Why don’t they just stop?
Shawn Lanham, LCSW, LCADC

One question I have been asked over and over when working with families of individuals that have substance use disorders is, “Why don’t they just stop?”.  People that do not understand addiction are quick to judge and often believe it is all about willpower and simply putting the bottle or needle down. This is far too simple regarding a problem that is complex with many variables and factors that play a crucial role in keeping our loved ones trapped in the cycle of abuse.  Although people begin using for many different reasons, their continuation of use and abuse can often lead to addiction.

First, for most people, we must understand once someone becomes ‘addicted’ to a substance, their ability to choose to stop is often lost.  Addiction alters brain chemistry and in doing so, tells the individual that getting high is more important than eating, relationships, employment, sex, and recreation.  The motivation to use again, and again, and again, is stronger than any of these things no matter how important they once were. Next, we must recognize the drive to use over and over is related to the chemical dopamine in our brain.  This chemical is responsible for getting us to repeat pleasurable behaviors and is crucial for our survival.  We get spikes of dopamine when we eat, drink, experience love, have sex and feel safe. When a person uses alcohol or other drugs, huge amounts of dopamine are released which signal us to do it again, and again without concern for the consequences or problems, it may be creating in our lives and that of our families.

To help you and families understand this, imagine I asked you not to eat for three days.  You may be able to avoid eating temporarily, but eventually, most people will seek out food and eat.  The drive to eat and nourish our body overcomes our willpower to abstain from food. We would become desperate to find food and little else would matter until we fill this need.  This is what a person with a substance use disorder experiences every day. At this point, they have lost the ability to weigh the consequences and will not stop until they satisfy their needs.  They are being driven to use again and again since they feel it is necessary for their survival.

So, what can we do?  One of the most important factors for recovery is the person must want to change.  If they are not ready and willing to acknowledge the problem and seek help, their success for sobriety is very small.  Depending on the substance, use history and many other factors, entering a detox program followed by residential treatment is often the beginning.  Once someone has been through detox and a residential program (typically 30 days), they can begin to work on their recovery program. Many go to Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) for additional and ongoing support.  It is also crucial they remain in treatment with a qualified mental health professional to address their addiction and help them learn new and effective coping skills to have the best chance at sustaining sobriety.

In addition to working on their recovery, the continuous love and support from family and friends will help our loved ones heal and hopefully begin to rebuild their lives.
If you have any questions or would like to discuss treatment options, please contact our office.