I always had a problem with the dichotomous way recovery from drug addiction was represented to me. The narrative was this: If you stayed off drugs you were clean (implying that users are dirty?) and success is quantified in terms of how long you can maintain this pristine state of normality. Everything I had ever heard about drug addiction focussed on this binary. At some point in time one stops using drugs and is granted enlightenment. From then on they are “clean” as if through baptism and live the rest of their life celibate from the drugs they once took, repenting for their miserable life as an addict, and seeking redemption. The taint of their sins having been expunged, this individual now counts the days and weeks from that fateful moment, having been reborn in their sins, and recites the interval from that date as a testament to their triumph over the scourge of addiction. If this sounds like a religious notion, it’s because fundamentally, it is. Although one may not literally call drug users filthy, naming abstinent individuals clean provides a very strong reciprocal implication. Likewise the seemingly innocent question “how long have you been clean?”, is not as neutral as the questioner may believe. How do I answer this question if I am on methadone? Do I say that I am clean or not? After all, I am still taking an opioid every day. I don’t want to dwell on this particular example because it is only just that, but I do want to make the point that this paradigm is not a very holistic one for framing recovery. Although I do not condemn people for employing it if it is useful for them, I personally find it extremely limiting and unhelpful, even stigmatizing.

I never challenged the clean/dirty framework when I was young, but after having to deal with addiction myself, I grew to resent this kind of thinking. Humans are complex, drugs vary in their effects, and we vary in our interactions with them. I have come to believe there is no “one size fits all” model for dealing with addiction. Some can find a way to moderate their behavior, others need to make a clear line in the sand, and yet others may decide that it is necessary to completely restructure their life or worldview to recover. However, there is one through-line that I think must connect all successful attempts at recovery, and that quality is honesty. I need to be able to be honest with myself about what I really want, and it helps if I am also honest with others. A big part of my recovery was discovering how to stop bullshitting myself and others, and I think it was more important than the constraints I put on my drug use. Let me explain what I mean.

First off, I want to point out that we live in the present moment. This may seem like a minor point but, the fact that we live in discrete moments in time means that we need to constantly make predictions based on memories that also exist “now” and try to navigate the “now” so that we can arrive into a future “now”, that we intend to enjoy (or at least be content with) . Thus, all our decision making is done with respect to reaching an endpoint that we perceive in the present to be different from the current moment somehow, but when that moment arrives, we will be in the present, planning another future moment. The only times when we are not planning for the future, are when we are so lost in the present moment, that we don’t even know it, or when we consciously choose to focus on the present moment. So, a lot of addictive behavior is a bit of a lie to begin with. We are trying to get to a better moment than now, and we have built a whole mental architecture in our brain for getting there, with a vague understanding that it will be good, but when we get there, we aren’t always satisfied. 

One of the hallmarks that I noticed with my addiction was that I was not actually content for very long, if at all. It took me a long time to realize this because I was so willing to believe that taking drugs made me happy. I didn’t take the time to really scrutinize how I felt moment by moment. When I finally did, I realized that drugs were not making me feel that good at all. But here is where I want to be very clear, it wasn’t all bad. I did actually have moments where I felt good, but the problem was more with the disproportionate value that I gave to those moments. I remember that I would just keep taking drugs long after I wasn’t feeling good anymore. I would set plans about rationing my drugs over a longer period of time, but I wasn’t able to stick to my plans because of an overly impulsive desire to keep taking them whenever they were available. I would keep taking heroin, for example, until I had a headache, then take more when the headache wore off, to get another headache. It was just compulsive behavior and I wasn’t able to temper it.

This may not be your experience, and that’s fine.  However, for me, it took a long time to admit to myself that my behavior was not compatible with my happiness. When I talk about the architecture in my brain, I am being somewhat literal. When we learn things, we change the physical makeup of our neurons. A pathway that results in a reinforced behavior physically grows when it is used. More receptor sites get created allowing the firing of that pathway to be easier the next time. As it is used more and more over time it continues to grow. This is how we learn things, from how to ride a bicycle, to learning to speak. We grow particular pathways that connect all the relevant parts of our brain to one another, so that a particular behavior can be expressed. Learning is reinforced by signaling to reward centers in the brain that make us feel good, but it can also be reinforced when we couple learning with negative sensation. For example, getting burned by a hot stove can teach us never to touch it again. In fact, aversion learning, where you learn something is to be avoided, can be learned very quickly. All these forms of learning result in physical changes to the brain. Addiction is just another type of learning. Drugs that make you feel good are strong reinforcers for all sorts of behaviors that we come to associate with the good feelings we get. They artificially reinforce our behavior resulting in an exceedingly accelerated type of learning and really strong pathways. Once they are built, you can’t get rid of them. Yes, I said can’t. As far as we know the pathways themselves will remain there, which is what makes addiction so persistent. However, what we can do is build additional “inhibitory” pathways on top of those. These pathways can turn off the addiction behavior pathways. It’s harder work to construct them because they are not reinforced as strongly as the drug induced learning. I know this isn’t particularly encouraging, but it’s the truth. Recovery is hard and lying about that fact wouldn’t make success any easier for anyone.

However, it is not all bad. There are other strong ways to reinforce the good learning still available to us. One of these is the use of social reinforcers. We are social animals by nature, and we are heavily susceptible to social rewards (this is why social media is so addictive too). We can use these to our benefit by surrounding ourselves with people who support our recovery goals (whatever they may be). When we get praise or even condemnation from a peer group, it can be a strong reinforcer for learning.

And this is where I want to come full circle about honesty. We need to know what it is we want: what we really want. It took a long time to get to the level of self-understanding I have now, and even so it is not complete. I am still searching for what truly makes me happy and fulfilled in life. I don’t know if drugs will play a part in that or not, but I can be quite certain that the compulsive types of behaviour and the toxic thought loops I associate with addiction should be avoided at all costs. I am working on gaining a deeper understanding of what makes me content: moment by moment. I still have an evolving picture of my ideal future and do not know exactly what a successful recovery ultimately entails. However, I do know that sitting down and really figuring out what I want is not easy. For me, I didn’t really want to stop doing drugs for a long time, but I recognized that what I was doing was not sustainable. Deciding that something needed to be done, and that I needed to make big changes was a start.  I began by getting on methadone instead of shooting heroin, which took me out of the drug-taking mind-set and the use of needles. I got myself out of the daily cycle of making money to acquire and do drugs and taking up all of my time. After about a year I gave up doing daily meth. As a result, my sleep and eating schedule became more normal and I started to get into cooking. I gradually cut more drugs out of my life over time as I concluded that I didn’t need them, or I wasn’t able to keep them under control. This took a lot of time, and it was hard to realize this was what I wanted. I rationalized my drug use for so long that it had become part of my identity. 

Of course, I wish I could have seen it more clearly sooner, but if I could have seen it coming, I would have skipped addiction altogether. It just wasn’t in the cards, and I had to do things at my own pace. I even frustrated the crap out of my first addiction doctor because I just refused to stop doing amphetamines and cocaine. At the time I was just stubbornly convinced that all I wanted to quit was heroin. Looking back on the whole experience, it’s comical how stubborn I was, but it took a lot of time for me to change. I needed time to adapt and there was no way to rush the process.

Even now I still take methadone daily, though I have slowly lowered the dose from 90 mg to 34mg a day. I still take amphetamines rarely in the form of prescribed pills when I have really intense work for school. I take caffeine either in earl grey tea or in coffee on a semi-regular basis, which is still a mood-altering drug although we tend to forget. Finally, I sometimes smoke pot when I lower my methadone dose to help get over the unpleasant transition period. Over the last 4 years I have made progress, but recovery, like life, is a journey, not a destination. I still don’t know if I truly want to be drug free or if that is even my goal, but I know I don’t want to continue to encourage behaviors that don’t contribute to my happiness. I want to build the brain that I want to live in, one pathway at a time.

I want to be clear that I am not advocating drug use in general. Everyone is different and some people find it easier to just quit completely. On some level I envy the people who could do that because I tried and failed repeatedly with that approach. I encourage everyone to follow the path that they think is right for them, while acknowledging that they may feel differently in the future. Mistakes are just setbacks and plans are not set in stone. The only thing I suggest you strive to achieve is honesty: both with yourself and with those closest to you. Even if you cannot achieve that pristine state that society has decided is “clean”, you can still strive to be filthy honest.