Thursday, December 31, 2009

Treating Addictions [Guest Post]

The ABCs of rehab.

[Journalists like me tend to get immersed in the scientific and medical aspects of addiction. Not a bad thing, to be sure—but sometimes a simpler rendition puts a finer point on the matter. Today’s guest post was contributed by Susan White, who writes on the topic of Becoming a Radiologist.  She welcomes your comments at her email id:]

It’s very easy to find fault and assign blame when you’ve never been in the other person’s shoes; how often have we found ourselves judging people for their bad habits? Why can’t he stop that obnoxious habit? Oh, she’s not strong at all, she cannot stop drinking! I would never sink to the drug-induced state he is in, not even if the worst things were to happen to me – it’s easy to say all these things because we don’t know what an addiction feels like and how hard it is for people to quit. They’re just like you and me; they don’t like the way they are, but their substance abuse controls their bodies, minds and everything they do or say.

To understand an addiction, you need to understand that the body goes through changes, both physiological and psychological. If the addiction is to alcohol, drugs or any other chemical substance, the high euphoric feeling is what makes you go back again and again. But as time goes by, the high decreases and you begin to take in more of the abusive substance in your quest for that initial euphoria. It’s a vicious cycle that feeds itself, and if you stop, you feel withdrawal symptoms because your body is so used to its daily or even hourly fix.

It takes a supreme effort to admit that you have a problem and seek help. Rehab centers work because they make the addict quit cold turkey; they are cloistered and controlled environments where addicts have no access to the abusive substance. The sudden withdrawal causes abnormal reactions in your body, and you’re treated with medicines that help soothe your frayed nerves. When the initial craving subsides, you’re put in therapy and other forms of rehabilitation. Your diet is regulated, and your body slowly starts to recover and rejuvenate. 

The hardest part of rehab however comes when you step out of the cocoon of the de-addiction center and enter the real world. You have to face the demon that had its tentacles around you and fight it down, and for some people, this is where they suffer a relapse. Once they are surrounded by temptation, they succumb and are soon back to their decadent and sorry state. Others however, are made of sterner stuff. They know that they cannot afford to lose control again and they are disciplined enough to say no when they come face to face with temptation.

Addiction, be it to a substance, person or thing, is not something to be taken lightly. Unless admitted to and treated at the earliest, it could end up having serious physical and mental consequences. 

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1 comment:

gloriousday said...

I had hoped that someone else would comment on this post so I wouldn't have to.

I'm taken aback that Ms. White failed to notice the glaring contradiction in this post. She begins by exonerating addicts for their behavioral failures, attributing them instead to the phenomena of tolerance and withdrawal. Two paragraphs later, she refers to relapse as a "sorry" and "decadent" state, and asserts that addicts who don't relapse are simply "made of sterner stuff." I'm a neuropharmacologist and a scientist and thus am disinclined to feel emotion, but this particular hypocrisy really disgusts me.

Relapse frequently occurs because popular treatment paradigms fail to address a basic pathology of the addict: devaluation and temporal discounting. Not only do drugs of addiction become less pleasant with repeated administration, they also decrease the value of virtually all other pleasurable activities, and shorten the addict's temporal horizon. Thus, the shorter the latency to pleasure, the more strongly preferred by the addict. If such disordered decision-making is not addressed in treatment, upon re-entering the real world the addict is still quite likely to prefer drug to the vague and uncertain reward of remaining sober.

I could easily spend an hour on this comment, but I only lecture when contractually obliged to do so; instead, I simply urge Ms. White to do more research before publishing any more articles on addiction. Gene Heyman's Addiction: A Disorder of Choice is an excellent place to start.

[Dirk, your intro is no less baffling. Immersion in hard science and medicine is preferable to watered-down accounts that appear to be based on copy-friendly SciAm sound bytes. The author's failure to stick to the main premise of her own argument renders this post meaningless at best, and at worst, misleading. I hope no one reading this post took the title seriously.]

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