A New Understanding
It's time for a new understanding of cocaine addiction.
As an addiction professional and an ex-addict, I struggle with the ‘experts' view of cocaine addiction. I don't believe cocaine addiction is an incurable disease, or even ultimately a real medical problem at all. And I certainly don’t believe that cocaine addiction has anything to do with lack of will power or personal weakness. On the contrary most of my clients are highly successful, determined and dynamic people.
Yes of course cocaine addiction is partly about escaping emotional pain, unhappiness, loneliness, or boredom, we all want to be at peace with ourselves, but it is also about wanting to get high. This is what the experts miss. My clients do cocaine because they want to get high plain and simple. They are full on and highly driven people, they are chasing, always looking for the next high, whether that is in their work, their relationships, their social life, or through drink and drugs, they are always chasing. This in its self isn’t a problem, it is often the very reason for their success. The problem is they way they go about it……
So what is cocaine addiction then?
Cocaine addiction is an addiction of the mind. You may have noticed that when cocaine is not on your mind you have no desire to use. It’s common for addicts to go on holiday for two weeks and it never enters their heads, yet the moment they get home the cocaine thoughts start again and they are back on it.
Cocaine stimulates the reward pathways in the brain and after a while anything that your mind associates with cocaine - people, places, pub toilets, CD covers, cash machines, £50 notes, alcohol etc will trigger a craving. You will usually experience a craving as compulsive thoughts about using cocaine. Once the craving is triggered, no matter how hard you fight the thoughts they will always carry you off to score. Although it’s sensible to avoid triggers if you can, it’s not possible to avoid them all, not all triggers are external, some are internal. Mood states can be very powerful triggers – boredom, frustration, stress and even excitement can produce very strong impulses to use. You may be able to avoid the pub but you can’t say you will never be bored or frustrated again. Shutting yourself away in rehab will only help while you are there, after your release, sooner or later you will be exposed to a trigger and ultimately you will need to learn how to manage your response to that trigger differently. And that is what I want to teach you to do.
In practice learning how to deal with a craving is pretty straight forward and most people pick this up easily, but unfortunately there is much more to beating cocaine addiction than learning to “surf a craving”. When you stand back and see what is going on you will see that you have been doing cocaine for a reason, or more accurately for two reasons and unless we address these reasons you will either relapse or swap your cocaine problem for another addiction. This is how I messed my liver up!
What are the reasons behind addiction?
Cocaine Addiction is partly an attempt to escape uncomfortable feelings. Everyone wants to move away from uncomfortable feelings and to get the “highs” in life. It is not an illness; it is a natural normal human drive, but with addicts this drive becomes exaggerated and misdirected.
Here’s how it works… We discover early in our lives that we can chemically alter our mood. It usually starts with alcohol. I discovered at the age of 13 or 14, that if I had a drink it took away my anxiety, I felt more confident and I could talk to girls, I used to get so drunk that they didn’t want to talk to me, but a pattern was put in place and from that point I used drink, and later cocaine and any other mind altering substance to change my state of mind and change how I felt feel inside. It doesn’t have to be severe pain we are escaping, even slight emotion discomfort, boredom, frustration or simply restlessness is easily avoided chemically. It makes us feel better, feel good, it gets us high and it takes us away from the space we are in. We like it and after all who wouldn't, so as you would expect, we do it again and again and for a while it works and over time we come to rely on it to make us feel better. We aren’t alone in doing this, it is really common and even people who would never acknowledge having drink or drug problems tell me that they just have drink after work to relax, they chemically alter their mood. You aren’t to blame for this, it was how you were taught to deal with feelings. If you went to a doctor and said “doctor I feel awful”, he would give you some drugs, even doctors think like addicts!
But as you are discovering this is only a short term solution, eventually the cocaine that made us feel so good starts to cause the problems we are trying to escape. There are the come downs, problems at work, the expense, the damaged relationships, the broken promises, the health problems, depression and paranoia. Need I go on? But the only way we know how to deal with it all is to use more, or to move on to another addictive behaviour. All our attempts to feel better end up making us feel worse, which in turn makes us do more. It’s a crazy cycle which seems impossible to escape. The harder we try the deeper we get. You can't live with it but how the hell do you deal with yourself without it?
But there is also another side to cocaine addiction and I think the choice of drug is really interesting. Why cocaine? If this was all about shutting down pain, there are much better drugs for that – alcohol, heroin, tranquilisers. Cocaine is about something else as well and I’ve already touched on this. Cocaine addicts are chasing a high. Cocaine is all about chasing, that’s the whole point, in fact after a while you never get there, it all about the chase! This drive, this restlessness is part of who you are, it is an integral part of your personality and even if you can leave the cocaine alone for a bit and fight that urge to get high, ultimately you have to live with what is going on in your head and also deal with the awful emptiness of not using. Can you really face the prospect of never getting high again? It’s a powerful drive.
For me recovery is not about fighting the need to move away from pain or suppressing that chasing drive, it's about learning how to manage it effectively, how to work with it and channel it in a way that allows you to be at peace with yourself and to live well in the world rather than letting it destroy you.
So what is wrong with traditional treatment?
Residential Treatment Centres are expensive and rarely work, the recovery rates for cocaine addiction are shocking. Most of them are geared towards alcohol and opiates and are mostly concerned with detox, which is completely unnecessary for cocaine addiction. Doctors are completely lost when it comes to cocaine addiction. There isn’t a drug they can prescribe as a substitute and using chemicals to manage feelings is a seriously bad idea long term anyway, after all that’s partly what got you in the mess in the first place. And besides how many of us can afford the luxury of leaving home and going missing from work for six weeks in rehab?
Nearly all treatment centres follow a 12 step approach, and a lot of people, me included, have difficulty swallowing their philosophy. They require you admit to having an "incurable disease" that you must always fight day in day out. You need to submit to a higher power and attend meetings for the rest of your life. This doesn’t sit comfortably with most people and it usually results in a never ending round of relapse. Don’t get me wrong, some 12 step counsellors are highly skilled and healing individuals and the meetings can be a great support. I’m not knocking the good work they do, but lets be honest, CA meetings are full of people who relapse week in week out and it is not a solution for many people.
Your local community drugs team isn’t an appealing option either, I used to work for one and that was bad enough, but the experience for clients can be really grim. You’ll find yourself queuing up for drug tests with your little cup of urine along with street addicts desperate for their next dose of methadone. And when you get to the front of the line the odds of recovery aren’t good either. In 2007 for example, the National Treatment Agency spent an additional £131m of tax payers’ money, which was very generous of you, but they only helped 70 extra people get clean – that’s a cost of £1.85m each!
You could always try counselling and analyse all of your issues, but that tends to bring up the very feelings that we use to escape. You could end up with a very good understanding of your neuroses, but a raging habit to go with it. You don’t need a clever understanding of your problem, or a detailed examination of your relationship with your mother. What you need is a solution.
So what’s the solution?
Well it’s obvious really. You are using cocaine to deal with feelings and to experience highs and this drive is natural and normal. The solution therefore is to learn a better way to do this, a better way to do what you have been trying to do. You need to learn a new way to change your state of mind, to deal effectively with your painful feelings and find a way to get high, to get a real buzz from life without chemical assistance. And that is what my work is about.
