Addicts look to fix problems, not feed habit

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SUBSTANCE ABUSE/ Junkies and alcoholics never learned capacity for self-care, according to leading expert

Second in a two-part series on crime and violence among today's youth.

Some people dismiss junkies and alcoholics as weak characters who live only for happy hour and deserve scorn for the misery their self- destructive behaviour inflicts on others.

But, according to a leading expert on addiction, their condition likely has much less to do with selfish hedonism than with self- medication gone awry.

Dr. Edward Khantzian -- a professor of psychiatry at Harvard Medical School who has studied psychological factors associated with drug and alcohol abuse for more than 30 years -- shared his observations recently at the Caring For Our Youth symposium at Stenberg College in Whalley.

He sees substance abuse as a "self-regulation disorder" and drug addiction/alcoholism as an individual's misguided attempt to fix problems rooted in infancy.

Substance abuse usually manifests itself in adolescence but has antecedents in childhood, noted Khantzian, a founding member and past president of the American Academy of Addiction Psychiatry (AAAP).

According to him, drug or alcohol addiction can be traced to an individual's failure, during early development, to develop the capacity to care for him or herself. Khantzian sees this lack of self-governance or self-care -- which should have developed through parental nurturing, protection and ministrations in early infancy -- as an ego defect.

"I'm seeing addiction not as a place where one falls down, but it's where someone starts out to solve a problem only to have it backfire for them," Khantzian said.

"This is not about pleasure seeking," he stressed.

"I've yet to meet anybody who primarily got hooked because they were pleasure seekers ... people are trying to solve problems with their use of drugs, and it's a solution that ultimately brings them to their knees."

Khantzian is famous for his self-medication hypothesis, which holds that drugs ease psychological suffering and that addicts tend to choose their poison, so to speak, because of its psychopharmacological effects.

Heroin, for instance, might suppress rage, while alcohol relieves anxiety and isolation. Cocaine, on the other hand, might relieve depression.

"Happy people -- people who are reasonably comfortable inside their skin -- people who feel better in their surroundings, are less apt to get addicted," Khantzian said.

"Drug addiction is less about seeking pleasure or self- destruction but it's much more to do with self-medicating one's kinds of distress one struggles with."