Enrolling in care is a commitment, and most people who do so have at least some hope that they can leave drugs behind for good. However, some people who accept addiction care do so at the bidding of the people they love, and deep down, they might still feel as though using and abusing drugs is the right course of action for them.1 Their motivation to really recover is low, and that could force them to drop out of treatment before their work is complete.
Ambivalence about healing is considered normal and natural, according to the Substance Abuse and Mental Health Services Administration, and many people who use drugs harbor conflicting thoughts about their habits.2 They might want to stop using drugs, but at the same time, they might like the way the drugs make them feel. They want to stop, but they want to keep using at the same time.
Motivational interviewing (MI) is designed to help clients see these contradictions and work to overcome them. Through gentle questioning, therapists help clients to identify their life goals, and think about how substance abuse might help or hinder the achievement of those goals. Therapists might also help clients to think about how their lives might be different if they quit, and how life might stay the same if they continue to use. It’s not a combative therapy, but it can help encourage a loved one into therapy. In time, even an ambivalent person might become deeply committed to sobriety and willing to work hard to make it happen.
It’s been said that knowledge is power, and when it comes to addiction, many people who are afflicted don’t understand how their chemicals work and how those substances might harm them. For example, addicted people might claim that they can stop their use at any point, as long as they wanted to do so.
Research has suggested, on the other hand, that a remarkable number of people who use drugs become compulsive users who can’t control their intake. Of those users:
- Nine percent develop marijuana dependence
- 17 percent develop cocaine addictions
- 15 percent exhibit alcohol addictions
- 23 percent develop heroin dependence
Understanding how substances work can allow people to plan for the future. They’ll know that taking drugs, just once, could put them back on the path to misery, and they might be less likely to experiment as a result. A deep understanding of drugs can also help people to be patient when it comes to their own healing process.
Group classes involving drug chemistry, addictive behavior and typical healing patterns can be helpful, but some programs augment this learning by providing reading, videos and lectures for addicted people to take in on their own time. Homework assignments might help therapists to ensure that their clients are working toward sobriety outside of the therapy room.
Addictions often have their roots in chemical damage caused by powerful substances. Each little hit leaves a mark behind, and in time, all of those wounds can result in a remarkable lack of control when it comes to substance use and abuse. Sometimes, however, there are specific emotional states that can make hidden damage spring to life, and people with addictions may have a lack of ability to soothe their minds without drugs when they’re placed under this kind of emotional pressure.
A study in the journal Psychopharmacology, for example, suggests that cravings for cocaine spike in addicts under stress.3 These people might always feel an urge for the powder, but when their emotions run high, their damaged brain cells call out for relief in the most efficient way possible. These cells call out for drugs, and their cries can be hard for addicted people to ignore. Strong feelings of sadness, anger or nervousness might cause a similar spike in cravings.
Therapy can help by providing people with tools they can use to soothe their distressed minds. They might learn how to meditate when they’re feeling anxious, focusing on an outcome that might fill them with pleasure rather than thinking about an ending that might cause them pain or distress. People might also learn how to use art, exercise, talking or writing to ameliorate strong sensations, without using drugs at all.
Skill-building sessions like this are often provided in group settings, allowing people to learn in the company of understanding peers. These sessions might also allow people to practice their new skills in real time. The people who make up the groups can change with time as some people learn faster than others, but the group setting always remains supportive and positive.
While handling triggers when they arise is vital to preventing relapse, people who avoid the people, places and things that cause an upswing in distress might experience an even more profound sensation of relief. They won’t need to use their new skills as they won’t place themselves in situations in which distress and misery are likely. Cognitive Behavioral Therapy (CBT) can allow people to identify their triggers for drug use and come up with techniques they can use to keep these situations out of their lives in the future. For some, this involves making new friendships. For others, this involves moving to a new neighborhood or finding a new job. For still others, this means avoiding bars, chat rooms or other places in which drug talk is common. By leaving these spurs behind, people might not be so tempted to use and abuse drugs of any sort.
Dealing with Underlying Issues
While situations can certainly cause a spike in the need to use drugs, some people have underlying mental illnesses that work as a constant impediment to their ability to heal. The National Alliance on Mental Illness suggests that the link between drugs and mental illness is complex, as some people develop drug addictions in response to mental illness while others develop a mental illness in response to drugs, but everyone who has these concerns needs specialized therapy in order to heal.In essence, they need therapy that assists with the mental illness, and that therapy should be infused with knowledge of drug addiction chemistry.
People who have anxiety disorders, for example, might use drugs to help them sedate their nervous feelings when they’re forced to interact with the object of their fears. Exposure therapy might allow people like this to slowly become accustomed to the target of their anxiety. They might look at photos of the object, and then watch videos. In time, they might look at the object from afar, and then touch the object. At each point, the person might be tempted to use drugs, but the therapist can provide alternate self-soothing techniques that can take the place of intoxication. In no time at all, people might feel much more comfortable when they’re forced to interact with their fears, and they might not have the need to use drugs.
Therapy like this is individualized as the treatments provided for specific mental illnesses can vary dramatically. In addition, some people with addictions have a long and well-known history of mental illness while others might have never been diagnosed with a mental health concern in the past. Programs that specialize in providing care to people with both mental illnesses and addictions tend to provide thorough evaluations, ensuring that the treatment team understands the issues the addicted person faces.2 Evaluations like this can also help to make the path to healing a little easier for the treatment team to map.
Including the Family
Addictions often begin with the habits and preferences of an individual, but the choices that person makes can impact families in the following ways:
- Emotional health
- Communication styles
Families impacted by an addiction can be fractured, unable to support one another and unable to see how the damage began. Inadvertently, a family like this can keep an addiction in play. Loving partners might coddle an addicted person through a bad binge, or they might take over household responsibilities and provide the person with more time to binge. Breaking these habits is vital to the healing process, and family therapy can make it happen. Here, people learn more about how the addiction has changed the whole family and what they all might need to do in order to make the issue fade away with time. The group might also learn new techniques they can employ as they communicate with one another, and they can also learn how to effectively support young sobriety in the person they love.
Family therapy sessions are sometimes large, including each and every person who is a member of that family.3 However, they can also be quite small, including just one or two people who have a specific need for healing at that time. Some families need only a few sessions, but others might spend months in therapy until they have built up the skills that can allow them to function effectively. Thankfully, there are no time limits on this kind of therapy, so families can do what’s necessary in order to get better.
Changes with Time
As people continue to participate in therapy, the lessons they must learn can ebb and flow. In the beginning, for example, they might need to know more about how their issue began and how the body heals. In the middle of therapy, they might need to focus on the issues that can keep their specific addiction in play. As therapy draws to a close, they might need to develop an understanding of how to prevent a relapse from taking place. As a result, most therapy programs strive to change as the addicted person changes. New lessons are incorporated, groups shift and time spent in therapy can change. Sometimes, people even spend fewer hours in therapy each week as they learn, and other times, they’re asked to augment their time commitment in order to deal with a new issue.
Recovery Never Ends
While therapy can be vital for people who have drug addictions, the National Institute on Drug Abuse suggests that addictions are akin to chronic conditions that can result in repeated relapses and repeated needs for therapy.4 People who stay in their treatment programs for a long period of time—at least several weeks if not several months—have a more robust shot at long-term healing, but even so, some people may find that they have a few lessons to learn when their formal programs are complete. They might have relapse challenges in the community that they hadn’t planned for, or they may have new concerns that just didn’t appear when they first chose to enroll in care. Touchup therapy sessions can be vital in cases like this, as they can help people to further enhance their sobriety skills, and they might be able to maintain the gains they made in their original treatment programs.
Black Bear Rehab, provides integrated care for people who have substance abuse issues complicated by mental health concerns. Since aftercare is such an important part of the healing process, we provide all our clients with a lifetime of support. We even have a specialized treatment program for people who have chronic relapsing concerns.4 If you’re addicted to drugs, we might provide just the environment you need in order to get well. Please call us at our 24-hour, toll-free helpline to start the enrollment process today.
1 “Enhancing Motivation for Change in Substance Abuse Treatment.”Substance Abuse and Mental Health Services Administration (SAMHSA), 1999. (Treatment Improvement Protocol (TIP) Series, No. 35.) Chapter 3: “Motivational Interviewing as a Counseling Style.”Web. Accessed 10 August 2017.
2 Arkowitz, Hal and Lilienfeld, Scott O. “Experts Tell the Truth About Pot.”Scientific American. 2012.Accessed 10 August 2017.
3 R. Sihna, T. Fuse, L.-R. Aubin, and S.S. O’Malley. “Psychological stress, drug-related cues, and cocaine craving.”Psychopharmacology. 2000.Accessed 10 August 2017.
4 “Treatment Approaches for Drug Addiction.” NIDA. 2016. Accessed 10 August 2017.