Why People Stay Stuck in Addiction

Helping a loved one begins by understanding the barriers to wellness.

Shame is one of the primary barriers preventing recovery. Bricolage/Shutterstock

My friend Tom called recently to share the news that his 36-year-old son, Adam, had died of vital organ failure due to a decade-long battle with alcoholism.

“I can’t count the times I told Adam to just stop drinking,” Tom said through tears. “I pleaded with him often, ‘Find the strength to overcome or it’s going to catch up with you in the worst way.'”

And tragically, it did.

As a mental health specialist for the past 35 years, I have heard painful experiences like this many times over. The details may be different, but the heartbreak is almost always the same.

Anyone who has suffered the anguish of watching someone they love succumb to an addiction will agree that it feels like being trapped in a disorienting and daunting carnival hall of mirrors. Once you step inside, your footing feels treacherous, the way forward is confusing, and the way out begins to feel impossible to find. Every turn only leads deeper into a maze of dead ends and trap doors.

Trying to know how to best help an addicted loved one can feel like a lonely, isolating pursuit—like you’re in the struggle all by yourself. But the fact is, millions of Americans are currently or have been in the same situation, concerned about the addiction of someone close to them.

Specifically, nearly half (46 percent) of U.S. adults have a family member or close friend who has been addicted to drugs. And that figure doesn’t account for other types of addictions that don’t involve substances. So the “addicted loved one” saga is likely experienced in some form by a majority of Americans.

These findings come from a Pew Research Center study that found that this issue cuts across gender, race, age, education level, and even partisan lines—meaning that almost no one is immune to having a family member or close friend who struggles with addiction.

Many times, friends and family members of someone battling addiction struggle to understand why the person can’t “just stop” or “find the strength to overcome,” as my friend Tom said. They might believe the problem could be overcome if the person tried harder, had more self-control, committed to abstinence, or prayed more fervently.

It’s true that tenacity, fortitude, and faith are essential for the individual seeking to overcome dependence on a substance or destructive behavior. Still, addiction is a deeply rooted problem with strong emotional undercurrents that keep many people stuck in their chronic compulsion.

With the goal of helping our struggling loved ones pursue wellness and sobriety, let’s look at common reasons why people stay stuck in addiction:

Altered physiology and brain chemistry. Addictions of all kinds affect the brain’s production of neurotransmitters, such as dopamine, which is released in what has been called the brain’s pleasure center, the nucleus accumbens. Medical experts describe the process this way:

Generally speaking, when you experience a positive sensation and dopamine is released into the pathways of the reward center, your brain takes note of the following:

• What triggered the sensation: Was it a substance? A behavior? A type of food?
• Any cues from your environment that can help you find it again: Did you experience it at night? What else were you doing? Were you with a certain person?
• When you’re exposed to those environmental cues, you’ll begin to feel the same drive to seek out that same pleasure. This drive can be incredibly powerful, creating an urge that’s hard to control.

Since 1991, a technology called functional magnetic resonance imaging has allowed medical and mental health professionals to more fully understand this process—by creating a three-dimensional “map” of minute physiological changes in the brain. In short, addiction alters brain chemistry that strongly compels the user to seek more and more of the substance or behavior to achieve the desired “high.”

Denial

Addiction is fueled by the steadfast refusal to accept that something is true. Denial is a state in which a person disavows or distorts what’s really happening. He might ignore the problem, shrug off people’s concerns, or blame others for any issues. In terms of addiction, denial is a powerful coping mechanism to delay facing the truth and therefore delay taking helpful action.

There’s a reason participants at an Alcoholics Anonymous (AA) meeting begin with “Hello, my name is ... and I’m an alcoholic.” Acknowledging such a truth publicly catapults the person over the barrier of denial. Once you’ve accepted that addiction is part of your life, you can use that truth to dictate what part the addiction will play in your life going forward.

Fear of Failure

To admit an addiction is to admit powerlessness, as reflected in step 1 of AA’s 12-step recovery program. In our culture, we’re taught to be self-sufficient and to assert our independence and autonomy in all kinds of situations. Whatever the circumstances, we strive to become masters of our fates and captains of our souls.

So imagine the sense of failure when an addiction becomes both captain and master, making a person a “servant and slave” to his cravings. Acknowledging that addiction has made life “unmanageable” is to also acknowledge that willpower, attempts at self-control, and having more faith in God won’t cure the disease of dependency. Almost universally, a true acknowledgment of addiction is quickly followed by a crushing sense of personal failure, whether initially expressed or not.

Anticipating Judgment and Rejection

Admitting an addiction can be extremely difficult because of the terrifying possibility of rejection by others. Admitting addiction to others can seem like walking over hot coals—a prolonged journey of excruciating pain as the person anticipates harsh, judgmental, or disgusted reactions. The addiction will argue that telling the truth is sure to cause any remaining relationship foundation to cave in and crumble.

At the root of the fear of rejection is the question, “Will you still love and accept me?” In some cases, the answer has been no. Because people have the free will to reject that relationship, “no” is an ever-present possibility. However, rejection happens much less frequently than addiction’s apocalyptic prophecies to the contrary.

Need for Secrecy

Addicts are highly skilled at finding ways to hide because addiction thrives in secrecy. Addicts think being exposed is harmful, so they act in secret.

A phrase used often in AA is, “You’re only as sick as your secrets.” That means a secret kept in the dark grows and becomes more entrenched and damaging. But once it’s brought into the light or released, it loses its power. Secrets foster negativity and self-loathing, keeping a person sick and trapped in addiction. That’s why the need to be honest is essential for addiction recovery.

A Sense of Shame

The renowned psychologist Carl Jung once said, “Shame is a soul-eating emotion.” I agree, and I have found that shame is one of the driving forces behind addiction and one of the primary barriers that prevents recovery.

Addiction takes a toll on a person’s sense of self. It causes one to think, believe, and act in ways that cause humiliation, regret, and self-condemnation. There can be deep shame in admitting that you aren’t in control, and addiction is.

Shame is an isolating, debilitating emotion that causes deep-seated feelings of self-doubt and unworthiness. For those in active addiction, shame isn’t just an occasional occurrence; it’s something experienced almost continually.

Let’s end on a positive note, because there’s always reason for hope. Many people struggling with addiction do find the courage to address the problem and seek professional help. And many go on to live a life of healthy, joyful sobriety, almost always aided by the support of caring loved ones.

Because of the complexity of this issue, I encourage you to see my book, “When a Loved One Is Addicted.”

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Telltale Signs of Addiction

According to the American Society of Addiction Medicine (ASAM), addiction is characterized by the following:

• Inability to consistently abstain. Even when the person knows they should say no, they keep saying yes.
• Impairment in behavioral control. The addiction takes over what the person says and does, causing pronounced changes to personality and behavior.
• Craving. Having is never enough; instead, the person is left constantly wanting more.
• Diminished recognition of significant problems with one’s behaviors and interpersonal relationships. The struggling person loses the ability to see how the addiction is ruining his life and relationships.
• A dysfunctional emotional response. Your emotions aren’t in line with what is really happening, and you are unable to figure out what the proper responses should be.

ASAM goes on to say, “Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”

Addiction doesn’t go away on its own; it doesn’t get better, it gets worse. Pretending addiction doesn’t exist ensures it does.