It’s sometimes said that the justified ones are by far the most dangerous. They’re the most difficult to let go of, and the most likely to develop into an obsession.
A reasonably good rule of thumb for differentiating results of substance addiction from other illnesses: When the substance use stops for an extended period, the symptoms improve dramatically or go away entirely.
Patients with severe substance disorders may experience depression as a result of the cumulative effects of their substance use.
If addiction really is a brain disorder based in complex adaptations to a substance, then who’s to say those adaptations won’t occur with a different drug?
Try thinking of the interaction between drug seeker and practitioner as type of negotiation where the two parties have very different goals.
It may seem to the individual as if it happens by itself– the result of an autopilot, set to return home.
But given the experience in other fields of healthcare, a return to the old lifestyle, however destructive, may be little more than human nature.
It seems to me that it’s entirely possible for one person to be lying, ambivalent, and in denial at the same time.