Tim was a young adult in the England of the 1980s. He was, along with almost everyone else from his council estate just outside of London, unemployed and broke. He clearly had no future and he needed an escape. Like most of his social group, he sought it in drugs. They tried all sorts, but Tim ended up a heroin addict and eventually died from either an accidental overdose or suicide (his friends were never sure), after contracting hepatitis C along the way.
Claire grew up in almost identical circumstances and tried heroin, too. Like so many in her social group, of which Tim was a part, she used. But she used less often than the others. She kicked the habit more easily than some of her friends when she was ready, went on to become a nurse, and lived to tell the tale.
Petra, who told me this story, wandered into this world of despair from a different set of circumstances, a more affluent background free from the abuse the other two had suffered; Tim's parents were violent alcoholics, and Claire was sexually abused by her father. Petra was Tim's girlfriend before he became addicted, and though drugs were all around her and she experimented with lighter ones like weed and shrooms, she never became addicted to anything she tried and never went on to experiment with heavier drugs at all. What's more, though she says she smoked for 20 years, she actually found nicotine quite easy to kick in the end.
The path to addiction: How people become substance addicts
Addictions do develop in stages. Here's the "reserve 12-step program" that leads there, which actually has five steps:
- Experimentation. You won't get hooked — physically or psychologically — on a substance you've never tried, so every addiction starts with that first time, and then those first few times. In some cases, the whole process will end here. Certainly, many people are able to use substances to which others become addicted, like alcohol or marijuana, recreationally without ever developing an addiction. But those who do become addicted often start the same way as those who don't. Most often, this stage begins voluntarily. In the case of substances well-known to be highly addictive, the future addict may convince themselves this won't happen to them. But they aren't so unique, and...
- The person begins using more often. This could happen in a number of ways. Those first, horrible, few cigarettes smoked behind your school's utility shed with your friends turn into cigarettes smoked at home when nobody's watching. That coke you used recreationally at a few parties becomes a crutch you rely on more and more often to feel the same way again. The alcohol you were previously able to enjoy once in a while morphs into a dangerous form of self-medication.
- The substance starts taking over your life, and your use becomes increasingly risky. You may no longer be able to perform well at work or school, can't think of anything else when the substance isn't around, and go to great lengths to obtain it — and, frequently, more and more of it. You start losing control.
- Dependence is the fourth stage. You kind of know there's a problem and may wish the substance wasn't in your life, but you keep coming back to it.
- Addiction is the final stage. Using the substance has changed your brain wiring in such a way that you now depend on it, and if you try to quit, you'll find that this is an incredibly hard task. Some addictions are solely psychological, while others are physical, as well. Many addicts do attempt to stop, and actually quit for a while, but come back to their substance with full force.
Why do some people become addicted, while others don't?
Petra, who experimented with magic mushrooms and weed and smoked cigarettes for a few decades, told me that the difference between her and her two friends — one of whom died from heroin-related causes and one of whom kicked her addiction — is that she doesn't have an "addictive personality". Is this a thing?
Addiction isn't, however, simply caused by a lack of will power or some kind of personality flaw. Addiction is a chronic and often progressive illness much like, I don't know, chronic obstructive pulmonary disease, multiple sclerosis, or major depressive disorder, in which there may be periods of remission and relapse. Addiction alters the brain's pleasure and reward system so the person is shackled to the substance they're addicted to and feels highly anxious when they aren't using. Nobody is immune.
Slogans like "meth — not even once" make a lot of sense. Not getting started with a substance means you'll not become addicted to that substance. But not all substances people become addicted to have an almost universally bad reputation. Alcohol is socially-acceptable in many places, weed is becoming more so, and smoking cigarettes very much used to be and still is in some areas. Very few people would advocate that no person should ever try alcohol, but while many people use alcohol responsibly, that addictive potential is there. Using a substance can create that notorious "addictive personality" through altered brain wiring.
Petra could have become addicted to heroin like her friends. But Petra saw first-hand what addiction could do to a person. She describes "people leaving their kids, robbing their relatives... it was yuck". This kind of education can help prevent addiction, and though addiction can be treated and overcome once it has started, the easiest way to stop it is before it ever begins.