The Emotional Life of the Newly Sober

Individuals new to sobriety often find their early days in alcohol and addiction treatment centers marked by significant swings in experienced emotions. Early in rehab, the alcoholic/addict may be plagued by a variety of uncomfortable and challenging feelings that can overwhelm their ability to cope. This is certainly not surprising given that most folks in drug rehab are experiencing for the first time release from the anesthetizing effects of their drug of choice, be it alcohol, cocaine, heroin, or whatever.

Early in recovery, as the mind re-awakens, the newly sober may find themselves gripped with marked anxiety, a tremendous sense of fear--sometimes about the things that have occurred in the past, sometimes of the consequences of their use, sometimes of an uncertain future. And sometimes they experience marked fear for no identifiable reason. In many instances, underlying anxiety disorders, undiagnosed and self-medicated for years surface to trouble the alcoholic/addict.

For others, early sobriety can lead to the re-emergence of painful memories of trauma in childhood which can spill out in the form of deep and penetrating sadness, hostile and aggressive feelings of anger, or inordinate shame. And as is regularly discussed in alcoholics anonymous meetings and associated literature, newly sober alcoholic/addicts in the early stages of recovery are particularly prone to resentment--the sense of focussed and bitter anger based on perceived past slights or harms that can lead directly to relapse.

Not all emotions in the newly sober are negative. Frequently in the early days of alcohol and drug rehabilitation and treatment, the alcoholic/addict experiences tremendous feeling of joy. They often describe a "pink cloud' or feeling of prolonged euphoria that can serve to reinforce new found sobriety.

With time, continued treatment, a recovery based lifestyle and supportive environment, the alcoholic addict can develop those skills that allows him/her to modulate his/her emotions, to achieve a sense of balance to his/her internal affective life, and to find appropriate releases when emotions pass individual "critical levels". Even after years of chemical numbing, the alcoholic/addict can redevelop the capacity to feel.

Drug Rehabs that say Addiction is not a Disease

As a medical doctor, it bugs me when I read or hear about drug rehab programs that teach "addiction is not a disease".

Clearly, if you look at addiction through a scientific lens, there is no refuting that addiction IS a disease. First, what is the definition of "disease"? One definition is that a disease can be a hereditary condition that causes major illness or impairment. Let's compare addiction to heart disease. Have you ever gone into the doctor's office and filled out a new patient form? It will invariably ask if anyone in your family has had heart disease. Why do they ask that? Is your doctor just being nosey?? I don't think so. You are being asked that because heart disease is what's called a heritable condition. Your doctor needs to know that information because family history is a risk factor for developing heart disease. Does this mean that you will, for sure, develop heart disease just because some of your relatives had heart disease? No, of course not. But it creates a situation in which you are more predisposed to develop heart disease, especially if you have other risk factors (smoking, overweight, high blood pressure, high cholesterol, etc). The more risk factors you have, the more likely you are to develop the "disease".

Addiction is not all that much different from heart disease. It is also a disease that runs in families. It can be quite disabling. And, it requires treatment. If your mom, dad, brothers, sisters or grandparents suffered from addiction, you have a higher chance of developing addiction yourself. You are predisposed to developing addiction because of heredity. Some people may be more highly susceptible to the throws of addiction than others. Addiction may also be subject to risk factors such as repeated exposure to drugs or alcohol, childhood trauma, depression, anxiety, stress, etc.

So, now there is no question. Addiction is a heritable condition that causes major impairment or disability. Hence, it is a disease.

Now, I must say that there is some good that comes out of the mind-set of saying that addiction is not a disease. Well, let's say "half-good". The half that is good is that it forces you to look at underlying causes behind the addiction. That is to say, underlying core issues that have further predisposed you to develop the disease of addiction. Thus, in the treatment of addiction, one does not totally focus on the disease process. That is only half of the story. The other half focuses on the behind the scenes stuff that precipitated the addiction in the first place. Maybe it was repeated trauma in childhood or a major depressive illness. In any case, it is just as important to look at the reasons behind the addiction as the disease itself.

So now you can see, the viewpoints that addiction is a disease and it is caused by underlying issues can peacefully co-exist. Most importantly, they should be treated simultaneously. That is the focus of the cutting edge addiction studies currently. And guess what? The best success is seen when both the disease process and the core issues are treated concurrently.
Surprised? Not me!

John Neuhaus, M.D.
Paradise Recovery