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Speaker 3So the question today is why two people can drink the same way for years. One walks away while the other can't stop. Many people assume addiction is simply about willpower discipline. I'll just choose to change my life. I'll just take up new habits. I'll start working out. I'll join a gym. I will see a therapist and things will just get better. I will get my choice back, my control back. And we're back. Welcome everybody to Recovering Out Loud podcast. I'm Anthony. I'm an alcoholic. I'm an addict. And today I want to talk about why some people get addicted to drugs, alcohol, and others don't. Others seem to be taking it or leaving it. Taking it with immunity. Not having any problems caused. And no consequences of their actions and drinking and using. And they can turn it off. I was not one of these people. I'm not one of these people. That was evidenced by when I relapsed after seven and a half years. Going into a spiral of shame, depression, and uncontrollable drinking and using. I couldn't stop. And it was so hard for me to come back into recovery. And I work with tons of people that have the same experience. They, once they start, they lose power and control. Some people go for months without drinking or using. But inevitably, invariably, they find every time they pick up, they cannot get out of it. They cannot stop. They lose control or power and choice in the matter. The obsession that every abnormal drinker can control one day, be able to control his drinking or her drinking, is the great obsession of every abnormal drinker and every alcoholic. Modern research suggests addiction is influenced by multiple interacting factors. So it's multi-layered. There's, it's not just one reason that I am different than my fellows. The central idea here is that addiction appear, addiction risk appears to come from combination, a combination of biological, psychological, and environmental and learning factors. So in this episode, I'm going to talk about genetics. I'm going to talk about brain chemistry. Trauma and coping, environmental exposure, and learned behavior. These are all factors that contribute. So first I want to talk about genetics factor. Research has found that family history increases the risk of substance use disorders. Many studies estimate genetic vulnerability contributes roughly 40 to 60% of addiction risk, though estimates vary by study and substance. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. So 40 to 60%, you're 40 to 60% more likely to be addicted to drugs than you are to alcohol. there is no addiction in the family. I traced it back all the way to my great-grandparents, and we think that none of them were alcoholic or drank abnormally. So genetics may influence how rewarding substances feel. So it might feel better for me to do a hit of cocaine than my friend. I get more of a reward out of it, and then I chase that dragon more than the next guy. Impulsivity. Genetics influence how rewarding the substance feels, impulsivity, and stress response. Some people may experience stronger dopamine responses from substances, and I find that I fall into this category. I just like the effect produced by substances more than the average person. So the important point is genetics do not mean destiny. It indicates increased vulnerability, not inevitability. So it's not 100% certain, but it is increased vulnerability. You're more vulnerable if it runs in the family. Second topic, second point, brain reward systems. I'm going to talk about dopamine and the reward circuits. Substances activate the brain's reward pathway, so dopamine. The pathway includes areas such as, in the brain, the nucleus accumbens, the prefrontal cortex, and the ventral tagmental area. So the brain is wired to repeat behaviors that feel rewarding. If I do a line of coke, I enjoy it, I'm going to chase that feeling for the rest of my life if I don't get help. Chase that first high. That's why you often hear people saying they're chasing the first high, their first five minutes when the drugs and alcohol used to work for them. It made our problems go away, or whatever the effect produced. It varies by individual. Drugs and alcohol can stimulate reward signals far beyond natural rewards. So looking at a sunset might not give me the same amount of dopamine, or eating a steak or awarding dinner might not give me the same amount of dopamine that, say, drugs and alcohol do. And I just, that's why you hear a lot of people, they lose the joy in recovery, in simple things in the beginning. It's hard to enjoy the things that used to give you dopamine. So essentially, this may make substances more difficult for certain individuals to stop using, because the reward is just so great. Next point, trauma and emotional regulation. So the psychological drivers. Substance use often functions as a coping mechanism. I am coping with my trauma, with my emotional regulation. It helps me quiet the noise in my head. It helps fear go away. It helps self-pity go away. When I'm drunk, when I drink or use, my problems seem to vanish. They seem to disappear. This is also why a lot of people use the spiritual method in 12-step recovery or other practices, because we come in here with a lack of power, control. That is our dilemma. We have a God-sized hole, you hear some people say, and it can only be replaced, that solution that alcohol provided, can only be replaced by a spiritual experience for a lot of people, not everybody. And if you want to hear about more spirituality, I have a whole episode on spiritual spirituality and how it benefits recovery. Many people use substances to regulate anxiety, depression, emotional pain, trauma responses. So there's something called ACE. There's an ACE test you can take. It's called adverse childhood experiences. Research on adverse childhood experiences suggests higher ACE scores are associated with increased risk of substance misuse later in life. So this is a test you can find online. It asks you a series of questions, such as, was one of your parents an alcoholic? Was your parents an alcoholic? Was one of your parents an alcoholic? Did you have a troubled home? Were your parents around? And then it gives you a score based on your adverse childhood experience. So it could be associated with increased risk of substance misuse later in life. For some people, substances temporarily reduce emotional distress. This can reinforce the behavior through relief. So my life is a mess, I turn to substances for relief. Addiction may develop not only from pleasure seeking, but from pain relief. So I'm going to have fun. I'm trying to escape pain. I'm trying to escape myself, the thoughts, the noise in my head. Next, environment and exposure. So the environmental influences, availability and social environment strongly affect substance use patterns. So if I grew up in an environment, in a trap house for say, let's say, I might be more at risk. If I grew up around parents that were constantly gambling or using drugs or partying to escape, I might be, I'm more likely to contribute to that, to fall into that pattern. Cultural norms around drinking or drug use vary widely. Some examples of this are social groups where heavy drinking is normalized. Cultures, Italian culture is one of them, wine at dinner every night, early exposure during adolescence. So if you hear a lot of people come into recovery, they started drinking at 13 or 12 or 14. So the developmental vulnerability around this is that the adolescent brain is still developing, especially the prefrontal cortex responsible for impulse control. Early exposure may increase the likelihood of later problem. Okay, next we have learning and conditioning. So behavioral learning. Addiction can involve habit forming and conditioning. Certain cues can become associated with substance use. So places, music, people, emotional states. That's why we get triggered by these things in early recovery. We walk by a bar we used to drink at. We hear a song we used to party to or a festival that brings up a lot of emotions. People we hang around with. I hang around, I was talking to a guy that was hanging out. He started talking to a guy that he used to party with and that got him back into relapse because he associated the fun times with partying with that guy. A memory starts to circulate around in your head. Another example would be someone that always drinks with when stressed after work. You start to build that pathway in your brain. I feel stress because of work. I drink. It makes it go away. And then your brain adapts to that and learns the behavior. Over time, stress itself becomes a trigger. These are reinforcement loops. So temporary relief reinforces the behavior. I like that thing. My brain likes that thing. I'm going to go to it. whenever I feel emotional stress, the brain learns the association. It's like smoking and coffee. If you have a hard time quitting smoking, you know, I know it's a lot harder whenever you have a coffee because your brain associates nicotine with caffeine. Okay. So we have the interaction model. Addiction risk likely results from multiple interacting factors rather than one cause. Possible interaction examples are genetic vulnerability, early trauma, high exposure environment, and stress coping patterns. You put these things all together and it is very hard to get sober. So conceptually, each factor may increase vulnerability. Combined factors may significantly increase risk. It's interesting because I didn't have a lot of these factors in my life, but I definitely had the stress coping patterns and the maybe some trauma, but nothing big T related. I didn't have, you know, I had a good childhood growing up, but I think I just built over time. I related stress and emotional pain. I wanted to escape myself with drugs. It worked for a long time until it didn't. Some individuals may be able to stop easily. Others may experience powerful biological and psychological reinforcement. This is why treatment and therapy is so essential in the early going, especially because we need to understand these things, the science behind it, the biology behind it, so that we can rewire our neurotransmitters. So the key takeaway points here are addiction is rarely explained by a single factor. There's usually multi-layered risk. It's usually multi-layered. Risk appears influenced by genetics, brain chemistry, trauma, environment, learning, and conditioning. A question to reflect on here is if addiction risk is influenced by many factors, how should society think about treatment and recovery? So there's not just one problem and there's not just one solution in this state. If you're looking at it from this perspective, how do we solve these problems? For me, it's important to know that when I'm coming out of treatment, I can't go back to the same environment. I have to rewire my brain. I have to rewire, relearn behaviors, relearn how to have fun without drugs and alcohol, how to handle stress, how to cope with emotional behavior, emotional disturbance. I need a power greater than myself. I need spirituality. I need a program of recovery that's going to keep me connected to something greater than me. And not just this religious God that I talk about. It's not religious God, not just spirituality, but spirituality. And spirituality can include community, which is so important. Whenever I'm spinning out about things in my head, my life is seemingly the sky is falling on me. I can turn to other recovering addicts and alcoholics to achieve sobriety. I can get help. I can talk about my issues. I can get it out. I always say this, but secrets keep you sick. You're only as sick as your secrets. So get it out. Understanding all of these influences may help reduce stigma and support more effective recovery approaches. People are not just stupid. They're not just looking to have fun. They're not just homeless people trying to have a good time or lazy or it's, there's many factors. So the next time you look at, let's say a homeless person or someone smoking crack on the street, think about the factors, have some empathy. There's a reason that this person is escaping pain or seeking relief. There's a reason. And it's not just surface level. It's deeper than that. Go deeper. And this might help you understand yourself too. The reason why you use and drink it's deeper than just, I'm trying to have fun. I hear all the time, people saying, I just liked cocaine because it was fun. It's deeper than that. You are. Usually we are escaping something. There's some sort of coping going on. There's some sort of relief that is needed. And that's why recovery comes in and replaces the drugs and the alcohol. For me, it's a recovery program. It's a spirituality. It's a power greater than myself that I don't understand on most days. And I don't need to understand it, but I know that it's my self will availed me nothing. I am not going to get through this. Simply by trying harder. I need outside help. I am beyond human aid. This is not something that I am going to will myself out of. If you're like me, you tried everything before you came into recovery. You tried all of these rehabs and sanitariums and treatment centers and treatment programs and books, self-help books and exercise and meditation. And these things individually don't work for us. I came in here. Because everything else failed recovery. The community I'm a part of was the last house on the block. I didn't willingly come to recovery. I didn't willingly go to rehab. I had to go. I had to be forced there by outside factors. And then I develop, begin to develop a way of living. I begin to develop principles in my life where I can live happily and without suffering most of the time. If I take some simple action and follow some direction, I think too, that it's beneficial to stop. For a long time, I obsessed over the fact that why can't I just drink like other people? Surrender that idea today. Try to surrender the idea that I don't drink like other people. I just don't drink like the Bud Light commercial. That's not been my experience. That is not how I party. I don't fantasize about a couple of drinks on the patio today. I fantasize about Tony Montana's Scarface. That is my idea of fun and escape. I don't enjoy these first couple of drinks. And that is not what I obsess over or fantasize about. I am an all or nothing guy. I go balls to the wall every time. I don't know moderation. And that is evidenced by other areas of my life. I get obsessed about things. I go all in. And that can be used as a superpower, as a strength today. I can put that into my work. I can put that into my recovery. I can put that into helping others. I can put that into this podcast. It is a beautiful thing to use to your advantage. We have an unfair advantage in recovery. I truly believe that today. If you liked what you heard today, please follow, subscribe, rate, and comment on this podcast. I appreciate it. We have gotten a lot of new listeners lately, and I appreciate every single one of you. I love you. Don't ever forget, recovery is simple, not easy.
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