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Old 02-08-2012, 09:15 AM
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Default The Definition of Addiction

"Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors".

The Definition of Addiction

Addicts tell me the worst part of the addiction is worrying about how to keep a steady supply of the drugs they are addicted to. They say the drugs don't even make them feel better anymore but they are powerless to stop. Unfortunately the rate of relapse is extremely high.
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Old 02-08-2012, 11:15 AM
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Is there any way to treat this dysfunctional circuitry without turning the person into a zombie in the process?
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Old 02-08-2012, 01:07 PM
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Most definitely! They are detoxed by taking them off all of the drugs and/or alcohol they are addicted to. It's a much more kinder and gentler detox than in the past. Those who are addicted to opiates get sublingual Subutex which acts on the same targets in the brain as the various opiates and suppresses the withdrawal symptoms and relieves cravings. They start out taking it QID and over a period of 5-7 days are weaned off of it. In the meantime if they have stomach cramps, headaches, diarrhea, nausea, etc....we have a list of comfort meds such as phenergan, zofran, motrin, tylenol, antispasmotics, maalox, etc. If they have a history of seizures with withdrawals, they also get an anti-seizure medication.

If they are addicted to alcohol or benzo's they get Valium and Phenobarbital and all of the comfort meds are available to them also. They are likewise weaned off of the Valium and Phenobarbital. If any of the medications make them sedated then we back off of them, and adjust the dosage,so that does not occur.

They get a daily nicoderm patch and PRN nicotine gum to keep them from craving cigarettes.

They see a psychiatrist and medical doctor daily. They are kept on all of their home meds such as for BP, diabetes, COPD, etc....They get 3 meals a day, 3 snacks a day, time in the gym daily, they go to at least 3 classes a day (1 hour each) learning about their triggers, how to handle cravings etc...they have an AA or NA meeting every evening. By the time they leave they are completely detoxed. They get RX's for medications to take daily to keep them from craving. They are set up with rehab. Some inpatient, some outpatient. While they are on the detox floor they are treated with respect, they have choices they can make. They have the use of phones (even long distance) TV, games, DVD's, books, magazines, sometimes they just get together and talk about their issues on their own.

The problem with relapse is that they still have the same problems that they had before they started using and while they were using and now they have to face all of those issues and feelings without the numbing effects of the drugs/alcohol. They go home to the same people they used to be around who more than likely are addicted to drugs/alcohol.

They try, they try really hard. They come back. The doctor taught us, "never give up" it may take multiple detox's before they get it but eventually many of them do. They deserve the best care we can give them.

I know that you were in a psychiatric facility when patients were not treated like humans and were not treated with the respect you deserved. In the past, patients were more harmed by the treatments than helped and a stigma was placed upon them. Thank God we have come a long way in the treatment of addictions and mental illness.
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Old 02-08-2012, 10:21 PM
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I only hope that such treatment is also available to people who don't have a lot of money/insurance. it sounds horribly expensive, otherwise. I didn't have either when I was in that facility; I'll bet that that sort of problem still exists.
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Old 02-08-2012, 10:51 PM
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Quote:
Originally Posted by Poliopioneer View Post
I only hope that such treatment is also available to people who don't have a lot of money/insurance. it sounds horribly expensive, otherwise. I didn't have either when I was in that facility; I'll bet that that sort of problem still exists.
No, as a matter of fact quite a few of the patients are homeless or live in shelters, the mission, etc...Few have private health insurance but they are all treated the same. As I said....Thank God we've come a long way. I'm just sorry it wasn't soon enough for you and 1000's more.
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Old 02-09-2012, 10:16 AM
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ITA. Nobody knew what to do for addictions back then (1974). Most of us were there for other reasons; one of my roommates was an alcoholic, trying (vainly) to get free from that. She got the same meds as everyone else: heavy-duty, old-school antipsychotics that really didn't help anyone. There was no gym, lousy food, a nighttime snack (if it wasn't grabbed first by the quick and the mobile), and absolutely no classes or one-on-one exploration of one's problems. Yes, you've come a very long way, and I'm grateful for that.

Just out of curiosity: how are other psychiatric illnesses treated in in-patient facilities, these days?
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Old 02-09-2012, 01:55 PM
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I was watching "Biggest Loser" one night, at my parents (they love that show) and they discussed this.

The doctor was showing the participant how their brain reacts to being stimulated when one is anticipating eating food. The brain tends to over react and creates a "must have it" sensation by making us feel as though we are going to be stimulated by eating the food (almost as though the brain is promising to release w/e chemicals it uses to produce the feeling of happiness and closure). The entire process, all the way up to when the meal ends, is identical to that of a drug addict.

For the food addict though, the cycle does not end there. While the addict feels "fixed" and returns to normal (no longer craving the chemical, until next time), the food addict then enters another stage of feeling unfulfilled. The "promises" of feeling happy/satisfied are left undone, and the food addict has an emotional crash. The end result is, we feel the meal, no matter how good it was, was not good. We interpret our emotional let down as being the result of still being hungry and/or being disappointed in the meal and often eat more (in hopes of getting the promised "happiness").

I can see this taking place when I start getting stressed out and want to rely on my best friend "Pepsi" to get me through the hard times. When I say that, it sounds ridiculous but I run to Pepsi the way normal people turn to friends, during times of stress.

I'm a firm believer in there being an "addictive personality". I do think some people trend towards addictive behaviors more than others. On the other hand, I don't agree with the current social norms of how we react to it (as evidenced by my assertion that drug diversion should be a one time = out for good position). I think the best medicine is Tough Love. Addicts rarely change unless they are given the freedom to "hit bottom", so any enabling behavior that postpones this is, IMO, counterproductive.

The idea of there being a "Video Game" addiction is starting to take hold more now too. Every watch one of the specials on it? They use WOW as their prime example of how addiction to games leads to the same place addiction to alcohol/food/drugs/tobacco does. There are some VERY scary stories out there regarding video game addiction. Its part of the reason I got rid of my Playstation 3 and went with play Wii (which has much less involved/time consuming games).
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Old 02-09-2012, 10:36 PM
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I guess, although I'm also guilty of stress eating, that either I'm not addicted to food, or I've come up with some very good strategies to deal with it. Example: I'm supposed to cut back on fat consumption so, when I'm jonesing for candy, I substitute Smarties for Butterfingers (damn, I miss those little monsters). ITA that video games (and computer solitaire) can be addicting; I make rules about when I have to stop, and generally adhere to them. How much do you want to bet that they're even more hazardous for lonely people?
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Old 02-10-2012, 09:14 PM
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Quote:
Originally Posted by Poliopioneer View Post
Just out of curiosity: how are other psychiatric illnesses treated in in-patient facilities, these days?
Basically the same way. Medications, classes, group therapy, exercise, arts & crafts, etc....
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Old 02-10-2012, 10:24 PM
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You must be fortunate enough to work in a great place, then. From some of the things I've heard, it isn't that way all over, or all the time.
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