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  Getting Away With Addiction?
There is more to addiction than meets the eye
Floyd P. Garrett, M.D.
 
 

Sooner or later most serious addictions converge upon a final common pathway of cat-and-mouse (or Elmer Fudd and Bugs Bunny)  pursuit and avoidance behavior in which the addict maneuvers, often with astonishing ingenuity and amazing endurance, to escape detection by others as he continues to practice his increasingly irrational addictive behaviors. Such avoidance and escape behavior is seemingly oriented towards eluding the notice and disapproval of those with whom the addict comes into contact and who may be in a position to interfere with the continuance of his addiction. 

But the addict, by means of mental defense mechanisms of denial, avoidance, rationalization and justification, also seeks to hide from himself the gravity and frequently the absurdity of his addictive infatuation and pursuit of a substance, process, or person. 

The addictive process, because of its profoundly irrational and inhuman demands, cannot long exist in an atmosphere of free and open exchange of information. Just  as the first casualty of war has been said to be truth, so in the progression of addiction there is usually a steady erosion of personal frankness, candor and basic honesty in regard to the addiction and its mandated behaviors. The addict is driven towards the margins of his social and interpersonal world by his addictive process, which expands like a malignant tumor that crowds out or destroys neighboring tissue.

Attempts to define and understand addiction in terms of frequency or quantity of consumption or use of the substance, engagement in the behaviors(spending, gambling, sex, eating), or the negative external consequences of the addiction all fail to consider the primary, direct and internal consequence of addiction upon the addicted individual.

Many addicts,  at a certain stage of their deterioration, still  possess sufficient clarity, honesty and awareness to recognize and admit to themselves that their behavior in the service of their addiction is neither fully rational nor prudent - but they comfort and justify their addictive behavior by noting that certain consequences of addiction have not (yet) happened to them, while they point with pride to their positive accomplishments in other areas of their lives. They reason that their addiction is 'not that bad,' or that they are 'not as bad as some people.' They may say that they 'have a problem' with whatever substance or process holds them captive and controls their actions, but they balk at the term 'addiction' to describe it. Or they may concede that, yes, they do suffer from an addiction, which it would be better, wiser, and healthier for them not to engage in. But they take comfort in the fact that they are 'not as bad as some people' while they reassure themselves and those concerned about them that the time is coming, is indeed right around the corner, when they will once and for all put a stop to their addictive behavior.

The addict, like those around him, usually looks to conventional and obvious external or physical consequences of his addictive behavior to gauge his success at balancing the requirements of his addictive process with the demands of his wider life. Thus he and others are prone to think in terms of job performance, financial success, interpersonal relationships, and health and legal status as the chief or only means of assessing whether he is indeed getting away with it as he practices -or is practiced by- his addiction.

Individuals frequently assert that they 'cannot be addicts' or that they are 'not that bad' if they hold down jobs at which they are successful, or if they have never been arrested or in legal trouble for their addiction, or if they have no obvious health consequences as a result of their addictive behavior. (Of course, even when such problems do arise, the addict more often than not will minimize or rationalize them away as not being of sufficient importance to require him to cease his addiction. But if they have not yet appeared, their absence is often cited as proof that the addict has not been harmed by his addiction.)

Such individuals, afflicted by addiction, even wholly under the thumb of and controlled by addiction, therefore believe that because they are experiencing no adverse external(material) consequences, they are getting away with addiction. They imagine that they are successfully 'having their cake and eating it too' - perhaps the deepest and most intractable desire of all human beings.

Standard medical definitions of addiction usually include a reference to the continued use of a substance(or engagement in a process such as gambling) despite adverse consequences.  And this 'consequentialist' approach to the recognition of addiction invariably emphasizes certain obvious, conventional, external, and materialistic sequelae of addiction, e.g. job loss, health or legal problems, relationship difficulties. It is assumed that if the individual does not experience such problems that the chances of his being addicted are slim to none.

But if one reflects upon such conventional and superficial consequences as those just noted, he immediately realizes their contingent and accidental quality. Whether one is cited for driving under the influence depends upon many factors besides his drinking behavior. Someone, for example, who does not own an automobile will never receive a DUI. Similar considerations apply to job difficulties, since the demands of jobs and their liability to the consequences of addiction vary widely. And again, one who does not work will surely never experience vocational problems from his addictive process, no matter how severe the process may become! Similar considerations apply to health matters and even personal relationships(partners vary widely in their tolerance of addiction - and of course, the addict may, in the extreme case, simply have no personal relationships.)

Thus if we consider all such usual and customary 'negative consequences' of addiction, we find that they are without exception accidental, contingent, and non-necessary. Their presence may well signal the activity of a serious addiction; but their absence, because of their accidental and non-necessary nature, by no means indicates the absence of addiction. We must look elsewhere if we wish to understand what is truly crucial and essential to addiction rather than what is merely accidental and not  associated with the thing itself.

The essence of addiction, that which is always and necessarily present and hence is the sine qua non of addiction, lies in the subjective relationship of the addict to the substance or process of his addiction. 

It is the way that the addict thinks about the object of his addiction that is the tell-tale mark of addiction. External behaviors are of use in identifying by inference the subjective state of the addict but always take place far 'downstream' from the addiction itself, which originates and resides in the mind of the addict, directing and controlling the observable behavior of the addict. 

Because addiction exists first in the mind, independent of -and prior to- any external behavior, it may be said that addiction is its own consequence, and that therefore no one truly 'gets away with addiction.' Indeed, from a certain point of view we may even regard those individuals with addiction who succeed in eluding most or all of the usual external negative consequences of addiction as the most unfortunate of all who are addicted. And we may view those individuals who suffer early on the gravest and most dramatic complications of addiction the luckiest of the addicted population because attention is thereby unmistakably and indisputably drawn to the presence of the addictive process which in less obvious cases may be silent, like undetected termites in a foundation, yet invisibly destructive.

But if addiction originates and resides in the mind, if the usual negative external consequences of addiction are simply accidental and fundamentally unrelated to the addiction, and if addiction is its own consequence, what then are the effects of addiction on the mind that cause(or ought to cause) harm and concern? How is it possible to say that addiction is a bad thing for an individual if he experiences none of the conventional adverse consequences of his addiction?

Addiction is its own consequence because addiction distorts and stereotypes the psyche of the addict by enslaving the self to a false and unhealthy center -addiction- from which all radii subsequently emanate and around which the circumference of the addicted self is henceforth constructed and maintained. Freedom, flexibility, spontaneity and independence of thought are judgment are lost -actually sacrificed- to the interests and demands of the Idol of the addiction that has become the addict's jealous god. The addict's mind is in a sense no longer his mind but has become an agent and tool, however unwitting, of the addiction whose absolute and fundamentally irrational mandate the addict now exists solely in order to fulfill - even, if necessary, at the cost of his own life. But long before his physical life is surrendered to 'the Cause' of the addiction, the addict has sacrificed his soul and his individuality to satisfy the requirements of the addiction.

Less abstractly: the addicted self is centered upon and organized around its addiction in the manner of the moth revolving around a candle flame. For just as the moth may be said to have been captured by the candle flame, the addict has been captured by his addiction, which for him becomes the aiming point and goalpost of his thoughts. The word 'addiction' derives from the Latin addictere, 'to be bound to another,' as in the relationship of a slave to his master. For the addict, his addiction becomes his telos or purpose of being, in the process replacing all other possible goals - including in many cases that of survival itself.

And because the psyche of the addict is enslaved to his master, addiction, freedom and flexibility are spontaneity are thereby sacrificed to the dire and incorrigible telos of addiction. The addict becomes like one who subsists under a ruthless totalitarian regime which cares nothing for the individual but everything for 'the Cause' which it promotes by every means at its disposal. And 'the Cause' in addiction is the gratification and fulfillment of the addictive process, not the health or human potential of the individual addict.

Considered from this point of view, no one who is addicted can be said to 'get away with addiction.' Those who seem to be doing so are in the worst predicament of all. For like sufferers from an occult yet terrible disease, they go about their business thinking nothing is wrong, that indeed they are in the pink of health. But inwardly and invisibly the disease of addiction is nevertheless furiously and destructively at work, disorienting the self, shifting priorities, influencing choices, and shaping a lifestyle and worldview that is unconsciously and ingeniously adapted to the continued operation of the addictive process.

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Original Papers

The Addict's Dilemna

Addiction, Lies and Relationships

Addiction and the Mechanisms of Defense

Alcohol Addiction

Drug Therapy of Alcohol Dependence

Excuses Alcoholics Make

The Female Partner of the Male Alcoholic

Getting Away With Addiction? 

Intervention for Alcohol and Drug Dependence

Obstacles to Recovery from Addiction

Prescription Drug Abuse

Prolegomenon to the Metaphysics of Recovery

What is Recovery?

Why is Recovery So Hard?

Worried Sick About His Drinking?

Your First AA Meeting: An Unofficial Guide for the Perplexed