Addiction: Is It A Disease Or A Choice?
Mia Williams, MS ❘
The controversy over whether addiction is a disease or a choice is important for those who work with substance abuse and who struggle with addiction.
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Whether it is deciding to break open the gifted bourbon from a grateful client, sipping Aunt Sue’s holiday eggnog all evening on Christmas eve, or having more than a few cocktails at the never-ending string of holiday parties, we know that this season of comfort and joy may find us going a little heavier on the “comfort,” which can be especially troubling for those with a substance use disorder.
The holidays certainly offer plenty of occasions to use alcohol in a celebratory fashion. However, multiple studies have shown that levels of unhealthy drinking habits skyrocket during the holiday season. This can take the form of justifications such as, “It’s fine! I always have a few glasses of wine when we decorate,” to “It doesn’t really count. It’s the holidays!” Regardless of the rationale used, even those who are moderate drinkers throughout the year can be found giving themselves permission to consume more alcohol during this time of year than what is usual for them at other times.
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According to a study conducted by the American Psychological Association (APA), 38% of people surveyed said their stress increased during the holiday season. Increased stress levels can lead to physical illness, depression, anxiety, and substance misuse. The reasons attributed to this behavior were lack of time, financial pressure, gift-giving, and family gatherings to name a few.
Interestingly, a separate survey reported that that the average American drinks 27% more during the holiday season as compared to the rest of the year. The Distilled Spirits Council of the United States notes that a quarter of the $49-billion-a-year distilled spirits industry’s profits come from the month between Thanksgiving and the New Year.
On an even more serious note, New Year’s Day is the deadliest day for alcohol-related crashes, with 58% of crashes being alcohol-related according to the U.S. Department of Transportation (DOT) and the National Highway Traffic Safety Administration (NHTSA). They also report drunk driving-related deaths spike 116% above the baseline average, making it the most dangerous holiday of the year for drunk driving. Other causes of alcohol-related deaths during the holidays include alcohol poisoning and incidents at home such as falls, domestic violence, or accidental deaths due to firearms.
Given these surveys, statistics, and behaviors, the question then becomes: why? Why during the season that promotes so much romanticized idealism, magical folklore, and messages of peace and goodwill do we report experiencing so much stress and anxiety? Perhaps the following categories reported by individuals experiencing holiday stress can provide some insight.
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The perception of the “perfect holiday” looms large in the minds of those who find themselves responsible for pulling together all the festivities. The pressure, whether self-imposed or imposed by others, is to have “the best holiday ever” with no hiccups or let downs. When reality doesn’t meet our expectations, it is inevitably a disappointment waiting to happen. Comparative thinking is a fast track to depressive thinking, and resentments are fuel for our entitlement to indulge ourselves in any number of behaviors.
The increase in entertaining, social obligations, and the demands on our time during the holidays almost goes without saying. Friends, family, co-workers, and everyone in between may have parties, dinners, or events they’d like for you to attend, all of which may present the opportunity to be surrounded by triggers.
The likelihood that we can attend every event is unrealistic. What’s worse is choosing whom you’re willing to disappoint can be stressful and produces a lot of anxiety. The logistical challenge of an overly committed calendar creates opportunities for conflict as well as a level of tension that can drive many to self-medicate with drugs or alcohol.
Most everyone is familiar with the common saying, “you can choose your friends, but you can’t choose your family.” Family dynamics can certainly be a recipe for triggers, over-drinking, and relapses. For many, the anticipation of encountering certain situations can cause panic even weeks before the actual events. Ruminating on old wounds and unreconciled trauma can be a source of pain that justifies self-medicating in the minds of those who experience it. Holidays often force us to engage in family situations we can keep at bay during other times of the year.
Many people report feeling “over-committed” during the holidays. Living into the demands of our schedules is exhausting physically as well as emotionally. Without proper time to decompress we will most often return to our medications of choice. An overly-filled calendar leaves no time for self-care or the practices that go along with a healthy recovery or daily life.
The mere thought of airports during holiday season can cause even the most well-tempered individuals to experience panic and frustration. The anxiety of catching flights, rescheduling cancelled flights, and long layovers in airports can create stressful scenarios where drinking can become more than just a pastime in the airport lounges.
Finding the perfect gift, staying within the agreed budget for spending, and the general atmosphere in most retail establishments during this season can be daunting. Watching the credit card balance go up daily can also create a sense of angst and overwhelm. Financial pain is often in the top reasons for relapses and is what many in treatment cite as a motivator for continuing to self-medicate. Creating healthy spending limits not only helps our finances, but also minimizes opportunities to feel triggered by the stress of overwhelming credit card debt.
Many families have holiday traditions that lean heavily on alcohol consumption. Nana’s sangria, Uncle Bob’s spiked cider, or simply the obligatory cocktails before a big dinner can create the perception that partaking is a part of belonging and connecting. This subtle sense of expectation to join in can derail our recovery if we buy into it.
The first years without certain loved ones we have lost is beyond disheartening, and is something many people are unable to comprehend. Grief and looking back at years past where there were more people around the table, the family was a bit larger, and the laughter a little louder can be a very difficult adjustment to navigate. Grief and disappointment can give way to despair which can certainly open the door to drugs or alcohol.
The reality that some people have very few, if any, loved ones to share holidays with can be a silent pain that they are reluctant to share. For those people, isolation is an alienating pain that often has no empathetic witness. Isolation is very often the catalyst for over-drinking and self-medicating. Being alone in our pain is never going to produce a best outcome.
These reported scenarios can explain why a season that proclaims comfort and joy on one hand can result in anxiety, frustration, and a desire to escape on the other. What we may refer to as the holiday blues is often the hangover of a combination of these experiences coming together to create the perfect emotional whirlwind. Without support, boundaries, and an intentional game plan to help us navigate these realities, we can be very susceptible to overmedicating or a relapse with consequences that live far beyond the holiday blues.
If you or someone you know is struggling with drugs or alcohol, don’t wait until the holidays are over to get help. If you’re ready to take the first step, contact a treatment provider today to get started.
A survivor of addiction himself, David Hampton is a Certified Professional Recovery Coach (CPRC) and a member of the National Association of Alcohol and Drug Abuse Counselors (NAADAC).