Are All Addictions the Same?

No. In fact, I’d guess they’re all different. Meaning, being addicted to a particular substance (say, alcohol), has different feelings, sensations, consequences, treatment, and prognosis than addiction to a different substance (say, tobacco/nicotine). In my life, I’ve been addicted to two substances. Those two substances. And I’ve quit them both. I’ve written about both, I’m comfortable with my “expertise” on discussing cessation techniques and treatments for both.

But that doesn’t mean I know much about quitting, say, heroin. I suspect I know a bit more than someone who’s never been addicted to anything. I know I can talk about it from a place of empathy and shared experience, because I have. I know I can help people with addictions to substances other than alcohol, because I have. But that deep-in-the-bones feeling? I don’t know much about it. The best way to deal with cravings? I don’t know.

Especially for the initial detoxification period (this has nothing to do with the new-agey bullshit “detox” regimens that are so popular these days but actually do nothing at all), it is important to consult physicians, when giving up alcohol or many other substances. If you drink like I drank, sudden cessation of alcohol can be lethal. Sudden cessation of nicotine will just make you feel awful but do you no physical harm. And I don’t have any idea what sudden cessation from heroin or alprazolam will do. Talk to a doctor who specializes in addiction.

But beyond the physical effects, I have good evidence that the actions and program of recovery for pretty much any mood-altering substance is pretty similar. Once an addict is beyond the acute detoxification stage of relinquishing an addictive substance, that is when the work begins, and that is when we have to disengage from a purely medical treatment.

Medicine cannot cure us. Doctors and psychologists love to think they can, but they are wrong. Often arrogantly so. But that’s not their fault. They’re just ignorant, with no way to learn what we in recovery know. That recovery, long term sobriety, must be a program of personal responsibility. That relying on doctors or mental health professionals to manage us is a recipe for failure. Physicians have an important role to play in recovery, but it is not a lifelong one. Nor is it a curative one.

The hard work of recovery is personal, and shared among addicts. It means looking at why, once sober, we choose to return to our drugs of choice. The deep, “spiritual” work of of changing ourselves internally, so that we become people who do not treat spiritual and emotional angst with anesthesia. So that we learn the courage to face life on life’s terms.

So no, addictions are not all the same. Cravings are not all the same. Detox is not all the same. I may have less to contribute to discussions of people who are addicted to things I’ve never tried. But that deep part of our souls that’s broken? That we need to repair to become people who can live in the world? That’s similar to all of us. And I know how to face that. And I know how to fix that.