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The Disease Aspect of Addiction and Alcoholism, Part Two

“Why can’t they just use more willpower and quit?”
Variations of this question have a logical answer if you believe that addiction is a disease. If not, the consensus is that the addict doesn’t want to change, they are weak, or they have some sort of moral defect. But there are physical explanations that help us better understand what the addict is going through.

In reality, someone who decides to quit and walks away without much effort did not have the disease of addiction because their brain was not affected the same way. Cocaine, meth, heroin, alcohol…all affect the body in different ways, but they all have the same impact on the brain.

When habitually abusing addictive drugs, the brain no longer does its job of controlling the areas responsible for:

• self-control
• judgment
• motivation
• memory
• controlling emotions
• learning

This is a huge problem that affects the addicts life at every level. Their cravings are uncontrollable, their driving force is to get their hands on drugs/alcohol. They lie, cheat, steal and break the law in order to satisfy their need for the high, the substance or both. The cravings are so severe that they are driven by the all consuming desire for more. Its not as simple as making a choice, if it were, how many people would choose to continue to self destruct and hurt the ones they love? I know my son would have quit long ago if it were that “easy”.

I hope this doesn’t sound too discouraging, but my point is to help others understand how difficult it is. I remember after his first round of rehab thinking, all of this was behind us. He’d been treated, he had the tools to recover, why would he mess up again? At that time I didn’t realize what was happening to his body and to his brain.

It takes a lot of hard work, moment by moment strength and a willingness to give 100% to recovery. I believe residential drug treatment is needed to break this cycle and give the addict/alcoholic the tools and support they need to stop. Often one time in residential treatment is not enough, but its never a wasted experience, each time they try they get further along the path to recovery. I know some addicts that believe they can quit on their own, but statistically its rare and I haven’t known anyone successful at it. Being under the care of professionals 24/7 makes sense because the using lifestyle consumed all of the addicts time, so recovery should also be the complete and only focus until they are able to manage their lives independently.

It’s also helpful to understand that in addition to being psychologically addicting, there are two substances that are also physically addicting. These are the tough ones to quit, these are the ones that more often lead to death. They are Opiates and Alcohol. (Opiates include heroin, morphine and prescription meds such as Oxycontin, Vicodin,, etc.) Ironically, alcohol kills the most people per year but it’s the only one of these drugs that is legal.

Aside from the obvious reasons that opiates and alcohol are so dangerous, there is also a serious concern with withdrawal – its agonizing and dangerous. When the addict stops using opiates or the alcoholic stops drinking (intentionally or forced) symptoms begin anywhere from 8 – 72 hours after the last dose/drink. Heroin addicts refer to this as dope sickness.

Symptoms can include:
• restlessness
• excruciating muscle and bone pain
• insomnia
• diarrhea
• vomiting
• cold flashes with goose bumps (“cold turkey”)
• kicking movements (“kicking the habit”)

Watching someone be “dope sick” is not for the faint of heart. I’ve witnessed it more than once and it was a violently painful process. Most residential treatment centers have a detox program and require active users to go through the most intense part of withdrawal before starting to work on their recovery. Although it’s not essential, I highly recommend being under medical supervision while detoxing/withdrawing. There are several medications that can be given to ease the pain and make the symptoms more bearable. I watched my son suffer for days at home and then saw him detox medically – huge difference.

For alcohol withdrawal its imperative to seek medical treatment when withdrawing, some of the possible complications can be fatal. There have been reports of death from heroin withdrawal, but its rare.

Hopefully this gives you an idea of what the physical part of being addicted is like. I sometimes wonder if the best anti-drug campaign would be to let high-schoolers watch someone in the throes of withdrawing. For the rest of us, being aware of what the drugs are doing to the mind and the body of the addict may help us to help them more effectively, and to be a bit more compassionate when we don’t understand why they just can’t quit.

Barbara Legere writes about Heroin Addiction on her award winning Recovery Happens blog. Her son Keven has been struggling with his heroin addiction for over 3 years. Join Barbara on her blog or Twitter.