Monday, November 03, 2014

A Sunday Evening Musing on the Grip of Addiction.

For years addiction therapists and counsellors tended to be people who had been addicts themselves, these days, not so much. Drug and alcohol counsellors who have experienced addiction first-hand represent a dwindling slice of the addiction therapy community. Someone once told me that it isn't possible to become a drug addiction counsellor if you've never been addicted to drugs like heroin, cocaine and so forth. Or you wouldn't be a very good one at least. While they were no addict themselves it did get me thinking, and in a sense I could see the point through their naiveté.
I think that's probably like saying you can't help someone suffering from alcoholism because you aren't an alcoholic; or that you wouldn't be able to deal with suicide bereavement because you never tried taking your own life; or a paedophile needs to be reformed and rehabilitated by a former paedophile. I mean that may sound like a bit of a sledgehammer to crack a walnut, but their opinion is not too dissimilar.
I don't think that all addictions should have to be approached and individually tailored to the client presenting. William S. Burroughs remarked before, whether ''you sniff it, smoke it, eat it, or shove it up your ass, the result is the same - addiction''. Sure, a heroin addict is going to have a different set of circumstances when trying to avoid their substance, than say an alcoholic, who would be presented with far more opportunities to access and even come into contact with the substance they're trying to avoid. The 'availability hypothesis' states that the greater the availability of a drug in society, the more people are likely to use it and the more they're likely to run into problems with it (Thompson, 2012). The alcoholic's addiction is given extra traction by the innumerable ways society shoves it in their face. It's actively encouraged, under-priced, and sold aggressively. Sure what the hell are ye doing without a pint in yer hand?

''The essential process of addiction is the replacement of people with things. Addicts form primary relationships with objects and events, not with people. In a relationship with an object, the addict can always come first'' (Thompson, 2012).
But what's driving the addiction? It is at the end of the day a mixture between psychology and physiology. Psychologically, it's a cognitive battle. Respite only comes from changing your thinking and you won't be able to change anything if you don't change the thought patterns. But how does an addict attempt to change their biology? Physiologically, all addictions are going to have their roots in the major reward centres of the brain. The pleasure pathways. The networks that quash all the aversive psychological effort and scream far louder than most people can cope with.

Addicts go for pleasure even if it is detrimental to their lives. It is often the thoughts of withdrawal that poisons the outlook of an opiate addict. A psychological fear of an impending physiological nightmare. They can say they won't use anymore, but when the body starts to go into the initial phase of withdrawal, nothing will make sense to the person other than another hit to dampen the pain. It's cyclical. It's tragic. For some people, there really is no silver spoon but plastic spoons and dope; but heroin addicts should be treated like patients and not criminals foremost. You have to deal with person - not the crime of using heroin.

It's similar reward paths for tobacco. It has in fact been argued that giving up cigarettes is analogous to that of opiate withdrawal. But who gives a sh*t about the cigarette smokers, it's only a drug that kills over 5 million people annually worldwide. For heroin, a conservative estimate recorded 7,630 drug-induced deaths in EU member states and Norway in 2009, with the majority of these related to opiate use. It accounts for the greatest numbers of deaths related to drug use in Europe; Ireland having the highest rate of heroin use in Europe with just over 7 cases per 1000 population. There's no denying that these figures are a paltry sum in comparison to tobacco products. 
''None would argue that gambling is a vice, one in which most of us indulge from time to time without harm. But as with all vices, there is the problem of overindulgence, or addiction'' (O'Brien, 1995). Often in the mire of an addiction, people become detached from the things that had a lot of meaning for them. But there's always a choice point for people. I mean gamblers know over the long term that the house will always have the edge. But does that stop them from throwing down weekly wages on bets when the electricity's gonna be cut off at home? You can bet your arse it doesn't. Right there and then, reward circuitry, pleasure, the immediacy of positive feelings. The guilt hides out back and doesn't show up till later, if at all. Same physiology.

What about sex addiction? Is this just a fancy term for promiscuity? If I was arsed I'd have researched it more, but the closest I have for now is relating to a Freud remark in the early part of the 20th century, ''Masturbation is a shortcut between desire and satisfaction, allowing the subject to by-pass the external world''. Again, replacing people - the addict wins. And win they do! To be honest if you want a good representation of sex addiction then just watch Shame with Michael Fassbender.   

Then there's food addiction, I mean a lot of people nowadays have a private relationship with food, they'll hide their negative eating habits behind closed doors and comfort eat. This isn't anything new. It only takes a quick look up and down the high street to see who's wearing in public the unhealthy choices they're making in private. There's a modern plague of obesity happening in a world where 'cupcakes are the new cocaine' (Thompson, 2012). Again, it harks back to the same underlying physiological roots.

Drug use is human. It has been around since day one. It will never go away. We use addiction to resolve our problems. People are constantly chasing the semblance of happiness and we are pushed in the direction of addictive solutions (Loose, 2012). People are hooked on gadgets and technology. Billions are spent on trying to be beautiful. You're being force-fed the ''you're worth it'' type of attitude, and you god damn well better be hungry. It really is incessant. People are looking for an effect from their consumption; preferably something physical and immediate please.

Drug-use is an extremely effective way of dealing with suffering; it brings immediate relief. For some people, addiction is something that stabilises their structure, ''this is why I worked all day for old douchebag up in the insurance brokers shitbox, now I'm letting loose''. Back to reality. Sometimes however the hooks can go deep, and deeper yet again, before they know it, it's a full on marathon just to keep up. Addiction of any form is a struggle that shapes many peoples day to day lives and it's a difficult terrain to navigate. It's toxic. It's a sickness. But for a lot of people it's not about getting them to be extremely happy again or an attempt to cure. It's about getting them back to 'zero'.

I think in essence addiction is a very personal thing, not something that is the sole realm of ex-addicts. Indeed an ex heroin addict would be an excellent person to learn from in dealing with a heroin addiction. With addiction though, experts talk treatment, not cures. Edward de Bono remarked that an expert is ''someone who has succeeded in making decisions and judgements simpler through knowing what to pay attention to and what to ignore''. What can be learned from an addict is immeasurable; the patterns, the pitfalls; and the lies and excuses one will believe that stoke the furnace of addiction. So in that sense ex addicts are probably the real experts.

But there's just one little hair in the soup; the world isn't filled with ex-addicts.  So to say that addiction can't be dealt with from a qualified professional angle, is quite obtuse and frankly utter nonsense.
"...addiction implies in most cases the avoidance of the social bond with other people. It is for this reason that the term a-diction is appropriate as it indicates that addiction is largely a matter of avoiding speech, language, communication, symbolisation and representation"
                                                                                                                       ~ Rik Loose (from 'Addiction in Modern Times')