Inhibitions Lowered by Addiction

This young man was clearly without his inhibitions when he decided that tattoo would be a good idea. (Felix Renaud/Dreamstime)

It is no major secret that drugs and alcohol have a tendency to lower our inhibitions. In fact, many people use this very fact as a justification for their substance abuse. We drink and do drugs because we are “too shy” or “no fun” without them. Of course, this viewpoint tends to change a bit once we have entered recovery. Upon reviewing the wreckage of our past, we realize that we were anything but fun. Our lack of inhibitions did not make life easier as we once believed, for now we must sift through the destruction that we have wrought as we attempt to salvage the jobs and relationships that we have ruined.

The lack of inhibitions resulting from substance abuse can lead to some numerous unfortunate consequences. Some are mild, such as a night out that lasts a bit too long and leads to a nasty hangover. Others are much more troublesome, such as a lost career opportunity or the end of a relationship. And in some particularly extreme cases, these consequences can even be fatal.

Various Types of Inhibitions

Before we start breaking down inhibitions into categories, let’s take a look at Merriam-Webster’s definition of the word. They provide us with several definitions of “inhibition,” which are:

• the act of inhibiting; the state of being inhibited
• something that forbids, debars, or restricts
• an inner impediment to free activity, expression, or functioning
• a mental process imposing restraint upon behavior or another mental process (as a desire)
• a restraining of the function of a bodily organ or an agent (as an enzyme)

While that last definition is not as relevant to our discussion as the definitions preceding it, there is a clear theme here. When we talk about inhibitions in regard to our behavior, we are talking about something that impedes our actions. For instance, a primary source of our behavioral inhibitions may be our conscience, or even just our capacity to clearly visualize the consequences of our actions. In short, our inhibitions are usually what keep us from doing the wrong thing. Of course, there are also times at which our inhibitions may keep us from doing the right thing.

That brings us to social inhibitions. In many cases, social inhibition manifests in the form of fear. In fact, many of addiction’s co-occurring disorders such as depression and social anxiety may be based in this form of inhibition. As a person develops, they will find that they have trouble approaching social settings. However, when this same person drinks or uses illicit drugs, they will find that they are no longer as inhibited around others. This is one of the most common causes of early addiction, as the addict will feel the need to use on a regular basis long before they have begun to build up a physical dependency.

In some cases, social inhibitions can actually hurt our ability to function at work or at school. Since those who suffer from latent social inhibition are often too anxious or afraid to carry a conversation, it is difficult for them to manage working closely with colleagues. In fact, those who suffer from social inhibitions will often not perform as well when other workers are in the same room, regardless of whether or not they are actually socializing with said workers. This is due to what is known as evaluation apprehension. Again, those who are intoxicated will not generally feel this kind of pressure. They may begin to get drunk or high at work. If they are a functioning alcoholic, they may even get away with this for a while. But as we’ve covered before, functional addiction almost always spirals eventually.

Sexual inhibitions are another category of inhibitions which may be dulled by alcohol or drug use. In some cases, this may even be considered a disorder of sorts (inhibited sexual desire, or ISD). When a person becomes intoxicated, they will not find intimacy as difficult. Unfortunately, our inhibitions also often keep us from engaging in hypersexual behavior or sexual addiction. When we turn them off, we are prone to becoming a bit loose.

As noted by the above examples, our inhibitions can affect us in one of two ways. There are the good inhibitions, which prevent us from lying, cheating or stealing. There are the bad inhibitions, which prevent us from making friends or pursuing valuable career opportunities. By turning off these bad inhibitions through the use of drugs and alcohol, we convince ourselves that we have made a positive change. But rare is the person who is able to turn off one set of inhibitions without turning off the other. This is why we experience so many consequences through our substance abuse, something we will explore in more detail later on.

How Addiction Dulls Inhibitions

Substance abuse affects the frontal cortex, which is important to cognitive processes involving morality and decision-making. (decade3d/Shutterstock)

We’ve already mentioned above that substance abuse can dull one’s inhibitions, leading to behavior that would normally be considered out of character. But why does this happen? Are non-addicts predisposed to the exhibition of certain inhibitions that are simply not present in the addict, or are drugs and alcohol themselves to blame?

The answer, as many might presume, is not so cut and dry. There are certainly some people who do not exhibit the same inhibitions as most members of the general populace. On the other hand, drugs and alcohol certainly have major effects on our neural pathways that lead to a lack of inhibitions, which may become more pronounced with frequent substance abuse over time.

Drugs and alcohol primarily affect the brain’s frontal cortex, which is responsible for not only inhibition, but also decision-making, planning and memory. Basically, the frontal cortex is responsible for overall cognition. To say, however, that the frontal cortex regulates inhibition is to address only one side of the coin. While our general behavioral inhibitions may be regulated by the frontal cortex, it also regulates what are known as response inhibitions. As substance abuse dulls our inhibitions and our capacity for sound decision-making, we become increasingly likely to react to situations inappropriately.

The issue actually extends far beyond the dulling of response inhibitions. Studies have shown that, over time, addiction to drugs such as cocaine and marijuana can lead to frontal cortex abnormalities. These dull our inhibitions to such an extent that we become “hypersensitive to potential rewards—no matter whether they [are] immediate or long-term.” This can lead to other forms of addiction, such as gambling addiction. It also heightens our need for a strict program of relapse prevention, since the short-term rewards of relapse may appear to outweigh the long-term rewards of sobriety.

Dr. William Silkworth was of the opinion in the 1930s that some people who were perfectly intelligent and of sound reasoning would react to alcohol in a fashion which differed drastically from the reaction experienced by most people. This helped us to define our modern notion of the alcoholic. Silkworth wrote in Alcoholics Anonymous that many people consume liquor “essentially because they like the effect produced by alcohol. The sensation is so elusive that, while they admit it is injurious, they cannot after a time differentiate the true from the false. To them, their alcoholic life seems the only normal one. They are restless, irritable and discontented, unless they can again experience the sense of ease and comfort which comes at once by taking a few drinks—drinks which they see others taking with impunity.”

Whether or not he realized it at the time, Silkworth’s words apply greatly to the addict or alcoholic who has suffered frontal cortex abnormalities as a result of prolonged addiction. Having experienced the thrilling sensation of a life without inhibitions, they cannot imagine going back to their old ways. As much as the drugs themselves are addictive, an uninhibited lifestyle may become even more so. This is the point at which there is little hope of turning back without some type of intervention.

Behavior Under the Influence

Drunk driving is one of the biggest problems that results from a lack of inhibitions. Without that internal voice of reason telling us not to get behind the wheel, we put others at risk and potentially take innocent lives in the process. (Andy Dean Photography/Shutterstock)

A recent article by informational comedy website Cracked covered unbelievable attempts at winning pointless bets. Most of the entries are standard fare, but it is quite telling that the very first two entries on the list both involve alcohol. One involves a drunken man stealing a plane and flying it into Manhattan on two separate occasions, while miraculously failing to hit any buildings on the way down. The other involves a man flying his plane into the center of a hurricane (again, twice) just to win a highball. In the first, the man was already quite intoxicated. In the second, he was simply trying to win a free drink. Both men risked their lives, and potentially the lives of others (the man who flew into the hurricane did not fly alone). It’s safe to say that these were men without many inhibitions.

Now, these stories are far from common. Most people do not have access to planes, or know how to fly them. Most people also will not go to lengths as great as these to win a simple bet. But even if these stories are rare gems befitting publication on a comedy website, they demonstrate the extreme depths of irrationality that may befall us when our inhibitions are turned off. While these men were supremely lucky to survive their great risks, there are many addicts and alcoholics who have sacrificed their lives due to much lesser risks. In fact, it happens just about every 51 minutes.

We’re referring to the nearly 30 people per day in the United States who lose their lives to motor vehicle crashes caused by alcohol. There were a grand total of 10,076 such casualties in 2013, amounting to 31% of all traffic deaths in the country that year. Many of those who died were not intoxicated themselves, but this is hardly a relief for the alcohol-impaired driver whose inhibitions did not stop them from taking the wheel. Thousands of people must now live with the fact that their actions have taken a life. About 200 of those drivers in 2013 had to deal with the fact that the life in question belonged to a child aged 14 or younger. And over half of those 200 children were in the car with the intoxicated party, meaning that many alcoholic drivers are currently mourning the loss of their own children. Driving while under the influence may sound funny in the context of a man drunkenly landing a plane on a New York sidewalk, but the reality of operating a vehicle while intoxicated is indeed a grim one.

The above statistics may pertain to alcohol, but about 18% of motor vehicle crashes involve other drugs. Regardless of whether or not a life is lost, the driver will usually face major legal issues. Granted, not all of these drivers are true addicts or alcoholics. But that fact alone was not enough to maintain their inhibitions and make the right choice. The difference between the addict and the non-addict in this case is simply that the addict is more likely to repeat their crime if they do not receive treatment. Even in the case of those who are caught and face major legal issues, recidivism rates for those who do not receive treatment are quite high. And with every DWI, they are increasing their odds of becoming involved in a fatal crash.

Our behavior while under the influence of drugs and alcohol can result in other consequences as well. How many times have we blacked out, only to find ourselves performing a great deal of detective work the next morning? After running out to the driveway in our underwear to ensure that the car is still there (and in one piece), we must go through our phones to see if we made any regrettable phone calls or sent any inappropriate text messages. We must check our bank statements, to ensure that we did not go on any spending sprees. We look over every inch of our bodies in the mirror, wondering at the cause of our mystery cuts and bruises.

The more intoxicated we are, the wilder our behavior may become. Our head writer once broke into two houses, and was arrested while undressing himself for bed in a stranger’s guest room because he had suddenly come to believe he was staying the night at a friend’s house. That was only the second or third time he had ever blacked out. He later had a roommate who kicked in the front door of their apartment after losing his keys, necessitating expensive repairs that he was unable to pay after he lost his job due to his addiction. That same roommate was once escorted home by the police, his hands bleeding from wounds sustained while climbing a barbed wire fence. That occurred mere days into a relapse.

These consequences are extreme, but even the milder consequences of losing our inhibitions are less than ideal. We may speak our minds in situations that call for more tact than we are capable of displaying while under the influence of substance abuse. We may fall in with a seedy crowd of friends because we value a lack of social inhibitions over the effort it takes to forge meaningful relationships. We may toss people or jobs aside, an act of grandiosity fueled by the belief that we can do better. We may engage in questionable sexual encounters, illegal activities, or sheer exercises in time wasting. Because we are no longer running the show. When we surrendered our inhibitions to drugs and alcohol, we surrendered the rest of our cognitive processes that comprised our personality along with them.

Rebuilding Sober Inhibitions

Exercise helps mitigate social inhibitions without resorting to liquid courage. (Maridav/Depositphotos)

Don’t be fooled by the title—we’re actually going to be discussing two very different things here. The first is how to rebuild positive inhibitions. The second is how to lower negative inhibitions without resorting to drugs and alcohol. We’ll begin with the second point.

Research has related our negative inhibitions to low levels of cAMP response element-binding protein, or CREB. When we are low in this protein, we may exhibit the type of anxiety we discussed in our example of the worker who is unable to perform with other people in the room. When we drink, however, our CREB levels are prone to rise. Over time, we develop a tolerance to alcohol that will lead to more drinking. In short, using drugs or alcohol to boost our CREB levels will result in the rapid development of tolerance, as well as increased dependence on our drug of choice and its psychological effects.

If we wish to let go of our overwhelming social inhibitions without the help of a bottle or a needle, then we must find alternative methods of raising our CREB levels. Fortunately, there are many ways of doing this. Some medications, such as antidepressants and specific beta blockers (most commonly propranolol), have been linked to a rise in CREB levels.

But don’t go running to the pharmacist just yet, because you can also raise your CREB levels through simple means such as listening to music and exercising regularly. This may be part of the reason that music therapy and adventure therapy have proven useful in addiction treatment. From a more practical standpoint, involving music and exercise in your life will often make life just a little bit more livable. And when you’re more comfortable living in your own skin, those social inhibitions just won’t take as great a toll on you.

Now, on to the issue of rebuilding positive inhibitions. This one is a bit more complicated, due to the dysfunction of the frontal cortex during addiction. Studies have shown that the effects on our neural pathways can be quite long-lasting, to the extent that our more impulsive reward centers may be reactivated upon using, even after long periods of abstinence. While the brain will attempt to repair itself over time, even the mildest relapse can push back that goal line by quite a bit. This is why our programs emphasize the importance of relapse prevention. It is also why we generally recommend that our patients spend some time at one of our sober living facilities upon graduating treatment.

Through addiction therapy and good old-fashioned abstinence from substance abuse, we will begin to regain our more positive inhibitions. We may feel guilt and shame over some of the actions we have committed during active addiction, and sometimes that leads us to believe that there is no hope. But remember—the mere presence of this guilt implies that our conscience is still in play. The addict is not a bad person, but merely a person who got lost along the way. As we regain our positive inhibitions and find healthier ways of shedding the negative ones, we will come to discover that there is hope for us after all.

We drank and used drugs because we thought they would create an ideal version of ourselves who was fun, outgoing, personable, and more. Through sobriety, we have found that such a person does exist. We simply went the wrong way about bringing that person to the surface. We don’t have to do that anymore.