As we proceed with this program, you will find that some of this will apply to you and some will not. Approach the process with an open mind and try not to reject ideas without spending some time with them. If you are struggling with a family member or friend with addiction to substances or behaviors (whether mild, moderate or severe) your life can be so much better if you give this process a chance.


Each day Dr. Mel Pohl, who is the Chief Medical Officer at the Las Vegas Recovery Center, will present you with some assignments – no one will be grading them – that are provided to help you understand and experiment with the principles set out in each section. If you love or care for someone who has addiction, then true improvements in your life will occur if you take action to facilitate change. Learning about the nature of addiction is the first step for you in improving your life.


The Basics


Addiction is a chronic, progressive and potentially fatal brain disease. What’s the brain in charge of? Essentially everything – what we do, say, think, remember, decide, all of our actions and sensations – yes, everything. The brain is divided into several parts; the two areas of focus for this discussion are the frontal lobe (thoughts and executive function) and the midbrain (reptile brain), which contains the limbic system (survival functions and emotions).


In defining addiction, we need to recognize certain symptoms and characteristics. Craving is one symptom of addiction and is defined as having the desire for the drug or behavior when it is absent. It’s the reason he or she uses after promising to never do it again. Tolerance occurs when a person’s body accommodates to the substance with chronic use, and the substance has less effect on him/her despite an increase in dose (this is the condition when someone can “hold his/her liquor” without appearing intoxicated).


Physical dependence occurs when the body has changed so much after regular use of the substance, that it is not normal without the substance and the addict will experience withdrawal (the opposite effect of the drug). These symptoms also occur with behavioral or process addictions.


The most common reasons your friend or loved one uses substances and behaviors are to feel good (reward) or to escape from feeling bad (relief). Everyone wants to feel good and avoid bad feelings – that’s human nature. What happens in the brain of an addict is that he feels so good and gets so much relief when he uses, that he pursues these “improved states” despite bad things happening and at the expense of your well-being. The drug works so well that it develops survival salience, which means that his brain thinks and feels like it needs the drug to survive – even more than food, water, sleep or sex. That’s why someone you care about seems not to care about you at all.


Loss of control is a key symptom that occurs for the addicted person because of, essentially, a brain short-circuit. This means that one inevitably leads to ten and a binge follows - with a DUI, broken promises, or squandered paychecks being a few of the common ramifications. 


The other defining characteristic of addiction is continued use despite consequences. In other words, your loved one or friend continues to use even though her job is on the line, his relationships are damaged, finances are wrecked and self-esteem is down at the bottom of a deep dark well.


Does cutting back work to treat addiction? Sadly, not very well because of this loss of control phenomenon. Optimal treatment is abstinence from all mood-altering drugs and behaviors.


Please answer the following questions in your notes below:


  1. What are the reasons you can think of why your loved one uses substances or acts out? This could be things like; to get high, to escape etc.
  2. If you believe he is using to escape, then what does he want to escape from?
  3. How does your addict respond when she has a craving?  
  4. What are some of the consequences for your addict because of his using substances or behaviors?
  5. What are some of the consequences you have experienced as a result of your friend or loved one’s using substances or behaviors?


Meet Your Host:


Dr. Mel Pohl is a family practitioner and Chief Medical Officer of the Las Vegas Recovery Center, where he developed the Chronic Pain Recovery Program. Dr. Mel is certified by the American Board of Addiction Medicine and is the Clinical Assistant Professor in the Department of Psychiatry and Behavioral Sciences at the University of Nevada School of