They have to be motivated. It takes the realization that their family, their future, their employment—all these—are becoming severely compromised. The subtext isn't that they just "walk away" from the addiction.
But I've had a number of patients in the clinic whose six-year-old says, "Why don't you ever come to my ball games? For example, they change whom they associate with. They can make it harder to access drugs, perhaps by never carrying cash with them.
People will put obstacles in front of themselves. True, some people decide they can't do it on their own and decide to go into treatment—that's taking matters into one's own hands, too.
What do professional drug addiction programs offer that is difficult to replicate on one's own? If you're already in treatment, you've made a big step. Even for court-ordered treatment, people often internalize the decision as their own. You get a lot of support. You get instruction in formal relapse prevention therapy.
You might get methadone for withdrawal and medications for an underlying psychiatric problem. Most experts regard drug addiction as a brain disease. Do you agree? I'm critical of the standard view promoted by the National Institute on Drug Abuse that addiction is a brain disease. Naturally, every behavior is mediated by the brain, but the language "brain disease" carries the connotation that the afflicted person is helpless before his own brain chemistry.
That is too fatalistic. It also overlooks the enormously important truth that addicts use drugs to help them cope in some manner.
That, as destructive as they are, drugs also serve a purpose. Treatment enables people to counteract addiction's disruptive effects on their brain and behavior and regain control of their lives. The chronic nature of addiction means that for some people relapse, or a return to drug use after an attempt to stop, can be part of the process, but newer treatments are designed to help with relapse prevention. Relapse rates for drug use are similar to rates for other chronic medical illnesses.
If people stop following their medical treatment plan, they are likely to relapse. When a person recovering from an addiction relapses, it indicates that the person needs to speak with their doctor to resume treatment, modify it, or try another treatment.
While relapse is a normal part of recovery, for some drugs, it can be very dangerous—even deadly. If a person uses as much of the drug as they did before quitting, they can easily overdose because their bodies are no longer adapted to their previous level of drug exposure. An overdose happens when the person uses enough of a drug to produce uncomfortable feelings, life-threatening symptoms, or death. Research shows that when treating addictions to opioids prescription pain relievers or drugs like heroin or fentanyl , medication should be the first line of treatment, usually combined with some form of behavioral therapy or counseling.
Therapy can help you to cope with uncomfortable feelings and help you unravel the irrational thoughts that keep you addicted. Quitting is not easy or straightforward, but a good support group and treatment program will help you achieve it when you are ready. Overcoming an addiction is a process that requires making the decision to quit, planning how you will quit, dealing with the effects of withdrawal, and avoiding relapse.
With addiction, you want to make sure that you set yourself for success. That means if you are trying to avoid alcohol, in the beginning of your recovery journey, avoid places where you know there will be alcohol. Some other strategies for quitting an addiction include:. In addition to medications, psychotherapy can also be effective in helping overcome addiction. Cognitive behavioral therapy CBT is one approach that can help people change their thinking patterns and learn healthy skills.
It's important to remember that there isn't a single treatment that is right for everyone, so working with a therapist to find the right approach for you can improve your chances of success. Other approaches that can also be effective include contingency management, rational emotive behavior therapy REBT , step programs , SMART recovery , and mindfulness-based approaches.
For more mental health resources, see our National Helpline Database. Learn the best ways to manage stress and negativity in your life. National Institutes of Health. Drugs, brains, and behavior: The science of addiction. Updated July National Institute on Drug Abuse.
Understanding Drug Use and Addiction. Updated June National Institute on Drug Abuse for Teens. Tolerance, dependence, addiction: What's the difference? Published January 12, Behavioral addiction versus substance addiction: Correspondence of psychiatric and psychological views.
Int J Prev Med. Pharmacological strategies for detoxification. Br J Clin Pharmacol. Treatment approaches for drug addiction, DrugFacts. Published January 17, Ambivalence: Prerequisite for success in motivational interviewing with adolescents? Psychopathological symptoms, defense mechanisms and time perspectives among subjects with alcohol dependence AD presenting different patterns of coping with stress. The effects of social contact on drug use: Behavioral mechanisms controlling drug intake.
Exp Clin Psychopharmacol. I have no cravings today 30 years later. This is a question I hear often from the user as well as the family members. If you can live without than do so. And go to meetings of some kind. Truly a good article, thank you. Thank you for connecting and sharing your thoughts. Having over 27 years if sobriety from alcohol, marijuana, cocaine and shrooms.
Through one 21 day rehab stay. Holding two master degrees pre sober and post sober, I understand your points. I do believe I have an addictive personality and have substituted healthier options for that bring me the same focus and mind quietness that came from alcohol and drugs.
Not sure about different classes of drugs not bothering me as much as those of choice.. As a progressive disorder, all those who tell me they picked up after years of sobriety go way over the edge and are lucky to return having not killed themselves or anyone else.
My ex husband was an alcoholic who would stay sober for a year or nine months and then decide it was ok to drink again, because he was able to stop for the long period of time. It turns out he could have a drink and another and another and make me crazy.
As the mother of a recovering addict, I have seen the relapses that come with addiction. Been to too many of his peers funerals. My son went to a good rehab with addiction specialist medical doctors. The mid brain defect that predisposes one to addiction will always be there. I think this opinion of yours may work for you, but is very dangerous public advice. Thank you for sharing your thoughts. Five years — probably. But, thirty years later? Pete — great article! I work, I own businesses, I pay my taxes…..
It is a complex discussion, addicted vs. Self-esteem very often seems [to my layperson view] to be the genesis of addictions. Self-esteem may create the initial demand for mood-altering substances. They can alter mood it in a healthy, albeit addictive way, e. I agree with Dr Grinspoon that, while there may be lifelong behavior patterns, they alone do not indicate that all substances will be overwhelmingly addictive.
Thank God for those who found clearer choices for how to alter moods. Thank you! Our society is steeped in drugs and alcohol and, yes, anyone in recovery has to reckon with this difficult issue…. Lack of logic with a sub-conscious agenda; blind spots exist for everyone. Much easier said than done but a pathway to true and lasting peace of mind; which what every human seeks. We are spiritual beings having a spiritual experience.
To deny this is a rough path for sure. Good luck to all. I think this is a very interesting subject and definitely worth exploring. I know people who struggle forever, but others who seem to get past it. My guess is that the ones who substitute or revert are those who have not gotten to the underlying issue that causes the behavior.
I agree with you, we should not just assume everyone is addicted forever. Strange lack of distinction here between other-direction and inner-direction.
Behaviors such as gambling, over- or under-eating, video game playing, Internet use, sex, work, religion, exercise, compulsive spending, etc. Here we have weight training for chemical addiction. Sow, what? This article is a risky opinion piece. Thank you for your interesting comments. Back around , a physician wrote a book about narcotics, alcohol and smoking addictions.
He found smoking to be a dangerous addiction leading to lung cancer. If correct, this suggests an even more positive conclusion than presented here — the neurochemistry can change to get past the addictive condition. As a surgeon and long-time methamphetamine addict who is now in my 15th year of recovery, I found Dr. I cannot imagine a circumstance where I would find it prudent to use any mood-altering substance again. If this is the case, perhaps the solution is not to find a way to justify drinking the wine….
Thanks for the comment, Dr. My brother started at a young age with drinking, went through rehab for alcoholism but fell later for cocaine and opiods, a wide range of drugs. Multiple rehabs did not help. Only at 50 when his underlying dual diagnosis was treated and he had a stay in jail has he been able to stay sober. I am now 83 years old! I have had an anxiety disorder most of my life, which the Drs treated with zanex for many years.
Then they changed it to clonipen years ago, and now generic brand called clonazepam 1mg. I kicked my addiction to pain meds years ago which I was given for arthritis.
I did not know for a long time that the pain meds, or the zanex was addictive. The dr. Writes my prescription for 3per day of clonazepam now, however, I have never taken but one half pill nightly.
Recently I decided to quit that, but easier said than done. I have been cutting back for some time and making one third of one pill do me each night. Could you someone please suggest something off that I can replace the clonazepam with? It is not that dinner without a glass of wine is difficult.
For some of us, we have dinner maybe 5 nights a week without a glass of wine. But we may like to enjoy a glass or two over a special occasion dinner, without going over the top with it!
It makes life more enjoyable for me. Hi David! Obviously, if you have any difficulty, you should avoid it like the plague. But, in fact, many most? Thanks for your comments. In any case, congrats on your recovery!!
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