10 most frequently asked questions about addiction

The ultimate solution or a dangerous trap?

Addiction is probably one of those things that everybody has an opinion about but nobody really knows.

These days, if you look around, you will see a lot of people sitting in bars with cocktails on their tables, smoking tobacco and cannabis, and provocative nude pictures of women in commercials and on billboards everywhere … has having fun by abusing substances and behaviors become the norm in our culture? And where is the invisible line that one crosses to become an addict? Let’s take some time to rethink our boundaries:

1. How do I know if I’m addicted?

The ugly truth is – you’ll probably be the last to know. You’ll notice other people exchange strange glances when you’ve poured yourself the third glass even before the waiter brought the menu, or feel the need to hide your drinking from others to avoid comments. You’ll try to control your drinking to “just a sip” to find out that the whole bottle was empty … addiction is a disease of denial, and people tend to ignore the warning signs. Ultimately, you may come to the point when it will be impossible to deny them anymore, and only then you’ll surrender to the realization that you can’t control your drinking (or any adverse behavior). Loss of control is the tell-tale sign of addiction, rather than the quality, quantity or severity of the behavior. (see 11 signs of addiction)

2. What should I do to stop my acting – out?

Acting out an addictive behavior can easily be stopped for a while, but very hard, sometimes almost impossible, in the long run. Addiction is a disease of certain brain circuits that drive our behaviors, and it is the long-term result of repeating the comforting and mood-changing behaviors. People like to think that they always choose and control their behaviors, but after frequent repetitions, especially when challenged by high stress and life changes, any comforting behavior may become automatic and uncontrollable.

When you admit to yourself that control over harmful behavior has been lost, your best chance to recover is to seek help from those who know what addiction is, and how to treat it.( See Is it true that addicts cannot just stop their use?)

3. I have not been drinking (using a substance or behavior) for three months. Am I cured?

Abstinence is not the same as recovery. However, it is the beginning, and an important one. But once you are sober and your body and psyche starts to recover, you will become able to address the painful issues that made you indulge in the comforting behaviors in the first place. There will probably be some traumatic issues from early childhood. Finding a good therapist is the best you can do to sort them out. If you feel too confident in your ability to control your behavior too soon, you may be caught off guard by life’s challenges, and relapse.e.

4. What is the difference between abstinence and sobriety?

Abstinence means that you do not indulge in a specific behavior (drinking alcohol, gambling, using porn …) anymore. Sobriety, however, means that your mind (brain) is not under influence of and mind-altering substance or behavior. The point is; addiction is one disease, a hellish rollercoaster in your brain that can be run by many different substances and comforting behaviors. You may, for example, abstain from alcohol altogether, but if at the same time you gamble too much, your brain will experience similar alterations as under the influence of a substance, so you will not be sober. It is too easy to exchange one addictive behavior with another, or compound many of them in an addictive cocktail. But this is not sobriety nor recovery.

5. Is it possible for a recovering addict to use again in moderation?

I think this is the most frequently asked question from people in early recovery, and even many therapists lower the bar by allowing, for example, smoking in rehabilitation centers for addiction. I, however, do not believe this to be safe. I have seen many people try, even after years of sobriety, but sooner or later they ended up losing control and relapsing. Once the brain learns its “shortcuts”, it will remember them easily and we’re back where we started from. (See Inability to stop & Addiction).

6. How long does the therapy take?

As a rule of thumb, you can expect your therapy to last from 3 to 5 years, depending on the difficulty of your problems and your ability to cooperate. A person’s psyche is a complex matter, made of millions of connected beliefs, prejudices and memories, mediated by the delicate neuronal connections. Once this complex structure is challenged, it needs time to recover and re-assemble in a new way. There are no shortcuts if you want your changes to last. (See What’s Trauma got to do with Addiction?)

However, therapy is not the same as recovery. After some time, you’ll be on your own, and there will be life with all its challenges. Some of them may tempt you to start using again and trying to fool yourself that it is safe enough. But what has been carved in your brain circuits has not been erased, and may awaken into a full-blown relapse in a very short time, shattering your life to pieces again. Recovery has to last forever and you may never take the shortcut again, if you don’t want to wake the sleeping beast inside you. To avoid the danger, it is wise to join a recovery community and practice the recovery rules, one day at the time.

7. Can I recover by myself?

It is not impossible, but certainly not easy to do. The human psyche has its defense mechanisms that avoid change and try to keep things as they are. Why struggle, when help is available? There are many good recovery programs available and you can find one that will suit you.

8. After recovery, will I be able to live like it never happened?

I don’t think this is a realistic goal. The goal of recovery is not to restart from zero, but to accept your history as part of your spiritual path. There will be some bruises and scars, but also some well-earned new skills. You will be aware that, whatever happened, you have survived and thrived through it, and it has made you stronger. (See Why is it so hard to change?).

9. When should I start worrying? What are the signs of alarm?

When you feel ashamed of what you do …
When you try to control, curtail or stop the behavior, but fail …
When you feel the need to apologize for your behavior …
When you start worrying about the time and money you spent …
When you constantly think about the past and future acting-outs …
When you say “just a few minutes more,” and the next a few hours have passed …
When you get criticized for doing it during working hours …
When you decide to spend the weekend with your kids, and can’t stop thinking about anything but acting out …
When most quarrels at home revolve around your addictive behaviors …
When you feel incredibly anxious if you can’t get your next dose … (see 11 signs of addiction).

10. Are addicts bad, inconsiderate people?

Addiction results in bad behavior, that affects all dimensions of the addict’s life, corrupts their relationships and results in a lot of misfortune for everyone. But it does not start like that. It rather starts by repeating what most people do when faced with painful circumstances or life’s anxieties. They learn that some comforting behavior, whether drinking alcohol or using marihuana, gambling, some relationship and sexual maneuvers or even only daydreaming, can correct their mood and ease their pain, without them doing anything to grow out of it. And then they repeat it too often: first as a choice, next as a habit, but then increasingly out of need. When they get so far, addicts really behave badly, but that does not mean they are intrinsically bad people. As a society, we support such behavior by putting pleasure on top of our priorities list, but we turn our backs at the addicts in the late stages, when we should support them in their recovery efforts.

Sanja Rozman is a medical doctor, psychotherapist and author of 8 books on behavioral addictions.

that is about to be published by Brandylane Publishers Inc., Belle Isle Books.