Alcohol and drug addictions are progressive conditions. In most people, addictions begin slowly and grow until the addict’s life becomes increasingly unmanageable. As repeated efforts to gain control over the addiction fail, life for the addict begins to fall apart.
Alcoholism and drug abuse shatter lives. Consequences are reflected in the addicted person’s health, family life, social life, school or work relationships, legal situation, and spiritual well-being. In the face of a multitude of problems, the addicted person continues to use. Without treatment, repeated efforts to quit or cut down invariably collapse.
People with a chemical addiction can usually stop using — for a while. But most need professional help to stop for life. For some, treatment in a sheltered environment, safely removed from daily stress and pressure, is needed for recovery. Many people, however, are helped without the interruption of inpatient or residential treatment. They are able to enter recovery through an out-patient treatment program that does not take time off from work or school, or leaving families. Success in outpatient treatment, however, is largely dependent upon the extent of the support system that the person entering recovery has in place.
Addiction can be psychological, physical, or both. This is worth noting because of the seriousness of some of the symptoms of withdrawal associated with certain chemicals, including alcohol. Substances, including heroin and other opioids, have a significant physical withdrawal syndrome associated with detoxification, which is very uncomfortable but not deadly. Other drugs, including alcohol, and the benzodiazapam medications like Valium and Xanax can be lethal if the addicted person isn’t part of a medically monitored detoxification program. Withdrawal from these chemicals may be accompanied by seizures that shut down the respiratory system and cause death — sometimes as long as two weeks after cessation of use.
Given the above, one of the first interventions that I make when evaluating a person with chemical dependency, is to assess the chemicals that are being used, the frequency with which they are taken, and the dosages. With that information, I can understand if the detoxification process may be lethal or merely uncomfortable. A non-lethal but profoundly psychological addiction, such as that found with methamphetamine, cocaine and marijuana, can be just as difficult, if not safer, than detoxifying from a physiologically addictive chemical. Therefore I will take a careful history before making any recommendations or formulating a treatment plan with the patient.
