Substance abuse and addiction wreaks havoc on our relationships for any number of reasons. In the local area, authorities busted 15 members of a drug ring in Crossville that was distributing cocaine, methamphetamines, marijuana and prescription drugs. In Knoxville, four churches have been burglarized and I am willing to venture that these burglaries are related to supporting a drug habit. Although the social implications of these stories are apparent, what is not mentioned is the interpersonal misery that is caused by substance abuse and addiction. While the headlines focus on the broader aspects of drugs in society, the lives effected by drug abuse and addiction are only marginally acknowledged. A recent case where we may imagine the relational hurt caused by substance abuse and addiction is the Taconic State Parkway crash that left eight people dead, including four children, and has been linked to alcohol and marijuana use by one of the drivers.
The tendency to ignore the individual aspects of these stories is unfortunate since substance abuse and addiction is fairly widespread in our society. It is likely that either we or those whom we know have experienced problems with substance abuse and addiction in some way, either personally or through family or friends.
Having been engaged in substance abuse counseling for the past decade, one of the questions I am frequently asked by friends and family members who are suffering from seeing a loved one choose substance abuse and addiction is "Why is this happening." I don't think their question is existential. They are asking to understand how someone they love and who once loved them can betray that relationship for drugs. It just doesn't make sense to them.
One way of understanding substance abuse and addiction is through Choice Theory Psychology. We all have five Basic Needs (Survival, Love, Recognition, Fun and Freedom) that we must attempt to fulfill. When these Needs are met, and they are met best through our relationships with other people, we are happy. When these Needs are not met, we are miserable. If I am not getting my Needs met, e.g., my wife has left me, I have been laid off at work, insert your own situation here., then I am going to be miserable. One way that I can feel better is to use alcohol or other drugs (AOD). It works every time. Unfortunately, AOD don't fulfill our Needs, they just cover up the misery of not having our Needs met, so when I come down off my high or sober up after my drunk I am just as miserable as I was before, if not more so because it's now been longer since I've had my Needs fulfilled. Because I am still miserable, I use AOD again. It is in this way that AOD get to be what we understand as pictures in our Quality World.
The Quality World is our mental photo album. In this album are stored the mental images of those things that we want. Our Wants are reflection of our Needs. Those things that either we think will fulfill our Needs or that do fulfill our Needs get to be pictures in our Quality World. These pictures develop in our Quality World like the old Polaroid photographs that you had to set aside and watch as they slowly developed. Things don't immediately move in and out of the Quality World. E.g., Most people have a picture of Mom in their Quality World because Mom raised most of us and she was probably the first to fulfill those Needs. This is the reason that when we start feeling miserable that many of us want our Mom, because she fulfilled our Needs in the past and we believe she can fulfill them now. It is the same reason that soldiers on the battlefield often call out for Mom when wounded.
AOD work in much the same as Mom. As AOD take away the misery of not having our Needs met, they become pictures in the Quality World. We think they are meeting our Needs because the misery in our lives goes away - for a while. Then we have to use again, after the misery returns. This begins the cycle of addiction.
The other way that AOD get to be pics in our Quality World is that using actually does help me fulfill my Needs. Let's say that my girlfriend, Betty Sue, runs off with Billy Bob. I'm going to be miserable because Betty Sue isn't there to help fulfill my Needs anymore (and misery is what happens when my needs aren't met). But I have a problem. I want to find someone else but I don't want to go out and look for anybody else. I have a hard time socializing and I don't like going to parties or clubs. I'm sort of an introvert. However, I've found that if I have a drink before I go out or smoke a little weed or pop a few prescription drugs I got from a friend of mine then I am much more relaxed and much less inhibited. I find that when I use, I can actually go out and have fun and hook up with people. Because using helps me fulfill my Needs for Fun and Recognition and Belonging, the picture of me using gets to be in my Quality World.
The bad news is that once a picture gets to be in my Quality World by meeting my Needs, it never goes away. Mom got to be a picture in my Quality World but she has passed away. Just because she's gone, however, doesn't mean her picture is removed from my Quality World. Just like an old photograph, her picture may begin to fade because she is no longer meeting my Needs, but it takes a long, long, long time to fade into oblivion. The picture of AOD is the same. I may choose to stop using but the picture of AOD will always be in my Quality World and it will always be a choice for me. This is how we understand relapse. We choose that old picture of using AOD as a way to meet our current Needs.
The good news is that we can do something differently in our lives and try to place other pictures in our Quality World. Of course, using AOD is still a choice and will always be a choice, but once we know that we can be happy without the use of AOD then we have an alternative.
If , given this alternative, we still don't believe that a life without AOD is possible or will be at least as good as a life of using AOD then we will not stop using. This is where our relationships really get bad. They have probably been getting bad or going from bad to worse as we tried to deal with drug abuse and addiction, regardless of whether we are the addict or just the one who cares about the addict. When one becomes addicted to AOD then their relationships with anyone else are over.
For the one who cares:
The addict will lie to you, cheat you, steal from you, threaten you and possibly even physically assault you. This includes family. If you are in a relationship with an addict and think it won't happen to you then you are fooling no one but yourself. The only relationship that is important to the addict is the relationship with the drug. The relationship you used to have is over, at least until the addict gets clean and sober and decides that your relationship is still in their Quality World and is something they want more than the drug. If you attempt to maintain a normal relationship with an addict then you are setting yourself up for failure. This doesn't mean that you cannot support them but you must support them at a distance. To do otherwise is probably a sign of co-dependency issues. In short, you think you've failed in some way so you try to make them not fail so you can feel better. This is an attempt to control them and may be recognized in thinking such as "I've got to save them," "I can save them," "I can help them save them from themselves," and etc. All of this thinking is an attempt to control someone else and that just won't work. In fact attempts to control others, even if we think is for their own good, are harmful to our relationships and just make a bad thing even worse.
All relationships have three entities. Us, the other and the relationship, itself. For any relationship to work both us and the other must be dedicated to seeing the relationship survive. If one person doesn't 
care about the relationship then that relationship is over. For an addict, the relationship with you takes a back seat to the relationship with the drug. Just like the painting attached to this article in which the Absinthe addict (absinthism was once studied as a form of alcoholism) chooses the relationship with the Green Fairy of Absinthe, despite his world burning up around him, the AOD addict will choose a relationship with the drug over a relationship with us. Delude yourself if you will but such is the case. Relatonships with other people are often difficult and sometimes ugly . A relationship with a drug is easy and very attractive.
This isn't saying that it will always be this way but that doesn't depend so much on you. It depends on the choices made by the addict - choices such as not using. This isn't meant to leave you with a sense of powerlessness. You have just as much control over the happiness and misery in your life that you have always had. Your pain comes from losing a significant relationship in your life, the relationship with the addict, and you want that back. As we know, however, we aren't in control of that. The addict is in control and you can move on from that busted relationship - and perhaps renew it one day when the circumstances change - or you can continue trying to control it and move the relationship to the point where even if the addict gets clean and sober they won't want to renew their relationship with you.
One thing you can do if you find yourself in a relationship with an addict is to set strict limits with consequences and religiously adhere to the rules you establish. If you don't then see the above paragraph about co-dependency. Talk is cheap. Our thinking determines our behavior. If the addict continues to use then it is because they still want to use and they value their relationship with the drug over their relationship with you.
I know this is hard to accept. It is just like having a lover leave you because they have found someone else. You haven't moved on but they have. You still want the relationship you have shared but they don't. Until you accept this and move on, your life will be miserable.
Addictive thinking is still telling them that using will get them what they Want and fulfill their Needs, even if using long ago stopped being pleasurable for them. Remember that once a picture gets into our Quality World, it is pretty much there forever. This seeking the same experience that they once got from the drug will continue because that picture of AOD used to work for them. This is known as chasing the dragon. That chase now defines their Total Behavior.
Just like a jilted lover, we must move on with our lives. We can hold out hope for our lost love but not to the point where it causes our own lives to be miserable. We must continue to meet our Needs in healthy and productive ways while we wait for our old flame to return.
For the addict:
Stop using and don't use - no matter what. Seek treatment. If you can remember a time in your life when you were happy and not using, try to remember what made that time so pleasant for you and then try to do those things that brought you happiness. Know that there are people who still care for you, despite what you may have done to them. You are in their Quality World and they may choose to renew their relationship with you. Happiness and misery in your life are your choice. Choose a life with healthy, Need fulfilling relationships. Others have made the choice to live without the use of AOD and are finding joy in recovery. You can find that same joy if you choose to do so.
Experiment with life. Nurture those you love.
Ron
Sites of possible interest: CDC statistics for illegal drug use. NIDA statistics on illegal drug use. SAMHSA site.
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