Understanding Addiction and Connection in Recovery

Understanding addiction is not as simple as watching an ‘addict’ or ‘alcoholic’ destroy themselves, nor is as simple as suffering from addiction yourself.

To someone who does not suffer from addiction, it is easy to see why such a stigma has become attached.

In active addiction, rarely are we considerate of others and rarely do we help others (unless our addiction stands to gain from it).

Rarely are we truly useful and rarely are we honest, if at all.

Often, our addiction causes us to unintentionally hurt ourselves and others, sometimes to a great extent.

To an outsider our actions make no sense...

Why is this? Why do we do the things we do in active addiction? Hurt our loved ones, isolate ourselves, cause lasting damage to ourselves and to our personal relationships?

In this article we explore what drives addiction. We also explain how connection is important in overcoming it.

Understanding the destructive nature of addiction

The reality of addiction is that it causes sufferers to destroy everything of true value and worth. Others cannot understand this, understandably so.

Thankfully, the medical world has advanced tremendously in providing hard evidence as to what addiction actually is. This evidence can help many suffers and their families gain a better understanding of what addiction is and how to treat it.

Addiction can be arrested and treated successfully. Recovery can then be maintained through continued growth and by adopting new and healthy coping strategies and practices.

At Recoverlution, we want to help de-stigmatise addiction by providing the cold hard facts, as presented by the most recognised medical institutes around the world

In doing so, we hope to help you in your continued recovery journey.

We also want to the help loved ones of those that suffer to gain in their understanding of addiction.

Let’s face it, when it comes to addiction, everyone wants answers to all the ‘Why’s?’

Understanding addiction from a medical perspective - What is addiction?

Addiction is a disease of the brain and a chronic mental health illness. Progressive in its nature, it is characterised by compulsion, relapse, inability to stop or moderate, craving and continuation despite negative consequences.

Alcohol and drugs, make those who suffer, feel whole and part of life; until they stop working. The addictive substances or behaviours then cause more damage than anyone could ever have foreseen.

Understanding addiction as a brain disorder

Addiction and substance use disorders are now recognised by the heavyweight institutes of the medical world as a brain disorder.

The following medical institutions are just a few of many, who now understand addiction in this way:

• WHO - The World Health Organisation
• NIDA - The National Institute on Drug Abuse
• NIAAA - The National Institute on Alcohol Abuse and Alcoholism
• The Royal College of Psychiatrists
• Harvard Medical School
• ASAM - American Society of Addiction Medicine

Many more science-based medical institutions are working hard to de-stigmatise addiction and discover further effective treatments.

The symptoms of addiction - The DSM-5 criteria

Regardless of the substance or activity involved, understanding that all addictions hold the same core characteristics is helpful in diagnosis. These characteristics are detailed in the DSM-5 (Diagnostic and Statistical Manual of Mental health disorders - Edition 5) .

The following chart is used to help diagnose substance use disorders and to measure their severity.

Substance use disorders that involve dependence, withdrawal, tolerance, relapse, preoccupation, loss of interest in activities, and physical/psychological problems related to use, are considered to be at the most severe end of the spectrum. They also include ‘craving’.

This DSM-5 diagnostic criteria can also be applied to behavioural and activity based addictions.

Addiction is not only a recognised psychiatric condition, but scientists have proven through MRI imaging of the brain, that the brains of those who suffer from addiction are substantially different to ‘normal’ control brains.

Addicted brains differ from healthy brains in their operation, pathways, reward system and structure. This has helped the medical world not only in their understanding of addiction but also in how to provide more targeted treatment.

Dopamines' role in understanding the addicted brain

Dopamine plays a key role when it comes to understanding addiction and how it affects the brain.

Dopamine is shown in red in the above MRI imaging and shows the amount of the chemical available. Dopamine is mother natures feel good reward chemical.

In those that suffer from addiction, eventually, the brain's dopamine receptors stop working organically altogether.

Over time, and with repeated exposure to a false instigator of dopamine, the brain's reward system becomes reliant on the addictive substance (or activity) to initiate its chemical release.

Dopamine plays an important part when it comes to understanding addiction and the compulsive need to get high.

Dopamine makes us feel good

The organic brain chemical dopamine not only makes us feel good but also motivates us and balances our emotions. It is essential to our well-being and what keeps us actively engaged in ‘healthy activities’ such as eating, exercise, hobbies, sex and time spent with loved ones.

When alcohol and drugs come along, the effect of the dopamine that they release is very profound.

Exactly why ‘the feel-good factor’ is heightened in some people is still an anomaly. However, most who suffer from addiction will remember their first drink, drug or behaviour that caused an abundance of feel-good chemicals to be released into the brain.

For many people that suffer from addiction, substances provided an escape from themselves. Perhaps the effect was so profound as the brain had already suffered from some form of trauma, or was already genetically primed.

Over time, and with continued excessive exposure, the brain comes to recognise the drug/behaviour as a primary source of instant reward and gratification. This is when the brain's pathways rewire themselves to primarily seek and engage in the substance or the activity, above all else.

Understanding how structural brain change happens in addiction

By the time the brain is ‘addicted’, it has undergone substantial structural change. These changes drive the afflicted person to extremes, just to relieve the relentless, chaotic and obsessive thinking and emotions.

Addiction, as yet, has no cure. The only known way to survive addiction is to break the addictive cycle and remain abstinent by unearthing and healing it at the root.

However, staying completely abstinent proves extremely challenging for most that suffer from addiction, especially in the early days. This is due to relapse being a characteristic.

Whilst the brain can never be cured of addiction, with continued abstinence, it does start to recover. The brain is able to re-learn how to produce dopamine through healthy means, providing a person actively engages in their recovery.

Continuing to apply a proven recovery programme and seeking the support of like-minded others, as well as mental health professionals, has provided a means for those with addiction to stay abstinent and get well.

Why do those with addiction need help to recover?

The disease of addiction centres in the brain, which is the source of our thoughts, and ideas, and controls how we process emotions.

Addiction biochemically changes the brain and causes lasting structural damage. This causes the brain to adapt and reform (and not in a good way!)

Trying to undo your own thinking with your own thinking is a bit like trying to play chess against yourself. You always know the next move of your opponent. Victory is short-lived and pretty pointless.

Add to that, battling an overwhelming obsession and compulsion, for most chronically afflicted people, a self-devised recovery is just not possible.

Why is it we can’t easily apply our knowledge of ourselves to ourselves? And, what makes us so resistant to accepting help?

Again, the answer goes back to the brain. Just as a psychiatrist cannot treat themselves for a psychiatric illness, someone with an addiction cannot either.

Those in active addiction are very unwell: physically, mentally, socially and emotionally. Understanding addiction as a diagnosable illness can help a person to accept the treatment methods available.

Understanding why those with addiction need like-minded others

Other people, who have recovered from addiction, can show someone who is still stuck the way out. They are able to think with a clear mind, conscience and motive.

Those in sustained recovery have come to understand the inner workings of their own mind and found strategies that have proven to work. Not only do these strategies (ie recovery programmes) keep them clean, but also help in changing thinking and behaviours. They have also bravely faced their demons and undertaken healing.

For those that are in the depths of active addiction, a recovering person provides hope that recovery is possible. A recovering person can be instrumental in connecting with a still-suffering individual where all other methods have failed.

Those in recovery set the bar for overcoming future obstacles and challenges, as they can share with others how they managed to do so.

Regardless of how far a person is into their recovery, there is always someone with more experience or a different perspective that can help in times of trouble.

The need to not feel alone during recovery from addiction

Connecting with others in recovery helps those of us with addiction to not feel alone in our predicament. It also helps us to understand our addiction, thinking and actions better.

Addiction is a disease, which, when left untreated, is often fatal.

Just as other people with fatal or debilitating illnesses have their own support groups, those of us with addiction have found it necessary to have the same.

In active addiction, many of us ended up isolated with only alcohol or drugs for company. The loneliness was overwhelming.

Coming into recovery it was necessary for us to break the habit of isolation in order to survive. At first, this may have proved challenging. Without addiction, many of us felt naked, vulnerable and full of shame.

However, as we grow and heal in our recovery journey, we can start to enjoy the company of others, especially others on the same path. There is a common goal, an unspoken connection and an understanding. For many of us, it is like coming home.

Denial can be deadly

Denial is a characteristic of addiction. It can prevent a person from seeking help and can make them vulnerable to relapse.

Interestingly, neuroscientists attribute denial in addiction to damage caused to the prefrontal cortex part of the brain and deficits in the brains control network, primarily during active addiction

The prefrontal cortex is responsible for processing information, perception, decision making and cognitive function. Many people in recovery attribute denial to ego and a way of self-preserving addiction. Either way, denial prevents a person from seeing what others can plainly see to be true.

Who knows? ….There is a certain plausibility in both explanations when understanding the denial trait of addiction.

Being connected with like-minded others is so helpful in overcoming denial. They hold us accountable and understand how this disorder affects our ability to think clearly at times. They care more about our lives than they do about upsetting our feelings.

Why helping others helps addiction recovery

Helping others with the same addictive disorder has proven to be invaluable during the recovery journey. It helps prevent overthinking the difficulties that life can present. It can also help a person from falling into a rut of hopelessness and depression by giving them a purpose in life.

Helping others to recover is challenging but ultimately very rewarding and provides healthy amounts of dopamine in the brain.  It can help to turn humiliating and tragic life events into useful tools and life experiences that can help others.

There is no end destination in recovery. It needs to be a continuous process that holds a persons interest and keeps addiction at bay.

In all methods of evidence-based addiction treatment and recovery, there is a great emphasis placed on continued personal development and helping others.

Standing still for us in addiction recovery isn’t an option. Just as the disease of addiction is progressive in nature, so must our recovery.

Read more:

How connection works as a treatment for addiction

References:

• Understanding drug addiction and addiction facts https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction
• DSM-5 Criteria for Substance Use Disorders and their rationale https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3767415/
• Phasic dopamine release in appetitive behaviors and drug addiction. Curr Drug Abuse Rev 2:195–213.CrossRefPubMed Wanat MJ, Willuhn I, Clark JJ, Phillips PE (2009)
• Neural mechanisms of drug reinforcement. Koob GF (1992) Ann N Y Acad Sci 654:171–191.
• The tonic/phasic model of dopamine system regulation and its implications for understanding alcohol and psychostimulant craving. Addiction Grace AA (2000) 95(Suppl 2):S119–S128.CrossRefPubMed
• Imaging dopamine's role in drug abuse and addiction. Neuropharmacology 56(Suppl 1):3–8.CrossRefPubMed Volkow ND, Fowler JS, Wang GJ, Baler R, Telang F (2009)
• The neurocircuitry of impaired insight in drug addiction - Goldstein RZ, Craig AD, Bechara A, Garavan H, Childress AR, Paulus MP, Volkow ND. Trends Cogn Sci. 2009 Sep; 13(9):372-80. [PubMed] [Ref list]
• The neurobiology of substance use, abuse and addiction - Chapter 2 https://addiction.surgeongeneral.gov/sites/default/files/chapter-2-neurobiology.pdf