This post is an excerpt from the study guide which accompanies the “Overcoming Addiction” seminar. This portion is an excerpt from “Step Two: ACKNOWLEDGE the breadth and impact of my addiction.” To RSVP for this and other Summit counseling seminars visit

addiction wheelEvery addiction has different effects. Stimulants have different effects than depressants. Hallucinogens have a different effect from pain medication. Both the short-term effects of use and the long-term effects of abuse are different. The chart below is meant to help you identify the primary effects of various drugs.

For this reason, it would be very easy for you to use this section to minimize your struggle. You will read material that does not sound like it applies to you, because your substance of choice does not have those particular effects. Please avoid the false assumption that when a particular section does not apply to you that this seminar does not apply to you.

22 effects - physical, emotional-cognitive, & logistical - of drug/alcohol abuse. Click To Tweet

Physical Effects

Whenever the negative health effects related to AoD are discussed, the inevitable counter is to discuss the positive health effects. Both are usually true. When both positive and negative health effects exist for the same substance their impact is represented by a bell curve; the initial benefits peak with moderate use and then quickly slide into significant health concerns. When moderation is lost, health will be compromised.

“In any event, all data agree that the consumption of three drinks per day offers no benefits over those observed with one or two, and at four drinks per day the risk for heart disease and cancers as well as other life-threatening problems increases significantly (p. 74).” Marc Schuckit in Drug and Alcohol Abuse: A Clinical Guide to Diagnosis and Treatment

However, this brings up a very relevant point in the discussion of addiction. Most of us had strong warnings against AoD as children. These warnings included education about the dangers of AoD. When experimentation began but these dangers did not occur, we assumed the warnings were false – exaggerations intended to scare.

The pleasures of AoD were quick, episodic, and intense. The dangers of AoD are delayed, cumulative, and lasting. This is a combination of factors that allow for a high degree of self-deception and growing mistrust for the voices that would speak wisdom into our lives. Avoid making the same mistakes with these warnings that you did with your early warnings.

Read Genesis 3:1-24. What was one of Satan’s primary strategies in tempting Eve? He called into question long-term consequences that had not had the time to come to fruition, “You will not surely die (v. 4).” Imagine Satan whispering to a 17 year old you, “You will not surely wind up with a broken marriage, jobless, or unable to think straight without your substance.” In both cases, Satan was short-term accurate and long-term wrong. Satan used this strategy to cause Eve to doubt God. Satan still uses this strategy to get you to doubt parents, teachers, coaches, friends, bosses, or any other voice that would lead you to the way of life instead of the ways of death. Become aware of this empty sales pitch so you can begin to mistrust it.

In this section we will examine ten body organs or systems affected by addiction.

  1. Kidney: Your kidneys filter your blood. Therefore, the more (by quantity and potency) foreign substances you put in your body, the harder your kidneys have to work. Your kidney literally lays down its life to protect the rest of your body by storing these substances until they can be metabolized and removed from the body.
  2. Liver: The liver plays a filtering function similar to the kidneys. Drugs’ negative effect on the liver can range from general symptoms (e.g., fatigue, a generic feeling unwell, nausea, itching, and loss of appetite) to more severe symptoms (e.g., jaundice, enlarged liver, pain in the upper right abdomen, confusion, disorientation, and reduced alertness).
  3. Heart: Most illegal drugs can have adverse cardiovascular effects, ranging from abnormal heart rate to heart attacks. Injecting illegal drugs also can lead to cardiovascular problems, such as collapsed veins and bacterial infections of the blood vessels and heart valves. Any change in the energy level in your body will affect the activity level of your heart. The more you artificially change your heart rate the unhealthier it is for your heart.
  4. Lungs: Next to the brain, drugs impact the lungs more than any other organ. Even when drugs are not consumed through smoking, drugs interact with the gas exchange that happens in our lungs, making it more difficult for our lung tissue to exchange gases. The damage to delicate lung tissue is exemplified when the drugs are smoked.
  5. Immune System: When the body is under stress of any kind, one of the first places it pulls energy from is the immune system. As your body uses energy to return to the equilibrium disrupted by the AoD, it pulls from the immune system. Irregular sleep patterns, imbalanced nutrition, and other body stressors created by AoD abuse further decrease the amount of energy the body can devote to the immune system.
  6. Exposure to Diseases: It is not only the suppressed immune system that leads to increased illness. With AoD abuse frequently brings an increased exposure to diseases. Habits of personal hygiene are usually not a high priority while under the influence of mind or mood altering substances. Compromises in judgement result in more risky health behaviors (i.e., unprotected sex, sharing needles, etc…). The toll on body organs and systems combined with this increased disease exposure accounts for the escalating physical effects of addiction.
  7. Testosterone (for men): The body has biological priorities. Testosterone is not at the top of the list. When the body is under a degree of stress that it cannot achieve all of its normal functions, it neglects its non-survival functions. So, in the same way the immune system is neglected during stress, so is the production of testosterone.
  8. Brain: In the next section we will examine the cognitive and emotional changes that addiction produces, but here we will consider the physiological changes that happen in the brain. Addictions interfere with neurotransmitters, damage connections within the brain, reduce the ability to experience pleasure, and ingrain expectations of unhealthy habits into brain circuitry. These physical changes account for many of the difficulties in breaking an addiction.
  9. Stomach: Anything you put in your mouth that burns (e.g., hard liquor), burns all the way down. Your digestive system was made to process nutritious food. When you frequently introduce substances that it was not designed to store or metabolize, then your stomach must adapt. Another example would be opioid drugs, which create constipation. After your body adapts to abusing these, the result is a season of irritable bowel. When our body adapts to unhealthy circumstances we force upon it, the result is pain and suffering.
  10. Tooth Deterioration: Many drugs have the side effects of dry mouth or teeth grinding due to elevated energy level and body tension produced. Both of these side effects result in significant tooth decay.

The more parts of our body that become uncomfortable, the more prone we become to abuse AoD. The mind or mood altering effects of AoD begin to be used to offset the very symptoms they created.

“No matter how they start, addictions eventually center in distress and in the self-defeating choice of an agent to relieve the distress. In fact, trying to cure distress with the same thing that causes it is typically the mechanism that closes the trap on an addict—a trap that, as just suggested, might be baited with anything from whiskey to wool (p. 131).” Cornelius Plantinga, Jr in Not the Way It’s Supposed to Be: A Breviary of Sin

Read Psalm 102. We do not know if the affliction experienced by the author of this psalm had anything to do with addiction. But, regardless, we find in this psalm an invitation to make our physical pain known to God. Notice the rise-and-fall of this psalm. It doesn’t move from despair to hope. It has many ups and downs. But even its downs are Godward downs. This is the pattern God wants you to follow. Bring your pain to him; even when you caused it. God is willing to comfort your suffering even when it’s caused by your sin; which He is eager to forgive if you are willing to relinquish it. Be honest about when your fear is greater than your hope. Despairing to God is a form of faith.

“It is an act of faith to bring that complaint to him in the pattern of these psalms. Your faith in God should never silence you in the dark hours of grief. Rather, this is when we begin to understand how deep, rich, and sturdy God’s love for us really is (p. 9).” Paul Tripp in Grief: Finding Hope Again

Emotional-Cognitive Effects

Often we falsely assume our brain only has one control center. Actually, our brain has many control centers. Emotions, reason, and rewards (just to name three) have their own region of the brain where they weigh incoming data and arrive at conclusions. An imperfect metaphor would be that these control centers are like different branches of the United States government meant to hold each other in check.

One way (not the only way) to understand addiction is that reward and emotion mutiny against reason. Taken too far, this metaphor reveals why many addicts believe they will never be able to live sober: If reason has to dominate over reward and emotion, then the only way for me to be sober is to never be happy. But the actual goal is a balance of power, not a reverse mutiny. Restoring balance may feel like suppressing reward and emotion initially, but a livable sobriety will require balance in these three faculties.

As you read through the emotional-cognitive effects of addiction, don’t just look for examples of these in your life but also consider how these reveal a diminished-imbalanced role for reason in your decision making process.

  1. Depression: There are at least three ways addiction can contribute to depression. First, many AoD’s are depressants (review the chart earlier in this chapter). It only makes sense that regularly consuming significant quantities of a depressant would increase your level of depression. Second, it is physically exhausting to be addicted. Fatigue increases your rate of depression. Third, addiction requires time, and this time comes at the expense of rewarding activities in which you can find satisfaction.
  2.  Anxiety: Stimulants are to anxiety what depressants are to depression. Additionally, the mounting number of daily chores and work-school responsibilities that are neglected create a growing sense of anxiety whenever we begin to allow reason to play its intended role again. It is often this sense of being overwhelmed that causes us to retreat to processing life through our emotion and reward centers again.
  3.  Paranoia: At least two factors related to addiction can foster paranoia. First, addiction involves regularly violating our conscience, at least that part that remains sensitive (I Timothy 4:2), and sometimes involves violating the law. These factors create a growing sense that we are doing something wrong and everyone knows it. Second, AoD can deteriorate the reality testing area of the brain – the part of our brain that goes dormant while we sleep which accounts for fanciful dreams. The result of this deterioration is that is becomes more difficult for us to discern rational fear from irrational fear; which fuels paranoia.
  4. Shame: The emotion of shame is a strong indicator that our addiction is seeping into identity (more on this in the next section). One common way to differentiate guilt and shame is that guilt is a negative emotional response to what we’ve done while shame is a negative emotional response to who we are.
  5. All-Or-Nothing Thinking: This may be the most destructive cognitive disruption that emerges (or becomes more pronounced) because of addiction. In this mode of thinking things are either great or awful, easy or impossible, perfect or ruined, etc… Because overcoming addiction (or doing anything else worthwhile) is a journey and requires a process, they are deemed impossible. It may be helpful for you to create a chart when you find yourself getting trapped in all-or-nothing thinking.
Negative Extreme Reality Positive Extreme
Ruined Learning / In-Process Perfect
Impossible Worth a Bit of Hard Work Easy

6. Distorted Sense of Time: Addictions work fast. “Delayed onset addictive substance” is an oxymoron. If there was a cheap drug that had a long high but had a 24 hour delay between consumption and its effects, it would not be popular. The low cost and pleasurable high would not offset its delayed effect. This accounts for how addiction begins to dominate life. Most things worth doing take time. When addiction creates a life built around immediacy we lose our tolerance for these long-term investments. This undermines recovery, because recovery takes time.“Addicts may not seem as illogical as they first appear if we understand one thing: the addictive thinker’s concept of time (p. 27)… Addicts are intolerant of delay for the sought-after effect (p. 28)… To effectively prevent chemical use among young people, we would have to establish (1) ultimate goals in life other than sense of gratification and (2) tolerance for delay. Our culture is not likely to embrace these changes. Instead, our culture embraces addictive thinking (p. 16).” Abraham Twerski in Addictive Thinking

7. Negative Emotion Intolerance: The goal of addiction is to feel good, or, at least, to not feel bad. The more we build our life around this value, the less we are able (or willing) to tolerate unpleasant emotions. Empathy, uncertainty, grief, boredom, insecurity, doubt, and similar emotions become “reasons” to use. The more we escape these normal (often healthy) unpleasant emotions through substance, the more intolerable we perceive them to be; which results in more and more emotional reasons to use. “All of humanity’s problems stem from man’s inability to sit quietly in a room alone.” Blaise Pascal in PenséesA primary effect of #6 and #7 combined is impulsivity. As we increase our demand for immediacy and lose tolerance for anything unpleasant, our decision making becomes profoundly reactionary. We are no longer thinking. We begin to simply demand and escape.

8. Inflated Sense of Normal: After the prolonged exposure to the artificial reality created by AoD, normal feels dull, painful, muted, or subdued. It is comparable to the experience we have after jumping on a trampoline. Afterwards, when we are off the trampoline, our normal jumping feels stunted.

“Regular cocaine users begin to find that ‘normal’ life, experienced without the influence of cocaine, has lost its color and excitement (p. 49).” Carlo DiClemente in Addictions and Change

Read Psalm 51. Notice that David prays that God would “restore to me the joy of my salvation (v. 12).” He was aware that his sin with Bathsheba (the artificial high of an illicit relationship and high stakes political maneuvering to cover it up) had impacted his thinking and emotions. He needed them to be recalibrated. The purpose of this section is raise our awareness of what we are asking God to restore so that we can increasingly cooperate with God’s grace through faith and obedience.

Functional Effects

Addictions don’t exist in a vacuum. They exist in space and time. They cost money. They require planning. They force us to rearrange priorities. While addictions may be hard to define, it is easy to identify their functional effect in our life if we are willing to acknowledge these effects.

In this section one of the things you should learn is that addiction is not just an activity; it’s an investment. When we only view addiction as recreation, it is easier to minimize it. When we see the value of what we are investing to perpetuate our addiction, it becomes harder to avoid the reality of what’s going on.

In this section we will look at four functional effects of addiction for you to consider. These four forms of impact will serve as a transition for you to consider how your addiction is affecting others.

1. Time: There are two types of time investment in addiction: direct time and indirect time. In this point, we will consider the first.

    • How many hours do you spend using AoD?                    _____ per week _____ per month
    • How many hours do you spend high or intoxicated?  _____ per week _____ per month
    • How many hours do you spend “hung over”?                _____ per week _____ per month

2. Planning and Covering Up: The indirect time cost associated with addiction has to do with planning and covering up your addictive behaviors.

    • Hours spent planning for your addiction?                 _____ per week _____ per month
    • Hours spent covering up for your addiction?           _____ per week _____ per month
    • Hours spent ensuring access to your addiction?     _____ per week _____ per month

These first two points allow us to make a very practical assessment that is likely beginning to creep into your thinking, “Is the amount of time I’m spending on this study ‘worth it’?” Now you can do the math.

    • Hours Working Steps:                    _____ per week
    • Hours Invested in Addiction:  – _____ per week

It would be easy to view this as a math trick. It’s not. It’s reality. These are the kinds of decisions that you have to begin to make. This is an example of allowing reason to have its right role over emotion and reward. When whether it’s “worth it” to pursue sobriety becomes an emotional decision you will end up making choices that cost you huge portions of your future for relatively small slices of present sacrifice.

    • Net Gain/Loss                                      _____ per week
    • Hours in Counseling / Group:   + _____ per week

3. Money: As it does with time, addiction comes with a direct and indirect financial cost. Scripture calls us to consider the financial cost of addiction (Proverbs 21:17, 23:21) as a way to awaken ourselves to the danger and folly of our actions.

  • Money spent on AoD:                                 _____ per month
  • Money lost because of work missed:    _____ total

Now convert this total amount of money into hours (by dividing it by your hourly wage) and include it in the “worth it” computation above.

    • Money lost due to injury or accident:     _____ total
    • Money spent because of guilt:                    _____ per month

4.Priorities: This functional effect is less tangible. We can’t create a countable commodity like hours or dollars. But the lack of tangibility does not make this impact less significant. If anything, this aspect of addiction’s functional effect is more significant. The questions below are meant to help you identify the way addiction has changed your priorities.

    • What dreams have died or have you stopped pursuing because of addiction?
    • What relationships have been lost, or at least placed at risk, because of addiction?
    • What opportunities have you not pursued because of addiction?
    • What difficulties do you willingly live with instead of abandoning your addiction?
    • What values and beliefs have you changed in order to accommodate your addiction?
    • What would you want that is better for your children than what you experience because of your addiction?

Read Romans 5:1-11. After an examination like this, we doubtless will wrestle with shame. It is hard to acknowledge what we see in the mirror. This passage reminds us that shame need not be our destiny (v. 5). But, if we want to experience change, we must still face our shame. Jesus bore its penalty but we cannot avoid its reality. On this point, C.S. Lewis offers a helpful metaphor. Lewis compared shame to hot coffee. If we spill hot coffee on our skin we are burned, scalded, and feel disgusting. However, if we drink coffee we are warmed, nourished, and energized. When we avoid shame or wallow in shame, it becomes like spilled coffee. When we handle the stigma that may exist over addiction in the ways that are outlined in Scripture, then even our weaknesses draw us closer to Christ, remind us of the necessity of the cross, and give us testimony to share.

If this post was beneficial for you, then considering read other blogs from my “Favorite Posts on Addiction” post which address other facets of this subject.