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Why can certain users handle their drug use with responsibility while many can't?

I was given one year to live, without a liver transplant. Driving to Detroit everyday for six months to piss into a cup; before I would be put on the organ donor list seemed like too much of a hassle besides I only partial stopped drinking. When I was released from the hospital almost exactly 8 years ago, I planned on staying sober. My mom had died in November of 2015; Complications of cirrhosis and then I got real sick and ended up spending 2-3 weeks in the hospital only 1-2 weeks after my mom's death. My sister died a year later in November 2016. I went into a terrible drinking binge: in early December of 2016 I got a DUI. I hadn't drank since the morning/ early afternoon of the day before. I finally quit after almost puking on my doctor. Also the judge at the first hearing told me to not drink.
I left the house feeling fine, but my liver wasn't processing alcohol, then it hit me as I was driving.
The cops took me to the station; but they wanted a blood test to really screw me over.
It was .37 something or .38 something. Nearly 5 times the legal limit and well over the new super drunk, DUI law. The judge was nice to me.
Simple DUI. My worthless public defender was shocked I got off easy.
The funny part was, I can barely remember but I told the doctor I was an alcoholic and if I go to jail and detox, I might die of withdrawals. So I spent a long weekend getting IV morphine and IV Ativan(lorazepam).
A hospital bed with drugs, TV and decent food for a hospital.
Being nice can really help in a sort of minorly bad situation.
 
Jnowhere said:
I was given one year to live, without a liver transplant. Driving to Detroit everyday for six months to piss into a cup; before I would be put on the organ donor list seemed like too much of a hassle besides I only partial stopped drinking. When I was released from the hospital almost exactly 8 years ago, I planned on staying sober. My mom had died in November of 2015; Complications of cirrhosis and then I got real sick and ended up spending 2-3 weeks in the hospital only 1-2 weeks after my mom's death. My sister died a year later in November 2016. I went into a terrible drinking binge: in early December of 2016 I got a DUI. I hadn't drank since the morning/ early afternoon of the day before. I finally quit after almost puking on my doctor. Also the judge at the first hearing told me to not drink.
I left the house feeling fine, but my liver wasn't processing alcohol, then it hit me as I was driving.
The cops took me to the station; but they wanted a blood test to really screw me over.
It was .37 something or .38 something. Nearly 5 times the legal limit and well over the new super drunk, DUI law. The judge was nice to me.
Simple DUI. My worthless public defender was shocked I got off easy.
The funny part was, I can barely remember but I told the doctor I was an alcoholic and if I go to jail and detox, I might die of withdrawals. So I spent a long weekend getting IV morphine and IV Ativan(lorazepam).
A hospital bed with drugs, TV and decent food for a hospital.
Being nice can really help in a sort of minorly bad situation.
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That is a "majorly" bad situation bro. Take heart that you made it through all of that in one piece. No small thing. Stuff like this crumbles a lot of people, it's great that you've made some improvements in your life.
 
What does it mean to “handle drugs”

I’ve got everything you could ever want on paper. Most ppl look at my life, my job, my wife, my family etc and would never imagine I’m a drug addict.

Despite all that I don’t believe this constitutes “successful drug use.”

There’s a lot more under the surface about how drugs have ruined my life…I won’t even get into that because anybody that knows my post history knows the story.

Let move on to my internal mental health via A vis the “will power” point you made. I will forever have this internal battle of having to moderate myself and be responsible which does take will power as you said. Forcing yourself to live a life where you deprive your self of something you crave is unhealthy. It’s like ppl that don’t have sex due to religion; they are broken people. This constant use of will power to keep my use at a manageable, legal, and not completely dangerous manner is a will power and battle that although u succeed at…is miserable battle to fight

I disagree with you. I think that using drugs to escape negative feelings or boredom is wrong and a pitfall. If you have chronic pain and use narcotics I understand that but it doesn’t make the end result any less horrible cs recreational use.

I would give anything to be born into a body and mind of those types of ppl that try drugs and are like “this might feel good in the moment but is stupid and not worth any of the baggage.”

Instead I am a person that says "this temporary escape is worth damaging my mind and body.” The damage can be limited and drugs can be used very responsibly…but there are always side effect and life/legal/relationship effects from drug use no matter how responsible you are. No free lunch when it comes to drug…you’re gonna pay back that loan on happiness or relief you took out by doing drugs with interest in the emd
 
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I don’t think there’s a one-size-fits-all explanation for it. There’s probably a genetic component involved but I don’t think that’s necessarily a determinant factor. I’m inclined to think of problematic substance use as primarily an environmental phenomenon but then again there are people who will go completely off the deep end regardless of their environment or life circumstances.
 
Madness said:
OP - Human to human, if your relatives are suffering, do your best not to shame them
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There comes a point when you need to get tough with them. My family enabled me and well it didn't do me any good. The only thing that really interested me was alcohol, That was genetic I have come to realize. If I was healthy you could put anything but alcohol and I could pass on.( not gonna admit publicly to anything but I am not innocent, just a former hard core alky, cannot physically drink now, I would have drank my self to death after my sister died but I thank God my body became allergic to alcohol. It doesn't bother me to be around it, but the smell of it now digusts me and it is a non issue.
 
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Burnt Offerings said:
I don’t think there’s a one-size-fits-all explanation for it. There’s probably a genetic component involved but I don’t think that’s necessarily a determinant factor. I’m inclined to think of problematic substance use as primarily an environmental phenomenon but then again there are people who will go completely off the deep end regardless of their environment or life circumstances.
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Genetics plus life circumstances does seem like a logic conclusion, i agree.
 
Jnowhere said:
There comes a point when you need to get tough with them. My family enabled me and well it didn't do me any good.
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Or gave up because you can no longer be bothered with it lol.

Had my uncle, sister and her partner, even me to try help my older brother with his addiction, but couldn't. Some people just can't change :/
 
Sorry if it's been said but I believe it relates to early trauma, which Dr. Gabor Mate writes about. Those of us with trauma will try to hide from it and will be susceptible to addiction, to keep trying to treat the trauma. Others who have had happy early years and are well adjusted etc can use recreationally and go back to their happy lives. I'm sure it's not as black and white as that but every addict I've known has had some trauma in their lives, varying degrees, to the worst imaginable. Some whole communities are traumatised and hence have addiction issues on a large scale. Also you see people become addicts later in life after divorces, bereavement job losses and other traumatic events. How many divorcees pick up a bottle of whisky or vodka to reel in the sadness (which ofc never works), start getting a few a week, then have a nip in the morning. Soon enough they could be dependent. Career stresses too - look at how many lawyers, politicians etc are coke heads and alcoholics. And I imagine that there are aot of doctors who write themselves scripts on the regular. I knew a pharmacist who was an addict and had her doctor father write her scripts. Dunno about any trauma with her but she was crazy (I mean that in a nice way) and I suspected she'd had some difficult times.
 
I was never an “addict” until I was scripted addictive LEGAL drugs. Before that I was just happy-go-lucky raver, usually using psychedelics in a more-or-less harmless manner, and it was about going to the illegal raves in the 90s, dancing to some amazing EDM, and bonding with other people. However, once I was scripted Xanax, it was the beginning of my downfall. Got clean of that, then abused my Fioricet, then my Percocets (this was back when they handed these things out like candy.) So I feel like strong LEGALLY PRESCRIBED drugs were way more destructive, for me anyway. However, I don’t deny that I have plenty of trauma from my past (gradually becoming completely deaf, extensive bullying in grade school, an eating disorder and general low-self esteem, and fraught relationships with family and others. 2 of the men in my past abused me physically, for one)

Recreational drugs have almost always been just for fun. I quit crack when it was no longer fun anymore. Was never terribly into heroin. Poppy pods were only used when they yanked my Percocets away, and only cuz I both needed to not be sick AND because the pain continues to this day. I have switched to kratom long since and I feel like it’s a much healthier option for me. I have actually turned down opiates from my pain management doctor because I know at some point, later in my life, those will become a NECESSITY due to chronic pain. So I would prefer to get back on those much later in my life, because once I get back on them I will not be coming off again. It’ll be that until I die. So I would prefer to reserve that until as late in life as I can, preferably waiting AT LEAST until I’m 60, longer if I can. One never knows how long they will live, and, given my chronic illnesses/chronic pain, I am well aware that they will be necessary to have any quality of life.

Anyway, I’m REALLY glad that I can enjoy recreational drugs without falling back into that headspace of addiction, where all you ever think about is acquiring that next hit. I would literally be trying to enjoy time with my family but unable to enjoy it because my brain just kept obsessing over when it would be time for my next pill. Counting the hours. It really sucks. Crack I think I only indulged in as long as I did was because 1. Stimulants calm my ADHD brain 2. I was pretty miserable at the time I began using it regularly (divorcing, dealing with DUI, etc) but once things started getting better for me, it wasn’t even giving me that high I wanted anymore, and I looked at it one day and was like “why the fuck am I doing this” and just stopped. Haven’t done it since. (Powder cocaine doesn’t have the same pull over me. I just had some recently and I still don’t have that crazy impulse to redose over and over; I did a couple lines and was like “ok I’m done for today”) and obviously, my DOC (it’s in my username lol) physically CANNOT be used every single day. So that’s spaced out by quite a bit of time, cuz it’s also very time-consuming. LSD is fun but also requires a lengthy block of time to commit to it, and with 2 teenage daughters at home, I have very limited time for these things. Shrooms I can and do use for mental health reasons, and they work wonderfully for that, and also seem to help with my physical pain. Was actually thinking of experimenting with microdosing (like, below threshold so not really too obvious an effect) but even that probably wouldn’t be every day, more like once or twice a week. Everything else is just like a spice, a little goes a long way and they’re just like “take it or leave it.” Dissos are fun, but not my first choice. So I feel like I’ve reached a healthy equilibrium with substances. Back to using for positive reasons, not negative.

But also, a lot of my mental traumas have been dealt with at this point. I had extensive DBT outpatient treatment (2 years, 3x/week) that taught me many of the healthy coping strategies and emotional regulation skills that I utilize until this day. I am no longer suicidal (and I made several serious attempts in the past. Sometimes addicts genuinely don’t care about the physical harms they’re inflicting on themselves because they’re wishing for death, and have such a low self-esteem that whatever physical/emotional/financial/social consequences that occur because of their addiction seem like a fitting punishment for being such a waste of space.)
 
I hate to say it, but the difference between use and abuse (including leading to addition) comes down to free will.

They either never learned to say no to themselves or they decide that no doesn't matter.
 
I've always believed that everybody has the potential for an addiction of some kind. Whether it be to drugs, food, sex, work, or spending / making money, attention grabbing, or whatever.

I really don't think willpower has all that much to do with it. I think some people are just wired differently and are much more susceptible to certain kinds of addictions. I'm a very strong-willed person, and at different points in my life have been able to quit. My willpower didn't change, the motivating factors did though.

My father-in-law used to look down on addicts (until he met me, and realized that we're not all the same). He worked and retired from the federal government, and has never touched an unprescribed drug in his life, and says he could count the number of alcoholic drinks he's ever consumed on one hand. He weighs close to 350lbs at 5'2. I described addiction to him in terms of food. He can't go to the store without buying some kind of cake or sweet. I asked him why he can't stop eating them, and he says he didn't know why he couldn't stop eating, even though his doctor has told him multiple times that weight loss is necessary for his health. I explained through addiction to drugs is the same thing, it's just a compulsion, even though the consequences are severe.

I think a lot of it also has to do with motivating factors for quitting. Before I had kids, I really didn't have much to live for, so I was willing to take the risk, and be an IV heroin user (back before fentanyl). When my son was born, I realized that if I didn't stop what I was doing, it would ruin his life. I'm not going to lie, I struggled getting "clean" off dope specifically for a few years. I still smoked weed and took the occasional Xanax, but after being on Suboxone for a little while, I was able to finally get clean off of opiates. (Full disclosure, I take kratom periodically to help with cravings, for some reason it doesn't make me want to continue to redose, and it has a ceiling effect that makes it hard for me to actually get high. Kratom withdraw and consequences are much less severe than "real" opiates, for me at least.)

Going to prison was my wake-up call, willpower didn't matter because I was forced to detox an environment where drugs (or even adequate medical care) were unavailable. I realized that if I continued to go down this path, I would either be dead, or be speaking to my son through a piece of plexiglass for the rest of my life. That shit's not for me.

I fucking love drugs, I love heroin, I love the rush of a good bag. However, I know that using will slowly take everything I have from me. I think STAYING clean requires a good bit of willpower, but getting clean in the first place is more than that.

It's been years since I did a shot, and I still think about it every day, I struggle from when I wake up to when I go to sleep, but it's worth it because I get to hang out with my kids and wife.
 
Burnt Offerings said:
I don’t think there’s a one-size-fits-all explanation for it.
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Agreed. And to me it is simpler than having control or not. We are all chemical machines. Sure some drugs take us off balance, but if it were not drugs it could be something else. Gambling, shopping, etc... There are a variety of ways to lose control and all of them are just us being human beings.

Honestly I use to beat myself up for using all kinds of drugs. Mostly opiates (and psychedelics but I don't consider them a big risk, steered clear of stimulants and benzos too for the most part except cocaine in the early 80's) but I learned to go easy on myself. Being off balance with a substance sucks, but it is totally within the person's grasp to get more balance and even get sober as Madness so elegantly put it.

I have almost made total peace with all my drug use. At the moment only addicted to kratom and cannabis but even then in a light way. What use to cause me guilt was doing the wrong thing, hurting people, stealing. I think I had said this before when I used street heroin in the 1980's and 1990's I did still steal and would do what it takes to get what I need. Then working in the family florist I got poppy pods mailed to the store for real cheap and were real strong. This started in 1993. Never stole again. And would not ever again having grown past that. So if you ask me making things illegal causes people to get off balance and feel guilty. I realized I was a good person that just needed a leg up and the substance I was addicted too. Making it illegal is what made the criminal.

Just wanted to add I do think focus on recovering needs an overhaul in society. Growing up for me tranq dope and ketamine were not a thing yet. But now it really stretches what rehabs need to do. I mean ketamine, while not physically addicting seems to really grab on to some people. And if someone wants off we for sure need a recovery route. Same with xylazine. I feel for people. They all just need a leg up and a way to recover if they choose.
 
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Dead Machination said:
I really don't think willpower has all that much to do with it. I think some people are just wired differently and are much more susceptible to certain kinds of addictions.
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Absolutely. There’s definitely an element of choice, but also a genetic component in some cases. For example, children of alcoholic parent(s) tend to wind up being alcoholics themselves. That’s also probably “nurture” as well as nature; being around that kind of behavior teaches a child that that is an acceptable coping method. Even children of alcoholics/addicts who hate their parents for it and swear to never do it, a lot succumb at some point. So definitely NOT because of being weak-willed. As @Burnt Offerings said, it’s probably not just one thing, it’s probably for different reasons in different people.
 
I agree, I am too tired to elaborate a good response but addiction, other than nicotine which seems to be addictive so easily to so many who try it a few times, is complicated and genetics is one component but alcoholism seems particularly genetically predisposed.
 
I think some people are a lot more predisposed to addiction than others. Either genetically or because of trauma or mental illness.
Like for me, I had very severe anxiety and the first time I ever took diazepam it was like "HOLY SHIT I'm not nervous". Like I wasn't high or anything: I took 5mg and it was from a paramedic for a panic attack and when I described how I felt (or, rather, didn't) he was like "most people feel like that most of the time".
Like, I legit didn't know that it wasn't normal to feel nauseated/shaky/tachycardic 100% of the time.
Or, I'm always exhausted (health problems) and that + depression meant the first time I ever took an amphetamine I felt happy (again, not HIGH or manic, just content) and I had enough energy to function through the day. So I immediately took it every 5 hours every day and soon morphed into Sara Goldfarb.
 
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