Drug addiction: The relationship between reactivity, resistance and resilience

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Part One

By an Anonymous L.A. Post Examiner Contributor

There are few topics more unifying and polarizing than drug use.

On one hand, people use drugs to connect, if only on the level of “connection” that occurs when they gather in a group while ingesting, injecting, snorting or inhaling the same substance. Contrarily, the effects of compulsive drug use can lead to isolation beyond what seems psychologically tolerable. The same crowd that bonds with you while using will be the first to avoid when you feel the need to regain a sense of control over your life and usage.

I’d be one of the first to say we have — in many respects — royally failed in our treatment of addiction and addicts. There are still too many in power with limited understanding and experience that seek to criminalize drug use rather than address the roots of a very complex problem.

CDC graph
CDC graph

Addiction has been an inheritance in my biological family. My earliest baby photos showcase a woman with a build so thin she was instantly tested for HIV, and the hands and arms holding me still had sores apparent. The grandpa who took these pictures was a man who always had a drink in his hand as he walked around his smoke-filled house. In the last two years, it’s become clear that I have virtually no relationship with my sibling who is in the midst of a parental custody case and the other aftereffects of a heroin relapse.

Like demonic possession, the first hit has generally turned each family member into someone quite unlike themselves. Think of it like a curse released: They opened the Ark, or the mummy’s tomb, against better judgment. They only meant to find relief or release or excitement or escape. In one case, it began with Morphine, and in another it started with early drinking. Both times, that source of comfort was supposed to be temporary. I’m sure that if it was simple, if it was a decision, they would all decide to stop.

But they don’t make those decisions anymore, because each time they begin fighting (whether with social supports, drug recovery programs, Methadone, etc.) some unseen force seems to come alone and swiftly take the wheel. That, please understand, is not a shift of accountability or an excuse, nor is it a lack of depth on my part. It is the poetic interpretation of what addiction looks like when it’s people you know.

On some level, everyone has an understanding of addiction and addictive behaviors, because everyone has a vice or a compulsion they nurture despite their best intentions. Hell, if I could decide to keep alcohol in my house to serve when my friends stop by without risking the chance that I’ll get myself blackout drunk on any given day, I would decide to keep my cupboards stocked.

Poppy field in the Czech Republic (YouTube)
Poppy field in the Czech Republic (YouTube)

If I could wake up and tell myself that there’s no reason to feel anxious or depressed about my life, and certainly no reason to dwell on every mistake I’ve made in the last two years, I would make that a priority. If I could simply choose to go grocery shopping on the days when I can’t even look a stranger in the eye without my heart palpitating, I wouldn’t need to buy so many canned foods. All of these decisions would certainly beat the negative alternatives.

The problem is that over-drinking when alone, obsessing over the negative, and avoiding social situations have become as natural as driving the same route to work at this point. Making different choices when my natural inclination is so prominent takes resources that I don’t always have the time and strength to obtain and maintain.

Resistance to these particular behaviors takes more than I usually have at my disposal, and my propensity to endorse these habits has been ever-strengthened by the years of up-and-down, intermittent success and failure in taming my demons or beating the curse. Fortunately, I’ve never touched seriously addictive opiates, because I knew that in my family it seemed to be flesh-eating bacteria. Touch the infected surface, and it’s all over.

An unenlightened few uttered meaningless phrases about my mother’s inability to love her child more than drugs, which I never contested — but I should have. I should have told them that her brain experienced greater positive reinforcement when she shot up than when she held her child, and yet she chose to try and raise another after she lost me. Her problem wasn’t a lack of love; it was an excess of ego. Admitting that the resources to temper your most powerful emotions are beyond your human capability takes a level of humility not many people have.

Essentially, I’ve learned that synthetic experiences like the biopsychological effect of a stimulant can impact your brain as if you’ve just had the most amazingly authentic conversation.

CDC graph of overdose deaths
CDC graph of overdose deaths

My theory is that there is a strong and still understudied relationship between several factors at play.

(1) Reactivity: Everyone has a different chemical makeup, and a different metabolic rate. Some people are highly reactive to experiences like drugs, sexual experiences, roller coasters or social interactions.

(2) Resistance: People generally have natural temperamental leanings toward caution or impulsivity. If they are cautious, they are more resistant to risky experiences that may have negative long-term consequences, even when there are positive short-term effects. We could also call this temperance, to so as not to be confused with the way in which the word “resistance” is used in addiction recovery circles, as a barrier to treatment like “denial” and “ambivalence.” Here, I am using it due to its connotation being more in line with personality than virtue, as a resistance to the adoption of addictive habits.

(3) Resilience: This is the marriage of any level of reactivity and resistance. I theorize that high reactivity (chemical reaction) plus high resistance (ability to weigh pros and cons, to process negative and positive stimuli and ultimately apply executive planning skills to avoid negative consequences in the long term) =medium resilience (protective factors against addictive behaviors). High reactivity + low resistance=low resilience. Low reactivity + high resistance=high resilience.

For some addiction is the flu. For others, it’s a cold. For others, it’s the final virus that attacks a compromised immune system. It depends on how it’s introduced and the vulnerability of the affected person.

Furthermore, the ability to combat addictive behaviors is built upon the innate and the circumstantial. Ideally, one would have low reactivity (chemical component), low impulsivity (personality component), and a healthy stress versus extreme intermittent spikes in di-stress (environmental/circumstantial component). This would, in theory, result in high resistance and ultimately increase the overall resilience of a person exposed to an addictive substance.

Top photo of addict in the Czech Republic shooting up. (YouTube)