Addiction Treatment Blog

It would be nice if this illness was like strep throat. Get treated and it’s gone. Even if strep throat left long lasting effects, like scarlet fever or a heart valve problem, the disease itself is gone. Unfortunately, addiction is not like strep throat. The medication we use to treat the illness, at best, suppresses the symptoms. The treatment, at best, corrects any non-reality based learning caused by the disease. And if the disease would just go away those benefits of medication and treatment would be enough. Sorry, the disease is not going to just go away.

Some of you are saying, “But wait a minute. My Uncle Ben got religion and just stopped drinking and did fine for the rest of his life.” Yep, you’re right, and everyone knows an Uncle Ben. I’m sure you can find several examples. But if everyone like Uncle Ben, I could be doing something else for living. I’m doing this because Uncle Ben is actually pretty rare, and as we’ll discuss later, probably in recovery anyway, just in a different way.

So let’s talk about what recovery is so we can know why we need to be doing it. Of course my view of recovery is colored but my bias of understanding this illness in a biological way. There are many people who see recovery in a lot of different ways, and I in now way mean to invalidate them. I hope you see by the end of this answer that it doesn’t matter what words we’re using to describe recovery, but recovery is recovery. William White and others put together a monograph on recovery which is a much broader discussion than I’ll have here.

I guess I don’t have to repeat here that there is more to recovery than just not using. There’s also more to it than just not using and not having symptoms of low dopamine (irritable, not enjoying life, aloof). Not using and not having the symptoms of low dopamine are, hopefully, the end result of working a recovery program. They are the outcome, not the action itself. This concept is confusing to a lot of people I meet. It’s kind of like whishing for cooler weather so you put your thermometer in the refrigerator. Nothing changes but the number on the thermometer. So as we discuss recovery, remember the difference between the thing itself and the measure of the outcome.

So what is recovery? Well, I’ve been putting this definition off for few paragraphs haven’t I? It’s time to take the bull by the horns and answer the question. Recovery, for this addiction doctor at least, is taking action in every moment of the day to minimize the feelings of aloneness and less-than that precipitate a lowering of our dopamine receptor density.

I can imagine many ways to do recovery and everyone else can to. And if all of these ways worked, again, I’d be doing something else for living. So we have to go further. The actions we take actually have to be effective. Since millions of people have been in recovery in the past, we should have ample evidence as to what works and what doesn’t. But we can even do better than that. We can find someone like us, someone who tells our story when he tells his own, but has found a way to live that gives him the happiness, freedom, and joy that we want. I’m betting that the actions he lives by will have better odds of success than a random set we could come up with on our own. If you have any experience with 12-step recovery, you’ve probably recognized the description of how to pick a sponsor. Even if you don’t want to work a 12-step programme, the idea is the same. You can maximize the odds of a good outcome by choosing someone who you can relate to, someone who has what you want, and then by following his path. Kind of a cop out for me, huh? I said I’d tell you what recovery is and then told you to get a sponsor. Now that I got that out of the way, here’s what I think you’ll hear from that sponsor. Read more…

Imagine if you will someone with diabetes whose diabetes progresses to the point where they have their foot amputated or become blind. Now imagine that someone comes along with a treatment that gets their diabetes under control. We won’t expect them to re-grow the foot or regain the sight just because the biology of the disease is under control. So it is with addiction as well. Once you’re open to the idea that most people with addiction have the biology from birth, it becomes easy to understand that the biology of addiction has a profound effect on the personality of the person as they grow. They will make accommodations for the illness just as anyone else would. When the biology and the symptoms come under control, it takes time to learn to live without them.

That might sound strange but there is an old vaudeville joke that illustrates the point. A man breaks his hand and goes to the doctor to get a cast. The man says, “Hey Doc, when this hand heals will I be able to play violin?” “Sure,” says the doctor, “No problem.” “That’s great,” says the man, “’cause I never could before.”

While anybody can see that someone who couldn’t play the violin isn’t going to be able to play simply because they get some medical treatment, we don’t apply it to things we take for granted like forming relationships, being honest, and trusting the universe to provide. We figure everyone should be able to do those things without any learning, but it’s not really so. The disease actively blocked a lot of learning about how life really works, and that learning has to happen even after the biological symptoms of the disease are suppressed. A lot of this learning takes place over time in a 12-step programme, but several studies have shown that the addition of professional treatment improves the outcome. Read more…