The Physiology (and Psychology) of Addiction

Regardless of the expense, location, duration and method…rehab success rates hover between 17% and 21% over five years. Don’t believe me? Click here. Which leads to our next question.

How does an addict lose her way (or her mind)? In other words, how is it possible that a drunk or a person addicted to illicit or prescription drugs reaches the point where they will effectively kill themselves and all their relational connections? How does an addict reach the point, cognitively, where they value being high more than family, friends, children, sex, or food, water, and shelter? How is it that they so lose their way and make the choice of remaining on the same destructive path? As a counselor, I’ve worked with a number of addicts over the years. Some ‘beat the habit’ some do not. My previous church was a large church of several thousand people in an urban kind of setting. It had/has its share of recovering addicts (somewhere in the neighborhood of 250 or so). Those who became my friend told a similar story. The needle, the pipe, the bottle, or the pill becomes your very best friend, your closest confidant… like family but better. At times it’s almost a spiritual feeling or experience. How is that possible? How is it that people will forgo shelter, warmth, water, and caring (rather than exploitive) companionship until they waste away and die (by violence, disease, or organ failure due to a host of co-morbidities)?

Why (how?) do they stay on the path to ruin? Let’s try and keep this simple and non-technical. When people are high (or stoned) they feel better, at least they think they do. Then the drug wears off. This requires another dose. With the next dose that good, euphoric (or numb) feeling returns. Life seems better… tolerable… manageable even… less painful. Pain may take many forms, from physical to emotional. What we have here is an attempt to self-medicate. Don’t get me wrong, not everyone self-medicates. Some people become addicts because a person acts like a the chemical tourist who seeks the thrill of seeing the sights through the lens of narcotics. Depending on the drug, repeated trials and tries starts to habituate both body and mind to an altered state that seems desirable. The addiction becomes emotional and physical.

Complicating or intensifying this problem are physiology and biochemical issues. As a person enters into these altered, pleasurable states the body’s glandular system secretes hormones (i.e. like dopamine) that reinforces the body’s desire for this drug and the altered state it brings or induces. Now the mind wants more and the body wants more. We do well to remember the connection between the mind and the body. Like an angry two-year-old throwing a tantrum as the body’s desire for this drug, intensified by the secretion of this hormone from the endocrine system, adds to the withdrawal symptoms (sweats, nausea, anxiety, tremors, etc.). The only way to satisfy the body’s rage is more drugs, resulting in more hormonal secretion, and more mental and physical dependence.

Here’s the tragic catch-22. The more drugs the body gets the more drugs the body wants and requires to recreate the desired effects. The more drugs the body gets the more hormones it secretes. The continues progressively until the body wants more and more quantities of drugs, stimulation, pleasure, and highs. By the way, the same hormonal reaction applies to gamers, tech junkies, etc. Try and get people to put their phones down. It’s not easy. In a different arena people get runner’s high from running. It’s the same type of mechanism. But with drugs, you have the double whammy of the introduction of habit-forming chemicals and the hormones that reinforce stimulation, pleasure, etc. As time passes and addictive forces progress, the conscious mind grows to fear the absence of drugs and their effects. The addict becomes anxious and less stable. The addict’s body becomes crampy, sweaty; nauseous. Like a wild animal on a quest for food, or a person in a desert wasteland on the verge of dying of thirst, the addict begins a determined quest for satisfaction, satisfaction at all costs.

Ever try to reason with a starving lion? Ever try to convince a hungry cougar in the mountains or foothills of California to leave the neighborhood pets alone? Not likely. They are too hungry and that hunger drives them to relentlessly invade residential spaces until they are captured (imprisoned) or killed. That ‘hunger’ must be satisfied for survival, or in the case of an addict, perceived survival. Just like a starving animal, addicts won’t listen, even before their mind is irreparably damaged to the point they can’t. Their appetite for their drug of choice must be satisfied at all costs. It’s as if some primal survival instinct has been triggered. The addict becomes more and more a creature driven by impulse and instincts rather than a thinking, rational, and reasoning being. Human beings, created in the image of God, have an ability lacking in other creatures; namely, will, reason, and the combination of both--wisdom. Drug abuse impairs and eventually destroys both.

Drug abuse damages the will. The addict’s ability and desire to reason, to think; to change are eroded and gradually destroyed. That’s why they will lie, cheat, steal, and kill to get what they want. That’s why they will affirm their need to ‘get better’ and even tell you what they think you want to hear and then do the polar opposite. Addiction, as it progresses, trumps reason. The conscience becomes seared. No amount of reason, persuasion, bribery, enabling, or love will change their behavior. Getting between an addict and their quest for drugs is not unlike getting between a mother-bear and her cubs.  Depending on how far they are down the continuum of addiction, forget about reasoning with them. Your chances are better reasoning with a bear robbed of her cubs.

 What about 12 step programs and rehab? Inpatient, outpatient, and various forms of residency ‘treatments’ last between 21 and 270 days. Regardless of the expense, location, duration and method…rehab success rates hover between 17% and 21% over five years. Don’t believe me? Click here. Twelve Step Programs have similar success and failure rates. People will not change until they surrender their pride. Once they do this, they begin (begin, having not yet arrived) to see things with a tad more clarity. Once pride has been put to death, they need to jettison every person, place, or thing that contributes or has contributed to their drug use in any way shape of form. In Matthew’s gospel Jesus says this:

 “Woe to the world for temptations to sin! For it is necessary that temptations come, but woe to the one by whom the temptation comes! 8 And if your hand or your foot causes you to sin, cut it off and throw it away. It is better for you to enter life crippled or lame than with two hands or two feet to be thrown into the eternal fire. 9 And if your eye causes you to sin, tear it out and throw it away. It is better for you to enter life with one eye than with two eyes to be thrown into the hell of fire. (Matthew 18:7-9).

 This is about ‘detach and discard.’ Whatever, whoever, causes the addict to drift anywhere near the old way has to go. There are some places he can’t be. Some people he can’t see. But that comes after putting pride to death—not before. Often addicts will ‘relocate,’ forgetting that problems are portable. The addict is the problem and everywhere he or she goes the problem goes, too. I suppose that’s why some commit suicide, ultimately making a bad situation worse (Hebrews 9:27). So, where’s the hope? How does one ‘recover?’

So, where’s the hope? Where’s the upside? How is it that we do in fact hear ‘success stories?’ Success stories are the exception as opposed to the rule. For every seemingly miraculous rehab and recovery there are at least 5 to 10 fails. Why is that? In a word, choices. Most people don’t see rehab through to the end. There are many reasons. First, and foremost, you don’t break a bad habit (that’s what addiction is at its root) in a month. It takes six weeks to form a habit. Most of the habits most people form are not intensified by drugs and further complicated by body (and or brain) chemistry. Another reason for the high failure rates is ‘friends.’ People seldom if ever abuse drugs in a vacuum. There is a drug crowd that is only too happy to affirm, sponge off of, manipulate, and otherwise aid and abet addicts. This includes their new ‘sober friends’ they make in rehab. Hopefully, they never see them again. Why? Because most of them will return to addiction and drag the addict with them. Let’s not forget the enablers who for various reasons keep bailing them out of trouble delaying any chance of the addict hitting rock bottom. There’s almost always a family member too inclined to believe the line “I really want to change this time…” or believes the addict is a good soul who’s just making (or made) a few bad decisions. It’s a sad thing. But the enabler continues to bail the addict out providing money, goods, shelter, and an endless supply of second chances that delays hitting bottom. The addict must hit rock bottom if there is to be, humanly speaking, any hope of turning things around.

The main impediment to hope and recovery is the addicts own pride. Pride can be more lethal than any drug. Every addict thinks he’s in control or can handle it. Failure is never their fault. They never get what they deserve. Someone, something, made them what they are. They are not at fault. Also, there is a tendency in some circles to refer to this as issues of low self-esteem. This is also a deadly idea. Invariably, addicts esteem themselves too highly, bringing us back to ‘pride.’ If you haven’t read the previous article do so here. Until the addict hits rock bottom, pride will prevent rescue and redemption. The sooner they hit rock bottom the better. The self-esteem excuse is an enabling one that delays ‘rock bottom.’ Think about it. If a person is truly self-loathing, with low self-esteem, how does her or she elevate himself or herself above the law, to godhood, granting themselves the right to break the law, steal from others, rob others (acts of violence), or insist that others tolerate their aberrant behavior.

Back to hope. Hope requires a changing in thinking and a change in direction. Of the 17-21% that make it (that’s less than one in five) there is what some call a ‘significant emotional event (“S.E.E.”).’ They have a moment where they do the proverbial ‘hitting rock bottom.’ They come to the end of themselves. They see that they are the problem. Hitting rock bottom, they get so low that there is no way to look but up. A small selection of the 1 in 5 exercise sheer willpower and stop repeating the insanity. In AA many of these folks end up as “dry drunks.” What’s this mean? It means that they control their outward behavior but the root problem still remains and they are often irritable folks who feel like they are perpetually getting over a hangover but have not had a drop to drink in days, weeks, or years (‘dry’ drunks). This is one reason that the failure rate is so high. The dry drunk type is more likely to ‘relapse.’ The biblical analogy for the dry drunk is putting a fresh coat of paint on a tomb full of dead man’s bones. The outside appears nice but inside it’s still filled with dead man’s bones (the junk that bent their thinking in the first place, to appropriate a metaphor). The change is outward, not inner. As long as he or she stays in AA they may stay sober. The other S.E.E.’s are religious is nature. For some that’s ironic. Many drug addicts go from atheist to person of faith. Why is that?  When you think about it, you never really hear anyone say, “Hey, I became an atheist today and it changed my life, I overcame my addictions from the inner strength provided me through atheism.” Atheism devalues human life, reducing it to the level of animals and insects. Faith is another matter. There’s more than just your being here by accident. Every human has a purpose… and a hope.

From my vantage, not just any religious experience will do. There are many religions in this world but all religions fall into one of two categories. The most popular category is the religion of human achievement. That’s where humans bribe, appease, or manipulate their gods by doing something for them to get a pay out of some kind. It’s a give to get thing. These acts range from human sacrifice (Aztecs, Incas, etc.) to some ritual or another. People trick or manipulate god into doing their bidding. They change god and curry his favor. Considering the success 17%-21% success rates of rehab and addiction programs, it doesn’t seem likely that human achievement is the way. The religion of human achievement includes many denominations. Islam requires you to please Allah by performing the 5 pillars of Islam. Hinduism requires you to achieve Nirvana by doing good deeds and changing your cosmic station in life through reincarnation. You keep doing good to you evolve out of your miserable state. Buddhism involves some form of self-perfection. Self-perfection? Know any perfect people (17%-21% of recovering addicts were never perfect). When you really think about it, how could anyone be good enough, perfect enough, wise enough, or manipulative enough (or rich enough) to bribe god, manipulating the one who created them. How many mantras do you have to chant? How much penance to you have to do? Can any human go a day, a week, a month or a year without acting selfishly? So much for the religion of human achievement. Then there’s the religion of divine achievement, where God does something for you that you cannot do for yourself—particularly since you don’t deserve it (i.e. human achievement). That’s Christianity. You know:

16“For God so loved the world, that He gave His only begotten Son, that whoever believes in Him shall not perish, but have eternal life. 17“For God did not send the Son into the world to judge the world, but that the world might be saved through Him. 18“He who believes in Him is not judged; he who does not believe has been judged already, because he has not believed in the name of the only begotten Son of God. 19“This is the judgment, that the Light has come into the world, and men loved the darkness rather than the Light, for their deeds were evil. 20“For everyone who does evil hates the Light, and does not come to the Light for fear that his deeds will be exposed. 21“But he who practices the truth comes to the Light, so that his deeds may be manifested as having been wrought in God.” (John 3:16-18)

 God sent His Son, Jesus, to die in your place for your wrong-doing and rescue you. Through Him, God offers hope, healing, and restoration—salvation… redemption. You don’t earn His mercy. You don’t earn His forgiveness (it’s a gift). Basically, you put your trust in God not in you. You believe He can save you and you surrender your will, your rights, to Him. He does the heavy lifting. Sure, you cooperate but He’s done the hard work already. You enter into a life changing relationship with God. He knows your thoughts so you can’t manipulate Him. He knows your needs before you ask.

 The religion of divine achievement is simple in truth but hard to believer. He offers every single human being, no matter who they are or what they’ve done forgiveness as a gift. But… and here’s the problem… He only grants forgiveness and life change to those who will be humble enough to accept it on His terms. So much for pride. You recognize you don’t deserve anything but hell on earth and hell in the life to come and ask Him for the gift (like a beggar). He promises to give you eternal life and real and lasting change. He doesn’t change you all at once but little by little as you learn to trust Him more and more.

Embrace the religion of divine achievement and let God change you. You don’t work to receive forgiveness. But afterwards you respond by working to honor it. It’s counter intuitive, yes. But we know what doesn’t work, right? All the previous failures point to what doesn’t work. Maybe your addicted friend is struggling to grasp this. Maybe you are. Maybe it sounds unbelievable. But you already know what doesn’t work, right? After all, maybe you’ve tried everything but this?

How do you do this? Where do you start? Start here (invest 5 minutes).  what have you got to lose? Are you an audible learner? Try here. It’s the same story, expressed differently. Basically, it comes down to this. You’ve got to want God more than air—more than drugs and be willing to go where He would and will take you. There’s no half surrender. Just as a half-truth is a whole lie, a half surrender is no surrender at all.

Like an enemy combatant or terrorist, you’ve got to lay down your arms and trust God. Then you learn to walk and grow as a Christian in baby steps because you will have embraced the truth and the truth will set you free. Once you enter into a relationship with God in Christ (by faith… trust…) your world will begin to change—your eternal destination already has. God will provide you new ability, empowering change.

Some will say, “but I’ve done the Jesus thing before…” Have you? Have you really? What was your motive? Often people get emotionally and want escape more than they want God. That’s not the same thing as surrender to Christ. It’s just another form of (attempted) manipulation.

Believing in God isn’t enough. The Bible says even the devils believe in God (James 2:19). Knowing you are thirsty and actually drinking the water are two different things. Wanting Him is different. There’s no negotiating, only surrender. There’s no half surrender. Think about it. By now many will have tried meditation (emptying your mind), yoga, diets, positive confession, etc. Did it work? You tell me. Could it be that not all religions are created equal?

 Real change is supernaturally empowered. When you have really, humbly done business with God things change (2 Corinthians 5:17). If an addict could change or if you could change an addict—wouldn’t it have happened by now? Without God lasting change is impossible because our problem is, as the Bible indicates, habituated. Humanly speaking, once addiction occurs the cards are stacked against ‘recovery’ physiologically, psychologically, and even sociologically (wrong friends and surroundings). With a failure rates of near 80% in terms of rehab and such, I’d bet on God rather than man. Think about it. What do you have to lose? Really, what does anyone have to lose by trusting God, particularly when life hurts? Next time, the final posting on addiction.



Keith Crosby