If you are struggling with addiction, you probably did not intend for it to happen. People who begin using moodaltering substances usually have a number of reasons for doing so.

Most of the patients that I have treated tell me that they first used an addictive substance in their midteens.

They typically report that they began drinking beer with friends on weekends at about the age of fifteen or sixteen. But, after a while, things would change. Future “social drinkers” find the effect of the beer mildly interesting, but not worth the effort if it makes them sick or gets them into trouble.

But the future alcoholic or addict often reacts to the first use of a mood-altering drug with a sense of having finally found a way to feel “normal.” We now know that there are probably genetic differences in the brains of alcoholics and addicts that cause them to have this exaggerated reaction.

When I was in medical school, a professor once suggested that a way to determine whether a patient was likely to be alcoholic was to see whether the person could remember his or her first drink. I have routinely asked this when taking histories, and I find that in many cases they can. Alcoholics and addicts (who often start with alcohol) are likely to remember their first drink as a distinctly pleasurable experience.

“I finally felt like I could fit in and socialize” is a statement I hear frequently. People say that the first time they used marijuana they were able to feel relief from chronic anxiety or that the first time they used stimulants they got relief from chronic depression.

Naturally such a positive experience will probably be repeated. If you find that drinking or using drugs helps you to solve a problem such as shyness, anxiety, or depression, then it is likely that you will start to look for opportunities to obtain and use alcohol and drugs. It is this initial effect that provides the motivation for the continuing use of a substance.

People who work with alcohol and drug abuse prevention try to influence young people not to begin experimenting with drugs for just this reason. They feel that focusing later efforts at the treatment stage is like closing the barn door after the horse gets out. We do know that there are many people who come from families with a strong history of addiction who decide never to try alcohol or drugs. Those people manage eventually to work out their emotional problems, finding other ways of coping besides using a mood-altering drug. But once a vulnerable person has used alcohol or another moodaltering drug, a powerful learning effect takes place, especially if the person is young and not yet mature.

Elizabeth Connell Henderson, M.D.

 

Glossary

Appendix A: Regulation of Addictive Substances

Appendix B: Sources of Additional Information