Cancer patients didn’t plan their journey. Diabetics didn’t eagerly await a restricted diet and daily medication. People who use alcohol and other drugs never, ever expect to become addicted. It’s a rare person who has never tried a potentially addictive substance. For those with a genetic predisposition, a few tastes of something that fulfills a need and makes them feel better in some way and the ball is rolling.
The Disease Model of Addiction
Addiction to alcohol and other drugs is recognized as a disease by the American Medical Association, the American Psychiatric Association, the Centers for Disease Control and many other reputable organizations. Many well-documented studies support this stance.
It happens instantly for some, far in the future for others, but usually somewhere in between. Maybe it’s a few cocktails. Maybe it’s sniffing a little heroin. Maybe a doctor has prescribed opiates for severe pain, or benzos for anxiety or sleeplessness. If a genetic predisposition is present, or if these substances are consumed for an extended period, physiological changes will occur and the user will develop tolerance. Their brain adapts by increasing the number of receptor sites responsive to the molecules of that substance, and then requires more of the drug to achieve the same result. That is tolerance, and the beginning of dependence.
The brain doesn’t differentiate between legal and illegal drugs. It doesn’t care if they’re socially acceptable. Words written by a doctor on a piece of paper have no effect whatsoever on how that drug will change brain chemistry. In fact, abuse, per se, does not need to occur to produce dependence. Taking an addictive substance as prescribed, for a sufficient length of time, can be all it takes to produce the changes we call addiction.
Identifying as an Addict
According to the Basic Text of Narcotics Anonymous (NA): “Who is an addict? Most of us do not have to think twice about this question. We know! Our whole life and thinking was centered in drugs in one form or another – getting and using and finding ways and means to get more, We lived to use and used to live. Very simply, an addict is a man or woman whose life is controlled by drugs. We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions and death.”
Knowing how bleak the outcome can be, it’s heartening to hear a recovering addict say, “I was a hopeless dope fiend; now I’m a dopeless hope fiend.” But that comes later, after abstinence, work, and change. Those are probably not the folks we’re talking about. For addicts, stopping using substances is a frightening experience even for the ones who are highly motivated to get clean/dry out/get into recovery. Denial is a huge feature of addiction, so they may not even be aware of how fearful they are; they just know they’re feeling something uncomfortable and want it to STOP —NOW! Until we educate them otherwise, they only know one way to make that happen: use drugs, be they liquid or “dry goods”.
A Perspective on Newcomers to 12 Step Meetings
Of course, some newcomers really just want to get high. They are still “in the grip of that continuing and progressive illness” and haven’t yet reached a point where they are motivated to seek recovery because they want it for its own sake. They may never be ready. They may die first. Their motivation for going to detox, to treatment, to meetings is probably about making the consequences stop. That’s pretty normal, don’t you think? Pretty human? If they’re lucky enough to stick around for awhile, they may come to understand that the consequences are waiting just outside the door for those who don’t do the necessary work. If only we could reach them all!
Using was a Full Time Job. So is Recovery.
It’s good to remember as well that when human beings spend most of their time thinking about/obtaining/justifying/hiding their substance, actually using it, and recovering from using, they have little time for introspection, development of social skills, or learning how to cope with life. Using becomes a full-time job. Much of what might be termed personality or behavior is actually fear-based camouflage, a desperate attempt to look and/or feel okay.
Sharing is Helpful – Letting Everyone Share Experiences
To lecture or scold someone who is at this newcomer level is to threaten their precarious facade. Addicts are very sensitive, though they will go to great lengths to avoid showing it, and they will raise an invisible fortress when a finger is shaken in their direction—usually unaware that they’re even doing it. Then they can’t hear a thing!
That’s probably why 12-step programs work so well. The theory is that we share only our experience, strength and hope, and who can feel threatened by that? Of course, at times advice shows up in the rooms, even directives! But after all, recovering people, even those with time, are human, too.
12 Step Newbies are Good People with Illness
Possibly the most useful approach when working with newcomers (or just being around them) is to view them as good people with an illness that affects them emotionally and behaviorally. Hopefully they have begun their journey in recovery, but they are still in the grip of insanity. If you can blend empathy and compassion with vigilance and skepticism, and if you can remain aware of the unfortunate fact that we can’t fix anyone but ourselves, you may find newcomers just a little less trying.