Substance abuse counselors help addicts towards recovery. They help family members, friends, and employers deal with emotional stress caused by addictions. Substance abuse counselors can work with individuals and with groups to formulate treatments that meet each client’s needs. They partner with other professionals to offer support services, medical evaluations, monitor progress, and to teach new coping skills. They may also work in schools or community programs where they raise awareness and increase community support. They are often seen teaching children in school about the dangers of drugs and how to avoid them. They educate parents to prevent drug use and teach them signs to look for and what to do if a child or loved one needs help. Substance abuse counselors can be a voice of reason in worlds of chaos.
Counseling people who suffer addictions takes love, compassion, and commitment, and it also takes trust. A client has to trust the counselor and feel safe enough to open up about their experiences. Duty to warn and other confidentiality policies have to be clearly explained, and at the same time, counselors have to commit to seeing their clients through to recovery. Treatment options vary and there is no one-size-fits all to work with. Instead, there are many models that may be science-based and others that are more wellness-based. Relapse rates vary between 30% to as high as 70%. There is still the hypothesis that addiction can be cured and prevented.
People have been studying addictions since the early 1900s. Early ideas about addiction stemmed from concepts that something was morally and spiritually wrong with people that become addicts. Addicts were even punished for their behaviors and still are today. There have been many trials and errors in the addictions field and there is still no cure. It has came to be understood as a complex medical condition that is caused by biological and environmental factors. Many studies have been conducted, but still more research still needs to be done to truly understand the causes, effects, and costs to effectively treat and prevent this complex disease.
People from all walks of life can become addicted and even though addiction has been studied for years there is not that much that is known about it. There is no cure to stop addictions and although educating people about addiction and raising awareness can help stop someone from becoming addicted there still needs to be more research done to find what works. What causes addiction?
Most people with addictions also have co-occuring disorders that will need to be treated, yet it is reported that only about 10% of the 22 million people in the United States that need treatment got it. The American Board of Addiction Medicine (ABAM) reported that a little over 2 million people received treatment, but that generally the treatments they received were not evidence-based. And in 2018, the CDC reported that the rate of drug overdose deaths is still increasing. Twenty percent of all deaths in the U.S. every year are the result of untreated addictions. The CDC says that the cost of addictions is greater than the cost of diabetes and all forms of cancer combined.
Some people still don’t accept addiction as a disease and believe that it is a moral problem even though evidence shows that the brain changes. No little boy or girl ever claims to want to grow up to be an addict and addicts can’t quit even when they know a substance is hurting them. Family and friends often want to know how they can motivate a loved one to seek help. Addicts want to know that there is hope and that somebody cares and will support them through recovery. Counselors want to know how they can help their clients recover. Researchers want to know what causes the disease and how it can be treated and prevented. Policy makers want to know how much treating the disease will cost and what the cost of addiction is. The addict just wants to know that there is hope and that there is someone that they can trust to help them through to recovery.
The most important reason to find answers to preventing and treating addictions is of course because addiction can be deadly. There are clues that addiction is a problem and when people are aware of what signs to look for and how to help someone that they care about, outcomes can be better. Families can stay intact and children do not always have to end up in the broken child welfare system.
Withdrawals can be dangerous for an addict to experience so medications are often necessary and a medical doctor will have to keep a close eye on the patients. Medications combined with counseling and other behavioral therapies can be effective treatments for addictions. Behavioral approaches can be used to motivate and modify attitudes and behaviors related to drug abuse and to teach skills that help addicts handle stressful circumstances and environmental cues that trigger cravings for alcohol and drugs that lead to relapse. Family involvement is very important to an addict’s recovery and especially important to adolescents recovering from addictions.
Personality is an important concept when it comes to addictions. Many of my own friends, family, and people in my social networks still believe that addiction is a personality flaw. It is sometimes difficult to explain to people I run across that blaming the addict or telling them that something is wrong with them is only making the problem worse. Personalities make us unique individuals, but some people believe that “personality flaws” lead to addictions and other behaviors that societies do not accept. Life experiences, genetics, childhood adversities, family history, social environments, and culture are some of the things that make us who we are. Up until around 1950 addiction was believed to be a spiritual problem and that a person that became addicted lacked morals. And then, in 1950, the American Medical Association defined alcoholism and later addiction came to be defined as a primary, chronic disease with genetic, psychosocial, and environmental factors influencing the condition’s prognosis. The controversary continues though about whether or not there is an addictive personality. Some people believe that certain personalities types become addicted and some people believe that genetic and environmental factors cause the brain to change making a person more likely to become an addict. Illicit drug use is associated with sociodemographic factors, with all measures of childhood adversity, with having a first-degree relative possessing an alcohol problem or a drug problem, and with all mental disorders, except anxiety disorders.
I believe that trauma causes addiction and that it can happen to anyone, and there are plenty of studies that show that trauma is a major factor that contributes to people becoming addicted. Some people turn to addictions as a way of self-medicating themselves. The forty-year old successful businessman, the accountant, and the doctor may turn to alcohol in an effort to escape some of the pressure that they feel. The teenager or the college student may start drinking because of peer pressure. And then there are the people that are less fortunate that turn to substances to escape tragedy in their lives. The girl that was sex-trafficked and stands on the street, the child in foster care that feels like the only place he belongs is with the people that accept him, and they are smoking weed and drinking. The mother who lost her children and can’t make sense of her life.
People’s lives spiral out of control. Substances alter a person’s decision making skills and behaviors because trillions of nerve connections and complex thought processes inside the brain are associated with reasoning, emotions, pleasure, rewards, and motivation. Dopamine is released when we crave something causing us to behave a certain way to get what we want. Rewards function as associative learning that affects decision making and behavior.
Humans learn what we like, what makes us feel good, and what we have to have to survive. Substances such as heroin, cocaine, and methamphetamines among many other substances make use of the reward network. As a person’s motivations change from feeling satisfied to not being satisfied, the person’s behaviors change to fill that need. Addictions happen when normal pleasure signals are weakened through use of addictive substances. Physiological response becomes dull and a person enjoys the reward less. The sad part is that an addict cannot quit even when they know abusing is hurting them. Sometimes I wonder why we say addicts are abusing drugs when what they are really doing is abusing themselves. The harm addictions costs society is immeasurable and addicts still have to make the choice to get help and unfortunately, many people that want help cannot afford it. The person that hits rock bottom probably does not have insurance to pay for treatments. And that brings me back to the fact that addicts have to have someone that they trust that is committed to seeing them through. It takes love, compassion, and commitment, and it also takes trust, time, and money to get the best outcomes.
If someone you know needs help, SAMHSA’s National Helpline: 1-800-662-HELP (4357) and TTY: 1 800-487-4889 is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. And online treatment locators.