Addiction – Understanding the Illness

Addiction - Understanding the Illness

Ian Koch, MS, LADC, Northeast Addiction Consultants, explains addiction.

Addiction is often a misunderstood disease which can also make treatment difficult.

The following is a guest post by Ian Koch, MS, LADC, and Operations Manager of North East Addiction Consultants, established to help families of drug addicts and alcoholics guide their loved one into recovery. Though they specialize in the northeast, their network spreads across the United States, with clinicians who have lived through personal addiction and/or lived with family members who have suffered for years. Ian can be reached by phone, 1-800-723-1073, or email,

Addiction – Understanding the Illness by Ian Koch, MS, LADC

Getting the truth on addiction is not only an intimidating task, but it takes a scientist to explain all the brain chemistry. Anyone can do a search on the internet using the words addiction, alcohol abuse and drug affects on the brain. Not only will this produce a tremendous amount of results but sifting through the information can be confusing as well. A search using the words “alcohol abuse brain” produces 21,700,000 results… Where does one begin?

In the past, I have worked with thousands of addicts, alcoholics, and their families. When people are operating under the pressure of addiction it is important to use everyday language; not only when talking to the addict but when talking to the family. My experience tells me most mothers are not concerned with her kids Dopamine and Serotonin receptors, they just want them to stop abusing alcohol or drugs. Science can and will explain parts of this model but that is not the purpose of this essay.

The easiest and most effective way to explain addiction is by using a three part model. This model will help you understand your family member that is using alcohol and drugs, regardless of the consequences. The model has been adapted from some of the concepts in 12-step recovery; I would be willing to say that 90% of programs, counselors, detoxes ect., all recommend the addict or alcoholic attend these groups. Using this model will not only help you to better understand the addict or alcohol abuser, but it will help them to understand why they are “powerless”.

The first part of the illness is that it has a Physical component. This only happens in addicts and alcoholics. It is manifests as an irresistible craving to use more of the substance. This happens only after the substance is in the body. In other words, when an alcoholic takes one drink they tend to get thirsty and want another. After the second drink the alcoholic becomes even more thirsty so they have another drink. The alcoholic continues to drink until they are drunk or have run out of alcohol. This is why alcoholics can not have one; because this craving or compulsion develops, then they can not stop once they start using. It also explains why addicts will take cash advances from the ATM machine, why they will strip copper from old homes, why they will steal from their parents.

After the substance is in the body they can not stop until there is no possible way of them not getting the drug or alcohol. Once this is developed in the body it never goes away, which is the reason complete abstinence is the answer.

The Physical part of the illness explains why they can not have even one drink or drug. This, however, is not enough to keep anyone sober. If you ask an addict why they can not “say no”, usually they will offer a hundred excuses. The truth is that there is a Mental phenomenon that happens. At any point during a period of abstinence (if untreated) the addict or alcoholic will fall into a mental trap or obsession. This obsession becomes so strong, they can not stop perseverating on the substance and the only option is to use.

Addicts and alcoholics consistently go back to the substance after any length of abstinence, and the truth is they do not know why. At some point, the drink or drug looks like a good idea again or they do not care at all about any possible repercussions; they think they can have just one. Once they succumb to this desire, the physical piece begins again and then it becomes almost impossible to stop.

I believe all of this is driven by a deeper Emotional problem. These symptoms usually manifest as depression, anxiety, worthlessness, fears of not being good enough and deep feelings of discontent. Many, if not almost all, that I have treated at some point were diagnosed with some emotional disability that is outlined in the DSM-IV (Diagnostic Statistical Manual 4th edition).

The addict and alcoholic usually becomes aware of these feelings when they are abstinent from the drugs or alcohol. As these feelings grow and develop, it becomes unbearable and that triggers the mental part which leads into the physical. Treating this discontent with medications does not always work. In fact for the addicts and alcoholics I have seen it almost never works.

What does work is deep therapy with a good cognitive behavioral therapist, preferably one who uses motivational interviewing. The 12-step process is extremely affective, if the addict is willing to try it. Symptoms Displacement Counseling is another very affective tool a counselor can use, it removes the emotional discontent, therefore, the mental and physical parts are not an issue.

Knowing the brain science along with this model can be very effective for addiction treatment. It is this model that addicts respond to and understand. They identify and relate to what is happening in their past and present experiences. As a concerned family member or friend it is imperative that one understands this model. It is essential because families and friends need to understanding that separating the addict or alcoholic is not good enough for lasting sobriety. The user needs to be willing to do deep work on themselves if there is any hope. Parents, family members and friends need to understand the importance of boundaries and the role they play to better help the recovering addict and alcoholic.

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One Response to Addiction – Understanding the Illness

  1. […] “It just takes one to stop the dance, to change the steps and start a new dance. But if both change and learn the new steps and practice those steps, together, a new dance is created. Sometimes one or both will go back to the old one – that’s normal – it’s what is most comfortable; it’s what they’ve practiced for years. But a new dance is possible. It may be together; it may be solo, but it is possible. It takes learning the new steps, and it takes a lot of practice.” ~ Lisa Frederiksen of Breaking the Cycles – Changing the Conversation […]

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