Aug 23

Addiction in Your Family: Three Helpful Books

When addiction is in your family or among other loved ones it’s challenging to apply the concept of detachment, involving taking care of oneself while trying to remain connected. (See previous post “Detach With Love”: The Why, The How, The Meaning).

Featured below are additional quotes from best-selling books about dealing with others’ addiction.

I. Clean: Overcoming Addiction and Ending America’s Greatest Tragedy (2013) by David Sheff   

Addiction medicine isn’t an exact science, and it’s still a relatively new one.

Once and for all, people must understand that addiction is a disease. It’s critical if we’re going to effectively prevent and treat addiction. Accepting that addiction is an illness will transform our approach to public policy, research, insurance, and criminality; it will change how we feel about addicts, and how they feel about themselves. There’s another essential reason why we must understand that addiction is an illness and not just bad behavior: We punish bad behavior. We treat illness.

The main problems with America’s addiction-treatment system stem from its roots in the archaic notion that addiction is a choice, not a disease. One common symptom of the disease of addiction is relapse. Kicking an addict out of treatment for relapsing is like kicking a cancer patient out of treatment when a tumor metastasizes.

II. Beyond Addiction: How Science and Kindness Help People Change (2014) by Jeffrey Foote, Carrie Wilkens, Nicole Kosanke, Stephanie Higgs

The dopamine system can and does recover, starting as soon as we stop flooding it. But it takes time, and in the time between shutting off the artificial supply of dopamine and the brain’s rebuilding its natural resources, people tend to feel worse (before they feel better). On a deep, instinctual level, their brains are telling them that by stopping using, something is missing; something is wrong. This is a huge factor in relapse, despite good intentions and effort to change. Knowing this can help you and your loved one make it across this gap in brain reward systems.

…(A)pproaches that treat substance abuse like any other behavioral problem are significantly more effective than confrontational approaches aimed to challenge a person’s denial about their disease.

Substance problems are complex and multidetermined, often driven by underlying psychiatric disorders such as depression, anxiety, bipolar disorder, or attention deficit disorders that require specialized attention over and beyond just treating the substance problem. In other words, good treatment often includes psychiatric care, which has historically been overlooked or even discouraged in some drug and alcohol treatment settings.

III. Unbroken Brain: A Revolutionary New Way of Understanding Addiction (2016) by Maia Szalavitz

…(A)ddiction is a developmental disorder—a problem involving timing and learning, more similar to autism, attention deficit hyperactivity disorder (ADHD), and dyslexia than it is to mumps or cancer.

Our brains are embodied—much of the problem with the debate over addiction and psychiatry more generally is a refusal to accept this and our ongoing need to see “physical,” “neurological,” and “psychological” as completely distinct.

Anything you can associate with achieving a drug high, you will. As a result, when you try to quit, everything from a spoon (you could use it to prepare drugs) to a street (this is where the dealer lives!) to stress (when I feel like this, I need drugs) can come to drive craving. Desire fuels learning, whether it is normal learning or the pathological “overlearning” that occurs in addiction. You learn what interests you with ease because desire motivates. In contrast, it’s far more difficult to learn something you don’t want to understand or care to comprehend.

Apr 18

“Unbroken Brain”: Addiction Is Learned

…(A)ddiction is a developmental disorder—a problem involving timing and learning, more similar to autism, attention deficit hyperactivity disorder (ADHD), and dyslexia than it is to mumps or cancer. Maia Svalavitz, Unbroken Brain

According to journalist Maia Svalavitz‘s new book Unbroken Brain: A Revolutionary New Way of Understanding Addiction, the ages-old wisdom about addiction recovery is often off base.

Some of the ideas Svalavitz sees as myths:

  • The addict has a “broken brain.”
  • An individual becomes addicted because of his or her “addictive personality.”
  • One type of addiction treatment fits all individuals.

Or as Dana Goldstein, Slate, eloquently points out on behalf of Svalavitz, the entire following scenario is suspect:

The narrative of addiction is familiar. A pleasure-seeking ‘addictive personality’ spirals out of control, ‘enabled’ by friends and family, and eventually hits ‘rock bottom’ in the form of arrest, divorce, or homelessness. She may then succeed in a 12-step program, where she’ll embrace a ‘higher power,’ receive ‘tough love,’ and accept total ‘abstinence’ from substances including antidepressants and drugs that ease withdrawal symptoms. Even if she gets clean, she’ll be an addict forever, and is more likely than not to relapse.

In long-term recovery herself (cocaine and heroin), Szalavitz “offers an alternate way of thinking about what addiction is: neither an illness nor a sign of an immoral personality, but a learning disorder.”

How does she define addiction? “Compulsive behavior despite negative consequences.” Why/how does this happen? The addict learns “that the problematic substance can help soothe some other problem in [one’s] life, such as depression, social anxiety, physical pain, or, in Szalavitz’s case, what she believes was an undiagnosed childhood autism-spectrum disorder.”

What This Means For Addiction Treatment

A few basic principles addressed in Unbroken Brain:

  • Individuals can benefit significantly before hitting rock bottom.
  • Not all substance abusers have to forego all substances. The harm reduction model can work well for many.
  • Imprisonment usually doesn’t benefit the addict and often makes things worse.

Moreover, 12-step programs are only useful for some. Publishers Weekly: “Szalavitz may alienate otherwise sympathetic readers with her critiques of popular treatment methodologies such as 12-step programs. This study may not be for people who have recovered using such treatments, but it can help promote the importance of understanding—and working toward fixing—a persistent problem.”

Marc Lewis, author of The Biology of Desire“Szalavitz catalogs the latest scientific knowledge of the biological, environmental and social causes of addiction and explains precisely how they interact over development. The theory is articulate and tight, yet made accessible and compelling through the author’s harrowing autobiography. Unbroken Brain provides the most comprehensive and readable explanation of addiction I’ve yet to see.”