Why Does My Loved One Return to Using Drugs/Alcohol?

If you have a loved one who has been struggling with substance use disorder, you've probably been through this roller coaster with them. They manage to get off drugs or alcohol for a period of time; maybe 3-6 months. Things are going really well and you as a family member are so proud of them! They get and hold a job. They save up enough money to get a new car. They even bring home a well-mannered significant other, that mother approves of! They seem like they have made it over the hump and they are living a productive life free from the destructive consequences of addiction. 

Then it happens...All of your hopes are dashed again!

They go back to using their chemical!

But wait! You have no idea how to interpret this. Why would they go back to these drugs when they have so much to lose? Why would they risk their new job, the pretty girlfriend, the new car and the newly found self-respect? After all, don't they already know from experience that the drug will take everything away from them like it did so many times before? Many family members of those with substance use disorder have asked this question, "Why can't they just stop?"

Now it is important to start almost every discussion about addiction with the proper, BALANCED definition. Here is the definition provided by A.S.A.M. (The American Society of Addiction Medicine)

"Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors." Link

Notice carefully how this definition includes the whole person. It includes all the centers of the brain, including the reward, motivation and memory. Also, it states that addiction reveals itself as a BIO-PSYCHO-SOCIAL-SPIRITUAL problem. Stay tuned for future blog posts where we will tackle all of these aspects. In the first few months that someone stops using, it is especially important to understand how these chemicals change and hijack the brain at the basic bio-chemical level.

But in this post, we are going to focus on the way that substance use disorder affects the memory and psychology of the individual and how this leads them to go back to the chemical, even though it will lead to them losing everything. 

Back to our scenario above. Why would someone who has put their drug or alcohol use behind them and gained so much, jeopardize it so easily? The answer from the psychological explanation of addiction is that their thinking has been distorted. Or to put in another way, there are defense mechanisms in place that prevent the addict from thinking properly about returning to the use of their chemical. They are locked in what Dr. Abraham Twersky, the founder of Gateway Rehabilitation Center here in Pittsburgh called, self-deception. I highly recommend his book as an incredible overview of this. 

Very briefly, there are two basic forms of self-deception that I want to cover: Omnipotence and Euphoric Recall.  

The most basic form of self deception is that the addict truly believes that they can return to their chemical and this time they will be able to control it. This is called the self-deception of omnipotence.  Please understand this point: WE AS ADDICTS RARELY EVER INTEND TO LOSE EVERYTHING WHEN WE RELAPSE. Instead, we are under the self-deception that we can use our chemical in a controlled fashion that will not result in losing everything. The secret self-deception in the heart of every true addict is that we can have a job, a family, money and success, but ALSO use heroin and cocaine on occasion! Ask any addict of this is the case, and they will agree. But the reality is that we have NO power over our ability to control our use of mood altering chemicals. And this idea also includes the common self-deception that an addict can safely use a "less dangerous" (in their mind) chemical than their drug of choice. The most common form this takes is that a heroin addict or alcoholic think they can simply switch to using marijuana and it will not lead them back to their main chemical of choice. But this is rarely the case. 

Also, there is a concept in AA and NA called "romancing the addiction". Or in modern psychological terms it is called "Euphoric Recall". This is when an addict chooses to remember only the positive and pleasurable experiences associated with their drug use, then ignores and represses the negative and painful experiences. When an addict in recovery starts to seriously think about using drugs or alcohol again, they usually only think of the positive and pleasurable experience it will give them. Think about it, who says to themselves, "You know what, I'm going to go get drunk at the bar and crash my car and get a DUI!" Of course not! Nobody premeditates to experience pain after they chase a pleasurable experience. But the reality of euphoric recall creates a situation where the addict only thinks about the pleasurable experience of going back to their chemical and doesn't think of the pain and heartache that will come soon afterwards. 

So what is the answer? Here is why recovery from addiction is an active battle everyday to identify and address these self-deceptions. This is why we addicts need to be in a community of others who will point out these self-deceptions in us, when we can't or won't see them in ourselves. We also need to remember the pain and destruction that our addiction caused us, and resist the natural tendency to only think of our chemical in positive terms. All effective substance use treatment or counseling will address these two major aspects of self-deception. 

So take heart if you have a loved one who keeps falling back into their chemical use. There is hope! Get educated about these topics and start to address their self-deception!

Check out our latest Recovery Minute program on the same topic!