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Adult or Adolescent : The Rx for Addiction

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Published: Friday, September 18, 2009

Most envision addiction as being the result of some underground, highly secretive, and maybe even defiant, undertaking. You know - the group of adolescent friends driving aimlessly after the football game while drinking, or the friends doing lines of cocaine in some bathroom, or the couple of students smoking a joint out in the distant areas of a school campus, or the rowdy music-loving teenagers taking some ecstasy or other hallucinogenic at a wild and loud concert venue. On the other side of the spectrum is the highly-successful professional who drinks a couple of drinks at every business lunch or immediately upon walking through the home front door at the end of the day. Then there is the depressed mother who questions her value and the direction of her daily life and smokes a joint whenever the doubt rings too loudly in her head, or the overworked health-care provider who uses methamphetamine in order to perform in the high-stress work environment that is the job.

While it is true that these scenarios are common and well known, the reality is that there is a much less known and more pervasive trend involving addiction and prescription drugs. The very medicines that your doctor has perhaps prescribed because of an injury or other condition turns out to be the drug that your teenager discovers to be "fun" and in high demand among peers while the adults complacently fall in to the routine of numbing any discomfort - be it physical or mental - with the little pill readily available in the medicine cabinet and introduced with the hastily written directions given at the family doctor's office.

Because of easy access (the household bathroom medicine cabinet), low cost (the prescription has already been purchased at the local drug store), a portion of the risk and stigma that is attached to illicit drugs has already been removed. There is no need to seek out the local drug dealer or to saddle up to the downtown bar. There is no need to accumulate and carry large sums of money, to carry and store quantities of drugs, or to store bottles of alcohol in a secret location. All that is needed - it turns out - is a partially full prescription bottle kept in an easily accessible place and the high is, quite literally, moments away with no need for a transaction or interaction with anyone else.

A shocking statistic that has been reported by the National Institute of Drug Abuse (NIDA) shows that between the years of 1991 - 2007 there has been a 700% increase in prescription amphetamine abuse among high school seniors. Within that same period of time, there has been another huge jump in prescription opioid and benzodiazepine abuse among the same age group. These facts send a strong and urgent signal that our imagined pictures of drug abuse among adolescents need to be seriously redrawn.

The same jump in prescription abuse among adults has been demonstrated and is now a common feature in the news as we hear of the tragic injuries, and even deaths, among high-profile celebrities and leaders of society. Make no mistake - this is not a situation particular to those viewed as pampered and/or wealthy. The reality is that with the onset of pharmaceutical advertisements and the open discussion of the benefits of such drugs as Xanax for the depressed or Oxycontin for those recovering from a medical procedure or injury, prescription drug use is now a part of our everyday conversation and rarely causes a raised eyebrow as the conversation of these medicine's benefits are praised and even advocated.

The truth is that addiction to prescription drugs is just as possible, if not more so, than to any substance obtained on the street. The same type of addictive behavior that is attributed to alcohol abuse or drug addiction develops over an often very short period of time with prescribed medications, sometimes in as short a period of time as 30 days. The same negative consequences to the body and personal interactions often await as the addiction to medications that have been prescribed take hold.

What is also true is that treatment for an addiction to any prescription drug requires a period of detoxification and therapy just as is needed for alcohol or any other drug. It is important that an acknowledgement be made to the fact that addiction to any substance has physical and mental components that are complex. There is an irrefutable need for these issues to be fully addressed in a structured and directed setting in order to adequately build and promote sustainable recovery.

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Intervention: When All Else Has Failed

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Published: Monday, August 24, 2009

For any person who has witnessed a loved one struggle with the issues that come with addiction, be it an addiction to alcohol and/or drugs, gambling, sex, shopping, or eating, the line that determines the boundaries between healthy and unhealthy support usually is crossed unexpectedly and without intent. The desire to believe in the addict's best abilities and traits as being enough to bring the person back to the healthy, productive lifestyle once led becomes the rope onto which sober family and friends hang.

Conflict usually becomes a frequent feature surrounding the person involved with the addiction. Those observing the changes in temperament and behavior understandably avoid producing more conflict, or any "stirring of the pot". Ironically, the temperament and behavior of those who are surrounding the addicted person also experience changes in temperament and behavior as interactions become strained, doubts riddle thoughts and often unspoken concerns develop into outright fear.

For very different reasons, all involved in this situation begin the struggle between what they hope for and what they are actually witnessing. The ability to identify appropriate roles becomes more difficult as the cycle of chaos, dishonesty and uncertainty takes hold. The addict cannot readily see the damage that is taking place because he/she is in primal mode, obsessed with filling the inner-cry for whatever the addiction is that has taken hold, much the same as a famished person's craving for food. The pleadings of those they love are not enough to counter the pleadings of the brain for more of the addictive behavior. Those who care for the addict find themselves continually hoping to "love them back". Functioning under the well-intended but misguided notion that somehow the answer can be discovered if they just hold on long enough, loved ones strain to make their tears noticed, and their pleas heard. Their commitment, they hope, will successfully withstand the battering long enough to convince the addict to stop.

The truth is that addiction is a disease of the brain and body that removes much - if not all - of the addict�s ability to tap into the resources of the mind and spirit. The brain and body have been trained to need and respond to a particular behavior repeatedly. The struggle truly is with the power of the brain, not the power of the will.

Sadly, it usually requires a crisis for the wall of misconceptions to be breached. Be it the diagnosis of a health malady, an inability to get or keep employment, the severe weakening of the family structure or a serious legal problem, the time comes when there is no escaping the fact that the consequences of an addiction has taken over the lives of the addict and those that surround him.

Interventions are a means for a third party - the interventionist - to assist those concerned with the addiction of another. The goal is to formulate a plan that effectively addresses the need for the addict to receive the appropriate care and direction to help stop the continuance of addictive behavior. Interventions are meant to serve as a method to "raise the bottom" for the addict before more destructive consequences and crisises occur.

The strength of interventions come from the fact that a group of people come together to become educated, prepared and committed to face, as a team, the issues that have resulted from the addiction. The goal of interventions is always to lovingly but firmly confront the addict from a position of unity and conviction and to present a shared bottom line and plan of action. The intent is to convince the addict that there is an undeniable need for the addiction to be addressed immediately in a pre-determined program where arrangements have been made prior to the intervention itself.

While interventions seem scarey and riddled with the risk of the addict further removing him/herself from those who are concerned, the reality is that an insidious and painful form of separation has already taken place once the addiction has taken hold. An uninterrupted life of addiction provides only one guarantee, and that is a guarantee of continued and increased separation coupled with more crisis for everyone. This is the stark reality of addiction and is the measurement upon which the decision of anyone concerned with the life and future of an addict should be based.

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Addiction's Puzzle: The Perfect Storm

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Published: Friday, August 7, 2009

Addiction is a complex occurrence that generally takes place over a prolonged period of time. Despite the many scientific disciplines that have conducted research in an attempt to conclusively identify the causes of this disease, there remains a lack of consensus as to the fundamental elements of addiction.

Accounts repeatedly reveal that there are five common pieces to the puzzle of active addiction that serve as the basic foundation leading to seeming disempowerment and entrapment. These pieces come together to form a perfect storm, much like in the movie "The Perfect Storm", where many independent storms from different directions converge and become so powerful that the fishing boat cannot escape, only with addiction, the way out seems impossible as the addiction itself becomes the dominant driving power of each day.

In addiction, the five pieces of the puzzle are:

Genetic Predisposition:

This could be refered to as the genetic "roll of the dice", similar to the well-documented family predispositions to such diseases as cancer and diabetes.

Social Interactions:

This element speaks directly to the people that one spends the most time with as the examples, attitudes and influences of those one chooses to surround oneself with directly impact our perspectives and our decision-making.

Environment:

The locations where one spends time fosters a sense of acceptable boundaries. If one frequents places where addictions can easily be encouraged or accomodated, addictions have the opportunity to strengthen and further develop.

Life Events:

These are those circumstances and experiences that both precede and result from addictive behaviors. The degree to which coping skills are developed determine to what extent addictions will serve as the primary coping mechanism to trauma, stress, disappointment and other negative occurences in life.

Emotional Disturbances:

Addiction is an emotion-driven mechanism to deal with life. There is little, if any, other mechanism readily identifiable to the addict as decisions are determined in much the same way as was the case of Pavlov's dog. Reaction to outside events is with little thought or logic but rather based upon familiar, impulsive reactions to any series of triggers with no consideration to the consequences.

Genetic predisposition is a much-discussed subject as to its importance in determining a wide-range of diseases and disorders. Much effort is being made to accurately identify the DNA structure and exact genetic make-up of any disease, including alcoholism or drug addiction. While it is not accurate that having a genetic predisposition guarantees addiction, it does reflect an above-average possibility within a family and should be taken seriously. It should also be noted that it is not unusual for addiction to skip a generation with the male side of the family more often exhibiting these behaviors than the female side.

This raises the question - can a person with the genetic predisposition to alcoholism drink like a "normal" person? It is a high risk to take, especially as it sets in place one major, unchangeable and fundamental piece of the five part puzzle that will most quickly lock on to any - or all - of the remaining four pieces to the condition known as addiction.

I know of one family whose mother and family were both alcoholics and passed as a direct result of the damage done from the years of drinking. The second and fourth child became addicts from a very young age and struggled through adulthood with all of the issues that this situation brings. The first child escaped any addictive tendencies but had a son who did struggle with addiction. The third and fifth child did not become addicts but seemed to always attract people who suffered from addiction themselves, thereby continuing the cycle in a less overt way.

From the neurobiological and biological view, it is most unlikely that a person would be able to sustain "normal" social drinking once any peripheral trigger is pulled. From that point on, the puzzle pieces quickly fall into place to paint the picture of addictive behavior.

The last inescapable consequence of addiction is the shared impact it has on both the addict and those that surround him/her, primarily the family. No matter which side of the equation, each person is consumed by feelings of loss, hopelessness and despair. Chaos is the prominent sensibility. Trust is battered, if not completely dissolved. Joy is but a faint memory, and fear is the driving emotion upon which each thought and decision is based.

The good news is that there is help to be found. It does require acknowledgement of the issue, a willingness to travel the road to self-discovery and a commitment to replacing old behaviors and habits through the development of new thinking and coping skills. At the end, a new foundation for living can be placed upon which a more peaceful, productive and satisfying life can be built.

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