Dependency and Codependency
Recovering from substance abuse can be difficult. Know why.
Many who are recovering from substance abuse have become dependent on their substances of choice. That dependence is just as real and powerful an influencer of continued use as is the addiction to the substance. As though that isn’t enough of a challenge to recovery, some of those closest to us may develop codependency disorders, unwittingly enabling our destructive habits.
What is dependency?
We all need water to live. An apple pie cannot be without apples. There would be no honey without bees. There is no light, no happiness without coffee. In each case something is dependent on another: humans are dependent on water, apple pies dependent on apples, honey on bees, and my mood on that dark liquid brewed from those magical little beans. The Oxford English dictionary defines dependent as “requiring someone or something for financial or other support” and “unable to do without.”
Like everything to do with substance abuse and recovery, though, dependency on drugs is nuanced. (Argh! Why can nothing be simple? I need coffee.) There are two kinds of dependency associated with substance abuse: psychological dependency and physical dependency.
Psychological dependency is all in your head.
I can’t sleep without a blanket or sheet covering most of my body, even if the temperature in the room is comfortable without. It’s not physically impossible, of course, but without a blanky I’ll find it difficult to fall asleep and I won’t sleep well. (Seriously, can I get some coffee?) This is psychological dependence: there’s no physical reason why I need a blanket to sleep well, but not having one itches at some unconscious discomfort.
Psychological dependence can manifest independently from physical dependence, so even substances that are not technically addictive, like cannabis, can be habit forming, especially when used in ritual or associated with other activities. Consume cannabis before eating every meal for a week, then go back to eating sober and somehow the same food may just not be as tasty. The brain associates the effects of the drug with the tastiness, so eating without the high might trick your brain into believing that the food isn’t as good.
Psychological dependency is usually treated with behavioral therapy.
Physical dependence can set your body to work against you.
Miss my morning cup of coffee and I’m an irritable zombie for the first part of the day. I can suffer headaches in addition to feeling less awake. My body has come to rely on caffeine to signal to my brain that, yes, I really am awake and, yes, I really do have to go to work. This is physical dependence, and our bodies can become so physically dependent on some substances, like alcohol or barbiturates, that withdrawal—when the body doesn’t get the substance it has grown dependant on—can be deadly.
Physical dependence can also trigger symptoms of psychological dependence upon withdrawal. As it turns out, skipping my coffee in the morning not only leaves me drowsy, with a headache, but it also makes me grumpy. Caffeine doesn’t really stimulate feelings of happiness, but I’ve come to associate the physical aspects of coffee drinking—the wonderful aroma, the warmth in my stomach—and the physical perks of coffee drinking—being more alert, having more energy—with the emotional state of happiness. Less coffee equals less happiness.
Physical dependency is usually treated with gradual reduction of the substance, medication to counter the more severe withdrawal symptoms, and behavioral therapy to address any associated psychological dependency.
Codependent relations can make matters worse.
The Oxford English dictionary defines “codependency” as “excessive emotional or psychological reliance on a partner, typically one with an illness or addiction who requires support.” The basic idea is that a codependent builds his or her life and identity around caring for or supporting someone with a problem, like substance abuse.
This phenomenon is common in families of alcoholics, and particularly in children of alcoholic parents. A child or a spouse might create an identity around caring for, cleaning up after, and supporting an alcoholic family member. Seeking outside help—counseling, community intervention, or any other form of recovery aid—is a challenge to that identity, so a codependent person will usually choose to try managing the alcoholic family member on his or her own. Particularly in those cases of codependent children with alcoholic parents, such management is rarely successful or helpful, and the harmful behavior will continue indefinitely and perhaps even worsen.
A person who struggles with codependency may only need to learn assertiveness skills, but cognitive-behavioral psychotherapy can be employed as well. Family counseling can be especially effective, since it can address the behavior of the substance-dependent family member as well as the codependency issues of other family members.
Why does knowing any of this matter?
Knowing about dependency and codependency increases the likelihood that you will be able to identify dependencies and codependent behavior. You will then be in a better position to begin the process of mitigation and recovery from dependence or codependence, for yourself and your relations.
To borrow a line from the G.I. Joe heroes of my childhood:
“Knowing is half the battle.”