Habit, Addiction, and Treatment

I’m dealing with a tough situation right now. One of my best friends from my hometown is going through some horrible stuff. He’s a drug addict, and I’m struggling to understand the situation.

I feel terrible for my friend. It’s clear that he’s miserable right now, and that none of this is what he wanted for his life. However, I’m also having trouble dealing with the fact that this is not “his fault.” He dropped out of school, he’s in trouble with the law, and it’s been hard to be friends with him for a while now. I know he can’t help his habit, but I don’t know. I mean, aren’t we all responsible for steering clear of things like drugs? We all have bad habits we can’t break. Where is the line between an addiction and a “bad habit,” and why is one of those your fault, while the other lets you get off blame-free? I feel like a terrible person, but I’m struggling here. Experts, please help.

When a person deals with an addiction, they aren’t the only ones who suffer. An addict’s friends and family have a great deal with which to cope, too, and that feels unfair. It’s natural to struggle to understand how addiction, responsibility, and personal boundaries interact. Having issues understanding your friend’s struggle does not make you a “terrible person.”

Let’s talk about how addiction works. We’ll focus. for the time being, on physically addictive substances, but we’ll talk about the psychological side of addiction later.

When we take in an addictive substance--whether it’s alcohol, cigarettes, cocaine, or any other addictive drug--we affect our bodies. Chemicals in these substances have effects that make us enjoy them. For instance, cocaine works by affecting our brain’s synapses. It blocks a transporter that removes dopamine from the synapse. Since the dopamine isn’t being removed at the rate that it should, it accumulates. Since dopamine makes us feel pleasure, this results in a surge of pleasure. Addictive substances work in all different ways, of course, but they each affect our body’s systems in some way.

We all feel urges to do things that feel good, of course, but physical addiction has another factor. Our bodies react to the changes wrought by the addictive substance. For instance, a cocaine user’s brain will counteract the excess of dopamine by producing less of it. That’s the problem: once our bodies account for the substance we’re taking, we don’t just feel normal without the substance and better when we have it. We feel worse than normal when we’re without the substance. We need the substance to feel normal, and need even more of it to feel “high.”

This is part of why addiction is considered an illness: in the case of physically addictive substances, addiction is a physical condition!

Dire consequences result from this. For an addict forced to go without his or her substance of choice, almost anything can be preferable to sobriety. Addicts often commit more crimes than non-addicts, say criminal defense lawyers in South Carolina; in particular, petty crimes like theft. Addicts must get their next fix, no matter what. Stealing to pay for drugs is, for them, a “necessity.”

Of course, there is a psychological side to addiction as well. Experts found evidence that some psychological addictions look similar to physical ones--for instance, you can come to be dependent on the rush of gambling. This does indeed blur the line between “bad habits” and “addictions,” but we should all do our best to understand that addictions, by definition, consist of habits so serious that they cannot compare to more minor bad habits.

Returning to a moment to physical addiction: what does quitting an addictive substance look like? However, it looks very unpleasant indeed. With physically addictive substances, the act of quitting forces the addict to face down the “new normal” of a body that has counteracted the effects of the substance for the length of the addict’s addiction. Until the body stabilizes, addicts go through “withdrawal,” suffering mental and physical pain that can often be very acute.

In some cases, alternatives to full withdrawal exist. For instance, opioid addicts sometimes get treated with methadone, which is itself an opioid. Addicts receive smaller doses, to wean them off of their addiction. Other medication-assisted treatment options use medicines to treat pain, ease anxiety and depression, and more.

Or take, for example, cigarette smokers. While experts agree that cigarettes kill, the findings on e-cigarettes yield less harsh stats. Experts agree that e-cigarettes are far less dangerous than traditional smoking. Since e-cigarettes have nicotine, some cigarette addicts choose to dodge withdrawal and instead opt to swap their habit for e-cigarettes. Spending time picking out the best e-juice and vaping indoors is far preferable, experts agree, to smoking cigarettes, pipes, or cigars.

However, not all addicts can swap their habit for a healthier one. For those addicted to illegal drugs, run-ins with the law becomes hard to avoid. Your friend’s legal troubles happen to many addicts. Most pay a legal price for being caught with their substance of choice or, as mentioned above, by turning to crime in order to maintain their habit. Addicts tend to see their personal relationships suffer, too: in the face of a serious addiction, things like keeping promises and prioritizing friendships and familial relationships often fall behind the back burner. For addicts, these things may just be impossible--yet it may also be impossible for them to break their habit’s grip on their lives, leading to a terrible and endless cycle.

For many addicts, the way to break the loop is to seek help. What can’t be done alone can, in many cases, be done with proper professional help. We urge anyone who believes they suffer from addiction to seek support. Turn to a therapist, psychologist, or psychiatrist. Attend AA meetings nearby (or the meetings of another twelve-step program that specializes in your addiction). Look for support groups. Go to rehab. It’s important that you take control of your addiction!

For those in your situation, who deal with a loved one’s issue: please remember that you, too, have options for support. Consider speaking with a mental health professional about what you’re dealing with in relation to your friend. You should also remember that understanding addiction’s role in your friend’s actions doesn’t have to mean accepting the treatment you get from him. You can, and should, establish boundaries and respect yourself. Understanding that your friend is not “to blame” does not mean condoning his actions or allowing yourself to be mistreated.

“Rock bottom became the solid foundation on which I rebuilt my life.” - J.K. Rowling


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