Oftentimes when I am speaking to a group of people I ask, “How many people here know someone who struggles with addiction?” Then I ask, “How many people have known someone who has died from an accidental overdose?” The responses are alarming. While there may have been three or four people in a room raising their hands as recently as ten years ago, the fact that so many people raise their hands to that question reveals the unfortunate reality that addiction is very common today. People are dying every single day due to addiction and relapse.
Recently a patient came into my office and asked a load of questions: “Dr. De Carvalho, what is addiction? Why do I have this addiction? Where does it come from? Why am I dealing with it?” It’s likely that you or someone you know has asked these kinds of questions. Before I can provide answers for questions like these—whether for a patient, for someone at my church, or for you—I start where addiction begins.
Does addiction begin with the individual, for example, who has thousands of images of pornography on their home hard drive? Believe it or not, young people, both guys and girls, encounter internet pornography as early as nine years old.[i] These encounters at young ages are often by accident as the nine-year-old is “surfing the net,” playing games, or doing homework. I’m often asked, “Dr. D, how do I prevent this from happening to my kids?” My answer? I tell people that while you put up various boundaries, which is good to do, at the end of the day, you may not be able to prevent it. The question most of us will face is this: “When this happens, what will you do?”
The child at nine may continue to look at porn throughout their adolescent years undetected. Why? Everybody else in school is doing it, and it’s not even a taboo subject for their peers. The young child becomes an adolescent, then a young adult—all the while, porn might be their “go to” fix for emotional difficulties. When a stressful event hits them, as will always happen in life, the now grown woman or man immediately turns to pornography. It’s how they’ve programmed their body and brain to handle stress.
Where does addiction, by way of another example, begin for an individual who comes across cigarettes? The nicotine helps to dampen their anxiety on a day-to-day basis. They go from a few cigarettes a day to a pack a day, to two packs, or more. Years pass, and what began as a few cigarettes turns into a malignancy in their lung with inevitable chemotherapy treatments to follow. They keep smoking, though—struggling with the habit all the while—because they can’t deal with anxiety. They never learned how to get unstuck.
Or, as another example, does addiction begin with the woman who finishes work and cannot wait to get home to just have a glass of wine? The day has been long and stressful, her kids are demanding, and she knows that a glass of wine will relax her. This slight intoxication allows her as a professional businesswoman to forget about tomorrow’s work. It enables her as a mom to disconnect from the noisy kids in the background. The problem is this: what was one glass soon becomes two glasses, then three, and then a bottle or a bottle and half of wine. Suddenly, it’s easy to slip up and she drinks and drives, which leaves her facing incarceration due to multiple DUIs.
Could addiction begin with the young teen who goes to his dentist to get his wisdom teeth taken out and then gets addicted to Percocet? Dentists are traditionally known to be the number one prescriber of opiates. The dentist gives the patient some Percocet because he’s going to experience pain associated with oral surgery. Little does the dentist know, the adolescent is dealing with social anxiety in school, and he begins taking Percocet for his emotional pain. It allows him to feel normal. Now he can go to school, navigate through the halls, and talk to people. He even feels confident for the first time. He’s hooked. Through the remainder of high school he buys pain pills from friends to keep feeling “normal.” Eventually, he gets into University, goes out to party, and a friend of his gives him a Percocet—but this time it’s laced with Fentanyl, which is a hundred times more powerful than Percocet.
His mom finds him dead the next morning.
Could addiction begin with the individual who can’t go to bed at night, so they eat food to cope? Racing thoughts fill their mind—uncertain thoughts about tomorrow, about taxes, about their job—but they’ve learned that by binging on food, they can sleep. They end up overweight, unhappy, and sick.
How about the individual who enjoys playing Texas Hold ‘Em online? An innocent game. He thinks, Hey, everybody plays it, so it’s not a problem for me! But he has learned to escape his pain through gaming. His anxiety and feelings of uncertainty give way to his living in a fantasy world of online gambling games. Inevitably, his wife will go to answer the ringing doorbell one night only to see that the bank is repossessing both of their cars because her husband has gambled away all their money.
Then, there’s a classic example of the person who “games” all night. I know what you’re thinking: kids with gaming addictions. Don’t be mistaken, though; this is more common than you might realize among adults. The man who comes home and can’t deal with the stresses of his wife and his family walks into a room, puts on a headset, and plays video games all night instead of dealing with real-life issues. Addiction has entered his home.
The Centers for Disease Control and Prevention (CDC) labeled the opioid crisis an epidemic with ninety thousand people dying last year.[ii] This statistic has doubled every year since 2014. In 2018, 175 Americans die every day.[iii] Even now as I write this, the numbers are going up. People die every day from accidental overdose of pain pills. Addiction is such a critical issue today that our President recently declared the “opioid crisis a public health emergency.”[iv]
(Excerpted from Marcus De Carvalho, Untangling Addiction, 2018.)
[i]“Talking to Your 8-12 Year Old About Pornography,” iParent, accessed September 28, 2018, https://www.esafety.gov.au/education-resources/iparent/onlinerisks/online-pornography/talking-to-your-8-to-12-yearold-about-pornography.
[ii]“Overview of the Drug Overdose Epidemic: Behind the Numbers,” Centers for Disease Control and Prevention, accessed July 18, 2017, https://www.cdc.gov/drugoverdose/data/.
[iii]Jerry Mitchell, “With 175 Americans dying a day, what are the solutions to the opioid epidemic?” USA Today, January 29, 2018, https://www.usatoday.com/story/news/nation-now/2018/01/29/175-americans-dyingday-what-solutions-opioid-epidemic/1074336001/.
[iv]Greg Allen and Amita Kelly, “Trump Administration Declares Opioid Crisis A Public Health Emergency,” Nashville Public Radio, October 26, 2017, https://www.npr.org/2017/10/26/560083795/presidenttrump-may-declare-opioid-epidemic-nationalemergency.
