Self-medication or self-destruction?

Last post I reviewed a study showing powerful correlations between traumatic experiences in childhood and adolescence and addictive behaviours in adulthood. Although several readers found significant holes in the research, the study maintains a fair bit of respectability, and besides, if we look at our own lives, I think we often see clear connections between personal hardships and addiction. This sort of “anecdotal” evidence, subjective and biased though it may be, is often the strongest reason, deep down, for accepting (or rejecting) the self-medication model.

The self-medication model portrays addictive behaviours as attempts to diminish the feelings of anxiety, loss, shame, and loneliness left in trauma’s wake. For me, the connection is too obvious for words. I was lonely, depressed, and constantly on the lookout for personal attacks while at boarding school as a teenager. Within a year of leaving, I had shot enough heroin to end up unconscious in a bathtub, appearing to my friends to be dead. I don’t for a moment doubt the connection between these episodes of my life. And I say that, not as a scientist, but as a regular person, trying to make sense of my life.

I recently spoke with a reader who has serious problems with alcohol, but only when things go wrong in her personal life. Eleven months of the year she has no craving, no attraction to alcohol. She doesn’t even have to be on guard because there’s no urge to get drunk. However, when her (now, thankfully, ex) husband became verbally and physically abusive, when her custody of her child was being challenged, when she had to go and live with her parents because the matrimonial home was a torture chamber….those were the times she drank to excess. Emphasis on excess. How can you be an “addict” only when things get tough, and then become a non-addict when life goes back to normal? The disease model simply can’t explain that sort of pattern, whereas the self-medication model predicts it. Threat and anxiety lead her to take alcohol, which makes it easier for her to bear.

But there are problems with the self-medication model that need to be addressed.

First, although trauma may lead to addiction, it isn’t necessary — addiction does not have to be preceded by trauma. Some people fall into addiction without any evident history of trauma. Instead, other factors, such as peer pressure or simple exposure, might be sufficient. Check out the video recommended by Steve Matthews as a prime example.

Second, we know that self-medication doesn’t work very well. The things we take or do to diminish bad feelings actually increase them in the long run, or even in the not-so-long run. Maybe we’re not very good doctors. We prescribe for ourselves treatments that do more harm than good. Or they work for a little while — a month, a week, an evening — and then we get hit by the after-effects. Our dopamine-powered beam of attention cares only about the immediate, not the long run. Pretty short-sighted for a doctor.

These iatrogenic (more harm than good) effects don’t actually conflict with the theme of self-medication. If you’ve ever tried prescription antidepressants (SSRIs) or painkillers for legitimate reasons, you know that many medications produce iatrogenic effects. These drugs often lead to dependency and an uncomfortable period of withdrawal. But the fact that self-medication often makes matters worse leads us to another question: Is the trauma we are “medicating” produced by the medication itself? That’s about as vicious a circle as I can imagine, and it challenges the very idea that trauma causes addiction — rather than the other way around, as pointed out recently by Conor (in a comment following my last post).

So let’s imagine a causal story that goes completely opposite to that proposed by the self-medication model.

As I noted above, some people start down the road to addiction without having lived through serious trauma. But even given a certain amount of trauma in childhood/adolescence, one’s PTSD or depression might be under control. When I first tried heroin, I wasn’t terrifically happy but I wasn’t in great psychic pain, relatively speaking. Then I stumbled on a substance that made me feel terrifically happy. Enter the choice model: I want to do that again, because it’s more valuable to me than any alternative. After a while, the substance or activity is a presence in one’s life. And that presence takes on increasing value: it’s sorely missed when it’s gone. Now the source of my anxiety wasn’t so much my historical injuries (e.g., my mother’s depression, my stint at boarding school).  Rather it was my present fear of going without dope, and wanting it badly, and not being able to stop thinking about it. Now we’ve got at least two of the most common outcomes of trauma – loss and anxiety – both caused by present drug-taking rather than historical events.

Then along comes outcome number 3: shame. The loss of self-control – whether due to dirty underwear at age 4 or slavering desperation to get high at age 24 – is contemptible. That’s how others see it, so that’s how we see it. The result is shame, and guess what? Shame is one of the most common residues of trauma.

From an article in The Fix, on 25 Sept 2011, comes the following:

Of all the ACEs (adverse childhood experiences) that muck up one’s life, “’the one with the slight edge, by 15% over the others, was chronic recurrent humiliation, what we termed as emotional abuse,’ says Dr. Vincent Felitti, one of the directors of the study.” Shame is one of the few emotions that is directly, viscerally painful. Now, combine the loss you feel after running out or stopping, with the anxiety you get from craving what you can’t seem to get, with the shame that comes from your lack of self-control, and you’ve got a feast of negative emotions. The need for self-medication is now at its peak — indicating that the addiction itself is the trauma.

The vicious circle — connecting addiction to psychic pain leading to further addiction – may well be the causal engine we’ve been searching for. But self-medication is only one part of this cycle: it doesn’t work all that well as an explanation that connects traumatic life events to a special, intrinsic need for self-soothing. What it really shows, as suggested by Nik, is that, for some period of time, we believe that there’s one thing in the world that can make us feel better.

Of the three models of addiction, self-medication works best for me. As long as we acknowledge that trauma is an ongoing progression with its roots in our childhood but its branches still growing, still advancing, sometimes wildly, out of control, with each addictive act.

22 thoughts on “Self-medication or self-destruction?

  1. John Krier August 10, 2012 at 10:31 am #

    Hi Marc

    Again in my case I am confronted by chicken and egg. Drug use for me was confined to high school beer bashes until 1967 and the world of sex, drugs and rock n’ roll came along and lessened the peer pressure against experimentation with all kinds of crap.
    Like the “Heap” my roomies and I even had a door-to-door sales guy just like the Fuller Brush Man (for those old enough). By our late 20’s we had ALL quit the use of anything but alcohol among the psychotropic mind benders. That was the easy part.

    I, on the hand, was getting ever increasing depression episodes that started AFTER college, even while using only alcohol and non-addicive use at that. Two (serious) suicide attempts followed in their wake. Lots of exercize and tricyclic meds got me thru the middle years until the episodes returned with a vengeance somewhere in my mid forties. No trauma, no trigger, normal life , good family overacheiving kids (with the usual hiccups) making lots of money by then, just mixed episode (major and minor) chronic depression. THAT is what sent me down the spiral path to alcoholism by my mid 50’s. SSRI’s, starting in 1989 helped some but I had too much receptor damage for one target to encompass.

    That is where the brain infection that you and Nik keep skipping over, kicks in. It was NOT just trauma but Mersa followed by trauma that did it. I was never the same after that. Subtle and not-so-subtle changes all happened within the same year ….when I was 11. Some like chronic lying, and utter lack of self confidence (obviously connected) were the more salient features. Never like that before.

    In closing as I have said repeatedly in hundreds of AA meetings I would estimate conservatively that 70-80% of alcoholics came from families where one or more parents were alkys whether nature or nuture. I did not.

    Thks for allowing my amateur input.

    PS I am going to start CPD with a guy my brain specialist says is the best in the city in order to try to repair some of the damage to the Limbic from my recent vascular episode.

    • Marc August 14, 2012 at 5:29 am #

      Hi John. Your history sure does sound different from the typical path of depression and alcoholism — if there is such a thing as “typical”. If I understand you, you were diagnosed with MRSA, a serious bacterial infection, at the age of 11 — and that’s where you feel your troubles originated.

      MRSA apparently has vastly different symptoms depending on where in the body the infection resides. But you say the infection was followed by trauma. Not surprising that an 11-year old kid would be traumatized by a serious medical condition, no matter where it manifested. And then depression, leading to alcoholism, started up after your college days and got considerably worse in middle age. And it sounds like you’re still looking for the best explanation as to why.

      What comes to my mind is a developmental process sometimes called “kindling” — this was discussed in one of my favourite books, Listening to Prozac, by a guy named Peter Kramer, which came out in 1993, at the start of the SSRI boom. Kramer (following a researcher named Post, if I remember) says that limbic structures like the amygdala get more and more sensitized to cues concerning trauma, threat, rejection, etc, as life goes on — so that you get an increasingly hyperactive amygdala as you age, which eventually slips into overdrive all by itself, with nothing at all to trigger it. A hyperactive amygdala spells depression and/or anxiety….and we all know that either or both are excellent gateways to addiction (that self-medication model again).

      The kindling idea comes from the study of seizures in rats. First they are induced by electric shock (very traumatic!) — but as time goes by, lower and lower voltages are necessary to produce the seizure…until eventually the rats will have seizures spontaneously. Maybe it’s a very emotional brand of Pavlovian conditioning. So combine this (very depressing!) syndrome with the tendency for self-medication to become the primary trauma in one’s life (see my current post). Now you’ve got kindling –> increasing depression –> increasing alcohol (as self-med) –> more depression…etc, as your poor amygdala becomes a little boat tossed in a sea of self-perpetuating storms of ever larger proportions and greater frequency!

      It sounds like you are riding out these storms, and that’s truly admirable. I hope that this second-look at brain dynamics can help to reassure you that none of this is your fault. The nervous system just keeps on developing, and sometimes it grows in directions that cause us a fair bit of suffering. In a nutshell, that’s my vision of addiction.

      • John Krier August 15, 2012 at 1:22 pm #

        Hi Marc

        I read “Prozac Nation” many years ago, I even went to see Kramer speak and have a signed copy (after battling my way thru a group of anti-drug protestors). It started me on the long and winding path to self- discovery about my illness.

        As for the MRSA (I call it Mersa for ease of typing) mine was so severe that at one time the Dr told my mother that I had 26 internal infections throughout my body. The treatment was what I call my “WW1 sepsis treatment”) which consisted of keeping the incision open for almost 3 months while it drained.I also had external infections wherever the drainage touched my skin. As a result it is hard to say where and how the brain was affected. Was it a protracted over-active immune response, or a brain infection? My Brain Specialist said I was “lucky” as the worst outcome of this type of illness was severe OCD (same continuum). Just lucky to have merely horrendous Double “D”.

        One month after “recovery” my father died under traumatic circumstances. Therefore chicken and egg.

        You hit the nail right on the head with amydalae thing. That is what it seems to be about and is the foundation of my work with the Doc. Unfortunately it has expanded to the Limbic Loop now and so treatment is like herding cats. I am trying everything I can find so I will keep you posted as I am sure you will be interested in my strange case.


  2. Peter Sheath August 10, 2012 at 4:31 pm #

    Hi Marc
    Yes the self medication model works for me also. I’ve always had a kind of association, at the back of my mind, with shame and my own addiction. Sometimes I think the shame I was experiencing wasn’t even my own. I believe that I was like a sponge throughout my life absorbing my own shame and everyone elses. I also believe that I inherited a kind of cross generational shame, not genetically, but the shame my mother absorbed from her mother and so on.

    This shame became very toxic to me, often manifesting when I enjoyed some external success as nagging self doubt and an almost constant fear of being found out. I was never sure who was going to find me out or what the terrible thing was that i would be found out for. It was so bad at times that I would have panic attacks, sweat profusely and burst out in tears for no real reason.

    I was a mental health professional, most of the time working with very damaged people, but having very little insight into me. The ONLY time I felt anything like whole or part of was when I dosed myself to the latest substance that was doing it for me at the time. I have done loads of work on myself in all sorts of therapeutic settings and this stuff can still pop up and start playing games with me. The difference today is that I know exactly what it is and know exactly what to do to get through it.

    I have talked about Bruce Alexander before and another thing I remember from his book was him talking about the euphoric effect of Heroin in addiction. He talks about this whole experience as being much more intense and powerful, something not really reported by people using it therapeutically as an analgesic. I have talked to many people who have used Heroin with me who really didn’t like it, I’ve talked to others who enjoyed it but couldn’t relate to my God-like experience of it.

    I suppose the question is, is this because I felt so shit and so full of shame before, that it had such as aprofound effect on me?
    Gabor Mate talks about endorphin systems not developing due to maternal bonding being interupted and/or absent and the endorphin system development becoming stunted. This also makes sense to me, because he also talks about the first dose of an Opiate being akin to every bit of love you’ve been searching for all your life. That was exactly how it was for me, although I was projectile vomitting for over two hours.
    I think it’s something like having a glass of water when you’re really really thirsty. It’s a completely different experience to have a sip with your meal!

    Anyway Marc I have been asked to ask you if we could use some of your blog material on wired in to recovery? We are interested in your three explanations of the models of addiction and, I’m pretty sure it would help some people to make sense of what they are going through at the moment.

    • Marc August 15, 2012 at 5:44 am #

      Hi Peter. You bring up several very interesting points.

      Many of us are talking about the toxicity of shame. You add that there may have been a cross-generational element as you absorbed shame from those around you. First, thanks for sharing your experience so candidly. Second, excellent point! My mother was very punitive when I left stains in my underwear as a four-year old — and shame is certainly one of my characteristic emotional responses to lots of things, especially loss of self-control. Only years later did I realize how prim and perfectionistic her own mother had been. So there’s three generations, passing along shame from one to the next. It’s pretty tragic, isn’t it.

      Then you say that certain drugs might have far more profound effects on some people than others, because of a baseline condition. Like an antidote to a life-long illness or insufficiency. This would give the self-medication model a lot of extra juice, so it’s critically important to consider. At least I agree that drugs feel very different to different people. I’m aware that many people don’t like opiates, though personally I find that hard to imagine! So maybe you’re right. Maybe there is a chronic shortage that is suddenly and profoundly compensated when you take the appropriate drug — e.g., heroin.

      I have seen it that way in relation to environmental issues. I felt primarily UNSAFE in boarding school (as well as shame and depression). The central function of opioids is to soothe anxiety and instill a feeling of safety. So, that seems to be what I needed most. This connection always made sense to me. I may have needed more opioids to correct my particular lack — a lack of safety and security.

      Whether these endogenous differences can be present at birth, as Mate says, either due to maternal physiology/experience or to genetics, I really don’t know. I sort of doubt that the opioid system could be knocked off the rails like that in utero, as it is so fundamental to normal neural function. But as I said in a recent comment, it may not matter. There’s a huge amount of personality formation going on in infancy, which of course is reflected in brain development. I can well imagine long-term imbalances starting then and continuing throughout the lifespan, simply due to insensitive interactions between parent and baby in the early months or years of life.

  3. Nate August 15, 2012 at 5:09 am #

    Your explanations Marc are indeed insightful and I appreciate you sharing the wisdom of your own experience through your Memoirs and blog as I’m finally coming to understand a lot more about my own addictive and compulsive behaviors let alone those of family and friends! You made an interesting remark in your previous post,
    Addiction as Self-Medication that: “At the very least, drugs, booze, gambling and so forth take you out of yourself. They focus your attention elsewhere. They may rev up your excitement and anticipation of reward (in the case of speed, coke, or gambling) or they may quell anxiety directly by lowering amygdala activation (in the case of downers, opiates, booze, and maybe food). The mechanisms by which this happens are various and complex. But we all know what it feels like. If we find something that relieves the gnawing sense of wrongness, we take it, we do it, and then we do it again.” Even in this post you linked the vicious cycle of “connecting addiction to psychic pain leading to further addiction,” which I have found so true. I, like so many young adult males in our highly sexually charged society, am well aware of the addictive nature of sexual behaviors like casual sex, habitual masturbation and pornography. Indeed, it’s usually the latter behavior that works as a catalyst for the former to take hold since so many lonely or depressed individuals will surf the net late at night to find some solace in an attempt to feel “connected” with the wider world “out there” or, as you put it, “self-medicate” to numb themselves from these feelings for whatever the reason may be. And like the fantastic scenarios of sci-fi reality pornography in particular acts in the mind of the sex addict to create a kind of psychic dislocation that initially excites and tantalizes, but for more than a few can lead to feelings of shame and self-loathing afterwards for having lost self-control since, as you put it, “That’s how others see it, so that’s how we see it.” Perhaps like any other muscle we need to learn to exercise self-control so pathways will be either renewed or strengthened and next time we face temptation in whatever form it might take we will be well equipped to resist its advances rather than meander along the slippery slope of self-destruction. And with the scientific discoveries behind addiction making headways I feel it can be truly empowering to the individual in figuring why we do the things we do even when we know it’s bad for us in the long term and what we can do, if anything, to halt it in its tracks.

    • Marc August 15, 2012 at 6:03 am #

      Nate, thanks for such an articulate and sensitive depiction of sex addiction. It’s one of the addictions I’ve known least about. But the way you describe it, I can really see that it functions just the same way as other addictions. I think it’s particularly important that you highlight psychic dislocation, initial excitement and intrigue, and then (of course) the shame and self-contempt that come later. It’s also fascinating the way it gives you a bridge right directly into another world — I can see that.

      I guess the other thing you bring to light is that sex addiction is quite specifically about connection with others, or at least the fantasy of connection. I wonder whether some kinds of emptiness or loneliness pull for that sense of connection whereas others don’t. Is the crack-head/speed-freak looking for connection, and if so, is it connection with other people or rather a sense of intense connection with the material world? And I wonder: when I took opiates, I was very content to do it alone, but one of my main goals was to float in a fantasy domain that was entirely bustling with the whispered voices and images of other people — such that I didn’t feel alone at all. As well, people who take dissociatives (or even Ecstasy) often talk about the enhanced “sense” of connection they provide, even though they know it’s delusional. It was like that for me too when I took DMX.

      So…thanks for opening the discussion out in this way. I’d like to hear what others think as well.

  4. John Krier August 15, 2012 at 5:37 pm #

    Hi Marc

    Apologies for two mistakes my wife pointed out. First I meant CPT not CPD then I mentioned the wrong title for Kramer’s book ( which I consider revolutionary for the time and still do) You are correct it was “Listening to Prozac”. The book I mentioned was an anti SSRI screed although by that time it was true that Prozac, like Zoloft now, was vastly over-prescribed.

    My only excuse was being in a hurry for my weekly with the “Brain Washer” which is what I jokingly call him as we have a close personal relationship after 9 years…. and he will probably be reading this. If you get a comment from a guy named “Lance” you will get the connection.

    He did get me a referral to the best (in his opinion) CPT guy in town who was a former CIA head of interrogation. Water Boarding here I come!!

    • Marc August 17, 2012 at 6:54 am #

      Good luck with your self-selected torture. I hope you don’t reveal any state secrets that you might not know you know.

      And thanks for the clarification…

  5. Jocelyn August 17, 2012 at 9:08 am #

    Dear Dr. Marc Lewis,

    First of all, I am so grateful for your book and this blog. I read the book to my husband and we had hours of discussions around the nature of addiction. I have read most of the posts here and have learned much which has ultimately enhanced my recovery process.
    The discussions regarding opiates are particularly meaningful to me (ultimately my drug of choice). My “accelerated learning” process revolved around using opiates prescribed for injuries and eventually ended up becoming the emotional “blanket” I “needed” to live in this world. Today that has changed.
    Again, thank you. The discussions here and in your book have awoken my mind to new possibilties and ideas.


    • Marc August 18, 2012 at 5:59 pm #

      That is wonderful to hear. I swear, I sometimes tune into these comments just because they make me feel so good.

      The blog has become a lovely thing — its own thing, not my creation at all. Such diversity of people, souls, backgrounds, knowledge bases, belief systems, biases, ideas, and coming from so many different stages in the journey we all seem to be travelling. Yes, there is a lot here to awaken us to new possibilities and ideas, and I hope it keeps on that way.

      Good luck to you in your own journey.

  6. Arne August 22, 2012 at 2:56 pm #


    I’ve been working on a drug education video series for a client who works mostly with classrooms of 5th-8th graders, and stumbled on your blog while doing research. It’s been extremely valuable to me in getting my head around addiction and the action of drugs in the brain. The challenge has been how to translate that into information that might help insulate a kid from going down that path when drugs are encountered. Do we focus on kids never trying, or on preparing them to stay away from abuse rather than use? Our client is focused on a core of preparing kids with knowledge about affects on the brain, both as a possible protection against drug abuse but also as a way to educate about the brain. A sort of two-fer. This is combined with other features, preparation to face peer pressure, exposure to former users, etc, that are done in the classroom and not in the videos. We’re mostly tasked with the brain and some warnings about consequences. Anyway, reading your blog has helped me get out of the sort of too-physical brain model and to dip into some of the mysteries and I thank you for that.

    My question about addiction is perhaps most what I see as a non-drug-addict (as you rightly elucidate, there are plenty of my behaviors that mirror those of addicts, but I don’t have any addictions to drugs) who is working in the space between kids and drugs. One thing I haven’t read here in your blog or the resulting comments is a sort of social prism. Thinking of myself as a youngster, the feeling of getting out of my body or being in some ecstatic space was extremely important. I dabbled in various hallucingens mostly, but I think because I had enough other experiences of joy that I saw them as interesting but not essential. If anything, I feared drugs because the resultant come-down deprived me temporarily of access to the more natural experiences of authenticity I treasured. I think of Ben in the video you link to up there. Sure, he had no overt trauma, but he grew up in what seemed one of those imprisoning and somewhat dulling strata of UK society…loving family, but perhaps not much room for connection to anything other than a row house and a job? Isn’t there a trauma in culture? In growing up in a civilization or particular society that requires a certain kind of adaptation that many of us are unable to produce, whether biologically or, if you bend that way, spiritually? I think of the kid in Into the Wild…it wasn’t drugs for him, but he needed something out of his life that his sweet upbringing couldn’t provide. Drugs for many might provide the only experience of ecstasy they’re likely to have…and who are we to ask them to prefer a long life of frustration and being an upstanding citizen to a few fleeting moments of feeling truly alive? What are we alive for, exactly? To execute our biological and social functions? I think these discussions of being and the brain are extremely fascinating, and I think a lot of work is being done lately to understand how networks affect behavior and health, but I feel like there’s a big gap here as we individualize and anatomize too much around addiction and think less of perhaps the more philosophical question of our purpose here. For non-traumatized potential drug addict kids, what do we offer them as a culture that makes resisting drugs an appealing choice? Fear of ending up like Ben obviously isn’t enough. What’s the positive path we give them? If we value euphoria as a culture, does our current system work? Is euphoria a vital part of being alive, or is it a trick that drugs use to get into our brains? I started reading your book and couldn’t help feeling that there was more to your drug use than the obvious trauma. Not only were people mean to you and you felt loss leaving home, but it seemed that drugs gave you a path to the sublime that was missing in your surroundings. Your lyrical writing in those passages certainly attest to a sense of doors being opened…maybe the major psychic pain you allude to not having above was the lack of venues in your social situation to access joy or hope? I often think about this when working with kids at risk…are we really telling youth to work at McDonald’s (if they can even get that) and be upright citizens for the mere sense of satisfaction and safety that come with that choice, rather than choosing either the visceral thrill and sense of joyful community of being in a gang, or the (temporary) euphoria of drug use?

    • Marc August 23, 2012 at 8:39 am #

      Hi Arne. Where do I start? Maybe by saying that I find your take extremely insightful, extremely important, and….difficult to reconcile with a few other things. I know the Rat Park study quite well. I even name a chapter in my book “Night life in Rat Park”. I was running rats, using Skinner boxes, etc, as a psychology student. I was bored, I wasn’t getting along well with my wife, and so on and so forth, when I discovered the leftover morphine in the lab fridge. That kept me going for quite a while. But back to my Berkeley days: indeed I was in a sort of shut-down state, I was lonely, like Alexander’s rats, and existentially in a sort of a blind alley, and drugs sure did give me a path — first to the sublime (I’m talking psychedelics) and then to the warmth I didn’t know how to get from human relationships (heroin, etc.).

      Please see the comment I just posted at the foot of the article you just found in the Walrus — other readers, see below. Great article. As I say there, my only addendum to Alexander’s pitch would be: environment is not an objectively-definable entity. It’s how we perceive and interact with our environments that is “causal” re addiction. Well of course it is. So we do need an emphasis on individual differences (which brings us back to the conventional trauma story — bad shit that happened to some of us as kids) as well as attempting to specify what’s wrong with our culture in general terms.

      But your observations about our culture and about the meaning of life really strike a chord with me. Being a cog in the machine has little to recommend it, as noted by Pink Floyd, whether we think in terms of our biological role or our societal role (which are highly overlapping for most people). And that observation brings me to a conclusion I’ve held for a long time: there is nothing morally wrong with taking drugs or other substances. There is nothing even illogical about it, except for one thing, and that is the prevalence of addiction, and its terrible consequences for self and others. I have stated elsewhere that the use of psychedelics can be highly beneficial for many people, though I don’t recommend dropping acid three time a week like I used to do. So, anyway, there is no fundamental, implicit reason NOT to take drugs. The reason to “just say NO” is that drugs often, not always but often, lead to addiction, which is incredibly miserable, and which almost always leaves you (and those you love) with a net gain of suffering.

      The only way I find “meaning” in my life is through my relationships with others (as noted by so many) and also through meditation and/or nursing a state of mind that allows for moment-to-moment awareness (also an idea that’s been around for a long time). But how are you going to convey that to 5th-8th graders?! I think you’ve got a real problem on your hands. Kids will — in fact there is good reason to — try drugs, given that adolescence is all about searching for what’s meaningful. You mention this about your own history.. So to get kids not to even try drugs, yes, basically, I think you have to scare the shit out of them. Show them the Ben movie. (and I totally agree with you, Ben’s life seemed a trifle stifling) And then — again I agree with you on the down side — it’s as if you’re telling them: don’t take chances, don’t take personal risks in your search for meaning, and now go get a job at McDonald’s.

      You ask if there are positive ways to keep kids away from drugs — that is, not just by scaring them. I really have a hard time with that one. If I knew — really knew — that my own kids weren’t disposed to addiction, I would find it hard to present very good reasons for them not to try most drugs (with major exceptions for heroin, crack, meth…and a few other nasties).

      Let me think about it some more, and thank you for such a thought-provoking comment (and yes, front runner for the prize of the longest yet).

      In fact, come to think of it, maybe you can let me know if you’d mind my using your comment as the centrepiece of a new blog post. Let’s both think about it.

      • Arne August 23, 2012 at 2:17 pm #

        Of course, I’d be honored and very interested if you further elaborated in another blog post.

        And thanks for the thoughtful response. Many things are sparked in my BRAIN, but I’ll hold off larding this poor blog post with more of my musings and save it for a newer one if you decide to do that. I’ll just say your comment reminded me of something my dad once said (ex-revolutionary/hippie/mystic)…In High School I mentioned that I was sad to have missed out on the Love-Ins and joy of the ’60s. He brought me up short and said “What no one ever mentions about the ’60s is that most of us were doing that stuff out of incredible anguish. We were seeing kids we grew up with dropping napalm on children and little girls blown up in churches. Those were desperate attempts to break through with drugs and whatever else we could find.”

        • Marc August 25, 2012 at 5:31 am #

          It sounds like dear old Dad was more sensitive than most of us. As a member of that era, I was distressed about Vietnam and Alabama, but I didn’t carry it around with me. Most of my anguish honestly came from very selfish quarters: my wish to be happier, be more admired, have more friends, and so forth.

          I think I will post your post as a post. Let’s see what comes of it.

  7. Arne August 22, 2012 at 5:27 pm #

    Ok, I know I’ve already written the longest comment in the history of this site, but just came across this in my further research:

  8. Bill Smart August 26, 2012 at 8:58 am #

    Whoooaaaa Marc

    YOU are making this much too complicated — seems to be common in psychology :).

    The problem here is US. And we start to make, usually unwittingly, choices that at first seem ok , and then turn out not so ok.. There are lots of these as we grow up and not all are addictive.. Its called learning.
    So we start making choices based on other factors– really the root causes of addiction falling into biologic ( think genetic) , and psychologic ( think organic depression) and social ( think Dads abuse and the bad ” – hood ” .These might be considered as risk factors to use a medical- like concept.

    Until we develop effective strategies with dealing with all of them in context, we dont have much chance of successful management of this terrible problem .

    • Marc August 27, 2012 at 3:54 am #

      Well maybe. And yet a lot of people DON’T become addicted. The numbers vary from drug to drug and study to study, of course. But, for example, most pot smokers never become addicted to pot.

      Yes, you’re right, it’s all about learning, and a lot of learning is through trial and error. The problem is that the “error” part of trial and error sometimes doesn’t show up until AFTER a lot of learning has taken place. In other words, we’ve learned how satisfying the drug or drink can be, and then — oh yeah — there’s the bill that comes in the mail a year later.

      Depression is a biggie, for sure — and if you look closely, everything is organic!

  9. Kerryn September 12, 2012 at 3:55 am #

    Hi Marc
    My psych says I self medicate. You are spot on about the loss of self control compounding the trauma. I always say to him when I am clean I can’t bear my family and friends guilt they lay at my feet. I already told you my story — you get so many you probably don’t remember but you said I was the epitome of addiction. My mother wouldn’t cuddle us and called her severe criticism, constructive critism. And as I told you I was abducted at 16 for 3 days and repeatly rapped and threaten to be buried out the back any way i got away after than everything changed my recreation use became extremely heavy. I found peace from it and lost all respect for myself and started to self loath. Clean at 23 but relapsed when my life turned to shit at 35. I am 39 now and clean from meth 28 days again. I can see they way the drugs became my trauma and my escape from suicidal thoughts. I still on Valium cymbalta and seroquel and cannabis. Since I have been clean again new doors have opened and I want to be off everything again. It’s so scary thought of not a single escape from aniexty and the cannibis stops me dreaming so no nightmares. Since my kids started school and the suicide of my best friend 2009 I am scared to feel. But I hate my habits and how in others eyes it deprives me of credibility in simple things like opinions in side the family. As I told you when I told my mum I was rapped she told me I deserved it cos of my lifestyle. I was just a low life junkie. I started taking drugs 13 cos it was fun but after 16 I 5,5 and dropped to 40kgs lived on the street with other kids. Last week my mum rang me and threaten to cut me from her life so I forced her to hear what happened to me. She didn’t wana hear it. The thing that I fear the most tho is to feel the dread and grief and anxiety with no escape. How do you control it???
    Thanks for your inspirational work you have helped me understand so much more about myself cheers Kerryn

    • Marc September 13, 2012 at 3:45 pm #

      Hi Kerryn,
      I know what you mean. The feeling of not having IT around permanently is so terrifying, because how the hell are you supposed to control the anxiety, dread, and despair? You sure have your share. I was also sexually assaulted at the age of 17. That weighed heavily on my soul for years to come. I finally talked it out with a therapist, and that released a lot of it. I could actually re-live the imagery without freaking out. It was VERY helpful.

      There are a number of people I correspond with who are just on the brink of recovery, like you, and like you they can’t quite imagine saying “never again”…The loss of that safeguard against anxiety and loneliness is just too much to contemplate. The loss of that “friend”.

      First, try playing it a day or a week or a month at a time. You can say “no” I won’t go back to it this week, because I KNOW how shitty it will be afterward. Then, as the time period increases…it may become easier to bare the loss of it, actually the fear of the loss of it, so that you actually can start to relax with the idea that you just don’t do that anymore.

      I also strongly suggest meditation. Of all the things I’ve tried, including an embarrassing amount of time in psychotherapy (I think 12 years plus, all told), meditation has been the single most helpful thing. It lets you get to know yourself, feel yourself, bit by bit, until you start to feel comfortable in your own skin. There are many ways to start, but here’s a link that I find quite heart-warming. Not exactly a recipe, but a very sweet man who tells you the “theory” behind it:

      Also, stay with us on the blog. There’s a sort of community here…it may help.


      • Kerryn September 14, 2012 at 9:41 pm #

        Sorry at the top I meant the lose of self control compounding the trauma, I typed that on my iphone and spell check changed a few things and I never proof read l always in to much of a hurry.

        I thought I was over the past and saw a good phych at 23yo who helped me alot. Since then totally blocked it from my mind. Now all these years on and in therapy again it seems to be rearing its ugly head again.

        Maybe my brain was programmed years ago to block it with drugs any drugs I could get my hands on really. Maybe the relapse brought it all back and the my brain pathways to drugs and that experience are connected in some way. I dont know? What do you think?

        I know the loss of self control severly increases my self loathing.

        Anyways my phych nurse who is absolutly fantastic and an ex addict has suggested meditation and is giving me link dvds cds and all that nxt time I see him so I will give it a good try.

        Also I have a determination this time around, the last few times I quit didn’t feel as determined. I have got to the point where as much as I love being high I am sick and tired of it interferring in my life and holding me back. This time I have created a direction to follow and created ambitions and oppotunities and plan on opening a shop in 4-6 weeks and I have to stay clean because I have alot riding on its success.

        I also want to mention that before I was like driftwood floating in the sea with no direction or ambitition and creating it has made a huge differnce to my determination to stay clean. Without direction and ambition we are lost in some weird time warp of oblivion where times seems to disapear unnoticed.

        Thank you for your invitation to coninue to write to you I know I am not as educated as some who write here. But your reasearch thoughts and ideas are so valuble to me I am an avid reader of your blog even tho I don’t comment often.


        • Marc September 16, 2012 at 7:32 am #

          Kerryn, I knew what you meant. And I’ve gone back and edited the first few lines of your comment. Also, I assume you meant “psych” not phych…so I edited that too.

          I think that the self-loathing caused by taking drugs can bring you right back to the state following the sexual abuse. (you also spelled “rapped”…so it does seem that you have strong defenses piled up against it) Because SHAME and loss of self are two things that those experiences have in common. So if you inject yourself full of shame, so to speak, and feel the loss of self, then you are indeed activating synapses (cells) in the amygdala and related areas (the part of your brain that attaches emotional significance to events). And by activating those synapses, you now bring the feelings and memories of the sexual abuse back to the surface. That’s my interpretation, anyway.

          I’m really glad you have another strong goal in your life. It seems impossible to quit if you just focus on the NOT, like NOT doing it. You have to focus on something positive, the YES, not just something negative, in order to activate new synapses, new networks, and get them rolling, including the sense of attraction, even craving, of something other than the drugs.

          I wish you success!!!

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