Old Ideas About Addiction – Part I

Addiction as brain disease
Addiction

There are stubborn ideas about addiction that persist in spite of decades of knowledge and experience that contradict these old ideas. Many people believe addiction is a moral weakness, a failure of will power. There’s still the idea among many mental health therapists that addiction is the result of some underlying psychological disorder. Let’s address this one first. Addiction might cause psychological problems, and psychological disorders might co-exist with addiction, and addiction might make a co-existing psychological disorder worse, but there’s no evidence that addiction is caused by an underlying psychological disorder. This idea has been that a person was, say, neglected as a child, then grew up with low self esteem that became, say, depression or anxiety — the person starting drinking alcohol to deal with the low self esteem and depression or anxiety and this caused the person to become an alcoholic.

This is from WebMD:

Drug addiction is a chronic, often relapsing brain disease that causes compulsive drug seeking and use, despite harmful consequences to the drug addict and those around them. Drug addiction is a brain disease because the abuse of drugs leads to changes in the structure and function of the brain. Although it is true that for most people the initial decision to take drugs is voluntary, over time the changes in the brain caused by repeated drug abuse can affect a person’s self-control and ability to make sound decisions, and at the same time create an intense impulse to take drugs.

Why is it that people from healthy, loving environments become addicted to alcohol or some other drug? Why is it that people with no history of psychological disorders become addicted? There’s a theory going around now that people who live in poverty or dire situations like war with very few choices to pursue happiness and love become addicts because of their living conditions, and that this is likely the cause of addiction — the theory states that “addicts” don’t need abstinence — they need love and a better life. How does this explain the millions of addicts who come from middle class, upper middle class and very rich families and living conditions?

The truth is that those who become addicted to alcohol and other drugs can be well-adjusted prior to drinking and using drugs — they can be from good, caring families– they can be moral — they can be spiritually grounded — they can be rich, financially comfortable or poor — they can be any combination of things. This is all before the addiction. The course of addiction can change a person, of course. The moral person can act immorally as the addiction advances and the impaired judgment has its affect — the rich person can make bad choices during addiction and lose money — the person who becomes addicted can become very sick mentally.

When I was working as a counselor in an inpatient treatment facility, we treated several Catholic priests who started out drinking alcohol socially like a lot of Catholic priests — but these priests I counseled became alcoholics. I heard their life stories and there was nothing unusual about their lives before becoming alcoholics. They had the same experiences of growing up as most people — no terrible trauma — no sexual abuse — no overbearing mother or violent father. They started drinking alcohol and it changed their brain chemistry to the point they craved alcohol and got lost in the craziness of alcoholism. The point is that it’s illogical to say psychological problems cause addiction. There’s a big difference between cause and effect. Science doesn’t yet know the complete cause of addiction, but the more science learns about brain chemistry, the closer we get to the cause, or causes.

I’ll write several parts to this, because there are many old ideas that need to be addressed.