it occurs to me that not everyone (perhaps not most) understand just how shitty withdrawal from an addiction really is. you try to explain it, but you can tell from the look on their face that they dont really understand what it is youre going through. i think it serves as an indicator of how difficult it is to explain if you consider that im reasonably good at painting pictures with words, and people STILL dont get it, no matter how many different ways i try. it leads me to question whether it is even possible, and yet, i find myself compelled to try, one more time. i think im going to go at it a little differently this time though.
first, id like to give a little background on the actual pharmacological action of nicotine on the brain.
nicotine is a stimulant, as i think everyone knows, and it does all the things one would expect a stimulant to do. but it also has an additional affect: it acts directly on the reward center of the brain. now, when you talk about the reward center in a clinical sense, you arent talking about the normal kind of "reward" that most people think of... like, say, feeling good about a job well done, or what have you. no, the reward center is the part of the brain that responds to and reinforces the most BASIC required functions for moment to moment SURVIVAL. it is a very old, very primitive part of the brain. it is primarily concerned with little things, like breathing, eating, fucking, and shitting. almost amoeba-level actions. every time you take in a breath, the reward center releases a little hit of pleasure, saying "yep, thats good, breathing is good, keep on doing it. so, you know, you dont DIE or something"...
now introduce nicotine into the mix. nicotine, when introduced to the body, ALSO gives the reward center a little pop. in a very short time, the brain integrates the action of receiving a hit of nicotine as an ESSENTIAL SURVIVAL FUNCTION, right along side BREATHING. if you get your nicotine by smoking, it is even worse, because it ties TWO survival functions together, very tightly. every time you take a breath, the brain expects to also get a little pop from receiving nicotine. if it doesnt get it, it begins to grow... concerned. if it doesnt get it for long enough, it becomes convinced you are dying.
to get some idea of just how powerful the compulsion is, id like you to try holding your breath. go on, give it a shot, right now while you are reading. dont stop, just keep reading. doing it? good.
after a very short span of time, well before you begin to experience the physical effects of oxygen deprivation, you will begin to feel very uncomfortable in a way that is difficult to describe. you know something is wrong. you know there is something you should be doing, something you really NEED to be doing. you will begin to experience anxiety over not doing it. just a little bit, at first, nothing you cant overcome by thinking your way through it.
then, youll begin to get physical indications that something is wrong. your lungs will begin to burn. youll find it increasingly difficult not to breathe, even though you are trying hard not to. you STILL arent suffering the effects of oxygen deprivation, that actually takes a while, but the reward center is starting to wake up and say "hey. dumbass. you seriously need to take a breath, probably real soon now." and it will begin to dump anxiety into your system, in increasing quantities.
it is now only a question of time as to how long before your intentional control is overridden, and the body takes over, forcing you to inhale. i suspect it is actually impossible for you to hold your breath until you pass out, even for the most disciplined among us. you ARE going to breathe, because you have no choice in the matter. and eventually... you will.
so that is some SMALL measure of what goes on. thats what a smoker begins to experience about two to four HOURS after not getting a pop of nicotine. and remember, this is a VOLUNTARY action, like holding your breath, no one is making you do it, and yet, you have to keep on holding it... for hours, for days, for months, for YEARS to come.
then, it starts to get really bad.
lets take the experiment further. you probably wont be able to actually carry out this part, in fact i wouldnt advise it even if you could find someone that would participate. but... now imagine that you no longer are voluntarily holding your breath. someone is choking you. holding your head under water. again, at first, you can deal with this just fine. its uncomfortable, but not so terrible you cant stand it. however, in a minute or two, you get to the point where youve decided, ok, enough is enough, the experiment is over, its time to breathe now, and you indicate as much to your experimental partner.
however... they dont let go. the continue to choke you out, to hold you under. youre beginning to get a little concerned that they dont understand, they are supposed to let you go now. you give them a look, or maybe slap the side of the water tank with your hand. you try to express "come on now, seriously, we are done, i get it".
and still, they dont let go.
now, you are beginning to panic in earnest. you cant breathe. your chest is constricting, your heart begins to pound. you start to realize youre going to take a breath of water if you dont get to air soon. you begin to struggle, with purpose at first, then with a will, thrashing, kicking, hitting, doing anything you can to get to that sweet, life-giving air.
and still, they dont let go.
you realize... you are dying. not tomorrow, not next week or next year, but RIGHT THE FUCK NOW! you HAVE to get air! your very EXISTENCE is threatened, you will do ANYTHING required to get just one more brief gasp of life.
and STILL they dont let go.
now, consider for a moment... when i am quitting smoking, i dont have anyone hanging on to my neck, no one is holding my head under water... only *I* am here, doing this, forcing myself not to breathe, not to breathe, not to breathe, even though i feel like i will DIE if i dont get another pop of nicotine. i dont just "feel" like it, my brain is ABSOLUTELY CONVINCED of it.
and somehow, through sheer force of will, i am supposed to continue not to breathe.
THIS is what a smoker deals with. and THAT happens around the SECOND DAY. it actually gets WORSE from there.
is anyone really surprised that i would slip, that it would take two, three, or more attempts before i manage to actually hold my breath for so long my brain stops being convinced im going to die if i dont get another cigarette? its like willfully, deliberately WATERBOARDING yourself.
The world according to Tim
addicition and withdrawal
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I still want a cigarette, but it isn't a craving. The thing that keeps me from relapsing is that the last thing I ever want to go through again is nicotine withdrawal.
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