Drug & Alcohol Addiction

Overview of Drug & Alcohol Addictions: One of the most important, difficult, and complex areas of mental health is the field of addiction. Research indicates that the vast majority of people who are addicted to drugs or alcohol have an underlying mental illness or significant emotional/psychological difficulty, and about half of people with mental illness will be involved with drugs or alcohol at some point, usually as a form of self-medication. Addiction is difficult to treat, and there is a good deal of controversy about the causes and best approaches to treatment of addiction.

 

Drug and alcohol abuse may be difficult to define. Opinions vary with people’s values and beliefs. For some, any use of an illegal drug, and any use of alcohol with the primary purpose of intoxication constitutes abuse. For others, abuse is indicated by a negative impact in the individual’s life, for example, the presence of several of the following signs:

 

• failing in school or missing work

• driving while under the influence

• injuring oneself or others

• developing illnesses

• damaging relationships with friends and family

• spending too much money

• diminished interest in other activities

• getting in repeated legal trouble

• overdosing

 

Beyond abuse is dependence or addiction. Dependence is indicated by one or more of the following:

• Severe on-going abuse

• Inability to go without the substance

• Need for greater and greater amounts (tolerance)

• Complete lack of other activities

• Cessation of relationships outside of those the individual uses with

• Increasingly frequent use of the substance

• Withdrawal symptoms

• Other signs of possible abuse or dependence might include:

• Hiding your use from friends and family

• Forgetting what happened last time you used (black outs)

• Trying to quit but not being able to

• Using more than you intended to, repeatedly

• Drinking yourself sick, repeatedly

• Using first thing in the morning

• Using several times a day

• Going on binges (long nights, or several days, of heavy using)

• Being told by others you have a problem

 

The Medical Model and Addictions: Quitting using a chemical substance can be extremely difficult. It can also be dangerous. Chronic users of alcohol and prescription drugs should not attempt to stop cold turkey without medical assistance. Opiate withdrawal can be temporarily debilitating, but not fatal. Other chemicals may lead to physical sickness, personality changes (temporary), loss of appetite, insomnia, nausea, mood swings and other disturbances when quitting is attempted.

 

Fatal overdose is possible with many commonly abused drugs. Marijuana – which can lead to diminished lung functioning, memory problems, mood and cognition impairment, and other health issues (while also being a potentially legitimate medicine in the eyes of mainstream medicine, if not the Drug Enforcement Agency) is the most prominent exception.

 

Drugs and alcohol can temporarily relieve the symptoms and feelings associated with psychological illness and distress, but in the long term will almost surely worsen any emotional or psychological condition. Chronic self-medication may be a sign that therapy warranted to address an underlying condition or difficulty. People sometimes fear seeking help for drug addiction. Be advised that privacy and confidentiality in substance abuse treatment is mandated not only by professional ethical guidelines and, usually, state law (like all mental health treatment) but also by special federal laws.

 

Case Examples of Addictions:

 

Clara, 57, has been a heavy drinker of beer and vodka for almost 45 years. However, since the death of her husband of alcohol-related symptoms, her drinking has increased dramatically; instead of weekend binges and a few daily cocktails after work, she has taken to drinking throughout each day, and recently lost her job for missing days while hungover. She was also arrested for driving drunk and lost her license as a result. She is estranged from her two children, who, she believes, blame her for their father’s death. Clara recognizes her problem but her anxiety and depression compel her to continue self-medicating. Quitting would be dangerous alone, and Clara agrees to enter a treatment facility. With medical help, she is able to maintain sobriety, and upon release, begins an intensive program of therapy and 12-step groups. Soon, she begins to deal with her grief, not just over the death of her husband, but also over the many losses and regrets that come from a life spent intoxicated. Facing these realities tempts Clara to drink, and she suffers several relapses, but eventually kicks the habit and restores her relationships with her children, which brings her a great sense of healing, accomplishment, and peace.

 

Billy, 17, has begun smoking marijuana frequently and experiments with harder drugs – cocaine, LSD, valium – ever sine senior year of high school began. He has already been accepted to college, and verbalizes that he sees “no reason to do anything but party”. His parents are very concerned, and admonish him constantly to quit, but he meets their pleas with disdain and derision. Family sessions reveal deep hostility between Billy and his strict father, and a growing distance between the anxious, depressive mother and her son and husband. Therapy centers on enhancing communication and emotional expression, as well as establishing boundaries more appropriate to Billy’s transition from youth to adulthood. When Billy’s parents back off, his drug use curtails, though he still smokes marijuana and drinks alcohol at parties. Soon, Billy is asking for help getting his habit under control, his father enters into individual therapy for anger issues, and his mother, now taking an antidepressant, files for divorce. Billy leaves home with a great sense of relief and continues therapy in college, eventually becoming a peer counselor and working with other students trying to stay healthy and abstain from drug abuse.

 

Therapy for Drug & Alcohol Addiction: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of addictions. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Marriage Counseling may be important part of therapy for worry if worry is occurring in a relationship. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for addictions or any other issue, it is helpful to familiarize oneself with these elements.

 

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Drug & Alcohol Addiction Article Summaries

He Quit Drinking So Why Don't I Have My Husband Back?

Written by Mary Ellen Barnes, Ph.D. It's a common, if quiet, complaint heard over lunch, or at breaks in meetings, at the Chamber of Commerce mixer, or the League of Women Voters retreat. "My husband finally quit drinking, attends AA, and life is certainly calmer, but…" The "buts" are varied, but essentially come down to the fact that while one's spouse is no longer actively drinking little else has changed. An unfortunate side effect of AA and other 12-Step based programs is that while they may help a man ... Read the rest of this entry »

Women, Hormones, Menopause, and Alcohol Abuse

Over the past decade research has found that for many women the onset of alcohol abuse coincides with changes in hormone levels – changes that many women are unaware of in the early stages. When this is combined with other stresses in their lives - job changes, health concerns, children leaving home - women can find themselves abusing alcohol for the first time in their lives. In our teens, 20s and 30s, our ovaries and adrenal glands produce a form of estrogen called estrodiol. Later, during our mid to late 40s ... Read the rest of this entry »

Emotionally-Charged Expressions Fall Flat on Alcoholics

A GoodTherapy.org News Headline There are a number of challenges that alcoholics in search of recovery face on a regular basis, but a recent study has suggested that it's the face itself that may present one of the most difficult social aspects of recovery. The research, performed at the University of California at San Diego, tested the reactions of a group of abstinent, long-term alcoholics to a range of emotionally-charged faces against those of a control group, and found ... Read the rest of this entry »

Study Finds Confidence in Restraint May Indicate Risk of Succumbing

A GoodTherapy.org News Headline Temptations, in myriad different forms, are available everywhere, often in copious amounts. To some people, temptation may take the form of a cigarette or stiff drink, while to others, a sweet snack or attractive person may represent the ultimate temptation. Most people are likely to report that they have a fairly high ability to resist temptation, but as a study recently performed at the Kellogg School suggests, those with strong convictions about such an ability are ... Read the rest of this entry »

Positive Family History Contributes to Intensity of Depression - 30-Year Longitudinal Study Suggests

A GoodTherapy.org News Headline It's long been suspected and suggested through quality research that a positive family history for a range of issues can point to an increase in the likelihood that such an issue will present itself. But this isn't to say that people are “predestined” for feeling unwell or seeking treatment. Enforcing this idea and adding a new twist, a study performed over the course of thirty years in New Zealand has shown that while people with a family history of depression, anxiety, ... Read the rest of this entry »

The Myth of Hitting Bottom

Last month we wrote about the first two of the “ Read the rest of this entry »

The Myth of Powerlessness and Disease

Last year we wrote a free download that we posted on our website entitled "6 Secrets Ex-Drinkers Know That You Don't, And 12 Step Programs Don't Want You To Find Out. It's been popular, though not without controversy. Indeed, one Canadian who described herself as a "Therapist, Counselor, and Alcoholic" declared we were downright dangerous and had to be stopped! That made us think we needed to get the facts into wider circulation so here's a newly minted rendition of the first two "Secrets" for you consideration. We started with the notation ... Read the rest of this entry »

Sex, Drugs and Body Image: A Coping Plan for Teens & Parents

As a therapist who offers counseling for teens and their families, I’ve become aware of some of the biggest issues facing young people today. While depression and anxiety remain two of the major reasons why parents seek my help, often these are not the first issues that drive them to consult a therapist about their child. Usually, it’s one of the “Big 3” teen issues of our day – Sex, Drugs and Body Image issues (which includes eating disorders and steroid use). Understanding the Adolescent Brain Adolescence seems to be ... Read the rest of this entry »

The Alcohol and Depression Question

Alcohol Moderation or Abstinence?

Native Americans, Alcoholism, and the Failure of Treatment

A colleague recently asked me for my assessment of the applicability of the "disease model" of alcoholism with regard to Native Americans. She asked not only because my adopted children are Inyupik, and from alcohol devastated families in northwestern Alaska, but also because I have worked in non-traditional ways of combating alcohol abuse for over twenty years. My answers have evolved out of the past forty years of my experience, work, observations, research, discussion, and reflection. To begin with, the repeatedly discredited "disease model" negatively impacts everyone suffering from alcohol ... Read the rest of this entry »

Unjustly Accused: Divorce, Alcoholism, and the Alcohol Treatment Trap

“Two things will be believed about any man whatsoever, and one is that he has taken to drink.” -Booth Tarkington It isn’t unusual for people to seek treatment for their alcohol abuse problems when divorce is looming on the horizon. Indeed, probably two thirds of our clients come to us with crumbling marriages. What is surprising is that at a few of these clients don’t really have an alcohol problem and many of the rest are abusing alcohol, but aren’t alcoholics. How does that happen? Simply put, ... Read the rest of this entry »

New Perspectives on Alcohol Treatment

We recently returned from a conference on alcohol treatment called “New Perspectives.” The conference, hosted by Edgewood treatment center in Nanaimo, Vancouver Island, British Columbia, was, indeed, as advertised. Presenters echoed the same theme: the usual methods of “treating” alcohol abuse and dependence don’t work. While this isn’t news to some of us who’ve looked at the statistics for over twenty years, it is the first time we’ve ever attended a conference that wasn’t hyping the same old failed models. Perhaps being Canadian – a country ... Read the rest of this entry »

Sabotage - Counseling’s Unexpected Outcome

We work with clients very intensively – four or more hours a day for five to seven days – and with a well defined presenting problem – alcohol abuse. Following this initial treatment phase, during the ninety days of follow-up, we frequently see family members sabotage progress once clients return home. Undermining progress is rarely intentional, but nonetheless it is the second most common factor in clients reverting to old behaviors. Only clients’ self-sabotage is more destructive. Combine the two and any progress will be stopped dead in its tracks. Why do spouses ... Read the rest of this entry »

Don’t Wait To "Hit Bottom"

Have you ever been told a person has to "hit bottom" before they can begin to recover? What do you suppose that even means? Exactly what is “hitting bottom?” Do you suppose it's really a good idea to wait until you're divorced, or bankrupt, and/or facing another DUI before looking for an answer to your drinking problem? We don't think so. The concept of waiting to hit bottom isn't just useless – it’s dangerous. How? Consider how that tenet would play out in the case of a real disease, ... Read the rest of this entry »

Freeing the Parents of Adult Alcoholics and Addicts

by Mary Ellen Barnes, Ph.D. The conversation began easily enough, "My brother is bleeding our parents into the poor house with his unending demands for money - money to support his addictions – and they don't seem able to stop giving it to him, even though he isn't getting any better. What can we do?" Or we hear from the parents themselves, "How can I get my spouse to stop giving our adult daughter money she just spends on booze or drugs? Her promises are worthless and the demands endless." ... Read the rest of this entry »

A Wolf in Sheep's Clothing: The Trauma Underlying Addiction

Written by Sarah Jenkins, MC, LPC Sit down, and let me tell you a story, a fable that tells of a wolf in sheep’s clothing. It is a fable, written by Aesop, that you may be curious to learn, and can tell us of addiction’s common deceptions. Perhaps you will find the lesson in the beginning, or even at the end, but you will be curious about what you will soon learn, as you read on. “A wolf found great difficulty in getting at the sheep owing to ... Read the rest of this entry »

Alcohol and Substance Abuse

Written by Edward A. Dreyfus, Ph.D. I have been alarmed by the increasing incidence of alcohol and drug abuse, especially among teenagers.  Users are getting younger; even children as young as eight years old have been found using various mind-altering substances.  This article will focus on giving you information about the various treatments available for alcohol and substance abuse in the hope that it may help you or someone you know obtain the treatment needed. Drug, alcohol, and tobacco use is the cause of more deaths, illnesses, and disabilities ... Read the rest of this entry »

This Year Stuff the Turkey, Not the Guests

By Lee Kotsalis-Thulin, MA, RCC As the holiday season shifts into high gear, here’s a plea for a different kind of moderation: let’s all hear it (softly please) for moderate hosting. Moderate hosting means fighting the urge to measure your success as a host by the amount of food and alcohol and sociability your guests consume. It means not pressing the matter when a guest turns down an alcoholic drink, or a second helping of pie, or a third pass under the mistletoe, and keeping in mind the ... Read the rest of this entry »

Smoking: Addiction or Habit? You decide!

By Ronald Soderquist, Ph.D. Before we explore whether smoking is an addiction or a habit, let’s look at tobacco’s “Good Old Days”. In 1566, tobacco cured many diseases. Catherine de Medici, the Queen of France, received snuff (powdered tobacco) to treat her migraine, and later decreed it Herba Regina. Numerous claims were made of the benefits of tobacco, such as prevention of toothache, losing fingernails, worms, halitosis, lockjaw, and cancer. Talk about the Good Old Days for tobacco, it didn’t cause diseases – it cured them! “Good Old ... Read the rest of this entry »

The Quest for Wisdom

By Sarah Jenkins, MC, LPC At a recent event, I had the joy of watching a boy, no more than seven years old, exploring his world. His energy sparkled and his spirit was pure; he was an “old soul,” to say the least. As part of a “quest” he was asked to bring back the answer to the question “what is wisdom?” He waited patiently as my friend and I considered our reply. The answer was painstakingly difficult, and at best, only touched the surface of wisdom’s substance. “Wisdom ... Read the rest of this entry »

The Importance of Amino Acids in Substance Abuse Recovery and Relapse Prevention

Written by Peggy M. Huff, President and Executive Director of Essence Recovery Centers, Inc. I’ve been in active recovery from alcohol dependency for more than 20 years.  I have watched thousands and thousands of people come into recovery, and just as quickly, they disappear, only to come back again and again, claiming a desire to get better.  What causes them to go through that revolving door for so long, and why are they in so much emotional pain? I have studied alternative medicine for 15 years or more, and have learned ... Read the rest of this entry »

Generation RX: The Dangers of Teens and Prescription Medication Abuse

By Sherry Gaba, LCSW and Life Coach Viewers cannot turn on the television today without a story depicting pop icon Michael Jackson and his un-timely death. It has brought to the forefront of everyone’s mind a reminder of the dangers of abusing prescription drugs. What parents may not realize is although overall teen drug use is down nationwide; prescription drug abuse is on the rise, as one of the fastest growing addictions amongst teenagers today. Since 1992, the number of teenager’s ages 12 to 17 years old abusing controlled prescription drugs ... Read the rest of this entry »

The Bucket of Crabs, or Why AA and Alanon Can Be Bad For Your Health

The "Bucket of Crabs" is one of our favorite analogies. Pulling crabs out of traps on Kodiak Island, we'd just toss them into a big bucket – no need to put a lid on the bucket. Why not? Because as soon as one crab would start to climb out, the other crabs would drag him, or her, right back down into the bottom of the bucket. There's no escape to life back in the ocean. And that keeps happening until all of the crabs end up in the steamer. The point? Read the rest of this entry »

Link Found Between Past Alcoholism, Poor Sleep

A GoodTherapy.org News Headline There are many adverse symptoms, both psychological and somatic, associated with alcohol abuse, and those in recovery often find themselves struggling with the inherent challenges. However, a study recently published in the journal Sleep suggests that even those who have been abstinent for years may still suffer from insufficient sleep. The study examined the sleep patterns and behaviors of a range of recovered alcoholics as well as a control group, and found that those with a ... Read the rest of this entry »

Nation Wakes Up to Need for Greater Dual Diagnosis Care

A GoodTherapy.org News Summary Most people are well aware that some percentage of the population grapples with a substance abuse issue, and that trends in the precise substances used may change from time to time, but difficulties that arise as a result remain largely the same. Problems at work, within social lives, and at home can easily arise in the presence of substance abuse issues, and there are many factors that can compound the negative potential of drinking or drug use. But many people are not clear about the ... Read the rest of this entry »

Use of Pain Relievers, Anti-Psychotics Wreaking Havoc in Kashmir

A GoodTherapy.org News Headline Often, an inability to access or receive meaningful mental health services can lead those experiencing debilitating symptoms to rely on pharmaceuticals and other substances in an effort to self-medicate. Such instances carry great risks, not only for physical and mental health, but for the development of deep addictions, engendering further negative consequences. This situation has been clearly observed recently in Kashmir, where long-term violence and social disorder have led to a growing ... Read the rest of this entry »

Binge Drinking in Adults More Prevalent than Thought

A GoodTherapy.org News Summary The associations between young people and binge drinking or the excessive and frequent intake of alcohol are strong and seemingly omnipresent. Through the efforts of marketing officials at major alcoholic beverage companies, youths are often targeted as the ideal customers for beer, liquors, and spirits, and ideas about heavy drinking in college or among young professionals help to bolster the notion that binge drinking is a problem experienced well before middle age. But this focus on the connection between young people and binge drinking may ... Read the rest of this entry »

Dubai Investigates Internal Drug Addictions, Possibilities for Help

A GoodTherapy.org News Summary Dubai has been in continuous and remarkable growth for decades, exemplifying the inspiration and diligence of the region as it improves services and highlights its cultural specialties to its residents and to the world at large. But as with every area of the world, Dubai experiences as considerable drug addiction issue within its native population, and the effort to help residents overcome their addictions and to create a safer and more prosperous society are on the top of the to-do list for many officials and ... Read the rest of this entry »

Study Links Bad Eating Habits with Addictive Behavior

A GoodTherapy.org News Summary For many years, scientists and academicians have worked towards helping to explain the why and how of modern obesity epidemics, both in the United States and in other parts of the world. Recently, a study published in the American Journal of Clinical Nutrition has explored the patterns of thinking about food and eating in relation to behaviors exhibited by those with substance abuse issues, resulting in a significant link between the two. While there ... Read the rest of this entry »

Troubling Mock Therapy Practices Emerging in China

Aversion therapies can be successful in helping people with addictions, who also wish to free themselves from the related behaviors, overcome their difficulties. Such therapies are commonly administered after a more psychodynamic approach is taken; the exploration of the causes of the addiction itself and its role within a person's life is often able to facilitate positive change, but is sometimes ceased in favor of the more invasive and direct approach of aversion. Such therapy is, for the most part, handled with extreme care and is carried out by seasoned ... Read the rest of this entry »

Intervention or, What's a Family to Do?

by Edward W. Wilson, Ph.D., MAC As a family member becomes increasingly alcohol dependent, most families find themselves wishing they knew what to do. Initially we all tend to look the other way and hope that we're wrong, but eventually most of us will start getting angry as the side effects begin to spill over into our lives. Then were also, probably, going to feel guilty about being angry. It is, after all, a disease, isn't it? How can we be mad at someone who is ill? Lewis Thomas, ... Read the rest of this entry »

Alternative and Non-Traditional Alcoholism Treatment

Written by Edward W. Wilson, Ph.D., MAC Non-traditional alcoholism treatment methods have always recognized that 12 Step models work for some individuals but not for most, at least not for very long. The problem is that nothing else seems to either. Designing effective treatment for individuals turns out to be a complicated business that must take into account many variables in ways that don’t easily lend themselves to any particular model. As a result most programs offer little beyond "don’t drink, go to meetings, work your program, and ... Read the rest of this entry »

Can Alcoholics Recover and Drink in Moderation?

Written by Edward W. Wilson, Ph.D., MAC For decades the research, both formal studies and informal observations, has shown that some alcoholics could return to moderate or controlled drinking, and that many do. However, Alcoholics Anonymous and other powerful recovery programs have defined an alcoholic as a person who can never again drink in moderation. This has placed them in the curious position of maintaining that someone who returns to moderate drinking wasn't an alcoholic - not matter how obvious the evidence to the contrary. While their traditional conceptions ... Read the rest of this entry »

Alcohol Abuse, Abstinence, and Moderation - AA and 12 Step Alternatives

Written by Mary Ellen Barnes, Ph.D. No single idea keeps people from seeking help with their alcohol related problems as much as the mistaken belief that alcohol abuse, dependence, and addiction are always the symptoms of an actual "disease" and that there is only one "cure." However, just as everyone knows someone who currently has problems with alcohol, we also know someone whose problems seemed to disappear. How can a supposedly life-long, progressive, and fatal disease simply evaporate and not just occasionally, but often enough for remission to be ... Read the rest of this entry »

Interventions for Chemical Dependency

Written by Lana M. Ackaway, LCSW-R, NCPsyA, CASAC The chief issue with chemical dependency/addiction is that most often an addict believes he/she can use safely. I've never encountered a chemically dependent individual who thinks, feels, says or behaves otherwise. Some never give up on this idea—and as a result, there exists needless deaths—some mentally, some spiritually, and for others, real death. For many, “Intervention” is the only way to save a life. Interventions for substances (alcohol, other drugs and prescription medication) to families and others (employers, ... Read the rest of this entry »

Living with Addiction

Written by Eric Denner, LMFT It can be very difficult to tell if someone has a problem with drugs or alcohol. In the past addiction was defined primarily by physiological measures: tolerance and withdrawal. In the past few decades the definition has expanded to include: - taking the substance in larger amounts or over a longer period than intended - desire or unsuccessful efforts to cut down or control use - a great deal of time spent in activities necessary to obtain, use, or recover from the effects of a ... Read the rest of this entry »

The Dark Side of Prescription Drugs

Written by Patti Geier, CSW "I lost everything when the police raided my house looking for prescription drugs. My husband and two little children were home that night. I was so ashamed I couldn’t even look at them. I was arrested, put in handcuffs and locked up. My husband divorced me. My children were taken away from me. I knew I had hit bottom." Sylvia* is a 44 year-old professional,  former president of a local organization, and a prescription drug addict. An Invisible Epidemic A great deal has been written ... Read the rest of this entry »

Is Your Teen Dying to “Huff?”

Written by Kent Toussaint, MA, LMFT One day, you go into your son’s room and to your surprise, you find that missing can of whipped cream under his bed.  You think to yourself, “That’s odd.” Out of your daughter’s backpack falls the can of paint thinner you used three years ago when you remodeled the kitchen and has since been sitting out in the garage among the other discarded tools and supplies.  You then ponder, “Is she in art class this semester?” If something like this has ... Read the rest of this entry »

The Psychology of Addictions

Written by Marcia Singer, MSW, CHt. "All addictions begin and end with spiritual bankruptcy.” Dr. Kip Flock Years ago, in a bold attempt to release some of my own inner turmoil, I set out to gain a better grasp on the issue of addictions. John Bradshaw’s now legendary work with addiction, family systems and the shamed “inner child” had moved me deeply and sent me scurrying to the first series of codependency workshops for therapists developed by Bradshaw and colleague, Kip Flock, Ph.D. Codependency was the word coined ... Read the rest of this entry »

Risk Factors Refined for Substance Abuse Disorders in Children

A GoodTherapy.org News Headline Substance abuse disorders, including difficulties with the regulation of alcohol intake and retaled behaviors, affect many people at different stages of life, though a significant portion of those who grapple with these issues are in their mid to late years. It may seem inconsistent, then, that a study supported by the University of Pittsburgh School of Medicine has searched for signs of substance abuse risks in children, but the gathered data may serve the primary purpose ... Read the rest of this entry »

Virtual Reality Treatment Shows Promise for Nicotine Addiction

A GoodTherapy.org News Headline The search for effective tools to help people quit smoking has been underway for many decades, with scores of mental health professionals devoting some or all of their careers to assisting clients curb the habit. A study aiming at addressing smoking with the help of virtual reality has recently concluded, with positive findings that may make the technological technique popular for cessation programs. Participants who crushed virtual cigarettes as part of a smoking cessation program showed ... Read the rest of this entry »

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