A New York Times Investigation: Why Do Some People Become Addicted To Drugs While Others Do Not?
Why Do Some Become Addicted to Drugs?
Is there anything worse than when a family member or loved one becomes addicted to drugs? Illegal drug use is rampant and frightening. According to the 2008 National Survey of Drug Use and Health, 46 percent of Americans have tried an illicit drug at some point in their lives. But only 8 percent have used an illicit drug in the past month and fewer become addicted to drugs. Most people who experiment with drugs do not become addicted. So why do some people become addicted when the vast majority do not? The New York Times asked this question after the death of Amy Winehouse and the account below is adapted from the original article about why some people become addicted to drugs that was written by Richard A. Friedman, M.D.
Doctors have long been aware that people who suffer from mood, anxiety and personality disorders are more likely to become addicted to drugs. According to the National Institute of Mental Health’s Epidemiologic Catchment Area Study, patients with mental health problems are nearly three times as likely to have an addictive disorder as those without. In addition, 60 percent of people with addiction problems are dual-diagnosed, meaning they have both a substance abuse disorder as well as a mental health issue.
Addicted To Drugs Through Self-Medication
The conventional wisdom is the link between mental illness and addiction represents a form of “self-medication” where people start using drugs to medicate their other mental problems. Alcohol and drugs affect mood and behavior by activating the same brain circuits that are disrupted in major psychiatric disorders. No surprise, then, that depressed and anxious patients turn to alcohol and sedatives to help treat their conditions. What is so disturbing is that beyond being illegal, these substances are terrible antidepressants and only worsen the problems the potential addict is facing. This leads to a downward spiral of depression and leads directly to these people becoming addicted to drugs.
Although mental health is a major factor, emerging evidence suggests that drug abuse is linked to a developmental brain disorder. Dr. Nora Volkow, director of the National Institute on Drug Abuse, has shown in several brain-imaging studies that most people addicted to such drugs as cocaine, heroin and alcohol have fewer dopamine receptors in the brain’s reward pathways than the vast majority of people. Dopamine is a neurotransmitter critical to the experience of pleasure and desire. It sends a positive signal to the brain that raises self-esteem and fosters the ability to pay attention and focus.
When Dr. Volkow compared the responses of addicts and a control group of non-addicts after being given a stimulant, she discovered that the non-addicts with high numbers of D2 receptors, a subtype of dopamine receptors, found it aversive, while addicts with low receptor levels found it pleasurable. This finding suggests that drug addicts may have blunted reward systems in the brain. For the addict, everyday pleasures don’t come close to the powerful reward of getting high, thus they become addicted to drugs.
Ending the Spiral of Addiction
The New Definition of Addiction as a Brain Disease
At the same time, drug use also changes the brain and can turn anyone into an addict. Primates that aren’t predisposed to addiction will become compulsive users of cocaine as the number of D2 receptors declines in their brains. One way to produce such a decline is to be placed in a stressful social situation. Without question, addiction and addictive disorders are a deadly disease of the brain that lead directly to destruction and death. Once exposed to the demon of addiction, there is no easy way out, but there is a solution. Still, almost anyone, regardless of baseline genetic risk, can become an addict under the right circumstances. If you do heroin or cocaine for an extended period of time, you will become addicted, regardless of your genetic predispositions. ONE80CENTER offers help and a way out for those caught in the spiral of addiction. Even if you or loved one are addicted to drugs, there is a way out and there is an answer.
The Tragedy of Addiction
When tragedy strikes, I go into a state of reflection. You might not know it if you were to see me during those times; I am able to continue on with my daily activities and maintain my composure, but lately before I have an emotional response to anything, I have to mull it over. I was taught to do that; pause when agitated. If I didn’t do that, I could easily become a statistic.
Recently I lost a friend, which happens more often than I want it to in recovery. When I got the news, I immediately shut off all the valves that deliver hysteria and sadness so I could allow it to penetrate- I didn’t want to make it be about me, and about how I felt. This is a new response for me; it wasn’t like this before. In my old way of being, I would get that first emotional hijacking and I would run with it, dive into it and milk it for all its worth. This time, like the past four or five friends who died from their addiction, I allowed the truth of his passing to slowly enter my consciousness.
Equine Therapy- A client’s standpoint
I woke up this morning with great anticipation for a new group at The One80center, Equine Therapy. I have worked with horses for years in different capacities, but mainly on a theraputic level with disabled and mentally challenged children. Needless to say, I was familiar with horses and was looking forward to working with them for the sake of my own therapy and recovery. Little did I know my entire sense of self would be shattered that day only to be rebuilt once again with a clearer, more authentic, sober self.
We arrived at the stables and were introduced to a beautiful Clydesdale. After grooming her, we learned she would be our therapeutic companion for the day. We were given a whip, asked to stand in the ring with the horse and told to instruct her to go around in circles on the outer edge of the ring, without physically touching her. Another client, whom I have grown to know and trust through our outpatient program, went first. He had little experience with horses, which one would have never guessed after witnessing his ease and grace with the Clydesdale.
Next it was my turn at Equine Therapy. I took the whip, gently slapped it on the ground and quietly made a sound with my mouth, indicating to the horse it was time to move. She looked at me, bewildered at my weak attempt to control her. I stood there, feeling her vulnerablity and my own. I tried again only to be met with more confusion and anxiety. In that moment I became paralyzed and mute. The tears began to flood down my face. Bernie (Clinical Director at ONE80CENTER and an amazing therapist) in her calm, healing manner, came into the ring. She put her arm around me and said, “let’s observe how you are feeling right now. Breathe.”
I had nothing to offer myself nor the horse. I stood there, looking at Bernie and the riding instructor and did not know what to do. Bernie said, “You have two people here with you, is there anything you can do to help yourself with the lesson?”
“I don’t know what to do. I need help,” I said behind the tears. These are three words many of us as alcoholics are ill equiped to use. Asking for help is a concept often discussed at AA meetings as being one of the hardest things to say. Addicts and alcoholics believe it implies weakness and forces us to admit that we can not live life on our own, especially in early recovery. In that moment, with the horse not responding to me, I knew I needed help. Sure enough, as soon as I reluctantly muttered the forbidden phrase, I found the relief I so desperately needed.
Several attempts later, with Bernie and the instructor’s help, the horse was still hesitating. There was something more going on within me that was preventing the horse to respond. Bernie asked that I set my intention before approaching the horse. She reminded me to breathe. Right then and there, all my past relationships with men popped into my head. In addition, memories of weddings and parties resurfaced where I was asked if I wanted a drink. Never had I refused a drink while being fully aware that I was an alcoholic. Nor had I ever stated to a man what I wanted in a relationship. The same way I was being unassertive with the horse, I was unassertive with myself and my relationship both to men and alcohol. I realized that I had been living a life without a voice, without a sense of what I wanted nor who I was.
Because I asked for help that day, not only did I get the support I needed I also got the greatest gift one could receive. I was given the gift of myself, my voice, my wants and needs. Wiping away the tears, I was encouraged to embrace the lesson as a major break through in my recovery. ”This is a great jumping off point for you,” Bernie said. I now had a direction to move in and the ability to say what works for me and what doesn’t. I feel confident going forward with life, relationships, and my own endeavors knowing that I can ask for help when I need it. Thank you to that sweet Clydesdale. Thank you, Bernie. Thank you One80CENTER.
The Alcoholic’s family dynamics
I have a new respect for this disease.
I’ve been watching what the disease does to the alcoholic’s family lately. When I was drinking and using, I didn’t have the perspective to observe what it was doing to mine. But now, I have been talking to a lot of mothers and sisters and husbands and dads. I hear the frustration and the sadness, the resignation. I also hear hope. And love. Everyone is tired, who is in the life of an active alcoholic. Everyone is walking on eggshells.
The alcoholic’s family dynamics and the toxic fallout
As the mother of a 14 year old (and a 12 year old, who is watching her sister), I am just starting to experience the nights of waiting up until my daughter comes home, playing detective by calling her friend’s parents and making sure all the kids’ stories match up, driving to pick them up when I am dead tired, worrying and wondering. My kid is a good kid, all things considered. But the few times she has given me a really good scare were the worst moments in all of my life. And those few times have made me hyper alert all the time, which is exhausting and consumes much of my time and headspace. Its only starting, and there is no telling which way it will go.
So I can’t imagine what it must be like to be on the other side of it, being the mother of a 24 year old, ten years of this anxiety and fear that I am just beginning to experience. In fact, I took a mother aside recently and told her- “I give you props, I really do. I can’t believe what this must have been like for you.” Her child is in his early twenties. Her face is careworn and her eyes are kind. She has recently come to understand how she played her part in the family dynamic that has been so toxic for everyone involved- she tells me she has been an Enabler all these years, trying to help but doing more harm than good by doing so. She isn’t an alcoholic, but she loves one, and that puts her in a compromised situation. And she further did her part in the dance by constantly fixing the situations her son got into, making it all okay. He would fall down, but she would get the bruise.
I then spoke to another mother and father, who are very angry and hurt at their daughter’s relapse. I try to encourage them into family groups, to look at the dynamics. I also register the discomfort this brings up for them- alcoholics are not the only ones who hang onto their habits. The question “Who would you be if your daughter was not an active alcoholic?” Can bring up both positive and negative feelings. As much as they may hate that their family spends a great amount of time discussing the ‘black sheep of the family’, they get something out of it, too. She is like the bonfire around which they constantly gather. And the Black Sheep gets to be the continual fuck up, which is a major tool of the Disease. Being the Fuck Up is disempowering to sustainable sobriety, so that alcoholic has a further investment in staying in that toxic dynamic and behaving in ways that reinforce the designation of Black Sheep/ Fuck Up. Since the family has learned to revolve around this Black Sheep, the family has to learn how to exist without that focal point. And vice versa.
I also had a conversation with a Husband of an alcoholic. He didn’t even realize it when he said to me, “If she gets better, she won’t need me.” He had become the one who cleaned up the house when she destroyed it in a blackout, and when she woke up, she didn’t remember. The house was spotless, the sheets did not have any mess on them any longer, and she didn’t remember the state she had left it in. He was miserable in this role, and yet he was willing to hang onto the misery because it gave him a role in which he was needed. It was sad to come to understand this particular dynamic; it was so insidious. It looks like love, and the intentions are good, but its like a non-detectable poison gas that eventually corrodes both people. Both people support the slow death, and both people need help.
Finally, I have recently witnessed the anger and resentment of the family towards the alcoholic. I know of a family that is furious at their son for his relapse. They want nothing more to do with him. When they discovered he had relapsed yet again, they stormed into his house, yelling into his face. I think anyone can understand it- after a period of 9 months of peace, the family is thrown back into the worry and despair again, and they don’t want it. They have had years of picking him up from jails and hospitals. The sad thing here is that their son has a debilitating, life threatening disease. It often takes many relapses for a person to finally ‘get it’. If it were a matter of will power, it wouldn’t be considered a disease, but a character flaw, a weakness. I was there when all the yelling happened, and it made me sad for all of them. Now that the man in question is a couple of months sober, the family is still refusing to see him. I hoped they would come forward and stand beside him, but they’ve had enough. He has a lot to prove to them, and it may take years. I am not that family, but I am sure it hurts to turn their backs on their son and brother. As much as it hurts to be the one who is shunned from the family. Everybody hurts.
I now really understand why we have another 12 step program, the one that Bill Wilson’s (one of the founders of AA) wife started- Al-Anon. Its for the people who are involved in the lives of alcoholics. When they say its a family disease, they don’t mean that its passed down from generation to generation- they mean it permeates into all the primary relationships, and everyone becomes invested in the alcoholic’s disease in one way or another. I have heard some people, when Al-Anon was suggested, say, “Wait, why do I have to go do this work? He/she has ruined my life for years, and now you expect me to go do work?” Well, yes. Yes and yes. Because it is a family disease, the whole family needs healing. It isn’t work, its relief, its a solution, and its available.
For anyone involved with an active or newly sober alcoholic, there is support for you. Take it. There is work to do. Do it. There is nothing more important in life than the healing of family dynamics, than the ongoing health of loving and sustainable relationships.
Pick Your Poison: a civilized cocktail in a pretty glass? Or a bottle of Mad Dog? It’s all the same thing.
I do a lot of pondering while I am driving. Living in LA, that means I do a LOT of thinking. Today, I was thinking about all the different phases I went through in my drinking. By phases, I mean my chosen poison, which reflected my lifestyle choices at the time. Or, possibly my beverage of choice dictated my lifestyle- its hard to say.
As a teenager, it was Milwaukee’s Best beer. Horrible stuff. I hated it, but I was determined to develop a taste for it. There was a small convenience store just past the bridge in the small town I grew up in that would sell to minors. I can still remember how that case of beer held promises. It promised something fun, something different. It meant I would get noticed, I would feel more brave, be bulletproof and charming and therefore irresistible- something awesome was bound to happen. Usually it was something sloppy I regretted, but the promise still held fast every time before getting my drink on, and that never changed in the years that followed.
Growing up in rural Virginia, there was always moonshine to be had. In a mason jar by the fish sticks in the freezer. We had to sneak tiny sips, but that is all you really needed. Shortly after that, it was Jaegermeister. Anyone who has ever tasted the foul stuff and is reading this now is probably cringing a little at the thought. During this phase, I was at some point in the course of a night hugging a toilet, room spinning, wishing I had never been born. And still, I didn’t give up. I still believed the promise, and I was determined.
When I moved to Colorado, I went through a Mad Dog phase. I thought it was romantic in an off-kilter, Bohemian way- derelict wine, Hobo wine, train hopping wine, thick and syrup-y and nearly hallucinogenic, in crazy flavors that would make your stomach turn. Banana, for instance. Or butterscotch. I suffered for my slip-shod romanticism; this was a cheap thrill that, like all the others, created dismal, throbbing mornings full of shame and regret, and a trail of wreckage that fueled a vagabond existence for a while.
I moved from that phase to Tequila. I thought it was epic to keep tequila by my bed and do a shot upon waking- sometimes to chase a hangover, but even without one, it seemed rather original to me. I was out to prove something to myself. And I was still chasing the promise.
When I got to LA in the early nineties, tequila was still the drink of choice, and Zima was new and everyone was drinking it. By the time I got here, I was at the point where I would challenge men in bars to drinking contests. 40 shots. Lets see who can drink more. It was like the scene with Karen Allen in Indiana Jones drinking the big guy under the table- it garnered respect for her, and I thought it wuld do the same for me. Drinking was the one thing I knew I could do. I had a fast metabolism and earned the nickname Hollow Leg. I was also called Wolverine, because that is what I ended up acting like. I was also called a tragedy waiting to happen, because that was obvious. At no point did I think I had a problem; this was just what life was.
Then it was Jack Daniels. Oh boy. We were a pair. I would dress up and flirt with Jack, and he would end up beating the crap out of me every time. I always crawled back to Jack, thinking the next time would be different. It was during this time that my boyfriend would frequently call me from the hospital, and I would answer at 3 or 4am, asking why he was there. “Because you cut me again,” he would say. Or the time I drove through the desert with a man I barely knew but had just married in Vegas. We had a bottle of Jack and parked the car and spent the day in the desert. We don’t know what we did out there, except we were covered head to toe in severe catus scratches and sunburned to the point of blisters. It never ended well when Jack and I were together.
Next it was Ketel One, chilled, in a rocks glass with a coke back. Finally I was drinking ‘cocktails’. This was an attempt at being civilized. Things went from bad to worse. Nights at home I would drink Two Buck Chuck from Trader Joes’, feeling sophisticated as I prepared meals for my kids, glass of wine in hand, as if I had finally grown up. Except later I would be incoherent and my children, frightened. Or I would switch to champagne during the holidays, again, very civilized, in a Waterford crystal champagne glass- which would turn into two bottles a night, or three. Alone.
And then there was my bottom. 
My bottom really commenced when I would buy tiny bottles of vodka for lunch during my break, while I still had a job. I am not even mentioning the drug use at that time in this blog, but suffice it to say, it contributed to the decline of me. When I quit that job, because I was convinced that everyone was crazy, it was big bottles with handles, alone at home. Handfuls of pills.I forgot how to eat. If I felt hungry, I drank. I couldn’t even chew anymore. I drank to feel slightly normal, to make the shakes subside. I drank to pass out at night. I didn’t smile for a whole year.
Finally, on February 19, 2007, I stopped believing the promise that never came true. And on February 20, I walked into an AA meeting, and they saved my life. Why this long drunkalogue? To tell you- I GET IT. We develop such a relationship with the drink- besides the act of drinking and all that goes with it, there is that relationship with it, the dance, the lies we believe, that we feel we can’t live without. Something will be better if I drink. Something will happen. I will find freedom, I will be happier. My outlook upon life will change. I will suddenly not be as baffled by situations, and fear of financial insecurity will leave me. Every time I drank, I believed this would happen.So when I heard the AA Promises in the 9th step, you can’t imagine how relieved I was. Here, AA was promsing me the exact same things that alcohol had promised me. Here they are-
The Promises (properly known as the “9th Step Promises”)
If we are painstaking about this phase of our development, we will be amazed before we are half way through. We are going to know a new freedom and a new happiness. We will not regret the past nor wish to shut the door on it. We will comprehend the word serenity and we will know peace. No matter how far down the scale we have gone, we will see how our experience can benefit others. That feeling of uselessness and self-pity will disappear. We will lose interest in selfish things and gain interest in our fellows. Self-seeking will slip away. Our whole attitude and outlook upon life will change. Fear of people and of economic insecurity will leave us. We will intuitively know how to handle situations which used to baffle us. We will suddenly realize that God is doing for us what we could not do for ourselves.
Are these extravagant promises? We think not. They are being fulfilled among us—sometimes quickly, sometimes slowly. They will always materialize if we work for them. (Alcoholics Anonymous, pp. 83-84)
This felt real. This felt like something I could really believe in, and I wanted it. I always wanted it, I was just looking in all the wrong places.
But then again, I wasn’t. All of those wrong places lead me to the right place, eventually. I wouldn’t be here if I hadn’t been there. I’ve hurt many people in my life, and I have made and continue to make amends for that. But I know my life has happened exactly the way it was supposed to, and lead me to exactly here and now, which is where and what I want to be. Who I have always wanted to be. I am so grateful for everything that brought me to this point. But it isn’t easy, the good stuff in life never is. I earned my seat. And I am saving a seat for anyone who needs it.
Could A Sober Companion Have Prevented The Tragic Death of Amy Winehouse?
They tried to make me go to rehab, I said, “No, no, no”
Yes, I’ve been black but when I come back you’ll know, know, know
I ain’t got the time and if my daddy thinks I’m fine
He’s tried to make me go to rehab, I won’t go, go, go
— Amy Winehouse, lyrics to her hit song, Rehab
The senseless and tragic death of singer Amy Winehouse at the age of 27 marks another example of how hard and terrible is the disease of addiction. At 3:54 pm BST on July 23, 2011, two ambulances were called to Winehouse’s home in Camden, London. Shortly afterwards, the Metropolitan Police confirmed her death. As of July 24, the investigation to determine the cause of death, which is described by police as unexplained, remains open. Given her extensive history of drug and alcohol abuse, multiple arrests on a variety of charges and her frightfully young age, there is a rising consensus among the media and addiction experts that the cause of death was a fatal drug overdose. If this is the case, could a sober companion have been the key to keeping Amy Winehouse alive long enough to receive the help she clearly needed?
Amy Winehouse Said No To Rehab
With horrible impulse control and a rebellious attitude milked by the tabloid media, Amy Winehouse had a long history of drug problems and extreme signs of addiction. Her ex-husband Blake Fielder, who is currently in jail on drug charges, once told a paper that he had introduced Winehouse to crack cocaine and heroin. Quickly, they descended together into the depths of addiction, reportedly trying everything to quit, including the horrors of cutting to replace the pain of withdrawal. What Amy Winehouse refused to do, as expressed in her hit song, was go to a medically monitored drug and alcohol rehabilitation facility where she could have received the help that she truly needed.
Amy Winehouse Left Rehab
On May 25, 2011, Amy Winehouse entered the Priory Clinic in London to receive help with her addiction problems, but she was not willing to remain willing. In less than a week, she left and returned to her home alone where she died two months later. Karen Heller of The Philadelphia Inquirer described the popular culture’s perspective of the singer, writing that Winehouse was… “…crashing headfirst into success and despair, with a codependent husband in jail, exhibitionist parents with questionable judgment, and the paparazzi documenting her emotional and physical distress. Meanwhile, a haute designer Karl Lagerfeld appropriates her disheveled style and eating issues to market to the elite while proclaiming her the new Bardot.”
A Sober Companion Offers Safety And Support
In other words, popular culture found the travails and insanity of Winehouse to be a form of entertainment, and she simply was allowed to self-destruct for the enjoyment and amusement of her adoring public. There was a human and artistic side to the young woman that few people ever saw or experienced. British singer Lily Allen described this side in a Scottish newspaper when she said, “I know Amy Winehouse very well. And she is very different to what people portray her as being. Yes, she does get out of her mind on drugs sometimes, but she is also a very clever, intelligent, witty, funny person who can hold it together. You just don’t see that side.”
What is so frightening is how common it is for addicts and alcoholics to be kind, creative human beings who are simply caught in the vise-like grips of a fatal disease. A question that has to be asked beyond the horrible reality: What possible could have been done to help Amy Winehouse? How might she have been saved?
Clients Like Amy Winehouse And Sober Companions
ONE80CENTER has an individualized program that is designed to meet the needs and specific background of each of our clients. Since we have many successful clients, we understand that they often are resistant to entering treatment because they still have the material wealth. In addition, they are unwilling at first to enter our treatment facility without first going through a private detox. As a result, we offer a remote detox with medical visits and the consistent presence of a sober companion.
By being able to detox in the comfort of their own homes or at a hotel, certain clients often become more willing to embrace the program. Without question, Amy Winehouse was a difficult case, highly resistant to treatment. The presence of a sober companion in her home, however, could have helped to prevent her death and facilitated a path to recovery.
Tragic Loss Of A Beautiful Artist And Lovely Lady
People die from this disease, whether they are intimate loved ones or famous celebrities, there is nothing left behind in the vacuum beyond the tragedy and so many unanswered questions. The focus of the individualized program of ONE80CENTER is to meet you or your loved one where they need to be met in order to foster the beginnings of recovery. After all, as long as health is maintained and the gift of life is kept sacred, there is hope for recovery.
At ONE80CENTER, we only wish that Amy Winehouse had been able to walk this road to freedom before she was taken from this world. Could our individualized program, including remote detox and sober companions, have saved her? Sadly, probably not since you cannot help anyone who is not willing to try to help herself. We would have valued the opportunity to offer our very best in expertise, services and experience to such a talented young lady who will be sorely missed.
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