There is enormous value in understanding the neurobiological mechanisms that underscore addiction and chemical dependence, but the perspective must never be lost that the true root of addiction is completely psychological (Ewald et al., 2019). Addiction is the result of an emotional or mental deficiency, need, or trauma that the person in question does not have either the intrinsic or the trained coping skills to reconcile. The triggering condition may be trauma, neglect, abandonment, abuse, or other loss, and it may occur during childhood, adolescence, or the adult years (Garami et al., 2019; Moustafa et al., 2021; Zdankiewicz-Ścigała & Ścigała, 2018, 2020). When an opportunity presents itself to provide a quick and relatively easy relief from what feels in the moment like unending agony, the reward system in the brain is hardwired to latch onto that form of relief and associate it with a greater level of importance than it would otherwise (Advokat et al., 2019). This marks the difference between someone who is capable of occasion drug use for recreational purposes and someone who is truly prone to addiction.
Defining Addiction Specifically
Addiction is distinct from chemical dependence in that chemical dependency creates physiological effects such as when abstinence from a substance creates withdrawal syndromes. Addiction is often accompanied by chemical dependency, but it is possible to be psychologically and neurologically addicted to something without there being a chemical dependency. We see this with gambling addiction, excessive electronics fixations, addictions to sex and pornography, or any other addictive-compulsive behaviors (Hardy et al., 2018; Horak et al., 2021; Moore & Grubbs, 2021; Wéry et al., 2019). Likewise, it is possible to be chemically dependent on a substance without being psychologically addicted to it, for instance prescription medications for sleeping disorders, diabetes, or depression.
What defines addiction as a serious problem is when the psychological attachment to the effect of the substance or activity becomes a motivation in its own right, encouraging antisocial behavior (stealing, lying, cheating) and prioritizing the acquisition and use of the addiction over any other social dimension. Inasmuch as the maladaptive measure is first used to cope with a negative emotional event, without some kind of intervention to salve and educate, the injury remains and the drive to relieve the pain becomes reinforced.
So, in order to approach the question of addiction as the ultimate result of a reasonable first response to an unreasonable and untreated negative personal condition, imagine that the injury is physical and that the mechanism is a standard anodyne. The faster the pain-relieving action, the more we appreciate the relief. If the injury doesn’t get healed, we have to rely on the pain reliever again and again, and we go through the physiological stages of building tolerance and requiring more anodyne to get the same level of relief. As the relief becomes more significant – which is to say, it becomes the dominant conscious experience rather than the original pain of the injury – the emotional need to address the injury fades, even though it is still there, and the drive to use the anodyne increases.
Historical Survey of Substance Use Versus Addiction
Addiction and the use of psychoactive substances as escapism and trauma response are a distinct and separate function from use of psychoactives for spiritual journeying and healing. The main natural psychoactives, cannabis, psilocybin, and mescaline, have been used for millennia in a variety of foraging-tribal sacred settings (Winkelman, 2021). They were used as mental awakenings, rites of passage, and remedy from loss and pain, and though they are all freely available in a given region and access was not “controlled”, they were treated with respect and used by the average person only sparingly. The role of the shaman-esque figure was deferred to for rites and rituals of wisdom and expansiveness; the wisdom of the tribe was that those who spoke the most with the spirits was probably the one to listen to on issues of spirituality. This type of practice not only maintained a sense of harmony and mental health for individuals, it contributed to a sense of community and social identity (Dupuis, 2022).
Keep in mind that this type of spiritual access being available to all members of the community but not habitually used is a distinct feature of foraging–tribal societies; when agriculture and large permanent settlements became more common as in Mesopotamia, the role of psychotropic substances changed. Social classes emerged as larger communities required more management, and with more management came social stratification (Gray et al., 2018). After the Sumerians first (accidentally) created beer around 4,000 BC, it was a centerpiece of daily life and was often used as a meal ration for the working class. Beer simultaneously acted as a nutritional supplement (it was thick like porridge) and also as an emotional blunting tool as the living conditions were often less than ideal, and inebriation made the plights more bearable (Damerow, 2012, sec. 7). Alcohol use has been observed since Man first noticed birds flying erratically after eating fermented fruits, but excessive inebriation and habitual use (alcoholism) have historically always been frowned upon (Hirsh, 1953; Rollbston, 1927).
Modern Onset of the Addiction Epidemic
Keeping in mind this historical context with what we know about the actual mechanism of addiction as a mental/emotional health crisis, when we examine the marked increase in addiction over the past few hundred years compared to the millennia of availability of psychoactive substances, the question is clearly outlined: what happened to society and humans in the last eras that provided more trauma and less social support than in the ages preceding?
As Winkelman and Dupuis pointed out (2022; 2021), social stratification creates inequality, and where there is inequality, there are negative emotional conditions; and where there are pervasive negative emotional conditions, there are motivations for addiction. When one’s social status is constrained and foiled, when support and structure are insufficient or absent, then the soul begs for relief by whatever means available.
Even stepping past the specific political facts of the contrived and massively racist “War on Drugs” (Cooper, 2015; Earp et al., 2021; Provine, 2011; Rosino & Hughey, 2018; Tonry, 1994), the fact is that comparable living conditions have consistently worsened in terms of mental, emotional, and in many ways physical health over the last two hundred or so years, since the advent of the Industrial Revolution.
With the arrival of the Industrial Revolution, populations moved to larger cities, and the shift from community to nuclear families tore apart the fundamental social structures that previously provided support for those in need, leaving holes of hurt that were readily filled with drugs and alcohol.
The pious (and one might say “pompous”) moralization of substance use from the Victorian era onward heightened the social divide between those who fell into addiction and those who were “above reproach”. Because the “demon” of addiction was seen as a moral failing instead of a spiritual, mental, or emotional need, it was answered with punitive measures of incarceration and (further) social destitution. In the United States, the application of a felony indictment involved incarceration and the removal of voting rights, which points to a significant motivation to keep drug usage and addiction illegal: if a large enough non-socially-dominant population can be aggravated and repressed enough to suffer a disproportionately high rate of addiction and drug-related felony charges, then voting demographics will always favor the socially dominant (Merrefield, 2024; Uggen et al., 2022).
What is especially interesting about this last observation is that we know and have known for decades that incarceration and punitive actions do absolutely nothing to improve drug abuse and addiction rates – and they may even be responsible for higher rates of addiction and deaths from drug overdose (Gan et al., 2021; National Institute on Drug Abuse, 2020; Pew Trusts, 2018; Rowell-Cunsolo et al., 2018; Widra, 2024).
Back to Basics
Addiction is not a moral failing, it is a maladaptive response to trauma and pain that our society as a whole does not support or teach people to manage. My hypothesis is that the rise in addiction and substance abuse over the past two centuries is directly tied to the degradation of structures of support for our collective mental and emotional health as well as the demonization and negative pathologization of trauma. While there is profit to be made and benefit to be had from keeping increasingly larger portions of the population distracted, high, and powerless, we cannot expect policies to change at a formal level.
Instead, we must take mental health and emotional well-being into our own collective hands and rebuild the support systems ourselves. Addiction is never cured with punishment and shame; it is only ever solved with compassion. This is what motivates us to strive for ever more effective pharmaceutical remedies (Advokat et al., 2019), but they can only ever be part of the solution. Healing the mental and emotional condition and resolving pressing social inequalities must be the rest of it.
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