Billy’s life was a struggle. His relationships were suffering. He had lost jobs and was barely holding on to his current one. The addiction was wreaking havoc on his mental and physical health. He had tried a bunch of different programs but the addiction wouldn’t go away even after periods of sobriety.
Billy’s story could be multiplied millions of times over. The chains too often are predictable and harrowing. What to do?
Combat Addiction Myths
Myth #1: People with addictions are losers. Sinners who refuse to face up to their evil ways. Weaklings who can’t suck it up to throw off their bad habits because they are just not trying hard enough.
Myth #2: “Talking therapy” is the only effective treatment. If all people with addictions would just “work” their program, they would be cured. (1)
The problem is that addiction is not just a matter of willpower but it is a medical illness. The medical illness that is addiction must be treated like one. It is not about trying harder or talking more. The underlying causes and risk factors must be clearly understood. Those with addiction must realize they have a chronic brain disease. It is characterized by functional changes to brain circuits involved in reward, stress, and self-control that don’t just instantly vanish once they are free of the substance or exposure for a few months. Those changes may actually last a long time after a person has stopped actively engaging in the addiction (2).
For this reason, addiction has also been characterized as a disease of “pathological learning”. In an article on addiction and cognition (3), Gould quoted Steven Hyman as saying:
“Addiction represents a pathological usurpation of the neural mechanisms of learning and memory that under normal circumstances serve to shape survival behaviors related to the pursuit of rewards and the cues that predict them.”
Brain changes take time. I love the old saying, “It is a law of the mind that it gradually adapts itself to the subjects upon which it is trained to dwell” (4).
A comprehensive treatment program that includes medical, psychological, lifestyle, and spiritual treatment must be engaged in. This is a personalized approach for each individual in order to properly address the disease that is hurting the brain and body.
1. Genetics — An important risk factor. Certain brains are simply much more prone to addiction than other brains. A family history of addiction substantially increases the risk. Genes play a significant role in developing an addiction, influencing about 20% to 50% of the risk.
2. Exposure — One has to be exposed to something addictive in order to risk developing an addiction to that thing. Different things have different levels of addictive risk. For example, there were no tobacco users in Asia and Europe prior to the 1500’s when they discovered the Americas where it had been used for a long time. Easy access to substances at home, school, or work, for example, increases risk. Smokers are much more likely to compound more addictions than nonsmokers.
3. Emotional State — High levels of stress, emotional pain, or anxiety may lead some people to search for ways to alleviate the mental suffering in an attempt to block the turmoil. Both the severity and persistence of certain stress hormones may be associated with a slide into addiction. Stress at home. Trauma. Domestic violence. Sexual abuse.
4. Cognitive and Psychological factors — Brain injury, depression, post-traumatic stress disorder, ADHD and other neurological and mental health conditions affect addiction risk.
5. Social and Cultural Factors — Socioeconomic factors play a role, as well as access to education about addiction and treatment. Lack of supervision when young may play a role in addictive exposures.
6. Age – Teenagers are at the highest risk of developing an addiction, though an addiction can be developed at any age. For example, those using drugs or alcohol by age sixteen or earlier are 40% more likely to develop an addiction than those who do not start using drugs or alcohol until 21 (1).
7. Gender – Men are at higher risk than women.
8. Lifestyle Factors – Factors involving nutrition, exercise, water, sleep, sunlight, and exposure to natural environments, for example, may improve brain inflammation and stress coping, lowering the risk of addiction.
The environmental factors listed above, for example, have a significant impact on gene expression in the brain and body. This is called epigenetics. If the environmental factors are changed, this will change gene expression and the result will influence the activity of the brain disease.
People in recovery programs often refer to their environments as part of what makes it difficult to stop misusing substances. For example, if a person stops using substances, but stays in the same stressful or unhealthy living and social environments, it may be more challenging to remain abstinent (5).
Develop A Strategy
Genetics — Consider genetic testing. This can provide clues as to which medications, diet changes, herbal/supplement options, and lifestyle actions would most likely favor that person’s particular characteristics.
Exposure — Adjust your environment wherever possible to reduce exposure to unhealthy triggers and increase exposure to healthy alleviators.
Emotional State — Build skills to improve emotional resilience. Counseling with a well selected counselor can be very helpful. A number of additional resources (6) can also deepen your understanding and help you work on building better emotional habits and identifying thinking errors.
Cognitive and Psychological factors — Seek medical help to treat underlying mood disorders, attention deficit disorders and other medical problems that may be worsening your cognitive function. Medications may be necessary for a time, sometimes longer. Avoid substances and foods that worsen cognitive function. Engage in healthy learning processes, classical music, healthy forms of reading, and study of proverbs that grow and strengthen your cognitive function.
Social and Cultural Factors — Drop unhealthy relationships that increase addiction risk. Seek out healthy relationships with people who do not increase addiction risk.
Lifestyle Factors – increase dopamine boosting foods (soy/tofu, beans, almonds, apples, avocados, bananas, beets, chocolate, green leafy vegetables, green tea, lima beans, oatmeal, oranges, peas, sesame and pumpkin seeds, tomatoes, turmeric, watermelon and wheat germ). Vigorous exercise boosts dopamine levels. Cold water immersion therapy may increase dopamine levels by 250% (7).
Billy Walked Away
Billy decided he was a person with great value and it was time for him to take responsibility for his actions. He started studying how to unlearn his pathological learning, how the chains had been built in his brain and how to overcome them. He sought medical help and for a time needed medication. He deepened his understanding of himself. He adjusted his exposures and reduced his triggers. He worked on his stress resilience. He participated in counseling to understand his emotions, thinking errors and he learned to reframe them.
Billy sought forgiveness of the broken relationships, improved them and sought new healthy relationships. He started looking after himself and found healthy lifestyle behaviors. He made new goals for his life and actively began to achieve them. It all took time, but the time Billy invested in his healing was time well spent.
To Your Best Health,
Greg Steinke, MD, MPH
1. Healing the Addicted Brain: The Revolutionary, Science-Based Alcoholism and Addiction Recovery Program, by Harold C. Urschel III, MD. Naperville, IL: Sourcebooks, Inc., 2009. 288 pp.
2. NIDA. 2020, July 13. Drug Misuse and Addiction. Retrieved from https://nida.nih.gov/publications/drugs-brains-behavior-science-addiction/drug-misuse-addiction on 2022, December 2.
3. Gould TJ. Addiction and Cognition. Addict Sci Clin Pract. 2010 Dec;5(2):4-14. PMID: 22002448; PMCID: PMC3120118.
4. White, E. G. (1985) Reflecting Christ. Wisdom That Fulfills God’s Purpose, May 24. Hagerstown, MD: Review and Herald Publishing Association. p. 158.
5. Sinha R. (2008). Chronic stress, drug use, and vulnerability to addiction. Annals of the New York Academy of Sciences, 1141, 105–130.
6. Helpful books include The Lost Art of Thinking by Neil Nedley and Healing the Addicted Brain by Harold Urschel.
7. Šrámek, P., Šimečková, M., Janský, L. et al. Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol 81, 436–442 (2000). https://link.springer.com/article/10.1007/s004210050065