RECOVERING FROM SUBSTANCE ABUSE CAN BE DIFFICULT.KNOWWHV.

Many who are recovering from substance abuse have become dependent on their substances of choice. That dependence is just asreal and powerful an influencer of continued use as is the addiction to the substance. As though that isn't enough of a challenge torecovery, 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. Therewould be no honey without bees. There is no light, no happiness withoutcoffee. In each case something is dependent on another: humans aredependent 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 someoneor 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? Ineed coffee.) There are two kinds of dependency associated withsubstance abuse: psychological dependency and physical dependency.

PSYCHOLOGICAL DEPENDENCY IS ALLIN YOUR HEAD.

I can't sleep without a blanket or sheet covering most of my body, even ifthe temperature in the room is comfortable without. It's not physicallyimpossible, of course, but without a blanky I'll find it difficult to fall asleepand I won't sleep well. (Seriously, can I get some coffee?) This ispsychological dependence: there's no physical reason why I need ablanket to sleep well, but not having one itches at some unconsciousdiscomfort.

Psychological dependence can manifest independently from physicaldependence, so even substances that are not technically addictive, likecannabis, can be habit forming, especially when used in ritual or associatedwith other activities. Consume cannabis before eating every meal for aweek, then go back to eating sober and somehow the same food may justnot be as tasty. The brain associates the effects of the drug with the tastiness, so eating without the high might trick your brain intobelieving that the food isn't as good.

Psychological dependency is usually treated with behavioral therapy.

PSYCHOLOGICAL DEPENDENCY IS ALLIN YOUR HEAD.

Miss my morning cup of coffee and I'm an irritable zombie for the first partof the day. I can suffer headaches in addition to feeling less awake. My bodyhas come to rely on caffeine to signal to my brain that, yes, I really am awakeand, yes, I really do have to go to work. This is physical dependence, and ourbodies can become so physically dependent on some substances, likealcohol or barbiturates, that withdrawal-when the body doesn't get thesubstance it has grown dependant on-can be deadly.

Physical dependence can also trigger symptoms of psychological dependence uponwithdrawal. As it turns out, skipping my coffee in the morning not only leaves medrowsy, with a headache, but it also makes me grumpy. Caffeine doesn't really stimulatefeelings of happiness, but I've come to associate the physical aspects of coffeedrinking-the wonderful aroma, the warmth in my stomach-and the physical perks ofcoffee drinking-being more alert, having more energy-with the emotional state ofhappiness. Less coffee equals less happiness.

Physical dependency is usually treated with gradual reduction of the substance, medication to counter the more severe withdrawalsymptoms, 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 onewith an illness or addiction who requires support.The basic idea is that a codependent builds his or her life and identity around caringfor 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 createan 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 chooseto try managing the alcoholic family member on his or her own. Particularly in those cases of codependent children with alcoholicparents, 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 beemployed as well. Family counseling can be especially effective, since it can address the behavior of the substance-dependent familymember 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 andcodependent behavior. You will then be in a better position to begin the process of mitigation and recovery from dependence orcodependence, for yourself and your relations.

TO borrow a line from the G.I. Joe heroes of my childhood:

"Knowing is half the battle:'