In Chapter 5 of the book Alcoholics Anonymous there’s a warning about alcoholics seeking an easier, softer way to deal with alcoholism. Often someone suffering from addiction will seek help through a friend, a pastor, their doctor, a family member or maybe an individual therapist. I won’t say that any of these forms of help can’t work. I do know that addiction treatment is usually required if there’s to be much lasting change at all. The tough decisions and commitment necessary to deal with a medical condition as powerful as addiction are not easy. Some people deal with the problem through non-professional methods, but most people who suffer from addiction require some level of specialized addiction treatment.
The mistake most people make when trying to help someone who’s addicted to alcohol or some other drug is to immediately assign psychological reasons for the constant drinking or use of drugs: She had a bad childhood – He lost his wife – She has never fit in. In addiction treatment, we deal with the medical condition first. Addiction is a medical condition, a chronic brain disease, with a strong genetic influence that’s complicated by social and psychological factors.
Treatment begins by stabilizing the medical condition — detoxification, medical assessment, and understanding the chronic brain disease. Medication might be needed for detox, but the ideal course of action is to become drug free as soon as possible. When dealing with opiate addiction, Suboxone might be prescribed for the early period of treatment, long enough for the client to get into treatment and establish a support network. If the client can’t detox on an outpatient basis, inpatient detox will be recommended, and perhaps a few weeks of inpatient treatment.
Once there’s medical stabilization and we develop a treatment plan, then we begin dealing with the social and psychological aspects of addiction. Sometimes, a person is depressed and anxious in the beginning, but this is common for someone who’s been living a life torn apart by addiction. In some cases the depression and anxiety might have preceded the addiction, so that these co-occurring conditions are addressed and treated along with addiction. Depression and anxiety are not known to cause addiction, but they can co-exist with addiction, and addiction almost always makes co-existing conditions worse. So, when someone says that they’re drinking because they’re depressed, they don’t understand that alcohol is a depressant (although the first few drinks might have a stimulant effect) and makes depression worse over the long run, not better.
The life of addiction creates or masks problems that are dealt with if a person is to have the best chance at recovery. If a person stops drinking and nothing else changes, they’re usually filled with chaotic emotions, guilt, remorse, anxiety, depression, resentments, etc. These lingering consequences of addiction can overwhelm a person, making them restless and discontent, so much so they that go back to their drug of choice. If the person resolves the social and psychological problems, though, this doesn’t mean that he/she can return to social drinking or recreational drug use. Once biological predisposition to addiction is established, active addiction will recur once the person starts drinking or using again. Addiction is a chronic brain disease and so far there’s no known cure. If the person remains abstinent, however, they can lead a normal, fulfilling life. It’s not just people with addiction who are filled with chaotic emotions and psychological scars, but the person recovering from addiction has a chance and a need to deal with these problems and gain peace of mind — who wouldn’t benefit from taking time out to assess our emotions and psychological state?
So, if a person with an addiction problem tries to deal with the symptoms of addiction with symptomatic solutions, they might miss the fundamental nature of addiction which has to do with how the drug affects the brain. Many people who’re searching to find help, want help that will allow them to one day drink and use drugs socially with no consequences — the easier, softer way actually becomes very hard and painful. Ironically, (paradoxically?) it turns out that, for the addict, the easier, softer way is abstinence and recovery management.