Addiction Thinking
How someone can rationalize repeatedly using intoxicants, aware of the possible deadly consequences or incessantly engage in behavior (sexual, gambling, DUI, etc.) that places everything in their life at risk, to the rational individual, is truly baffling. Those addicted to Heroin will lament how they “hate” kicking (detoxing), never wanting to do it again since the experience is so unbearable and painful (think of the worst case of the flu with severe body aches you have ever had and multiply by 2 or more and you have a rough approximation of the experience) but when asked how many times they have detoxed, the answer, typically, is “I don’t know, too many.” Being fully aware of the consequences, would someone rational purposely subject themselves to an experience they “hate” repeatedly, say like volunteering for a needless root canal or IRS audit? Let alone something potentially deadly? Of course not, that would be irrational.
Yet this is the mindset of individuals who suffer from addiction. Repeating the same action expecting a different result demonstrates a base form of insanity. Yes, it is strong language but how else would you describe someone who after being repeatedly arrested for driving under the influence, incurring large financial and personal consequences, continues to drink and drive? The Opioid addict who was literally just brought back to life by a timely dose of NARCAN ® (Naloxone HCl), their first action to make sure no one used the rest of their drugs or if they came to in a hospital take the first opportunity to leave AMA (Against Medical Advice) to return to using the same drug which put them there in the first place! Or the individual who completes a professional treatment program, frequently costing over 100,000 dollars, after a 90 day (depending on their insurance) stay relapses often within days after “graduating.” From experience, having worked with thousands of individuals over the past 35+ years both as someone in recovery and a recovery professional, the above examples are unfortunately typical.
When you change the way you look at things, the things you look at change. Education, though important, has proven not to be the overriding answer, while CBT(Cognitive Behavioral Therapy), DBT(Dialectical Behavior Therapy), EMDR(Eye Movement Desensitization and Reprocessing) are effective professional treatment modalities along with Psychotherapy, as currently employed have all largely failed, principally because they are not scalable, i.e. Healthcare Providers do not cover these modalities beyond the end of the professional treatment cycle. Another contributing factor is the gulf existing between the professional treatment community and the outside recovery communities of AA, NA, etc. Due to built-in limitations and restrictions inherent in both, as well as some cooked in institutional prejudice coupled with a culture-based unwillingness to change or adapt, strikingly prevalent in the outside recovery communities, no genuine path exists to bridge between them. While the professional community’s hands are tied due to the constraints of Insurance Providers and HIPPA (Health Insurance Portability and Accountability Act) guidelines, many in the outside recovery communities remain fixated on a single path, disparaging other paths or modalities often making individuals who come to the Fellowships from professional treatment feel unwelcome, running truly contrary to the dictum all should hold dear: “first, do no harm.” Mix in the brokers and treatment centers on the professional side whose only interests are financial, with little or no regard for suffers or recovery, tainting all in the professional sector, providing fodder for the negative narrative in the outside recovery communities and the reasons for today’s abysmal long-term recovery rate (20% according to the National Institute on Drug Abuse, though many believe it closer to 10%) and the high chronic relapse rate comes into focus.
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