Understanding and Treating Drug Abuse
By: Pulkit Sharma

Dr Drug abuse can be defined a persistent, relapsing disorder wherein the drug user compulsively spends time looking for and using a psychoactive drug. The person has a longstanding addiction which becomes the topmost priority for them than anything else in life. There are several harmful effects of drug abuse. The addict cannot control the drug taking behavior, spends a lot of time and effort in procuring the drug, may go to lengths to get it, takes progressively increased doses and neglects all other activities that interest them or the chores that they are supposed to do.

A popular myth: A drug addict takes a drug because they enjoy it
There are several popular myths associated with causes of drug addiction and abuse. It is commonly believed that drug abusers find it hard to give up drugs because they enjoy them, do not have self-restraint, lack discipline and moral values, get influenced by media portrayals, are unmotivated or have certain withdrawal symptoms.Repeated attempts to de-addict a chronic drug abuser often fail. Although these factors may have a role to play but the preceding factors seem to be just the tip of an iceberg. There are more important psychological factors that cause drug addiction. Important but often overlooked factors contributing to the continuation of addiction are deep-seated. This complicates treatment of drug abuse.In order to be successful, the treatment of drug addiction must be targeted towards understanding and dealing with these deep-seated factors rather than external control and manipulation.

Raj (name changed) a Delhi-based businessman was addicted to alcohol and marijuana. He had been sent to a de-addiction home near New Delhi seven times for treatment. He felt that drugs were a nuisance and wanted to be away from them. At de-addiction home he would go of the drugs as there was no availability but as soon as he was discharged he went back to the drugs. The conventional treatment of drug addiction in his case failed miserably. This happened not because he enjoyed drugs or had a poor will power but because he needed drugs. Without these drugs he developed catastrophic psychological symptoms- panic, severe hopelessness, wish to kill himself and others- and he found this to be extremely distressing. In order to prevent a psychological breakdown he had to rush back to drugs.

Drugs as chemical friends
Drug addicts are well aware about the harmful impact of drugs on their life, do not enjoy it and hate to take it but they find it hard to give it up. Even when they are treated for withdrawal symptoms and there is no physical need to take drugs they relapse. A prominent reason is that they experience overwhelming emotional states of panic, rage, shame, dread and hopelessness and drugs help them in dealing with these by numbing the feelings. A majority of people have developed a capacity to soothe themselves in face of normal day-to-day frustrations. Chronic drug abusers did not get an opportunity to develop this ability and therefore minor stressors overwhelm their mind. When they take drugs they feel relaxed. Therefore for chronic drug addicts, drug is often a crutch without which they may fall down. Using the drug is a form of self-treatment for these individuals. Farah (name changed) shared her experience of self-treatment through a drug in her psychotherapy session, "Doctor, without the drug I was this unsure person full of flaws, I felt scared going out of my house. I had this sense that people will reject me due to the multiple flaws. Once I started the drug it all vanished magically, I could do almost everything."

Another factor causeof drug addiction is failure to have trust in human relationships and intense dependency. Everyone wants good and secure relationships to depend and rely upon especially early in life. Once people get such relationships in the childhood, they develop ability and skills to be self-reliant. If one does not get such relationships they feel traumatized and there is a lifelong search for something dependable. For some drug abusers, the drug acts as a substitute for such a dependent relationship. These people come from family backgrounds where everyone was self-absorbed and paid little attention to the needs and feelings of the child. In an environment like this, the child is left with feelings of emptiness, loneliness and rage and a search for something consistent and constant. The person finds it extremely hard to be alone. This is where the drug comes in. As Poonam (name changed), a drug addictrevealed, "I feel so alone. Though my parents got so many things for me, they were always too busy in their world. I was always like a guest in my house that was treated well but kept distant. I always feel this painful rejection and loneliness. This sense magically went away when a classmate gave me a drug for the first time. I was no longer helpless and powerless. Everyone else can let you down but not the drug; it has always been there for me and soothed me."

Some drug users feel unloved and neglected and experience intense rage towards people close to them. However, because they also love these people, it is hard for them to acknowledge the rage. Often, they turn the rage back on their own self and wish to destroy it. Compulsive drug use is also a form of self-punishment and expression of pent up rage. As Amit, a drug user mentioned, "I feel so helpless when I get angry and fear that my head will explode. But then I take crystalmath and have this imagination that it is destroying something in me. This makes me feel powerful and relieved."

Treatment of drug abuse
Controlling, punishing and rejecting a drug addict is counterproductive. Criticizing them lowers their self-esteem further, makes them enraged and confirms the already strong belief that people cannot be relied upon. If you or someone close to you is suffering from addiction, the first thing to acknowledge is that it is a very complex problem.The treatment of drug abuse requires empathy and understanding. Why someone is using drugs and what purpose is the drug serving psychologically for the person are important questions to ponder over. One needs to keep in mind that drug addicts are traumatized by helplessness, painful emotional states, and lack of a reliable relationship. It is important to acknowledge and accept these feelings and then encourage the person to develop more constructive ways of dealing with them. Once they develop skills to express their rage in a constructive and assertive manner, a strong self to endure stressors and form good interpersonal relations they would not need drugs.

Pulkit Sharma is Clinical Psychologist & Spiritual Therapist in private practice at Pondicherry (Puducherry), near Auroville. Email:- info@thepsychologistindia.com