Most of us have seen the headlines of celebrities struggling with addiction and going to rehab. With that, comes the scandal, shame, and stigma portrayed by the headlines and tone with which the stories are written. As a society, we have been conditioned to think that addiction is correlated with weakness and a lack of willpower. The stigma of addiction is slowly lessening with more exposure and education, nonetheless, we have a long way to go. Addiction does not discriminate and can affect people of various ethnicities, socio-economic statuses, and genders. In Canada, it is estimated that approximately 21% of the population (about 6 million people) will meet the criteria for addiction in their lifetime (CMHA, 2021).
But how does that make us feel if we are the ones who are struggling with an addiction dependency? It may make it more difficult for us to seek support if we are feeling shame or embarrassment, which in turn makes us continue to use our substance of choice/problem behaviour, impacting our health and risking overdose or long-term damage.
People become addicted for a reason and depend on substances or behaviours to self-soothe when triggered.
An addiction counsellor or registered psychotherapist can help you determine if you have an addiction, and how to recover from it.
What is Addiction?
Addiction is when we are dependent on something, and we feel physical or emotional withdrawal and distress if we do not have or act out on our substance/behaviour. It is when we are compelled to continue to use despite negative consequences and it involves reward, motivation and memory.
When we do not use our substance of choice or behaviour, our body may go in shock, commonly referred to as withdrawal. Withdrawal may look differently for everyone and commonly includes:
- Short temper
- Sleep disturbances
- Runny nose
- Hand tremors
- Hot/cold sweats
- Restless leg syndrome
- Tactile disturbances (sensation of something crawling on your skin)
Why Do Some People Become Addicted and Others Don’t?
Anyone can become addicted. However, those who have a genetic predisposition (ie. someone in the biological family has a history of addiction), history of abuse/trauma, environmental factors (stress, instability, being overly prescribed addictive medication usually after a medical procedure), and personality traits can all impact a person’s probability of becoming addicted. A trigger (event or situation) can ‘awaken’ dormant genetic markers and we may learn to cope with chemicals or behaviours.
What Are the Different Types of Addiction?
- Chemical: drugs, alcohol, nicotine, vaping
- Behavioural: gambling, sex, relationships, shopping, food, video games, internet, cosmetic procedures, thrill-seeking activities, work/achievements, exercise
Some people may abuse their substance or problem behaviour daily, a few times per week, weekend binges, binge every few weeks/months, or circumstantially (stressful event, celebration) as a way of coping. If someone uses their problem substance/behaviour as a way of coping/escaping, has built a tolerance to the substance/behaviour, experiences distress if they do not use their substance/behaviour, and continues to use despite negative consequences, a dependency has been established.
The Stages of Addiction
The stages of addiction vary from person to person, and many are able to reach their desired goals at different stages:
- Initial use (usually introduced socially or during a stressful period to cope)
- Abuse (overly using a substance/performing a behaviour and more frequently)
- Tolerance (require more of the substance/behaviour in order to get the desired effect)
- Dependence (feeling physical/emotional distress if not able to use)
- Relapse (after a period of time of not using or a period of decreased use)
- Interrupting the cycle (treatment, learning about your triggers, and practicing healthy coping skills)
The Stages of Change
The stages of change model (Prochaska et al., 1992) explains how deliberate change can happen.
The model describes five stages that people go through when changing their behaviour: precontemplation (not ready), contemplation (getting ready), preparation (ready), action and maintenance. The model assumes that everyone goes through a similar process when changing a behaviour (Prochaska & Prochaska, 2009). An unofficial sixth stage is called “relapse.” At this stage, a person returns to old behaviours. For example, someone might have a beer after a period of abstinence or smoke a cigarette after quitting. Relapse is common. It is best to be realistic about the likelihood of relapsing, and to see it as a normal part of the process, rather than as a failure (CAMH, 2021).
Harm Reduction versus Abstinence
- Harm Reduction or moderation: An approach that seeks to reduce harm associated with health, social, and legal factors in an attempt to reduce negative consequences. Continuing to use the problem substance/behaviour but in a decreased manner (for example, consuming 1 glass of wine daily instead of 1 bottle) and may utilize a delayed use approach (instead of beginning to smoke cannabis at 1pm, delaying until 2pm) and other strategies.
- Abstinence: Complete avoidance of the problem substance/behaviour, usually after a few attempts practicing harm reduction without achieving the desired goal, commonly termed as sober/sobriety. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), abstinence-based treatment is “complete cessation from substance abuse of any kind” and is the safest approach to treating drug addiction.
Usually, folks struggling with dependency begin with harm reduction and some transition to abstinence.
Addiction treatment looks differently for many people however talk therapy/psychotherapy/addiction counseling is a key component to reprocess past memories, gain self acceptance and forgiveness, and learn healthy coping skills. A combination approach is particularly beneficial and may include:
- Anti-craving medication, if applicable and possibly antidepressant medication as addiction goes hand-in-hand with underlying mental health concerns such as depression/anxiety and is termed concurrent or dual-diagnosis.
- Talk therapy such as cognitive behavioural therapy or dialectical behavioural therapy among other approaches, specifically with an addiction counsellor, registered psychotherapist, psychologist or psychiatrist.
- Attending community detox or medical detox.
- Community detox: Usually government funded in Canada and involves residing in a facility up to 2 weeks while you detox with the support of a medical team.
- Medical detox: For those folks with health concerns such as a history of seizures, cancer, diabetes, etc,
- Usually government funded in Canada and involves residing in a hospital up to 1 month or so, with the support of a medical team involving a psychiatrist.
- Generally includes a lengthy waitlist as there are limited government-funded beds within a hospital setting.
- Residential treatment is when folks voluntarily live in an addiction facility/agency for a period of time and receive 24/7 support by trained staff. Some residential treatment facilities are fully or partially government funded which entail waitlists while others are paid privately which can be costly however little to zero waitlist.
- Community support such as Alcoholic/Cocaine/Narcotic/Gambling etc Anonymous Meetings, SMART Recovery Meetings, etc held daily within the community, free of charge where you may attend to build a network of like-minded individuals. The opposite of addiction is community and has been proven to provide added benefit to addiction recovery and to help people feel less alone during an isolating and challenging period.
- Support groups for family and loved ones are also beneficial as addiction affects the family unit and can affect their trust, boundaries, and finances to name a few.
Once stable, a person in recovery may benefit from a holistic approach to cleanse/detox their body. Did you know that the gut produces about 95% of the serotonin in your body, and changes in your serotonin level affect your gut as well as your brain? The gut bacteria produce neurotransmitters such as serotonin, dopamine and GABA, all of which play a key role in mood (many antidepressants increase levels of these same compounds). When addicted, healthy eating and lifestyle is usually not a priority and if using chemical substances such as drugs and alcohol, the gut microbiome is overworked and coated in toxins which effects how it creates and releases natural feel-good hormones and melatonin that affects mood, anxiety, digestion, and sleep to name a few. Becoming active and practicing meditation has also been proven to be helpful during recovery and also naturally produces feel-good hormones.
Contact Marta Leskiv, A Registered Psychotherapist in Toronto
Marta Leskiv has extensive training and experience working as an addiction counsellor in Toronto as well as an addiction psychotherapist in Toronto in community, residential, hospital, and private settings for over 7 years. She has been able to help hundreds of people reach their recovery goal and full potential.
Seeking help for addiction is an incredibly brave and scary thing to do. Your problem substance/behaviour may have become your best friend, lover, and confidant before becoming your enemy. Recovery also means a death to your addiction and can involve many feelings to process through this grieving stage. Reminding yourself that you are brave, capable, and worthy of recovery (whatever that may look like for you) goes a long way.
If you or someone you know is struggling with dependency and want to learn more about addiction and recovery and what that might look like, please do not hesitate to contact me for a complimentary consultation to see if we might be a good fit to work together. But, at the end of the day, please do not give up. Addiction is an incredibly isolating and challenging disease when we go through it alone but know that you don’t have to.
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