WHAT IS ALCOHOLISM OR OTHER DRUG ADDICTION?

One of the really important things that complicates our basic understanding of addiction (aka chemical dependency or alcoholism) is distinguishing between what is normal use and when use becomes problematic ... and what people need to do when they finally accept that they have a problem - or their gut tells them someone they love or work with has a problem.

Of course we we know deep down when our, or someone else's, use of alcohol and other drugs  becomes a problem. We know by the problems they create - in relationships, work and careers, with the law, in physical and psychological health and spiritual well-being.

It is our individual and collective refusal to accept the evidence of reality that leaves us scratching our heads and wringing our hands as lives and families crumble in the grip of alcohol and other drugs. 

We use terms like "social use", "abuse" "recreational use" - and my favourite, "experimenting" - to identify our own or others' patterns of ingestion, which in the end are ways of sugar-coating reality. 

But to be fair, it is confusing because most adults drink alcohol and many people ingest drugs in reasonable ways - for a good purpose. 

Let's try and sort out how the use of alcohol and other drugs becomes problematic, and what that means, in practical terms, for our relationships. There is a continuum of ingestion: Use, Abuse and Dependence. 


USE:

Alcohol ingestion that is moderate ... or reasonable ingestion - for a purpose that can be described as beneficial. A couple of examples: drinking alcohol in moderate amounts that enhance the pleasure of a social situation, or taking a drug in regulated amounts and periods of time for the express purpose of say, relieving pain or other physical symptoms.  
The relationship a person has with alcohol is casual, and his or her relational focus is still person-to-person and not person-to-alcohol or other drugs. If you think about it, getting drunk or stoned is essentially anti-social, so when the person's relationship focus shifts to alcohol or other drugs the ingestion moves from use, to abuse.    


ABUSE:

When person ingests alcohol or other drugs in an unreasonable way, which is essentially harmful. This causes problems directly related to their ingestion of alcohol or other drugs - such as arguments with family and friends about their drinking, binge drinking (defined as 4 or more drinks for women and 5 or more drinks for men on any one occasion), blackouts, lying about how much they’re drinking, driving while under the influence, work or school performance problems, arrests, unplanned or unprotected sex — in other words, doing things they just would not do if they hadn’t been drinking.

In relational terms, the person abusing alcohol or other drugs is in process of shifting from a casual to a committed relationship with them. It is still possible to return to a relational focus of person-to-person, but he or she is sliding into a person-to alcohol or other drugs commitment.

Abusive ingestion patterns can be changed. A person can step back from their problematic ingestion and return to reasonable use.

All addicts (chemically dependent people) go through the abuse stage of ingestion. but not all alcohol or other drug abusers become addicts.


DEPENDENCE:  

Addiction (aka alcoholism) is a chronic, relapsing brain disease caused by biological, environmental and developmental factors.

It occurs when a person’s alcohol or other drug abuse causes chemical and structural changes in their brain (by interrupting normal neural connections), which sets up the characteristics of addiction:  increased tolerance, cravings and loss of control. A person with the disease suffers the same, and more, consequences as the person abusing alcohol or other drugs.

It can also be viewed as a relational and spiritual disease .

In relational terms, the person's primary concern is the person-to- alcohol or other drug relationship. All other relationships become secondary, because of the commitment a person makes to their drug(s) of choice. This commitment is obsessive and compulsive. It is total self-surrender of the whole person to the relationship with alcohol or other drugs. 

The disease of addiction (aka Chemical Dependency or Alcoholism) cannot be cured (meaning you can not go back to drinking after a period of time of abstinence), but it can be treated.