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In her book Love Warrior, author Glennon Doyle writes about her experience battling addiction. She often laments about the period in her life, when undergoing active addiction, when she appreciated the numbness that alcohol and food provided. She recalls that once getting sober she felt that life was overbearing and difficult to endure emotionally. She often refers to the fact that coal miners previously used to utilize the life of a canary in the mines to determine whether the conditions were safe, based on whether the bird was singing and surviving, or quietly suffocating. She analogizes her own emotional vulnerability toward the world to the canary's physical vulnerability in the harsh elements of the coal mines. Addictions are much more than coping mechanisms, and we will explore this perception of addiction as a complex maladaptive coping strategy in a chaotic world [3].
What is drug addiction? What are the causes?
Substance use disorder, which encompasses drug addiction, is generally defined as the inability to stop the usage of an addictive substance to the point that it interferes with the person’s quality of life. There are copious factors that affect the development of an addiction. Whether or not someone develops substance use disorder is dependent on whether that person has a genetic predisposition to addiction, had abuse present in their childhood, experienced poor mental health, had a high level of exposure to addictive substances at an early age, or had generally poor parental guidance throughout their child and teenagerhood. Addiction is a mental affliction that cannot be controlled through force and should be clinically addressed and treated with either talk therapy, group therapy, sponsorship, etc. [5,10].
The procurement of addiction should not be limited to the circumstances listed above but should be thought of as a complex conglomerate of reasonings, situations, and genetic traits. Dax Shepherd, an actor, producer, writer, and host on Armchair Expert, has openly discussed the struggles of his addiction with his audience. He often points to his need for control as a contributing factor to his addiction, along with a history of abuse, a genetic predisposition, childhood struggle with OCD-related behaviors, etc. You will notice a need for control is often a contributing factor to addiction but is typically left out of scientific articles relaying the typical behavioral precursors and causes of addiction [5,10,12].
What is a coping mechanism?
A coping mechanism is used to manage stress and navigate a difficult period or time in a person's life. There are different categories of coping mechanisms such as task-focused coping mechanisms, emotion-oriented coping mechanisms, avoidance-focused coping mechanisms, and the absence of coping mechanisms. Task-focused coping mechanisms are when a person fixates on developing a plan of action to help solve the stressor in their life. This may seem like a good coping mechanism, but it is not useful in all stressful circumstances. For instance, if a person’s stressor is psychological, like loneliness caused by isolation from the pandemic, this cannot be fixed through solely task-centric efforts.
An emotion-oriented coping mechanism is when a person fixates on their internal state in the throes of a stressful life circumstance. This may also seem like a favorable coping mechanism, but it again cannot be useful in overcoming or managing every stressful hurdle. For example. If the stressor in a person's life is related to a deadline, then the most beneficial coping mechanism would be task focused one.
An avoidance-focused coping mechanism is a practice of avoiding stress and stressful situations at all costs. By avoiding the stressor, it eliminates the need to cope with it. This type of coping is typically considered maladaptive because avoiding stress would limit the ability to live, and it would ultimately affect a person’s quality of life.
Having no coping mechanism at all in the face of stress would be very detrimental to a person’s overall mental, relational, and possibly physical health. People can utilize a mixture of these coping strategies, but usually, people will favor one over the other. The development of these strategies is currently up for debate but are most likely developed as a result of how they were raised in their childhood. However, it is important to note that a person’s coping proclivity can be changed through effort and practice [2,4,9,13,15].
Everyone has coping mechanisms, but not everyone is undergoing addiction. Coping can become an addictive or unhealthy behavior if that coping behavior starts to negatively affect the life of the person practicing it. For example, some people might exercise to cope with anxiety, but it is possible to exercise too much and too often, and this will result in maladaptive behavior. People use food as a common coping mechanism, but someone can become food addicted, despite food addiction not being clinically recognized.
So, how can someone tell the difference between a healthy coping mechanism and an addiction? Well, coping mechanisms are in a response to stress, so in the absence of stress does an addiction still persist? Unfortunately, this is a subjective and unanswerable question, because stress is ever-present. You might argue that famous, wealthy, beloved musicians with addictions were more likely to not have as much stress as a single mom living below the poverty line with an addiction, but stress is present in all lives, in all different forms. Stress can come in the form of social stress, familial stress, financial stress, vocational stress, environmental stress, etc. It should be noted that Portugal did legalize all drugs, and even has a drug administration facility, along with aid to provide people with addiction a job. This system did significantly reduce people's usage of addictive substances. Is it because of the reduction of stress [1,2,4,9,13,15]?
Do people with substance use disorder use their addiction as a coping mechanism?
The short answer is yes. In Yigitoglu et al. (2019) study they looked at 51 people that were admitted to an Alcohol and Drug Addiction treatment center in a hospital in Turkey. They found that the majority of the participants had delusional thoughts and had an emotional-based coping mechanism. Konopka et al. (2012) did a study comparing people with Benzodiazepine addiction to a group of people that had previously used benzodiazepine but were not considered to have a Benzodiazepine addiction. They found that people with this substance use disorder were more neurotic, introverted, and inclined to utilize emotion-based coping mechanisms. Valentino et al. (2009) argued that the neural pathway responsible for experiencing and reacting to stress in the brain intersected with the neural pathway responsible for addictive behavior. This means that this study was evidence that addiction is dependent on the presence of stress, and that addiction was in response to an outside force. Burke et al. (2015) found that adolescent rats, which lived in pairs, exercised more maladaptive responses to attacks, and inevitably self-administered more cocaine in adulthood when experiencing high levels of social defeat, compared to rats living alone and rats experiencing low social defeat. They found that self-administered cocaine usage was not as potent when rats experienced social defeat in adulthood. They argued that there was a large social component to addiction, but only within a certain time frame when socialization was imperative to development. The common thread of these studies is that addiction was a response to some negative outside force, and people were more likely to be afflicted by substance use disorder when their coping mechanism was emotionally focused [2,4,8,13,14].
Final thoughts
Addiction is a complicated subject matter that involves the lives of people with a substance abuse disorder, and the lives of those around them. Addiction can be a concentrated coping mechanism in reaction to the frightening and huge world we live in, a compulsive response to an internal need for control, a behavioral reaction to modeled substance abuse coupled with a genetic predisposition, or all of these things. No matter what the reasoning behind substance use is, it needs to be recognized as a mental illness, not a choice or desire. This country has often treated criminal cases involving someone with substance use disorder as a person succumbing to hedonistic tendencies, but these people with substance use disorder are experiencing an active mental illness. It could also be argued that people with substance use disorder are uncontrollably punishing themselves by utilizing a maladaptive coping mechanism, or by having a higher emotional capacity and more sensitive constitution in the face of the negative state. More research and personal accounts of different experiences with addiction are necessary to gain a greater understanding of substance use disorder.
References:
1. Bajekal, Naina. (2018). Want to win the war on drugs? Portugal might have the answer. Time.
2. Burke, Andrew, et al. (2015). Escalation of cocaine self-administered in adulthood after social defeat of adolescent rats: role of social experience and adaptive coping behavior. Psychopharmacology. 3067- 3079. DOI 10.1007/s00213-015-3947-5.
3. Doyle, Glennon. (2016). Love warrior. Simon & Schuster.
4. Greenaway, Katharine. (2015). Task-oriented coping. Science Direct.
5. Hilliard, Jena. (2021). Caffeine addiction and abuse. Addiction Center. Retrieved from https://www.addictioncenter.com/stimulants/caffeine/
6. Juergens, Jeffrey. (2016). Could you be replacing your addiction with another? Addiction Center. Retrieved from https://www.addictioncenter.com/community/addiction-replacement/
7. Khoury, Lamya et al. (2010). Substance use, childhood traumatic experience, and posttraumatic stress disorder in an urban civilian population. PubMed Central. Wiley Depression and Anxiety. 27(12): 1077-1086. doi: 10.1002/da.20751.
8. Konopka, Anna et al. (2013). Psychosocial characteristics of benzodiazepine addicts compared to not addicted benzodiazepine users. Progress in neuro-psychopharmacology & biology psychiatry. 229-235. doi.org/10.1016/j.pnpbp.2012.09.001
9. Koob, George et al. (2020). Addiction as a coping response: Hyperkatifiea, deaths of despair, and covid-19. Am J. psychiatry. 1031-1037.
10. Liebschutz, Jane et al. (2002). The relationship between sexual and physical abuse and substance abuse consequences. National Library of Medicine. 22(3): 121-128. doi: 10.1016/s0740-5472(02)00220-9.
11. NIDA. (2018). Understanding Drug Use and Addiction Drug Facts. Retrieved from https://nida.nih.gov/publications/drugfacts/understanding-drug-use-addiction on 2022, July 1
12. Shepherd, Dax & Padman, Monika. (2018). Armchair expert. Spotify.
13. Tasdemir, Gulay et al. (2019). Relationship between dysfunctional beliefs and stress coping methods in drug-addicted patients: A sample of Turkey. Indian journal of psychiatry. Doi: 10.4103/psychiatry.IndianJPsychiatry_285_17
14. Valentino, Rita et al. (2009). Corticotropin-releasing factor in the dorsal raphe nucleus: linking stress coping and addiction. Science Direct. doi:10.1016/j.brainres.2009.09.100.
Contributors:
Author: Katrina Peavy
Editor: Kayjah Taylor
Health Scientist: Chantelle