Addictionland - Addiction Recover Blog
As you or a loved one decide enough is enough and it is time to recover from an addiction, the first step will likely include a detoxification from the substance. The withdrawal and detox process can be painful, difficult, and even intimidating to navigate. One option to consider is medical detoxification, which involves safely helping an individual withdraw from a substance with the help of appropriate medication, under medical supervision. As you consider this option, take the time to educate yourself on what medical detox involves and how to find the right treatment center for your particular situation.
Detoxification is the removal of chemicals from the body, in this case a drug or alcohol. Medical detoxification is performed with the help of a medical professional and involves using medication to assist with the withdrawal process. The goal is to help the person eliminate any medical risks caused by no longer using the substance.
Withdrawal and detoxification are difficult and are often accompanied with the following symptoms:
The duration and length of withdrawal symptoms varies and depends on the length and severity of the addiction, the individual’s physical and mental health, and other factors that may be unique to the individual. When faced on their own, these symptoms can develop into more dangerous complications such as hallucinations, convulsions, heart problems, seizures, insomnia, intense cravings, and anxiety. These can cause the individual to forego recovery, relapse into their addictive habits, and overdose. This process can even lead to death. This makes proper medical detoxification that much more important to provide the best potential for recovery....
The problem of dual diagnosis & diseases of addiction have a comorbidity rate of 53% and climbing each year. One newer study suggests the rate of this comorbidity of both illnesses is actually closer to 2/3rds of people with depression who also have substance abuse/addiction problems. The connection between those who have addiction and are depressed is so strong and an unavoidable problem when it comes to treatment, that people are quick to believe and perceive that it is the addiction which is causing the depression. The newest evidence has shown that quite the opposite happens in many instances. It's like the old what came fist the chicken or the egg theory; And with addiction & depression/mental illness, it is not that simple a question to answer, but there are some answers that help doctors every day to diagnose and decide which is the primary illness and which is the secondary or if they co-exist.
There are 3 types of groups which are studied under the Mental Health & Drug Abuse Coalition. The 1st, is people who have depression or other mental illness, may seek help but find what they are given is not working, so they begin to experiment with other ways to alleviate their symptoms, such as alcohol and drugs, leading quickly to an addiction once the patient feels the substance has "cured" their symptoms. It is the very well-known phrase of "self-medicating" which was actually a term and theory first coined by a few doctors which included the author of many books on the subject of "self-medicating" with opiates, alcohol, cocaine & other drugs, Doctor Edward Khantzian, a psychiatrist from Haverhill Massachusetts, and a Clinical Professor of Psychiatry at Harvard University, who first published this hypothesis of self-medicating with heroin for depression in a 1985 paper, which expanded until it was accepted as a true theory and still used today to explain diagnosis & treatment. In this case it is shown that a person had an onset FIRST of mental illness, and then the drug addiction came next.
The 2nd group is those who are people who are chronic drug abusers, ie: addicts. They use their drug of choice daily and over time, they begin to develop mental illness symptoms, causing them to then increase their use and making it very difficult to stop. This group of people are difficult to convince to access treatment or professional help, because they are usually so afraid of trying to seek treatment for the depression, for the sole purpose of being scared that their addiction will be be discovered. Certain drugs, almost all of them, including ecstasy, alcohol, opiates, methamphetamine, cocaine & more, have been shown in advanced clinical research, including brain scans of addicts, with results showing that their drug use has directly caused malfunctions in major centers of the brain where a person's impulse control, emotion regularity, reasoning, cognitive ability and many more areas are damaged by the chronic drug use. So this group usually begins with trying different illicit or pharmaceutical drugs. finding one they like, and after chronic, daily use, their brains are actually being damaged on many levels, in many areas by the very drug they use. So first the drug addiction starts, and then sets in the mental illness symptoms, like depression & anxiety, bipolar and many others.
The 3rd group of people are those who have co-occurring conditions that are ongoing and increase in severity. The drugs do not alleviate the depression, anxiety, or other mental illness symptoms quite well enough to consider themselves in good mental health, but the substance abuse has already caused further damage to their brains in many areas, making it that they are the hardest group of patients to treat. They are however, the people who are most likely TO seek treatment for both illnesses, knowing very well they both exist at all times and are aware of it daily. The usually might begin by asserting or believing that their depression, low mood, anxiety, panic attacks, loneliness, bouts of crying for no apparent reason, mania, hypomania, isolation, etc are all directly the result of being forced to stop their drug of choice or attempt to stop on their own. They attribute these mental and mood changes to withdrawal, but they aren't; in fact it is that they DO now have a very clear diagnosable mental illness caused by the changes in their brains from the chronic drug use and since they have stopped using these drugs, the symptoms are now more present and bothersome than ever before. So this group already had mental illness but was made much worse by chronic long-term drug use.
When patients with dual-diagnosis are treated they have a fairly good rate of recovery IF they adhere to taking medications and make serious changes in their lifestyles. When you have such chronic drug abuse and depression it is hard for doctors to decipher which symptoms are causing the other so dual diagnosis treatment first is used to detoxify the patient from the drugs and stabilize them so they are not in pain. Once this is done they can begin to introduce therapeutic programs as well as medications for bipolar, depression, anxiety or any other mental illness, as is indicated. They are monitored closely throughout every 24 hour period, their vitals checked for stability, dosages changed daily if that needs to be done, and the patient upon release is given very specific and easy to follow directions for returning home. This typically includes an intake for an intensive outpatient program (IOP), meeting schedules, individual therapy set-up, follow up appointments with doctors and if needed, an appointment with a clinic for continued use of subutex or suboxone....
A lot of times in twelve step fellowships, heavy drinkers, heavy drug users end up in the fellowships because of an intervention of one kind or another; or maybe they just want to change their life and somebody has pointed them toward the rooms and they’ll show up. They don’t necessarily have to work the steps the way an alcoholic does. They don’t necessarily have to become consistent with meetings. A lot of times what will happen is they’ll come around for awhile and then slowly back away - disappear and learn that they can stay stopped on their own willpower, or they can even moderate, that happens quite often. That’s Type One.
“Type Two…your husband is showing a lack of control, for he is unable to stay on the water wagon, even when he wants to. He often gets entirely out of hand when drinking. He admits this is true but is positive that he will do better. He has begun to try, with or without your cooperation, various means of moderating or staying dry. Maybe he is beginning to lose his friends. His business may suffer somewhat. He is worried at times and is becoming aware that he cannot drink like other people. He sometimes drinks in the morning and through the day also to hold his nervousness in check. He is remorseful after serious drinking bouts and tells you he wants to stop but when he gets over the spree, he begins to drink once more. He begins to think once more that he can drink moderately next time. We think this person is in danger. These are the earmarks of the real alcoholic. Perhaps he can still tend to business fairly well. He has by no means ruined everything. As we say among ourselves, he wants to want to stop.” This is probably the majority of the people that show up in the twelve step fellowships, they are somewhere between a type one and a type two. But let’s just look at the type two. He’s showing a lack of control. He can’t quit even when he wants to. After a binge, he’ll come out of it and he’ll want to stop but then he’ll convince himself that he’s going to drink moderately next time and he’ll start drinking again. Sometimes he drinks in the morning and throughout the day to hold his nervousness in check. That nervousness is an actual detoxification from alcohol. That high level of anxiety is actually a part of a detoxing process.
Okay, Type Three. “This husband has gone much further than husband number two. Though once like number two, he became worse. His friends have slipped away. His home is in a near wreck and he cannot hold a position. Maybe the doctor has been called in and a weary round of sanitariums and hospitals…” or rehabs and detoxes…”has begun. He admits he cannot drink like other people but he does not see why. He clings to the notion that he will yet find a way to do so. He may have come to the point where he desperately wants to stop but cannot. His case presents additional questions which we will try to answer for you. You can be quite hopeful of a situation like this.”
Now why are they saying that? As the person gets worse, why are they saying you can be hopeful? I believe it’s because the closer we get to a full concession of our powerlessness, the closer we as alcoholics get to accurately assessing how much trouble we’re in, the more enthusiasm and motivation we’re going to have for practicing a recovery program that nobody wants to practice and few people will even believe will work for them because they’re so different. So again, his friends have slipped away…that happened to me. I didn’t have any friends any more. My home was in a near wreck. My home exploded and everybody left. Could not hold a position, I was becoming unemployable. The only reason I had a job was because I was in construction and there was lots of alcoholics in construction, including my boss. I started the weary round of sanitariums and hospitals. I had gone to outpatient. I had gone to in-patient. I had gone back to outpatient. I was trying to show up at some support group meetings but somewhere in the back of my mind, it was very, very difficult for me to realize that I am going to have to quit drinking for good and for all. That was a very, very difficult concept for me to come up with and I had all of the earmarks of the type three.
“Type Four…you may have a husband of whom you completely despair. He has been placed in one institution after another. He is violent or appears definitely insane when drunk. Sometimes he drinks on the way home from the hospital.” Or home from the detox or home from the rehab. “Perhaps he has had delirium tremens.” I had those. “Doctors may shake their heads and advise you to have him committed. Maybe you have already been obliged to put him away. This picture may not be as dark as it looks. Many of our husbands were just as far gone, yet they got well.” Okay so, the worse you became, the more hope these early Alcoholics Anonymous members have for you....