Wednesday, January 5, 2011

addiction



Honestly,

I dislike the superficial game I'm playing, this superficial phony game.
I'd really like to be genuine and spontaneous and me ~ but you've got to help me.
You've got to hold out your hand, even when that's the last thing I seem to want or need.
Only you can wipe away from my eyes this blank stare of the breathing dead.
Only you can call me into aliveness.

Each time you're kind and gentle and encouraging, each time you try to understand because you really care, my heart begins to grow wings, very small wings, very feeble wings, but wings.
With your sensitivity and sympathy and your power of understanding, you can breathe life into me, I want you to know that. 
I want you to know how important you are to me, how you can be a creator of the person that is me if you choose.
Please choose to.
You alone can break down the wall behind which I tremble.  You alone can remove my mask.  You alone can release me for my shadow world of panic and uncertainty from my lonely prison.
So do not pass me by.

It will not be easy for you.
A long conviction of worthlessness builds strong walls.
The nearer you approach to me, the blinder I may strike back.
It's irrational.  But despite what the books say about man, I am irrational.
I fight against the very things I cry for.
But I am told that love is stronger than strong walls.
In this lies my hope.
Please try to beat down these walls with firm hands, but with gentle hands for a child is very sensitive.

Who am I, you may wonder.
I am someone you know very well.
I am every man you meet.
I am every woman you meet.

"A core concept evolving with scientific advances over the past decade is that drug addiction is a brain disease that develops over time as a result of the initially voluntary behavior of using drugs." Alan I. Leshner, Ph.D, Director of the National Institute on Drug Abuse

The American Medical Association has recognized chemical dependence as a disease since 1956.  The diagnosis of dependence is evidenced by either tolerance or withdrawal. There is also impairment in social or occupational functioning.  Tolerance is when markedly increased amounts of the substance are required to achieve desired effect or there is a markedly diminished effect with regular use of the same dose.  Withdrawal is a substance-specific syndrome following cessation of or reduction in intake of a substance that was previously regularly used.  Classes of substances associated both with dependence and abuse include alcohol, barbiturates and similarly acting sedatives or hypnotics, opiods, amphetimines and cannibis.  A person must meet three or more of the following criteria to be diagnosed as dependent:

Repeated effort or persistent desire to cut down or control substance use

Often intoxicated or impaired by substance use when expected to fulfill social or occupational obligations

Frequent preoccupation with seeking or taking the substance

Has given up social, occupational or recreational activities in order to seek or take the substance

Takes the substance as a means to avoid experiencing withdrawal intended

Continuation of substance use despite a physical or mental disorder or a significant social or legal problem that the person knows is exacerbated by the use of the substance

Chemical dependence: the disease of addiction is a primary disease.  No other diseases or illnesses cause addictions; however, addiction is the cause of of many other diseases, i.e. lung disease, heart disease and cancers.  It is progressive.  The issue only gets worse with time.  The use increases in frequence, duration and amounts.  The individual finds himself progressively having more problems and feeling more out of control.  It is chronic.  There is no ultimate cure for it.  This is a disease that can be managed and maintained, similar to diabetes.  It is fatal.  Death occurs through accidents, violence, overdose and physical deterioration.

With addicts, the choice is gone.

Addiction = Chaos

"Almost all drugs that change the way the brain works do so by affecting chemical neuro-transmission.  National Institute on Drug Abuse:  The Science Behind Drug Abuse

Every thought, emotion or action one experiences involves the nervous system.  This system includes the brain, spinal cord and nerves that extend throughout the body.  To regulate thinking, feeling and action, the brain has to be more complex and flexible than any computer developed.  The brain accomplishes its multiple tasks through the use of electrical charges and chemicals.  Neurotransmitters are one of the main chemicals that the brain utilizes.  The end result of the brain's use of these electrical impulses and chemicals are new responses from glands, organs and muscles.  This also results in changes in emotions and behavior.  Main neurotransmitters involved in the changes that the brain experiences with substance dependence include dopamine ~ serotonin ~ endorphins.

The main areas of the brain that are affected by neurotransmitters include the mesolimbic system, which is involved in the ability to feel pleasure.  The use of substances can have the effect of intense feelings of pleasure.  The hypothalamus controls survival in humans and other animals.  Behaviors that are regulated include eating, drinking and sexual activity.  The medial forebrain bundle is a nerve pathway.  If this bundle is stimulated by an electrical charge of chemicals, one feels intense pleasure or euphoria.  This is the type of stimulation produced by mind-altering drugs.  Repeated exposure or stimulation of this pathway creates a compulsive need/want, which is thought to be a part of the compulsion that people with chemical dependence experience, making abstaining a difficult behavioral change. 

The brain modifies connections in response to experience.  When a person learns something or has a new experience, new synapses may form.  When a person takes drugs repeatedly, the brain changes in response to this experience.  He will crave the drug.  Tolerance is when the brain has adapted to having a certain amount of drug present and does not respond the same way it did initially.  That is why drug abusers and addicts take increasingly higher amounts of an abused drug. One of the most dramatic long-term effects of a drug is killing neurons.  Alcohol kills brain cells.  Amphetamines kill neurons that produce serotonin, a neurotransmitter that regulates appetite, sleep, emotions and so on.   Cocaine changes the brain in ways that may last for a long time.  Two years after the last use PET images show that the drug abuser's brain is less active.

Scientists don't know all of the effects that a drug may have.  The brain is such a complicated organ.  Individuals may respond differently to drugs due to genetic differences.  Many drug abusers abuse more than one drug and the combination makes it difficult to determine what the effect of one drug alone may be.  Drug addicts often suffer from mental illnesses, such as depression.  The changes that occur in the brain because of mental illness make it difficult to determine what changes the drugs have caused.  Someday scientists will answer questions about what happens in the brain to cause additiction, which will then help them understand how to prevent addiction.

Addict in the Family

For almost every addict who is mired in this terrible disease, others ~ a mother or father, a child or spouse, an aunt or uncle or grandparent, a brother or sister ~ are suffering, too.

In the words of Beverly Conyers, author of Addict in the Family, "Addiction to alcohol or other drugs plunges its victims into lives of poverty, homelessness, crime and jail.  It stunts emotional and spiritual growth and ravages mental and physical health.  Indeed, the consequences of the disease of addiction ~ and most mental health professionals agree that it is a disease ~ are as potentially devastating as those of most other illnesses."

The impact of addiction does not end there.  Families are the hidden victims of addiction, enduring enormous levels of stress and pain.  They suffer sleepless nights, deep anxiety and physical exhaustion brought on by worry and depression.  They lie awake for hours on end as fear for their loved one's safety crowds out any possibility of sleep.  They live each day with a weight inside that drags them down.  Unable to laugh or smile, they are sometimes filled with bottled-up anger or a constant sadness that keeps them on the verge of tears.

Despite their suffering, families of addicts seldom receive the kind of support commonly extended to families of, say, cancer patients or stroke victims.  Instead, they conceal their pain in the face of the all-too-common beliefs that addicts have only themselves to blame for their troubles, that addicts could cure themselves if they really wanted to and that addicts' families probably did something wrong to cause the problem in the first place.  Many families of addicts share these views, which only adds to their unhappiness.

Ms. Conyers goes on to say "It is normal to want to help those we love, especially when they are faced with a crippling condition such as addiction.  However, the burden of guilt, the sense that we have somehow caused the addiction, can intensify our resolve to cure the addict, spurring us on to sometimes unhealthy and even counterproductive levels of involvement in the addict's life.  Parents, especially, look back on all the regrettable but inevitable mistakes of parenthood and feel a heavy sense of responsibility."

Even if families recognize that they did not cause the addiction, most feel a desire, or even an obligation, to do everything possible to help their loved one.  As families assume more of the burden of addiction, they may spend enormous amounts of time and money in their attempts to get their loved one off alcohol or other drugs. Often, the harder they try, the more the addict resists their efforts. 

The truth most families eventually discover is that no one can cure another person's addiction.  Only addicts can do that for themselves.

Does this mean that families have no role to play in the miraculous process of recovery?  On the contrary, families can have a powerful impact on their addict's struggle for recovery.  Studies have shown time and again that addicts who feel connected to a family that supports their recovery (even if that family is just one person) have a better chance of staying clean than those who believe that no one cares. 

However, there is a catch.  The families themselves must be healthy if they hope to have a positive influence on their loved one...families must arm themselves with as much knowledge about addiction as possible.  They must understand what they can do to support the recovery process and learn successful strategies for coping with addictive behaviors.  They must recognize common mistakes that may actually prolong addiction and avoid getting trapped in unhealthy patterns.  Perhaps most important, they must reaffirm the value of their own lives and focus on their own peace of mind ~ regardless of what their addicted loved one does.

National Addiction Hotline
866-301-0367
If you or a loved one needs help to conquer addiction, call a hotline immediately, or contact your physician.  There is help and support available through a variety of sources, just seek and you shall find, ask and you shall receive, knock and the door will be open. xo