"Every form of addiction is bad, no matter whether the narcotic be alcohol, morphine or idealism." -- C.G. Jung
"When you can stop you don't want to, and when you want to stop, you can't..." -- Luke Davies
The concept of addiction has evolved from its ancient roots in alcohol and drug dependencies to what now has been aptly called "... self-induced changes in neurotransmission that result in problem behavior." (Milkman, H.) What continues to astound so many is that these ruinous, compulsive behaviors persist despite their obvious -- at least to others -- painful consequences. Quite amazingly, the addict in the throes of addiction may be most blind of all to the losses he or she incurs in love, health, work and everyday life -- that is, until recovery begins.
Because there is magic in naming, old habits can die hard about what we call an addiction. "And Rumpelstiltsken was his name..." said the imprisoned queen, and by uttering his name she freed herself and her child and destroyed that greedy creature. Even great wizards and witches of Harry Potter fame trembled at the name of Voldemort! Addiction too is a name (and thus a concept) with great power and one that needs changing: It is time for its updating. Addiction is more than alcohol and drugs. Addiction is a complex phenomenon with expression in a multitude of compulsive behaviors. Addiction is also the end point of the convergence of a ménage of brain, behavior and social forces. Addiction today needs to be considered anew, and so should be its remedies.
The director of the National Institute on Drug Abuse, Dr. Nora Volkow, writes that there is good evidence for non-substance-induced addictions. Dr. Volkow wrote the brain is:
"... composed of a finite number of circuits for ... rewarding desirable experiences ... So it is almost by necessity that we'll find significant overlaps in the circuits that mediate various forms of compulsive behaviors. We have yet to work out the details and the all important differences, but it stands to reason that there will be many manifestations of what we can call diseases of addiction. Thus, addiction to sex, gambling, alcohol, illicit drugs, shopping, video games, etc. all result from some degree of dysfunction in the ability of the brain to properly process what is salient, accurately predict and value reward, and inhibit emotional reactivity or deleterious behavior."
Dr. Volkow was speaking to the ubiquitous presence of compulsive behaviors that we see all around us. She was talking about the pleasures that compel so many of us to act in ways we know are destructive to our lives (and to those we love) yet which we cannot seem to resist. We witness these unbridled behaviors in gambling, sexual promiscuity and porn, overeating, drug and alcohol abuse, "shop til you drop" and video games, to name a few.
Recovery from addiction traditionally has been the domain of 12-step programs, dating back to Dr. Bob and AA. More recently, recovery has been aided by a variety of Western medications that diminish craving and reduce painful withdrawal symptoms and thereby help control drug and alcohol abuse. The first one used on a large scale was methadone; more recently, doctors are using buprenorphine and naltraxone. But as we learn more about the brain and its reward centers, new methods of controlling addictive behaviors are emerging.
In this series we will consider a variety of interventions beyond 12-step and medications. We will examine alternative and non-conventional recovery paths for people with compulsive and addictive behaviors. These have been called "complementary and alternative medicine" (CAM) -- but the term "medicine" seems too narrow, and we will go beyond medicine but not beyond what evidence and experience suggests can be helpful.
Addiction is a dark life, full of misery for the addict and all who love and support him or her. For those scores of millions of Americans and hundreds of millions of individuals world-wide who suffer the consequences of unchecked compulsive behaviors, there is hope; there are alternatives.
Life need not continue to be dark: "One must wait until the evening to see how splendid the day has been." (Sophocles) By reviewing a variety of approaches to addiction beyond 12-step and Western conventional medications, we hope to offer readers prospects for changing how their day shall end.
We want to invite your thoughts and comments about addictions. We want to bring your voice to the debate about what interventions work based on what you have seen effective. We also want to hear from you about what does not work, what snake oils might be out there luring people in trouble away from what might indeed be helpful to them.
Submit your thoughts in the comments section below. Some questions to get you started:
1. Do you think addiction is a disease?
2. Is addiction only about alcohol and drugs?
3. Have you heard about Complementary and Alternative Medicine (e.g., acupuncture, yoga, homeopathy, supplements) approaches to addiction?
4. Do you think nutrition plays a role in recovery from addictions?
Let's talk about addiction and its solutions.
Lloyd I. Sederer, M.D.
Medical Editor for Mental Health, The Huffington Post
The opinions expressed here are solely mine as a psychiatrist and public health advocate. I receive no support from any pharmaceutical or device company.
Visit Dr. Sederer's website (www.askdrlloyd.com) for questions you want answered, reviews, commentary and stories.
Yes, a bad habit can be a range of things, from IV drug user at one end, to someone burying themselves in romance novels or work at the other. Again, what are you escaping from and why? In that answer, lies your freedom.
"Under the Smoke-free Environments (Controls and Enforcement) Amendment Act 2011, sellers of tobacco will need to ensure that tobacco products are not visible to the public, either inside or outside their premises, except to the extent necessary to make a sale or receive new stock. Failure to comply with the new law is liable to a fine of up to $10,000.
“The Government is committed to achieving a smokefree New Zealand by 2025 - and removing tobacco from public view is another important step in reaching this goal,” says Associate Minister of Health Hon Tariana Turia.
2. No. But alcohol and some drugs can be physically addictive, meaning that the body will cry out for the addictive substance to get back to the state it’s used to, even when the person afflicted can be genuinely determined to quit. This is why some people will need medically-supervised detox to cope with the physical withdrawal symptoms before they can concentrate on staying quit in the longer term.
3. Yes. But none of these things teach people about the nature of addiction and how to deal with it.
4. Of course. Staying healthy is hugely important for mental well-being too. Good nutrition is a vital part of that.
Finally: " We also want to hear from you about what does not work, what snake oils might be out there luring people in trouble away from what might indeed be helpful to them."
I would include the 12-step program in this category.
Recovery Coaching has already had some impact in the US and is now being recognised in the UK as an important aid to recovery. I use Coaching with my clients along with Dialectical Behaviour Therapy techniques and NLP, in order to break old thinking patterns and establish new, healthier ones so people can move on with their lives.
I experienced the hell of stopping drinking without working on my thinking, which is why, once I'd 'got' recovery (the second time around), I set up my own service to help others. No-one wants to be white-knuckling it in their recovery - recovery is all about freedom - or it should be.
Whether through coaching or other methods, working on your thinking is vital to getting and staying sober - and being happy about it!
a comprehensive insight into both the causes and solutions of physical, mental and spiritual imbalances traditionally thought to be at the heart of addictions from the ancient Vedic and Ayurvedic wisdom traditions. YoR would be invaluable for anyone with working knowledge of the 12 steps, as well as those who come interested in yoga for the purpose of wellness. Ryan G MS, mental health advocate for Cornell University, the Social Security Administration, NYS OMH, NY APRS, NYS Psychiatric Institute of Mental Health, state board and Advisory Councils for NYSOMA Recovery Center initiate to introduce holistic wellness to individuals at the highest levels of psychiatric care.
This course was a gift! This insight and knowledge are enlightening. I now have a better understanding of Ayurveda which I plan to incorporate in my life on a daily basis. This course is first rate, A+ Thank you! Lynda F, age 56. yoga instructor 1 year. NA 23 years
I would strongly recommend this course to anyone with any association with people in recovery. Recognizing oneself and loved ones (or even coworkers) in the Doshas is quite liberating. The course is practical, entertaining and inspiring, a valuable way to go more deeply in to yoga and recovery. Lynn F, AA Yoga teacher
Besides drugs, alcohol, gambling, sex and binge eating, there are many with more socially acceptable addictions like workaholism, exercise, video games, etc. There are many ways to 'zone out' and not be present and available to your loved ones and community, and what they have in common is an increasing isolation and defensiveness about whatever the 'mood altering' substance or behavior is.
Gabor Mate has done some great work on this topic too (his book "In the Realm of Hungry Ghosts" is great).
The point is that its not just the individual we need to look at, but what is going on in the larger community, what is not working for so many, that so many of feel the need to escape and /or numb out.
2. Is addiction only about alcohol and drugs? NO. I've been using potato chips and reading to deal with rejection and abandonment issues since I was 9. That's 53 years now.
3. Have you heard about Complementary and Alternative Medicine (e.g., acupuncture, yoga, homeopathy, supplements) approaches to addiction? Yes. I knew an alcoholic who got drunk because of the alcohol in the homeopathic stuff he was taking.
4. Do you think nutrition plays a role in recovery from addictions? Bill Wilson thought niacin might be a cure for addiction, sort of like Pauling and Vitamin C.The availability of nutrition won't help, because like the rats with the cocaine, given the choice, the addict will go for the drug every time
Myself; Recovering alcoholic/addict/smoker Clean and sober from alcohol and drugs just over 26 years. Smoke free coming up on 21.
http://islandforgedh.com
I agree anyone who is in recovery and staying clean & / sober (whichever their addiction is) is being very strong.
congratulations on your long sobriety
For an alcoholic, temptation is everywhere. Do you stop going to the supermarket because it sells alcohol? For me, temptation is not about the proximity of the alcohol--it's about how I feel because that's why I drank and used--to not feel. I can be in a bar with my friends, having a great time, and not feel tempted to drink. And I can be sitting at home, feeling inundated with emotion, and seized with the need to drink, to the point of giving my car keys to my husband so I don't go seek it out.