By Keith Angelin, MBA, CADC-II, CNDAI

In 1956, the American Medical Association recognized alcoholism as a physiological disease. Chemical dependency is considered a disease much like schizophrenia and diabetes are. Accepting this concept is key to understanding the insanity behind drug and alcohol abuse. Why? Because being stricken with a disease takes away completely the ability to choose.

No one chooses to have cancer. Nor do they choose which symptoms of the disease they will manifest. Likewise chemically dependent people often don’t want to use alcohol and drugs. Instead they are compelled, even in the face of catastrophic consequences. It’s not unheard of for someone to leave the hospital after a near death experience only to buy liquor on the way home. Does that sound like free will?

Before today you may have labored under the misconception that drunks and burners simply lacked the willpower to change. You may have thought that while some people possess the strength, guts, courage, fortitude, character, self-control and common sense to drink or use drugs responsibly, others were born disadvantaged, weak, hopeless or losers. Worse, you openly blamed them for lacking the ability to “stop and be normal.” This is never more relevant to those in the military. Perhaps it is a shock – or a relief – for you to learn that none of these labels apply, because substance abuse has nothing to do with willpower. Addicts and alcoholics are generally terrific people with an awful disease.

What follows is intended to introduce you to the disease of chemical dependency; why it is a disease, what drives it, how to recognize it and the reason it is so deadly.

The Disease of Chemical Dependency

Have you had the bad fortune of watching someone you care about kill themselves a little every day? Or maybe it is you who suffers? If so you might be wondering; if chemical dependency is truly a disease – a disease that robs you of the ability to choose whether or not to drink or use – then what in the world is it that drives this insane behavior?

We know a lot about the disease of chemical dependency. We know it shares the same characteristics as many other diseases like cancer, hypertension and diabetes. We also know that chemical dependency attacks more than the physical body. More than the liver, kidneys and heart are in jeopardy. Why is dependence on alcohol and drugs so devastating? It is because substance abuse is a “bio/psycho/social” disease, meaning it attacks the user physically, mentally, emotionally and spiritually. It radically alters their behavior, ravages their families, and keeps them in denial by creating a wall of defense mechanisms that protect the entire sick system. For this very reason, any successful recovery program must address each of these components.

What Triggers the Disease in the First Place?

You’ve probably asked yourself this question countless times. Obviously no one suddenly becomes an addict or alcoholic. Rather, it is the result of a gradual progression of increased drinking or drug use.

Chemical dependency starts innocently enough with experimentation; perhaps pilfering a beer from the refrigerator or sneaking a joint with friends. If the experience is positive then using becomes recreational; or every so often. This leads to habituation, which is using the substance on a regular basis. Notice the person has thus far been drinking and drugging free of problems. Using has been either for the purpose of feeling good, or relieving stress, fear or some other uncomfortable emotion.

Habituation can lead to abuse, and abuse leads to consequences. For instance, the person might get caught for the first time driving drunk, or they could test dirty on a random urine analysis. Most substance abusers learn from their mistakes. They see the correlation between their drinking or drugging and the negative consequences experienced. This insight leads them to change their behavior. For them, it’s just not worth it.

But a minority of people cannot stop. Call it genetics, a brain condition, a disease, an allergy and obsession, or being spanked as a child… it doesn’t matter. Once past a certain point there is no turning back. They have lost their ability to choose. They become dependent, going on to abuse mind-altering substances pathologically, unreasonably and uncontrollably.

Symptoms of Chemical Dependency

If you suspect yourself or a buddy to be chemically dependent then there is probably good reason. There are seven well defined symptoms marking chemical dependency listed in the Diagnostic and Statistical Manual of Mental Disorders published by The American Psychiatric Association, of which a person need demonstrate at least 3:
1. Increased tolerance, resulting in the user needing more of the substance to get the same high
2. Physiological withdrawal when not using, and/or using the same substance to avoid withdrawal
3. Erratic behavior while under the influence i.e. blackouts, DUI
4. Continued use despite negative consequences to mood, self-esteem, health, job or family
5. Reducing or eliminating activities that are social, occupational or recreational
6. Spending significant time obtaining, using and recovering from use
7. Repeated unsuccessful attempts to quit or cut-down

One of the worst symptoms of chemical dependency originates in the user’s own brain. It is their utter reliance on Delusional Thinking.

Why is it, do you suppose, that such obvious symptoms as drinking and using every day throughout the day just to function, severe mood swings and multiple run-ins with the law or emergency room visits aren’t immediately recognized by the addict and alcoholic as serious warning signs? How can an addict whose physical and mental health is failing not see what he’s doing to himself?! How can an alcoholic who secrets bottles amongst the outside bushes not track with this bizarre behavior? After all, these are gigantic red flags to most “normal” people. And as time passes, the symptoms get worse and repeat themselves over and over again, yet they – or you – don’t comprehend it. The frustration for those around the user is unbearable as they desperately hold a mirror up to the addict or alcoholic hoping they will see what is clearly reflected back to them, without any luck. How do you fight something like that?!

What is a delusion anyway? A delusion is a false belief held with absolute conviction. For the chemically dependent person to maintain their disease they must lie to themselves, which is why people with this disease usually don’t seek treatment on their own. They simply aren’t aware they are chemically dependent. In other words, they don’t see an addict or an alcoholic staring back at them in the mirror. Instead they see someone who is: Tired, overworked, hurting, stressed, bored, discovering themselves, in control, the life of the party, blowing off steam, victimized, losing weight, creative, a leader, a failure, no different than anyone else, etc. They see everything but the truth, and actually believe these lies.

Intervention, written by Vern Johnson, calls this delusional state; pathological mental mismanagement, and this mismanagement is accomplished through the use of unconscious lies, called defense mechanisms. Think of each defense mechanism as a block in a wall that separates the chemically dependent person from the truth of their condition. Defense mechanisms such as rationalizing, justifying, blaming, denying, isolating, manipulating, projecting, isolating and awfulizing may be all too familiar to you.

Putting It All Together

Once a person becomes chemically dependent, their tolerance increases until something happens that is as unexpected as it is unwelcome. Every alcoholic and addict will eventually find that those substances which initially brought them pleasure or relief stop working. In fact these same substances now have quite the opposite effect! This gets to the very heart of the disease of addiction.

First, understand that when certain areas of the brain are stimulated they produce pleasurable feelings. Specifically, we’re talking about the stimulation of chemical messengers between nerve cells. Food is an example of a substance that stimulates the brain to produce these feelings. As the substance is metabolized, mood returns to normal. For most of us this is a natural process that occurs all throughout life. A cold beer is relaxing. The good feeling is short-lived, the body recovers and that’s the end.

The person who is chemically dependent continues on, using larger quantities more frequently. The effect of alcohol and other drugs alters the individual’s brain chemistry because they mimic, displace, block or deplete specific chemical messengers. We call this hijacking the brain’s reward system. The feeling is so good it reinforces the need to experience it again and again.

Eventually there will come a day of reckoning when the body cannot fully recover. Instead of the user’s mood returning to normal, it falls short; they crash. Now the need to feel better is greater than ever; they crave. The hopeless cycle of euphoria, crash and craving is the hallmark of addiction. As the disease progresses the abuser gets less and less benefit even though they are using more than ever. And each time they recover, their craving to use is more intense than ever. Inevitably they must use just to feel normal. It is for this reason substance abusers often say that the booze and drugs aren’t working anymore. They are in fact producing the opposite effect. Nevertheless they are compelled to continue even when there is no more enjoyment to be had. That’s why substance abuse is a brain disease of which drugs and alcohol are symptoms. Brain scans show that these brain alterations persist long after the user stops.

What may have previously seemed incredible to you perhaps makes a bit more sense now? You can see this effect at work in alcoholics who need an eye-opener to stop shaking in the morning. You see it in the opiate dependent person who swallows many times the recommended dosage and – instead of being knocked out – becomes clear-headed and energetic. And you see it in the heroin user who must shoot up every few hours like clockwork in order to feel comfortable in his or her skin. In each case the substance has the opposite effect. Chasing the high is what makes chemical dependency so deadly.

In Alcoholics Anonymous the saying is; “If nothing changes, nothing changes!” You can’t possibly hope a disease away. But you can help treat it if you take proper action. If you or someone you know is struggling with substance abuse, I encourage you take action today.

Keith Angelin, MBA, CADC-II, CNDAI, is a Master’s level, board-certified alcohol & drug counselor, and nationally certified intervention specialist. Prior to entering the field of substance abuse counseling he spent two-decades as a leading marketing executive in the health and nutrition industry where he worked with numerous professional athletes and celebrities including Sylvester Stallone, Arnold Schwarzenegger, Clint Eastwood and the Dallas Cowboys. A 14-year battle with drugs and alcohol included dying three times from overdose. His recovery compelled him to re-evaluate his life and share the miracle with others. He can be reached at (949) 939-9222 or through



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