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There are two types of addiction, physiological
and psychological. In physiological addiction, an individual is
addicted to a substance on which his body has grown dependent. When
the individual ceases taking the chemical substance, he begins experiencing
symptoms of withdrawal, the body’s way of responding to the
cessation by stating, “Hey, what did you do? I need more of
what you’ve been taking.” Withdrawal can result in a
variety of real physical symptoms such as rapid heart rate, nausea,
vomiting, diarrhea, and stomach pains. Tolerance is often seen in
long term addiction. Tolerance is the body’s need to acquire
more of the substance in order to reach a particular level of relaxation
or “high,” as perceived by the patient. It doesn’t
matter if the substance is alcohol, cannabis or tobacco.
In psychological addition, the individual may or may not be physically
addicted to a substance, but craves the “source,” which
may be a substance or behavior, in order to decrease severe anxiety
and stress. Psychological addiction includes sexual addiction, gambling,
internet, addiction to computer games, and/or substances such as
alcohol or drugs. Despite the impact on work and relationships,
individuals will go to great lengths to calm the severe stress and
anxiety that occurs with the absence of the substance or behavior
to which they are addicted, regardless of the consequences.
Image yourself as a child, spinning around on a merry-go-round,
arms outstretched, looking at the clouds, spinning and spinning
until extremely dizzy, then falling to earth, looking up at the
sky, noting that the environment around us continued to spin. We
would laugh, enjoying the feeling of the moment that we ourselves
were able to induce. This is an example of an altered state of consciousness,
and is usually what occurs and the reason why individuals choose
to ingest substances. They are attempting to alter their state of
consciousness, because they are afraid to function in the world
as it really is. This could be stress encountered in a relationship,
or in other areas of their lives. Subsequently, these individuals
end up taking substances to dull their feelings and emotions. By
doing so, they perceive they are able to more adequately cope by
decreasing their anxiety or stress. Unbeknownst to them, they are
slowing becoming addicted, and believe they need the substance in
order to function appropriately.
Much research has pointed to a strong hereditary component to addiction,
especially with alcohol, and a propensity to abuse other drugs.
There are many factors that influence addictive behavior. It is
not uncommon to see unresolved issues extending back to childhood,
including family dysfunction, conflict and stress. Shy and socially
awkward children grow to be shy and socially awkward adolescents,
who find that if they drink, they become more socially engaging
and confident, see themselves as witty and the life of the party.
Subsequently, as they move on to adulthood, they will continuously
need the substance in order to support their view of themselves.
Should these individuals be fortunate enough to reach a treatment
program, and are able to abstain from all substances, their true
selves are then revealed. It is not uncommon for these individuals
to feel very depressed, and may need anti-depressant medication
at that time. We also see marriages and other relationships slowly
deteriorate, even after treatment, as the person they married is
not the person they saw while under the influence of some addictive
substance. It is not uncommon to see couples where both individuals
are involved with addictive substances. Therefore, when one individual
“becomes clean,” it becomes very difficult for both
parties to maintain their positions, and alienation from one another
sadly occurs.
Sidebar: If an individual has not abused alcohol or drugs by the
age of 21, there is an extremely good chance of not becoming addicted
to any substance for the rest of their lives. Therefore, good role
modeling is extremely important while a child is growing up, with
good communication and good education by parents and teachers regarding
the hazards of chemical abuse and addiction.
It is not surprising that over the last 10-20 years, abuse and
addiction have been on the rise. We live in what this author calls
a “fast food society, with increased environmental stressors,
spiraling divorce rate, and the majority of individuals demanding
fast and immediate gratification. Abuse and addiction has increased
as more people attempt to alleviate stress and anxiety in their
lives.
Addiction Treatment
To successfully treat addictions, the complete person must be targeted,
the mind, body and spirit. There needs to be a strong social support
network, including family members who also become involved in group
and family therapy. Of course, there must be a strong commitment
by the individual who is seeking treatment.
Individuals need to prepare themselves for the possibility of recidivism.
They need to be assured that a failure is not the end of the world.
It should be noted that the most successful treatment program is
the Alcoholics Anonymous philosophy and the 12-step program.
The original 12-step of Alcoholics Anonymous are as follows:
- We admitted we were powerless over alcohol, and that our lives
have become unmanageable.
- Came to believe that a power greater than ourselves could restore
us to sanity.
- Made a decision to turn our will and our lives over to the
care of God as we understood Him.
- Made a searching and fearless moral inventory of ourselves.
- Admitted to God, to ourselves, and to another human being the
exact nature of our wrongs.
- We are entirely ready to have God remove all these defects of
character.
- Humbly asked him to remove our shortcomings.
- Made a list of all persons we have harmed, and became willing
to make amends to them all.
- Made direct amends to such people whenever possible, except
when to do so would injure them or others.
- Continue to take personal inventory and when we were wrong,
promptly admitted it.
- Sought through prayer and meditation to improve our conscious
contact with God as we understood him, praying only for knowledge
of his will for us, and the power to carry that out.
- Having had a spiritual awakening as a result of these steps,
we try to carry this message to alcoholics and practice these
principles in all of our affairs.
These 12 steps are reprinted with permission of Alcoholics Anonymous
World Services, Inc.
It should be noted that other programs have adopted the 12-step
program. For example, narcotics anonymous and marijuana anonymous
both have at least a 12-step program, but the steps are of course
specific to the particular drug to which the person is addicted.
Some programs refer to a “higher power” instead of
specifically using God’s name. This makes it more acceptable
to a wider range of individuals.
From a psychologist’s point of view, there must be a cognitive
understanding and acceptance by the individual that he is indeed
addicted to a substance, and he has to relinquish some of this power
over to something else. But there has to be an acknowledgement that
they are giving up their power to another source. This other power
may even be a particular family member who helps the individual
through the process. We will talk about this more in group therapy.
Individuals must allow others to help them. If that does not take
place, the addiction has a much higher rate of recidivism. The paddling
the canoe analogy is key here. Trying to paddle a canoe by yourself
is very difficult. With two people, it is much more proficient.
Individuals must understand that the will be drug tested periodically,
and need to voluntarily submit to testing. Unwillingness to do so
is an admission of failure.
Family members must be involved. Everyone living in the home of
the individual who is being treated should be involved in group
therapy and family therapy. What is not focused on enough in treatment
are post-treatment issues; that is, individuals are different after
therapy than prior to, and they must now reassess who they are,
both at home and in the workplace, as well as in social situations.
The individual must relearn who he is, as he is beginning life as
a new person in a way, without the aid of a foreign substance.
Treatment lasts a lifetime. An individual will always be in treatment.
That is not to say they are in formal treatment, but every day they
wake up, they are performing their own treatment and treatment assessment.
There are some excellent websites on the internet. www.soberforever.org
is an excellent resource. www.addictionresourceguide.com, www.drug-addiction.com,
are also most helpful, along wither others.
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