Alcoholism and Drug Addiction Are

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1 Chapter 10 Alcoholism and Drug Addiction Are a Bio-Psycho-Social-Spiritual Disease T But I used to wake up at 4 A.M. having FULL-BLOWN panic attacks out of nowhere. I would crawl the walls and freak, trying to calm down. My hangovers made me WISH I was dead. Puke, puke, puke... retch, retch, retch. Please let me die. Curled up in the bottom of a tub in a fetal position while having a cold shower is not my idea of a good time. And then I would suddenly remember that I drove my car some unspeakable distance at some unspeakable speed and then I would contemplate the reality (one more damn time) that for some unfathomable reason, neither I nor some innocent person who happened to be on the road with me managed to die that night. Talk about guilt and remorse. That was utter bullshit, I say. My god, if no one understands that kind of suffering, I m very happy for them. And the kicker was that I would do it again the next night. -Morris M. 113

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3 I have been an alcoholic and addict since teen-age years trying everything possible. Was not until later years I just went straight to using narcotic pain pills since the doctor would gladly give them to me. Well, that addiction grew huge. I got arrested for calling in a prescription that was not mine. Needless to say that was a blessing for me. I was sentenced quite heavily. I spent some time in jail and went through a treatment program. This was over two years ago. My family was very supportive at that time. Well, I have relapsed. I worked with a girl that popped Vicodins (my DOC) and she was always offering it to me. I said no for the longest time. But one day I gave in thinking that one would not hurt me. I can take them responsibly now that I know how. YEAH RIGHT, I bet you know what I did next. Yup. I went right back to the same Dr. that was giving them to me before. He gladly prescribed me 155 of those little white demons a month. Which I would use up in 9 days flat! So knowing the withdrawals was coming and I was caught in the trap again, I started my old habits again. Insane. Insane. Insane. I feel so ashamed and down. How could I do this to my self again knowing that I could possibly lose everything in my life? Sadly, Andrea A. s story is not uncommon initially voluntary consumption of alcohol and other drugs leads to a lifetime of self-deception, self-destructive choices, adverse consequences, and shame and remorse about her preoccupation with and compulsive pattern of consuming alcohol and other drugs. But how could Andrea s initially voluntary consumption of alcohol and other drugs reach the point that it 115

4 ASK DR. STEVE... How Can I Tell If I Have a Problem with Alcohol and Other Drugs? reached despite her knowledge of what it was that she stood to lose? Not because Andrea is insane. Not because she is stupid. Not because she is bad, or weak, or immoral, or afflicted with a certain type of personality. The explanation for how Andrea s initially voluntary consumption of alcohol and other drugs transformed into a preoccupation with and compulsive pattern of consumption of alcohol and other drugs is that Andrea has a disease. The name of her disease is alcoholism, drug addiction, and/or chemical dependency. But no matter the name by which you refer to Andrea A. s compulsive consumption of alcohol and other drugs, it s a disease nonetheless. I ve been educating people for three decades now about alcoholism and drug addiction. And more times than not, when I tell them that alcoholism and drug addiction are a disease, I get the same response an arched eyebrow, a furrowed forehead, a polite nodding of the head, and a smile that belies the skepticism that most people have about the idea that alcoholism and drug addiction are a disease. For more times than not, they have their own way of explaining what alcoholism and drug addiction and their root causes are. It sounds something like this, Alcoholism and drug addiction can t be a disease for alcoholism and drug addiction are caused by... Alcoholism and drug addiction can hardly be a disease, for alcoholism and drug addiction are caused by a deficit in one s conscious self-will or self-control. According to this explanation, the cause of alcoholism and drug addiction is one s inability or unwillingness to exert their will strongly enough or not applying sufficient self-control in order to cut down on the frequency and/or amount of alcohol and other drugs that they consume. 116

5 Alcoholism and Drug Addition are a Bio-Psycho-Social-Spiritual Disease Alcoholism and drug addiction can hardly be a disease for alcoholism and drug addiction are caused by an individual s moral depravity. By this way of thinking, one s immoral fiber is the determinant cause for the development of alcoholism and drug addiction. Alcoholism and drug addiction can hardly be a disease for alcoholism and drug addiction are caused by the diminished quality of and/or the deficiencies in one s character. By this way of thinking, alcoholism and drug addiction occur because an individual is weak and lacking in the right stuff. Because one s character is fundamentally weak, they lack the backbone or intestinal fortitude to just say no to one more drink, or so the thinking of this theory goes. Finally, alcoholism and drug addiction can hardly be a disease for alcoholism and drug addiction are caused by an addictive personality. This theory is just what it sounds like a type of personality exists that is the root cause as to why a person with that type of personality compulsively consumes alcohol and other drugs. None of these accurately explain, nor do they describe what alcoholism and drug addiction are. Alcoholism and drug addiction are a bio-psycho-social-spiritual disease. Again, more information that I ll break down for you. To do so, I ll discuss in this chapter what I mean by the phrase, bio-psycho-social-spiritual and I ll discuss in the next chapter what I mean by the idea that alcoholism and drug addiction is a disease. What do I mean by this phrase, bio-psycho-social-spiritual? Quite simply, the root cause of alcoholism and drug addiction is the complex interplay of biological, psychological, social, and spiritual variables. We ve already discussed the biological nature of this disease in the chapters about tolerance and withdrawal syndromes. A 117

6 ASK DR. STEVE... How Can I Tell If I Have a Problem with Alcohol and Other Drugs? concept that has been evolving with scientific advances is that alcoholism and drug addiction are a brain disease that develops over time as a result of the initially voluntary behavior of consuming alcohol and other drugs. The consequence is virtually uncontrollable compulsive alcohol and other drugs craving, seeking, and consumption that interferes with, if not destroys, an individual s functioning in the family and in society. We now know in great detail the brain mechanisms through which drugs acutely modify mood, memory, perception, and emotional states. Consuming alcohol and other drugs repeatedly over time changes brain structure and function in fundamental and long-lasting ways that can persist long after the individual stops using them. Addiction occurs through an array of neuroadaptive changes and the laying down and strengthening of new memory connections in various circuits in the brain. We do not yet know all the relevant mechanisms, but the evidence suggests that those long-lasting brain changes are responsible for the distortions of cognitive and emotional functioning that characterize individuals who have a Substance Dependence problem, particularly including the compulsion to consume alcohol and other drugs that is the essence of addiction. It s as if alcohol and other drugs have highjacked the brain s natural motivational control circuits. This may result in the consumption of alcohol and other drugs becoming the sole, or at least the top, motivational priority for the individual. Thus, the majority of the biomedical community now considers addiction, in its essence, to be a brain disease: a condition caused by persistent changes in brain structure and function. The psychological aspect of alcoholism and drug addiction refers to: 118

7 Alcoholism and Drug Addition are a Bio-Psycho-Social-Spiritual Disease The belief system of an individual that contributes to the chronic compulsive consumption of alcohol and other drugs The style of thinking of an individual that contributes to the chronic compulsive consumption of alcohol and other drugs The psychological defenses that an individual uses in order to protect themselves from the truth about their consumption of alcohol and other drugs The feelings that activate the craving, seeking, and compulsive pattern(s) of consumption of alcohol and other drugs The life circumstances, both past and present, that activate the craving, seeking, and compulsive pattern(s) of consumption of alcohol and other drugs What motivates an individual to take or avoid specific actions The nature of the relationship that one has with themselves that contributes to the chronic compulsive consumption of alcohol and other drugs To go into greater detail about the psychological aspect of alcoholism and drug addiction would take me far beyond the scope of this chapter. However, I go into much greater detail about the psychological aspect of the disease of alcoholism and drug addiction in my book, Ask Dr. Steve... How Can I Stay Clean and Sober? The social aspect of alcoholism and drug addiction refers to: The environment(s) in which one consumes alcohol and other drugs 119

8 ASK DR. STEVE... How Can I Tell If I Have a Problem with Alcohol and Other Drugs? The attitudes about the consumption of alcohol and other drugs within the environment that one works, lives, and plays The environmental cues or triggers that activate the craving, seeking, and compulsive pattern(s) of consumption of alcohol and other drugs The interpersonal relationships that activate the craving, seeking, and compulsive pattern(s) of one s consumption of alcohol and other drugs I refer you to my book, Ask Dr. Steve... How Can I Stay Clean and Sober?, for more specific information about the social aspect of alcoholism and drug addiction. Finally, the spiritual aspect of alcoholism and drug addiction refers to the overreliance on one s self-will to control their consumption of alcohol and other drugs. Simply put, one s overreliance on their self-will to control their consumption of alcohol and other drugs fuels, in part, the compulsive pattern of consumption of alcohol and other drugs. By experiencing a spiritual [re]awakening through the development of a relationship with a Higher Power and engaging in a process of rigorously honest self-examination, one is better able to forsake their overreliance on their self-will, give up their lose-lose quest to control their consumption of alcohol and other drugs, and experience a release from the hold their compulsion to consume alcohol and other drugs has on them. One last time I ll refer you to my book, Ask Dr. Steve... How Can I Stay Clean and Sober?, for more specific information about the spiritual aspect of alcoholism and drug addiction. That concludes my discussion of the bio-psycho-social-spiritual elements of the disease of alcoholism and drug addiction. 120

9 Alcoholism and Drug Addition are a Bio-Psycho-Social-Spiritual Disease In the next chapter, How Can Alcoholism and Drug Addiction Be a Disease?, I ll discuss with you how it is that alcoholism and drug addiction are referred to as a disease. 121

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