You may be wondering: am I dealing with substance abuse? Am I dealing with addiction? Those are scary questions - loaded with fear, hope, denial and a strong need for clarity and healing.
The purpose of this issue is to help you understand addiction and substance abuse - their differences and their similarities - to help you determine what battle you are fighting.
But before we get started on this ‘profound journey’, I want you to know three things:
1. First, you are not alone. Don’t let shame handcuff you or isolate you from getting the help you need. There are millions of people struggling with addiction, right now, as we speak. So don’t be embarrassed that you are one of those millions of folks. Do not let Satan isolate you from getting help. Satan uses shame as a strong weapon to keep you in slavery to addiction. Shame, and the fear of “being discovered”, are powerful weapons of evil to keep you in bondage. I know from personal experience that it is hard to admit to your friends, loved ones and professional colleagues that you have a substance-abuse issue you are working on. But I urge you to do the courageous thing and get the help you need.
2. Second, this will probably not be an easy or quick journey, but you can do it! It will take some time, there is some hard work to be done, painfully honest introspection and self-discovery to be done. There is also the distinct possibility that you may have brain chemistry issues that need to be diagnosed by a competent psychiatrist - and quite possibly you have developed some physical, chemical, dependencies that may need medical assistance to get you through. It probably won’t be an easy path, but you can do it.
3. Third, it’s worth it! want you to know that there IS life after addiction and substance abuse, there IS recovery and there IS hope. There is a new life, a wonderful life, waiting for you. Understand this will likely take some time and some hard work. But take it from me, it is worth it, big time! And through The Profound Journey I want to be here with you to help you along your path to healing and wholeness.
So, what IS addiction? And, what IS substance abuse? Are they the same thing or are they different?
Think of them as different points on the same spectrum. One of the defining differences between them is loss of control. With substance abuse there may still be some element of control. With addiction, you lose control.
Let’s look at a couple definitions I’ve found for both terms.
Here are some definitions I found for substance abuse:
· An early warning sign.
· The pattern of using a substance in a harmful way – either too much, too often, or in risky situations that increases the risk of negative consequences.
· Substance abuse means using alcohol or drugs that causes harm or risk, but without necessarily being physically or psychologically dependent. Examples:
Drinking to the point of blacking out
Repeatedly drinking in dangerous situations (driving, work, etc.)
Using more than intended on a (relatively) frequent basis
Key Point: substance abuse=harmful use, but you may still have some control and may not experience withdrawal or compulsive cravings.
Substance abuse - leads to prolonged abuse - which leads to addiction.
Someone can abuse a substance without, necessarily, being addicted.
Now, here are some definitions I found for addiction:
· A coping strategy for human suffering. (We will look at this more closely in future issues.)
· A chronic medical condition where someone loses control over their use and keeps using despite serious negative consequences
· Addiction is a chronic relapsing of a (medical) condition where the substance takes on a compulsive, uncontrollable role in someone’s life.
Key Features of addiction:
Loss of control over use
Cravings
Tolerance – needing more to get the same effect
Withdrawal symptoms
Continuing use despite major problems
Spending significant time obtaining, using or recovering from the substance
Prioritizing the substance over responsibilities, health or relationships.
Key Point: addiction= compulsion+dependence+loss of control
Addiction almost always involves misuse but it can go further – it changes brain pathways related to reward, stress and self-control
Here is a definition of addiction as disease:
A disease process involving neuroadaptation, reward pathways, and impaired executive function. We will look at this idea that “addiction is disease” more closely in the future.
Now, here is Dr. Gabor Maté’s definition of Addiction, somewhat paraphrased:
Any behavior – substance-related or not – in which a person seeks pleasure or relief (or tries to soothe pain), and continues doing it despite long-term negative consequences.
Dr Maté goes on to say:
Addiction involves a compulsion or craving, a preoccupation with the behavior, impaired control, persistence or relapse despite harm, and intense discomfort when the “object” (substance or behavior) is unavailable.
In Dr. Maté’s mind, addiction doesn’t necessarily mean a specific substance – addiction could be to behaviors: for example, work, gambling, shopping, internet use, etc. but we will leave that for another day. Although, perhaps this relates to you: are you possibly addicted to a particular behavior as well?
Notice what is missing from Dr. Maté’s definition: there is no mention of “moral failing” or “disease”. Your addiction is NOT a moral failing. Don’t let shame or evil cause you to think like that. And the notion of addiction being a disease can lead some people to think that because they have a “disease” there is no cure for the addiction, or, that they are genetically doomed to their addiction. We’ll get to these two topics in future issues but for now take heart that you are not a moral failure and you have the power to do something about your addiction.
As you can see, Dr Maté views addiction as a coping strategy to human suffering. To Dr. Maté, he views the external behavior (drugs, alcohol, gambling, etc) as a manifestation of deeper pain and suffering.
Let’s take another, more expanded, look at some of the evidence of addiction:
Cravings
Failed attempts to quit
Withdrawals when you don’t get it
Loss of control, control is severely impaired
Tolerance - needing more and more to get the same effect.
Substance abuse becoming central to your life
Obsession or preoccupation with getting it or consuming it
Disrupting work and/or relationships
Continuing use despite negative consequences
Continuing to use even while your job, relationships, health or safety are falling apart
So, what do addiction and substance abuse have in common?
Both can cause harm to health, relationships and work
Both can lead to risky behaviors
Both can be motivated by stress, trauma, anxiety, depression, loneliness, or emotional pain.
Because of the similarities between addiction and substance abuse The Profound Journey will continue to use the terms interchangeably.
Where do you see yourself in these descriptions? Where do you see yourself in this spectrum? In either case, I strongly encourage you to get help ASAP. NOW is the time to take action.
To summarize:
1. Substance abuse is harmful behavior
2. Addiction is a chronic (i.e., on-going) condition
3. You are NOT alone
4. It’s going to take time and some hard work, but you can do it!
5. It’s worth it!
6. Addiction is many things and is marked by a loss of control, but it is primarily a coping mechanism for human suffering.
Now is the time to be brutally honest with yourself. Where do you stand on the abuse-addiction spectrum? Your honest assessment, that is, admitting where you really are, will expedite the process of your healing and getting the help and wisdom you need. Naming the truth will give you a fighting chance.
In the next issue, I will introduce you to Dr. Gabor Maté and we will explore the causes of addiction and substance abuse. It is my intention that in the issue following the next one, to discuss actionable steps you can take to begin your journey to healing.
Excellent article, abuse and addiction being differing points on the same spectrum. The ability to heal - so good!