For people effected by substance abuse and addiction, there are a number of questions:
- How did I get here?
- What am I looking for?
- What do I really want from life?
- What does my future look like?
- How can I get where I need to be?
Family members and friends can fail to grasp the severity and the full scope of where an individual is with an addiction or substance abuse problem. Not many people that have these kinds of problems know how to tell others what is going on. Maybe they make up a lie to cover up an event because they feel guilty. Some may try to down play the situation, saying that it really isn’t “as bad” as it seems. They may be self medicating to treat co-occurring issues like depression or anxiety. When some people try a substance and they find it helps them feel better, they think that is the answer. Many people think they are in control. They may even think there is no problem with an occasional binge or maybe it’s just for social occasions. It could be that young adults and teenagers are coerced into trying new things because of peer pressure or they are afraid of social judgement. Whatever the excuse, most of the time it is just that. An excuse. The truth is that there is a problem and they need help. But what kind of treatment really works? Do they really need the help of a professional? Addiction is a disease with ties to specific functions within the brain. With that in mind, who is really in control in the case of addiction? Is the dependence laced with compulsion or is it a genetic predisposition that can’t be controlled?
We’ll divide the answer into four different parts. First, it’s important to understand how our brain responds to drugs. Second, let’s see what the argument for addiction being out of our control and look at what causes the brain to respond to substances. Third, let’s see what choices we can make in regards to behavior that can change the way we respond to substances. Lastly, we’ll explore a more realistic approach to the argument of who is in charge when it comes to addiction and just how plausible it is for recovery to take place.
What Happens In Your Brain
The brain is one of the most fascinating parts of our bodies. It develops slowly through our adolescent years and isn’t entirely done growing until we are around the age of 18. Our brains do a series of “self-cleaning” processes as it grows. It’s called “pruning” because there are branches of the brain that are cut back as they are not needed or less called upon. What results is a more efficient process with only useful information that is relative to the short term. Other storage capacity is also available in the long term part of the brain.
When your brain is doing the regular maintenance of our entire body system, it has a series of chemicals that it systematically releases to keep everything functioning. These chemicals help to control our mood, appetite, behaviors and everyday essential functions. One of these chemicals is “Dopamine” and it helps to regulate movement, emotion, motivation and pleasure. Certain drugs work by either blocking the receptors that usually store Dopamine or they encourage more production of these chemicals. This irregularity in the chemical structure of your brain over time teaches it to produce more or less of the chemical and develop a dependency on the supplementation of the chemical through the drug. Because this area of the brain controls movement, lethargy is one possible outcome. Having erratic emotions and lack of motivation also stem from irregularities in this part of the brain. When your brain is flooded with Dopamine, the pleasure centers are stimulated and it teaches your brain to repeat the behavior because it is being rewarded.
Nearly all drugs, directly or indirectly, target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that control movement, emotion, motivation, and feelings of pleasure. The overstimulation of this system, which normally responds to natural behaviors that are linked to survival (eating, spending time with loved ones, etc), produces euphoric effects in response to the drugs. This reaction sets in motion a pattern that “teaches” people to repeat the behavior of abusing drugs.
The beginnings of behavioral psychology stem from this very concept. The actual ramifications of which were so important to early ideas of psychology and how we as a society started to form our ideas about the brain. Classical conditioning refers to the process of using a reward system for behavior. It links something controlled to something that is not, and then teaches a behavior. This reward system is part of our most basic, primitive brain. That means that it’s essential for our survival. Ivan Pavlov, a Russian physiologist instituted a very simple experimentation using rewards and a stimulus. In the early 1900’s he helped pioneer behavioral health research and the learning process almost by mistake as he was intending to study the digestive process of dogs. Instead, he started to notice an odd behavior pattern when feeding the dogs. Whenever the bell would ring, the dogs would start salivating because it meant that food was on its way. Even when the food wasn’t present, the dogs would begin to drool at the sound of the bell.
Addiction is often classified as a brain disease because it interrupts the normal function of the brain. Over time, these changes become learned by our brains and it makes adjustment to the amount of chemical it naturally produces which creates a dependency on the outside source or drug. Our bodies can adapt to drugs and learn how to counter act it so we need more of the drug to achieve the same feeling as when our bodies first experienced the drug. With more of the drug, our bodies adjust again and dependency is formed.
The process for drug detox helps to bring down the amount of drugs in the body slowly so that the body can regain the normal balance and function. With the right medications, supervision and therapy, our brain function can return to a more normal state. Keeping in mind that every individual doesn’t work exactly the same, the concept is true for just about every one. There are effects from drugs and alcohol that can be permanent or irreversible. Working with medical professionals and psychiatrists ensures the best outcome for those looking to detox and recover from a substance abuse or addiction problem. Many clients have more than one mental health concern. Through the process of dual diagnosis, healthcare professionals can identify co-occurring mental health problems to help treat the whole person. Many people self medicate to treat symptoms of other mental health issues, when the underlying problems are correctly diagnosed, it makes the process of recovery much easier.
When clients or patients enter treatment, it is often because they have tried and failed to quit. When dependency is understood, it is easy to see why simply “quitting” without support is a very difficult task that could cause major medical problems and be detrimental to mental health. Understanding that this process is very complex, residential treatment is necessary. In a controlled environment surrounded by supportive people and professionals, recovery has the best chance.
Out of Control
Knowing what takes place in the brain, there is a compulsive element that comes in to play and many people assume that the compulsion is something that cannot be controlled. Think about it this way; when our bodies are deprived of food, we get hungry. Maybe we’ll see some one eating something delicious or we’ll smell the aroma of a barbecue in the air and we’ll start to salivate. So now we have a thought process and a physiological response by our body making more saliva. Maybe your stomach will start to ache. You can start to get a headache, now your body processes are beginning to be effected by the lack of nourishment. Now in this state, someone takes you to an all-you-can-eat buffet. What do you do? Is it about self control or survival at this point? Now think of how this would feel and take that to another extreme. This would be like going without drugs and then trying to quit. Much like the food example, the body starts to crave; but the functions that are effected are located in your brain and could effect your health more drastically.
“So while they may make an active decision and spend considerable effort translating that decision into action, the behavioral pattern itself seems recruited through some associative or implicit learning process independent of practical deliberation and voluntary control. Consequently compulsive persons often regard their own action as excessive, unpleasant, and pointless. That is, they do not associate anything pleasurable or desirable with its performance. It does not seem plausible that they are driven by a strong cognitive desire to perform it. Nevertheless, they perform it intentionally. They even make an effort to do it “properly.””
National Center for Biotechnology Information, U.S. National Library of Medicine : Addiction: Choice or Compulsion
Compulsive behavior seen in substance abuse and addiction is debated among professionals in the field. While some argue that the need to do something compulsively is for pleasure, while the pattern of behavior is often viewed as not pleasurable in cases where some one is acting obsessively. This erratic behavior is often cyclical and repeated in environmental situations. If a person knows that it is bad for them, but they are presented with the opportunity to use, the compulsion to give in takes a priority. Environmental intervention and strict adherence to avoiding triggers can help minimize compulsive behavior. The end goal being a feeling of pleasure, compulsive behavior can also lead to feelings of guilt and regret.
“The term “compulsive behavior” simply refers to repetitive behavioral patterns performed in characteristic circumstances which the compulsive person finds it difficult to override by intentional effort. On this description, compulsive persons are not necessarily powerless with respect to their compulsive behavior. Neither does it rule out the possibility of this behavior being voluntary, intentional, and even motivated by the compulsive person’s decision-making processes. This does not, of course, show that addictive behavior is compulsive. Some critics of the disease view who argue that addictive behavior is not caused by irresistible desires appear to take this to suggest that addictions must involve ordinary rational behavior instead.”
National Center for Biotechnology Information, U.S. National Library of Medicine : Addiction: Choice or Compulsion
While patterns of behavior seem contradictory, the elements that make up an addictive pattern of behavior suggest that the complex chain of thought that leads to a relapse is something that can be rationalized. These thoughts build on one another so much so that even if a relapse occurs, addicts will not recognize it as a relapse because they view it as an independent event that is separate from past occurrences. Many have a very difficult time seeing the problem because they are so wrapped up in their own thought pattern and justifications for why they are using or drinking.
In addiction, the areas of the brain that tell us we “like” something and the area of the brain that tells you that you “want” something become separated. So much so that those that use drugs or drink alcohol don’t necessarily “like” it but they “want” it. If that isn’t confusing enough, how is someone that is living with this condition supposed to properly identify that it is a problem and they need help? It’s the support of family and close friends that save addicts lives. By showing compassion and care and finding treatment for addicts, they can begin to recognize the disfunction in their thinking and begin the process of recovery. But the will to change still must exist.
There is a reason why drug rehab programs exist and they are becoming more common as the need for detox arises. Our bodies are a very delicate system that works together but the ultimate controller is our brain. When we damage the function of our brain, it can effect the other systems of our body and cause the delicate balance to be disturbed. Still there must be an epitome of thought that results in action to change. One must have a renewed hope for a better future and start working towards healthy goals.
Making the Right Choice
Ultimately, if some one does not want help, does not seek help and will not allow others to help them; they cannot be helped. There is a strong argument for choice. With the way our brains work and understanding the rationalization behind compulsive behavior, it can more easily be understood when an individual can’t view their life as being out of control. They see their problems as temporary. They have a misguided belief that their past status away from substances can be achieved very easily but they are just going to use or drink “this one time”. These kind of thought processes are dangerous but that doesn’t mean that they can see that.
In recovery, the thing that helps people understand they are where they need to be is when some one sets a goal. If they have more of a direction the recovery will have more purpose. Learning to deal with failure is very important to understanding recovery and focusing on moving towards positive affirmations about themselves. The teachings that are incorporated in treatment for borderline personality disorder also apply really well in the cognitive behavioral therapy associated with people that have suffered with substance abuse problems and addiction. Dialectical Behavioral Therapy was originally developed to treat personality disorders like borderline, but it can be applied to other therapy treatments.
By encouraging mindfulness, emotional regulation, distress tolerance and interpersonal effectiveness, those that suffer from substance abuse and addiction problems can start to make more permanent strides in staying sober. DBT can help by taking an approach from a more healthy mindset, looking at situations with the intent to stay focused – using a mindful approach can help cultivate a better decision making process. Part of the addictive mind is having irrational or skewed perceptions. When your mind is in the right place to think with a focus, it can help with clarity. Regulating emotions so that one can take a step back and think about how they are really feeling and what is occurring around them can keep addicts from guilting themselves into a depressive state. Learning to tolerate stressors, distress and triggers is another important key in keeping focus on recovery. Finding healthy environments and keeping clear of old habits that fall into addictive behavior also encourage positive mental health. Finally, interpersonal effectiveness helps by teaching patients to have positive interactions and view themselves in a positive light. Accepting help and finding a focus prove success can be achieved.
“…the common observation that quitting drugs is hard if you are an addict, but without entailing that this is because addicts are driven by irresistible desires for drugs or have lost their powers of resistance. A dual-process analysis of the notion of compulsivity does not, therefore, rule out the intentionality of addictive behavior. However, nor does it rule out the possibility that some other psychological or neurological mechanism (or combination of mechanisms) than incentive-sensitization might in the end turn out to provide the best empirical explanation of the compulsive behavior of human addicts (or at least be part of such an explanation).”
National Center for Biotechnology Information, U.S. National Library of Medicine : Addiction: Choice or Compulsion
This quote comes at the conclusion of a research project that sought to explain choice verses compulsion in relation to addiction. To paraphrase; the findings of the study concluded that it is hard to “quit” when you are an addict, but there really is more to it than that. Most of the time, when triggered, an addict will fail. Repeated failure and repeated exposure in a short amount of time make it more likely that the event will occur again. If the ability to change environments to avoid triggers is not present, a relapse occurs. Having other rationalizations for not using can also confuse the justification for not using and lead to failure. All of that said, there can also be neurological or processes in the brain that incentivize the behavior more so than some one who is not an addict. One belief is that a genetic predisposition to having addictive tendencies may be present, making this especially difficult to avoid falling into addictive patterns.
What Really Works
When it comes to using drugs, even if they are “just pills,” and it becomes a regular occurrence or the events become more frequent, you may need help re-establishing the balance of chemicals in your body. Drinking alcohol, while innocent to some degree in moderation, can also deprive your body and interrupt essential functions. When consumption begins to be regular or if binge drinking becomes a habit – even if you think it is just “social” – you may need help.
Treating substance abuse and addiction is a very serious process. It is important that when you enter a treatment program, you understand that a commitment must be made from all parties. The family, friends and individual all must make a commitment to the program. Sticking with the process is not always easy. Having medical professionals, psychiatrists, therapists and trained staff available to oversee detox and treatment is absolutely necessary in the recovery process. Finding a program that provide evidenced based treatment, dual diagnosis, proper training in treatments that have been extensively researched and proven to be efficacious is also imperative to finding a new road.
“Research shows that combining addiction treatment medications, if available, with behavioral therapy is the best way to ensure success for most patients. Treatment approaches that are tailored to each patient’s drug abuse patterns and any concurrent medical, psychiatric, and social problems can lead to sustained recovery and a life without drugs.”
Keeping in mind that everyone has their own story, their own psychology, their own experiences, it really does take a team of people who know what they are doing to support an addict as they recuperate. With all the experienced staff at New Roads and constant training on all the latest techniques and treatment methods, you can trust that your experience will be positive and provide a long lasting recovery with a brighter future. The team at New Roads doesn’t just talk the talk, we have experiences every day that prove we care. With group therapy, family therapy, constant counseling, consultations to family and friends, New Roads doesn’t just treat an individual. We coach the entire family and parents on how to help their loved one. Many times we tell the parents that they will get their son or daughter back, but in order for treatment to be effective and recovery to happen, they will also have to let them go.
Listen to Eric Schmidt, the CEO and Founder of New Roads Behavioral Health talk about a memorable treatment story of a young man that had tried and failed many times to find the right recovery path. He probably had a history of therapists that called him “too taxing” and had dismissed him. This particular case was very challenging. The difference that New Roads provided was consistency; the fact that they stayed impacted this young man. He was able to change and learn the skills to build a much happier life because he was given support when he needed it the most. Through substance abuse and mental health issues, there are a number of road blocks and set backs. With the correct treatment, recovery is possible and healing can happen. But only if you endure through the hard times and you can count on evidence based treatment that has a proven track record of bringing results and relief to patients in treatment.
In summary, addiction and substance abuse problems are extremely complex. There is hope. Treatment can work when the right choices are made. It is not an easy path to recovery, but help with drug detox in a professional residential treatment program can ensure that health and balance can be restored. Not only can recovery happen, but a better life can be made by encouraging mindfulness. With the skills to excel at daily activities, success can happen in all areas of life. The potential to achieve greatness lies within each of us if we can only recognize our ability to choose. With that being said, many of us have disadvantages, challenges and road blocks. With the right help and support, it is possible to work through these challenges and lead a happy, sober, healthy life.
You can do this, we can help! Call now to talk to some one who cares: 888-358-8998
Sources:
Web MD: http://www.webmd.com/mental-health/addiction/drug-abuse-addiction
National Center for Biotechnology Information, U.S. National Library of Medicine : http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3736117/