In this Gorski Blog we’re going to continue to explore the remaining four things people want to get out of using alcohol and other drugs.  In the last blog we reviewed the first three.  1: To Get High, 2: To Relax, and 3: To Be More Social.

Fourth, some people use alcohol and drugs To Manage Feelings.  They may want to get rid of “bad” or uncomfortable feelings.  They may want to start feeling good, or they may want to make “good” feelings better. The mood altering effects of alcohol and other drugs make them perfect tools for managing feelings.  If you do not like the way you feel, relief is just a swallow away.

If you are addicted and do not like the way you feel, relief is just a swallow away.

The problem is this, when a person manages their feelings with alcohol and drugs, they have no need to develop or use other emotional management tools.  As a result, they need to use alcohol or other drugs in order to cope with any strong feelings.  One of the primary tasks in adolescent development is to learn how to responsibly manage strong feelings and emotions.  People who start using alcohol or other drugs on a regular basis during their teenage years never learn these skills.  Why work hard at learning how to manage feelings when a quick dose of alcohol and drugs will allow you to manage it with little or no effort?  As a result, most addicted people find it very difficult to manage feelings and emotions when they try to get into recovery.

Fifth, some people use alcohol and drugs To Get More Energy.  They want to get stimulated, feel excited, and be powerful.  The drugs that are most likely to produce these energizing effects are the uppers such as amphetamine and cocaine.  The problem here is that this drug induces a sense of power and it is a false sense of power.  You feel down on yourself, lonely, and weak.  Then you snort a line of cocaine or shoot up some amphetamines all of a sudden, you feel like superman or superwoman.  Are you really?  Of course not!. You are the same person you were before you took the drug with one very important exception, the drug is distorting your judgment and making you feel like something you’re not.  You are not stronger, tougher, or more competent than you were before.  You just feel like you are.  If you are dumb enough to put this drug-induced delusion of strength to the test, you will probably end up falling flat on your face.

Sixth, some people use alcohol and drugs To Block Out Pain.  They want to get rid of unpleasant thoughts, feelings, and memories.  The narcotic drugs, like heroin and morphine, are most likely to produce this effect.  The primary pain people want to escape from is emotional pain. This is because in using drugs to manage their feelings, they have never learned to manage emotional pain.  So whenever their feelings get hurt,  out comes the bottle or the needle or a line of coke.  Why?  Because the pain feels unbearable and they don’t know any other way to handle it.

Seventh, some people use alcohol and drugs To Be More Spiritual.  They want to alter their consciousness and have mystical feelings.

They want to be spiritually connected and learn to transcend themselves by connecting with some higher power, higher vision, or higher set of values.  They also want to feel closer and more deeply connected with other people.  The Mind Benders like LSD, and Ecstasy are most likely to produce this effect.  Once again, there is a problem.  Most drug induced spiritual experiences are not genuine.  They are merely the affect of the drug disrupting your brain chemistry in a social setting suggestive of spirituality.  The same is true of intimacy.  If two people take Ecstasy and fall in love with each other, they usually are not experiencing a genuine sense of love.  What they are experiencing is a shared love of the euphoric high that they are sharing in the moment.

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.

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.

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.

Over the past thirty years, one thing has stood out to me more than anything else.  You must have accurate information to recover from substance abuse and addiction.  The more you know about addiction, recovery, and relapse prevention – the better chance you have of making a full recovery.

You must have accurate information 
to recover from addiction.

Whether you know it or not, accurate information is your most important recovery tool. You cannot recover from something you do not understand.  Therefore, my primary goal is to help you understand what addiction is, how to recognize it when you see it, and what you can do about it when you do see it.

I want to make this material easy to understand.  As a result, I have chosen to use a style of writing that speaks directly to recovering people and their families.  In this way, professionals, as they read this material, can benefit and pass it on to their clients to speed up the addiction education process.

Reading these blogs will give you a solid understanding of substance abuse and addiction.  Unfortunately, understanding alone is not enough. To recover you will need to take ownership of the material.  You will need to apply the information to yourself and put what you have learned into action.

Information alone is not enough. 
You need to apply what you have learned to yourself and put the new knowledge into action.

In learning about addiction, recovery, and relapse prevention it is critical to apply the information to yourself and those that you love.  If you just read the material as some abstract information that doesn’t apply to you, it won’t help you or those you love to strengthen your recovery program.

A formula guides many people in their recovery: This formula is: accurate information plus effective action equals the ability to recover. To recover you will need to apply what you have learned about addiction to yourself.

Accurate Information + Effective Action = The Ability To Recover

To learn you must become actively involved in what you’re reading.  This means reviewing the information with an open mind and seeing if the information fits your own experiences. Some of the information in these blogs may challenge the way you currently think about yourself and your understanding of substance use, abuse, and addiction. I promise you this – these blogs will contain the most recent science-based information that clearly shows that addiction is a progressive Biopsychosocial disease and presents effective tools that can help people to recover and avoid relapse.

The problem of addiction progresses because of a complex interaction among four things.
Addictive Brain Responses :The unique way the brain of addict responds to a drug);
Addictive Psychodynamics: The unique way the mind of an addict responds to a drug,
Addictive Behavior:   The habits that addicted people develop that constantly put them around people, places, and things and things where alcohol and other drugs are readily available.

Addictive Social Systems:. The way addicted people structure their lives to make heavy, abusive, and addictive alcohol and drug use possible.

You must address all four of these areas simultaneously to increase the chances of recovery.  This means that you need to take ownership of this information.  Taking ownership means finding what applies to you and then using it to make sense out of what is happening in your life.  As you read these blogs I want you to see that accepting the truth about your addiction help you. It will make it easier for you to think about and talk about your problems with alcohol and other drugs. It will make it easier for you to determine if alcohol and drugs are causing problems in your life.  If they are, itwill make it easier for you to seek the help you need to recover.

There was once a man named Al who had severe diabetes.  Al did not want to believe that he was sick.  Whenever his doctors tried to explain what diabetes was and how to manage it, Al would get upset.  He would tell his doctors that he was not sick.  He would refuse to listen to or follow their advice.  He would not regulate his diet or manage his stress. He would not take his insulin. According to Al, his doctors were crazy. They did not know what they were talking about.

Even though Al kept getting sicker, he would not believe that he had diabetes. His diabetes got so bad that he had to have his legs amputated, but even this did not change Al’s mind.

Right up until his death Al insisted that he did not have diabetes.  Al did not care about the facts because his mind was made up.  He was right and everyone else was wrong. He went to his death insisting that his doctors were wrong — insisting that they did not know what they were talking about.

The real tragedy is that Al’s diabetes was treatable.  If Al had been willing to learn about his illness and apply that information to himself, he could have lived longer and had a higher quality life. His doctors constantly put accurate information before him, but Al refused to listen.  The price he paid was a horrible and painful death.

As you start learning about substance abuse and addiction, you are facing an important decision.  Will you listen with an open mind, or like Al, will you close your mind to the information that could save your life?

Relapse! It’s a frightening word for many addicted people and those who love them. It is especially terrifying for people who have established what they believed to be a stable recovery and the suddenly, for reasons they don’t understand, start using alcohol or other drugs again.

My name is Terry Gorski and I work at Challenges in Fort Lauderdale as the Director of Relapse Prevention Services.  We see people in this dilemma every day.  The recovering person thinks everything is going well, then things just start going bad.  Old problems come back and the harder they try to fix them the worse they seem to get. The pain and problems become so bad that nothing seems to help.  This sets the stage for the addictive thinking and craving.  “Alcohol and other drugs can fix my problems and make me feel better.  I want5 relief real bad and to get relief I need my drug of choice.  The craving grows until it seems unbearable.  Then the person gets into a high risk situation where alcohol and other drugs are available, people will support their use and there is no one around to support their sobriety.  So, in a moment of weakness, they give up and start drinking and drugging.

I have been working in the substance abuse field for almost forty years.  During that time, I have seen many people recover from addiction.  Tragically I have also seen many people relapse. Some of these people who relapsed died as a direct result of returning to their addiction.

These deaths affected me deeply. It seemed to me, as a young man and a new counselor that more could have been done.  The problem was, we didn’t know what to do.  As a result, early in my life, I made it my primary mission to help suffering addicts, their families, and their communities.  I was determined to find more effectively ways manage addiction and its related problems.  I committed myself to develop new and more effective systems for promoting recovery and preventing relapse.  In this series of blogs I want to share with you some of the key aspects of what I learned.

In the next blog I’ll continue sharing with you what I’ve learned.