Alston liked to say that his chronic marijuana use was the only thing that could help him relax. Imagining quitting was simply not an option for him; how else would he be able to unwind or even sleep? Whenever he got together with his buddies, they bonded around the experience of smoking – the breaking of stems, the rolling of joints, and the sharing; a take-turns endeavor that went in a predictable pattern around the circle of friends. Someone always had a little weed, and always they pooled their resources. The process was so reliable that Alston came to depend on the ritual as much as the intoxication. No one in his group ever demanded anything of him, and the group held together a set of traits with which Alston strongly identified. They were all ex-soccer players in their early 20s who smoked. No topic heavier than the merits of soccer over football ever came up, but Alston didn’t feel his group needed to “get all deep or emo or anything.” They were close-knit without having to spread and separate out their inner workings – even if they had known what those were. On the weekends, Alston’s buddies did a lot of drinking. Though he’d dropped out of college mid-semester and his living arrangements were tentative (he was couch surfing), he always found money for pot and beer. One of his friends usually invited everyone home to eat from his mom’s kitchen, so Alston didn’t feel the need to worry much about his own security. He believed he was as secure as he might ever be. Then Alston learned that his mother wanted contact again; she hadn’t been in his life since she left his father when Alston was 3. According to his dad, his mother had been a “party girl” who was “irrational, selfish, and insincere.” His dad had been the opposite: fiercely logical, abrasive and blunt. This made him critical of Alston and often demanding in a way that made their relationship especially tense. He expected his son to “get a life,” and from this, Alston flinched. He was no happier at the prospect of seeing his mother, however. She had abandoned him and he didn’t need her to do it again. Then he learned that his mother had been killed in a four-car pileup. He had nowhere to put his grief, an emotion he wasn’t able to understand, and then the pot and the drinking stopped feeling sedating. Suffering from insomnia and feeling frequently agitated, he took himself to see someone.
Understanding Through Therapy
Alston, like many addicts, experienced the kind of infancy and childhood in which his needs had gone unmet. The need for emotional connection, for affection, and for the consistent love of early caregivers is as important to the health and well-being of a child, and eventually an adult, as are needs for food, shelter and the activation of independence. Because a small child lacks the ability to self-regulate their needs and emotions, they are strongly dependent on caregivers to manage their needs for them and to help them regulate their moods. When a small child fears abandonment, he needs his caregiver to provide reassurance and to help him self-soothe. Alston’s mother left when he was at a highly vulnerable age; as a toddler, he still had little ability to help himself feel calm in the face of frustration or fear.
The Dopamine/Serotonin Equation
Harvard trained psychologist and author, Ronald Ruden, PhD, writes of the biochemical underpinnings of addiction in his book, The Craving Brain. According to his research, the components of addiction arise from the same mechanisms designed to oversee three critical activities essential to our survival: eating/drinking, avoiding harm and reproduction. The nucleus accumbens, front and center in the brain’s reward circuit, is a small structure belonging to the primitive brain that regulates the exchange of two essential neurotransmitters – serotonin and dopamine. Dopamine motivates us to do what is necessary to meet our needs, and once a need has been met, the nucleus accumbens triggers the release of serotonin. Serotonin, which helps us feel sated and contributes to feelings of happiness and well-being, then inhibits the compelling motivation of dopamine. When serotonin levels are low, the motivating effects of dopamine in the brain become amplified. In this scenario, anything that might be associated with the motivating need, say hunger, becomes strongly provocative. Seeing an advertisement for food, thinking of a kitchen table, hearing someone snacking on the train, all become strong triggers for dopamine and the motivation to sate hunger. Stress, especially chronic inescapable stress, lowers serotonin. When serotonin is low, not only do cravings increase, but depression and anxiety can also result. In this way, a person can become vulnerable to any substitute that has an effect on dopamine and serotonin levels, such as alcohol, drugs, or addictive processes such as sex, gambling or overeating. In Ruden’s model, Alston’s young brain is seen as having been forced to contend with chronic stress from a young age, a result of neglect and the low self-esteem created by his father. His marijuana addiction plays a vital role in superficially helping him to not only regulate his emotions – something he was never safely helped to do in his primary years – but to satisfy his cravings for the sated feeling produced by serotonin. Through therapy and 12-steps, Alston is now examining the ways that marijuana and alcohol served a function he had not been properly able to foster in himself – self-regulation via self-medication – and he is also becoming aware of the brain chemistry concurrent in this dance. Having this knowledge has helped him in his commitment to recover – not just from drugs, but from his emotional circumstances. And although it’s been an up-and-down path, he’s still walking it with a sense of purpose.