[Baking Typewriter] If You Can't Quit Dependence, Reduce the Risks

Stories of Dependence Shared Between Patients and Doctors
"Addiction Rooted in Pain Relief?Harm Reduction as the Solution"

"I couldn't sleep without drinking. It was almost at the level of dependency." Webtoon artist and broadcaster Kian84 recently revealed on YouTube that he had suffered from panic disorder and severe alcohol dependence in the past. Obsessively trying to quit drinking was not the solution. Instead, he chose running as a way to alleviate his pain. "As my running distance increased, my drinking decreased. In the past, I only got dopamine from drinking, but now, running has increased my satisfaction with life," he said.

Everyone relies on something to get by. The problem arises when people become excessively dependent on alcohol, cigarettes, drugs, games, or social networking services (SNS) to gain momentary relief. Some modern individuals remain unable to break free from their indulgences, even though they are aware of the negative impact on their daily lives and health.

The new book "Everything We Lean On" is a collection of letters exchanged between Japanese psychiatrist Matsumoto Toshihiko and literary scholar Yokomichi Makoto. While most previous testimonies about addiction have come from 'prepared individuals' who have already distanced themselves from their problems to some extent, this book delivers the rarely heard 'work in progress' voices of those still struggling, through conversations between the two authors.

Toshihiko still has not been able to quit smoking, and Makoto says that from the age of 18 to his mid-40s, there were fewer than 30 days when he did not drink. Makoto, in particular, confesses to a wide range of addictive behaviors, from a pathological tendency to steal as an elementary school student, to sex addiction, overeating, and alcohol dependence. Upon reaching his forties, he was also diagnosed with autism spectrum disorder and attention deficit hyperactivity disorder (ADHD). He admits, "Whenever I tried to escape from pain, issues of dependence were always close by."

"Pleasure can become tiresome, but relief from pain never does." Toshihiko views the essence of dependence not as the pursuit of pleasure, but as the alleviation of pain. People do not fall into drugs for the thrill, but because their longstanding pain disappears, even if just for that moment. Even behaviors that seem far removed from pleasure, such as self-harm or trichotillomania, fall within this context. Therefore, the core of genuine treatment and recovery is not simply abstinence or severance, but learning to accept oneself as is, without isolation, and striving for a better life.

The key to recovery is a "harm reduction" strategy. Rather than eradicating addiction itself, this approach focuses on reducing the health, social, and economic damage it causes. In Switzerland, drug users are provided with clean syringes free of charge, safe injection rooms are operated, and less harmful substitute drugs are administered. In the United Kingdom, there are programs that provide homeless people with alcohol dependence with nutritious meals along with small amounts of alcohol.

Maintaining healthy relationships with those around you is also important. However, what is needed is a "not too close bond." In relationships that are too intimate, such as with family or close friends, it may actually be more difficult to share personal issues. Whether one has quit alcohol or drugs is not the essential issue. In fact, Makoto himself organizes various self-help groups to maintain connections with peers. Examples include Alcoholics Anonymous (AA), Narcotics Anonymous (NA), private rehabilitation facilities such as DARC, and Al-Anon for families.

Toshihiko emphasizes, "If a doctor unilaterally sets abstinence as the treatment goal, there is a risk that the patient will leave the treatment setting. If patients are not able to say 'I want to drink' when they feel like it, or honestly say 'I drank' when they actually have, then treating dependence is impossible." A society that helps each of us find better ways to alleviate our pain-this is the true vision of recovery proposed by this book.