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The process of addiction to alcohol or another drug consists of a vicious cycle. The cycle begins with an individual ingesting alcohol or a drug. For some individuals a relationship begins with the substance being ingested. As the use of the substance becomes a predictable pattern over time, noticeable physiological changes begin to occur. Specifically, the alcohol/drug interferes with the work of neurotransmitters. These are chemicals in the brain that are responsible for the transmission of messages from one neuron to another. Changes in neurotransmitters affect moods, sense of well being and cognitive abilities. The more a chemically dependent individual uses a substance, the more he/she changes the concentration and functioning of neurotransmitters. For example, the presence of cocaine in the body sends a message to the brain that certain neurotransmitters responsible for well being are no longer necessary and hence are not produced by the brain. Since the cocaine is mimicking a sense of well being, the body/brain adjusts by shutting down the production of neurotransmitters responsible for a sense of well being. When the effects of cocaine dissipate, the individual feels “depressed” with no rescue from the brain’s natural resources. Therefore, the individual resorts to more cocaine to improve his/her mood or sense of well being.

Chemical dependency is a disease that manifests itself in signs and symptoms in three domains: biological, psychological and social. As addiction progresses in the individual, there are clear physiological forces that drive the addiction and therefore the individual. The addicted individual physically craves the drug and will do anything to relieve the pain of its absence from the body. As time passes, tolerance to the drug increases, i.e., larger amounts of the drug is needed to attain the desired effect. Heavy and prolonged use of a drug also generates withdrawal symptoms in the absence of the drug. For example, some alcoholics experience delirium tremens among other serious withdrawal symptoms when they suddenly stop drinking. Similarly, withdrawal from heavy and prolonged use of a stimulant by an individual will induce a deep depressive mood. From these examples, it is clear that detoxification for those with prolonged use of a substance requires medical intervention.

The psychological and social factors that support the addiction are significant and necessary to address in recovery. These factors are generally about harmonizing relationships with self and others. Drug addiction is disruptive to relationships. Similar to the brain adjusting and adapting to the presence of the drug, individuals and communities close to the chemically dependent person will adapt to the presence of the drug. Sometimes the adaptation is helpful in relieving the pain of addiction and helping the chemically dependent individual receive the help he/she needs. Other times the adaptation is counterproductive. In the field of addiction treatment, counterproductive behavior is termed “enabling.” Any behavior by an individual designed to eliminate or minimize the consequences of a chemically dependent person’s behavior fits the category known as enabling. An example of enabling behavior is the husband that consistently calls his hung-over wife’s supervisor to report that she will be absent because she is sick. Admittedly, knowing how and in what ways to help a chemically dependent individual is not easy. But, there are treatment protocols for families and friends of the chemically dependent, which address these concerns. Addiction is known to be a family disease for two reasons. First, in many cases of addiction, genes set the stage for addictive behavior. Second, all members of a family are adversely affected by the drug abuse and are in need of assistance and support in breaking the vicious cycle of addiction. For more information contact the Alcohol & drug Council at 274-6288.Sober Talk is a monthly column by the Alcohol & Drug Council of Tompkins County, Inc. and runs in the Journal the first Thursday of each month. Tom Lipa, M.Ed, CASAC is a clinician at the Alcohol & Drug Council.