One of the more interesting findings in the major research project that we just conducted here at SCHC is that all participants told us that drug use was their choice.
If you read a great deal of expert literature on addictions—or if you read the popular media or watch TV on the topic—the idea that drug use is a choice will likely seem very odd. Almost everyone it seems, from Time magazine to HBO specials on addiction, tells us that addiction is a disease or, at least, a disruption in the brain. “Addicts are powerless over their addiction” is the mantra.
It seems that our research participants disagreed with this expert literature. How can we make sense of this? Those who participated in the research project told us that they had heard addiction was a disease. All knew that the 12-step program states they are powerless over addiction. Those who had previously attended addiction treatment before coming to SCHC said that the addiction professionals told them they were powerless. So, it’s not lack of awareness.
There is something about a drug-induced altered state of consciousness that is very appealing to addicts. So what is this appeal? Why are addicts willing to suffer the inevitable consequences of drug use—financial, social, occupational, physical—for that feeling of being high?
When we asked those who volunteered for our research why they used drugs, at first, they gave us answers that we typically hear about on television or read about in magazines or newspapers.
Some said it was to get rid of the stresses at work and home. Others said they were using drugs to medicate a mental health issue, such as PTSD. Some said that they used to relax after a hard day’s work. In this sense, it appeared as if drug use was a deliberate act of the client, not the result of being powerless.
Asked how drug use got out of hand, they were a bit baffled. Participants knew they were competent men with good values. Most succeeded in whatever they did (if they really tried). They were intelligent. So trying to figure out how the self-medicating got out of hand was confusing. Several suggested that they simply associated intoxication with feeling good, and, since they liked to feel good, they used regularly.
Drug Use as a Mystery
After initially telling us that they used drugs to alleviate negative emotions, we asked a simple question: “Did you ever use drugs when you were not medicating negative emotions and moods?” Of course, they answered, “Yes.” Birthdays, winning a business contract, New Year’s, parties—all were times to get intoxicated.
When they recognized that they used drugs even when they were happy, they realized that their story of medicating negative emotions and moods was not good enough. The participants seemed to be thrown into a bit of a quandary. They tried to find new explanations, but none were very convincing.
They thought there must be some mystery factor at work. Some suggested they had, perhaps, an undiagnosed mental health problem. Others suggested that maybe the drugs had altered their brain chemistry. Whatever they suggested, it was clear that, for the participants, these ideas were just dead husks. They just tossed out these ideas and didn’t really believe them.
In fact, after we talked with the research participants for quite a while about why they used, almost all admitted that they didn’t really know why they were addicts. They were confused; their addictive use of drugs made no sense to them.
Drug Use as Attending to the Self
In the research project we recently completed at SCHC, only one participant said he used drugs because he didn’t really like himself. He thought that his “real” self, his sober self, was so dull that others felt burdened by being around him. He preferred the “fake” person, who was intoxicated. The intoxicated person was funny and outgoing and a pleasure to be around.
But the other participants liked who they were. Of course, they didn’t like a lot of behaviors they engaged in while seeking and using drugs, but they were okay with themselves as people. These participants used drugs for other reasons. Analyzing the data, we discovered that the one time in their lives when they paid attention to themselves was in active addiction. This may seem a bit odd, because the popular idea is that addicts are only interested in themselves.
We discovered that the real issue is that addicts have a weak sense of who they are as individuals. All the research participants paid very little attention to themselves. They rarely thought about their lives. They rarely took a step back and asked themselves if the life they were living was acceptable to them. They hadn’t really thought about what they wanted from life. They had no real goals.
Content people know who they are and what they want out of life. They have developed an anchor within themselves, from which they reach out into the world. This was not the case with our participants. They relied on the outside world for guidance on how they were feeling, how to structure their lives, and what they should do.
Drug use was their way of taking time for themselves. The participants told us they would arrange time for intoxication when it would not interfere with work or family (and were very upset when their careful arrangements were disrupted). Or they said when they noticed they were too anxious or depressed or stressed then they would turn to the drug for relief.
Drug Use as Agency
Francis Seeburger, a very fine philosopher, has written about addiction. He argues that addiction is “agentic” behavior. What he means by “agentic” behavior is agency—those things we do to assert ourselves. Everyone needs to feel in control of his or her life. For addicts, intoxication is the vehicle they use to give them perceived control over the way they feel.
This is why they looked to drug use. It was their time for themselves. It is a time when they stopped listening to the outside world and did something only for them.
It’s an odd kind of thing, but it was true for all our participants. And our analysis is very close to what Seeburger said about drug use. Seeburger quotes Augusten Burroughs’ famous autobiography about addiction. Burroughs said he used drugs “as an escape hatch” but also as a “destination.” The destination is some place they want to get to. Seeburger pointed out that addicts consciously use drugs to reach this destination. They cannot find it in their sober lives.