In recent years, society went from describing opioid abuse as a moral failing to framing it as a disease. The change in tone is fitting because substance abuse is not just a physical problem.
Important psychological factors are at play before, during and after someone develops a substance use disorder. Comprehending how the mind works during each phase is crucial to understanding opioid abuse.
The mind before abuse
Dr. Joel Martin, chair of psychology at Butler University, warned against popular beliefs of “addictive personalities” and “types” of people who more likely to develop substance abuse disorders. It’s more accurate to think in terms of personality traits that may make people more susceptible to addictive substances. Dr. Tim Kelly, an addiction psychologist at Fairbanks Alcohol and Drug Addiction Treatment Center, compares substance abuse disorders to diabetes: genetics and choices determine the likelihood of developing a problem.
For example, people’s genetics determine what being high on opioids feels like. According to Kelly, most people feel “sluggish,” “fuzzyheaded,” “nauseated,” and possibly even constipated while on opioids. Others experience a sense of energy and euphoria due to their genetics, making them more likely to continue taking opioids.
Laura Nowling, who is in recovery for opioid abuse, said she began taking opioids due to the energy it gave her. Being a mother who worked full time, Nowling found the energized feeling from opioids helpful. If she ever needed to tackle a task such as painting around the house, she would take Vicodin and work off the high.
Martin said behavioral traits also can increase chances of developing a substance use disorder. For example, a strong leaning toward the trait “openness to experience” might make someone more likely to try opioids for the first time.
Most substance abusers suffer from both genetic and behavioral determinants. For example, Nate McCarthy, a former opioid abuser in recovery, possessed a genetic determinant because his mom suffered from addiction and a behavioral determinants because he experimented with substances at a young age.
“I smoked my first joint when I was 11,” McCarthy said. “My first sip of alcohol I could remember is when I was 12 or 13 in junior high school. As they say, it’s a progressive illness.”
The mind during abuse
Substance abusers develop what Kelly calls an obsessive-compulsive disorder (OCD) relationship with the substance, where thoughts about the drugs become increasingly frequent. He compared it to gambling addiction. The average person thinks about gambling a few times a year, but addicts think about it daily.
Mike Thibideau, director of Indiana Workforce Recovery and recovering substance abuser, said opioids eventually become intertwined with survival instincts. Substance abusers then often prioritize their abuse over other commitments such as family, friends and work.
“My brain had been hijacked,” Thibideau said. “I was trapped in a hopeless cycle, and I was unable to pull myself out of it because willpower is not part of the conversation. It’s not because I didn’t want to. It’s not because I didn’t try. It’s not because people don’t care … It’s that they are no longer in the driver’s seat.”
Caitlin O’Dougherty, CVS pharmacist tech and speaker, said the prioritizing of opioids often causes people to display chronic dishonesty, sudden mood or personality changes, increased negativity, irritability and social withdrawal.
The mind after abuse
Breaking substance abusers out of their mindset is not a matter of confrontation or willpower. Martin said that intervention strategies, including Scared Straight programs and boot camps, are not effective. The most effective way to reverse the psychological grip of opioids is a combination of medicine and therapy. Afterward, support from a social network will allow those in recovery to best handle future temptations.
When firefighters resuscitated McCarthy after he overdosed on heroin, he decided to change his direction in life. He moved to Indianapolis to be near his aunt and begin a new life. McCarthy enrolled in Pathway to Recovery, where he found medicine, counseling and a social support system to help him seek recovery.
McCarthy appreciates how the change in location removed him from the places he developed a substance use disorder and put him in touch with a supportive social circle. He finds that being around supportive people increases his confidence that he can continue recovery.
“For me, it’s a matter of being in a structured environment, having people around me that’s loving and caring all at all times, people that can identify if I’m going tough anything, people who can that know the signs [if something’s wrong],” McCarthy said.
Contact staff writer Ben Lashar at 317-762-7848. Follow him on Twitter @BenjaminLashar.
