The Cycle of Addiction: The Holidays & The Social Learning Theory

By Marty Rein, Ph.D., LPC, CAC III

Happy Holidays! What does this statement mean to you? For many, it means joyous gatherings with family and friends to celebrate the end of a year and beginning anew. For others, who are struggling with substance/alcohol abuse and other challenges in their lives, participating in holiday gatherings can be very stressful. This stress is due in part to the social expectations, such as attendance at parties and gatherings that often come with the holiday season.

The complexities of social interactions during the holidays are too numerous to go into in this article, but I’ll throw a few ideas out. Previously, I wrote that we are social beings. We naturally seek out connection and acceptance with other people. It makes us feel safe, which feeds a basic survival instinct that drives our behaviors. One explanation of this phenomenon is described in Social Learning Theory, developed by Albert Bandura, the prominent psychologist at Stanford University.

Social Learning Theory suggests that people regulate their behaviors based on social cues. There are four elements to the Social Learning process: attention, retention, reproduction and motivation. First, a situation attracts a person’s attention through repetition or novelty. Second, the person retains that information and can remember the behavior that was observed. Third, the person is able to reproduce the behavior. And finally, the person has adequate motivation to imitate the behavior.

Social Learning is apparent in every part of society. Think about how people interact, dress, and celebrate, for example. Consider how New Year’s Eve is typically celebrated. Early in their life, one might see their parents attend a party for New Year’s Eve. This information is retained as accepted behavior. Eventually, one becomes able reproduce the behavior. Then, through social cues that tell us that this behavior is expected in order to be accepted, that person has motivation to act the behavior out.

What would it be like to go against the social expectations that are impressed upon us, if we did something different? Well, it would probably not be a very comfortable feeling because going against those expectations means taking the risk of not being accepted.

The holidays are a time when social expectations take precedence. The nature of relationships and situations, both good and bad, are magnified. Because we tend to compare ourselves to others to gauge our success, the pressure to “look good” is immense. While this article doesn’t address other conditions that make the holidays difficult, like family problems, depression, anxiety, and financial stress, here are a few tips to help those struggling with substance problems navigate the holiday get-togethers:

  • When going to a party where alcohol will be served, bring your own “special” non-alcoholic drink, like a six-pack of fancy root beer or fruit juice and soda.
  • If you are hosting a party, be sure to have a non-alcoholic drink choice (besides water) available.
  • Take a trusted friend with you to the party who will support your choices.
  • If you know someone who is alone or away from their family, invite them to your gathering.
  • Have a back-up plan to graciously exit the gathering in case you feel uncomfortable.
  • Use the HALT method; don’t get too hungry, angry, lonely, or tired. Bad choices can follow these conditions.
  • Relax and know that most people won’t notice if you are having a non-alcoholic drink.
  • Go to the party late and leave early.
  • Be aware of your feelings and trust them.

There are many more strategies to be safe and still participate in holiday activities. Be creative. Don’t miss out on a happy holiday season with your family and friends. Enjoy yourself and your loved ones during the holiday season and know that, if you do have a struggle, it’s okay to ask for help.

The Cycle of Addiction: The Physiological Process & the Concept of Homeostasis

Marty Rein, Ph.D., LPC, CAC III

By Marty Rein, Ph.D., LPC, CAC III

Many factors contribute to the development of substance use dependency. One of those factors is a physiological process that happens over time with continued substance use. It may not be noticed by the user because it happens so incrementally. Awareness of a problem only arises when the person experiences an inability to stop using. Therefore, understanding how the physiological development of dependency occurs is important.

We are all born with an internal regulating system that maintains stability in body temperature, blood pH, and glucose levels, among many other things. The body strives to maintain its systems of functioning within a normal range. This process is the phenomenon of homeostasis and is essential to our survival.

Homeostasis is the physiological process that maintains equilibrium in our bodies and allows us to function normally. Our bodies strive to maintain homeostasis when systems fluctuate. The body accomplishes this through “complaining.” For example, one way our bodies complain is to shiver when it’s cold. Shivering produces heat and is our body’s attempt to increase temperature. Likewise, when the body overheats, it complains by sweating to decrease temperature.

When alcohol and/or drugs are ingested, the body tries to return to its normal homeostasis by processing them through the liver, kidneys, and lungs. If substances are consumed to a point of intoxication, the body reacts with an upset stomach or possibly vomiting in order to stop the person from consuming more. This is the body’s effort to buy time in order to process and/or purge what it perceives to be poison in its attempt to return to homeostasis.

The problem occurs when a person continues to use despite the body’s complaints. Through continued use a person’s homeostasis can become “reset.” The same process still happens, but with a new homeostasis set to the substance levels the body has become accustomed to. Now, when the new, reset homeostasis fluctuates, the body again complains. Only instead of complaining when the level of the substance is increased, the body complains when the substance level decreases. These complaints are known as withdrawal symptoms. Common withdrawals from alcohol can be irritability, tremors, clamminess, headache, and nausea. These symptoms are the body’s attempt to return to the new homeostasis. One way to reduce withdrawal symptoms is to re-use the substance, like having a mimosa during Sunday brunch after a Saturday night of drinking in order to alleviate hangover symptoms. The substance has now become the medicine for the symptoms it actually created.

A particularly dangerous withdrawal symptom from alcohol abuse is the possibility of a seizure. Anyone experiencing high levels of continued alcohol consumption should consult a professional for a safe, medically monitored detoxification process.

Nicotine withdrawal symptoms can typically be headache, nausea, anxiety, insomnia, and fatigue. Withdrawal symptoms from marijuana can be headache, nausea, anxiety, insomnia, disturbance of appetite, paranoia, and irritability. Cocaine withdrawal is experienced by tiredness, depression, anxiety, and moodiness. Opiate withdrawal can be all the above, but also include muscle aches, high blood pressure, increased heart rate, and intense cravings. Sometimes withdrawal symptoms are confused with chronic pain. (This list is not exhaustive or definitive.)

Understanding how the process of substance dependence develops is important, but it’s also crucial to listen to our bodies. Our bodies constantly send us information on what is working and what isn’t working for us. It’s an individual experience. We need to ask ourselves if the substances we are using have become the medicine for symptoms they have caused.

The Cycle of Addiction: Evaluating the Legitimacy of the “Gateway Theory”

Marty Rein, Ph.D., LPC, CAC III

By Marty J. Rein, Ph.D., LPC, CAC III

“If you use marijuana, you will end up using more dangerous drugs.”

This is a phrase commonly heard when people talk about substance use problems and how they develop. The notion that the use of a substance viewed as less harmful will lead to the use of harder, more addictive substances is known as the Gateway Theory or the Gateway Effect. Caffeine, nicotine, marijuana, and alcohol are among those most commonly labeled as “gateway drugs.”

The Gateway Theory does have merit overall, but substance abuse issues are complicated, varying with each individual. There are contradictions to the theory, such as persons who have difficulty with prescription opiates, but who have never had smoking or drinking problems. Also, many people use caffeine, nicotine, alcohol, THC (the active component in marijuana), and prescription medications and never develop problems or progress to more potent substances.

Is it possible to avoid substance abuse problems by avoiding gateway drugs? Unfortunately, it’s not that simple. It’s not the drug that matters so much as the effect that the drug has on a person, what the person believes about that effect, and how their decision-making is influenced by their beliefs. People are also influenced by social and cultural beliefs instilled through families, friends, and schools, etc., that tell them how to behave in order to be accepted.

Decision-making plays an important role. One approach proposes decision-making as an “inside job” influenced by our beliefs, and posits that we constantly revise our beliefs to fit with what our experiences telling us. For example, humans have an inherent need to be “part of” something – to share experiences. It’s the basic “herding instinct” we possess that motivates us to seek interactions and relationships with other humans. So, if someone believes that using alcohol will help them fit in with a particular group of people, then that belief influences that person’s decision-making when they are with that group of people. It doesn’t matter if the belief is accurate or not: It will be acted upon until sufficiently proven wrong. Furthermore, if that person feels accepted into the group, whether it had to do with drinking or not, the idea that they were accepted because of drinking may become solidified and have an even more pronounced effect on future decision-making.

It’s also about brain chemistry. Nicotine, for instance, promotes the release of dopamine, a neurotransmitter released with activities related to survival (e.g., eating and sex). Dopamine is powerful motivation for the continuation of nicotine use because it calms and stimulates simultaneously. Through this experience, one might say, “When I smoke, I am calm, focused, and alert and I get a lot done.” The person might combine this belief with a common social belief that success is measured through accomplishment. This pairing creates a strong influence on whether that person makes the decision to continue using nicotine or not. Also, when nicotine is processed through the body, the result is a feeling of lethargy combined with restlessness – a not so desirable outcome. Eventually, the person may start to believe they cannot function properly without nicotine because it continually takes higher doses of nicotine to induce the desired effect. The person might say to him/herself, “Nicotine isn’t working like it used to any longer. I need something stronger.” The person’s decision-making is different than it was before because it is skewed by the new beliefs that nicotine has saddled them with, not to mention the physical need felt through the withdrawal from it. That person might then make the decision to seek out a more powerful substance.

The assumption is that this process could lead to experimentation with marijuana as a replacement, for example. Marijuana contains THC, which releases a higher amount of dopamine in the brain, creating euphoria in the user. The person again revises their beliefs followed by new decision-making patterns that could lead to trying even more powerful substances.

Any abusable substance or behavior could be plugged into this process – things such as exercise, food, sex, thrill-seeking, gaming, or even work – because everything we do elicits a chemical response in our brains.

Avoiding “gateway drugs” is not a bad idea, but it is even more important to avoid “gateway beliefs.” One needs to pay attention to the underlying motivations that influence the decision to use substances in the first place.