The fact that many people start to use alcohol and other drugs, but only about 10% go on to become heavy or addicted users which leads me to another question.  “What did people want to get from using alcohol and other drugs?  What do they want the booze and drugs to do for them?” Surprisingly almost everyone gave me one of seven answers to that question.

What People Want From Using Drugs

1.    To Get High
2.    To Relax
3.    To Be More Social
4.    To Manage Feelings
5.    To Get More Energy
6.    To Block Out Pain
7.    To Be More Spiritual

Let’s look at each of these in more detail.

First, some people use alcohol and drugs To Get High. They want to have the euphoric feelings of their drug of choice, which they cannot get in any other way.  Some people feel good when they start using alcohol and drugs.  In fact, they feel better then they have ever felt.  They do not feel “drunk” or “stoned” in the usual sense of those words.  What they feel is a unique sense of well-being.  Everything seems right.  Everything seems to be working well.  They feel normal, competent, functional and relaxed.  They feel like they can handle anything and do anything that they want to do.

I call this unique feeling of well-being euphoria.  This state of euphoria, this special feeling, this unique state of consciousness is different from anything else we have ever experienced.  This is the feeling that addicts want to have.  After awhile, this becomes the feeling that they need to have and become willing to do just about anything to get.

Second, some people use alcohol and drugs To Relax, to turn off stress, get away from pressure. They calm down to feel mellow.  The Downers are the usual drug of choice for relaxing.

Third, some people use alcohol and drugs To Be More Social.  They want to make it easier to get along with other people.  Many people find that they feel better about themselves when they are drinking and drugging.  As result, it is easier for them to deal with other people.  This newfound social ease is caused in part by the biological actions of the alcohol and drugs.  Another big part is psychological.  When under the influence of alcohol and drugs many people can give themselves permission to do things that they would never be able to do sober.  Many people develop a social persona based upon their self-image as a drinker and drug user.

If they were to stop using alcohol and other drugs, they wouldn’t be sure of who they really were, how people viewed them, and how they fit into the world. In the next Gorski Blog I will review the other reasons why people want to start.

Why do people keep using alcohol and other drugs after they start?  I have asked addicted people this question for more than thirty years and come to the conclusion that people keep using alcohol and other drugs for one, and only one, reason – The drugs work!

Let me repeat that.  People keep using alcohol and other drugs because the alcohol and drugs work! They make people feel the way they want to feel.  This is what keeps people coming back.  Their drug of choice, whether it is alcohol, valium, cocaine or heroin gives them the mood altering effect that they want.  If it does not, they will not keep using it.

People keep using alcohol and other drugs 
because they work!

Not only does the drug work, it works quickly and reliably.  They get the effect that they want and they get it NOW!  What is even more important is that the drug is reliable.  It produces the effect they want every time they use it.  They come to depend on it.  My drug of choice gives me what I want when I want it.  There is no fuss and no muss.  I get pain-free pleasure right now, on demand, any time I want it.

If I feel bad or just want to feel better what do I do?  Do I go into therapy, work long and work hard trying to feel better without drugs?  Or, do I use my drug of choice and instantly get the effect that I want?

Let’s see…  I am feeling bad and I want to feel better?  What should I do?

Should I invest a lot of time and energy figuring out what is making me feel bad?  Should I then invest more time and energy figuring out how to fix it?  Should I then invest more time and energy in trying to fix it? Or, should I do all of this when I know that what I am doing might not work and that even if it does work, it will take a long time to make me feel the way I want to feel? Should I take something that instantly gives me the effect that I want with little or no effort?

Can you see why so many people decide to drink and use drugs?  They know that relief is just a swallow away.  They believe in better living through chemistry.  It is quick.  It is easy.  It seems painless.  Moreover, it works for them every time.  It gives them the effect that they want, when they want it without any real effort.

If mind-altering drugs are dangerous, why do people use them?  Why are they willing to take the risk?  To answer this question, we have to consider two things.  First, why people start using, and second, why they keep using after they start.

People start using alcohol and other drugs for three basic reasons — curiosity, social pressure, and automatic cultural response.

People who start using out of curiosity want to see what drinking and drugging is all about, so they experiment.  They try it to see if they like it.  The primary thing that drives them to start is their desire to get first hand information.

People who start using because of social pressure believe they have to drink and drug in order to belong or fit in.  They see alcohol and drug use as a ticket to social success.  They think that drinking and drugging will help them get along with other people. They also believe that if they don’t use alcohol and drugs they will be rejected.

People who start using alcohol and drugs out of an automatic cultural response are usually part of a sub culture that views alcohol and drug use as normal.  Drinking and drugging merges with the habits of everyday life because it is so common that most people do not even notice it.

When you are driving your car, you often do not even notice that you are in the right lane, everyone drives in the right lane.  You have been trained to drive in the right lane and you have driven in the right lane for such a long time that keeping your car there has become a normal part of your driving.  So we normally do not even think about it.

You would start thinking about it pretty fast if you ever have to drive in England where all cars are expected to drive in the left lane.  Suddenly all of your training and habits begin to work against, you can get yourself killed, if you don’t work hard to overcome them.

This is just like people who grow up with families and friends who regularly use alcohol and other drugs.  Drinking and drugging become just as normal as driving on the right side of the road.  The problem is, if you get addicted all of the rules change and suddenly you have to learn how to drive on the opposite side of the road or your whole life could fall apart.

People who start using alcohol or other drugs out of an automatic cultural response see everyone around them using and abusing alcohol and other drugs. It’s been that way from the time they were born.   Drinking and drugging is so common that they do not even consider the possibility of not doing it.  They see drinking and drugging alot like other people who breathe air.  Of course, you breathe air, you would never consider trying to live without breathing.  If you did, it would mean there was something seriously wrong with you.

Therefore, people start using alcohol and drugs as a result of curiosity, social pressure or automatic cultural response.  Over the years, I have learned that people start using alcohol and other drugs for one reason, and keep using for another.  In the next Gorski Blog I will explain why I believe some people keep using alcohol and other drugs after they start.

Drugs of abuse can change our mood by altering our natural brain chemistry.  Each person has a unique biological response to every drug they take. (Scientists call this biological individuality). In other words, the same drug can and probably makes two different people experience two different feelings.  This is because the same drug taken in the same dose can affect different people in different ways.

Although some drugs are more addictive than others, drug abuse and addiction do not “live in” the mood altering substance. Abuse and addiction result from a complex interaction between the drug and the brain chemistry of the person taking the drug.

Addiction results from a complex interaction
 between the drug and the brain chemistry 
of the person taking the drug.

Some people are biologically predisposed to have powerful and pleasant responses to one or more drugs, others are not.  Those who have powerful and pleasant responses to mind altering drugs are more likely to use them more frequently.

These powerful and pleasant feelings occur because the drug of abuse causes a rapid release of pleasure chemicals in the brain.  This surge of pleasure chemicals creates intense pleasure, which is called euphoria.

When you take a substance and feel euphoric, you are drunk or stoned. The high levels of pleasure chemicals make you feel exceptionally good, very powerful, capable, and essentially fearless. As a result, there is a good reason to want to use more. This euphoric feeling is so good that most people want to feel it repeatedly, and as often as possible.

Most people experiment with different kinds of alcoholic beverages and different kinds of drugs.  They find that some drugs make them feel better than others.  In other words, they find a drug of choice.  They find one specific drug that they prefer to use because it causes a rapid, powerful, and pleasurable mood altering response.  Some people have one drug of choice, and some have many.

The brains of some people will not produce a deluge of pleasure chemicals in their brain no matter what drug they use.  As a result, they never find a drug of choice.  Their brains resist the mood altering effects of most drugs.  When they use them, they experience one of two things: either nothing much happens or they start to feel bad.  Because these people usually find using alcohol or drugs to be a neutral or unpleasant experience, they do not look forward to using alcohol or other drugs and when they do use,  they use very little because they either don’t feel good or they quickly start to feel bad.  If they use at all, they do so infrequently and tend to use very small quantities to avoid the unpleasant effects.  For obvious reasons, people who are biologically unable to develop a drug of choice are at low risk for abuse and addiction.

The opposite is also true. For people who experience an intense release of pleasure chemicals when they use a drug, they want to keep using it and as a result are at a high risk of using the drug regularly, heavily.  They are also at higher risk of abusing the drug and getting addicted.  In the next Gorski Blog I’ll explain the difference between an addictive brain response and a normal brain response.

Here is the critical point that I want you to remember.  I want you to burn this idea deeply into your consciousness: Mind-altering drugs directly affect our brains and can cause brain damage. They make us feel better by disrupting the normal functioning of our brain, but we always pay a price.

Mind-altering drugs can cause brain damage. 
They make us feel better by disrupting the normal functioning of our brain. 
But we always pay a price.

Any time we take alcohol or other drugs into our bodies, we are tampering with the chemical balance of our brains.  The brain is the most important and a complex organ in the body.  Disrupting the way it works by using alcohol and other drugs can be dangerous.

Using alcohol or other drugs is like putting your brain in a bucket and pouring a combination of anesthetics and acid over it.  While the acid is damaging the brain, the anesthetic is blocking out the pain.  As a result, we feel fine, at least until the drug wears off. Once the drug wears off, we have difficulty functioning normally. The brain dysfunction associated with the use of alcohol and drugs can make it difficult to think clearly, numb and distort our feelings and emotions.

This will make our behavior difficult to control.  This condition is in its early stages and is called Post Acute Withdrawal; (PAW).  In its later stages, it can develop into permanent brain dysfunction.

Here is another thing to consider.  Some people have brains that are sensitive to and easily damaged by alcohol and other drugs.  If you are one of these unfortunate people, using drugs will do a lot of damage to your brain in a very short period of time. As a result, you will have to pay a higher price in the future for the good feelings you are getting today.

Some people have brains that are sensitive to 
and easily damaged by alcohol and other drugs.

If you are using alcohol or other drugs to handle your problems or to make you feel better, it is important to keep one thing in mind:  Life does not give free rides. There is always a price to pay.  We can pay now by stopping our use of alcohol any other drugs or we can pay later by having to deal with the pain and dysfunction of addiction.

The problem is that not everyone responds the same way to any drug.  The effect of all drug use, even medicines that don’t make us high, is a directly result of both the drug we take, and how our own unique brain chemistry responds to that drug.  Since each of our brains our different, no one will experience the exact same effect from the same drug.  In the next Gorski Blog, we will look at how this individual response to a drug can cause us to really like and crave some drugs,  feel little or no effect by others, and not like the effect of still other drugs.

The problem with the Legal Schedule of Drugs is that it does not help us to understand why people tend to use drugs in the first place. People use, abuse, and become addicted to drugs in spite of the fact that they are threatened with punishment. Imprisonment has not reduced drug use, abuse, and addiction. In fact, many maximum security prisons have a hard time keeping drugs out of the prison itself.

So, instead of defining drugs by their legal status, we are going to define them in another way, by the effect that most users experience when they use the drug. People tend to use drugs because they like their effects, they like the way the drug makes them feel. If the drug makes them feel good enough, many people are willing to risk the consequences of breaking the law in order to get and use the drug.

It can be helpful to classify drugs into one of four groups based primarily upon their mood altering effect:  The four groups of mind-altering drugs are uppers, downers, painkillers, and mind-benders.  We are going to deal with alcohol and marijuana separating them in the next Gorski Blog because although you can squeeze them to fit into one of the four categories we will discuss, they are different enough to warrant some discussion in their own right.

Uppers stimulate and excite. They stimulate the nervous system and create a sense of emotional excitement.  They speed us up.  They make us feel more alive, more energetic, and more powerful.  Some common stimulant drugs are cocaine, crack, methamphetamine, and amphetamines.  Methamphetamine has become a major problem in the United States because of its severe addictive potential.

Downers are depressant drugs that sedate and relax. They slow us down, they take the edge off. They make us feel more mellow and calm.  Some common depressant drugs are alcohol, sedatives, barbiturates, and anti-anxiety drugs.

Please notice alcohol is the most commonly used depressant drug.  People can abuse and get addicted to alcohol.  More people have serious problems with alcohol than with all other drugs of abuse combined.

Mind Benders are psychedelic drugs that alter consciousness by distorting our sensations, perceptions, and emotions.  They also distort thinking, self-image, and our sense of spirituality.  Some common psychedelic drugs are Club Drugs like Ecstasy and MDMA, LSD, PCP. Some people say marijuana and hashish fit into this category and other say that it really doesn’t. As I said before, I will deal with alcohol and marijuana in separate categories in the next Gorski Blog.

Pain Killers dull pain and create a detached sense of euphoria. They are used primary to escape pain or get away from problems.  People like to use painkillers because they block out physical pain, psychological pain, and dull unwanted thoughts.  They replace these thoughts and feelings with a detached and pleasant state of euphoria.  Narcotics make some people feel like they are floating away.  This creates the illusion that they are leaving their problems behind.  Unfortunately, the problems do not go away.  They are just temporarily blotted out by the effect of the drug. Some common narcotics are Heroin, Codeine, Morphine, Demerol, Vicodin, Oxycodone, OxyContin, Roxiset, and Roxicodone solution.

It is beyond the scope of these blogs to explain the details of how each mind-altering drug affects the brain. It is important to realize that these substances have a powerful physical affect on how your brain functions and that each general class of drugs (described above as uppers, downers, mind-benders, and pain killers) are designed to produce a specific change in brain chemistry. This creates a specific effect upon how we think, feel.  In the Next Gorski Blog, I will explain what these drugs do to your brain.

Mind-altering drugs are chemical agents that alter brain chemistry our in a way that changes how we think, we feel, act, and relate to other people. In other words, mind-altering substances physically change how your brain works.  Taking a mind-altering substance is a lot like letting a surgeon operate on your brain using a rusty scalpel.  Let me explain why I say this.

The human brain is a complex chemical factory.  Millions of nerve cells communicate with each other by releasing and absorbing chemicals called neurotransmitters. Mind-altering substances change our thoughts, our feelings, and our behaviors by changing the levels of neurotransmitters in our brain cells.  Different mind-altering substances stimulate or inhibit the production of different neurotransmitters.  As a result, different types of drugs produce different mind-altering effects.

There are many different types of mind-altering substances.  The Controlled Substance Act of 1970 defines five categories of controlled substances that are dangerous enough to be controlled by law.  It is important for actively using addicts and those in relationship with them know which drugs are illegal and what the legal penalty are for being caught buying, possessing, using or selling these drugs.  The penalties can be quite high and no addict is immune from being caught.

Potential drugs of abuse are legally classified using four criteria: (1) the drug has a high potential for abuse as demonstrated by the fact that many users start to abuse and get addicted to the drug, (2) the drug has limited medical usefulness, or there are other drugs with a lower addiction potential can that can meet the same medical need, (3) the drug has a high potential for dependency or addiction if a person starts using it, and (4) the drug needs special control and monitoring procedures to minimize the risk of abuse and addiction among the general population.

There are five categories of controlled substances, which if used or misused become illegal drugs of abuse. Here is a description of each of the five schedules or categories of these drugs.

Schedule I drugs have a high abuse potential and no accepted medical use. This schedule includes drugs such as heroin, marijuana, LSD. (See Appendix 1)

Schedule II drugs have a high potential for abuse and a high risk of severe psychological and/or physical dependency and addiction. These risks, however, are offset because in certain situations they have significant medical value. Examples of schedule II substances include narcotics, amphetamines, and barbiturates. Prescriptions for Schedule II substances can never be ordered with refills and must be filled within 7 days of the date originally written.

Schedule III substances have less potential for abuse than Schedule II substances and moderate dependence liability. Examples of Schedule III substances include nonbarbiturate sedatives, nonamphetamine stimulants, and medications that contain a limited quantity of certain narcotics. Schedule III drugs also have significant medical value in certain circumstances. Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within 6 months.

Schedule IV substances have less abuse potential than Schedule III substances and limited dependence liability. Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within a 6-month period. (See Appendix 4)

Schedule V substances have limited abuse potential and are primarily antitussives or antidiarrheals that contain small amounts of narcotics such as codeine. Prescriptions must be filled within 30 days of the date written and may be refilled up to five times within 6 months. (See Appendix 5)

It’s important to understand the schedule of controlled drugs because using or selling drugs in Schedule I or illegally obtaining, possessing, using, or selling prescription guidelines for schedules II and III could put you in jail for a long time.

Legal classification is useful in warning people about what drugs are dangerous and in providing legal definition for use in a criminal trial and in sentencing guidelines.  I have found that the legal classification system does very little to help addicts understand why they are drawn to and tend to addicted to these drugs in spite of the risks.

To understand this, let’s look at a way of classifying the alcohol and other drugs of abuse by the effects each class of drugs was designed to have on the people using it.  This will be the subject of the next Gorski Blog.

In this blog we are going to take a hard look at mind and brain altering drugs that are capable of turning people in addicts.  I am often amazed by how many people who regularly use these substances know so little about what they do to the brain and the mind to produce the desired effect.

The bran and mind-altering substances that can activate abuse or addiction include alcohol, certain prescription drugs, illegal drugs, and certain over-the-counter drugs that alter mood and behavior.  First let’s look at what causes people to want to experiment with brain and mind altering drugs in the first place.

Relief from Stress or Pain: Most of us use alcohol and other drugs to get relief from pain and stress, to fit in socially, and to have unique feelings and experiences that we can’t get without the drugs.  The most abused drugs provide a thing call instant gratification;

People who like to use alcohol and other drugs are usually looking for a quick fix.  They want something that will change their mood quickly and dramatically.  They want to use drugs that work fast and pack a big punch.  They want to feel better – NOW!

This need to feel better now is called instant gratification.  One recovering person put it this way:  “The problem with instant gratification is that it’s not fast enough.”  This need for a quick fix means that the most frequently abused drugs will produce an intense mood altering effect in a short period of time.   These fast acting substances are called drugs of abuse.  People like them so much that they can easily abuse them or get addicted to them.

There are different types of brain and mind altering drugs that create different subjective effects.  Most people like some of the drug effects and not others.  We will discuss this in a future blog entitled drug of choice.  Before we can go any farther, however, we must come up with an easy to understand working definition of addictive drugs and a simple classification system based upon how they tend to make people feel.  That will be the subject of the next Gorski Blog.

Recovery from chemical dependency requires accurate information about the disease of addiction, recovery, relapse prevention, and recovery resources.  These are four vital areas of information that recovering people and their families need to know to maximize their chances of staying sober.  Let’s briefly review these three areas.

1.    Chemical Dependency as a Biopsychosocial Disease
Chemically dependent people suffer from the after-effects of chronic alcohol and drug poisoning to the brain.  As a result, brain function becomes impaired and people cannot think clearly, manage their feelings and emotions effectively, or remember things well.  This short-term brain dysfunction causes personality disorganization and changes value systems.  This leads to a disruption in social systems such as work, friendships, family, and intimate functioning.  Understanding the physical, psychological, and social symptoms of chemical dependency is the first  step of recognizing and accepting that you are chemically dependent.

2.    Understanding the Recovery Process
Once chemically dependent people recognize that they are addicted and make a decision to recover, they need to understand recovery as an ongoing developmental process.  There are six stages in the recovery process.  In the transition stage, people recognize they are chemically dependent and make a commitment to abstinence.  In the stabilization stage, people recover from the physical, psychological, and social crisis that follow them into recovery.  In the early recovery stage, people change addictive thoughts, feelings , and actions.  In the middle recovery stage, they balance out their lifestyle and repair lifestyle damage that was caused by the addition.  In the late recovery stage, a person resolves family of origin problems that lower the quality of recovery.  In the maintenance stage, people continue a program of personal growth and development.  Understanding these progressive stages, the  tasks associated with each, and the common relapse warning signs are essential to keep moving ahead in a efficient recovery process.  (A latter blog will cover these stages in greater detail).

The first three stages of recovery can be summarized as Stage I Recovery.  Here people learn the basic skills of understanding, recognizing, and accepting their addiction, and learn the basic principles of recovery planning.

The second three stages of recovery can be summarized as Stage II Recovery.  They encompass the middle, late, and maintenance stages of recovery.  It is here that people need to deal with learning how to develop a meaningful and satisfying lifestyle.  They need to set goals and objectives for themselves, and need to deal with personal problems that interfere with their ability to be happy.

3.    Understanding Relapse Prevention
Each stage of recovery carries with it specific warning signs that the person is in trouble.  It is important to understand the generalized warning signs that lead from stable recovery back to chemical use, and then to look at each stage of recovery to understand the stage-specific warning signs that can act as     clues or triggers that a person’s recovery is in jeopardy.

Once people understand their relapse warning signs, they can learn how to develop a relapse prevention plan that allows them to identify and manage those warning signs before they return to alcohol or drug use.  Should they return to chemical use, they can develop a relapse early intervention plan which trains friends, relatives, and fellow members of the recovery program in how toeffectively and efficiently intervene and help them to stop drinking and drugging and get back into recovery.

A thorough understanding of these three areas of recovery will give people a road map for sobriety.  It will help chemically dependent people todevelop a checklist and answer the question, “What do I need to do to stay clean and sober and to have a healthy and happy lifestyle?”

4.    Recovery Resources
The final critical information that people need to avoid relapse is to know what resources are available in their communities that that can help us to stay clean and sober.  Nearly every community has Twelve Step Meeting including Alcoholics Anonymous, Narcotics Anonymous, and Alanon.  There are also a number of treatment centers that provide medical detoxification, primary rehabilitation, extended treatment, and sober living. Most of these resources are listed in the telephone book or can be obtained by calling the local AA or NA.  the internet can also give vital information about recovery services available in your community.