Am I Addicted
May 2010

It can be very challenging for us to examine our habits and come to the realisation that there is a lack of conscious control of one or more of them. Usually we are alerted that something is amiss by someone in our life telling us that they believe we are over-indulging in our favourite activity. Around this time, things are starting to go wrong in our lives. Sometimes it takes us a long time to realise that the relationship breakdown, the accident, the financial crisis could have been avoided if our life had been in balance.


The substance or activity that we choose to over-indulge in is one that makes us feel good or numbs distress. This can include shopping, sex, texting, chat rooms, relationships, food, coffee, prescription drugs, as well as the usual suspects of drugs and alcohol. This article is mainly concerned with alcohol use and cannabis use, but many of the concepts apply to other addictive processes.


Your pattern of use may be one of binging for a period of a day or more, during which time the activity is undertaken excessively, often to numb some emotional upset, but also as a reward. This may be followed by a period of recovery which might be as short as a few days, and may be as long as months. This period is needed to physically and/or economically recover, and also for the effects on yourself and those around you to be forgotten or lessened by time. The main thing that identifies the pattern is a lack of desire to or inability to stop the activity until some limit has been reached. The limit may be one's physical ability to consume or do more, negative outcomes, or financial, time or availability constraints. A binge pattern can be quite difficult to break because we have become experts at "relapsing". We can easily give up and we can equally easily start again.


The other risky pattern is daily or almost daily use of any mind-altering substance. If you are a person who can have one standard drink every evening and never more, then you will be fine, remembering that your body has come to expect that, and observing what you feel if you do not have that "reward" at the end of the day. Also remember that a standard drink is really quite a small glass of wine (7 to a bottle), less than a bottle of beer, and a nip , not a slosh of spirits. It is very easy to have a generous serving, and then reach for the bottle for just one more. People often speak of having "a couple of drinks" If they actually relate exactly how much they drink on that occasion it is often a great deal of alcohol, at unhealthy levels. Healthy levels are around half a bottle of wine for a woman, and less than a bottle for a man, and not more than four times a week.


A common pattern for women is to begin drinking while they are cooking the evening meal. Without others noticing, they might consume a bottle, and start the second after dinner when they are on the phone chatting. They then go to bed to sleep it off.  Women are more vulnerable to the health effects of alcohol because of their smaller stature and their lower bodily water content (water in the body tissues helps dilutes alcohol).  They can develop diseases such as cirrhosis of the liver (scarring of the liver that can be fatal) much more quickly than men.  If pregnancy is possible, it should be remembered that alcohol consumption in the first three months is likely to harm the baby, at the very least causing difficult behaviour patterns, through to serious intellectual disability.


Alcohol only helps us get to sleep, not stay asleep and it interferes with our REM sleep which is the times at night when we process the days activities via dreams. When people give up drinking or using drugs, they often have a period where they experience vivid, unpleasant dreams catching up on lost dreaming opportunities. If we drink or smoke cannabis every night, we are likely to feel depressed the next day, due to either the ongoing effect of the substance in our bodies (both are Central Nervous System depressants) or to the effect of withdrawal. If you are taking an antidepressant, you might experiment with eliminating alcohol or cannabis from your life as an alternative solution to depression.


Other socially acceptable and frequent excessive use patterns occur in the work place where the culture is one of lunch time of after work drinks (often subsidised), in the context of sporting activities, and in the social milieu where people mix usually in the hope of finding a partner. The latter is interesting because, although alcohol does reduce anxiety and lower inhibitions, it is hardly a good environment to choose a suitable companion. Your choices have a high chance of being inappropriate as our judgement is eroded by alcohol or drugs, and the likelihood of disillusionment and negative outcomes are high. On these social occasions, if you find yourself not eating because it interferes with your ability to get drunk, or you are the one that does not go home, or behaves badly, then you might wonder if this is serving you.  If you try to cut down your consumption and find you can't then you should seek help.


The more obvious signs of addiction or dependence to alcohol are:

  • Not being able to remember what happened to you when drunk, called blackout.

  • Having to drink more and more to get the same effect, called tolerance.

  • Having to drink every day to stop your hands from shaking and to counter your hangover, called withdrawal.

  • Alcohol becomes more important to you than just about anything else in your life.

  • You are suffering many negative effects from your drinking but you still continue.

  • You hide your alcohol from others and drink secretly and alone.

It is useful to know that if your drinking fits even one of these criteria, and you have tried to cut down and failed, then it is likely that you must stop drinking. One reason for this is that you may be suffering damage to the brain, which, as well as impairing your memory, your coordination, and your abstract thinking abilities, also impairs your impulse control, so your ability to control your impulse to drink diminishes the more that you drink. This is not fully irreversible, so stopping and knowing that you cannot drink again will at least allow your brain to heal somewhat.


The half life of a substance is also important. It takes one hour for a standard drink to be eliminated by the body and so two bottles of wine (14 standard drinks) would find you still affected by alcohol the next morning (and risk incurring a drink driving charge).


This elimination time is particularly important with a substance like cannabis, which has a half life of seven days, which means half of the THC is eliminated in one week, and then half of the remainder is eliminated in the next week and so on. This shows that even one joint a week would result in increasing THC levels in the body. Daily use of one joint would indicate dependent use. A good measure of your dependence levels is to stop for more than three days. Typically, if you are dependent, the withdrawal symptoms of mild anxiety, agitation, sleeplessness, sweats, stomach pain, will have you searching for the smallest roach in the back of the couch. You need to keep in mind that this will be gone in 14 days at the most, and it is worth the uncomfortable process of withdrawal to experience life without your mind being clouded by and somewhat immobilised by cannabis.


People's reasons for smoking cannabis are often to enable sleep, or to manage negative emotions, or to be more creative, to enhance activities. Cannabis is the great deluder. There is little evidence that any performance is actually enhanced. The reality is that generally it is the drug that makes you think it is better. Often cannabis will give you what seem to be great ideas and elaborate plans are made, but they are not realised. Cannabis can rob us of our futures. Many people who seem to be functioning say in their late twenties that they have lost ten years. Nothing in their lives is different - no partner, same job, no assets.


You certainly may laugh more readily and socialise more easily on cannabis, but in the long term, most users become quite isolated. It does help one to manage negative emotions, but not to deal with the cause of them. Consequently irreconcilable differences and relationship breakdown are common, along with negative consequences such as unmanageable debt. It makes it possible hurt other people without having to feel the remorse that you would normally feel. Cannabis has a similar effect on sleep as alcohol, so getting to sleep is easy, but REM sleep is compromised and a dreaming debt occurs which is regained in withdrawal.


If you would like to know more, see my next article about the different causes of addiction and the way I treat addiction, or make an appointment with a health professional to talk about your habits.