The Escape Road – Is addiction a disease or a choice? Yes it is.

MIRAGE MEME II

Imagine there is a crowd of onlookers next to a lake where there are people in the water who are drowning. Instead of throwing a rope out to the drowning people to pull them in and save their lives, everybody just stands at the shore of the lake arguing about whether the drowning people fell into the lake or jumped in. Both sides of the disease vs. choice argument contain elements of truth, which fuels the fire of the circular debate which is usually just steeped in dogmatic fallacy. Meanwhile, according to the Center for Disease Control, 72,000 people lost their lives in 2017 to drug overdose (not including deaths from alcohol abuse). So in effect, 72,000 “drowned”, that’s more than most football stadiums hold, while people debated.

Is it a choice? Of course – nobody was born with a bottle of vodka in their hands or a heroin needle in their arms. At some point, in everybody single person’s life, they made a choice to take a risk and do something they know that they should not do. For instance, many took the risk of having unprotected sex when they were in high school, most gambled for the first time, smoked that first cigarette, drank that first beer or shot of whiskey, smoked that first joint, etc. People made a choice to take a risk. For most, the choice to take that risk did not result in a life shattering series of events going forward. But for the millions of us, whether we fell into substance abuse, were pushed into substance abuse, or gladly jumped into substance abuse, we continued to make the choice to use those substances, even after it posed an imminent and immediate threat to our life and threatened to destroy the lives of our families. So technically yes, we made a conscious choice.

Is it a disease? The policy of the American Medical Association under the “disease theory”, for both psychiatric and medical sections of their policies, states “The AMA endorses the proposition that drug dependencies, including alcoholism, are diseases and that their treatment is a legitimate part of medical practice.” But arguments have been made that those classifications were made for economic reasons, in particular third party reimbursement (insurance) for the treatment of addiction and alcoholism. There have also been recent studies that challenge the classification of addiction or alcoholism as a disease. But right now, almost all major health organizations classify addiction/alcoholism as a disease. So technically yes, it is a disease, or at minimum an “illness”.

So both sides of the disease/choice debate can claim legitimate support for their positions. Nobody willingly chose to become an addict or an alcoholic, but by the same token nobody contracted addiction because an addict sneezed on them. In reality, it is technically both a “disease” and a choice, or at least a choice that leads to or becomes a disease or an illness (or whatever it may be called), so the debate rages on. However it is much more easily and simply defined than just a disease or a choice, because it may be both and it may be neither.

Most people don’t like the feeling of loss of control created by heavy alcohol or drug use, or the sickness that follows, so they rarely ever return to that place. But for the rest of us millions of people, the euphoria generated by alcohol or drugs created a neural pathway (a mind road) to a euphoric escape from pains of life – “The Escape Road”. We became drawn back to The Escape Road like moths to a light. There are a variety of opinions and another hornet’s nest of debate under the root cause behind the predisposition for addiction – genetic vs. environment, nature vs. nurture, inherited vs. acquired, or just an accident. Whatever the cause, for those of us who have abused substances, we found the feeling of euphoria and the relief of The Escape Road something that was almost impossible to resist. Drugs and alcohol provided a magic carpet ride away from mental pain, physical pain, even spiritual pain. It temporarily soothed the misery of bonafide mental illnesses like PTSD from childhood or adulthood trauma, Bipolar Disorders, Generalized Anxiety Disorders and others. So once we had a taste of that relief and the euphoria of walking on The Escape Road, we found ourselves returning until it became a habit, then a physical/mental dependency, and ultimately an addiction.

Once The Escape Road was heavily paved and we became mired in full blown addiction, the shame of our addiction, and the guilt of those activities, got added to the heavy mental illness baggage many of were carrying around before we became addicted in the first place. So we became even more thoroughly entrenched in traveling on The Escape Road to obtain relief. While we may have wanted to step off, we knew that doing so would result in, not only the loss of our escape hatch, but the return of the weight of the pain we were trying to obtain relief from, and we were also faced with the paralyzing anxiety and crushing misery of withdrawal. In the case of drugs like alcohol, suddenly withdrawing from it can be life-threatening. Our minds are intuitively aware of this, so a fight or flight response was triggered when confronted by withdrawal. Because our addiction backed us into a corner, our hijacked minds imagined that our lives were threatened by withdrawal, and we were faced with the loss of our only escape route, we were willing to do whatever it took to stay on The Escape Road, including lying, cheating, stealing, hurting ourselves, hurting others, risking our lives, even risking other people’s lives. When all of these things are taken into consideration, when someone is in full blown addiction, the decision to continue using may not even be a choice (arguably), but rather a survival-type auto response.

Now none of this is intended to provide a justification for substance abuse nor is it intended to provide some rationalization to the millions of people who lost friends, family, and people they loved, to addiction or alcoholism. Those people, who suffered loss, are filled with deep intense sadness, burning anger, smoldering resentment, agonizing frustration, and a host of other horrible emotions. Which is completely understandable and tragically heart-breaking. But maybe a modicum of understanding in how and why this often happens might help take a baby step towards placating some of these emotions and provide at least a little peace.

When a person is drowning in the lake of addiction to drugs or alcohol, they cannot be “enabled” because enabling them is like pushing their heads under the water. But those people who are drowning need to have a rope thrown to them so they can be helped to make the decision to pull themselves out of the water. People need education on what can be done to help those who are struggling with addiction make that choice, and to help them without enabling them. Once people have been helped to make the choice to recover, there are a variety of different recovery programs and recovery paths that they can follow. There are some arguments and studies on whether abstinence-based recovery is the best approach or not. However, for people who have had major issues with addiction to alcohol for example, returning to it under a controlled drinking or moderation environment could be potentially catastrophic. Because, if they are on the path of moderation, which they would argue is not traveling directly on The Escape Road, they are in effect walking along on the shoulder of that road. Major hardships, or a serious of smaller hardships, that often happen simultaneously, are common to everybody. It is not a question of if, but a question of when. When those hardships happen, The Escape Road would be right at their feet (since they are already walking on the shoulder), so then returning to chemical dependency full physical/mental addiction would be an all-too-easy natural progression, and would only take one small push.

The mind will never completely forget the feeling of euphoric escape through drugs or alcohol, so The Escape Road and the knowledge of that escape hatch is always going to be there. It will always be possible to consciously or subconsciously get drawn back to it, so a person who has been addicted to substances is never completely “cured”. From that standpoint, a person who has been addicted could be considered permanently “diseased”,  as is a common reference in 12 step programs. There is a recovery catchphrase in those programs that says “once an addict, always an addict”. Because the mind will never forget The Escape Road and the feeling of that euphoric escape, from that view, that catchphrase is not at all inaccurate (albeit perhaps stigmatizing). I knew someone who had been sober and abstinent for 25 years, regularly worked a recovery program, was happy with her life working as a nurse, and was in a state of overall well being. One winter morning, her car was covered with snow from the night before,  she couldn’t find her keys, was late for work, her car wouldn’t start, she was yelled at by her boss, had a bad day besides, and ended up stopping at the liquor store on the way home without even thinking about it. Three days later she was in detox and almost died. The Escape Road is never forgotten.

If we are helped to make the decision to withdraw from our drug of choice and obtain sobriety, our minds will still never ever forget the feeling of The Escape Road. Fear is one of the worst motivators there is for anything, so fear of drugs/alcohol, or fear of relapse or returning to The Escape Road, may not be the best approach, just by itself. But even fear can still keep people off of that road. A much better approach is using reputable recovery programs and/or group support, individual therapy, learned coping mechanisms for dealing with life’s difficulties, safe medication for people suffering from mental illnesses who have a substance abuse history, and physical/mental activities that release things like endorphins and natural dopamine. Any of these positive things can establish brand new neural pathways, or healthy new highways that the mind can travel on, which allow it to permanently steer clear of The Escape Road. Once we are on the road of recovery (or recovered), and traveling on these new neural pathways, we are able to always ‘make the choice to avoid the disease’, permanently stay off The Escape Road, and remain cured on the healthy new highways we have paved.

You’re Not Broken

EAGLE SOARING MEME

When something bad happens to us, it’s easy to feel like we are broken, we’ll never heal, and we’ll never be the same. But we heal when we allow ourselves to feel, so it’s important to not try and drown that hurt with drugs or alcohol. Yes it hurts, but once the hurt heals, we’ll be much stronger than we were before the hurt happened, and so much better than we were before.

Self-Care

SELF CARE

Just starting to take care of myself, in the most basic ways, began a journey of self-love, which did not mean some kind of narcissistic, self-absorbed, worship of myself. It was simply beginning to respect myself enough to care about my own cleanliness, how I looked, what I wore, who I associated with, etc. It also started the great feeling that came with doing things in my life that I knew in my heart were the right thing and avoiding doing things in my life that I knew in my heart were the wrong thing. For a change. This all created self-respect, self-esteem, good character and a great overall sense of well being.

 

Please Help Me

ASKING FOR HELP

“Please help me” were the most important three words I ever spoke and those words were the key to my recovery from drugs and alcohol. That 3 word mantra took down all the protection barriers I had put around myself that prevented me from allowing people in but also stopped me from getting out, and the key that unlocked all the doors.

 

Flirting With Disaster

FLIRTING WITH DISASTER IMAGE

In some cases, the addiction/alcoholism journey started with binge partying that became habitual and ultimately led to physical and mental addiction and chemical dependence. For many (if not most), the substance abuse was spawned by the need to feed the escape from the reality of pain from deep wounds caused by some past trauma. In any case, we couldn’t wait to ride that magic carpet away from reality every day. Social anxiety disappeared, we went from low self-esteem to superhero, boredom evaporated and life became a giant party, or at least an adventure that was happily tolerable. Right up until that giant balloon of substance abuse exploded and burst our lives and everything in them into flames. The spiral staircase that spun downward into the bottomless hell of addiction all started with the irresistible temptation to escape reality through the artificial euphoria created by drinking, swallowing, smoking or snorting something.

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During my life of addiction, I had conditioned myself to always being able to disconnect from life through the use of substances. If I was having a bad day, I could make it better and if I was having a good day I could make it great. There was always that escape hatch for me to crawl through when I didn’t want to deal with life anymore. When the general anxiety became too much or spiked because of something bad life through at me, boredom took hold, or depression got a grip on me, or anytime the road got rough in any way, I could always jump back onto that train that took me away from it all. Eventually and predictably, my substance abuse and chemical dependence elevator that was going up, flew through the top floor and ended with me in a coma and not expected to survive. Then that train I was riding derailed and left everything in tatters.

TRAINWRECK

The concept of  substituting a different drug for the drug of choice in my life is something I just cannot wrap my mind around – where I have to justify and rationalize it in my mind by saying that “Well, at least I’m not using my original drug of choice anymore.” Haven’t I still just created a new life of illusion, just on a different path? What happens when life throws a new major hardship onto that new path? Do I seriously think I’m not going to start abusing that new drug? What if that new drug isn’t enough to numb me through this new hardship? I’m still on a road paved by the conditioning of chemical dependence that would eventually circle back to my original drug of choice.

DEAD END II

The same thing goes for me attempting to just use reduction and moderation of my drug of choice, rationalizing that under the delusion that if I reduced my overall usage, or set amount limits on a given night and stick to that, I have it all under control. Using the previous example – things might go just fine right up until the point where life puts some major hardship my way, or a compilation of many smaller but significant problems all at the exact same time. Am I naïve enough to think I won’t return to abusing my drug of choice to escape these problems? I’ll be swallowed up into that pit of addiction faster than I can drop a glass. And let’s say I choose the path of moderation, and I feel I have all my addictions conquered and under control now – If I really have them under control and I think I’m no longer dependent on drugs or alcohol, then why do I feel like I can’t live a happy life without them? I have yet to hear any coherent answers to that question.

Whichever of these tempting paths I think I might lead me to happiness and contentment, wouldn’t I still just be returning to that same mentality of substance use, as a solution to my problems, being a staple of my life? Wouldn’t I just be reverting back to that same old conditioning of being able to escape reality by drinking swallowing, smoking or snorting ‘euphoria drugs’? Aren’t I still just keeping myself in the prison of chemical dependence to those types of drugs? Both paths would eventually lead me right back into that dark pit.

DEATH DRUG DEALER

Everybody’s recovery path is their own business and none of mine, so I’m not criticizing anybody else’s path at all, because I have no right to do so and it’s not my place. I’m only stating my own case for my own path. I’m totally in favor of short term Medically Assisted Treatment (MAT). This isn’t the 1930’s where they strap you to a bed for 30 days until you “dry out”. I also 100% support long term treatment, under dual diagnosis for mental illnesses, using medications for those illnesses deemed safe by the professional medical community for people with substance abuse history.

Wherever I refer to “chemical dependence” and “euphoria drugs”, I’m specifically talking about all substances, whether legal, illegal or prescription, that are considered by the professional medical community highly addictive and particularly dangerous for people with a substance abuse history, because they create an artificial feeling of sedative euphoria and/or alter reality. For my own personal recovery, because I’ve had substance abuse issues, abstinence from all these types of substances is the only logical path for me.

Conquering life’s problems with a clear unaltered head creates quality character, which strengthens my hope and self-esteem. To be able to look life in the eye and say, “give me your best shot”. As opposed to turning tail and running back to the pretend sanctuary of substance use at the first sign of trouble. No – if I flirt with disaster long enough, I’ll eventually return to that bottomless hell of addiction. Thanks, but no thanks. I love my life and I love life, free from the chains of substance abuse and out of that prison of chemical dependence.

BREAK THE CHAINS

End The Stigma

BREAK FREE MEME

According to the Center for Disease Control (CDC), 72,000 people died last year from drug overdose and another estimated 88,000 deaths from alcohol consumption. That’s 160,000 people EVERY YEAR, way more than the largest football stadium could hold – that’s over 400 people EVERY DAY, or over 18 people EVERY HOUR and that number is growing. In fact by the time you’ve finished reading this post another person already died.

Changing the method and manner that addiction/alcoholism is being treated seems to gain little traction and the treatment industry just continues to follow an old textbook, dogmatic paradigm, that obviously is falling way short. Then the inane, senseless debate rages on as to whether it’s a disease or not. Plus the view of the general public seems to be, unless it affects them personally, they couldn’t care less – those weak-willed fools chose their poison so let them rot and die from it. Even within the recovery community of those who have personally gone through addiction or alcoholism, it seems once people have a couple years of sobriety under their belts, empathy and desire to help other people recover seems to wear off and replaced by a general “to each his own” apathy. But that’s because it often seems like there is only so much you can do and what else is to be expected when it feels like the world has cast us all aside and shunned as outcasts who just wanted to take the easy way and escape reality.

Only people who have personally gone through the despair of addiction or alcoholism and the hell of withdrawing understand the courage, resolve and strength it took to recover from it. Change can be sparked by rejecting the stigma that forces us to cloak ourselves in the shadows of anonymity. Where else in history has that happened – where a group of people had a stigma stamped on their foreheads, forcing them to congregate with other people who were given that same stigma? Let that one sink in. It’s easy for those labels to stick to us like toxic barnacles, because we’re usually already trying to set down the guilt and shame baggage of our past. Plus, in a world where privacy is paramount, we often feel compelled to either slink around in secrecy or avoid the recovery world altogether, and just be accepted back into the herd. But if we all start to break free from the stigma and boldly wear our recovery courage as a badge of honor, as a collective, loud voice, more people may take notice, start to listen and real change has a chance to happen in the treatment industry and recovery world.

Over 400 people every single day – 18 people every hour – no longer with us, who will never get a chance to experience life, love or friendship. Then there’s all of the people who loved them and will never get to see them again on this earth. If I’m going to ever feel seriously guilty again about anything in this life, it would be if I sat on my hands and did nothing. We all know the despair of addiction, the hell of withdrawal and how horribly difficult it was to obtain sobriety. We can give help and hope to anybody who is struggling with addiction and we can encourage everybody in recovery by boldly showing that addiction and alcoholism is nothing to be ashamed of. In fact recovering from it is a major accomplishment to be extremely proud of.  We can be just as courageous in ending the stigma as we were in becoming sober in the first place. Because we can all be extremely grateful that we’re still here and that we didn’t end up a statistic on a CDC chart.