Addiction: A Neurological Disorder
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 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 had 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 theybecome 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!”
This article may be paraphrased, or referenced in the public domain, provided that the following reference is provided: Internet article: “Addiction as Disease” by David R. Hughes, 1997. URLhttp://www.medical-online.com/addict.htm
* Tourette’s Syndrome is a neurological disorder manifested by uncontrollable ticking, or body twitching. Years ago, Tourette’s Syndrome was recognized by unintentional, inexplicable verbal outbursts, (sometimes cursing), in the middle of normal conversation. Today, it is well recognized that Tourette’s Syndrome is a much more comprehensive disorder. It affects millions of people. It is often manifested by forceful eye blinking, mouth twitching, or other spontaneous gesticulations. The addict-alcoholic who just suddenly calls the connection, or whose car drives itself to the liquor store, is exhibiting uncontrollable neurological compulsion similar to Tourette’s Syndrome. Though sufferers of Tourette’s, or addictive disorder CAN exercise temporary control, the nervous impulse inevitably overpowers them. In the late 1990′s, statistical evidence clearly demonstrates that families that who’s members suffer from Tourette’s Syndrome, also have a markedly higher incidence of other obsessive-compulsive disorders.