Addiction Treatment: Cause and Effect

Most people I talk to still perceive addiction as caused by psychological issues, such as being raised in an abusive home environment, depression, stress, trauma, on and on. Addiction can develop even if a person is mentally and emotionally healthy. Psychological problems complicate addiction, and vice versa, but research has found there’s no direct causal relationship from psychological issues to addiction. There are many reasons people start drinking alcohol, snorting cocaine, smoking pot or popping pills, and they’re not always are even mostly to deal with some kind of mental or emotional pain. Some people, about 13%, are susceptible to addiction regardless of their mental or emotional state. It gets even more complicated when we look at people who’re prescribed medication which can cause physical dependence. Physical dependence is not necessarily addiction. Addiction is a chronic brain disease involving complex interactions among brain circuits and genetics, complicated at times by environment and life experiences.

The person who’s susceptible to and develops addiction is compelled to use even after removing the drug, including the drug alcohol, out of their system. A person who’s not susceptible to developing addiction, who went to a doctor and was prescribed opiates for chronic pain and became physically dependent, will not likely need or want the drug once the doctor has resolved the pain problem and has weaned the patient off the opiate medication. Most people don’t want to be dependent on a drug. There’s an X factor with addiction that has to do with brain chemicals that causes irrational craving for the drug and distinguishes it from physical dependence. 

The addict is compelled to use their drug of choice, even when they’ve resolved mental and emotional issues, and in spite of negative consequences. It’s why so many people suffering from addiction who go to a psychologist, but aren’t honest with the psychologist about the true nature of their alcohol and drug use, continue to have problems related to drinking alcohol or other drug use. The person thinks they’ll drink or use their drug of choice normally if they’ve dealt with their psychological issues. It seems logical — if it’s true that depression from, say,  a bad childhood is causing the problem with drugs, then, if the depression and bad memories are addressed and resolved, the person shouldn’t have a problem taking a friendly drink, or socially using a little cocaine, or smoking a joint from time to time. Right? Wrong! The problem for the addict is the drug, and when the drug reaches the brain. The same insane compulsion develops over and over until the person learns how to stay away from the drug and understands that addiction doesn’t go away with counseling and dealing with past mental and emotional problems.

Past mental and emotional problems, if not dealt with, however, can cause a person who’s trying to stay away from all addictive drugs to return to drinking and using, and this is why in treatment we help clients learn to deal with mental and emotional issues, so that they have a better chance to remain abstinent, and to live a healthy and stable life. Mental and emotional pain, if not dealt with, can drive a person recovering from addiction back to the drug. But to think that dealing with mental and emotional issues will allow you to drink and use drugs normally without consequences is confusing cause and effect. What usually happens when someone has developed addiction is that any unaddressed mental or emotional problem they might have had in the course of their life becomes worse in addiction. The addiction makes the problems worse, and the problems make the consequences in addiction worse. But learning which is a cause and which is an effect is very important in addiction treatment and recovery.