Addiction: A Neurological
Disorder
by David R. Hughes
Addiction is a neurologically based disease. For many
years recovery
specialists have compared alcoholism or addictions to a physical
disease:
like diabetes. In reality addictions are more closely related to
a neurological disorder like Tourette's Syndrome* than they are to
diabetes.
If the problems you suffer stem from severe alcoholism
or addiction,
you must accept that these problems are not primarily mental or free
will issues. Addictions are not about will power. The
problems
facing addicts, alcoholics, and their families are miserable,
disgusting,
and infuriating. They are often hopelessly discouraging. But to imagine
that an addict "could change if he wanted to" is a
serious
misunderstanding of the long term dynamic of addictive disorder. The
fact
is precisely that an addict cannot change in the long run even
if
he wants to! That is the definition of addiction: "the loss of
control
over the use of a substance." It is important to understand
that
this loss of control is manifested not in terms of days or weeks, but
in
longer term behaviors: terms of months and years.
The reason addicts have lost control is because they
have suffered permanent
physical neurological changes based in their brains and
nervous
systems. The disorder manifests in long term obsessive-compulsive
behaviors
outside the realm of the addicts own control. It is true enough that
the
use of chemicals begins with chosen behavior. But if alcoholism
or addiction develops, the problem has moved outside the realm of free
choice. It has developed into a long term mental and physical
neurological disorder. All the emotional 'feelings' involved in
drug
or alcohol seeking are based in neurology. Addiction is based
in
physical dependency created by altered neurotransmitter balances, and
driven
by millions upon millions of new living, functioning active
neurological
pathways which have been established to sustain the condition in the
addicts
brain. The new neurological pathways are permanently established, and
they
will not just disappear. The primary neurological disorder is only
complicated
by physical dependence on the substances. The physical
dependence
on the substances is secondary! Physical drug withdrawal does
not change the underlying neurological addictive disorder. After drug
withdrawal,
long term overpowering cravings are predictable. These cravings are, in
reality, spontaneous nerve impulses. Even in the longer term,
overwhelming
cravings are outside the addicts control.
Example of a Nerve Pathway
It is difficult for people to grasp the meaning of a
nerve pathway,
or why this is related to addiction. Often when people hear a new idea
like: an addictive impulse is the result of a nerve impulse
- they are left unsympathetic. Addicts and non addicts alike have a
hard
time believing that drug or alcohol use is anything more than a choice
that is made in response to a habit. Deep down inside, most people
believe
that at it's root - the behavior is always a choice.
They
are very, very wrong. This author was stuck in addiction for over a
decade,
so completely was he convinced that the mind was an immaterial
spiritual
power - and that to call alcoholism or addiction a disease was a
cop-out
for the weak-willed. This author believed that - each and every time -
free choice was at the root of addictive behavior. Until one day, in
another
recovery facility - the author stumbled upon the concept of
neuro-pathways
- by reading a book called The Training of the Will - by a Jesuit
priest.
That book was written in the early 1900's. Even then, the Jesuits knew
that the root of almost all behavior was based - not in free will - but
in neurological wiring. For the Jesuits, training the will essentially
consists in training the body. After reading that book, this author
began
to understand that while his mind - his intellect - was indeed an
immaterial
power, the overwhelming cravings for drugs or alcohol were based in his
body. He came to believe that addiction really was a neurological
disease.
Consider the following: Most people can not wiggle their
ears. The wiggling
of the ears is really nothing but flexing the muscles of the scalp
above
the ears. The reason most people can not wiggle their ears is because
they
are not familiar with the neurological pathway which controls the
muscle
of the scalp above their ears. However, without exception, every person
in the world can be trained to wiggle their ears. Simply by applying
electrodes
to the muscles of the scalp above the ears causes the muscles to flex,
or spasm. Once the person feels where these muscles are,
he finds that in fact he CAN wiggle his ears. The only reason
he
could not wiggle his ears before, was because he had not established
the
neurological pathway which enabled him to do so. Like turning on a
switch
- a neurological pathway can be established simply by passing a charge
of electrical current into the nerves of the body. Once a person has
learned
to wiggle his ears - he might actually do it spontaneously and
unintentionally
- just because the words are mentioned.
This example is intended to illustrate how a simple
neurological pathway
is established. Before the electrode - there was no neurological
pathway.
After the electrode - the pathway has been established. The addictive
neurological
response to drugs and alcohol on the brain is infinitely more complex
than
this, but the physical basis is the same. The overwhelming craving for
drugs or alcohol that endlessly defeats addicts is in reality a
neurological
impulse - and they have absolutely no control over the craving when it
is triggered. All they know is that they want, they need, they feel
they
MUST have the drug. This "desire", this craving is not
a
free choice. This desire is an electro-chemical
neurological
brain impulse. A person who suffers from these cravings to the
detriment
of his own life, and the lives of others, is suffering from a physical,
neurological disease termed addictive disorder.
Recovery from Addiction
Withdrawing from physical dependence on the drug does
not change the
fundamental addictive disorder. The whole neurological, chemical and
emotional
being of an addict, or an alcoholic has become permanently disordered.
An addict or an alcoholic has developed a very, very severe disease. He
must take the matter very, very seriously. A quick 7 day "detox"
will
never be an answer. The alcoholic-addict in the longer term, is
like
a rat that has become habituated by a scientist to choosing cocaine
over
food. The rat in the short term, can NOT control the
neurological
impulse to choose the cocaine! The rat will continue to seek it,
ignoring
food and water, until he dies! The rat's nerve-impulse to use
the
cocaine has nothing to do with free will. The
addict-alcoholic
suffers from an identical disorder in the long term. The addict
cannot control these spontaneous overwhelming neurological impulses to
use, any more than the rat can on the short term! (The neurological
impulse
is called a craving.) Just by examining an addicted rat you
can't see the obvious problem. But the new neurological
pathways
that have now been established are permanent and life threatening!
These
are just as physical and real as any disease. Addiction is a
self-contracted
neurological disease. It IS a 'created' disorder. Nonetheless,
it
is also a physical problem on a neurological level, and it is
very real. A chemically dependent person can NOT stop the
over-powering
cravings for the substance in the long term, any more than someone with
Parkinson's disease can stop tremors. "Self knowledge avails us
nothing."
The addiction will never somehow go away without
intervention of some
kind. An addict will not ever recover if he can just "kick"
for
a few days. The whole emotional, physical, and neurological system has
already been altered too drastically for any temporary kick to
even
scratch the surface of the underlying disorder. At the very minimum, an
introductory 30 day dry-out period must somehow be enforced. Minimizing,
hoping, or rationalizing that the problem might be somehow be overcome
by more modest measures is wishful thinking. Addictive impulses are
generated
physiologically. They often lie dormant for many days or weeks
as
the addict attempts to recuperate from the painful physical or
emotional
trauma the addictions themselves have inflicted. But, the underlying
neurological
conditions remain very much intact. Neurologically based impulses to
use
or drink require at least 4 weeks of enforced abstinence just to
begin to dissipate enough to be manageable. Then another 6,
extremely critical, weeks are required to adjust to living without
the chemical. Depression, anger, boredom, and then "happy-excited
feelings" are predictable. These feelings always follow
initial
detox. All of these will feelings will eventually trigger an
uncontrollable addictive impulse in early sobriety. There is NO
way to turn off these inevitable overpowering addictive
impulses!
During this period the addict needs help. With the help they need, the
chemically dependent person can improve dramatically, if he can
work through the initial weeks of mandatory depression, cope with
reoccurring
anger, and maintain at least 10 weeks of abstinence. Seventy days seems
like an eternity in early recovery, but shorter periods of abstinence do
nothing to subdue the underlying neurological conditions.
With this in mind, it is essential that an addict
prepare himself for
almost 3 months of initial recuperation. It's precisely when the addict
feels that his system is stabilizing that he is in the gravest danger.
This usually occurs at about 45 days clean. It is then when the addict must
begin to resolve underlying emotional and social conflicts. For an
addict:
stress causes craving! To become free of addiction,
an
addict must resolve the conflicts in his life! He can do this by
accepting
responsibility for his actions, and by facing and resolving his deepest
anxieties. He must make amends to himself, to his family, and to
society.
The only way for an addict to relieve the stresses which cause him to
use
is to identify the interior and exterior conflicts in his life and
resolve
them. "You have to name it, to claim it." When
conflicts
are resolved serenity becomes possible. By achieving new levels of
interior
serenity, compulsive behaviors can be overcome. It is serenity
which
enables an addict to be relieved of compulsions. Serenity can only
be achieved by the resolution of conflict. Over time, and the
resolution
of conflicts, addiction becomes manageable. Most addicts are not
consciously
aware of many of the conflicts from which they actually suffer.
For permanent relief an outside
support system is
the most helpful. According to Alcoholic's Anonymous, the
alcoholic-addict
must come to accept that the underlying condition of the disease consists
precisely in always being defenseless against taking the "first
one."
No matter how much clean time one accrues, he forever remains
defenseless
against using again. According the Big Book of Alcoholics
Anonymous, at some point, at some time, for perhaps NO reason,
the
alcoholic-addict WILL ALWAYS use again! That is exactly what true
alcoholism-addiction
is! The addict-alcoholic remains forever
defenseless against using again that first time!
His
only defense against 'the first one' must come from a power greater (or
other) than himself.
The complete healing process comes from an internal
dependency
shift. Ten weeks of abstinence are required to subdue the
strong neurological impulses to use. After a minimum ten week neurological
pacification, (detox), the reoccurring compulsion to use the
chemical can
be permanently relieved. This is accomplished through a neurological
"re-wiring."
The alcoholic-addict must stop imagining that they can somehow
permanently
stay clean by themselves. This doesn't mean that they need to attend
meetings
for the rest of their lives. Eternal meetings are NOT the point. But, a
radical
dependency shift must be effected within the addicts own heart and
mind. He must psychologically shift away from relying on the validity
of his own thought process about his addiction! To
effectively
"re-wire" his disordered nervous system, he must come to rely
fiercely
and absolutely upon the directions provided from an external support
system.
By mentally changing what he relies upon, his nervous system undergoes
a profound change.
Consider this example:
Two new people attend a support meeting.
(It's not the
type of meeting, or support group, that is important.) The first person
thinks to himself: "I don't want to be here. These people are
unattractive.
The thought of having to associate with them forever disgusts me." He
is now depending upon the validity of his own internal thought process.
He drives away, and continues to try to stay clean on his own, and to
continue
to depend on the validity of his own thought process. Then he has
sorrowful
trouble in his relationships, which break his heart. He fails to
succeed
as he thinks he ought to, which breaks his heart. Something bad
happens,
or something good happens, (it doesn't matter), and he thinks to
himself: "I
can't deal with sobriety right now!" (This is the person
depending
upon the validity of his own thought process.) His addictive impulse is
triggered. In
a matter of time the strong cravings (neurological impulses) overwhelm
him and he begins to use again.
Now, consider the second person who attends the
support meeting.
He also thinks to himself: "I don't want to be here. These
people
are unattractive. The thought of having to associate with them forever
disgusts me." But, this person says OUT LOUD to the
group:
"I don't want to be here! You people seem unattractive! The
thought
of having to associate with you disgusts me!" And the
whole
group, with one voice says to him in reply: "That's how you are
supposed to feel! That's OK! You should feel that way! You're new!
This is new! We are unattractive! The thought of associating
with
us should disgust you! It's OK to feel that way.
But, from now on you must become willing to take directions! You must
become
willing to listen to us! You can NOT be in control of your own
addiction
anymore! You must let go absolutely, and no longer depend upon your own
devices, or you will never recover from your addiction!" THIS
PERSON
ACCEPTS WHAT THEY SAY! He is willing to shift his internal
dependency
away from relying on himself for recovery. This begins to re-wire
his
neurology. His nervous system learns new responses to old
stimuli. Then: he too has trouble in his relationships,
which
break his heart. He fails to succeed as he thinks he ought to, and this
breaks his heart. He also thinks to himself: "I can't deal
with
sobriety right now." BUT HE IS UNDER ORDERS! His habits kick
in! He calls for support! The support system says with one voice:
feeling bad IS ok ... but using is NOT OK! You can't do
that.
You will not do that! You would be better to drive up right
now to the local mental institution and check yourself in .... because
what you are thinking about doing right now is sheer insanity! Because
he has now shifted his dependency, and he no longer relies upon the
validity of his own thought process, he obeys! He takes directions!
The re-wiring of the dependency shift has taken hold: and he stays
clean! He
has established new neurological pathways and is able to stand fast
through
the critical moments. He has has effected the necessary dependency
shift! His
formerly disordered neurological system has become re-wired. When he is
triggered, he automatically goes to the support system, even if it IS
the
local mental hospital, but he stays clean. Through a total dependency
shift,
he is soon permanently relieved of the obsession to use the chemicals.
He recovers!
Effecting this necessary dependency shift is most easily
done through
submission to programs like Alcoholics Anonymous. Any unwillingness to
completely accept the directives of a support program just as it is
presented, is just a continuation of the addictive disorder. Sadly,
anyone "who is special" or who "doesn't need"
to comply with a support program, (just as it is presented),
will
permanently suffer the misery of addiction. There can be NO permanent
relief
for anyone who cannot effect the requisite 'dependency shift'.
This is only happens when they stop depending on themselves to manage
their
own sobriety and they become fiercely willing to take directions.
They must rely on the external support system more than
they
used to rely on the external chemical.
For many, the 12 Step programs have been the best answer
to addiction.
In this authors opinion, it really is God who gets miserable alcoholics
and addicts clean anyway. Though human beings have physical bodies, and
live in a material world: "the whole is greater than the sum
of
the parts." Human beings may be a complex mass of neurological
pathways: but
we are persons - not rats! We may be deeply frustrated, or
disappointed,
or wounded. Though we may suffer terribly, we do have an infinite
capacity
to heal, to achieve, to love and be loved, to create and to contribute!
No one deserves the misery of addiction. "There is one who has all
power,
that one is God: may you find Him now!"
Internet article: "Addiction
as Disease" by David R. Hughes, 1997. URL
http://www.medical-online.com/addict.htm
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