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Is the opposite of addiction really sobriety?

By Chris Tuell, Ed.D., LPCC-S, LICDC-CS

Lindner Center of HOPE Clinical Director of Addiction Services

 

In April of 1975, the Viet Nam War came to an end. During this 10 years of military strife, 58,220 U.S. soldiers lost their lives.  However, the end of the war also brought another difficult issue to light.  A never before scene was about to appear on the horizon.  Estimates indicated that approximately 20% or 1 out of 5 American soldiers returning from Southeast Asia were addicted to heroin.  Experts believed that once these soldiers returned home, our country would be faced with a heroin pandemic.  How would we manage such an issue?  It never happened.

Today, our knowledge of the neurology of the addicted brain has grown by leaps and bounds. We have gained a better understanding of the disease of addiction and how this new awareness clearly indicates that it is not an issue of character, nor is it a moral failing or a lack of will power.  Addiction is the result of the brain’s reward system being hijacked by outside substances (alcohol and drugs) and various behaviors (gambling, pornography, gaming, Internet).  This hijacking tricks the brain in believing that the drug or behavior has more importance than it really does.  Because of this pairing with certain neurochemicals, the brain believes this drug and/or behavior (like food) become necessary for survival.  Each of us knows that we don’t need alcohol, drugs, or gambling to survive. That’s true.  But, the brain thinks we do.  This survival drives the urges and cravings for the patient to use substances.  We know that patients who suffer from addiction, will engage in negative behaviors.  These individuals unfortunately will lie, cheat and steal in the midst of their addiction.  But equally important is the understanding that bad acts do not necessarily mean bad actors.  If each of us would be without water for three days or without food for three weeks, every one of us would lie, cheat and steal to survive.  This is what’s happening within addiction.

So why did the heroin epidemic of the 1970s not occur? Our new knowledge of the workings of the brain has also demonstrated that when substances are introduced, it impacts the very area of the brain where we develop meaningful, connected relationships. When mental illness issues surface, such as depression, anxiety, and trauma, the drug brings about relief.  It is this relationship that allows a sense of meaningful connection, even though that connection is unhealthy and problematic.  As one patient shared, using heroin was like “getting a hug from your grandmother on Thanksgiving morning.”  This experience becomes meaningful for the drug-addicted individual.  The drug’s influence on the brain creates a sense of connection causing a disconnect with truly meaningful relationships.  For the patient, the drug relationship becomes “on par” with other important relationships (i.e., spouse, children, parents, relatives, friends).  Unfortunately, sometimes the drug becomes number one.  For the Viet Nam soldier who was addicted, connection was re-established with loved ones, family and friends, and were able to reconnect within his or her community.  The heroin addiction ceased.  When an individual suffers with mental illness, the depression, anxiety, trauma, disconnects them from others resulting in a vulnerability to substance use and a hijacking of the brain’s reward system.

This phenomenon also occurred within the laboratory. In the early 20th century, research-involving rats found that when a rat was placed within a small cage and given the choice of two forms of water (pure water or water laced with heroin or cocaine) the rat would prefer the water laced with drugs.  The rat continued to use the drug laced water, eventually developing addiction, overdosing and dying.  Experiments like these shaped our view of addiction for many years.

However, a series of new research looked at the same experiment, but this time expanding the cage. In fact, the researchers created a “rat park.”  The cage was bigger with various levels and tunnels along with the addition of other rats.  The same two samples of water were provided.  Rats in this study preferred the pure water to the water laced with drugs.  No instances of overdose were recorded.

Mental illness interferes with our ability to connect with ourselves, others, and the world in which we live.   This isolation and disconnect creates the perfect storm for addiction.  Nearly 80% of individuals with a substance use disorder also have a mental illness. How many of us who have never experienced mental illness lose site of the importance of a meaningful connected relationships in our lives?   Perhaps the opposite of addiction is not sobriety.  Perhaps the opposite of addiction is connection.