Drug Addiction & Recovery

Addiction or the more accurate term ‘Dependence’ is a health condition when one loses control over the drug use, has withdrawal and craving for it and the level of use slowly creeps up over time. One continues to use the substance despite health warnings or other obvious harm like relationship issues as the use takes precedence over other areas and interests in life. However this full picture is not essential for a diagnosis; even half of this may be enough.

How then does one know whether one has dependence or not ? The answer is simple. If one has been using any psychoactive substance and facing any of the above described symptoms, then there is certainly a possibility. Psychoactive substances are those that have the ability to change our mood and our mental experience like cannabis. alcohol, party drugs, street drugs, sleeping pills or opiate painkillers. They are often used to ‘feel the buzz’, ‘take a trip’ or ‘just wind down and relax’.

The next question is- Why does one get dependent at all? The reasons reside in two places- the drug and the brain. First is the nature of the substance. All mind- altering substances are chemically similar in some way to our own brain chemicals and so can act on our brain receptors affecting the mind in unnatural ways. The second reason is the nature of the brain which is both genetically determined and influenced by past and current stressful life experiences. Hence when the psychoactive substance is consumed, certain brains react by producing a huge spike in the brain chemical related to pleasure & motivation. So when the substance is not there, the brain craves the same level of pleasure and feels a desire to repeat the behavior. Ordinary activities simply fail to produce the same level of drive. With continued consumption, one crosses the line between voluntary use to involuntary use or addiction. Unfortunately this happens at a biochemical level outside our conscious awareness and hence control.

So, are there any warnings for us to stop before we get addicted? Fortunately there are. The first warning comes quite early when we realize we really like the effect of the drug. That’s the first sign it is tightening its grip over us. The second is when our level of use in amount and frequency increases. The grip tightens further. Besides these early warnings, we can use a set of four questions and see if we answer ‘Yes’ to any. The questionnaire is known as CAGE questionnaire and is a popular screening tool for alcohol or drug dependence. The four questions are:

 1. Have you ever felt you should Cut down your alcohol/drug use?
2. Have you felt Annoyed at the criticism of your alcohol/drug use or a suggestion you may have a problem?
3. Have you ever felt bad or Guilty about your alcohol/drug use?
4. Have you ever used alcohol/drugs as an Eye-opener in the morning to ease discomfort ?

An honest ‘Yes’ in answer to any of these four questions is a warning to be very careful and if it is a ‘Yes’ in response to 2 or more questions then it warrants seeking a medical opinion with a psychiatrist or at least one’s family doctor as early as possible.

It is important not to take it lightly because any psychoactive drug use by its very nature is progressive. The harm often starts even before one gets addicted in terms of one’s physical and mental health, relationships, work, social or legal issues. This condition where one continues to use despite obvious harm is called ‘Harmful Use’. Here one may still have a good last chance to use one’s will and medical support to reduce the use or stop.

If however one has progressed to substance dependence, then it has to be seen as a disease of the will. So, the solutions involve minimal reliance on it where substance use is concerned. Addiction or dependence is a serious, progressive and ultimately fatal disease and the only solution is complete and life long abstinence. It may sound simple to those who have never misused alcohol or drugs but quite harsh to one who is dependent. The truth is that this life long abstinence is indeed a tall order but it is surely possible.

The Recovery process can be made easier and more comfortable with a multidimensional long term treatment approach. This involves detox, medication and self-enforced abstinence for the first few months along with psychotherapy and family therapy. After that, working a spiritual addiction recovery program along with voluntary participation in self-help groups like Alcoholics Anonymous or Narcotics Anonymous. ensures long term abstinence and a fulfilling life. The road to recovery may be a long one but the journey gets easier and more enjoyable over time.

To have long term abstinence and recovery from the disease of dependence we need to master only three qualities: First, we need to develop complete honesty about our disease and ourselves so that no part of our disease is left hidden in the shadow. Secondly, a deep willingness to seek help, learn new tools and skills and take action to apply this learning to all major areas of life is very important. Finally and most importantly, a genuinely felt need and desire to quit and stay abstinent is the quintessential component that cannot be overemphasized