These case histories illustrate numerous key points regarding the present treatise, but the main point to be further discussed below is the transition from drinking to feel good to drinking to avoid feeling bad. To some extent, this transition is facilitated by personality differences, presumably shaped not only by genetics but also by developmental and even social factors. As Khantzian (1997) cogently argued, addiction can be considered a type of chronic emotional distress syndrome that varies with the individual from physical and emotional pain to chronic dysphoria to stress and anxiety to interpersonal difficulties for which drugs can be argued to be sources of self-medication for such negative emotional states. Additionally, he argued that self-medication may be drug-specific—patients may have a preferential use of drugs that fits with the nature of the painful feeling states that they are self-medicating (e.g., opiates to counter intense anger and rage, stimulants as augmenting agents for high-energy individuals, energizing agents for low-energy individuals, and depressants [e.g., alcohol] for individuals who are tense and anxious). The common element argued by Khantzian is that each class
