Alcohol Abuse/Dependence

In my experience I have come to understand the alcohol, other drug (including nicotine) treatment field is a mix of Myths and Facts, distorting reality. The misinformation is making it more difficult for many who would like to gain independence from these and other thought based problematic behaviors.

The Thought Exchange does not label individuals “Addict”, “Alcoholic”,”Criminal”. Labels are irrational and generally counter productive; they are categorical in nature. The focus is on the negative while negating anything else about the individual and are self-fulfilling for many. Humans, after all, are multi-faceted.

The scientific terms are: ABUSE – Maladaptive Behavior that leads to negative consequences with no physical dependence. DEPENDENCE – Maladaptive Behavior that leads to negative consequences and generally includes Physical Dependence. (Review the Diagnostic and Statistical Manual (DSM) for specific criteria).

Traditionally addiction (Dependence) is labeled a “disease”, most recently, a “brain disease”, yet as I understand addiction does not meet the medical definition of a “disease.” As mentioned above the misuse of alcohol, other drugs and other thought based behaviors are maladaptive behaviors, with some including a physiological component. The one thing they all have in common is Irrational Thinking and the one thing humans have most control over is thinking! Therefore, maladaptive behavior, including Addiction is a Choice and is largely symptomatic of emotional distress. The most common response I hear when I suggest addiction is a choice is: “What do you mean? I didn’t wake up one morning and decide to become an “Addict/Alcoholic. No, but you did wake up one morning and by day’s end you did chose to consume alcohol or use some other drug, and you continued to use and use and will continue to use until you not only decide you want to stop but you put in what ever time and effort is necessary!!! The good news in all of this is individuals stop using and misusing alcohol, other drugs, including nicotine/caffine and stop engaging in other maladaptive behaviors, i.e., compulsive gambling, computer use, food related, etc. all of the time. Many do so on their own without formal intervention. Some find it easier than others. Most apply the following  COMMON FORMULA for ACHEIVEMENT:

1. ENHANCE MOTIVATION

2. AQUIRE PERSONALLY MEANINGFUL INFORMATION

3. APPLY THE INFORMATION WITH DETRMINATION and PERSISTANCE (If At First You Don’t Succeed, TRY, TRY AGAIN!!!

For many the suggestion that “RELAPSE” is a part of the process for “RECOVERY” can be self-fulfilling, when in fact relapse can and does happen BUT NOT ALL OF THE TIME. Many individuals stop the problematic behavior the first time they decide it is in their best interest to stop. RELAPSE IS NOT INEVITABLE. There is also a difference between a LAPSE and a RELAPSE: LAPSE equates with a SLIP, engaging in a problematic behavior for a brief time with limited negative consequence following a period of abstinence with a quick return to complete abstinence as compared to a RELAPSE being a return to the problematic behavior at its “worst.”

Ninety percent of treatment for these maladaptive behaviors is 12-step disease based, yet most do not find it helpful, in fact some find it harmful for very practical reasons. The good news is there are Professional Treatment and Self-Help options. Cognitive Behavioral based models, i.e. Rational Emotive Behavior Therapy (REBT.org and SMARTRecovery.org) are showing by study to be effective for many.

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