It's Getting the Best of Me," the title of a famous James Cagney movie, may very well describe the effect of the so-called "second-generation" drugs on the brain, whose long-term effects we are just beginning to understand. ### Is there any help for the addicted user? We do not know for sure what will happen if the addicts do not stop using the substances. In a certain sense, they do have a choice; they can commit to abstinence or continue in denial. There are some success stories, however. Two friends who were both alcoholics were saved by their wives. Marilyn's husband was having serious depression and anxiety. When she talked to her doctor, she learned about the chemical dependency, and he told her what she should do. She took some steps to help her husband and, in time, her husband kicked the habit. Curtis's husband committed suicide. After that, he started using, and then he turned to injecting the heroin. Curt's wife took him to the doctor, who, as is so often the case, told her there was nothing he could do to help. She then went to an addiction specialist, who told her that a substance she had been taking (she doesn't remember what) was a possible cause of her husband's addiction. He did not offer any treatment, but told her to stay with the psychiatrist, which she did. And she took the substance away from her husband. She says that he would have done anything, including killing himself, to get his hands on that substance. There is at least some basis for the fact that when the addicted person gets help and gets into a program, many of them have a chance of getting their lives back on track. There is the occasional bad outcome. Of course, nothing prevents the addictive person from going back to drugs. Sometimes people do. But when people get into a program, they can get themselves clean or sober at least once. A large number of them do. There are also stories of people who did not succeed at first but got into treatment and then did get clean or sober. I once knew a young man who got himself cleaned up, and he could not stop his friends from continuing to use. Eventually he started shooting up as well. He went into a program and got clean and sober for several years. But then he started smoking marijuana again. He was going to stop that as well, but he had a death in the family, and he smoked to get through the grieving process. Then he started using, and he could not stop. So he got into a program again. The only way he could get clean from the time he went back to using was when his father died, so he just decided to stay clean for then. Then he started using again. Finally, he kicked the habit, at least for a while, when his son got married. Then he got back on the stuff. ### Are certain drugs more difficult to get off than others? The short answer is yes, as follows. The longer you go without any use, the easier it is to quit drugs in general. Cigarettes are the easiest to quit, followed by wine, and then cocaine. Marijuana is harder to get off, but marijuana withdrawal symptoms, while they are real, are not serious. A large number of people are able to get off cocaine relatively easily. Marijuana withdrawal can be severe, but marijuana withdrawal can be dealt with. Heroin, although it is relatively easy to get off heroin, is very hard to stay off without treatment. Addicts have found various ways to use or get off using the drugs over the years. One of the most popular ways of getting off alcohol was to get into a detox program and do not drink while in a program, but instead drink coffee with lots of milk. They can do this because the alcohol gets used up quickly in their system and is gone within hours. While they are in the program they often make sure to binge on foods, most often sugar and starches, so that the sugar and starches will be converted into energy and keep them going. ### Are some drugs harder to get off than others? There are certainly differences between the drugs. Heroin is harder to get off of than cocaine or even than marijuana. The hardest ones are cocaine and heroin, followed by opiates like morphine. There are a number of reasons for this. Cocaine increases your energy level. Therefore, once you have done it, it is hard for you to slow down enough to go into withdrawal. You can use the drug or come off it to get energy, so you continue to use the drug and continue to become addicted. Heroin, while it feels good initially, does not give you the energy boost you get from cocaine. It takes a while for the effect of heroin to get into you. You have to stick it in your arm and inject it. As a result, you don't start using, but you have to stop using by sticking the needle in your arm a number of times per day. The needle gets you to start and stop using because it is convenient for use and for not using. The withdrawal takes place because of the fact that you don't have the cocaine. And heroin is very nasty in withdrawal, so you really have to want to quit. As to marijuana, it is a very small amount of a drug. That means that you can consume a lot of marijuana and not gain a lot of energy from it. On the other hand, marijuana does increase your hunger, so even if you start smoking marijuana because you can't sleep, when the effect wears off, you still have to eat something or else go into withdrawal. In the case of alcohol, the effect takes some time to wear off. Marijuana has little effect on the body chemistry for a while. Then, it affects you. It affects your thought process and mental outlook, so you have to deal with the effects of your use on a daily basis. Heroin has similar effects to cocaine, and so you can stay relatively active, at least for a while. Of course, after you get the habit you are still able to go back to work. ### Is there something addictive in drinking coffee? Yes, there is. It has a short effect, and it is a habit-forming drug. Coffee is just another drug you get used to. ### How can I get help with my addiction? Just talk to your friends and family and ask for their help. A lot of the time you are better off using a professional who is experienced at working with drug problems. You can also look in the yellow pages and find a local group. ### Is alcoholism an addiction or a disease? I believe alcoholism is a disease, but we have to be careful about saying what people are, because we do not have any way of knowing whether an addict is an alcoholic. What I mean when I say this is that I believe alcoholism is a disease but I do not believe that all people who call themselves alcoholics have the disease, just as I do not think that everyone who calls himself a schizophrenic has schizophrenia. But in many cases we can easily say that an alcoholic is an addict or that a schizophrenic is schizophrenic. It is only because alcoholics start using to deal with anxiety and mental problems, for example, that some may end up being addicts. I believe that as with other diseases, it is easier to say that alcoholism is a disease if you do not think you may have the disease. ### How common is alcoholism? It is estimated that about 25 percent of all drinkers become dependent upon alcohol. At the same time, it is estimated that about 4 percent of all people have some form of alcohol-related disease. This means that 15 percent of all drinkers are likely to have some kind of a problem, but only 4 percent have a problem that is considered "alcoholism" at present. ## 14 ## ADDICTED TO MARRIAGE ### What is the problem in marriage? In talking with my clients, I have discovered that most of them want their marriages to go well. They want their partners to treat them well and want the relationship to go well. In other words, most of them want to have what is referred to as a good marriage. The problem is that most of them are addicted to their own desires. They do not want their needs met, but rather to be happy, so that they can put their lives in order and make something of them selves. Therefore, they seek out partners who fit their needs. It is easier to go around with somebody who is just your opposite. When you think of it, your spouse is always there, always the same person. You may want to live with someone else, but you don't. So there has to be something else going on that is the problem. ### Does a husband need his wife? The husband does not need his wife the way the wife needs her husband. The wife may need her husband for what he can do for her: for example, in her case, to make her a better person and do well for herself. The husband needs his wife for his identity. A man who can go through his life without a woman who wants to be in love with him may be the one who has problems: "I don't need anyone, I can do it by myself." But what he is saying is that he doesn't need any woman. That may be his problem. He does not have to have a woman in order to know he is an individual. He can get through life without