THE PROBLEM IS ADDICTION, NOT DRUGS
People become addicted to experiences that protect them from life challenges they can't deal with. It is not possible to say that any one thing causes addiction. Most kids who use drugs and alcohol don't become addicted to them. On the other hand, they can get addicted to very typical, common activities--such as eating, the Internet, other media, games, even medications they are prescribed for other problems.
The core of an addiction is that people become enmeshed in an activity that interferes with their functioning and, for children, thwarts their growth. If your children avoid regular involvements and experiences, if they can't cope with their lives, and if you fear that, left to their own devices, they will either collapse or go haywire, your children face addictive problems.
Disagreements about the nature of addiction make for vast differences in how we go about combating it. I do not find it helpful to regard addiction as a disease, which is the prevalent view these days. Although many people, including scientists, now believe that a wide range of things can be addictive, they wrongly persist in seeing addiction as a biological phenomenon beyond people's control.
By contrast, I was one of the first proponents of the view that addiction is not limited to drugs. But its very universality makes it clear that addiction can't be traced to a specific neurological mechanism. If sex or gambling addictions are defined by changes in the brain, why do so many people who find these involvements alluring for a moment, or even enthralling for some time, then simply move on to other activities? As we shall see, the exact same thing is true of "addictive" drugs.
Addiction can be especially debilitating for the young, but young people are more likely than not to outgrow it. The way out of addiction is to develop a range of skills and engage fully in life. The disease mythology is particularly unhelpful for young people. Telling adolescents that they have inherited addiction as part of their biological makeup encourages them to get stuck in the problem, rather than motivating them to overcome it.
Although my view of addiction is not the conventional one, my way of thinking has been adopted by many and is gaining influence in the field. My approach includes recognizing that addiction is not limited to drugs, that people overcome addiction when they are motivated and when their lives improve, and that successful therapy for addiction builds on people's own motivation to change while teaching them better ways of coping.
At the same time that not all drug use is addictive, addiction does not have to involve drugs. People can become addicted to powerful experiences such as sex, love, gambling, shopping, food--indeed, any experience that can absorb their feelings and consciousness. Addiction to the Internet is now in the spotlight, and before that came addiction to television and then video games.
Addictions provide quick, sure, easy-to-obtain gratifications, and advances in the electronic age such as the Internet, cell phone, iPod, and BlackBerry bring more addictive possibilities. Two addictions intertwined with the Internet are pornography and gambling. People become enmeshed in these experiences in isolation, rejecting everything else in their lives. A typical Internet pornography addiction case reads like this:
My son is addicted to pornography. He can't stop looking at porn. He stays up on his computer all night. In the morning he can't stay awake, and he often doesn't go to school. I'm at my wits' end.
Likewise, we frequently hear of people who cannot stop gambling or shopping, often going deeply in debt. Such addicts, as adults, may steal, go to prison, and lose their families as a result.
To come to grips with how widespread addictive experiences can be, consider that love relationships can become addictive. We are all aware of this phenomenon, which is captured in popular song lyrics such as "Why must I be a teenager in love?" But these cases can be remarkably debilitating:
About a year ago I fell in love with someone I believed was "The One." Ever since then my whole life has been about him--and, as time went by, I've become more and more depressed.
I have always been easily addicted. But before this whole thing started I was a very happy and energetic person with a lot of interests who enjoyed living and loved talking to people. During the time we were together I just threw all of my life away: my friends, my schooling, my dreams. He became the only thing that mattered to me. I continued to feel this way even when I realized that he didn't really accept me.
At some stage we decided it would be best if we stopped dating and tried to be friends, but after a short time I realized I couldn't do that.
Now, I am depressed all the time. I've thought about him every second of my life for the past year. I can hardly sleep, I can hardly get out of bed in the morning. I feel like being alone most of the time. I have no energy, I nearly always feel sick. I find it hard to enjoy anything at all. I can't get him out of my head.
I described addictive love in 1975 in my book Love and Addiction. But because this idea is so shocking, it keeps resurfacing as though it were new. A woman wrote in the New York Times in 2006: "This is what love addiction did to my life: I dropped out of college, quit my job, stopped talking to my family and friends. There was no booze to blame for my blackouts, vomiting and bed-wetting."1
If we want to understand all kinds of self-destructive behaviors, we need a broader conception of addiction than the simple idea that some drugs are addictive: Addiction is a way of relating to the world. It is a response to an experience people get from some activity or object. They become absorbed in this experience because it provides them with essential emotional rewards, but it progressively limits and harms their lives. Six criteria define an addictive experience:
*It is powerful and absorbs people's feelings and thoughts.
*It can be predictably and reliably produced.
*It provides people with essential sensations and emotions (such as feeling good about themselves, or the absence of worry or pain).
*It produces these feelings only temporarily, for the duration of the experience.
*It ultimately degrades other involvements and satisfactions.
*Finally, since they are getting less from their lives when away from the addiction, people are forced increasingly to return to the addictive experience as their only source of satisfaction.
ADDICTIONS VERSUS NORMAL EXPERIENCE
Watching television every night, drinking daily (for an adult), and having an active social life are not necessarily addictions. Broadening the definition of addiction does not mean that everybody is addicted to something. The word is now often used casually, even humorously: a friend says he is addicted to crossword puzzles, a baby is addicted to his pacifier, a teenager to her cell phone.
Addictions are harmful, perhaps overwhelmingly so--as in the cases of pornography and love addiction described above. People may joke that they are addicted to exercise or coffee or work, and they can be. But it is only when these things seriously detract from their ability to function that people are genuinely addicted--for example, they can't stop exercising after they have suffered an injury, or they drink coffee throughout the day even though it prevents them from sleeping, or they are so preoccupied with work that they neglect their families.
Here's a case in which being well-balanced saved a man's life:
Peter was in the south tower of the World Trade Center when the north tower was struck. His floor was evacuated down a stairwell. But after going down several flights, a security officer told the evacuees they should return to their offices. A number of people who were in the stairwell with Peter did so.
Peter--who was well paid and worked long hours--thought about returning. The instruction by an official to do so reinforced his conscientiousness and dedication to work.
But Peter also thought about his wife and children, and decided to proceed down the stairs. Soon after he left the building, the second plane hit below the floor on which Peter worked.
After September 11, Peter's wife couldn't stop hugging him. "Every time I see him, I feel such love and gratitude that he was spared," she explained.
Peter was a person who might have been at risk for being caught up in mindless, compulsive working, irrespective of any damage it caused him. Instead, his independent thinking and commitment to his family saved him from addiction. For young people, too, the more connections to life they have, the better able they are to resist addiction. When people give up much of their lives for their addictions, as we saw in the cases of love addiction, it is because their other involvements are superficial or somehow unsatisfactory.
We all rely on fixed elements in our lives, and children especially do. It is essential to your children's security and psychological well-being that you provide them with consistent limits, acceptance, and love. You should also recognize that children and adolescents will often fixate on an object or activity--their stuffed animal or a recording artist, playing with dolls or video games, wearing certain clothes or going to particular places. These fads are normal phases in growing up, and you should accept them as such.
What makes for addiction is when young people cannot extricate themselves from an activity in order to do the things required of them--things that they in some sense would prefer to be doing. Instead, they persist in behavior that is consistently harmful, or that is disapproved of by society, or that damages their health, their future, or their relationships with other people.
One of the thorniest problems for parents is deciding whether children are addicted when they use a substance (such as marijuana) regularly but otherwise function successfully. One possibility is that their drug use is normal. A landmark study found that moderate experimentation with drugs characterized the most psychologically healthy adolescents, while heavier use and abstinence were both signs of poorer adjustment.2
You need to key in on how well your children are coping with the demands made on them to ascertain whether or not they are abusing a substance. But even when they are abusing a substance, it may be wrong to call the problem an addiction or unhelpful to put them in drug treatment. I deal with these dilemmas in Chapter 10.
ADDICTION IN ADOLESCENCE
Some adolescents do become so involved with drugs or alcohol that it completely dominates their lives. Consider these cases:
Alice grew up in a family that had many problems. Her parents repeatedly separated, then got back together. Her father was violent, and screaming and crying were typical in the home.
Alice quickly got used to going out with friends as a way of escaping the turmoil and pain at home. When she was fourteen, she began drinking with these other teenagers, many with backgrounds similar to her own. The first time she drank she became falling-down drunk--"wasted," as she described it. Alice soon became sexually active when she was intoxicated.
Alice would sometimes quit drinking, only to return to it with a vengeance. This became a pattern for her throughout high school. As a junior she attended meetings of Alcoholics Anonymous and entered a six-month period of abstinence. But soon she returned to drinking and began using drugs as well. At first it was marijuana. In her senior year, however, she also used cocaine and took LSD.
Alice was smart and attractive, but her academic performance was lackluster. She decided not to go to college. Instead, she became a waitress at a local restaurant, where other young employees joined her in drinking and using drugs following work.
In adolescence and early adulthood, Alice's life was devoted to intoxication and the activities that surrounded it--which she called "getting rowdy." Since her life centered around drinking and drugs in a way that limited her opportunities, her friends, and her future, Alice was addicted during this phase of her life. But Alice, as typically happens, quit drinking and drugs when she reached her late twenties. Unfortunately, her addictive phase hampered Alice, because of the opportunities she lost, even after she stopped abusing substances.
While Alice's background is common for youthful addicts, hers is certainly not the only path to drug and alcohol excess and addiction.
John's family was stable--his older sister did well in school and went on to become a doctor. His father made an excellent living in the financial industry. His parents got along well together.
But John began abusing drugs early in life. In fact, he had already used heroin by the time he was sixteen. To do so, he associated with other kids who engaged in the most negative behaviors. It was as though--as his father put it--John was "following the loser."
John certainly had ability and enjoyed successes as an adolescent. He was a very good runner, for example, and made the county championships in the quarter mile. His parents devoted themselves to taking him to track meets and getting him additional training--such as a summer track camp--to further this skill.
After he became addicted, John's parents placed him in a series of treatment programs. After each, he returned home seemingly prepared to resume a typical high school existence. But within a matter of weeks or months he was back with his old crowd, abusing drugs and heading to his next treatment episode.
Eventually, John's family felt they had to expel him from the household--he went into treatment, then a halfway house in a different state. His father told him he would continue to help John financially and stay in touch only if John could prove that he was clean.
For a time, John became a pariah to his parents, who felt it was best for their family to expel him from their home. I consulted with John's father and helped him to reach a better resolution with John. Although he didn't quit drinking and continued to use recreational drugs occasionally, John stopped using heroin and started to take his schooling seriously. I describe this harm reduction therapy in Chapter 9.
Both Alice and John began to abuse drugs and alcohol in early adolescence, and the abuse quickly become the focus of their lives. People like Alice--from fragmented, violent, or emotionally disturbed families and from families facing economic hardships--are more likely to abuse drugs and alcohol. But children from stable and prosperous backgrounds also do so. When children from well-off backgrounds abuse substances, they are failing to buy in to their family's values. The pressures placed on them to achieve may then saddle them with emotional problems and bad feelings about themselves.
Excerpted from Addiction Proof Your Child by Stanton Peele, Ph.D., J.D.. Copyright © 2007 by Stanton Phd Jd Peele. Excerpted by permission of Three Rivers Press, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.