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Why Some People Become Addicted (And Others Don’t) · Recovering Out Loud

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  So the question today is why two people can drink the same way
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  for years. One walks away while the other
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  can't stop. Many people assume addiction is
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  simply about willpower, discipline.
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  I'll just choose to change my life.
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  I'll just take up new habits, I'll start working out, I'll
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  join a gym, I will see a therapist and things will just
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  get better. I will get my choice back, my
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  control back and we're back. Welcome everybody to recovering
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  out loud podcast. I'm Anthony.
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  I'm an alcoholic and an addict. And today I want to talk about
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  why some people get addicted to drugs, alcohol, and others
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  don't. Others seem to be taking it or
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  leaving it, taking it with immunity, not having any
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  problems caused and no consequences of their actions
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  and drinking and using and they can turn it off.
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  I was not one of these people. I'm not one of these people.
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  I was evidenced by when I relapsed after 7 1/2 years,
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  going into a spiral of shame, depression, and uncontrollable
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  drinking and using. I couldn't stop and it was so
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  hard for me to come back into recovery.
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  And I work with tons of people that have the same experience.
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  They once they start, they lose power and control.
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  Some people go for months without drinking or using, but
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  inevitably, invariably, they find every time they pick up
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  they cannot get out of it. They cannot stop.
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  They lose control or power and choice in the matter.
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  The obsession that every abnormal drinker can control one
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  day be able to control his drinking or her drinking is the
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  great obsession of every abnormal drinker and every
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  alcoholic. Modern research suggests
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  addiction is influenced by multiple interacting factors.
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  So it's multi layered. There's it's not just one reason
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  that I am different than my fellows.
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  The central idea here is that addiction appear addiction risk
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  appears to come from combination a combination of biological,
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  psychological and environmental and learning factors.
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  So in this episode I'm going to talk about genetics.
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  I'm going to talk about brain chemistry, trauma and coping,
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  environmental exposure and learned behavior.
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  These are all factors that contribute.
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  So first I want to talk about genetics factor.
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  Research has found that family history increases the risk of
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  substance use disorders. Many studies estimate genetic
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  vulnerability contributes roughly 40 to 60% of addiction
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  risk, though estimates vary by study and substance, so 40 to
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  60%. You're 40 to 60% more likely to
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  be an addict or alcoholic if your dad was one or if your
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  grandfather was one. Again, it varies, but this is
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  just a general statement, general guideline.
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  If addiction runs in the family, the risk appears higher.
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  So if your dad, like I said, was an alcoholic, is an alcoholic,
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  chances are you might be 1 and I You hear this throughout the
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  rooms of recovery. A lot of people tell their
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  experience, strength and hope their experience is that their
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  parents were Alcoholics or their grandparents or it runs in the
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  family and then others like myself, you'll find that there
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  is no addiction in the family. I I traced it back all the way
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  to my great grandparents and we think that none of them were
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  alcoholic or drank abnormally. So genetics may influence how
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  rewarding substances feel. So it might feel better for me
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  to do a hit of cocaine than my friend.
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  I get a more of a reward out of it and then I chase that dragon
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  more than the next guy. Impulsivity.
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  Genetics influence how rewarding substance feels.
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  Impulsivity and stress response. Some people may experience
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  stronger dopamine responses from substances and I I find that I'd
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  fall into this category. I just like the effect produced
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  by substances more than the average person.
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  So the important point is genetics do not mean destiny.
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  It indicates increased vulnerability, not
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  inevitability. So it's not 100% certain, but it
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  is increased vulnerability. You're more vulnerable if it's
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  runs in the family. Second topic.
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  Second point, brain reward systems.
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  So I'm going to talk about dopamine and the reward
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  circuits. Substances activate the brain's
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  reward pathway. So dopamine.
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  The pathway includes areas such as in the brain, the nucleus
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  accumbens, the prefrontal cortex, and the ventral tag
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  mental area. So the brain is wired to repeat
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  behaviors that feel rewarding. If I do a line of coke, I enjoy
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  it. I'm going to chase that feeling
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  for the rest of my life since I don't get help chase that first
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  high. That's why you often hear people
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  saying they're chasing the first high their first 5 minutes.
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  When the drugs and alcohol used to work for them, it made our
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  problems go away or whatever. The effect produced for it's
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  individual. It varies by individual.
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  Drugs and alcohol can stimulate reward signals far beyond
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  natural rewards. So looking at a sunset might not
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  give me the same amount of dopamine or eating a steak or
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  rewarding dinner might not give me the same amount of dopamine
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  as say drugs and alcohol do. And I just, that's why you hear
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  a lot of people, they lose the joy in recovery and simple
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  things In the beginning, it's hard to enjoy the things that
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  used to give you dopamine. So essentially, this may make
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  substances more difficult for certain individuals to stop
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  using because the reward is just so great.
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  Next point, trauma and emotional regulation.
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  So the psychological drivers substance use often functions as
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  a coping mechanism. I am coping with my trauma, with
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  my emotional regulation. It helps me quiet the noise in
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  my head. It helps fear go away.
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  It helps self pity go away. When I drink or use, my problems
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  seem to vanish. They seem to disappear.
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  This is also why a lot of people use the spiritual method in 12
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  step recovery or other practices because we come in here with
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  lack of power control. That is our dilemma.
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  We have a God sized hole you hear some people say and it can
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  only be replaced. That solution that alcohol
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  provided can only be replaced by a spiritual experience for a lot
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  of people, not everybody. And if you want to hear about
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  more spirituality, I have a whole episode on spirituality
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  and how it benefits recovery. Many people use substances to
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  regulate anxiety, depression, emotional pain, trauma
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  responses. So there's something called ACE.
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  There's an ACE test you can take.
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  It's called adverse childhood experiences.
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  Research on adverse childhood experiences suggests higher ACE
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  scores are associated with increased risk of substance
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  misuse later in life. So this is a test you can find
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  online. It asks you a series of
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  questions such as was your one of your parents an alcoholic?
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  Did you have a troubled home? Were your parents around?
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  And then it gives you a score based on your adverse childhood
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  experience. So it could be associated with
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  increased risk of substance misuse later in life.
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  For some people, substances temporarily reduce emotional
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  distress. This can reinforce the behavior
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  through relief. So my life is a mess.
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  I turn to substances for relief. Addiction may develop not only
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  from pleasure seeking, but from pain relief.
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  So I'm not only just trying to have fun, I'm trying to escape
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  pain. I'm trying to escape myself.
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  The thoughts, the noise in my head Next environmental
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  environment and exposure. So the environmental influences
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  availability and social environment strongly affect
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  substance use patterns. So if I grew up in an
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  environment, in a trap house for say, let's say I'm, I might be
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  more at risk. If I grew up around parents that
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  were constantly gambling or using drugs or partying to
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  escape, I might be. I'm more likely to contribute to
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  that, to fall into that pattern. Cultural norms around drinking
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  or drug use vary widely. Some examples of this are social
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  groups where heavy drinking is normalized cultures.
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  Italian culture is one of them. Wine at dinner every night,
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  early exposure during adolescence.
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  So if you, you hear a lot of people come into recovery, they
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  started drinking at 13 or 12 or 14.
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  So the developmental vulnerability around this is
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  that the adolescent brain is still developing, especially the
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  prefrontal cortex responsible for impulse control.
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  Early exposure may increase the likelihood of later problem.
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  OK, next we have learning and conditioning.
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  So behavioral learning addiction can involve habit forming and
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  conditioning. Certain cues can become
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  associated with substance use. So places, music, people,
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  emotional states. That's why we get triggered by
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  these things. In early recovery.
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  We walk by a bar we used to drink at, we hear a song we used
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  to party to or a festival that brings up a lot of emotions.
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  People we hang around with. I hang around, you know, I was
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  talking to a guy today that was hanging out.
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  He started talking to a guy that he used to party with and that
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  got him back into relapse because he associated the fun
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  times with partying with that guy.
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  A memory starts to circulate around in your head.
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  Another example would be someone that always drinks with when
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  stressed after work. You start to build that pathway
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  in your brain. I feel stressed because of work.
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  I drink. It makes it go away.
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  And then your brain adapts to that and learns the behavior.
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  Overtime. Stress itself becomes a trigger.
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  These are reinforcement loops, so temporary relief reinforces
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  the behavior. I like that thing.
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  My brain likes that thing. I'm going to go to it whenever I
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  feel emotional stress. The brain learns the
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  association. It's like smoking and coffee.
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  If you have a hard time quitting smoking, you know, I know it's a
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  lot harder whenever you have a coffee because your brain
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  associates nicotine with caffeine.
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  OK, so we have the interaction model.
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  Addiction risk likely results from multiple interacting
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  factors rather than one cause possible interaction.
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  Examples are genetic vulnerability, early trauma,
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  high exposure environment, and stress coping patterns.
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  You put these things all together and it is very hard to
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  get sober. So conceptually each factor may
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  increase vulnerability. Combined factors may
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  significantly increase risk. It's interesting because I
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  didn't have a lot of these these factors in my life, but I
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  definitely had the stress coping patterns and the maybe some
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  trauma but nothing big T related.
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  I didn't have, you know, I had a good childhood growing up, but I
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  think I just built over a over time.
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  I related stress and emotional pain.
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  I wanted to escape myself with drugs.
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  It worked for a long time until it didn't.
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  Some individuals may be able to stop easily.
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  Others may experience powerful biological and psychological
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  reinforcement. This is why treatment and
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  therapy is so essential in the early going, especially because
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  we need to understand these things, the science behind the
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  biology behind it, so that we can rewire our
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  neurotransmitters. So the key take away points here
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  are addiction is rarely explained by a single factor.
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  There's usually multi layered. It's usually multi layered risk
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  appears influenced by genetics, brain chemistry, trauma,
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  environment, learning and conditioning.
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  A question to reflect on here is if a if addiction risk is
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  influenced by many factors, how should society think about
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  treatment and recovery? So there's not just one problem
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  and there's not just one solution in in this state.
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  If you're looking at it from this perspective, how do we
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  solve these problems? For me, it's important to know
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  that when I'm coming out of treatment, I can't go back to
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  the same environment. I have to rewire my brain.
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  I have to rewire, relearn behaviors, relearn how to have
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  fun without drugs and alcohol, how to handle stress, how to
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  cope with emotional behavior, emotional disturbance.
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  I need a power greater than myself.
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  I need spirituality. I need a program of recovery
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  that's going to keep me connected to something greater
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  than me. And not just this religious God
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  that I talk about. It's not religious God, not just
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  spirituality, but spirituality can be, can include community,
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  which is so important. You know, whenever I'm spinning
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  out about things in my head, my life is seemingly the sky is
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  falling on me. I can turn to other recovering
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  addicts and Alcoholics to achieve sobriety.
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  I can get help. I can talk about my issues.
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  I can get it out. I always say this, but secrets
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  keep you sick. You're only as sick as your
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  secrets, so get it out. Understanding all of these
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  influences may help reduce stigma and support more
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  effective recovery approaches. These people are not just
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  stupid. They're not just looking to have
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  fun. They're not just homeless people
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  trying to have a good time or lazy or it's.
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  There's many factors. So the next time you look at,
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  let's say a homeless person or someone smoking crack on the
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  street, think about the factors. Have some empathy.
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  There's a reason that this person is escaping pain or
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  seeking relief. There's a reason and it's not
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  just surface level. It's deeper than that.
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  Go deeper and this might help you understand yourself too.
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  The reason why you use and drink.
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  It's deeper than just I'm trying to have fun.
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  I hear all the time people saying I just liked cocaine
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  because it was fun. It's deeper than that.
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  You are usually we are escaping something.
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  There is some sort of coping going on.
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  There's some sort of relief that is needed and that's why
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  recovery comes in and replaces the drugs and the alcohol.
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  For me, it's a recovery program. It's a spirituality.
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  It's a power greater than myself that I don't understand on most
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  days and I don't need to understand it, but I know that
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  it's myself will availably nothing.
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  I am not going to get through this simply by trying harder.
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  I need outside help. I am beyond human aid.
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  This is not something that I am going to will myself out of.
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  If you're like me, you tried everything before you came into
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  recovery. You tried all of these rehabs
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  and sanitariums and treatment centers and treatment programs
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  and books, self help books and exercise and meditation and
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  these things individually don't work for us.
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  I came in here because everything else failed recovery.
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  The community I'm a part of was the last house on the block.
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  I didn't willingly come to recovery.
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  I didn't willingly go to rehab. I had to go.
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  I had to be forced there by outside factors.
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  And then I develop, begin to develop a way of living.
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  I begin to develop principles in my life where I can live happily
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  and without suffering most of the time if I take some simple
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  action and follow some direction.
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  I think, too, that it's beneficial to stop obsessing.
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  For a long time I obsessed over the fact that why can't I just
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  drink like other people? Surrender that idea today.
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  Try to surrender the idea that I don't drink like other people.
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  I just don't drink like the Bud Light commercial.
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  That's not been my experience. That is not how I party.
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  That is not I don't fantasize about a couple drinks on the
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  patio today. I fantasize about Tony Montana's
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  Scarface, that is my idea of fun and escape.
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  I don't enjoy these first couple of drinks and that that is not
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  what I obsess over or fantasize about.
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  I am an all or nothing guy. I go balls to the wall every
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  time. I don't kneel.
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  I don't know moderation and that is evidenced by other areas of
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  my life. I get obsessed about things.
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  I go all in and that can be used as a superpower, as a strength.
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  Today I can put that into my work.
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  I can put that into my recovery. I can put that into helping
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  others. I can put that into this
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  podcast. It is a beautiful thing to use
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  to your advantage. We have an unfair advantage in
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  recovery. I truly believe that today.
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  If you liked what you heard today, please follow, subscribe,
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  rate the podcast. I appreciate it.
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  We've gotten a lot of new listeners lately and I
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  appreciate every single one of you.
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  I love you. Don't ever forget recovery is
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  simple, not easy.