Treatment Overview

The Cause –

The single cause of alcoholism and other drug addiction is unknown, although we know of many contributing factors. Years of study and mountains of research by every kind of expert have failed to definitively uncover why some people become addicted to substances and the majority do not. There is reliable evidence to support the idea that some substance abusing people were born with or into this affliction while others drift into it over a period of years.

It may be hereditary, or cultural, or environmental or it may possibly be bio-chemical. There is evidence to support any and all of these possibilities, however, there is nothing conclusive enough to establish a single cause.

Even though the cause is unclear, it has definitley been established that the commonly accepted stereotypes are not factual.

We know that it is not a moral weakness, a character defect, a lack of willpower or any of the usual explanations.

We also know that the skid row representation of the alcoholic is wrong and that, in fact, less than 3% of this country’s alcoholics are on skid row. Further, 95% of alcoholics are employed and function throughout our society in every role from corporate executive, to clergyman, to doctor, to electrician, to truck driver and laborers.

Alcohol and Drug Addiction crosses all social-economic lines, has no relationship to intelligence, education, race or religion, although there may be subtle influences exerted by these factors which are probably more related to cultural and environmental circumstances. Addiction is an equal opportunity employer.

The Nature of Addiction –

“An overwhelming need to experience intoxication that transcends all other human needs, including food, sex or life itself.” (Dr. Richard Heilman, V.A. Hospital)

Alcoholics Anonymous calls it “an allergy of the body and compulsion of the mind”. It is especially tragic in that it destroys the whole person, mentally, physically, emotionally and spiritually.

As with any other disease, alcohol and drug addiction has a definite set of symptoms and the progression of the illness can be described and predicted.

However, because many of these symptoms involve behavior, it is a common error to try to treat the symptoms rather than the illness; or worse, attribute these behavioral symptoms to voluntary irresponsibility and lack of character or morals and completely miss the real cause of the problem.

Another aspect of alcoholism and drug addiction, which complicates the diagnosis, is the absolute denial of the individual involved. The individual will strongly resist any suggestion that chemicals have anything to with his/her problems, and is usually supported in this view by friends, family and employer. This continues until the illness has progressed to the point where the individual’s gross behavior has made dependency clear. The individual will then do a 180-degree turnabout and either avoids family members and friends or tries to control his/ her drinking behavior.

Even at this point, the individual will deny the illness in spite of mountains of evidence to the contrary.

In the diagnosis of alcoholism or any other drug addiction, we are not so much concerned with how much a person uses or what they use, but rather the effect of the substance on their life once they begin to use.

Intervention Strategies –

If the continued use of drugs and/ or alcohol has a destructive effect on an individual’s family or interpersonal relationships, job performance, health or financial condition, there is good reason to suspect dependency. Any of these areas affected by alcohol/drug use is more than enough reason for concern.

When addiction is suspected, every effort must be made to refer the individual to a qualified addiction counselor, where a complete diagnostic evaluation can be done and critical clinical treatment services prescribed if deemed necessary.

This is easier said than done, given the denial system mentioned previously. It is our suggestion that non-alcoholic concerned parties get some reading material; see a counselor for advice; join Al-anon, which is an educational, self-help organization for concerned relatives and friends of alcoholics; and learn as much about the illness as possible.

Intervention into alcoholism/ other drug addiction is a painful process for everyone involved and must be done with a clear understanding that it is necessary, even crucial, if the individual is to have a fighting chance at recovery.

A crisis is often necessary in order to force the individual to accept the seriousness of his/ her situation and accept help. Usually the individual will create a crisis, and it only remains for the concerned person to allow the alcoholic to be accountable for their own actions and therefore have a greater chance of recognizing the consequences of continued use.

All too often, the addict is supported in their addiction by those well-meaning people acting as their support system. In fact, the well-meaning people actually help to continue the addictive pattern because they feel duty bound (or guilt ridden) to constantly pick up the pieces for the person using alcohol and/ or drugs. They enable the addiction to continue by preventing the addict from facing the consequences of their behavior. These well-meaning people are called “enablers”.

The enabler operates from many points of view. Often the addict has succeeded in convincing the people around him/ her that they are responsible for his/ her addiction. This is a complete fabrication; no one is guilty of causing alcoholism or other drug addiction since we don’t know the single cause of it. These alibis only serve to justify the behavior of the addict and, at the same time, spread guilt among the people who support them. This guilt then strengthens the addict’s hold on their supporters.

Other “enablers” tend to operate from the premise that they can control the substance use and in some way manage both the addict and their problem. It does NOT work… addicts can stop their use, but they CANNOT control their use. Total abstinence is the safest remedy we know of.

Another type of “enabler” believes that addiction is only a symptom of some other underlying problem and if this causative factor can be dealt with, the addiction will disappear. This is simply not true and its fallacy has been demonstrated time and time again.

One last word on the “enabler”. An Alcoholic or Drug Addict cannot die of their illness without the support of at least one other person described above. Although there is not guilt attached to the dependency itself, it would seem that there is certainly a moral obligation on the part of the concerned person to see that the afflicted person gets the help they so desperately need.

Alcoholism and drug addiction, whatever its cause, is a “primary” illness, and must be treated as such. The addict who uses chemicals will continue to do so destructively whether there are any problems or not. The point is that other problems cannot be successfully dealt with except in the absence of the chemical; and when sobriety is maintained, many of the problems disappear.

In summary, intervention is a process of becoming detached from the problems created by their illness, not from the person, and letting the addict take full responsibility for their behavior.

If you are in a relationship with an alcoholic or drug addict, here is some advice: Stop lying for them, stop making excuses and protecting them from embarassment. Be honest with them no matter how painful and tell them like it is, being neither judgmental, or critical of them as a person. It is not a moral illness though they have secretly begun to think it is, and you will only strengthen this assumption and make matters worse by being critical and judgmental. Openly and honestly confront the person with the facts. Do not exaggerate anything or make emotional appeals. Point out the obvious conclusion and explain what help is available. Then tell the person what you are going to do and not what they are going to do. Lay out some alternatives that you are considering and give them options. Do not threaten any actions that you are not fully prepared to carry out. Remember that care and compassion are the keys to a successful intervention.

The focus of your efforts is always to get this person to a trained professional counselor or to Alcoholics Anonymous. If you have a strong relationship with a knowledgeable and understanding clergyman, doctor or social worker, fill them in on your objectives and possibly they will serve as the instrument by which the alcoholic or addict can be persuaded to see a qualified counselor. Please call (406) 727-2512 if you have questions about how to help someone who is having problems with alcohol and/ or drug use.

Recovery –

Recovery from alcoholism was thought to be impossible until as recently as 1935 when Alcoholics Anonymous was founded in Akron, Ohio by an alcoholic medical doctor and a New York investment broker.

Since that time, Alcoholics Anonymous (AA) has grown to a membership of over 2,000,000 and its success is a phenomena which today is being studied and copied by experts in every area of humna behavior.

The basic premise of AA is that abstinence is the only way to arrest alcoholism and in order to attain sobriety thare are 12 simple steps which must be followed. Rigorous honesty and becoming responsible are the threads that run through the whole program and the fellowship. Supporting other members in this common quest is the strength and fabric of a successful program of recovery.

Copies of the book “Alcoholics Anonymous” are available everywhere.

About 60 years ago, health care professionals and recovering alcoholic counselors began to work with alcoholics in institutions such as the Hazelden Foundation in Minnesota. Out of these efforts, a treatment process evolved which is now called the multi-disciplinary approach to treating illness. The basis of the program was the 12 Steps of AA, and the core team was the counselor who was supported by other professionals on the team, such as medical doctors, psychologists, clergymen and social workers.

This modality has become tremendously successful, beyond anyone’s expectations, and is the system used in the most successful treatment systems today. In addition to this fact, we continue to see a tremendous evolution in the field moving toward even greater levels of professionalism.

It was also discovered in the progress through the years that people addicted to chemicals other than alcohol could be treated with equal success. The chemical of choice seems to make no difference in the method of treatment, and since we do not allude to a particular drug dependency but to “chemical dependency”.

It is significant to note that the majority of dependent people can recover in AA; however, if the illness has progressed to the late chronic stage, treatment is usually advisable and widely available.

Structured treatment offers some advantages that may be necessary in sever cases such as removal from the environment, sheltered and structured living, and a very intense re-evaluation of self by the patient. Some people refer to treatment as an intensified and comprehensive cram course of the AA program, but done within a very focused and well documneted clinical arena.

A lifestyle of recovery is possible, accessible and attainable; however, it requires commitment and effort by all parties involved and whether we want to accept it or not, we are all responsible to some extent to work toward lasting solutions.