One of active addiction’s cruel realities is that gradually and progressively, alcohol and other drugs work less and less well. The inexorable truth the phenomenon of tolerance teaches all addicts is that the longer they use substances—whether from the street like crack and heroin, prescribed by a doctor like painkillers and benzodiazepines, or bought at a store like alcohol and now, in some states marijuana—the less of the desired effect they will experience. As human biochemistry adapts to the substance and becomes used to it, it takes more of that substance to produce the same mind- and mood-altering effects.
The only options are to continually increase the amount used or to switch to a more efficient route of administration (such as smoking or shooting) that delivers the payload more rapidly to the brain’s reward center. However, even these are but temporary fixes (pun intended). At a certain point in the evolution of an addict, a threshold is crossed where he or she no longer gets “high.” Past that point, alcohol and other drugs are used just to feel “normal,” and to avoid the agony of withdrawal. Using ceases being “fun” and becomes a form of work—a job unto itself.
The drug-induced dynamics of diminishing returns have two levels: micro—declining effects with each successive dose over the course of a given day or using session, and macro—decreasing desired effects that occur over the total length of time one has been using, whether weeks, months, or years. This notwithstanding, those in active addiction invariably continue to chase the sublime intensity of the rush they experienced early in their using careers. Addicts retain vivid Technicolor memories of that revelation of chemically-induced ecstasy. It is that perfect moment, resplendent as the memories of one’s first true love. Like petroglyphs etched in rock formations that are clearly visible hundreds of years later, those rhapsodic recollections are engraved deep within the midbrain—beckoning sweetly and seductively.
The progression of active addiction is a deviation-amplifying process, much like pushing a wheelbarrow in a rut. The more the wheelbarrow is pushed in the rut through time and repetition, the more well-established that rut becomes. The more well-established and deeper the rut becomes, the harder it is to get the wheelbarrow out of it. There comes a tipping point where it becomes much harder to get the wheelbarrow out of the rut than to continue to follow it, which only makes the rut deeper still.
The brain adapts to repetitive experiences by forming memory connections or tracks that are unconscious. When such repetitive experiences revolve around using, the memory tracks that are laid become the neurological foundation of the “habits” of addiction. These unconscious learned responses are strong enough that they remain operative, even after years of abstinence. As a result, people are naturally pulled back toward the experiences and behaviors with which they are familiar and comfortable, making it more difficult to stop such behaviors and stay stopped.
However, a predisposition to returning to using alcohol and other drugs or addictive behaviors (gambling, eating, or sex) does not predetermine relapse. For many people relapse is a reality, but it is by no means an inevitability.
Recovery is a deviation-counteracting process that involves consistent course corrections based on conscious awareness of one’s internal and external environment—for which basketball is an excellent analogy. On the court, as in real life, the environment and its circumstances evolve continuously. The action is ongoing but its pace varies, and energy and momentum can shift dramatically.
Different players rotate in and out of the game, some playing more substantial roles than others. Each person’s playing time and the significance of his or her role can change. Coaches and assistant coaches are resources that help to provide direction, guidance, and mentoring. Even the best players require the support of teammates in order to win games. And even the best teams have to call time-out on occasion, when the game gets away from them, and they are anxious or stressed and need to regroup.
In order to be successful, it’s important to be present-centered and not get sidetracked by self-defeating thoughts or distressing emotions. It’s imperative to be able to see the court accurately if one is to respond skillfully. Is the defense playing man-to-man or a zone? Is it ultilizing a full-court press or a half-court trap? Is the defense laying back to prevent the dribble-drive and giving up the outside shot? Or it is playing close and tight, creating opportunities to drive to the hoop? Success in different circumstances requires a different set of responses.
Achieving and sustaining recovery by negotiating the ever-evolving flow of life on its own terms requires a similar assessment of the full range of situations with which we are presented. And, as is the case with basketball (or developing real skills in any area), the way to become proficient is through persistent and dedicated practice. This is the 25th anniversary of September as National Recovery Month. Its message is that people can and do recover.
This blog originally appeared on the Psychology Today website
This blog was written by Dan Mager, MSW, author of SOME ASSEMBLY REQUIRED