subject: The Actual Nature Of Addiction [print this page] The most recent understanding of drug addiction is that it is not really a moral failing but rather a disease. In fact, if Health Care Reform passes, nature of addictionand mental illness will most likely be included in parity with other physical diseases. Funding then would come from the national health insurance rather than from federal or state block grants.
Even so addiction treatment has to be understood in a different way than treatment for traditional physical illnesses. For as an example, those suffering from similar chronic long-term illnesses such as hypertension and diabetes receive medication, such as insulin or blood pressure pills that help stabilize their chronic illness. In some cases with these 2 comparable chronic illnesses, these medications are all that is required. However, in most cases with these 2 illnesses, a lifestyle change is required as well, such as eating different foods or more exercise.
The disease of addiction is very similar to these 2 chronic diseases in that it requires lifestyle change and possible medication. For example, medication is often used for the detoxification process and other drugs are sometimes wanted to stabilize an individuals addiction and to prevent relapse. Unfortunately even though these medications have been available since the mid 60s, they are not nearly as effective with the disease of addiction as other medications are wit the diseases of hypertension and diabetes.
Exactly what we know:
We understand that the disease of addiction starts with a genetic proclivity and often a long incubation period starting with drinking or applying a substance off and on for years, with no noticeable deleterious effects. Until there is noticeable impaired functioning, there is often no recognition of the disease. The disease of addiction is generally realized between the ages of 35 and 45. On the other hand, youth get in trouble based on their criminal acts associated with money to feed their habits as early as 14. As the substance use becomes excessive and compulsive it turns to substance abuse, impairing normal functioning often leading to usually non violent criminal acts and alienating close good friends and family. The abuser becomes desperate as the realization sinks in that there is no way out without much more drugs. The disease is out of control and the addict knows it.
The addict does not need a treatment expert to tell him/her that he has the disease but the addict does need to understand the reality of the world of lies and manipulations and mistrust that he/she has created over the years. The addict, living and perpetuating these lies for so many years needs love and real grounding in the truth. Someone must understand his/her world to bring him/her out. That someone is usually a recovering addict but this is not essential.
When addiction is identified, an assessment for treatment needs to be finished, usually followed by outpatient or residential drug treatment. Since addiction promotes a fantasy lifestyle in the mind of the addict, rationalizations develope. These fantasies and excuses help the addict account for criminal acts, time in jail and hurt to his closest friends and family.
Treatment must focus on lifestyle modify in environments that are positive with role models to follow. Straight counseling, one on one is effective for some but all addicts must work on changing their lifestyles in order to remain in recovery.
A problem at this point is that most of our public does not understand the nature of the disease; the fact that the treatment protocol is much different than the normal individualized doctor - patient medical model. In the traditional disease model, the physician assesses and prescribes treatment and as long as this treatment is accepted and received by the patient, the patient improves.
As well, with the disease of addiction the patient must commit to being the prime agent of his/her own cure. The patient must actively be involved with his or her own treatment process and must understand that this disease can easily only respond to treatment that is provided essentially by the patient him or herself with the support of others. No medication has been devised for a drug addict or alcoholic, that will work effectively with the hundreds of substances that are now available to abuse, both legal and illegal.
While medicine can be used effectively with some types of drug addiction, the majority of addicts get better through self help, mutual support and often dramatic lifestyle change. However, the nature of addiction is that most addicts like to get high and dont have the desire to help themselves. They look for help from others without wanting it for themselves and therefore their prognosis for recovering is poor. Addiction is a chronic relapsing condition but it is treatable.
We all have learned from the National Institute on Drug Abuse that you dont need to be motivated to accept treatment. (#10. Principles for the most Effective Addiction Treatment.) In fact, this initial essential push or motivation can come from outside agents such as the courts or parents or school or other external sources. This external motivation is a good beginning for non-motivated addicts and it is often eventually internalized by the addict during treatment. This internalization must start during the course of treatment, but it takes time to spread to a positive lifestyle change. This is why Integritys recommended treatment protocol is 5 years.
An addict should not be called a patient as in the medical model, since this connotes a passive recipient of services. An addict must be encouraged to aggressively seek help from treatment. He or she must be the prime agent of change.
The 1st step for an addict to take in treatment is to understand the nature of the disease. This understanding is much easier to hear and believe from a recovering peer. Addicts have fed themselves lies for so long that they dont believe anyone and often can only trust one of their own; one who has been there and one who has climbed out of the hole. This dynamic is responsible for the success of Alcohol Anonymous.
There are many parts to treatment and recovery though that require outside help to fix the patch work of past lies and mistakes, manipulations, delinquent or criminal acts, medical troubles, educational needs, mental health issues, family relationships, nutrition problems, self image etc.
The plan of treating addicts in this country goes back to 1935 with the first arranged nature of addictiontreatment at Lexington Hospital. While treatment helped, addiction has been seen as a moral failing even from the substance abuse of housewives in the mid to late 1800s to the hard core criminal addicts that fill our jails today. The disease of addiction gained ground with the burgeoning abuse and addiction to legal drugs that has been exploding in our country since 1995. This is a lesser understood phenomena but new pain and anxiety medication such as Oxycontin, Vicodin, Percocet and the benzodiazepines (Xanex) are addicting hundreds of thousands if not millions of law abiding citizens.
