I have to premise this writing with a concern that some may have over it's content. I do not intend to say absolutely that current treatment doesn't work, only to help explain why it seems so difficult to overcome addiction and to suggest alternatives. It has been contended for years that addiction is not a disease. It shares some of the hallmark signs of disease, but it is not. It is a the result of a serious chronic health imbalance. The underlying psychological, physiological and biological issues are the primary concern. It is more complex than some have been led to believe.
I ask myself, why is it that people of sound mind and body, would consciously behave in a manner that will knowingly cause harm to themselves or others? That is hard to believe.
Very few clients I have met in my 30 years of working the field have been psychopathic, sociopathic or schizophrenic... or simply unable to distinguish between reality and non-reality. Certainly some become so physically addicted to their substance of choice that the harmful use needs to be attended to... in fact, on most cases abstinence is the preferred initial treatment.
We firstly must understand our own brain function... like it not all of us have essentially the same brains in terms of function, with minor variations.
Our brains are pattern-making machines... those patterns are developed over time and when reinforced through behaviour and cognitive patterned reasoning, seem very difficult to alter. Which explains why it is so difficult to change a habit, the patterns need to be changed. And this takes time... in some cases, lots of it.
Repeated use of drugs and/alcohol (or any mind altering chemical intrusion) actually weakens the brains ability to reason and greatly decreases impulse control. It is often not that someone doesn't want to quit using, it is lacking the ability to say no... sometimes against the person's own better judgement. It is a brain looking for dopamine input.
Because of the patterns, relapse is not only normal, it should be expected! Not that that's the preference, but it is the predominant pattern of recovering addicts. It can take years to create the paradigm shift required in brain function that assists better life choices.
Another myth is that people need to hit "rock bottom" before they'll reach out for help... This is not only untrue, it is potentially dangerous. Rock bottom can easily be death for some... It's like waiting for someone to commit suicide before saying that they should've reached out for help! Early identification is critical... it can be identified as increasing patterns of use, mood swings, secrecy, denial, change of relationships, etc. Harmful behaviour does not typically show up in it's extreme at the beginning.
People often choose to use drugs/alcohol because they feel it fills a void, an internal emptiness... and, coupled with an increased lack of impulse control, then increase their use. Over time it becomes a vicious cycle, a merry-go-round that seems impossible to get off of.
Many addicts show symptoms of depression, which contributes to their use. There can be a genetic predisposition to depression or other dysfunction or imbalance, not to alcohol use. A family history can be helpful to identify whether this may exist. Depression is primarily a chemical imbalance which can be improved with medication and proper counselling. And speaking of medication... I am aware that no one likes the idea of taking medication and I am not a pill pusher. However, I have come to realize over years of providing effective treatment to people that our bodies sometimes require assistance in correcting imbalances. Medication along with counselling is far more likely to produce positive results.
There have been vast improvements in the pharmaceutical field and there are new medications available that will support abstinence and block the brain receptors that contribute to cravings. It is not "the answer" but one which certainly will help to positively altering negative brain function.
There are three medication which have been approved for alcohol use in Canada and the U.S.:
Naltrexone (Revia - oral) and (Vivitrol by injection , only in the States right now) - which blocks opioid receptors in the brain, reducing the pleasure associated with drinking and can reduce cravings;
Acamprostate (Campral) which eases the side effects when initially stopping drinking (not to take anything can potentially cause serious brain seizures);
Disulfiram (commonly know as Antabuse) which increase the level of acetaldehyde which is a toxic by-product when alcohol is metabolized in our bodies (which cause alcohol poisoning), so people who drink while taking this become very ill.
Medication that can help reduce cravings:
Topirmate (anticonvulsant)
Baclofen (anti-anxiety)
Gabapentin (anticonvulsant under study for treating AUD - Alcohol Use Disorder)
As with all medications, it is important to speak with a trained medical professional who has knowledge of the proper use of these medications.
The "addicts" brain often will need help to re-organize and it is good news that people do not need to unnecessarily suffer for years and potentially never regain a positive productive lifestyle.
Alcohol and drug abuse cause billions of dollars to our society... productivity, treatment, relationship loss, policing costs... and eventually... death. This could be fixable if approached differently.
Effective treatment means that people get the help that is appropriate for their individual situation. It takes time and costs money. Families often will need help and support as well. Be hopeful... There is help available.
There are many recent studies which support new change which I will post on my website. I encourage other professionals to do the research and to contact me for referral assistance.
Individuals are invited to contact me as well through my website below.
Change can happen...
Leland Clipperton
CounsellingandMediation.com
