A new definition of addiction, part 2

A few months before Pete passed, he revealed to me he'd started drinking when he was 11 years old. It shocked me, and it's shocked his friends and loved ones when I share this.

We had been speaking on the phone more often that year, in the evenings. The year before, he'd lost a job he'd held onto for several years. Multiple job interviews and failed trial periods later, he was still unemployed. No doubt his ongoing alcohol use played an overriding role in his unemployment. Sometimes when we talked, it was hard to tell whether he was using; other times, slurred speech made it obvious that the drinking continued. Still, he often sounded positive, talking about the importance of love in the world. He didn't talk about problems or concerns, but he opened up more emotionally that he had before.

It is a serious thing when children that young use mind-altering substances. Returning to Szalavitz's book Unbroken Brain, she notes that among children who begin drinking at age 14 or younger, 50% develop an alcohol substance use disorder, versus only 9% if they begin at 21 or older (Szalavitz, Unbroken Brain, p. 61). I really don't like those odds. Pete didn't have much of a chance.

Timing matters in brain development, says Szalavitz, and regarding the risk of alcohol and drug addiction, adolescence is a time of particular vulnerability. She and other researchers/authors point out that adolescence is a time of major brain development, and if affected by regular alcohol or drug use, neural pathways and synapses change. Substance use can result in "overlearning" and "reduced brain plasticity (that) makes the behavior extremely resistant to change…." (p. 61), even despite any negative consequences of use. "Addiction...alters the way the brain decides what it values (p. 61)." More than that, other developmental experiences and learning that would have happened during adolescence are missed during repetitive substance use. The misses may iterate, and then maturation is stunted, and a developmental disorder may become established. In this way, Szalavitz reinforces her idea that addiction is a learning disorder.

A negative personal quality or experience, and/or resulting emotions, may become associated with these thinking patterns, further ingraining them - e.g. isolation, sensory or emotional sensitivity, austism, obsessive-compulsive behaviors(p.72).

Most people for whom alcoholism is a problem are running away from something....Usually, what they are running away from is feelings and the inability to deal with the intensity of their feelings.

- Pete Townshend, Szalavitz, p. 80

Uneven brain development can also create a vulnerability to self-medication with substances. Given how widely varied human biology is, especially in adolescence, it is easy to imagine a individual youngster having their own schedule and pattern of brain tissue maturation that leaves them at risk.

There can be signs of risk before adolescence; observed in early childhood, traits such as impulsivity, sadness, anxiety, or combinations thereof are future predictors of potential self-medication (p. 61). Fundamentally, these all may be distilled into the category "difficulty in self-regulation". Children develop the mental/emotional muscles of self-regulation through the experiences of adolescence, and if a substance use habit is developed early on, a child will miss or substantially alter those stages. The good news - it is never too late to learn. Brain scans of people with years in recovery show substantial new growth of gray matter.

Pete's history exhibits these risks. As a small child, he displayed a high level of sensitivity - a family friend who babysat Pete and I from our early years noted, "Pete was always a very sensitive boy." Our mother has said repeatedly that Pete, from earliest days, exhibited difficulty with impulse control: "He couldn't think things through before acting." Richard Reeves (among others) notes that this is a characteristic of adolescent males that puts them at a disadvantage to females at the same stage.

I've noted previously that my brother was briefly treated for ADHD, and Szalavitz notes, "Having ADHD alone, in fact, nearly triples the odds of...drug use disorders and increases the risk of alcohol disorders by 50% (p. 83)." Again, the connection is about a disorder of learned behavior - what drives habitual behavior, and decision-making processes about whether or not to execute a behavior (p. 96). Addictive behaviors veer into the automatic. Decisions are made based on different values, mainly the overriding values of pain relief, numbness, comfort and/or euphoria. But the false kinds, chemically-induced rather than reality-induced. The chemicals are far more reliable that reality - until the negative consequences begin to destroy a life.

What this means for treatment alternatives, coming next.