Addictions are symptoms of deeper problems

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The straight line; For many, addictions are symptoms of deeper problems; Part 4 of 5 Series: BRAINSTORMS

His name isn't important, for he could be any alcoholic or addict staggering down the path of destruction.

We'll call him Chuck, because in one way it fits with his story.

For several years, try as he might -- and Lord knows he tried -- Chuck could not stop drinking. His job was on the line. His wife and son threatened to leave.

But he could not stop reaching for that bottle.

So he went to the United States, to a clinic he'd heard of where they do aversion therapy. He paid $15,000 and for ten days the doctors gave him a chemical concoction to drink, which was followed by glass after glass of booze.

The substance was designed so that when combined with alcohol it created a kind of chemical, intestinal explosion. In simple terms, Chuck hurled his guts out.

He vomited scores of times each day; in the treatment room and his own room. He vomited until there was nothing left in his stomach. And then he vomited some more.

That was the idea; to burn that pattern into his soul. You drink, you throw up. You drink, you throw up. Eventually, you realize you just can't drink anymore. So you're cured.

Chuck left treatment and travelled home to Alberta, hoping beyond hope he was over alcoholism. But then a strange thing happened. Call it curiosity, or weakness or the nature of addiction, but he reached for the bottle. He drank and it stayed down. So he drank again and again and before he knew it, he'd returned to the path of destruction.

Such was the power of alcohol over him. Such is the power of addiction for many like him.

We're left to ask why? Why do some people become so completely possessed by alcohol, while others don't? The same question could be asked about drugs. The answers are much the same, for alcohol is a drug, and by far the most commonly abused.

Bill W., the founder of the Alcoholics Anonymous movement, called alcoholism an allergy, because he thinks alcoholics have a different reaction to booze than do other drinkers. Often you'll hear stories of someone who took a first drink in life and was immediately hooked, so powerful was the reward --the feeling of euphoria, or serenity.

``As they say in Alcoholics Anonymous,'' says Joel Cooper, a counselling supervisor at the Alberta Alcohol and Drug Abuse Commission. ``Alcohol is cunning, powerful and baffling.''

But again, it's only that way with some people.

Scientific evidence is emerging now which helps explain why at least some people become alcoholics and addicts. In their cases, this ``allergy'' to substances is an underlying emotional illness, like depression or an anxiety disorder.

This theory has been called the Self Medication Model, for it suggests many substance abusers are simply using alcohol or drugs to anesthetize the pain of profound sadness or high anxiety.

Colette Dowling promotes this idea in her book, You Mean I Don't Have To Feel This Way.

``The studies are indicating an underlying depression is very prevalent in people who abuse substances,'' says Dowling in an interview.

The thinking is that depressives, and those with extreme anxiety disorders, react differently to alcohol, says Dowling. They take a drink and Bang!, the brain chemistry changes and they have a profound experience --akin to a religious experience. They find relief and the feeling that there is more to life than pain and unhappiness -- something almost spiritual and good.

As one addictions doctor says, ``they don't call alcohol `spirits' for nothing.''

In these people, the reward and motivation to keep drinking is greater than for normals, who might get a buzz from drinking, but in many cases, don't enjoy it.

``Alcohol doesn't have the same physiological meaning for social drinkers because they feel OK to begin with,'' says Dowling. ``But for someone who feels like crap to begin with, who actually starts to feel like a human being when they get high, imagine what that's going to do.''

Dowling says studies now suggest many addicts and alcoholics have brain chemistry deficits, created either by genetics -- they're born that way -- or by stressful environments. These brain imbalances, she argues, can often be treated successfully by the modern anti-depressants and should be used in conjunction with talk therapy to treat addiction.

Dowling takes objection with some 12-step groups, which carry the message that members must be absolutely ``clean'' of all drugs. In those groups someone taking anti-depressants will be encouraged to get off them, she says.

But, while it's important to be leery of giving substance abusers addictive medication, anti-depressants aren't addictive. And if there's an underlying depression in that alcoholic, getting ``clean'' from anti-depressants is terrible advice, says Dowling.

Dr. Keith Gibson, a psychiatrist who heads the Substance Abuse Unit at Alberta Hospital Ponoka, agrees alcoholics and addicts often have underlying emotional illness. And he agrees medication is appropriate in some cases.

But he says the Self-Medication Model doesn't explain every substance abuser. Gibson says for some, alcoholism or drug abuse can simply be a habit gone bad. They begin to drink, perhaps for social reasons, and eventually get hooked on booze, an addictive substance.

Dowling agrees with that idea, to a point. But she still doesn't think people who are healthy and happy are prone to addiction.

``If a person wasn't heavily interested to begin with -- because the alcohol or drug made them feel `normal' for a change -- the addiction wouldn't happen,'' says Dowling. ``People who abuse substances have been so maligned for not having willpower and not having this, that or the other thing. But they've likely got some other problems, like depression, that other people don't understand.''

Psychologist Paul Sussman, a recovering alcoholic and a working psychologist, laughs when he talks about the differences between recreational or social users and abusers.

His wife stops drinking at a social setting when she gets a buzz, because she doesn't like having her feelings anesthetized, he said. ``She enjoys her feelings.''

Drunks, on the other hand, experience the buzz as a high, as finally having some sense of good feeling -- or at least the removal of negative feelings like depression or anxiety.

Joel Cooper, a counselling supervisor with AADAC, says the reasons people drink are many and varied. Yes, there are some with an underlying emotional illness. And there are some people who seem to have a definite genetic predisposition to alcoholism. The disorder has certainly been shown to run in families.

But like Gibson, Cooper sees many people who fall into another major group, those who simply develop drug or alcohol addiction. These people travel or live in a drug and alcohol culture, join it and eventually the profoundly addictive nature of the substances grabs them, and won't let go.

Drug or alcohol use might have begun for pure fun, recreation or a boost to their self-esteem -- ``See me, I'm the life of the party''-- but eventually takes over their lives.

Dr. Gibson of Alberta Hospital Ponoka says the different causes speak to the need for flexible treatment programs. AADAC's Cooper agrees. The AADAC program even considers the possibility some people just have to learn to curtail their drinking, which goes against the AA model, which espouses total abstinence.

AADAC and the Ponoka program work on lifestyle issues and the underlying reasons for the substance abuse. They ask people to look at positive change. Abusers might have to change their social circle, for example, or even quit a job. Also, much work is done on boosting self-esteem and nurturing a personal sense of spirituality -- of getting the alcoholic or addict out of their self-obsessive and negative lifestyle and opening their eyes to the good things in life.

June MacGregor, a supervisor of AADAC adult services, has worked in addictions treatment for 20 years. ``I'm addicted to alcoholics,'' says MacGregor, who knows addicts and alcoholics as well as anyone. For one thing, she was raised in an alcoholic home.

``Nobody truly knows what causes alcoholism,'' says MacGregor, who doesn't think the question is all that relevant to treatment.

``It's the old question, does he drink because he has problems, or does he have problems because he drinks?''

MacGregor thinks in a lot of cases it's the latter.

``But we always say get rid of the booze and then work on the problems. Until someone is clear or drugs or booze, they can't get rid of the problems.''

MacGregor thinks there is also a fighting spirit in all people -- a sense of spirituality -- which is killed by booze and drugs. This spirit allows people to be open, loving and caring for others and themselves. Again, you have to get rid of the spiritual poison, for a person's inner strength to return.

If, after that, there is need for some medical help, like from anti-depressants, so be it, she says.

Another view of treatment is that anything will work, so long as the person is ready. People reach an age where they are sick of the lifestyle, or sick of being sick, and are committed to change. As the old saying goes, ``when the student is ready, the teacher appears.''

MacGregor gets a bit upset when people demand to know the success rate of programs to treat alcoholics and addicts.

``What is the definition of success,'' says MacGregor. Someone who has had a profound addiction might relapse after treatment, she says. But it just means they need to do more work. It doesn't represent failure, necessarily.

MacGregor says she's often told that once an alcoholic goes through treatment and learns about life without addiction, they can never again be a carefree drinker.

``They say we've ruined drinking for them,'' she says. ``That, to me, is a measure of success.''

It's strange, though, that aversion therapy never ruined drinking for Chuck, the man who went to the U.S. to learn how to associate drinking with vomiting.

But eventually he turned up at the Ponoka substance abuse program, which stresses lifestyle change, as well as group therapy to make you face yourself and those inner conflicts which caused your drinking, or were caused by your drinking.

Chuck stopped drinking after spending four weeks in Ponoka a year ago. His wife and child returned. He gained back weight, then started exercising and hasn't felt this good since he was a kid.

He stopped drinking because he finally discovered that life was better sober than drunk.

There's only one problem. When he's around people wearing alcohol-based perfumes or colognes, he has this strong urge to vomit.

But then, he can live with that.

WHERE TO TURN FOR HELP

Here's where to go if you need help.

Alcoholics Anonymous