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Thursday, April 26, 2012


What Is Almost Alcoholic?

Two Kinds of People, or Many Different Shades?
Some people believe there are only two kinds of people in the world: alcoholics and nonalcoholics. The generally accepted criteria for diagnosing people with alcohol use issues has supported this concept. Moreover, many people also believe that we are either born alcoholics or we are not. This has been a prevailing view for a long time, and although this statement may seem dramatic to some, it does have some basis in reality. That basis is the fact that those who hold these beliefs tend to be people who have experienced or witnessed the most severe symptoms and/or the most severe consequences of drinking. These symptoms and consequences include the following:
  • Being unable to stop drinking, beginning from the first time he or she had a drink
  •  having blackouts (i.e., not remembering the next day what happened) after having only a few drinks
  • Being arrested multiple times for driving while intoxicated
  • Becoming violent on more than one occasion when drinking
We know from our own clinical experience that there are people who develop severe alcohol drinking patterns and behaviors such as the ones just described. Of those people who are admitted into inpatient alcohol treatment programs, a large majority have experienced problems such as those just described. They are true alcoholics. Fellowships such as Alcoholics Anonymous were founded by and for these very people—the so-called hopeless cases. It isn't hard to understand, then, why some people (including many health care professionals) conclude that there are only two kinds of people in the world: alcoholics and nonalcoholics.
Anyone who drinks heavily is at risk for adverse health consequences, but some people appear to face a heightened risk for developing alcohol-related health problems. The reason appears to be largely biological, although environmental factors also likely play a role in this difference. In support of this biological argument, researchers have found, for example, that people differ in how their bodies metabolize alcohol. Since our biological makeup is determined at birth, there is some truth in the idea that we have certain traits that make us more (or less) vulnerable to the effects of alcohol.
 The almost alcoholic concept came through many years of working not only with people who had the kinds of drinking problems just described, but also with a much larger group of people with a variety of drinking patterns that didn't meet the criteria for alcoholism. As noted earlier, the majority of this larger group came to us not because they were concerned (or because others had expressed concern) about their drinking, but for help with some other problems. The connection between the problems they sought help for and their drinking emerged only later.
Excerpted from Almost Alcoholic: Is My (or My Loved One's) Drinking a Problem? by Robert Doyle, MD, and Joseph Nowinski, PhD.   

Thursday, April 19, 2012

 Mindfulness practice is about becoming familiar with your mind.  It doesn’t matter if you struggle to stay focused - observe without judgement what is on your mind.  Accept and familiarise yourself with whats going on in your mind, in the moment. 
Read more  at http://blog.beliefnet.com/mindfulnessmatters/2012/04/obstacles-to-practice-agendas-expectations-and-striving.html#ixzz1sSU1mAyM

Saturday, April 14, 2012

Myths Of Addiction

It is not uncommon to read the testimonials of those who suffered many years of addiction and claim they found recovery without narcotics anonymous, therapy or any of the usual methods. In fact they claim the seven stints in rehab, years of attendance in AA or NA and CBT therapy were all unsuccessful. Generally these folk are selling something. The fact is recovery from addiction is often a long journey where many tools are gathered along the way and these tools are an essential part of recovery from addiction. Ultimately, these tools and experiences are the cumulative gifts that enable long-term recovery. Each relapse is different and you take what you have learnt while you were clean "this time".
There is no one size fits all treatment any more than there is an addictive personality. Will power alone is very unlikely to get you clean long term and yes sometimes a family system does, in fact, play a sizable role in enabling an individual's addiction. The most important things to remember are that people don't generally stay clean the first time and when they do get time up they need those closest to them to get help and support for themselves. Many times individuals come home after rehab to a family that is still functioning in an unhealthy state and end up relapsing. Addiction both affects and infects the whole family system.
There is no one profile of who will experience problems with substance abuse or addiction of any kind yet many treatments attempt to put forward one guaranteed method to cure addiction. This is simply not possible. There is a combination of factors involved with each and every individual who develops problematic addictions or dependencies and this combination will influence the efficacy of treatment. These are known as the bio, psycho, social factors. Personality type, family history - both genetic and family environment, social environment such as friends or community and levels of psychological functioning particularly in areas of depression and anxiety. For example a person with high sensitivity and introversion, family history of compulsive or addictive issues (siblings, parents, grandparents), community with high acceptance of substance abuse and high unemployment and adolescent depression is at high risk. Multiple factors such as these may be seen as the perfect storm. Each factor needs to be addressed with a client in an assessment in order for a treatment plan to be formed that will create maximum opportunities for change. There is no point in utilising AA as a part of a treatment plan for someone with social anxiety or arranging for a four week detox and rehab for a client who has been coerced by their parents to speak to you and has expressed no concerns in regards to their drug or alcohol use. Motivational Therapy would be a more productive choice for their initial treatment which would then lead to a more formal treatment plan.
Using only one treatment modality will lose many opportunities to assist clients at potentially high cost to both them and their families and is a dangerous and often ego- driven practice.  http://ezinearticles.com/?expert=E_Mack

Aly Birmingham Geats BA Psych, Cert AOD (Dist). PostGrad Dip. (Dist.)

Friday, April 13, 2012

 As a person supporting someone with an addiction we need to look also at ourselves and how this  addiction has infected the whole family. 
 We need to be very brave in our honesty and not back away from looking at how our behaviours play a part in the addiction. 
 We must be honest with ourselves and stop justifying our deficiencies by blaming them on the situation around us.
 We must be willing to accept criticism with an open mind. 
 We must be willing to get humble, open minded and become teachable. This is so important!!  Having an open mind and seeing our own part in things is probably the hardest part of all.  Its never about recovery for the addict alone but recovery for the whole family system.  That is what supports success.

Thursday, April 12, 2012


Family Support For Drug Addicts In Recovery

1. Be encouraging.
How to support a drug addict in recovery? The best support you can give is to simply be encouraging. Encourage your recovering addict to share their feelings with you and make the environment safe enough that the addict can trust you and be open and honest.  Encourage your loved one coping with urges and cravings to hang in there.  Encourage your family member with kind words and kind treatment.
2. Go to meetings.
If they are attending 12 step or self help meetings and ask you to go along, feel free to do so. It is nice to have someone you care about attend an open 12 step meeting with you to learn and meet fellows in recovery and learn about addiction recovery spirituality.
3. Keep drugs or alcohol out of reach.
Preventing relapse in substance abuse is key to continued sobriety.  As much as possible, keep the addict’s drug of choice out of site if you have it in the home, and try to abstain from personally using when in contact.
4. Encourage routines.
Encourage your addict to eat properly, sleep properly, exercise, take meds exactly as prescribed, keep all recovery appointments and meeting commitments, live a healthy lifestyle keep their recovery the top priority in their lives. As the new behaviour becomes ingrained in the user, they will ease into mainstream living.
5. Have realistic expectations.
Recovery for the addict will take time. Patience is required. Think how long it took your addict to hit bottom and get into recovery. Behaviour changes will not happen overnight.
6. Forgive and forget.
Yelling, screaming and throwing up the past constantly will not help!
In sum, openly caring about your addict and their recovery will support someone new to addiction recovery. Simply being there, learning to understand the issues, encouraging new positive behaviour; these are things you can do.

       Addiction Blog lee@addictionblog.org

Wednesday, April 11, 2012


Gifted, Talented, Addicted

by Douglas Eby
Writer Pearl Buck commented, "The truly creative mind in any field is no more than this: A human creature born abnormally, inhumanly sensitive."
Winner of a Nobel Prize in Literature in 1938, she also added, "By some strange, unknown, inward urgency they are not really alive unless they are creating."
A number of people with exceptional abilities have used drugs and alcohol as self-medication to ease the pain of that sensitivity, or as a way to enhance thinking and creativity. Sometimes they risk addiction.
Beethoven reportedly drank wine about as often as he wrote music, and was an alcoholic or at least a problem-drinker.
Among the many other artists who have used drugs, alcohol or other substances are Aldous Huxley, Samuel Taylor Coleridge, Edgar Allen Poe, Fyodor Dostoevsky, Allen Ginsberg, composers Beethoven and Modest Musorgski, F. Scott Fitzgerald, Raymond Chandler, Eugene O'Neill, Edna St. Vincent Millay, Dorothy Parker, William Faulkner, Ernest Hemingway, Thomas Wolfe, John Steinbeck, and Tennessee Williams.

At least five U.S. writers who won the Nobel Prize for Literature have been considered alcoholics.

Astronaut Edwin 'Buzz' Aldrin said that he had been an alcoholic for several years before the Apollo 11 mission of 1969, and had quit drinking only two days before the historic flight, but resumed after his return to Earth. He became an active crusader against alcohol abuse.

Scientist Carl Sagan was reportedly a regular user of marijuana from the early 60's until his death in 1996, using it on occasion to inspire some of his acclaimed scientific papers.

Richard Feynman (1918-1988; Nobel Prize in Physics, 1965) used marijuana and LSD while in his mid 50's, mostly while exploring consciousness in a sensory deprivation tank.

Naturopath Andrew Weil wrote in his book The Natural Mind (1971) about the advantages of "stoned thinking" in understanding health and diagnosing illnesses, and says he has tried about every drug in his book From Chocolate to Morphine.

While the National Institute on Drug Abuse says addiction to hallucinogens is almost unknown, some research they publish indicates that people who use or abuse one kind of drug are vulnerable to abusing other drugs, which may lead to addiction.

Actor Johnny Depp admits getting drunk to deal with his sensitivity, and having to go to functions like press appearances: "I guess I was trying not to feel anything." 
He thinks drug use "has less to do with recreation and more to do with the fact that we need to escape from our brains. We need to escape from everyday life. It's self-medication and that's the problem."

Writer and producer David Milch (Hill Street Blues, NYPD Blue and Deadwood), when he was an undergrad at Yale, did "a lot of pharmacological research" as he has described his years-long addiction to heroin and alcohol.

Jane Piirto, Ph.D., Director of Talent Development Education at Ashland University notes in her article "The Creative Process in Poets" that the "altered mental state brought about by substances has been thought to enhance creativity - to a certain extent.
But, she adds, "The danger of turning from creative messenger to addicted body is great, and many writers have succumbed, especially to the siren song of alcohol."

She quotes poet Charles Baudelaire on using alcohol to enhance imagination: "Always be drunk. That is all: it is the question. You want to stop Time crushing your shoulders, bending you double, so get drunk - militantly. How? Use wine, poetry, or virtue, use your imagination. Just get drunk"
an unconscious strategy

Addiction psychologist Marc F. Kern, Ph.D., notes that altering one's state of consciousness is normal and that a destructive habit or addiction is "mostly an unconscious strategy - which you started to develop at a naive, much earlier stage of life - to enjoy the feelings it brought on or to help cope with uncomfortable emotions or feelings. It is simply an adaptation that has gone awry."
Charles Baudelaire was an example of that. He wrote in Artificial Paradises [Les Paradis artificiels, 1860]: "You know that hashish always evokes magnificent constructions of light, glorious and splendid visions, cascades of liquid gold."
But he led a debauched, violent, and ultimately tragic life, dying an opium addict in 1867.
The cultural climate, the zeitgeist, can have a profound effect on how people think of addiction, and what substances they use or abuse.
As described in the article Addiction: a Myth of Modernity? by William Pryor, Dr. John Stith Pemberton, a medical herbalist, developed in the late 1880s his "Pemberton's French Wine Coca, which he copied from Vin Mariani, a blend of Bordeaux and coca.. [which had testimonials from] Thomas Edison, Emile Zola, Queen Victoria and no fewer than three Popes.

"In 1885 the good citizens of [Atlanta, Georgia] adopted strict temperance legislation forcing Dr Pemberton to find a way of taking the alcohol out of his tonic.

"After much experimentation he concocted a syrup made from coca
Coke logo leaves, kola nut (chewed in many West African cultures for its high caffeine content) and damiana (a mild psychoactive South American herb used to treat coughs, constipation and depression). 
"The syrup was taken mixed with soda water. He called it Coca Cola."

Pryor notes that in that era, "The population as a whole held psychotropic substance use in a rather different way from the febrile and contradictory attitudes we hold today, despite a few well-chronicled exceptions like that of laudanum-crazed Coleridge.

"In the late 19th century the only mind-altering substance to be illegal, and that in small pockets, was alcohol. The most-used medicines were opium and its derivative morphine."
Dr. Pemberton died in 1888 at age 56, from morphine addiction.
Pryor declares, "Addiction is a construct of modernity, one that knows no boundaries of class, circumstance or intellect, a mythic construct that seems to explain what is nigh on inexplicable, our strange response to the pain of being human."
That pain can have multiple dimensions, including existential aspects, and be especially poignant for highly sensitive gifted and talented people.
Linda Kreger Silverman, Ph.D., director of the Institute for the Study of Advanced Development and the Gifted Development Center in Denver, Colorado, notes in her article "Emotional Intensity" that intensity "is one of the personality concomitants of giftedness. It is natural for the gifted to feel deeply and to experience a broad range of emotions."
to dull sensitivity

Polish psychiatrist Kazimierz Dabrowski and psychologist Michael Piechowski have called this capacity for feeling "emotional overexcitability," and found that five such areas of "excitability" are strongly correlated with high intelligence.

Bill Tillier, a scholar of Dabrowski's work, noted in the Dabrowski Discussion Group newsletter that the "use of intoxicating substances to dull sensitivity would be considered an unsatisfactory and low level solution in Dabrowski's terms and would have to be seen as a negative disintegration... a maladaptive response. 
"Dabrowski would probably suggest that in the face of strong overexcitability one needs to relax and "weather the storm" without resorting to distortions of reality or the use of intoxicating substances."
In their article "A Bioanthropological Overview of Addiction," Doris F. Jonas, Ph.D. and A. David Jonas, M.D. consider that such a "nervous system so exquisitely adapted to perceiving the minutest changes in environmental signals clearly becomes overwhelmed and produces dysphoria when its carrier must exist among the exponentially increased social stimuli of a modern environment."

Those with a less sensitive nervous systems are, they write, "better adapted to our more crowded living conditions. The more sensitive can only attempt to ease their discomfort by blunting their perceptions with alcohol or depressive drugs or, alternatively, by using consciousness-altering drugs to transport their senses from the dysphoric world in which they live to private worlds of their own."

In her article "Overexcitability and the gifted," Sharon Lind says that people with emotional excitability â€Å“are acutely aware of their own feelings, of how they are growing and changing, and often carry on inner dialogs and practice self-judgment." 
If they also experience psychomotor excitability, when feeling emotionally tense, they may "act impulsively, misbehave and act out." Drug and alcohol abuse can be one form of this.

Heather King, a National Honor Society scholar, and a commentator for All Things Considered on NPR, says in an article of hers (Quitting the Bar, Twice) that she made a decision to go to law school because it would force her â€Å“to study so hard I would naturally cut down on my drinking. 
"Somewhere along the line I would be transformed from a person with a nervous system so sensitive that, when sober, merely being addressed by a fellow human being almost caused me to hyperventilate, into a bold, assertive, self-confident advocate for victims of racial oppression and gender discrimination."

Her addiction grew from her need to deal with her "sense of alienation and deficiency, this intuition that I had missed some kind of essential truth available to everyone else... it was the very reason I so ceaselessly craved the oblivion of alcohol. 
"People sometimes ask me, How could you have gotten through law school drunk? My answer is that there is no way I could have gotten through law school if I hadn't been drunk."

A concept related to excitability is "CNS augmenters" who have central nervous systems which augment or enhance the impact of sensory input. In his article Somatosensory Affectional Deprivation (SAD) Theory of Drug and Alcohol Use, James W. Prescott, Ph.D. cites studies indicating that being an "augmenter" is linked to substance abuse.

Stephanie S. Tolan, a well known author of young adult and children's fiction, as well as an author and speaker on exceptionally gifted children, says in her article Discovering the gifted ex-child that gifted people "frequently take their own capacities for granted, believing that it is people with different abilities who are the really bright ones. 
"Not understanding the source of their frustration or ways to alleviate it, they may opt to relieve the pain through the use of alcohol, drugs, food or other addictive substances or behaviors. Or they may simply hunker down and live their lives in survival mode."

A push toward addiction often starts at a young age. 
In the book Gifted Grownups: The Mixed Blessings of Extraordinary Potential, Lisa, 14, talks about being given Valium by a doctor: "Taking pills or smoking a joint helped get me through the day." 
She said gifted kids take drugs "To dull themselves... there is so much of the wrong kind of stimulation going on around you."
Acclaimed writer and memoirist Anne Lamott [left] has been very candid about her years of drug and alcohol abuse in her Salon.com column and elsewhere. 
In a PBS profile, she commented about starting in eighth grade: "You're completely hormonally challenged up the ying-yang and on top of all these feelings they make you go to dances. I stood around, and no one asked me to dance, and then I had like a beer and a half. And boys asked me to dance and I was home free. 
"I think things started to work for me a little bit better when I started to take drugs and to drink alcoholically. I started to drink pretty regularly by the time I was 13. I got very drunk on a nightly basis from the time I was about 19 'til 32." 
She now finds being sober a "grace" supported by her Christian faith.

Psychiatrist Leon Wurmser, M.D. comments in his article Drug Use as a Protective System that anxiety "of an overwhelming nature and the emotional feelings of pain, injury, woundedness, and vulnerability appear to be a feature common to all types of compulsive drug use."

In her memoir Looking for Gatsby: My Life, actor Faye Dunaway admits eating compulsively "to counter the stress of filmmaking. I've never stopped guarding against a return to that kind of emotional reliance on food, and as I grew into this sophisticated world, alcohol. I'm finally beyond that now, but it was the pendulum I would swing on for years."

Many gifted people are also susceptible to mental health issues such as mood disorders, and may self-medicate.

Writer and actor Carrie Fisher at times took 30 Percodan a day, and said in an article, "Drugs made me feel more normal. They contained me." 
At age 28 she overdosed, and was diagnosed with bipolar disorder. "Maybe I was taking drugs to keep the monster in the box," she said.

The use of substances, and the attitudes about that use or abuse, are very much tied to the social climate of the times. Researcher Stanton Peele, J.D., Ph.D. notes that although definitions of addiction are "putatively rational and scientific, they are actually historical and political.. not based on pharmacological criteria, but in order to create a basis for disapproving of and proscribing drugs."
One arena in which drugs are often prescribed is for the treatment of learning disorders such as ADD / ADHD.
A report titled Substance Abuse and Learning Disabilities: Peas in a Pod or Apples and Oranges? says there is an addiction or abuse risk with these disorders: "ADHD affected individuals have a high incidence of substance abuse, and ADHD is further associated with an earlier onset of substance abuse and a greater difficulty shaking addiction. 
"Studies show that as many as half of those suffering ADHD self-medicate with drugs and alcohol. An individual with ADHD is twice as likely as one without ADHD to abuse substances."
Addiction may be a convenient term, but the concept is not simple, and there can be a wide spectrum of behaviors and qualities of relationship with various substances.

Studies have reported that individuals exposed to stress are more likely to abuse alcohol and other drugs. But there are, of course, healthier strategies to manage stress.

One of the crucial questions is how much does use of a substance or engaging in a behavior help us cope, versus limit the expression of our unique selves and talents.

Dealing with addiction can be not only life-saving, but releasing. 
As musician Elton John has commented, "A lot of good things have happened to me, and it's all because of sobriety. I went into treatment [for drug and alcohol addiction], and I emerged with my eyes open."

Why Is Mindfulness Important In Recovery?

"When we have a negative experience or feeling, our autopilot instinct is to escape via our addiction. Through mindfulness, we learn to interrupt ourselves, take a pause. When an urge or craving comes, we can mindfully sit and observe it and recognize it for what it is– momentary and transient. We don’t have to act on it. We can know it will pass. Urges or cravings always do.
Cravings generally occur when something goes wrong. Through mindfulness, we learn to be with the negative feelings, to accept that suffering is a natural part of life. Mindfulness teaches us not to be too attached to happiness because it, like the negative feelings, is transient.
When we are mindfully attuned to our bodies and minds, we receive signals about what’s out of balance. Mindfulness teaches us to respect these signals and welcome them instead of pushing them away. Our body tells what we need if we are only able to pay attention."  "Addiction.org).

Saturday, April 7, 2012

Drugs behind family torture - Health - News - The Manly Daily

Drugs behind family torture - Health - News - The Manly Daily
Alcohol abuse and addiction - interesting article from newrelevent.com     Cheers, mack

The Impact Of Genetics And Environment On Drug Abuse Risk

The Impact Of Genetics And Environment On Drug Abuse Risk
The risk of abusing drugs is greater – even for adopted children – if the familyenvironment in which they are raised is dysfunctional, according to a new study conducted by a collaborative team from Virginia Commonwealth University and Lund University in Sweden.
Previous research suggests that drug abuse is strongly influenced by a mix of genetic factors and the environment, including influences of family and peers. That research is primarily based on twin studies and typically involves families that are intact. Relatives that share genes and environment make it difficult to determine if the family dysfunction is linked to the drug abuse or if it is genetics at play. There have been no large-scale adoption studies performed to verify the findings, until now.
In the study, published online in the journal Archives of General Psychiatry, researchers examined how genetic and environmental factors contribute to the risk for drug abuse in adoptees. Using a large and representative adoption sample from Sweden, they demonstrate that genetic factors played a moderate role in the liability to drug abuse.
“For an adoptee, having a biological parent with drug abuse who did not raise you doubles your risk for drug abuse,” said first author Kenneth Kendler, M.D., director of the VCU Virginia Institute for Psychiatric and Behavioral Genetics.
“But we also found an important role for environmental factors. If you have an adoptive sibling – with whom you have no genetic relationship – develop drug abuse, that also doubles your risk for drug abuse,”
More importantly, according to Kendler, the team showed that the impact of your genes on risk for drug abuse is much stronger if you are raised in a high-risk rather than a low-risk environment.
“A bad environment can augment the effect of genetic risk on drug abuse,” he said.
Kendler, professor of psychiatry, and human and molecular genetics in the VCU School of Medicine, and a team of researchers from Lund University led by Jan Sundquist, M.D., Ph.D., professor and director of the Center for Primary Health Care Research, and Kristina Sundquist, M.D., Ph.D., professor of family medicine at the Center for Primary Health Care Research, analyzed nine public registry data sets compiled between 1961 and 2009 of adoptees and their biological and adoptive relatives from Sweden.
The study population included more than 18,100 adoptees born between 1950 and 1993; 78,079 biological parents and siblings and more than 51,200 adoptive parents and siblings.

Thursday, April 5, 2012



Remember Northern Beaches has the old Phoenix Unit at Manly Hospital  re-opened through Kedesh.  Referral phone number is 4222 18000 or call us on  9944 0364  for assistance with other detox or rehab options or support.
www.northernbeachescounsellingsupport.com.au

Family Drug Support (FDS) website is full of great information for families struggling with drug and alcohol issues. 24 hour phone support line is also available for families.


NEW SOUTH WALES
Every Monday(Except public holidays)
(7-9pm)
NSW - Sydney - Ashfield
Venue: Volunteers Room, Ashfield Uniting Church, 180 Liverpool Rd, Ashfield- down right hand side of church
Enquiries: 0410 494 933
Every Monday(Except public holidays)
(7-9pm)
NSW - ParramattaVenue: Parramatta City Council, Dan Mahoney Room,2 Civic Place, Parramatta
Enquiries: (02) 4782 9222
1st & 3rd Wednesday of the month. 4 & 18 April, 2 & 16 May, 6 & 20 June 

(7-9pm)
NSW - Chatswood 
Venue: Dougherty Community Centre, Studio,
7 Victor Street, Chatswood
Enquiries: Liz 0417 429 036 or Hilary 0418 656 549
1st & 3rd Monday of month - 2 & 16 April, 7 & 21 May, 4 & 18 June
(7 - 9pm)
NSW - Coffs Harbour
Venue: The Mudhut, Duke Street, Coffs Harbour

Enquiries: Theo 0402 604 354
Every Tuesday
(10am – 12.00)
NSW - Charlestown
Venue: Uniting Church,(opp Attunga Park) 24 Milson St, Charlestown
Enquiries: Jim 0439 322 040
2nd & 4th Monday of month - 23 April, 14 & 28 May, 25 June
(7-9pm)
NSW – Byron Bay
Venue: Guide Hall, Carlyle St, Byron Bay (behind tennis courts across from Byron primary school)
Enquires: Margaret 0427 857 092          (9th April & 11th June are public holidays.)
Monday every fortnight – 23 April, 7 & 21 May, 18 June
(6-8pm)

NSW - Port Macquarie -
Venue: Educations Rooms - rear of Community Health Centre (next to watertank) Morton St
Enquires: Pam 0438 994 269      (9th April & 11th June are public holidays.)
1st & 3rd Monday of the month - 2 & 16 April, 7 & 21 May, 4 & 18 June
(7-9pm)
NSW – Kincumber
Venue: Arafmi Cottage, Unit 6, 20 Kincumber St, Kincumber 
Enquires: Marion 0439 435 382

All things drug and alcohol: MDECC Resource

All things drug and alcohol: MDECC Resource: Check out reset.org.au

Monday, April 2, 2012

Current treatments for substance abuse and addiction.


     Addiction treatments have come a long way in the past few years.  It is not so long ago that we were electrocuting our clients to cure them from their disease!  More recently our attempts to “break through their resistance” included confrontational and directive approaches which, in hindsight, can only be seen as directly oppositional to the techniques we now utilise.  The breakthroughs in science with tools such as fMRI which image the living brain have supported the disease model of addiction in which 12 step facilitation is based and further research has informed techniques such as motivational therapy and interviewing and cognitive behavioural therapy.  These three models of treatment are in the forefront of most current treatment services along with humanistic-existential therapies such as person centred and gestalt modalities.

     In this article we will briefly look at each of these treatment options with a view of understanding and educating rather than prescribing specific treatment plans.  It cannot be stressed enough that each individual treatment plan must take into consideration the client, their environment and the addiction of choice.

     Motivational therapy is an appropriate start as when a client initially makes contact, they may be in various stages of change.  These stages are known as
Contemplation – Acknowledgement of a problem but ambivalent to change)
Preparation - (preparing for change)
Action - (Changing behaviour)
Maintenance (Maintaining the desired behaviour change)
Relapse (Return to unwanted behaviours)
The idea behind motivational interviewing or therapy is to work with the particular stage in which your client is presenting.  For example, if your client has been coerced by their family to seek help but is apparently a “happy user” it would be counterproductive to pursue a commitment to abstinence.  This pre-contemplation stage is a point whereby a therapist would work to move their client from content with their current use to a point of acknowledgement that they may desire a change thus moving from one stage to the next and rather than breaking through resistance we work with the resistance.

CBT is an important tool for an individual who has progressed to an active desire to stay clean or possibly maintain  moderation management.  This modality works on the connections between feelings, thoughts and actions and teaches the client how to observe their own (and others) processes which lead to discomfort and the urged to use.  This is known as the ABC – activating event, belief and consequence.  A powerful tool for those struggling with an addiction that is extremely vulnerable to feelings of resentment, shame and isolation.  CBT also teaches the skills of observing our negative self-talk (automatic negative thoughts) which may swing a successful recovery into crisis when not recongised.

Our final tool in this article is twelve step facilitation (NA, AA) – a much maligned recovery support in some quarters yet the principles of 12 step programs are now supported by both science and most rehab facilities.  The aspect of a higher power is not one of religion but individual spirituality (the human spirit) and this higher power may be god, an addict’s family, their connection to nature or simply the power of the group in a meeting.  This is a powerful tool and not one to be dismissed due to its origins.  The sense of acceptance, belonging and support, particularly for those in early recovery is therapeutic in its own right and working the steps is not dissimilar to the process utilised in many counselling and rehab settings.  Recovery can be a very lonely and frightening experience and even the most socially isolated and damaged in the recovery community heal within this environment of unconditional positive regard.
The humanistic  existential and family inclusive approaches to recovery are appropriate modalities to utilise when working with this client base and will be discussed independently of this article due to the large body of information to be addressed.