| Who Understands Addiction? | | | | three months want to return to his old ways when |
| Understanding addiction has never been an exact | | | | the outcome could be (and sometimes was) fatal? |
| science, especially to those who are in the front line | | | | Addicts can quit many times and still relapse. There |
| trying to help people in their recovery. It can be | | | | must be something else going on. When I asked this |
| argued that addiction is a chronic relapsing illness. | | | | question of a recovered addict, he answered with a |
| Many in the world, who don't understand this | | | | question, "Why does a dog return to it's own vomit? |
| definition as applied to addiction, (and often the drug | | | | Because it's a dog! So why does an addict return to |
| users themselves), think that perhaps addiction is just | | | | addiction? Because he's an addict! There is much |
| a matter of choice and making right decisions. | | | | wisdom in this statement. |
| More Light and Less Heat Needed | | | | An addict starts out using drugs because it makes |
| Over recent years our understanding of addiction is | | | | him feel good. Eventually, as dependence kicks in, he |
| gradually having some light shone upon it. The | | | | needs the drugs to feel normal. But withdrawal takes |
| revelation is gradually unfolding a bit at a time. It's as | | | | a relatively short time, four to seven days should see |
| if we weren't ready for it all in one go. Those who | | | | the back of the symptoms. So why is it difficult to |
| work with recovering addicts are often mystified at | | | | stay on course even after 3 months? |
| the high relapse rate especially when a person has | | | | Drug Abuse or Drug Dependence? |
| completed, say, a 12 month programme and got a | | | | Current thinking is that there is a difference between |
| network of support around them. They just figure | | | | 'drug abuse' and 'drug dependence (addiction)'. Drug |
| it's par for the course. If you want to work with | | | | abuse in when someone , say, gets drunk every |
| addicts - get used to going to funerals! | | | | week enough to disable him, or uses some hard |
| What is the Question? | | | | drugs often enough to knock him out and not have a |
| On the other side of this equation are the academics | | | | recollection of what he did. A drug abuser can even |
| and scientists working on behaviour, and studying | | | | get physical withdrawal symptoms if they stop using |
| brain cells, to understand more about what is going | | | | (abusing). But if the circumstances changed, they lost |
| on. Have these people ever met a drug addict | | | | their job, or moved to another town, or the supplied |
| outside of a clinical environment? Possibly not. Maybe | | | | dried up, the abuser would simply stop abusing and |
| that's the wrong question though, perhaps it should | | | | may quit altogether. An addict can't do this. |
| be, "Are they making a contribution to our | | | | Dependency means a preoccupation with his drug of |
| understanding of the problem?" - I think we could | | | | choice. A love affair to steal for, and even die for. He |
| answer that in the affirmative. | | | | gets to the place where the drug is abusing him, yet |
| Whether we look at the problem close up and | | | | he still carries on the relationship. |
| personal, or through a microscope, we need to | | | | A Created Disorder |
| constantly improve our understanding of addiction so | | | | David R Hughes, a recovered addict, in his internet |
| that we can increase the odds in favour of those in | | | | article of 1997 argues that addiction is a neurologically |
| recovery. | | | | based disease. Drug addiction, is not primarily a |
| After Cold Turkey! | | | | mental or free will issue that an addict could change if |
| When the body starts developing a tolerance to the | | | | they wanted to. One definition of addiction is "the |
| drug, and more is required in order to feel normal, the | | | | loss of control over the use of a substance." The |
| drugs addict has reached a stage of physical | | | | reason addicts have lost control is because they |
| dependency. There will also be physical symptoms | | | | have suffered permanent physical neurological |
| linked to withdrawal which are too painful (for most | | | | changes based in their brains and nervous systems. |
| addicts) to think about. These may be 'flu like | | | | Addiction is a self-contracted neurological disease. It is |
| symptoms, sickness, cramps, headaches and | | | | a 'created' disorder. Nonetheless, it is also a physical |
| hallucinations. | | | | problem on a neurological level, and it is very real. To |
| Withdrawal is uncomfortable and miserable, but it is | | | | effectively "re-wire" his disordered nervous system, |
| the result of the body healing itself. It is part of | | | | the addict must come to rely fiercely and absolutely |
| breaking away from the physical addiction. | | | | upon the directions provided from an external |
| Withdrawal can be achieved gradually in a controlled | | | | support system (a rehab for instance). By mentally |
| way at a detox centre, or by reducing the drug (or | | | | changing what he relies upon, his neurological/nervous |
| drug substitute) intake gradually over a period of | | | | system undergoes a profound change. That is why |
| time to help our bodies break the physical addiction. | | | | rehabilitation over 12 - 24 months can work. |
| The other option of withdrawal without the help of | | | | Keep Talking and Re-wire the Brain |
| substitutes (cold turkey) requires much prayer and | | | | It is to understand that the detox does not last for a |
| will power, but can provide a very effective learning | | | | week, but for probably 3 months while the re-wiring |
| curve for the recovering person. | | | | is taking place. Then various models of therapy can |
| The Three Month Syndrome! | | | | prove effective, like the new therapies or a |
| Even after a detox it is important to maintain | | | | therapeutic community model. |
| sobriety for at least three months to even be able | | | | Recent evidence suggests that drug-induced changes |
| to contemplate dealing with any underlying issues | | | | in the physical brain over time may be the underlying |
| that need to be resolved. When working with | | | | reason for addictive behavior, and this is consistent |
| recovering addicts, we recognised this 'three month | | | | with the general idea that addiction is a physical |
| syndrome' when residents would hit a wall in the | | | | disease. But it is probably better to state that it is a |
| recovery process. | | | | medical disease. Prof Carlton Erikson puts it well in his |
| Often after dealing with the initial depression, anger, | | | | Addiction Today article "So, if addictions are a medical |
| anxiety and even boredom, the recovering person | | | | disease, why do we treat them behaviourally? What |
| would derail their recovery. No amount of persuasion | | | | is the similarity between behavioural or talk therapies |
| would convince that person to stay. We knew that | | | | and pharmacotherapies in the way they work? |
| 'the call' was too strong. The cravings and the | | | | Simple. Behavioural therapies probably change brain |
| compulsion to return to his old ways defeated | | | | chemistry! " |
| common sense. | | | | So all you carers out there, keep up to date, but |
| A Dog Returns to It's Vomit | | | | keep caring. And to you scientists, try to empathise, |
| Why would someone who had stayed clean for | | | | but keep looking through the microscope. |