In active substance use or behavioral addiction, the substance or behavior becomes the number one priority. This may seem unbelievable to those who do not suffer from this affliction, but it's the truth, and the science backs it up.
Why am I Number Two?
You aren't. Everything is number two. Well, not really, but everything is less beneficial for survival, at least the brain thinks so. “But why does it feel like my loved one is choosing drugs or behaviors over me?” I've heard this from parents and partners many times. The family and loved ones of someone abusing substances or behaviors are literally unable to comprehend choosing a substance or behavior over a family member, partner, job, health, or children. However, this is the reality of substance or behavioral use. In active addiction, obtaining and using the substance comes before anything else. This occurs because of constant abuse of the reward pathways in the brain which prioritize substances and behaviors in their order of survival value.
Why does the brain do this? Can't my decision-making faculties make these decisions? Yes, yours can, but not our ancestors. If the brain did not do this, we would not be here. Primitive organisms only survived because of these primal instinctual drives to stay alive. While we are no longer completely driven by these impulses, they are still there. The frontal cortex sits on top of this process and allows for reasoning and judgment. Unfortunately, someone who is in the throes of addiction has compromised this process, and the survival impulses are overriding logic, reason, and morality. It's not that the individual actually thinks substance or behaviors are more important, it's that they are paramount for survival. This is not true, but the brain believes it is true because of dopamine.
Dopamine and The Reward System
Dopamine functions to prioritize substances or behaviors. Drugs and modern behaviors aside, sex/reproduction was most likely the most powerful drive in ancient man or other organisms. This activity releases more dopamine than a sandwich for most. However, substances tend to release more dopamine and are thus prioritized over other behaviors. Once the substance or behavior becomes number one, other behaviors, activities, or people take the back seat. It's not that these are not important, they just aren't as important, though intellectually a using individual knows this is not true. It is because of the dysfunction in these areas and survival instincts that substance and behaviors are prioritized. It is easy to blame the individual, but this is a compulsion beyond comprehension if you have not lived it. If you are a family member, think of the food you crave the most, multiply that many times into a delusional obsession/compulsion where you will choose that food over your family, that's addiction. Intellectually you know it's not right, but ancient unconscious survival areas of the brain are telling you otherwise, incessantly. It is a very difficult experience, and why it is so hard to recover.
The stress system also has a role in this process. Stress gives the body signs that something is wrong and something is needed. This is best demonstrated by hunger. If you have ever been “hangry,” then you understand this. When the stress system kicks in, the body looks for something, and uses dopamine to determine what is best for it. That may be a pint of ice cream or a few shots for someone that does not suffer from addiction, but for those that do, it's as much of the substance or behavior that they can, because their body is trained to seek this to alleviate stress. Once the body is trained, normal pleasures and stress relievers won't cut it anymore.
Perhaps this makes sense to you now, but you are still number two, how is that process reversed. Realistically? Time. The brains dopamine expectations need to return to normal levels, and this will take time without abuse of this system. This is one reason treatment is useful, so long as people take treatment seriously and don’t abuse other behaviors and substances, as this will drag the process out. During this process, support from friends and family will be helpful, as will working with the counselor or treatment center. You might also encourage your loved one to attend a 12-step fellowship. There are many options and we are here to help!
At Independent Recovery, we completely understand this issue, and encourage our clients to have their family to be involved in counseling. We will not force the matter, but we do think it is best. If you would like a free consultation for you or your loved one, feel free to reach out to us on our Get Started page.