Addiction: Ask the Expert

Depression Diaries was formed to provide support for people living with a mental illness as well as their family and friends. All I can provide is my story, my insights, and the lessons I have learned along this winding road.

One topic that is exceptionally important to address within the realm of mental health is Addiction. While my time in Al-Alnon has taught me a great deal about Addiction, I see it as a major gap in terms of what support I can provide to others. So, instead of avoiding such an important subject I have partnered with Jim LaPierre, LCSW, CCS. Jim is the Founder of Higher Ground Services and is a Trauma & Addiction Counselor in Bangor.

I hope this Q&A can offer some support to people affected by Addiction, and insight for all others. Over to you, Jim!

Q. How do you describe the relationship between Addiction and Mental Illness?

A. The relationship is usually intimate. It is rarely the case that addiction causes mental illness – when that happens it is almost always fleeting and episodic.

While a very high percentage of folks who live with mental illness never develop substance abuse or addiction, rarely has a person lived with addiction without an underlying mental illness. Substance abuse is a way of coping with negative emotions and/or mental illness. Utilizing drugs/alcohol repeatedly disposes one to dependence, which often leads to addiction.

Recovery from addiction requires recovery from mental illness. In most cases, sobriety has to be the priority. Whatever gains a person might make in mental health are unlikely to endure if they continue to abuse substances.

Q. What are the major misconceptions you have observed with regards to Addiction?

A. There’s an old expression that there are only two types of people in the world – “us” and “them.” The misconceptions I see are generally attempts to distance oneself from the possibility that one could become an addict. Truth – none of us are immune.

Somehow we continue to question whether addiction is truly a disease as opposed to a moral shortcoming or lack of will power. I never argue this point. I suggest that maybe the A.M.A., the C.D.C. and the W.H.O. should be considered to have greater expertise than the average layperson as to what is a disease and what isn’t. They and virtually the entire scientific community agree that it’s a disease.

Further misconceptions – addicts are poor or lower economic status. They’re lazy, unemployed, homeless, and uneducated. In truth, addiction is the ultimate in equal opportunity. It doesn’t care what walk of life you’re from. It simply wants to take everything good away from you.

Q. What do you think is the path toward stemming the current heroin epidemic in Maine?

A. No social problem has ever been alleviated until sufficient levels of grassroots support has risen up. Until we come together at every level – from families to neighborhood to communities and focus on what unites us instead of what divides us, too little progress will be made. We need civic and religious communities to come together. We need to recognize that our individual efforts are far less than what we can do together.

We need to accept that law enforcement will not stem the tide. It’s bizarre to me that our governor and legislator are demanding more law enforcement while progressively, folks in law enforcement are saying, “We can’t solve this. We need more treatment.”

Addiction and mental illness impact us all. It’s only a matter of whether we’re impacted directly or indirectly.

Q. How can families notice Addiction in its beginning stages, and what can they do to avoid its progression?

A. Families can educate themselves. There are a ton of great resources online and very layperson friendly sites like choosehelp.com provide some very pragmatic suggestions on how to identify and respond to substance abuse and addiction.

Early warning signs are like pink flags – not hard to see but easy to discount. My guiding principle is that whenever I see someone behave in a manner that is uncharacteristic to who I know them to be, I respond by checking in with them and expressing concern without judgment. I look for defensiveness or deflection as indicators of a larger problem. I will not push the issue, but I will continue to reach out and show concern and a willingness to support. I urge families to notice changes in routines, schedules, new friends and the loss of formerly valued activities or relationships. Decreased overall health, sudden weight loss, declines in hygiene are all indicators of a problem. In this respect, mental illness and addiction share overlap of symptoms and so I urge folks never to make an accusation but always to state very simply and directly what they notice and offer to help.

Q. What are the top three pieces of advice you would give to someone who is silently suffering from Addiction?

A.1.    Stop being silent. Tell good people. You’re not imposing on them. You’re not a burden to them. Your silence does not protect them – it hurts someone they care about. Whatever you hide will run and eventually ruin you.

2.    You are not alone. Shame is our worst enemy. The very best people I know are like you and I – we’re fallible, we’ve made huge mistakes, we understand each other and accept you just as you are.

3.    Recovery is more than just being sober. It’s having a kick ass life. You deserve that. Those of us who have come through hell to have the good life only get to keep it if we give it away – you help us by letting us help you.

Q. What are the top three pieces of advice you would give to the family member of a person suffering from Addiction?

A. Learn about enabling and make sure you’re not doing it. Enabling is tough because it almost always feels like the right thing to do. If I protect a person from the natural consequences of their behavior, I rob them of motivation to change. Unfortunately, in all my years of doing this work, I have only ever found two things that motivate a person toward recovery from addiction: Spiritual awakening/growth and suffering. That’s why “tough love” is vital.

You are not responsible for your loved one’s addiction. You didn’t cause it. It didn’t result because of any shortcoming of yours. You cannot cure it. You are largely powerless and you simply must choose to take care of you. Think of it this way – your worry does not help your loved one. How healthy do you want to be when they’re ready for your support?

Please, please, please join us in Al-Anon, Nar-Anon and other 12 step fellowships. Don’t be alone with this.

Q. Would you please speak to the correlation between PTSD and Addiction?

A. The relationship is most often born in the temporary relief that substances offer to a survivor.

I often find very specific relationships between trauma and an addict’s drug of choice:

For a lot of survivors I’ve served, opiates and benzodiapines are the only things that ever provided a feeling of safety (albeit a false one).

For survivors I’ve served with PTSD and Attention Deficit Disorder, stimulants like crack cocaine and amphetamines slowed their brain to a pace that felt manageable and yet was utterly unmanageable.

For the survivors I’ve served seeking to overcome alcoholism, ingesting a known depressant offered temporary relief from depression at the cost of increased levels of depression in the long term.

Trauma throws a wrench in everything. The relationship between PTSD recovery and Addiction recovery is the least understood of what we call “dual diagnosis treatment/recovery.”

I worked with a survivor many years ago who expressed the issue better and simpler than I’ve heard it spoken. She explained, “Every time I get sober, I remember. Every time I remember, I get drunk. Safety is the most basic of human needs. Nothing is more important. In order for her to stay sober, she needed to incorporate basic grounding strategies, supports, and skills that promoted a sense of safety. Then and only then was sobriety manageable at all. This did not require exploring her past but rather adjusting to her present in an adaptive, consciously chosen manner.

The importance of support for a person seeking recovery from both trauma and addiction cannot be overstated. I urge folks to consider group therapy and support groups specific to PTSD and addiction recovery as options because it’s really tough to share so much of our story when we don’t know who will get it and who won’t. I see incredible possibilities when folks come together to share their experience, strength, and hope.

Q. What is the best thing the general public can to do help people living with Addiction, and stop its development in the community?

A. Short answer: invest in every child and young person you meet. Educate yourself and share what you learn. Every single thing you do to build community and a sense of shared belonging weakens drug demand. When we all feel a part of and valued, substance abuse diminishes.

Organize. Come together and speak truth to power. Demand support for medical detox, rehabilitation and life saving measures like Nar Can.

Support people in recovery: Consider employing people in need of a second chance. No one has better work ethics than people in recovery. Consider renting to people with lousy rental histories but great personal references. Help reduce stigma. Be a friend, a good neighbor, and if you know someone in recovery, ask how you can help.

Q. What are your beliefs regarding the legal system and Addiction? Do you think current laws are helping or hindering the community’s health?

A. No question – everything we’re doing is not working. I do not advocate light sentencing or otherwise failing to hold folks accountable. I do advocate considering the futility in consistently incarcerating folks who only possess usable amounts of a drug. There is a world of difference between a mass producer/distributor, a pusher, and someone who only deals to support their own addiction. Our current laws do not sufficiently consider these distinctions

Treatment, education, and creating opportunities in housing, employment, and inclusion at every level of community are far more common sense solutions and in most cases are less expensive then long term incarceration.

Q. What are three things I have not asked about, but you think are some important topics that need further discussion?

A. 1. Marijuana as a potentially safe and effective and safe medication for PTSD and whether it leads to addiction.

2. Different pathways to recovery from addiction – 12 step groups aren’t an option for everyone

3. How to best ensure a good fit for recovery when seeking professional help.

Photo via Visualhunt.com

Emerald Russell

About Emerald Russell

I have lived with PTSD & Depression for approximately 15 years. In this time I have navigated many of the challenges faced by people who live with a mental illness: stigma, employment, financial challenges, traveling with a mental illness, trauma, relationships, family issues, and more.