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Substance Abuse

9/24/2016

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I believe that a large part of my effectiveness as an ‘agent-of-change’ when working with my clients directly relates to whether or not I’ve actually experienced and navigated the same challenges they are attempting to recover from and move beyond.  As it relates to substance abuse, this correlation is especially true.

I began drinking alcohol at the age of eight. By the time I was twelve I was frequently impaired. The first time I drove a car at the age of fifteen was the first time I ‘dropped’ acid. For a period of ten years between the ages of fifteen and twenty-five, I was stoned on something every single day. Alcohol, marijuana, hashish, and magic mushrooms were the most common substances of choice on a daily basis. Cocaine and LSD were usually reserved for special occasions such as birthdays, graduations, and weddings.

Despite my extended proclivity for not being fully present in my mind, body, or this dimension; I somehow managed to complete five years of high school in three years and graduate from a reputable University with a four-year undergraduate degree.  (In Toronto, where I grew up, grade 13 was a requirement for admissions into University)

The good news is that I survived these years of extended impairment despite there being no rational explanation as to why I’m still alive. The sad news is that my brain and body were significantly compromised due to engaging in extreme, high-risk behaviors while under the influence of one or more mind-altering substances. Lots of broken bones, severe concussions, and a small neurological event referred to as a mild stroke at the age of eighteen ensured that I will never truly know the full capacity of the mental or physical acuities I came into this world with.

However, an important part of my recovery was to discover what all of the emotional, psychological, and physiological  factors were that put me at incredible risk for such an extended period of time during my most formative years of development. Many of these insights are now embodied within my clinical practice as well as the modality that this book is based on. Two of those insights are as follows:

  1. I inherited a strong, genetic pre-disposition to addiction through the DNA of my maternal and paternal lineages; the O’Connell’s and the McGowan’s.

  2. I was extremely vulnerable to manifest addiction as a dis-ease expression and a coping mechanism in response to significant chronic stress and trauma I experienced throughout childhood and adolescence.

At the end of my first year of graduate school in the summer of 2004 I was provided the opportunity to return to the substance abuse recovery center that I had attended as an outpatient in 1995 in order to complete my graduate internship requirement. This proved to be and incredibly surreal and satisfying experience for having come full-circle in the space of nine years.

Having sat on both sides of the room as client and clinician, I bring a much wider perspective to the issue of recovery from substance abuse and life in general; one that is far more holistic and non-judgmental.  And because the recovery framework I participated in was scientifically and biochemically based, lasting change actually occurred beyond the endless cycles of relapse that more than often characterize this complex and challenging issue.
 
                                           Understanding Addiction through the Biochemical Paradigm
 
The Baldwin Research Institute is a not-for-profit corporation approved by the New York State Department of Education as an institute conducting alcohol and drug research. Baldwin Research began its efforts in 1989 when it conducted studies of modern Alcoholics Anonymous and Narcotics Anonymous and their claims of success rates as high as 93 percent.  Baldwin Research was unable to validate a single treatment program with a success rate greater than 3 percent. Despite there being no research to date to support the efficacy of the 12-step model of recovery, 90% of addiction treatment facilities in the United States employ this approach. (BRI, 2003) 

This is one reason why adequate treatment continues to elude the current medical model. Many people still believe that 12-step interactive group psychotherapy can help individuals abusing drugs and alcohol achieve sobriety through self-understanding.  This perception diverts attention from the physical causes of alcohol and drug abuse and can compound the individual’s guilt and shame by encouraging them to surrender to a “higher power,” pray to have their “defects of character” lifted, and to accept their “powerlessness.”

The concept of addiction being a moral failure is still evidenced by our country’s investment in criminal justice rather than treatment. It is estimated that as many as 165,000 people are court-mandated to attend AA and NA meetings annually in the United States. Consequently, the need for community education is as strong as ever.   

Within the past 30 years, biochemical research has created a new paradigm of understanding that invites us to treat substance abuse problems more effectively at the cellular and molecular level.  This has allowed the field of psychiatry to change its thinking about addiction disorders, moving them from categories of moral failures to brain diseases.  

Millions of chemical reactions occur every second in the trillions of cells that make up our bodies.  Biochemical imbalance can result from inadequate nutrients being supplied to these cells.  These nutrients are the raw materials that allow our cells to carry out these complex chemical reactions.  If left uncorrected, biochemical imbalance can result in physical and mental deterioration.

Imbalances in the biochemistry of brain cells, known as neurons, can affect our moods and our behavior dramatically. Biochemical explanations focus on neurotransmitters as playing a key role in the cycle of dependency as manifested in the brain disease of addiction.  Neurotransmitters are chemicals in the brain, which act as messengers between the neurons and essentially control every aspect of our behavior. 

Feelings of optimal well-being are radically compromised when the brain’s ability to produce adequate supplies of these neurotransmitters is suppressed through the chronic use of alcohol and other potentially addictive substances.  When neurotransmitter availability is reduced, too few receptor sites are filled, resulting in symptoms that include craving, depression, and anxiety.  To ease these symptoms, the use of alcohol or drugs is repeated.  The cycle continues, resulting in increased tolerance and a need for more frequent use.  Chronic intoxication can cause behavioral changes and irreversible brain damage, disabling the person for a lifetime. 
 
Treatment is often difficult because of such poor recovery rates and the social stigma attached to the condition.  However, it is important for the alcoholic or addict to understand that the symptoms of their disease, such as cravings and withdrawal are not character flaws and they should expect the same level of care, concern and compassion that anyone diagnosed with a chronic and potentially fatal disease would expect to receive.

Since neurotransmitters are made up of amino acids, the nutritional components of a treatment program take on tremendous significance for long-term, successful recovery. The brain cannot synthesize all of the amino acids involved in the formation of neurotransmitters.  Some are derived from food and metabolism.  As a result, certain vitamins and minerals influence the conversion of amino acids into neurotransmitters. For example, vitamin C is involved in the conversion of dopamine to norepinephrine; vitamin B6 is involved in the conversion of phenylalanine to dopamine and tryptophan to serotonin, and zinc influences the metabolism of neurotransmitters in general.

The following chart outlines the amino acid deficiency symptoms and the corresponding amino acids necessary to supplement the brain depending on the individual’s drug(s) of choice. It is important to take these with a high grade multivitamin in order for the brain and body to be able to fully synthesize the amino acids and nutrients necessary for a sustained recovery process:

Picture

Amino acids are critical for stopping cravings because they are the essential building blocks of the neurotransmitters that tell the brain whether or not we are satisfied.  As a result, nutrition plays a critical role in healing addiction because key nutrients can help restore pre-existing neurotransmitter deficiencies and help heal the body of the destructive physiological effects caused by this disease.

The frontal lobe region in our brains is the primary location of the neurotransmitter activity associated with alcohol and drug abuse. This area, located behind the forehead, is thought by neurobiologists to be one of the last areas of the brain to develop. It also accounts for characteristics considered uniquely human such as artistic expression, subtle humor, creative thinking, and the ability to project what the probable consequences of our actions might be.  It is not until we reach our mid-20’s that our frontal lobes are completely developed.

For this reason, it is imperative that we develop educational tools and information for young people based on the biochemical understanding of alcohol and drug addiction.  Alcohol and drug use disrupts the development and growth of the very parts of our brain that separate us from other mammals.  

Historically, relapse prevention has focused on cognitive and behavioral modification techniques to counteract biological cravings and the conditioning process associated with chronic addiction.  However, Abraham Maslow aptly demonstrated that an individual’s foundation for building towards self-actualization must be physical stabilization.  This stabilization process in substance abuse and addiction must involve the improvement of brain chemistry capabilities.  Today, nutritional supplement combinations are available that dramatically enhance neurotransmitter availability and hasten the individual’s recovery towards long-term, higher level functioning manifesting in increased stability and confidence as well as positive feelings and thoughts.
 

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    Author

    Kate O'Connell is a licensed Child and Family Therapist with a private practice in Charlottesville, Virginia addressing the therapeutic needs of children, adults, adolescents, couples and families. Her extensive training in Intensive In-Home Services,  Addiction, Family Systems Therapy and Energy Medicine enables her to facilitate positive outcomes for her clients dealing with a variety of emotional and mental health issues.

    



    

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