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Posted by on in Drug Addiction
What is the Addiction Cycle?

 In psychological literature and in the field of professional addiction treatment, there has emerged a term called the ‘addiction cycle’. This cycle can mean different things to various people, and there is no official addiction cycle to serve as a standard. However, all forms of the addiction cycle generally have a few things in common. They involve a stage of abstinence, followed by some emotional or physical trigger, leading to a craving and eventually to addictive alcohol or drug usage. The addicted person may go through this cycle multiple times a day and it is hard to get out of. The viscous cycle of addiction is different for everyone, but one thing is for certain; once the cycle has started, it may take determined action to break free.

The Addiction Cycle Illustrated

 Let me describe the story of Dan and his addiction to anxiety medications. Dan remembers living with mild anxiety since childhood. His anxiety was always a hindrance to his social and romantic life, but never was debilitating. He has a brief history of alcohol abuse and recreational drug use, but has never been chemically addicted. A few years ago Dan saw a doctor who began prescribing sedatives for his anxiety. Dan quickly became both mentally and physically addicted to his medication, believing that without his sedatives he would suffer inexorable panic attacks. His increased tolerance to the pills led to obtaining higher doses of sedatives and getting prescriptions from multiple doctors. Finding himself becoming a slave to the medication, he decides he wants to get off them. He goes a day without the pills and then anxiety begins to creep in. Dan starts to feel tense and uncomfortable and recalls the feeling of ease that the sedatives provide. Eventually he experiences the physical withdrawal creep in from separation from his medication and his body and mind enters a process called craving. These ‘triggers’ cause Dan to take the sedatives to find emotional and physical comfort. After the pills wear off he becomes remorseful and feels guilty about his lack of control. He vows to stay off the medication and the cycle begins again, when the feelings of anxiety reoccur. Dan’s cycle looks something like this:

addictioncycle

Without professional help or some dedicated program to abusing the medications, Dan could stay in this cycle indefinitely. While Dan honestly wants to stop the cycle, the sedatives have him in a seductive hold. The anxiety that initially caused him to seek relief in sedatives has multiplied because of his growing addiction to the medication. Without the pills his anxiety becomes unrelenting and intense, the only perceived relief is in taking the sedatives.

Ending the Addiction Cycle

 The danger and power of the addiction cycle lies in the fact that each action in the cycle leads directly to the next action. Each step leads to the next step and offers no easy way to break out. Detox is often the first step in ending the addictive cycle. A good detox center will ease the person off of the substances to remove the physical craving to return to the addiction cycle. Once this part of the cycle has been broken, the cycle loses its hold over the person. Some helpful detox centers will even help the person begin dealing with their emotional triggers, in this case it would be Dan’s anxiety. Perhaps they teach Dan some natural or non-addictive means to control his anxiety without sedatives, therefore weakening another part of the cycle. However, many people require more intensive work to prevent a return to the addiction cycle. This may include identifying emotional triggers, cravings, creating a support system, and developing a relapse prevention plan. Detox, which usually last between 3-7 days, does not allow enough time to truly begin working on these important recovery tools.

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Posted by on in Alcoholism

Today many people believe that alcoholism and addiction are a disease. I also agree that there is some biological, neural, or genetic influences on whether a person eventually develops a drug or alcohol problem. Regardless of your personal views, alcoholism and addiction are uniquely distinct from other known medical diseases and afflictions. Like most other diseases, there is a physical component of alcoholism. Once a drink is taken, the body demands more. This is called a ‘craving’. However, there is another part to the disease of alcoholism centered around an overwhelming mental obsession for alcohol that occurs even when the alcoholic is not actively drinking. I will explain the difference between these two parts of alcoholism that make up the two-fold disease. While this article primarily discusses alcoholism, the concepts and theories are equally applicable to drug addictions.

The Phenomena of Craving

When an alcoholic takes a drink, their brain processes it differently than a non-alcoholic. Research suggests that the reason for this lies in the dopamine reward pathways, since alcohol releases dopamine. Without going too much into the science of the disease model of addiction, I will briefly explain how and why craving occurs. Because alcohol, like eating, hydrating, and sex, releases dopamine, our body recognizes it as a positive experience and this inspires us to repeat such acts. However, alcohol is literally toxic to our bodies, which explains why too much booze causes nausea, vomiting, and hangovers. Non-alcoholics experience these negative effects of drinking and it deters them from pursuing the dopamine release from drinking. In the body of an alcoholic the act of drinking becomes wrongly identified as a necessary activity for survival. Something in the brain of an addicted person attaches a need so powerful for alcohol that it overrules the negative consequences that deter non-alcoholics. Essentially the alcoholic brain tricks itself into thinking it needs alcohol, like food and water, to survive. This also explains why the alcoholic is unable to limit their drinking to just a few drinks. Their brain is receiving the positive signal produced by alcohol and the brain responds by craving more and more. The phenomena of craving occur when alcohol is introduced into the body, however the second part of alcoholism, the mental obsession, happens without any introduction of alcohol.

Uncovering the Mental Obsession

Many alcoholics in the first month of sobriety report a strong obsession to drink. Perhaps they go by an old bar or see a beer commercial on t.v. This tendency to constantly think about and desire alcohol is known as the mental obsession. It is different from craving because the mental obsession is not influenced by the presence of alcohol in the body. The mental obsession, if no changes occur, makes abstinence from alcohol unbearable to the alcoholic and often leads to a relapse. So why, even after detox, does the alcoholic brain obsess over alcohol?alcohol_and_TBI_iStock_000015394252XSmallResearchers into addiction science propose that the brain stores the experience of drinking in a special part of short and long term memory. The alcoholic brain processes and labels alcohol as high priority memory, like memories of eating and sex. Again this is rooted in the biology of human survival, since these memories are stored differently because they ensure our reproduction and health. With the alcoholic the brain incorrectly groups drinking alcohol into this important section of memories. This explains that when the alcoholic stops drinking, their brain still obsesses and demands alcohol.

 

Alcoholics, in my opinion, suffer from a two-fold disease. One-side, the craving, is a psycho-biological (aka physical) reaction to alcohol. The other side, the mental obsession, centers in the mind of the alcoholic. Both of these components explain that when an alcoholic tries to just quit drinking their chances of success are low. It requires a strong and committed recovery plan to overcome both the physical craving of alcohol and the mental obsession. Drastic measures often have to be taken to achieve long-term sobriety. These measures can include 12-step groups, recovery groups, therapy, spirituality, meditation, and others. Many people need some kind of in-patient or out-patient treatment services, like those offered at NewBridge Recovery. Patients at NewBridge benefit from medical assistance therapy, help building a recovery plan, and both group and individual therapy. 

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Posted by on in Alcoholism

When I first came into recovery I used to get frightened by other abstinent  alcoholics proclaim that they were so glad they did not get the “wet tongue” when they saw alcohol or people drinking alcohol.  I used to feel ashamed as I did have an instantaneous “wet tongue” or mild salivation (Pavlovian response) and still do  years later when I see people drinking alcohol. Is this a “craving” for alcohol, do I still want to drink? Do I still have an “alcoholic mind?“. Did I do my steps properly?

It used to churn me up, these so-called alcoholics who had no physiological response to alcohol-related “cues”.

Part me also thought it was linked to addiction severity, how bad or chronic one’s alcoholism become, how far down the line or how low your rock bottom was? There may some validity in that observation.

It was partly because of mixed messages from alcoholics and from various medical doctors that I decided to take matters into my own hands and do some research into my alcoholic brain.

What I have discovered is that I have an “alcoholic brain” and not a “alcoholic mind” and there is a huge difference.

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Posted by on in Food Addiction

It happens far too often.  You read about some celebrity who has a new diet that is guaranteed to help you shed those pounds.  Or you talk to a friend who has lost a ton of weight by following a new plan.  You even hear the experts describe it not as a diet, but as a new way of life.  So you go on it.  Then the inevitable happens: you get bored, you get stuck, you cheat a little and then the cravings hit.  The next thing you know it’s a slip then a relapse.  Your choice is to try again, or head off to the next diet.  Atkins. South Beach.  Body for Life.  Paleo.  Is it going to work? In fact, research shows that dieting actually increases cravings.

What if the problem isn’t what you eat, but what you do when you are not eating?  For most people that’s exactly the issue: the problem is cravings.  Cravings are why you switched from one plan to another; cravings are why you feel you need to “cheat.”  And cravings will come no matter what diet or “way of life” you choose.

So instead of, yet again, changing what you eat, why not change you, by changing what you do when you’re not eating?  Here a 5 suggestions that will help you do just that and get those pesky cravings under control.

Write it down

“Wait… you want me to write down every single thing I eat or drink?”  Absolutely. Keeping a food diary greatly improves your chance of success.  Food diary users are more likely to lose weight, less likely to crave and more likely to stick to their plans.  If writing down your meals is too cumbersome, a number of smartphone apps like LoseIt! and MyFitnessPal make logging a snap, and even allow you to scan the barcodes of foods to automatically enter their nutritional information.  If you have issues with orthorexia, this may require some special modification/attention, but most people who struggle should take inventory. Many food diary users, however, will log their meals for a while and then stop, which leads to the next suggestion:

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Posted by on in Food Addiction

Over the last several years, nearly every new diet on the scene has addressed cravings by suggesting “cheat meals.”   Usually the hack formula goes something like this:

All the other diets you have tried have been wrong because they didn’t pay attention to the problem with food X.  Food X and those like it are a major problem.  You need to stop eating them.  Here is a plan to do that and some recipes to show you that eating without food X is possible and even enjoyable. This is not a diet; it’s a way of life. Here are a bunch of people who have successfully lost weight on this plan.  Oh and by the way, because the cravings will be intense, you should give yourself a break and cheat every once in a while.    Of course, one major problem with these diets is that they don’t adequately address the more important issue:  craving.  In fact, research shows that dieting actually increases cravings.

However, another even more important reason these diets fail is that they never really address what is really core to the weight gain, dieting, weight loss cycle:  shame.  Shame drives the cravings bus.  Shame is why you gain the weight back every time.  Shame is what tricks you into thinking you “deserve” that piece of chocolate cake.  Shame tells you that deserve to cheat every once in a while.  For most people on the roller-coaster of dieting and weight gain, the diet they are really on is the shame diet.  And they are bingeing and purging shame in a vicious cycle that no diet will ever adequately address.

Rather than a cheat meal, want to know what you really deserve?  (Hint: it’s not some deep awareness about the toxic effects of wheat or gluten).  It’s self-love, acceptance, peace, a sense of purpose, and connectedness. Shame destroys all of these basic human needs by tricking you into thinking that you deserve something that actually hurts you.  Just think about it: does it really make sense that either cheating or dieting could be a solution for shame?

Leaving aside the issue of dieting…could it ever make sense that a new way of eating could solve the shame problem?  And if you’re doing the cheating, who exactly is being cheated?

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