At Livengrin we accept the scientific concensus
that addiction is a disease that can have behavioral,
social, psychological, biological and/or genetic
roots. We work to help people understand that,
while decision-making has a lot to do with how
one can fall into addiction, it isn't simply their
fault because they didn't
make the right choices or lacked
the will power to stop.
While there are many elements of dependency that
are common to alcohol and drugs, each has its own
characteristics in terms of how the body and mind
are affected, and how a person can move from "social
use" to habit to addiction.
Addiction can get its hook into just about anyone,
regardless of income, education, profession, race,
family makeup or spirituality. Medical science
tells us some people are genetically hard-wired
to fall victim to the disease, regardless of their
best efforts to resist. Not everyone with this
predisposition is affected; but combined with the
wrong environmental conditions and the introduction
of the substance, it can lead to addiction.
The Components of Dependency
Alcoholism and drug addiction are biological dysfunctions,
a form of a disease based on the body's overwhelming
desire for the substance that it has become used
to. This dependence is more than simply wanting
what are referred to as "recreational drugs" on
a social basis. Addiction is compulsive, marked
by what can be uncontrollable craving.
The human brain really does "force" an
addicted person to seek out the substances it craves
(just as it does with food). This craving and dependence
continues even though the drinker may know full
well that there are many undesirable consequences.
Failing health, legal problems, troubles at work
and eventual loss of employment, and many problems
within the family, are not enough to stop an addicted
person from craving and seeking drugs.
For many people, addiction to any drug, including
alcohol, can become a long-term condition; even
the best intentions cannot stop relapses even after
lengthy cycles of treatment and abstinence.
Generally, chemical dependency can be divided
into four components:
1. Craving (a compulsion and need to add the substance
to the body)
2. Physical dependency, in which the body must
have the substance as much as it needs food and
water, and which will develop symptoms of withdrawal
if the alcohol or drug intake is stopped
3. Tolerance, in which the body demands ever-larger
amounts of the drink or drug in order to feel the
effects
4. Impairment,
the effect on the brain and its functions that
interferes with thinking, decisions, the senses
and reaction to external stimuli (everything from
perceiving a doorbell to avoiding an accident)
The long-term medical effects of alcoholism
are well known: high blood pressure, cirrhosis
of the liver, heart disease, nutritional deficiencies
and digestive diseases, internal bleeding, depression,
low resistance to infection, pancreatitis, fetal
alcohol syndrome in babies, and impotence. Quite
a list. Heroin, cocaine, meth and other drugs have
their own lengthy inventory of terrible results.
Eventually, a person comes to the end of the line:
Addiction, allowed to continue, is fatal.
Choices, Fault and Other Factors
For decades - even centuries - society has believed
that chronic drunkenness or other substance abuses
were the product of the ill mind, the lack of willpower,
a kind of laziness or disrespect for oneself. It
was always thought curable - if only the alcoholic
or addict would just make up his or her mind.
Medical research has informed us, since the mid-20th
century, that drug dependency, including alcoholism,
is a disease. It has symptoms (both within the
body and in the person's life) that get worse over
time. It has been observed and studied enough to
show a predictable course; it is a progressive
illness that won't "just go away." It
can be influenced by genetics, family history and
environment.
Every type of drug can be abused by someone. It's
the ones that provide a euphoric "high," a
relief from problems or stress, or that make a
person more comfortable than usual, that lead to
abuse and addiction. But whatever the drug, the
brain usually follows a predictable path. There
are changes in the molecules and cells of the brain
that affect mood, memory, motor skills and the "intangibles" such
as judgment.
In practically every case, a person has made a
voluntary choice to indulge in a drug. Sometimes,
it's a prescription drug that is designed for relief
of pain or other disorders. But more often, it's
with those badly-named "recreational drugs." With
some people, addiction comes after significant
substance abuse, while for others, it kicks in
quickly because their brain and biological makeup
(at the molecular level) is especially receptive
to these chemical compounds.
In time, continued use of addictive drugs changes
a person in ways that are easy to feel and see,
and also in ways that cannot be felt at all. But
with all these variables, one thing is sure - the
brain is designed to want more of what it has become
used to.
A person's behavior is influenced by all these
factors. Eventually, the drug becomes the single
most powerful element in the abuser's life. He
or she will do almost anything for the drug. Is
it the addict's "fault" that they've
become like this? One can argue that the "brain
took over and is in control" of bad choices
because of the cravings that cannot be ignored
- but it usually began voluntarily.
Why can't people with chemical dependency quit
on their own?
Most addicted individuals spend a long time thinking
that an application of "will power" is
all they need to get off the habit. As a result,
they think that treatment is unnecessary, an admission
of defeat. Most of the time, this results in failure
in the long run. Drug use over a long period results
in significant changes to the brain that will last
after the individual stops using. Despite a person's
most sincere attempts to "just say no" and
abstain, the compulsion will remain that pushes
him or her to give up and return to the safe (but
dangerous) familiarity of the addiction.
The biological aspect is just one component of
a person's difficulty in maintaining abstinence
without getting the multiple facets of treatment.
There can be psychological stress from the job,
family problems, legal or other issues. Then there
are the "triggers" - the cues that remind
the individual of the pre-recovery life, such as
people from the past, locations or social situations,
even smells or sounds that were associated with
drug use. These all interact with biological factors
to "call back" the person to drug abuse
and get in the way of sustained abstinence.
Is there any good news? Of course! Research tells
us that even severely-addicted people can make
treatment work for them. But it takes a dedication
to getting off the addiction, and the help of others,
to make recovery both a daily and long-term result.
Treatment does work for
alcohol and drug addiction, from medical detoxification
to therapy to long-range behavioral changes. It's
a tough thing to do. Most people coming into treatment
are there not because they think it's a great idea,
but because they are afraid of a great loss - of
their health, the love of their family, the job,
or their freedom. However, there are studies showing
that it's the person who comes to treatment because
of that pressure from those "outside reasons" that
may do better in treatment. They have something
they value more than being high, that they want
to keep.
Treatment can occur in a variety of settings,
in many different forms, and for different lengths
of time. Because addiction is typically a chronic
disorder characterized by occasional relapses,
a short-term, one-time treatment often is not sufficient.
For many, treatment is a long-term process that
involves multiple interventions and attempts at
abstinence.
There is also a spiritual component to recovery
from addiction. While the organization doesn't
insist on any particular religious or spiritual
theme, we include this spiritual element to help
bring patients back to humanity – to re-establish
a connection with the world and a “higher
power” beyond what’s “in their
own head” where they may have been living
for quite awhile.
Livengrin can help - through a continuum of treatment
and care.
The Principles of Effective Treatment
Livengrin subscribes to, and applies to its work
with patients, many of the general guidelines for
addiction treatment outlined by the National Institute
on Drug Abuse. Among those guidelines are:
No single treatment is
appropriate for all individuals. Matching treatment settings, interventions, and
services to each individual's particular problems
and needs is critical to his or her ultimate success
in returning to productive functioning in the family,
workplace, and society. Livengrin creates a specific
treatment plan for each patient.
Treatment needs to be
readily available. Because
individuals who are addicted to drugs may be uncertain
about entering treatment, taking advantage of opportunities
when they are ready for treatment is crucial. That's
one reason that Livengrin is open 24 hours a day,
365 days a year.
Effective treatment attends
to multiple needs of the individual, not just
his or her drug use. To be effective, treatment must address - along
with the individual's drug use - any associated
medical, psychological, social, vocational, and
legal problems.
An individual's treatment
and services plan must be assessed continually
and modified as necessary to ensure that the
plan meets the person's changing needs. A patient may require varying combinations
of services and treatment components during the
course of recovery. In addition to counseling or
psychotherapy, a patient at times may require medication,
other medical services, family therapy, parenting
instruction, vocational rehabilitation, and social
and legal services. It is critical that the treatment
approach be appropriate to the individual's age,
gender, ethnicity, and culture.
Remaining in treatment
for an adequate period of time is critical for
effectiveness. The appropriate
duration for an individual depends on his or her
problems and needs. Recovery doesn't happen in
a week or two. The longer a person can stay in
active treatment, and then remain active with other
components, such as twelve-step groups, sponsors,
and actvities that lend to "staying connected"
(such as Livengrin's alumni groups), the better
the odds of long-term success.
Counseling (individual
and/or group) and other behavioral therapies
are critical components of effective treatment
for addiction. In therapy,
patients address motivation, build skills
to resist drug use, replace drug-using activities
with constructive and rewarding nondrug activities,
and improve the ability to make better choices
and solve problems. Behavioral therapy also facilitates
interpersonal relationships and the individual's
ability to function in the family and community.
Medications are an important
element of treatment for many patients, especially
when combined with counseling and other behavioral
therapies. There
are pharmaceutical products that can be effective
in combating addiction. Livengrin's medical staff
has done published research at the Foundation to
learn more about the use of medications.
Addicted or drug-abusing
individuals with coexisting mental disorders
should have both disorders treated in an integrated
way. Because it's common that
a person may suffer from addiction and psychiatric
problems together, Livengrin approaches treatment
for these patients in a well-rounded, inclusive
fashion.
Medical detoxification
is only the first stage of addiction treatment
and by itself does little to change long-term
drug use. "Detox" safely
manages the acute physical symptoms of withdrawal
associated with stopping drug use. While detoxification
alone is rarely sufficient to help addicts achieve
long-term abstinence, for some individuals it is
the best "first step" to take in the
treatment process.
Treatment does not need
to be voluntary to be effective. Strong
motivation can facilitate the treatment process.
Sanctions or enticements in the family, employment
setting, or criminal justice system can increase
significantly both treatment entry and retention
rates and the success of drug treatment interventions.
Of course, the more a patient believes in their
ability to win this battle, and follows the new
life-skills and recovery training they acquire
at Livengrin, the better their chances.
Possible drug use during
treatment must be monitored when indicated. Relapses
can occur during treatment. The objective monitoring
of a patient's drug and alcohol use,
such as through urinalysis or other tests, can
provide early evidence that the
individual's treatment plan may need to be adjusted.
Feedback to patients who test positive for illicit
drug use is an important element of monitoring
the need to "bump up" to a higher level of care.
Treatment programs should
provide assessment for HIV/AIDS, tuberculosis
and other infectious diseases, and counseling
to help patients modify or change behaviors that
place themselves or others at risk of infection.
Counseling can help patients avoid high-risk
behavior. Counseling also can help people who
are already infected manage their illness.
Recovery from drug addiction
can be a long-term process and frequently requires
multiple episodes of treatment. No one comes back from heart surgery
and just takes up an ordinary life. Things can
go wrong with that organ again. As with other chronic
illnesses, the hurt to the body from substance
abuse is still in there - and relapses can occur
during or after successful treatment. Addicted
individuals may require prolonged treatment and
multiple episodes of treatment to achieve long-term
abstinence and fully restored functioning. Participation
in self-help support programs during and following
treatment often is helpful in maintaining abstinence.
Recovery is possible! Help is available!
Click here to see our Programs
and Services or
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You may also visit our Resources page
to learn more.
To learn more about addiction, treatment and the
affect of this major issue on our society and families,
Livengrin invites community, school, faith-based
and service organizations to contact its Speakers
Program.
