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Re: addiction and recovery

Posted by MB on October 20, 2001, at 14:21:35

In reply to Re: addiction and recovery, posted by Elizabeth on October 19, 2001, at 13:42:01

Here are a few questions for everybody...just to stimulate conversation. These are tough questions, and I don't really expect hard and fast answers to them, but they are questions that, as an alcoholic in recovery, I have often asked myself.

OK, presupposing that we agree to separate *addiction* from *dependence*, and that we define addiction as "a psychological obsession with (and a compulsive use of) a drug," while defining dependence as "the developement of tolorance to a drug accompanied by withdrawal symptoms upon cessation of that drug"...and presupposing that we agree that dependence often accompanies addiction, while addiction does not necessarily accompany dependence, how would you answer these questions? (OK, that's a lot of presupposing. If anyone takes exception with the above definitions, by all means, please share your opinions). Anyway...

A) What is the differenece between a person who self-medicates a depressive/anxiety disorder and an addict (whom AA refers to as needing alcohol because of a natural tendency to be "irritable, restless, and discontent")?

B) Is there a difference between i) a self-medicater who becomes psychologically attatched to a drug because of the relief it offers, and ii) an addict who becomes "obsessed" (psychologically attatched) to a drug because his/her state is naturally "irritible, restless, and discontent" without it?

C) Are the differences between these two sets of people (and the way in which these people are treated) simply semantic, or are there deeper differences?

D) There is evidence that both addiction and mood/anxiety disorders are heritable. Could it be that inheritance of an addiction to a particular substance is the same thing as inheritance of a "subset" of mood/anxiety disorder for which the use of that drug is particularly efficacious (for the short-term) in alleviating?

In the AA group I attend, there is a dichotomy of people. There are the ones who, after getting clean and "working the steps," seem to flourish. They are depressed at first as they withdrawal, but then they glow. On the other hand, there is the group that, after getting clean and "working the steps," continues to struggle and struggle and struggle.

E) Could it be that one group comprises the "addicts" (getting better once withdrawn) while the other group comprises the "self-medicaters" (declining due to lack of pharmacological treatment)?

There is a selfish reason that I am asking these questions. I've suffered with depression and anxiety since early adolescence, and I'm also a recovering addict. I am really struggling to understand myself and to see where I fit into these groups. There are two polarized opinions I've encountered:

a) that I'm just an irritable person with character flaws who used drugs because I was selfish and too ungrateful for the life "God" had given me; and

b) that I suffer from a wholly physiological brain disorder which I attemped to self-medicate with drugs...and that with the proper biological treatment my affinity to illegal drugs and alcohol would become a non-issue.

The first model appeals to my tendency for self loathing, and the second model appeals to my tendency to abdicate responsibility, but both seem completely myopic and inadequate.

I feel like Jackie Chan standing and screaming "who am I??!!" in the extremely cheesy movie by the same name. Or, more philosophically, I want to scream "WHAT am I?"


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