There are many unanswered questions in the field of addiction including the neurological and psychological mechanisms involved. For example we don’t know why some drugs more addictive than others and why some individuals more susceptible to addictions than others. Addiction can be viewed as a rational, informed choice or an irrational, ill-informed choice. As well as choices made, the individual is affected by their impulses and their degree of self-control. Learning and conditioning psychological theories have helped us understand addictions more. Understanding what motivates an individual and the neurochemistry of reward systems are other key areas of research helping us to understand addictions better.
People can become addicted to chemicals or behaviours, which hijack the brain’s normal reward system. Examples of chemicals people can get addicted to include heroin, methadone, opiate painkillers, cocaine, amphetamines and ecstasy, alcohol, marijuana, benzodiazepines and nicotine. A few examples of behavioural addiction include gambling, food, computer games and exercise.
Treatment of Addictions
Recovery from an addiction is a journey and not an event. There is potential in every individual to embark on a personal journey process of change. Often the journey is not in a straight line and it usually needs to be taken with small steps. Sometimes crises can create opportunities. The development of hope and a secure base is really important in the early stages of treatment. Developing a sense of self and building up a network of supportive relationships are parts of the recovery process.
Inpatient treatment is usually only a first step in a life long journey. In-patient treatment usually starts with a high intensity 4-week primary treatment phase. After this a secondary, extended care phase providing lower intensity supported living may be required. Patients will have a wide range of experiences and outcomes depending on other mental health issues they have or trauma they have experienced. Levels of functioning, and insight and motivation at the time of admission also affects outcome.
Ensuring the medical safety of the patient at the time of admission is vital. It is important to treat other medical conditions the person may also have. For people with alcohol dependence syndrome ensuring they have enough vitamins to prevent brain damage, which can lead to permanent loss of short-term memory, is essential. Careful planning of the medication detoxification programme for alcohol or drug dependence with the patient’s input is really important.
Admission to a primary treatment programme provides a structure to contain the chaos the individual is in. Tackling immaturity, grandiosity, self-hatred, shame, guilt, fear, entitlement, dishonesty and manipulation when present is often an important early step. Gaining insight and perspective follows on from this. Helping patients understand the true cost of their compensatory behaviour is very important.
The next step is achieving balance by paying attention to physical health, nutrition, exercise, spirituality, self worth, and self-esteem. In the recovery process the person will move hopefully from addiction, isolation and self-will to a much healthier relationship with themself, others and society. Treatment programmes are designed to assist the individual develop motivation and self-belief. Relapse prevention is worked on during treatment and a clear plan is in place at the time the patient leaves an in-patient facility.