Addiction Treatment

Since Philip Seymour Hoffman's death, due to a heroin relapse, the issue of addiction treatment seems to be getting some well needed airtime!  Today I heard what I think is a useful discussion about Addiction and it's treatment on KQED's Forum with Michael Krasny.  Take a Listen if you have about 50 mins:

For a while I worked in a methadone clinic in downtown San Francisco.  I've also worked with drug abusing teens on the peninsula.  My heart has been so deeply touched by these people, and they have opened my mind to the daily (even moment to moment) struggle they must ensue to quit.  Addiction is such a devastating disease.  People sometimes wonder why it is considered a disease.  Paraphrasing from one of the experts on Forum's discussion today, addiction literally changes your brain.  When someone becomes addicted the need to "use" becomes like the need and urge to eat.  It literally feels essential for survival.  It is also accompanied by various physical symptoms that are extremely unpleasant.  

Not everyone that uses drugs or alcohol are addicted, some use socially, others abuse, and others are addicted.  Most people know someone that has abused a drug and then stopped.  This is a reason why some people have a difficult time thinking of addiction as a disease.  The logic goes like this: if some people can stop then it must be a choice, right?!  Wrong.  That's why it is important to delineate what type of user someone is.  If you are addicted, it is extremely important to be under a doctor's care.  In my anecdotal experience, the addicts I've worked with have co-occuring issues (i.e. grief and loss, victims of abuse, PTSD, depression and anxiety... just to name a few).  That it is also a good idea to see a therapist as part of your treatment plan.  Many find the 12 step programs useful as well.    


Any reason to quit is a good reason to quit.  Many people, if not most, begin treatment ambivalently.  I've found it useful in my work to assess why someone is in treatment, AND I've found that this discussion usually leads that person to think about their reasons more in depth.  This worksheet can be a good starting off point.  

Next it seems important to have a conversation about what "triggers" the person to use.  This conversation leads to making a plan to avoid relapse.  Triggers can be anything in a person's environment that cues them to want to use and/or internal feelings, thoughts, and drives.  After identifying that person's cues (aka triggers), I like to then brainstorm ways to avoid these triggers, ways to manage , and alternative choices/behaviors the person can take.  This worksheet can be a helpful guide to this important discussion.   


I hope this can be helpful with either your own addiction/drug use issues, or with another therapist in their approach to drug treatment/counseling.  Best of luck!  You are embarking on a difficult, but meaningful journey.