Pharmacological Principles, Part 6

Question 1: Describe the two elements of the addictive personality.

Answer 1: The addictive personality consists of 2 different elements: the Self, which represents the “normal” human side of the addicted person, and the Addict, which represents the human side that is consumed and transformed by the addiction. This personality does not exist prior to the illness of addiction, nor does it represent a predisposition to addiction. Rather, it emerges from the addictive process, in which the Addict becomes the dominant personality. The Addict side within does not care about family and friends. The Addict side does not care about the Self either. What it cares about is acting out and achieving the trance. There is an almost constant conflict between the Self and the Addict when facing the choice of acting out (the search for/consumption of drugs) or not. This great internal tension can go on for hours, days or weeks at a time, and is a large part of the suffering caused by addiction. But in the end of this struggle, the Addict invariably wins. The Self and Addict continue to fight for control: The Self regularly fights and argues with the Addict, but loses. The Self makes promises to control the Addict, uses will power to control the Addict, but loses. We see how the gradual loss of the Self occurs in addiction, and how the Addict slowly gains more and more control. The Self witnesses the addictive ritual and is often sickened by what it is forced to participate in, but it is held captive by the power of the disease of addiction. To fight and struggle against something that has more power than one self drains one’s self-esteem.

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Question 2: Discuss the constant treat of relapse to drug use.

Answer 2: A consequence of conditioning: the constant threat of relapse to drug use. Addicted people remain vulnerable to relapse throughout their lives. Drugs permanently alter the brain chemistry making them forever liable to redevelop uncontrolled use quicker than before. Relapse has much to do with the selfish brain’s selective memory of the good times associated with the use of drugs and its selective forgetting of the bad times associated with drug use. Relapse is triggered by cues previously paired with substance use, by stress, or by the presence of the drug itself. All of these phenomena are mediated by increased dopamine release, but even more important, by increased glutamate release. If the environment continues to pile stress on a former drug user, he/she will move to a level of susceptibility where he/she will return to uncontrolled addictive use with just one hit of drugs.

Question 3: What is addictive logic?

Answer 3: Addictive logic is not based on truth, but on the delusion of the addictive relationship. Addictive logic denies the presence of an addictive relationship. Addictive logic says it is alright to hurt one’s Self because the Self is not important – it’s the mood change or trance that counts. Addictive logic says it is all right to hurt others because relationships with people are not important. What is important is a relationship with the drug. Once addicted, people feel that drug use has become a matter of survival.

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