Some Things You May Not Know About Substance Abuse: When you stop using your drug, you find the real issue

“Ask one of the patients at your unit if you could interview him,” my professor said, giving me a tape recorder. “Ask him if he would tell you why he uses drugs.”

I said I would. I was ready. I wanted to know why people use drugs.

I was an intern at a chemical dependency unit at a VA medical hospital.

“Above all,” my professor added. “When you interview the patient, be non-judgmental. That’s all you have to do. When you’re non-judgmental it becomes easy for them to talk, and they need to talk. You’ll be graded on how non-judgmental you are.”

I thought the assignment would be easy, but when I found someone who would talk with me, once he began to speak, he told me what he said he had never told anyone before.

“I’m a child molester,” he said.

I almost packed up my tape recorder and went to find someone easier. I was supposed to be non-judgmental. I was being graded on this.

He went on to tell me that the first time was his little sister, then some children he’d babysat. He hated himself for it. He joined the Navy just so he wouldn’t be around kids, but they stationed him in the Philippines, where there were plenty of child sex workers. He left the Navy, and got married, hoping that would cure him, but his wife wanted children. When he began to take a sexual interest in his own children, he discovered heroin made him stop. That was his drug, heroin. Now the addiction was out of control and his wife demanded he go to rehab.

“She doesn’t know I’m a child molester. How can I tell her I can’t stop using?”

I didn’t know what to say, but I did thank him for letting me record him.

When my professor heard the tape, he immediately gave me an A. I guess I’d been sufficiently non-judgmental. He said I had to tell the director of the unit what the man had said.

The Director was old school. “He’s trying to justify his use,” he said. “He’s trying to distract you from what he’s here for. You fell for it. What makes you think if he was a child molester he would tell anyone. Why would he tell you, an intern, when he wouldn’t tell anyone else?”

A couple of days later the man absconded from the unit. Whether he went back to using heroin or molesting children, I have no way of knowing; but I do know that he changed the direction of my career. Despite the Director, I would always look for the underlying issue.

I have more sympathy for the Director now than I did then. I have since learned that few addicts know why they use their drug; so, when he heard of someone who said he knew, he was suspicious. I get that now; but I still believe that before using a drug becomes a problem in need of a solution, it was a solution to a different problem.

Let’s just say that a typical alcoholic is having a craving. She’ll say something like, “I need a drink.” If you ask her what she needs a drink for, she’ll probably say she just needs a drink. If you press her, or if she can’t get a drink, she might say that she’s anxious. “That’s why I need a drink,” she’ll say. “I need it for my anxiety.” However, you don’t know if anxiety is what started her drinking in the beginning or if she’s just anxious because she can’t drink.

If you dig down a little deeper and ask her how she began drinking, she might say, “I was a teenager at a party where there were a lot of people I didn’t know. I didn’t know how to talk to anyone; but when I started to drink, I didn’t think so much about it and I had a lot of fun.”

Now we’re getting somewhere. You could go on and ask what was important about knowing what to say.

“I didn’t want to look dumb.”

“What was important about not looking dumb?”

“People used to tease me.”

“What was important about people not teasing you?”

“I wouldn’t have any friends.”

You could keep going like this, all the way down a chain of solutions. Drinking solves not knowing what to say. Knowing what to say solves looking dumb. Not looking dumb solves getting teased, and so on.

If you follow this chain of solutions all the way down to the original problem, you come to when the woman was a baby. She cried. She didn’t know what she wanted because she was just a baby. Her parents don’t know what she wanted, but they wanted her to stop crying, so they tried a series of things; and, when she stopped crying after they bounced her up and down, they figured that was it. Crying was the problem and bouncing her up and down became the solution. When she cried, they thought it meant she wanted to be bounced up and down.

Is that what she really wanted? We’ll never know. We’ll never know because it is lost to time, but, even at the time, it was impossible to know because she had no words for it. She was an utterly helpless, unknowing, inarticulate human being at the time.

That’s what it all comes down to, I believe. That’s the problem that motivates everything. It’s the abyss.

The abyss is this deep, dark, depressing hole, full of chaos. It’s a chasm, really, and when you fall in, sometimes there’s no climbing out. When you call it anything at all, you call it death, brokenness, vulnerability, hopelessness, helplessness, or despair. I like to call it the abyss.

A lot of us like to believe the abyss is at the end of everything, but it’s also in the beginning. We came out of it. The baby is crying from the depths of it. When parents identify a solution, they pull her out.

The abyss is in the middle of everything, too. You walk around it, gaze into it, slip into it, and watch others fall into it all the time. It’s there whenever you see just how screwed up everything can be. You don’t like to think about it. It’s considered impolite to even acknowledge its existence.

You live at the edge of this hole; some dance at its rim; others peer carefully in; most keep their back to it, as if it wasn’t there. You often find yourself reeling, dizzy at the edge. You cling to something to prevent falling. Clinging to something enables you to live at the edge of the abyss more comfortably. You think, if you start to slip, you can haul yourself out.

What do you cling to? What are the bushes at the edge of this hole?

Solutions.

Unfortunately, anything we cling to starts to fall into the hole, too; taking us down, with it. Everything must fall in the hole, eventually. Every solution leads to more problems.

The alcoholic is clinging to a bush that is starting to go and fall into an abyss . She’s got to learn to swing from bush to bush. Let go of drinking and try something new. Of course, this means she’s going to have to let go and reach across the void to grab on to something unfamiliar. She may look crazy, swinging from bush to bush over a bottomless chasm like a mad monkey; but she’ll be the most sensible person of all.