Why do people start using alcohol or drugs? How can you help an addict quit?

An off-script Q&A about the biological reasons for drug use…and its treatment! An interview with Dr. Jim Tenney, Ph.D, the Clinical Director of Desert Hope, a premier addiction treatment center located in Las Vegas, NV.

minute read

It can be difficult to empathize with someone who struggles with drug or alcohol addiction. We know this. Firsthand. So, how can you begin to understand why people use drugs?

Today, we speak with Dr. James Tenney, MS, PsyD and Clinical Director of Desert Hope, an addiction treatment center just off the Las Vegas Strip. He’ll give us insight into:

  • Why drugs make us feel so good
  • When people are ready to quit
  • What you can do to help a loved one

Join us in this candid discussion here. Then, please ask your questions in the comments section at the end. We do our best to respond to you personally and promptly.

ADDICTION BLOG: Typically, why do people start using alcohol or drugs?

DR. JIM TENNEY: Ok, so I’m going to go completely off script.

The problem with drugs or alcohol is they are just “the perfect thing”. They are a hack to get to an experience, or a state that a lot of people want to experience in other healthy ways, but it’s a shortcut to get there and then it’s an amplified version.

Just to give you an example, from personal experience, you can run a one hundred kilometers race and at the end of it just be a wash and waves of endorphins and in your Mylar blanket eating a banana in bliss, or you can skip all that and go straight to the medicine chest to pull out an opiate. We can do a lot of calming and soothing, exercise and training for folks, for social anxiety or you can knock down couple shots of vodka, or Xanax.

The trouble is that drugs and alcohol are “the perfect thing” until they are not, and they become not the perfect thing very quickly for most folks. It impacts their:

  • Relationships
  • Jobs
  • School
  • Legal standing
  • Health

…so remarkably quick that after what they are chasing is a recollection of a fantastic experience, but they are not able to reach that again. By the time they end up in my treatment facility, their body is so accustomed to the substance that they are having to experience a lot of grief and loss for never reaching that amplified wonder again. It’s sure great to watch people come out of that cloud and really begin to have a meaningful experience with their day to day success, and their relationships, work and so forth…

ADDICTION BLOG: How specifically do drugs and alcohol work so well? Can you describe a little bit of what’s happening in the brain?


You know, what’s fascinating is that we have found things in nature that duplicate what’s already in the brain. If you look at pain relief and analgesia – the things that the brain produces naturally – repeating endorphins and [NOT SURE], opiates are a perfect lock for them. Likewise, marijuana and anandamide receptors link perfectly, alcohol hits the GABA receptors.

We have identified chemistry that perfectly mirrors what the brain is able to do, but in such a wrapped up form that it is so seductive and so hard to turn down: Once you’ve had a first experience or two, you want more.

Imagine the person who’s just graduated college. At their graduation they have that feeling of hopefulness into the future and elation and energy. Or, you can just skip college and take Adderall and have that experience of: “I can do anything!” The trouble is that tolerance build up to stimulants faster than any other substance and within a week, they are feeling depleted and inert. Then, the wreckage in life comes when we meet them.

But the things that we find to intoxicate ourselves with are just mirrors of what the brain will do naturally, but just not to that advanced, exaggerated experience.

ADDICTION BLOG: So the drugs are both effective AND intense?

DR. JIM TENNEY: Exactly.

ADDICTION BLOG: When do drugs become a crutch? Are they always a crutch?

DR. JIM TENNEY: Here’s the thing – and I like that you are using the word drug -instead of medication. If you think about the word ‘intoxicated’, it has to reach a toxic level before you and I would say that we have a good buzz. In this sense, a drug is actually beyond medication and into a toxic range before our experience is so altered. When drug users get high, they are actually receiving some false message of pleasure or energy or soothing, so the drug itself becomes a crutch.

Drugs certainly become a crutch when you can’t function without them, but they also become a problem when your relationships and work and health and legal standing are becoming problematic. Plus, we see that binge use is just as debilitating as daily use.

It’s a real problem when folks say they don’t have a problem because they only use on the weekends. Some questions to ask yourself:

  • How many days are you using, really?
  • Are you showing on Monday or Tuesday underperforming on work?
  • Does your spouse think that you’re poor contributor to the relationship?
  • Are you a poor contributor to home duties?

So, the idea of crutch and disability is just hand in hand with the idea of a drug.

When used as medication, drugs can have real benefits. Our physicians can help people out of anxiety or lift them out of depression with medications that enhance instead of take away.

ADDICTION BLOG: When do people typically start to ask for help? Is it when they reach the end of the road?

DR. JIM TENNEY: Nicely said.

My experience is that nobody is still having a positive relationship with their intoxicant and calls my facility. Something has to happen, there has to be, you know there is a lot of euphemisms or other slang we use like: “hitting rock bottom”, or “hitting the immovable object”, or you “having you come to epiphany moment”.

Folks will often times call for help when something drastically bad has happened and there’s just no other option. Because when things are working out well, everything about the brain says keep doing what you are doing, because it feels so good, or performing so well.

There is a tremendous dread amongst a lot of people of withdrawal, the fear of withdrawal, you can almost feel it. And the truth is, withdrawal is pretty quick, we can help folks out medically. It’s the post-acute withdrawal, it’s the period after the physical withdrawals that are a challenge, because then the questions are:

  • How do you regulate your own mood?
  • How do you keep yourself calm?
  • How do you wake up in the morning?
  • How do you sleep at night?
  • How do you interact with people?

…for all these part of your life to be reconciled just on your own biology – that takes a little while to get right.

As a matter fact, when people are first in recovery I hear the term “psychological sunburn” used. Everything feels really intense, everything outside of yourself feels aggravating, or distressing until you just get back in your own rhythms again. It’s really always inspiring to watch people bridge that gap.

ADDICTION BLOG: Can people with an alcohol or drug problem self-treat? Is it ever effective, or do we always need professional help?

DR. JIM TENNEY: Well I don’t think you would ever want to self-treat for alcohol, or benzodiazepines like: Xanax, Valium, Ativan … You wouldn’t want to kill yourself. Withdrawal from these classes of drugs can lead to severe symptoms such as extreme depression, seizures, or even psychosis. With stimulants and opiates, it’s just so uncomfortable to try to do it yourself.

I would always have some assistance, because withdrawal is a tall task. It’s often trying to do things yourself that gets people in trouble in the first place. “If I can just medicate myself, I can handle the thing that I’m not equipped for.” That kind of mentality is what got them in trouble in the first place.

I would just want folks to have a good start and a softer landing before they take off and then start to rebuild their lives.

ADDICTION BLOG: What are three things someone with a drug or alcohol problem can do to get help today?

DR. JIM TENNEY: Call American Addiction Centers (AAC). Just Google it. There is an 800 number.

Тhey can also let people around them know. I like to say this: The root foundation core of drug and alcohol abuse, but certainly dependency is – deception.

  • You lie to yourself that this substance will do what you want it to do.
  • You lie to everybody else that you’re not doing as much as they think you’re doing.
  • You lie to every police officer that stops you on the road.
  • You lie to your boss.

So, it’s nice to begin to come clean to your family, your support system and say: “You guys have been right, I really need help.” So first I would call AAC. Then, I would tell your family what’s going.

Thirdly I would say, commit yourself to whatever it takes. If it takes getting away for a month to get this straightened out…do it! In the context of 20 to 50 years of sobriety head of you, a month is such a short period of time. When folks fly into my facility and then when they fly back out again it’s often the same magazine on the airplane. It’s seems on the front bigger that it turns out to be, but what a great benefit you can get from it.

ADDICTION BLOG: Can you tell us a little bit about prevention and how until age 30 some of the more either chronic or long term effects of addiction can effectively be reversed?

DR. JIM TENNEY: The earlier we can treat any of this – if we can just nudge it by a couple degrees trajectory – the outcome decades down the road can be outstanding.

It’s never too late. We have a large number of our clients who are retirees, who were structured by their job, who now watch the morning shows drinking wine. They just are now not under any kind of control and they come and say: “I don’t want to waste my retire years in a blur.”

So we sure do like to catch it early, but it is absolutely never too late to come in and witness the miracle.

ADDICTION BLOG: Is there anything else that you would like to add for our readers?

DR. JIM TENNEY: I just appreciate this chance to be able to talk very informally about addiction. I know that there is some fantastic research out there, there is a great lexicon and a good jargon to go with all of this, but really the idea that these drugs and alcohol are a problem because our brain tells us: “Well, I just witnessed the thing I’ve been waiting my whole life and I’ll throw everything away to get more of it. It really does feel perfect.”

I don’t think it gets enough press so I appreciate the chance to be able to go off script and say this.

About the Interviewee: James F. Tenney, MS, Psy.D is a highly regarded therapist and clinical director at Desert Hope treatment facility for addiction and co-occurring disorders. Located in Las Vegas, Desert Hope provides all levels of care to adult men and women struggling with substance abuse and behavioral health issues.
About the author
Lee Weber is a published author, medical writer, and woman in long-term recovery from addiction. Her latest book, The Definitive Guide to Addiction Interventions is set to reach university bookstores in early 2019.
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