Dr. J on the power of addiction
Contributor: “Dr. J”Dr. J offers his irreverent, slightly irrelevant, but possibly useful opinions on health and fitness. A Florida surgeon and fitness freak with a black belt in karate, he runs 50 miles a week and flies a Cherokee Arrow 200.
Addiction is a stern master! If you choose to live in its house, you will be its slave!
During my residency, I was as close to one of my junior residents as to a brother. We worked hard and well together, setting a surgical record at my training center for operations performed in one month. Because of his good looks and my eyes, the staff nick-named us “Butch Cassidy and the Sundance Kid,” after that old movie.
Life was good.
He had as much talent and personality as anyone I’ve ever known. His life would be an easy adventure. Then it happened. During his anesthesia rotation, he had too-easy access to narcotics, and too stern a master to face, though I will never really know why, and he slipped into that cursed darkness.
There was a time I had suspected something was going on, although he denied straight to my concerned look that he was using anything. Not long after that I found a used syringe in the on-call room trash can, and had it tested for narcotics, but the lab did not have enough material to confirm my painful fears.
Not that much longer after that, he couldn’t hide it any more, and life as he had known it stopped with the suddenness of a plane hitting a mountain.
From crack house to Big Mac house
There is a debate as to whether obesity is a disease or a symptom of a disease, or perhaps a disorder or syndrome. I think perhaps, it is a disorder that becomes a disease. Obesity is both physical and mental, and probably can meet the definition of an addiction.
The DSM-IVR does not consider an addiction a disease at this time. The American Medical Association wants it to be classified as a disease, and the Congress has twice proposed a bill to classify addictions as disease, but has not been able to pass it.
Regardless of how it all plays out economically, philosophically, or morally, obesity is, in my opinion, frequently comorbid with an eating addiction, and this addiction needs to be recognized, acknowledged, highlighted, labeled and treated as such.
What is an addiction?
The term addiction is used in many contexts to describe an obsession, compulsion or excessive physical or psychological dependence. In medical terminology, an addiction is a state in which the body relies on a substance for normal functioning and develops physical dependence.
When the drug or substance on which someone is dependent is suddenly removed, it will cause withdrawal, a characteristic set of signs and symptoms. Addiction is generally associated with increased tolerance.
However, common usage of the term addiction has spread to include psychological dependence. In this context, the term is used in drug addiction and substance abuse problems, but also refers to behaviors such as excessive overeating.
In these kinds of common usages, the term addiction is used to describe a recurring compulsion by an individual to engage in some specific activity despite harmful consequences to the individual’s health, mental state or social life.
Eating as an addiction
I feel we are an addictive species. Each and every one of us has areas where we need to be vigilant for the potential of becoming addicted. This is not something to be taken lightly, because something that may seem minor, or a passing behavior that one can stop at any time, can possibly prove to be much stronger and relentlessly persistent than you might ever imagine.
If we are ever able to make any progress in the area of addiction, corrective and supportive measures must be applied for society and the individual as early as possible and as soon as possible. This means education and serious considerations of legal methods to limit production and access to addictive substances.
If you feel this is foolish with regards to what I consider the distortion of our food supply with increasingly excessive salt, sugar and fat, as well as portion sizes, I would ask you to consider the economic and social costs that our society has burdened itself with already, and which are growing to the point of breaking our health care system while we debate our addictive privileges.
I strongly caution against having the addict define what an addiction is, or to make his or her own treatment plan for recovery, unless the individual accepts that he or she has an addiction and is willing to activity participate in the formulation and actualization of the plan.
The rest of the story
As for my junior resident, but for the caring of those who knew him, he would have been lost. A wasted life of one with a rich life to live. Fortunately, he had influential people with critical resources that could be made available to him, that wanted to give him every chance to pull through and break free before that demon broke him forever and cast him aside.
It took more than one attempt, but he did recover and rebuild his nearly lost life, and has been as solid as one can be to this day.
(Send your questions for Dr. J to calorielab@gmail.com or leave a comment. If your question is used by Dr. J, CalorieLab will send you a $25 Dining Dough restaurant certificate — limited to U.S. residents. More Dr. J posts can be read in our archives.)
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I can relate to this story. I once felt I was in love with a heroin addict. He tried to quit numerous times. It was very, very painful. We both suffered a lot. He ended up lying to me often in his shame and desperation. Eventually I left. A few months later, he was even skinner and frailer looking, but still working at a famous investment firm in lower Manhattan. He spent his entire enormous paychecks on junk. He was always broke, despite his six-figure paycheck. I will never, ever forget him or that time in my life. He was a bright, good-looking guy and he was heroin’s bitch. It broke my heart. It wasn’t his fault, and it was. It was very confusing.
As for me, I now eat too much sugar and fat. Every day. My ex-boyfriend may be dead now, although a report from a surviving friend of that era said he was alive, in China, a few years ago. Who knows. I will probably die more slowly than he. But depending on any kind of fix in ever-increasing quantities to get you through the day is miserable when you look at it straight on. It makes me sad.
Here’s Step #1 from the Twelve Steps of Overeaters Anonymous:
We admitted we were powerless over food — that our lives had become unmanageable.
-Steve
Addiction is an anarchist, with a knife, a gun, and a detailed map to the soul of every man, woman, and child in the world.
No other comment except to say this is the best, and most significant piece I have read on this blog. I encourage you to farm it out to local media as well as to web media beyond your own. Well written and thought provoking. I am passing this along to everyone in my address book, as well as my local newspaper.
Addiction (including the over-eating that causes obesity) is NOT a disease in any meaningful sense of the word, because even the 12-steppers concede that people can cure it themselves, by making better choices – this is obviously not true of any other disease.
Read Rational Recovery (there’s free info on their site, rational.org) and you’ll see, addictions are a choice that you make a few times, until your body/mind get used to the high (food, drugs, alcohol, whatever), and you then choose to continue the behaviour. Thousands of people qyuit smoking, drugs, the whole lot every year just by choosing (however hard it may be) to simply STOP.
I too shared my life with an addict, and without going into details, reading Rational Recovery cured me of years of guilt over the whole 12-step syndrome of enablers, denial, blah.
Hi Hilary!
Thank you for sharing your touching, powerful story! I know of a book, “Das Energi,” by Paul Williams, that was written for special people, in challenging situations, and I recommend it to you. No words can take the place of action, but if they could, this book comes as close as one can.
Steve!
Every journey begins with that first step….and then the second.
Roy!
…and if and when one can disarm that great impostor, they will know a triumph unlike any other!
Hi Charlie!
Thank you for your thoughtful comment! I may be misunderstanding you, but I feel that making better health choices has the potential to cure many diseases which were acquired with poor health choices.
Thanks, Dr. J. I’m pretty sure you think I don’t listen to you, but I do ;). I’m just kind of . . . well, slow.
So glad he is okay – how terrifying.
And the obesity debate is always interesting to me, as far as what it is exactly. I have interviewed so many people through the years and it seems as though either they really don’t know how to eat right (or don’t care) or they gained the weight because of emotional eating. So I agree that it’s a disorder that turns into a disease. A horrible one.
wow.
Ive been blessed so far addictionwise BUT also agree/believe that we can become addicted to so many things.
from endorphins to FOOD to drugs.
I’m happy that your other half or Butch Cassidy and the Sundance Kid got help with his demons. From my point, the addition to food is as bad as any drug. The problem is that all access is legal and availability is in every corner of our world. We even celebrate this problem with profession eaters, new television show like “Man vs. Food”, and are even giddy when the All American Hotdog contest is on. Can you imagine having television cameras capture heroin shooting galleries and promoting it as sport?
Thanks Sahar! I truly hope some progress can be made to help people recognize their situations and to improve them.
Thanks Carla! We all need to be vigilant of those areas where we are more susceptible. Even the quintessential funambulist can fall.
Tom!
Great comment! I’m afraid when it becomes a struggle, food is all too often the winner :-(
Thank goodness for support groups to help out in times of trouble. I find it really scary how easily we can get addicted to just about ANYTHING; all the sudden something has a huge amount of control over us… at least the sugar challenge this week is definitely helping with any nutritional addictions I might have had!
In my own experience with both disease and addiction, I consider them both to be symptoms of imbalance. When we dig deep and treat the imbalance, the affliction or addiction will subside.
This might sound a little “New-Agey”, but I have definitely verified the truth of this assertion in my own life.
Sadly, Western medicine does not subscribe to this point of view, although many good doctors (such as you, Dr. J.), balance the technological and scientific practices of the West with the holistic traditions of other cultures.
Wow Dr. J. I’m glad that story had a happy ending, but too many people aren’t as lucky. Thanks for a great reminder that we can ALL fall prey to addictions. -Kami
Sagan!
We get by with the help of our friends :-) I’m very impressed with your determination with your sugar challenge!
Ruth!
I can agree with your view of imbalance. I have long been open to a variety of healing options. In surgery we have a saying, “When the normal channel is open, the abnormal channel will close.”
Kami!
Yes, my friend was very lucky. I am forever grateful that we did not lose him.
whew, addiction is such a cunning slippery slope, isn’t it? And everyone’s stories are so touching. There is so much say on this topic as it effects the body, mind and spirit and all three areas must be dealt with in recovery as well. Addiction touches us all in one way or another. I’ve always been interested in the physiology and brain chemistry side of addiction, but there are no easy answers…
Wise words, Dr. J.
No matter how it is designated, addictions ruin lives.
Jolene!
No, there are no easy answers. Only the difficult path out of the hole. Always worth it with success, but so hard during the climb.
Dr. Hubbard!
Thank you! Yes, we have all been touched by this.
Mizfit is addicted to weight lifting.
Of course, I am cured of my own addiction – food. NOT.
It is a day to day process for me.
Food addiction may not be a real disease but the underlying urge to stuff emotion with food is a compulsion that I battle with daily. I believe I can cure myself by making better choices, (and have been very successful) however, I have not conquered entirely the compulsive feelings/behaviors that drive me to consider food as some sort of comfort late at night when absolutely nothing is going on that *should* drive me to think of food.
“I feel we are an addictive species. Each and every one of us has areas where we need to be vigilant for the potential of becoming addicted.” I completely agree with this observation. I have a neighbor who’s addicted to food; a close friend used to be a borderline alcoholic (she stopped drinking); another friend used to drink way too much coffee.
For me, the area I need to be vigilant about it exercising. I exercise 4 times a week, 45 minutes per session, but I often feel tempted to add a second session in the evening. I don’t. For someone’s who’s not a professional athlete or a model, exercising 2 hours per day would be excessive.
POD!
Unfortunately, many people suffer with the echoes of addiction long after one has successfully gained some distance. Addiction is persistent, but controllable. It’s all about what you said, making choices, and good for you for doing so!
Vered!
As someone who really likes being an athlete, I can identify with over-training!
The person who made up the saying, “What doesn’t kill you, makes you stronger,” did not have an easy life!
Neitzsche.
This story reminded me of something that I experienced. My ex-girlfriend had a great life prior to drugs. She was going to UCLA for psychology (had around a 3.5 as far as I remember). Beautiful girl..extremely intelligent and very very well-liked. She was a typical college student who enjoyed getting drunk on the weekends and had the mind set where “you are only in college once”…which led to her downfall. She started doing cocaine. I noticed her doing it around 3 or 4 times a week (at least..this was what she told me anyway). I kept confronting her about it. I kept getting brushed aside..telling me it wasn’t a big deal. She overdosed..almost died..said she would quit and then got back on the drug two weeks later. She overdosed again where I finally got everyone I could invovled (parents, friends, her other family, my family). Eventually she got her life back into gear after going to rehab, but by that point she already missed so much class that she had to drop out. She currently works as a waitress without a college degree. Could have been a lot worse, but considering she was aspiring to be a psychologist right now it’s extremely sad.
I only wish she was made more aware about the harm of drugs. The Internet is a great resource for people to find information about addiction..if you Google “addicton”, “addiction resources”, and other terms you’ll get millions of results. There are websites that are dedicated entirely to addiction:
http://www.recoveryconnection.org
http://www.drugabuse.com
http://www.lakeviewhealth.com (the center my ex went to)
http://www.addictionresourceguide.com/
http://www.soberrecovery.com/
I feel like colleges (and other places) should be required to provide these websites to students to avoid the same type of hell my ex went through. Just a thought.
Hi Lonie!
Thank you for this comment. I’m sure it was very painful for you at the time.
Perhaps a turning point in your life?
Did we date the same girl? I was going with a woman who would fit your description of your girlfriend. It was cocaine, but she never let me know, till she was going out the door, although I had suspicions by then. Her life, sadly, spiraled downward and I don’t think she ever pulled through. I still think about that girl.
Dr J– Very powerful and moving story. I’m so glad to hear that he is now doing well and back on track with his life.
“Everything in moderation” is a great saying to live by. Addictions are so powerful and can just about infiltrate any part of our lives.
Thanks for this great piece!
Thank you so much, Rupal! I am very glad also.
Had a good friend of mine who I roomed with in the city with for a year get addicted to cocaine, It started out he would only do it maybe once a weekend and felt it was harmless, thought he wouldn’t get hooked. Next thing I know he’s buying bigger amounts and staying up all hours of the night ordering prostitutes and living this crazy new lifestyle it really got out of control, I couldn’t get him to stop for the life of me, I simply had to tell his family members so they could help him.
they ended up sending him to this rehabilitation place called the last resort
http://www.rehabilitation-center.org
He since has been living a clean and healthy lifestyle.
and its good to have a child hood friend back to normal.
James