Excerpt from Chapter One: It's a Disease!
Everything you know about addiction treatment is wrong.
I can safely make this statement to most laypeopleplus an alarmingly large number of health professionalswithout fear of being contradicted. Why? Because most people know very little about addiction, and what they do know (or think they know) boils down to this: addicts can quit if they really want to; all they have to do is commit wholeheartedly to their treatment, which consists largely of "talking therapy"individual or group psychotherapy or 12-step programs like Alcoholics Anonymous.
That's the sum total of most people's knowledge of addiction treatment. But it's dead wrong. And it's the main reason that the success rate for addiction
treatment is currently only 2030 percent. This means that 7080 percent of the participants in any given addiction treatment program will not be successful. No wonder people think that alcohol or drug addiction treatment doesn't work!
Fortunately, recent scientific research has discovered new avenues of treatment by showing conclusively that addiction is a chronic physical disease that attacks the brain, damaging key parts of the cerebral cortex and limbic system. This brain damage cannot be reversed by talking therapies; only select new medications and continued sobriety can do that. But when used together, these new medicines and talking therapies can literally work wonders.
In this chapter we'll look at the new scientific research on addiction and its effects on the brain. (Throughout the book I'll use the word "addict" to refer to both alcoholics and drug addicts, and "addiction" to refer to both alcohol and drug addiction, unless otherwise specified.) You'll learn what happens inside the brain of a person with an addiction, why talking therapy alone doesn't usually work, and how medications can help the brain repair itself, pushing the treatment success rate up as high as 90 percent!
Myths That Lead to Unsuccessful Treatment of Addiction
- Addiction is a serious brain disease that has reached epidemic proportions in the United States. The shocking statistics say it all:
- According to the 2006 National Survey on Drug Use and Health, about 22.6 million Americans aged twelve or older abused or were dependent on a substance during the previous year (9.2 percent of the population aged twelve or older).
- Of these, 15.6 million abused or were dependent on alcohol but not illegal drugs.
- 3.8 million abused or were dependent on illegal drugs but not alcohol.
- 3.2 million abused or were dependent on both alcohol and illegal drugs.
- Approximately 910 percent of children ages twelve to seventeen use illegal drugs, and about the same percentage report binge drinking.
- Each year, well over two million adults use pain relievers for non medical reasons.
- Over ten million full-time workers between the ages of eighteen and sixty-four abuse or are dependent on alcohol.
- There are roughly one million drug-related visits to U.S. emergency rooms every year.
- Americans spend close to $20 billion a year on treatment for alcohol and drug problems.
Seventy-five percent of alcoholics never enter a treatment program
- Of those who do seek treatment for addiction, 7080 percent suffer a relapse soon after "graduating" from these programs.
But perhaps the most frightening statistic of all is the death toll. Alcoholism is the third leading cause of death in the United States, right on the heels of heart disease and cancer. And although no one knows exactly how many additional lives are lost to the abuse of and addiction to drugs, the figure is surely in the tens of thousands per year.
Forty-five-year-old Simon, a high-level chemist at a Dallas-based manufacturer, was referred to me by a drug court judge when he was charged with his second DWI and facing a ten-year prison sentence. His life was in shambles. Alcoholism had put Simon's career in jeopardy and played a major part in the dissolution of his twenty-five-year marriage three years earlier. Since that time, Simon's drinking had progressed significantly. Of his three children, only his son was still speaking to him. Both of his daughters had banned him from their homes after he repeatedly showed up intoxicated and frightened their children. And alcoholism was beginning to take a toll on his health. His blood pressure and cholesterol levels were dangerously high, two classic signs of heart disease. And the whites of his eyes had taken on a yellowish tinge, indicating malfunction of the liver. All of these problems, his doctor told him, were directly related to his alcohol use. And yet he had never sought or received any treatment for his alcoholism.
Simon's story is not unusual. A full 75 percent of alcoholics are not in treatment for an illness that causes nearly as many deaths as heart disease or cancer. Why isn't our current treatment system working? At the inception, our ability to prevent and treat addiction is drastically hampered by two myths.
Myth #1: Addiction is a kind of "personality disease." People with addictions are often branded losers, sinners who refuse to face up to their evil ways, or weaklings who can't "suck it up" long enough to throw off their bad habits. The media does much to contribute to this belief. We've all seen the endless parade of stories about Lindsay Lohan, Robert Downey, Jr., Liza Minnelli, and countless other celebrities who bounce in and out of treatment programs. But after spending $80,000$100,000 a month for treatment, they all seem to race right out to a bar or to meet their dealers, diving head first back into old destructive behaviors. Since they appear to be getting the best possible (or at least most expensive) treatment available, the perception is that it must be their own fault that they can't stay sober; they must not be trying hard enough.
Myth #2: "Talking therapy" is the only significant treatment. Talking therapy is a series of discussions through which the addicted person learns the coping skills needed to deal effectively with stress and other issues related to the addiction. Most health professionalsphysicians, psychiatrists, psychologists, and addiction counselors alikebelieve that the best possible treatment for alcohol or drug addiction is some sort of talking therapy, such as group therapy plus individual counseling, coupled with participation in an ongoing 12-step program. Unfortunately, this approach works for only a meager 2030 percent of patients, a fact that has convinced most healthcare providers that addiction is not treatable.