How would you feel if your insurance provider told you that the doctors’ visits and treatment costs for your illness were not going to be covered, or that you would have to pay a high deductible? Many people in our country are being told just that, and the reason is that the illness they have is substance abuse. There has long been a view in the world that substance abuse is a choice, or a character flaw, not a mental illness. Things are changing, however, and more and more research is being done on the complexities of the brain and its reaction to substance abuse. People today are beginning to see that while substance use might start as a decision to try something new, it quickly becomes an addiction that can’t be controlled.
Congress approves Mental Health Parity Act
Congress approved legislation last week that would change the way insurance providers handle claims for mental illness and substance abuse. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 provides “equity in the coverage of mental health and substance use disorders by ensuring that group health care plans do not charge higher co-payments, coinsurance, deductibles, and impose maximum out-of-pocket limits and lower day and visit limits.” Supporters of this measure include many in the House and Senate, businesses, insurance companies, and physicians. However, a few questions remained and until last week, it was uncertain whether or not the bill would pass before Congress went into recess this year. By attaching it to the Wall Street bailout bill, however, Congress was able to pass it quickly.
Help is needed
Help can’t come soon enough for many Americans struggling with drug or alcohol addiction. According to the National Alliance on Mental Illness and the National Council for Community Behavioral Healthcare, mental illness is the leading cause, and substance use is the second leading cause, of disability among adults. Many of these adults are not getting the help they need to recover from their mental illness, and often it is because of the high cost of treatment. Another reason is fear of discrimination from their employer if they do seek treatment.
Equal Coverage for an epidemic
With legislation such as the Mental Health Parity Act, those with a substance abuse disorder can be reassured that their insurers will not be able to set a cap on healthcare coverage for mental illness or substance abuse that isn’t set for other illnesses.
In order to deal with the epidemic of substance abuse, we need more good addiction treatment facilities, more affordable health care to addicts, and more support behind families dealing with substance abuse. Through the passage of this bill, those with addiction should be encouraged to move forward and seek treatment, so that we can work toward decreasing the incidence of drug and alcohol abuse.
Sources
Congresswoman Shea-Porter Hails Passage of Mental Health Parity Act September 24, 2008
Many State Reform Initiatives Are Neglecting Mental Illness, Says Study July 08, 2008
Layton, Lyndsey Congress Approves Mental Health Bill Private Insurers Would Provide More Benefits Sept. 24, 2008
Ault, Alicia Equal Coverage For Mental Health?
Many States Require Parity, and Congress May Order It Nationwide November 6, 2007
Curley, Bob Congress, Bush Approve Addiction and Mental Health Parity Legislation October 3, 2008
Finding the right facility to treat drug or alcohol addiction is the first step toward a successful recovery. A good treatment facility will typically first deal with the patient’s withdrawal symptoms, followed by intense counseling and therapy.
There are different methods that treatment facilities have begun to use in order to enhance their therapy sessions. Things such as art therapy and play therapy can help a patient express themselves more easily than with a typical one on one conversation with a counselor.
Phototherapy is another method that has been used in psychiatric treatment since the 1850’s. Phototherapy refers to the use of photographs in a therapeutic setting, in order to help a patient work through painful psychological issues. Often a recovering drug or alcoholic abuser has underlying issues to sort out in their therapy sessions. Past trauma or abuse can often lead to substance abuse, and unless these issues are addressed, recovery will be difficult. Substance abuse counselors often have to break through barriers that a patient will put up as a defense, such as denial, deception, and minimization. Photographs may help a patient distance themselves from painful memories, while still being able to discuss them. Patients may also make excuses for their addiction, blame others, or minimize the problem. According to Benshoff and Janikowski (2000), “Defense mechanisms are unconscious efforts of the mind to protect the individual from psychological assault. Attempts to batter down defense mechanisms through verbal confrontation may only strengthen them.” (2)
Self Portrait of the Addict
With one technique of phototherapy, patients see pictures of themselves and are asked to talk about the pictures. Patients are generally more able to open up and talk about their feelings when talking about the pictures. It is easier for an individual to admit the pain they are causing their loved ones when they talk about themselves as a person in a picture. Or they may be able to verbalize the abuse that happened to a child in a picture more easily than talk about what happened to them when they were younger. Phototherapy is used, not in order to interpret the picture, but to help the patient open up and talk with the counselor.
Addicted Client-produced photography
Another use of phototherapy is patient-produced photography, in which the patient is asked to photograph objects as they wish. This allows the recovering addict to decide what it is they want to preserve in a photograph, and it helps the therapist see how they view objects around them, and what reality is to them.
There have been very few studies on the effects of phototherapy for substance abuse recovery, but for some it might be a useful tool. We know different people respond differently to certain types of treatment, and for some patients, phototherapy could play a part in their healing.
1 Healthwatch- Cameras to fight addiction September 15, 2008
2 The use of phototherapy in group treatment for persons who are chemically dependent Rehabilitation Counseling Bulletin March 22, 2006
There has been a push lately for research that shows whether or not exercise can help prevent substance abuse and/or aid in the recovery of addictions. Some say that there is new evidence showing that exercise can help prevent substance abuse. A study recently found that teens that exercised daily were 40% less likely to experiment with marijuana than those teens that didn’t exert physical activity. While the reasons behind these results are not fully known, it makes sense that teens that exercise and take care of their bodies may be too busy to get involved with drugs or alcohol. Exercise makes us feel good about ourselves, and helps people overcome the negative thoughts that can lead to substance abuse. Exercise is often a part of drug treatment programs, because of the distraction it provides, and the way it seems to give a boost of confidence while also relieving stress and depression.
But some of the studies now are showing what it is about exercise that helps in the struggle with addiction. Exercise stimulates endorphins, which are neurochemicals that help stabilize our mood. These neurochemicals are depleted in addicts, which leaves these individuals with negative thoughts to go along with their actions, leading them into a destructive downward cycle. With the benefits of exercise, an addict can bring positive behavior into their life to replace the substance abuse.
A study by Mark A. Smith from Davidson College suggests that physical activity can actually reduce the risk of becoming addicted to drugs. In his study, rats were less likely to ingest amphetamines if their cages had running wheels. According to Smith, exercise reduces the rewarding effects of drugs such as cocaine because it “alters the number of dopamine receptors in the brain, meaning that drugs then have less of a euphoric effect.”
Another study by Dr. Bess Marcus from Brown University found that smokers that exercised three times a week while trying to quit smoking were twice as likely to succeed as those that didn’t exercise.
However, the research in this area is minimal, and this has caused the NIDA to devote a two day conference this past summer to the topic. Scientists met in June to share their research on the connection between physical activity and the prevention of substance use. Some of the studies focused on neurobiological, developmental, and social effects of exercise and how this relates to substance abuse prevention. It was concluded at the conference that there are things scientists don’t yet understand about the role of physical activity in the prevention of addiction, but that there is some evidence that exercise aid in substance abuse prevention. However, the NIDA has plans to fund additional studies to discuss their questions about exercise. It is hoped that with further study on physical activity and its effects also on other health conditions, scientists will be more informed about the effects of exercise on substance addiction.
Sources
Neergaard, Lauran Can exercising exorcise addictions to drugs, alcohol? Associated Press Chicago Tribune September 2, 2008
Exercise May Prevent Drug Addiction Cocaine User Helping Hand July 11, 2008
Can Physical Activity and Exercise Prevent Substance Use:
Promoting a Full Range of Science to Inform Prevention NIDA Conference June 5-6. 2008
Many in the recovery community claim to be “Clean and Sober” But, what exactly does this mean? Clean refers to living without using drugs. Sober is used in the same context. However, the definition of “Sober,” also reveals a path, and a desired character. A path, and character, prescribed and modeled, by the founders of the 12 Step Fellowships. A path, and character, prescribed for spiritual living. Let us begin with the basics. Following is the dictionary definition for “Sober:”
1. Habitually abstemious in the use of alcoholic liquors or drugs; temperate.
2. Not intoxicated or affected by the use of drugs.
3. Plain or subdued: sober attire.
4. Devoid of frivolity, excess, exaggeration, or speculative imagination; straightforward: gave a sober assessment of the situation.
5. Marked by seriousness, gravity, or solemnity of conduct or character. Marked by circumspection and self-restraint.
The first, and second, parts of the above definition are about abstinence. The other three parts describe attributes. The person that displays these attributes is Sober, not just abstinent from chemicals, not just clean. His, or her, Sobriety is manifested in “all their affairs:”This person practices Sobriety, with a capital S.
This Sobriety with a capital S is manifested in the way people live their lives, not in what they say. Sobriety is life lived in the pursuit of simplicity, and “serenity;” a way of life that avoids “excess.” For excess is the way of addiction. Addiction is excess in everything. Excess in using chemicals, and in exaggerated thinking, and behaving. The addict is addicted to extremes, and drama, as much as he, or she, is addicted to a chemical. To incorporate the above described attributes into a Sober character is the antidote for addiction. And, the acquisition of this character is the foundation of recovery. As well as, the goal of any program, or therapy, that seeks to treat addiction.
To counter the addicted character, an addict must be confronted with a person that has developed a Sober character. A person that is capable of modeling what this character is. That is capable of displaying it in daily living. Capable of showing the addict how life can be lived Sober. Modeling for the addict new ways of dealing with the challenges of life from a Sober perspective.
Then, by observation, and practice, an addict begins to substitute old patterns of thinking, and behavior. Through exposure to a Sober character, they can begin to live “as if” they had this character. By ‘faking it, till they make it,” they get a sense of what Sober life is. When their new behaviors begin to yield responses that reinforce them, they become incorporated into a new pattern of dealing with life. Through this process, a new character is formed.
In the process of this new character formation, the presence of a Sober sponsor, mentor, or therapist is fundamental; the presence of a person that personifies Sobriety. If the sponsor, mentor, or therapist has not internalized, and manifest the attributes of Sobriety, all that the addict is exposed to is another role to play: The role of “recovering person.” Because addicts are adept at role playing, the modeling of a person who is clean, but not truly Sober, will invite the addict to create yet another persona, or mask. Recovery becomes a new way to act, speak, and relate to others, without true change, without authenticity.
Many in the recovering world have adopted the persona of a recovering addict. A person can become “clean,” if this is the price that he, or she, pays for sustaining new friendships, lovers, work, or status. For, they now belong to a community where respect, admiration, business opportunities, and popularity are founded on “clean time.” However; such a person is clean, not Sober. This kind of recovery is dangerous. It is dangerous to those who practice it, and for those who are seeking recovery.
A person with “clean time,” regardless of character development, is in a position to be a sponsor, a therapist, or even to run a treatment center. They can be in a position to dictate the process of addiction treatment. They can place themselves in a position of authority. They can be in a position of power. They can be in a position to do harm.
For, without the grounding influence of a Sober character, power, money, and status, become tools of the ego. They become tools for exploitation. They become means that allow the clean, but non-Sober addict to indulge in their addictive character traits. Under the guise of recovery, and “helping,” a clean, but non-Sober person can indulge in drama, chaos, blaming, and self-righteousness. They can exercise control over the lives of others, for self-gratification. They continue to act from the basis of their “defects of character,” even if they are not using chemicals. They harm themselves, and others.
The goal of the 12 Step programs, therapy, and all interventions of addiction treatment, is to “remove” these “defects of character;” not to find a new way to manifest them under the disguise of being “clean.” According to the founders of the 12 Step programs, in order to remove these defects of character, a person must engage in a spiritual path, seek a “spiritual solution.” A spiritual solution that is ancient, and Universal. A spiritual solution that has been taught by every spiritual master in history. This solution is to become free from the “bondage of self.”
What is this “bondage of self?” It is the bondage of a flawed self that the addict has constructed through the process of his, or, her life. Once this self became chronic, the addict constructed a character to protect it, to defend it. But, this self, and character are false. They were constructed as protections, and maladaptive strategies for survival. They cover up the true Self: the Self that was created by a Higher Power. So, every true spiritual path seeks the return to this true Self. Every true spiritual path offers a way, a method, and a program, to return to true living; to return to living life on “life’s terms,” to live Sober.
For, in Sobriety, life is again experienced, as it is. When the false self no longer rules a person, its demands for power, money, status, reputation, excess, drama, etc. no longer rule that person’s thoughts and actions. As a result, the person becomes free. The person is free to enjoy simplicity. Free to recognize the mystical of the everyday. And, through this recognition, a free person can find joy, pleasure, contentment, and fulfillment in the ordinary. They can again embrace life with the joy of a child at play, not because everything is perfect, but because it is all part of life; and life is good enough in its own terms. This is spiritual living. This is Sobriety.
This Sobriety is hard to attain. It is not easy to live Soberly in a culture that is increasingly hysterical. In a culture that prizes image above substance. We live in a culture of hysterical “personalities.” A culture of dramatic, “reality” television shows, screeching religious leaders, flashy gurus, “spiritual guides,” and shocking, instantaneous, psychotherapies. It is not surprising that the development of a Sober character is not a modern, or popular quest. However; for a recovering addict it is the essential quest. Just as it was for the suffering addicts that found their salvation in it, and prescribed it to future generations; as all spiritual seekers before them had done. In order for many to stay clean, many have to become Sober.
J. E. Lesende
Sober Definition From Answers.com
ABC News Recently reported on a “virtual reality game… that presents various temptations” the game created by Duke University Professor Zach Rosenthal, allows recovering addicts to make their way through a computer generated world that resembles the world they may encounter when leaving treatment. As Rosenthal puts it “What we’re trying to do is take people into a virtual crack-related neighborhood or crack-related setting and have them experience cravings, just like they would in the real world”. Rosenthal as many other professionals in the addiction field believe, cravings are a learned experience and can be unlearned.
In a nutshell the addict is put into a situation where a strong craving is encountered and once the craving begins to fade the therapist ties the moment of decreased urges in with a tone. As the article describes, “For example, if an addict ends up in a tempting situation, he or she can take out the phone donated by the program, dial a number and hear that tone. The addict remembers the sound learned in the therapy session, and the craving should subside.”
This idea is not new and has been used in other forms for quite some time. Dr. Paul McKenna, a world renowned hypnotist, author and now TV Star on the the Learning Channel TV Show I can Make You Thin, uses similar associative therapy methods to help people curb many addictions, including food, smoking, and drugs.
The power of one’s mind is certainly nothing new to addicts. These therapies are certainly something worth looking into. Learned behaviors drive the disease of addiction and the outcomes of these studies will certainly help save lives.
For more information, go to www.dukescience.org
