By Michael Pond, Special to the Sun
I’ve had the good fortune to be part of a film this year, made by my partner Maureen Palmer, which will air on CBC’s The Nature of Things on Jan. 21. In the film, called WASTED, leading addiction researchers reveal tantalizing clues to what causes addiction and make the case for new, compassionate evidence-based treatment.
Their work challenges deeply held, but erroneous beliefs about those who can’t quit drinking. Perhaps you’ll think differently as you watch a loved one struggle with a substance use disorder this holiday season.
1. If they just had enough willpower, they’d kick their habit.
Say you do the same thing 100 times on your computer. Your computer doesn’t change. But if your brain does the same thing over and over, the structure of the brain itself changes. Advances in neuroscience show us the reward circuitry in susceptible people’s brains can be hijacked by repeated use of booze or drugs, essentially overriding the user’s capacity to stop. That makes the choice to not use much more complicated than a lack of willpower.
2. Getting tough with the substance user will get him to quit.
Studies show tough love, shaming and humiliating persons with substance use disorder will only make their condition worse. They will likely feel worse about themselves and may use more in secret. To quote Stanford University’s Dr. Keith Humphreys, the former Senior Policy Advisor for the Obama Administration’s White House Office of National Drug Control Policy. “It’s remarkable that people believe what’s needed is more punishment. If punishment worked, nobody would be addicted. It’s a pretty punishing experience.”
3. Relapse is not a Fail.
It’s common practice to kick people out of rehab if they begin drinking or using again. But it’s wrong, according to the world’s experts:
Dr. Keith Humphreys: “This is the only field where you can be kicked out of treatment for demonstrating that the diagnosis was accurate. I view that as uncompassionate and really, really poor health care.”
Dr. Bill Miller, one of the world’s greatest authorities on addiction research and treatment: “The idea that if you have one drink, then invariably you’re going to drink a huge amount of alcohol just is not how treatment outcome data look. You can find individuals who look that way, but in general, what you see over time is longer and longer periods between episodes of drinking. And the episodes of drinking get shorter and less severe overtime, and then eventually fade away. “
The Betty Ford Center no longer kicks people out of treatment for relapsing. Instead, a relapse is a signal that treatment for the individual needs to be re-evaluated and changed.
4. He’s just one of those guys who has to hit rock bottom.
For thousands of people every year, “rock bottom” is injury, disease and death. The evidence shows addiction should be treated like any other serious chronic health disorder, early treatment, using every option available with community and medical support. Early screening and brief interventions for unsafe alcohol use could save thousands of lives and billions of taxpayer dollars spent on the consequences caused by out-of-control substance use.
5. You don’t use drugs to get off drugs.
There is a widespread, but incorrect belief that you don’t use one substance to get off another. But for many individuals, a proven medication can be very effective. Drugs like naltrexone, or its 30-day injectable form called Vivitrol, not yet available in Canada, can reduce craving, helps people remain abstinent, and interferes with the tendency to want to drink more if the individual does have a drink.
They don’t work for everyone, but nothing works for everyone. These medications can provide sufferers with a valuable new tool to manage their disorder.
Our film makes a persuasive case for an expanded tool kit to treat our No. 1 public health care problem — a tool kit based on science that offers hope to people whose lives and families are wasted by addiction.
Michael Pond is a Vancouver psychotherapist and recovered alcoholic. He writes in The Sun every second Tuesday.