Is All Drug Use Created Equal?

By Concentric Counselor Myron Nelson, LCPC    Edited by Concentric Counselor Jennifer Larson, LCPC, NCC

All drug use is not created equal.  Take a look at that statement again and see if it contradicts or confirms your views on substance use.  I hope by the end of this post you feel it does both.  As a country, we are simultaneously experiencing an opioid heroin epidemic and progression in the legalization of marijuana. Clearly, drug use is not so black and white.  I aim to gray the edges and disrupt some of your beliefs because critical thinking is needed in these cacophonous times.  

We often tell kids to beware the slippery slope of drugs.  As if smoking marijuana is a banana peel slide away from cocaine or criminal behavior.  Not only does that argument neglect to account for alcohol (being many adolescents first introduction into mind-altering substances), but it also purports that all drug use is inherently related or equal.  To say that one drug can lead to the use of another may be true, but that is because things kept hidden away in the dark tend to be hidden together.  Research debating the effects of the slippery slope can teeter in either side's favor but both sides would agree that every individual person's path does not neatly align one way or the other.  That point should not be ignored.  

If you are concerned about someone's drug use, talk with him or her about it.  There may be underlying mental illness issues or some form of trauma that is being treated by the effects of substances.  Many will turn to substances to self-medicate symptoms of mental illness, neglect or trauma.  Additionally, experimenting with drug use can be a normative behavior for certain subgroups.  That does not mean it is safe or healthy, but it also does not mean its intent is malicious.

When you talk with someone about their behavior, be sure to not talk at them.  Be mindful that attacking or judging their behavior typically is not going to lead to a productive conversation.  Come to them seeking to fully understand them and what is going on.  Coming down with an iron first also spreads the message that substance use is only dangerous.  To pretend that substances or drugs do not produce a euphoric or calming effect creates misconceptions.  

If I were to cite research and share stories about the detriments of TV and forbade you from ever watching it, what might happen if you finally caught a glimpse of some TV show?  You might find it enjoyable and then seek out other people who like to watch it too.  You may then find yourself containing this information for fear of being criticized by others.  So it becomes one of your secrets.  Likewise, what if all you heard about alcohol was that it causes hangovers?  

If you inform people about the benefits and consequences of substance use then they can start to formulate the foundation of decision-making and choices.  If you think it is too dangerous to expose them to that knowledge, you may need to think again.  You cannot stop it as images and scenarios of people enjoying being high on some kind of substance are constant in the media.  Plus, putting up walls of censorship in the Internet era can be futile with certain people.  You do not have to fight a battle against people discovering drugs can have positive effects; you can incorporate that as part of your conversations.  Conversations with a 's' -- it is plural for a reason.  No topic as big as substance use is going to be covered in one sit down.

Given what I've written so far you may imagine that I am an advocate in a way that I am not.  When it comes to most substances and drugs, I take a firm stance that substance dependence is unsafe with detrimental consequences.  I do not think someone's only way to relax after a long day at work should be to drink a beer and I do not think someone who is constantly depressed should seek to escape with substances, such as ecstasy.  How someone is using should be discussed as well as what they are using.  Certain drugs are more associated with images of horror or suffering, sometimes rightfully so, but do not let the name fool you.  

This blog post is one part informative, two parts inquiry.  It is a questioning of the commonplace idea that we have to draw deep lines in the sand about what drugs are not okay and when.  We would all benefit from looking at all use in more detail.  Parting words -- Experimentation is not addiction. Information is not dangerous (taking into account age and other factors).  Open up the conversation and have many of them.  Seek professional help if you believe you or a loved one struggles with substance abuse or dependence.

Response to Johann Tari's TED Talk: What's Really Wrong Here

By Concentric Counselor Jennifer Larson, LCPC, NCC

Admittedly I do not carve enough time to watch or listen to TED talks.  One of my clients referenced how she will listen to them particularly when she’s cooking dinner.  My dinner routine typically entails listening to music in the background, catching glimpses of my son playing a game or doing his homework, or practicing mindfulness to be present when making dinner in effort to de-clutter my head space and take a reprieve from the perpetual tasks of multi-tasking. 

Listening to a TED talk while cooking dinner never dawned on me, and I liked the idea.  So, this past Monday I popped onto TED and scanned the topics.  Everything you think you know about addiction is wrong immediately piqued my interest. 

It jumped out, well because various forms of addiction is all so familiar to me due to my childhood upbringing and how addiction permeated the fabric of my family’s life as well as I am a psychotherapist who helps people to heal and work through their own addictions.  Plus, I was so curious to listen given the title was loaded with terms such as “EVERYTHING you think you know” and “about addiction is WRONG” that I wondered if this somehow applied to my personal experiences and professional knowledge of addictions.  We cannot possible know everything, and I became curious to know if there is information that breaks through the past and current trends about addictions. 

In his TED talk, Johann Tari, a British journalist, speaks about his own relationship to his family members who struggle with addiction, specifically substances.  His thirst for wanting to have a better understanding of what contributes or causes addiction drove him to find the answers.  His journey covers speaking with various people from all walks of life, spanning different cultures.

As I listen to his voyage, I am struck by his journey as he spoke with a street user and a Vancouver Professor of Psychology who conducted experiments with rats in isolation and within a community of rats called “Rat Park” to referencing the Vietnam War and Portuguese approach to decriminalizing drugs. 

In the end, Johann Tari argues it is a lack of human connections that contribute to and maintain addictions.  Conversely, deeper, human individual and societal connections can allay (or treat if you will) addictions. 

While I most certainly agree of the importance of human connections being vital to our biosocial-cognitive-psychological development, overall well-being, and yes, people who suffer from addictions, I have also come to recognize understanding the causes of and treating addictions is far more complex that just forming individual and societal human bonds.  Also, I would like to add we know earlier childhood attachment and social connections play a significant role when understanding addiction, so everything we know about addiction is wrong isn’t entirely accurate. 

Let’s face it, humans and addictions are complex.  We do not know everything there is to understand about the various forms of addictions spanning different social environments and cultures, but we do know quite a bit, and understanding the etiology and treatment of addiction goes beyond just forming human connections.    

Without going into nitty-gritty details, there are many models of addiction.  A few to highlight are the disease model of addiction which looks at the biology, neurobiology, and genetics of an individual as well as his or her social environment.  Some understand addiction by assessing a person’s earlier childhood and developmental attachment with their caregivers, the inherent chemical properties or pharmacology of a substance, and social evolution of groups of people over time (e.g. socio-economic status).  The public health model informs us to look at addiction by understanding the person and his or her vulnerability, the substance and its inherent properties, the vector (who brings the substance in and its incentives), and the social environment that allows and supports the use of substance.  And, the bio-psych-social-spiritual (BPSS) model takes into account the interconnections and interplay of the biology, psychology, social, and spiritual aspects of a person. 

What about process addictions where there is no substance or drug, and subsequently no inherent properties to even consider?  Process addictions are an addiction to an activity or person, such as gambling, spending, Internet, or co-dependency.  And, I have not even touched up treatment and recovery of addiction models which by the way vary depending on who you talk to, the substance or process, the various recovery approaches including 12-step models, and what best fits the individual person within his or her family and community systems. 

So, what started off as a little diversion from my usual dinner preparation routine has prompted me to inform others that we do know a thing or two about addiction and it’s more than just forming human connections.  Some of us may know inherently or through acumen that individual, family, and community connections are necessary and important for our survival, evolution, success, and even recovery, but please know understanding the causes and treatment of addiction go beyond human connections.  Now, that is something we do know.