The kindling effect of addiction is not only responsible for repeated relapse events in addicts and alcoholics; it also makes each withdrawal more severe and potentially dangerous than the last. Unfortunately, there is still a significant amount of resistance to concepts centered on drug abuse such as the disease model of addiction, post acute withdrawal and the kindling effect.
However, considering that the kindling effect is accepted in many other areas of medicine, it’s logical to argue that this condition must be addressed pertaining to substance abuse if there is to be any hope of mitigating the serious public health threat of addiction.
Sensitized Versus Desensitized
To kindle a fire means to stoke it: to make it burn brighter, higher and longer. In medicine the idea of “kindling” is essentially the same, but can occur in one of two ways: either making the “fire” hotter, or dimming or extinguishing the fire completely. Consider the following scenarios:
- Sensitized: A person who uses a specific drug for a long period of time – especially alcohol – may become more sensitive to it as a result of the body’s dwindling ability to process the substance.
- Desensitized: A person who uses a drug consistently may become desensitized to it, as in the case of tolerance, where more and more of the substance is required to produce the same effect or “high.”
The kindling effect can also have a significant impact on a person’s behavior, irrespective of substance abuse or alcoholism. Consider the story of a young boy reported in PsychCentral.com by Nanette Burton Mongelluzzo. From an early age the boy was subjected to a series of accidents, then torment by his peers later as a result. Each progressive incidence caused the boy to become highly sensitive to certain events and interactions, until the point where he developed severe anxiety and what could only be termed as “hyper-vigilance.”
Addicts and alcoholics suffer from the kindling effect in a number of ways, including sensitization or desensitization to a substance, as well as behavioral kindling related to their drug use. But for people attempting to get clean, kindling has a number of other effects that can actually make withdrawal more dangerous and less likely to succeed.
The process of becoming addicted to a substance causes changes in neuronal activity in the brain and creates neurological pathways that “service” the addiction. With sudden cessation of drug use or drinking come a “reversal” of these changes, whereby neurons become hyperactive after being suppressed during active addiction. The kindling effect occurs with each successive relapse and withdrawal event.
As neurons change and adapt to active addiction and subsequent clean periods, they eventually become more and more sensitive each time withdrawal occurs. This is evidenced by an increasing severity and duration of symptoms related to AWS or Acute Withdrawal Syndrome. Dr. Howard C. Becker – a noted expert on alcoholism – explains in his article “Kindling in Alcohol Withdrawal”:
“Accordingly, although binge drinking may not initially result in serious, or even noticeable, withdrawal symptoms, repeated episodes of this pattern of alcohol intoxication followed by abstinence and withdrawal may lead to a worsening of future withdrawal-related symptoms.” Â (http://pubs.niaaa.nih.gov/publications/arh22-1/25-34.pdf)
And because it is these very symptoms that cause addicts to relapse in an effort to seek relief, the physiological effect of kindling in addiction is a significant risk to people in recovery. This is true for people of all ages, including teens and young people.
Behavioral kindling related to addiction is similar to the story with the young boy above. By continually going through active periods of substance abuse and then periods of sobriety, a person can become overly sensitive to living with – or without – their drug of choice. Relapse becomes more likely because stimuli that would cause little reaction in most people causes an extreme and compelling need to seek solace in substance abuse in the addicted individual.
Once the kindling effect has set in, it can pose significant challenges to the recovery of the affected person. This is often evidenced by the behavior of addicts or alcoholics that try time and time again to get clean with no results except the downward spiral of destroyed relationships, careers and health. In fact, the “revolving doors” of most drug detox centers and rehabs swing on the hinges of the kindling effect.
What this means in lay terms is that although many addiction experts expound the idea that relapse is a normal part of addiction, it’s actually a progressive, severe problem that must be arrested permanently, as early as possible. This requires educational programs, facilities, resources and infrastructure that subscribes to the notion of;
“You must stop using now and forever,” instead of “Better luck next time, see you when you get back.”
If we look at addiction and alcoholism as the chronic and potentially fatal diseases they are, it’s easy to see that the kindling effect is equivalent to a remission of cancer, whereby each new recurrence could be the final, fatal relapse. And because addiction is our most serious public health issue, spreading the word about this condition is essential considering its relative obscurity.
Ultimately, we’ve got to start a fire about the Kindling Effect.