What Your Substance Use Is Actually Treating

The Map No One Gave You

The previous article in this series dismantled the disease model of addiction and replaced it with a mechanistic framework: substance use as the nervous system's rational response to sustained attacks—trauma, parasitic infection, chronic neuroinflammation. The behaviors the system calls "addiction" fall out naturally from those conditions.

This article makes that framework concrete. Each major substance class maps directly to specific underlying drivers. The substance "choice" isn't random, moral, or evidence of a hijacked brain. It's the body reaching for what actually works when the medical system has failed or denied the real problem.

What follows is the map they should have given you from the beginning.

Trauma and Adverse Childhood Experiences: Alcohol, Benzodiazepines, Sedatives

Trauma isn't abstract. It's a biological event with biological consequences.

When a child experiences severe abuse, neglect, or household dysfunction—what researchers call Adverse Childhood Experiences (ACEs)—the developing nervous system adapts to survive constant threat. The hypothalamic-pituitary-adrenal (HPA) axis, the body's stress response system, becomes chronically overactivated. Cortisol stays elevated. The amygdala, the brain's fear center, becomes hyperresponsive. The prefrontal cortex, responsible for emotion regulation and impulse control, develops under siege.

The result is a nervous system stuck in survival mode: hypervigilance, emotional dysregulation, difficulty with attachment, baseline states of anxiety, shame, or emotional numbness. The CDC and public health agencies openly acknowledge that ACEs are major risk factors for substance use disorders in adulthood. Recent research confirms the dose-response relationship: more ACEs, higher probability of substance use.

But framing it as "risk" misses the mechanism.

A person carrying unresolved trauma isn't at risk for substance use. They're living in an internal state that's often unbearable—constant alarm, intrusive memories, inability to rest, emotional chaos they can't regulate on their own. Alcohol, benzodiazepines, and other sedatives temporarily downregulate that overactivated system. They quiet the hypervigilance. They soften the edges of emotional pain that has nowhere to go. They allow, for a brief window, something resembling peace.

The "compulsion" isn't mysterious. When your baseline state is relentless distress and you've found one of the few things that actually provides relief, of course you return to it. The brain has learned: this works. This is my emergency regulation tool.

And when treatment focuses on removing the substance without addressing the trauma—without helping the person process what happened, without giving them other tools to regulate a nervous system that was shaped by years of threat—relapse isn't a disease flare. It's what happens when life becomes unbearable again and the old solution is still in memory.

The system calls this moral failure. But the moral failure belongs to the system that pathologizes the coping mechanism while ignoring the wound.

Trauma creates the vulnerability. But there's another driver the system denies entirely: parasitic infection.

Parasitic Infections: Tobacco and Nicotine

Important: I do not advocate using tobacco or any of the substances discussed in this article. What I advocate for is identifying and treating the root causes—parasitic infections and unresolved trauma. Address those foundational issues and you create an actual path to recovery, healing, personal growth, and regained life purpose. Self-medication is a survival strategy when the system has failed you. It's not the solution.

Nicotine is an anthelminthic drug. It kills parasites.

This isn't fringe science or speculation. Nicotine's antiparasitic properties are documented. What the medical establishment refuses to acknowledge is that millions of people are unconsciously self-medicating against undiagnosed parasitic infections when they use tobacco.

The correlation between severe mental illness and tobacco use isn't coincidence. It's not "poor impulse control" or "addictive personality." People labeled with schizophrenia, bipolar disorder, and other severe psychiatric conditions smoke at rates two to three times higher than the general population. The standard explanation is that mental illness causes smoking.

The actual explanation is simpler: both the psychiatric symptoms and the tobacco use stem from the same root cause—parasitic infection. The nicotine is fighting the parasites that are driving the mental illness itself.

Consider Toxoplasma gondii , one of the most studied neurotropic parasites. In animal models, T. gondii alters fear and risk-taking behavior by manipulating dopamine and other neurotransmitters. In humans, latent toxoplasmosis has been linked to increased sensation-seeking, impulsivity, and higher rates of substance use. Recent clinical studies found higher T. gondii prevalence in people with substance use disorders, with evidence the infection alters dopamine levels directly.

The mechanism: parasite → chronic immune activation → neuroinflammation → changes in dopamine, serotonin, and other signaling systems → altered behavior, mood dysregulation, cognitive impairment, chronic fatigue. This same mechanism explains conditions like Restless Leg Syndrome , where parasitic infections create movement disorders the medical system calls "idiopathic."

From the outside, that looks like mental illness or addiction. From the inside, it's a biological assault on the central nervous system. And tobacco—specifically menthol cigarettes—provides one of the few accessible, affordable ways to fight back.

I documented this pattern in detail in my video on why America's poor smoke menthol cigarettes. The short version: menthol enhances nicotine delivery and has its own antiparasitic properties. The populations with the highest menthol use—Black Americans, poor Americans—are the same populations with the highest parasite burden. This isn't cultural preference. It's biological necessity in the face of systemic medical denial.

Chronic Fatigue and Brain Fog: Stimulants

Chronic fatigue doesn't exist in isolation. It's a downstream consequence of the root causes we've already discussed—unresolved trauma and parasitic infections, often both at once.

Trauma dysregulates the HPA axis and leaves the body in a constant state of stress. That chronic activation is metabolically expensive. It exhausts the system. Parasitic infections trigger chronic immune activation and neuroinflammation, which directly impair mitochondrial function and energy production. The result is profound, unrelenting fatigue that no amount of sleep or rest can touch. For detailed protocols on addressing these infections, see my comprehensive guide to treating parasites .

And with the fatigue comes brain fog—the cognitive manifestation of neuroinflammation. Difficulty concentrating. Slowed processing speed. Memory problems. The feeling that your brain is wrapped in cotton, that thinking requires Herculean effort, that you're operating at half capacity on your best days.

For someone living in this state, stimulants aren't about getting high. They're about being able to function.

Coffee is the socially acceptable version. Millions of people depend on caffeine just to get through a workday, to focus enough to complete basic tasks. When coffee stops working—when the fatigue is too severe, the brain fog too thick—some turn to prescription stimulants like Adderall or Ritalin. And when those become inaccessible or insufficient, the logic doesn't change: cocaine, methamphetamine. Different potencies, same underlying need.

People who use methamphetamine often describe it as "the only thing that makes my brain work." That's not euphoria. That's not recreational. That's someone whose baseline cognitive function has been so compromised by infection and inflammation that a powerful stimulant is the difference between functional and non-functional.

The "escalation" the disease model describes as loss of control? It's the underlying fatigue and neuroinflammation getting worse, not better. The dose that worked six months ago doesn't work now because the parasitic load has increased, the immune dysfunction has progressed, the trauma remains unprocessed and continues to drain the system.

I know this pattern intimately. I lived it. The system failed to diagnose or treat the infections and trauma that were destroying my ability to function. First came prescribed Adderall. When that wasn't enough, powder cocaine for a brief period. And ultimately methamphetamine for five years. I wasn't chasing euphoria. I was trying to have a brain that could think, a body that could move, some semblance of the person I used to be.

The system calls that addiction. I call it survival.

And when treatment removes the stimulant but ignores the chronic fatigue and brain fog—when the infections remain untreated and the trauma unaddressed—relapse is inevitable. The cognitive impairment is still there. The exhaustion is still there. Of course the behavior returns.

Chronic Pain: Opioids

Chronic pain is one of the most powerful drivers of opioid use, and like fatigue and brain fog, it doesn't appear out of nowhere. Pain is often the result of chronic inflammation. And chronic inflammation is often driven by infection and unresolved trauma.

Over 60% of people with opioid use disorder have chronic pain, and most had the pain before they developed opioid dependence. This isn't coincidence. It's cause and effect.

Chronic pain itself alters brain function. In animal models, chronic pain activates microglia—the brain's immune cells—in the ventral tegmental area, a key region of the reward system. This microglial activation reduces dopamine transmission and disrupts normal reward processing. The result is a reward-deficit state: nothing feels good, motivation collapses, and life becomes a matter of enduring rather than living.

In that state, opioids aren't providing euphoria. They're providing relief from an aversive condition that nothing else touches. This is negative reinforcement—the removal of something unbearable—not the pursuit of pleasure.

The person living with chronic pain that doctors dismiss, minimize, or inadequately treat is making a brutal but often unconscious calculation: the harm from using opioids might kill me eventually, but the harm from not using—the unrelenting agony, the inability to work or care for my family, the complete loss of quality of life—is unbearable right now.

The medical system created this crisis directly. Pharmaceutical companies pushed opioids, doctors prescribed them liberally, and millions of people developed tolerance and physical dependence. Then, when the system recognized the problem it had created, it tightened prescribing guidelines and abandoned chronic pain patients to withdrawal and untreated suffering. Many turned to street opioids. And the street supply shifted to fentanyl.

The timing isn't coincidental. Mass prescribing created the dependency. The crackdown created the desperation. The fentanyl followed.

The "compulsion" to use isn't brain disease. It's the body's desperate attempt to quiet pain signals that are often driven by the same root causes we've been discussing: inflammation from parasitic infection, the biological aftermath of trauma, immune dysregulation that leaves the nervous system under constant assault.

And relapse? Relapse is what happens when detox removes the opioid but does nothing about the chronic pain, the inflammation, the infection, the unresolved trauma. The internal crisis is still running. The pain is still there. Of course the behavior returns.

The system set people up to fail, then blamed them for failing.

The Pattern Across All Substances

Every major substance class maps to an underlying condition the medical system ignores, denies, or actively caused:

• Alcohol, benzodiazepines, sedatives → unresolved trauma and nervous system hyperactivation
• Tobacco and nicotine → parasitic infections driving psychiatric and neurological symptoms
• Stimulants → chronic fatigue and brain fog from infection and trauma
• Opioids → chronic pain rooted in inflammation, infection, and biological trauma

The "disease of addiction" pathologizes the coping mechanism and leaves the root causes untouched. That guarantees continued use, escalation, and relapse. Then the system calls it moral failure.

True recovery requires treating what the substance use is actually addressing. Identify and treat the parasitic infections. Address the trauma. Reduce the neuroinflammation. Give the body and brain what they actually need to heal. See my treating parasites series for accessible, affordable antiparasitic approaches.

Everything else is theater.

The next article examines how this crisis was manufactured and who profits from it.