of substances upon the genes that we have inherited. Every time the substance is placed in the body, the body will respond the same way. The person with this genetic make-up will have this response and automatically be incapable of moderate use. They will use like it is their jobs, on a professional level. The individual with this genetic makes has an extremely low probability of being able to use drugs successfully. They simply can’t use in moderation. Hence, the idea of successful use must be smashed and the idea of moderation be equally destroyed. These ideas don’t match our genetic make-up.

Mainly, these genes are passed down from the father’s side of the family. I can’t quote a particular study to validate it, but it seems to be my experience, both personal and professional. One of the reasons that we have bad relationships with our fathers is because of their addictive lifestyles. Hence, the genes that drove them are the same genes that drive us. This is powerless. It is in your genes. My mother’s side of the family is pretty normal. My father’s side of the family is replete with alcoholism. I get it from that side of my family. My allergy to the substances comes through that paternal genetic link.

The old Chinese saying goes, “First a man takes a drink, then the drink takes the man.” In essence, this is what we are saying in this section. We are validating our powerlessness from a physical standpoint because we can’t change our genes. We will always consume to the point of acute intoxication every time we use because our bodies drive us to do so. This is the allergy and this is the phenomena of craving. If you have it, your ability to use successfully is virtually non-existent.

We are not fools. We are acutely aware that many who are reading this will, in fact, use drugs again. This is not a requirement but a reality. So, here is our advice to those who are going to take the plunge again and try to use successfully. The next time you use, try to use in a controlled manner. Try to take two pills and quit. Try to stop abruptly and not touch it again. Try to just take two hits, two lines, two of whatever your substance of choice is, and see if you have this capability. Try it more than once and try it when you don’t expect to do it. This will test if you have this phenomenon. Again, we never encourage relapse. We acknowledge it as a sad fact with addicts. Hence, we try to make the most out of this situation. With this advice, the AA big book agrees. It states, “We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself. Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.” (6)
Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World services, Inc. New York, New York, third edition, page xxiv.

2. Ibid, page xxvi

3. Erickson, Carlton, “The Science of Addiction”, W.W. Norton and Company, New York and London, 2007, page 221.

4. As quoted from: author unknown; http://www.discussanything.com/forums/archive/index.php/t-1882.html

5. Ibid, Erickson, page 140.

6. Ibid, AA, page 31-32.

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Introduction

It’s not my job to convince you that you’re an addict or an alcoholic. I’m not trying to get anyone to stop using drugs or alcohol. If you are reading this book, you are capable of making your own decisions and I will not attempt to manipulate your free will. My purpose is to explain what addicts and alcoholics are like. How we think, act, and live. It’s a humble attempt to explain the insanity of continuing in a self destructive lifestyle. This book is written for two target audiences. First, those who have been told that they need some “help with drugs.” Secondly, those who know or love someone who is an “addict” and they can’t understand why addicts do what we do. As we go along, many will be able to identify with lots of what I’m saying. You may have already identified some after reading, “My Story.” If so, great! Your identifying with someone who had a serious alcohol and drug problem for about 15 years. If you can relate to me, it might tell you how successful you may be if you continue to use alcohol and drugs. Others will see and hear their loved ones in the pages of this text. Many will have experienced the things, first hand, from their loved ones that will be written here. This will tell us where your loved one might be headed and it will also give you some insight into the delusional thinking that controls their lives. My mission here is to bring some clarity to those who have never been exposed to the “ins and outs” of addiction.

It would be a great error to limit our discussion of addiction to only alcohol and drugs. Addiction is much more complex. For addicts, anything that makes us feel good, we can easily get addicted too. Anything! Food, sex, caffeine, nicotine, shopping, gambling, and relationships, just to mention a few and there are many others. For the sake of simplicity, we will use the terms drugs and alcohol to describe the substances of addiction. We will do this for two reasons. First, this is my experience and these are my substances of choice. Second, it is much simpler to discuss the addictive substance/behavior as simply alcohol or drugs. If your addiction involves something other than these, simply substitute your substance/activity of choice where drugs and alcohol are written.

The goal of every addict is to use successfully. This is the theme that we will develop fully in this work. Every addict wants to use drugs and incorporate them into their lives without any adverse effects. This is largely based from the fulfillment that is gained from them. The problem with most of us is that we have already proven that we can’t do this, but we continue to try. This is the insanity of our plight. We continue to do something that we have already proven we can’t do. Only we will not accept this position. To us, we will find a way.

They say there are only three ends to an addict. They either wind up in a jail or institution, they die from their disease, or they get sober. Addiction is a killer. It kills with strokes, car wrecks, high blood pressure, gunshot wounds, cancer, obesity, and by sexually transmitted diseases on occasion. A large percentage of federal inmates in prisons are there on drug charges. Addiction gets you locked up and humiliated. Billions of dollars are spent annually to fund rehabilitation centers to help addicts attempt to recover. Addiction puts us in the hospital and in rehab of some form or fashion. This work is a humble attempt to make the third option a possibility for the reader. The possibility that we, as addicts, can get clean. To live a life that is free from guilt, shame, condemnation, and fear. To have the opportunity to clean up the mess we have caused in our lives and the lives of those we say we love the most. To have the prospect that we, too, can have peace with God.

I am a Christian. I make no apologies for this and I refuse to down play my own spirituality. With this concept the AA Big Book agrees. It states, “We never apologize to anyone for depending upon our Creator…We never apologize for God. Instead we let Him demonstrate, through us, what He can do.” (1) However, I will say this: I am not trying to convert anyone. I’m not an evangelist. I am a nurse who, by relationship with God as I understand Him, has been able to stay clean a number of years. I’m not perfect and I don’t claim to have all the answers. Simply, I want to share my experience and lessons learned to assist those who may be struggling with some of the same issues. The biblical references in this work are placed only to demonstrate spiritual truths as the author understands them. I make no claim to absolute knowledge, only to what makes sense to me. Perhaps it will make sense to others.

Scientists and researchers don’t like the word “addiction.” It is too vague a term and science hates ambiguity because it’s not specific. I use the term in this book for two reasons. First, it is widely understood in public opinion that anyone who either continues to take a substance or perpetuates a behavior that is self-destructive as an apparent act of their will, is an addict. Secondly, it is the term that is used in recovery circles for those who are admitting their own powerlessness. “Hi, I’m Jon and I’m a recovering alcoholic and drug addict.” I realize that there are social stigmas attached to it. That’s O.K. It is an attempt in this work to help people understand that “addiction” as vague as it is, is a disease process. Even if one is not suffering from an addiction, this book will give them insight into why someone they know does the addictive stuff that they do. This is a book for those suffering from addiction and those suffering from watching addicts ruin their lives.

Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World Services, New York, NY, third edition, page 68.

Understanding Addiction

I’ve written this “book” about 4 years ago and have done nothing with it.  So, I thought it a good idea to post it and make it available for those who might have a need to understand addiction.  This is written with 15 years worth of growing up around it, 15 years worth of being active in addiction myself, and I was about 11 years clean when I wrote this (currently I’m at 15 years).  In the past four years there have been newer develops that I will eventually add to this work, as it does need an update (particularly in the scientific department).  Nevertheless, here it is:

 

Table of Contents

My Story Page 1 (this is already on the blog under “my testimony” so I have not reposted it here.

Introduction Page 9

Chapter One: Mechanism of Powerlessness Page 12

Chapter Two: Breaking the Delusional Thinking Page 28

Chapter Three: A Decision about Decisions Page 34

Chapter Four: Abuse vs. Dependence Page 29

Appendix A: Poems: The Perfect High Page 33