As many of you know, my journey into the career of counseling came about after years of working as a choral director in public education. I had spent the majority of my life as a part-time professional musician and educator, until my late 40s when I developed what’s clinically termed as Alcohol Use Disorder (AUD).
Of course, that recovery journey led to my change in careers, because of the incredible and positive changes that have happened, due to recovery. I’m in the unique place of understanding addiction (or now referenced by clinical terminology as substance use disorders – SUDs) both personally, and professionally.
Most of us tend to believe that any substance use is a matter of choice. While that is true early on as someone might use substances recreationally (having a drink, a smoke, etc.), there is a fuzzy line that’s crossed as substance use becomes more frequent.
The “Pleasure Pathway,” or “Reward System,” of the brain begins to develop the connection with substance use, and a pleasurable experience. I’m not going to go into great detail explaining all of what happens, but a short video out of Khan Academy (8 minutes) gives a pretty good instruction into what occurs, and how addiction is differentiated from “choice” or “morals.”
As I mentioned in the previous paragraph, once someone succumbs to addiction, it’s not about making a choice any longer. The urge to use the substance is overwhelming; denial sets in, and the individual cannot logically make a connection between use and the injurious set of events that may soon follow. There’s always a reason to use, and many attempts to limit use. “I’ll only have two drinks tonight,” “I deserve to wind-down after a long week of work.”
There’s also our culture’s perception that somehow a person’s moral character is flawed. We may think of an addict or alcoholic as someone living under a bridge; they’re lazy or unmotivated, their moral character is nonexistent. In reality however, many successful people have got through substance use disorders and then recovered. This is the thing about addiction; it can strike anyone. It knows no boundaries in terms of morality, social standing, financial wealth, or education.
What are recommended treatments if someone has lost the ability to limit/control substance use? Clinical interventions can be effective, and these involve inpatient treatment facilities as well as intensive outpatient programs.
Detox is a concern if use has been heavy and prolonged. Why that may be important, is the physiological effects of sudden cessation in use. There can be concerns that would be best served by a medically supervised team, so that your physical condition can be monitored.
One evidence-based program of recovery that’s recently been highlighted in the research, is that of peer-supported recovery groups like Alcoholics Anonymous. These twelve step programs have showed results that equal those of clinical interventions. Alternative peer-supported recovery groups include Refuge Recovery, Smart Recovery and Celebrate Recovery.
The bottom line is this: substance use disorders can happen to the brightest and best of us. While recovery from an SUD might be challenging, everyday people seek recovery and live lives free of addiction. There’s hope in recovery and the first step may just be in asking for help. If you or a loved one wants to know more information about this subject, feel free to contact me.
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