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Joel Stegen (USA)

A Humanistic Approach to Addiction - Part 2 of 4 - The Dark Side of Addiction


I have observed that many people who struggle with addiction are fundamentally more sensitive than most. I certainly was no exception. I was a nerdy, introverted child and was intimidated by my peers. It probably did not help that I’ve known since the age of seven that I was gay. I was born in 1967, so the world was quite a bit less progressive about sexual minorities than it is now. This dark secret of mine was a frequent source of dread and insecurity in relation to my peers.



In retrospect, I had a lot going for me in childhood and adolescence, though I was unable to see it at the time. I was bright and inquisitive. I had supportive parents who encouraged me to pursue my interests. I was fascinated with biology and medical science and have known since the age of 13 that I wanted to pursue a career in medicine. I grew up in Southern California, where it was a lot more OK to be gay than many parts of the country. When I finally came out to my parents at the age of 23, they were reasonably supportive.



Because I was a shy kid, home was really my source of security. I was 13 years old when my parents announced they were getting a divorce, and it destabilized my world. I remember being very disillusioned. I did not have the emotional maturity to identify what I was feeling, but the stark change in my behavior spoke to a great deal of adolescent anger. I went from nerdy teacher’s pet to truant pothead almost overnight.



My father moved into an apartment complex on the other side of town when my parents divorced. My parents settled on a joint custody agreement where my brother and I would alternate weeks living with each parent. I hated this lack of continuity. After a couple of months of alternating weeks with Mom or Dad I decided to move in with my father, whom I’d always been closer to.



I met some kids my age in that apartment complex. One of them introduced me to marijuana. I liked it because it obliterated worry and allowed me to just be present and at ease with my friends. I liked it so much that I started leaving school after lunch, so I had more time to hang out before Dad got home from work. I contrived frequent orthodontic or doctor appointments to excuse my truancies.



I had always been such a good student that it took a year for our attendance officer at school to confer with my parents and discover that all the notes they’d received excusing me from class were forgeries. I’d been running amok for a year before anyone noticed.



By the age of 16, I had tried methamphetamine for the first time. San Diego was considered the meth capital of the country back in the 80s and it was ubiquitous. While pot put me at ease with my friends and helped alleviate worry while I was with them, meth created a sense of confidence and euphoria that I didn’t get from pot. Feelings of shame and insecurity vanished. I felt empowered on meth. Armed with my synthetic self-worth, I set off for college.



I chose San Francisco State University because I knew there were openly gay people in San Francisco. Unfortunately, the problem with using chemicals to stave off the pain of adolescence is that you don’t experience the developmental stages that enable you to individualize and develop self-worth. Consequently, I found myself remaining closeted in the gayest city in the country… and my drug use escalated.



Over the course of three years in San Francisco I became more and more disorganized and unable to engage with school. My grades suffered a great deal. Toward the end, I graduated to IV (intravenous) drug use. This quickly landed me in my first of several rehabilitation centers for addiction recovery. I returned home to San Diego to go to treatment and continued to struggle with sobriety intermittently for many years.


San Francisco

I had periods of sobriety where I worked on some of the issues in adolescence that led me to seek solace in drug use. I accepted my sexuality and grew out of many of my insecurities, but I found that by the time I’d done this my addiction had a life of its own. I had changed my brain with substance use, and I was no longer using it to mask the pain of adolescence. Now, I was using drugs because I had burned these pathways into my brain with methamphetamine and conditioned drug use as my primary response to life’s stressors. These neurological changes that happen in the brains of addicts are why addiction is a chronic disease.



Because of the chronic nature of addiction, it often takes more than one attempt before someone obtains lasting sobriety. A recent study determined that the average number of attempts is 5. This number increases to 6 in patients with depression or anxiety disorders. (Kelly, 2019). I have had 6 treatment episodes in my past. I hesitate to call them treatment failures because my relapses were generally shorter, less severe, and less frequent over the years following treatment.



I had minor encounters with law enforcement over the years and accumulated several drug-related crimes. At the age of 26, during a particularly severe relapse, I attempted to evade arrest in a vehicle while under the influence and was sent to prison. Prison was an eye-opening experience. I was fairly sheltered as a middle-class white man from San Diego. The racism was staggering. I quickly learned that I was “disrespecting my race” if I played cards with a black man or had anything but a passing exchange with one. It was considered more acceptable to interact with the Latino population, but only for barter transactions. Deviating from these constructs or having an opposing opinion about them was punished as deemed fit by the designated “shot caller” for each race. This structure was sanctioned and supported by the correctional officers. The correctional officers themselves went to great lengths to exert their dominance through humiliation and degradation. It was an incredibly isolating experience because I had to keep my thoughts and opinions to myself to survive.





Being on the wrong side of the law changes one’s perspective on law enforcement. It has been my experience that most police officers have very strong biases about a person’s character. You are either a law-abiding citizen or a scumbag. Six months after I discharged my parole, I was stopped for a speeding violation on the freeway on the way to work. The police officer ran my name and saw that I had past convictions, so he handcuffed me and put me in the back of his patrol car while he searched my vehicle for 20 minutes to try and find something to arrest me for. This dehumanizing treatment gets internalized. Being seen as a scumbag because of the ravages of addiction results in shame and anger. These are powerful stressors that can exacerbate addiction.



The point of telling you all of this is to illustrate how addiction creates its own baggage. Lots of introverted gay kids struggle in adolescence and then mature as young adults without incident. As I look back on my life, I think the original reasons I started using drugs were no longer primary drivers of my addiction by the time I turned 30. At that point, I was a college dropout, a junkie, and an ex-con. I’d damaged all my relationships with family and partners because of my addiction. I’d lost jobs during relapses. I’d returned to college and failed a second and third time. These issues coupled with the neurological changes I’d created with my substance use would become primary drivers of my addiction for years to come.



References:

Kelly, J. F., et al. (2019). "How Many Recovery Attempts Does it Take to Successfully Resolve an Alcohol or Drug Problem? Estimates and Correlates From a National Study of Recovering U.S. Adults." Alcohol Clin Exp Res 43(7): 1533-1544.




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Next week - Part 3 - A Humanistic Approach to Addiction - A Different Approach


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