It takes more than will power to fight addiction

2012-09-13 00:00

GEORGE Baker enjoyed a successful career as a sound engineer in the film industry, where heavy drinking and recreational drug use were common. “Although alcohol was my drug of choice, cocaine use was almost standard in the industry, and before I knew it I was using so heavily I could not get any work as I’d developed a reputation for being unreliable,” he said. “I ended up unemployed, drifting between towns, sleeping on beaches and in my car as a cycle of binge drinking/drugging and recovery repeated itself. I was arrested twice for drunken driving, but managed to stay out of jail. Then a friend died after a seizure brought on by bingeing. I woke up one morning in my car and thought ‘What am I doing?’ That was my rock bottom. I got help and am proud to say I have been clean for seven years.”

Baker now works as a counsellor for the addiction treatment unit at Akeso, a private psychiatric clinic in Scottsville. As part of a team of health professionals that includes psychologists, psychiatrists and occupational therapists, he believes the clinic is unique in the support it offers the person trying to overcome addiction.

The clinic takes its name from Akeso, the mythological goddess of healing and curing who unlike her sister Panacea, believed that cure involved a process rather than a magical, once-off, cure-all event.

While the addiction unit is managed by Susan Spencer, a counselling psychologist, Baker’s role is to give patients the support and understanding of someone who has “been through the hell of addiction and survived.”

The clinic’s Addiction Treatment Unit works from the premise that many people who struggle with addiction need to deal not only with their behaviour, but also the underlying emotional issues.

Spencer said that many people who are chemically dependent have had traumatic histories that have led them to self-soothe through addictive substances or behaviours. Simply addressing the substance use ignores the dynamics underlying the addiction. Drugs serve as a coping mechanism, albeit an unsustainable and usually self-harming one.

“You can’t just remove this coping mechanism without replacing it. Also, as a result of active addiction, addicts’ lives and interpersonal relationships are often in a shambles and they need specific assistance, in the form of psychotherapy, to address these consequences of their addiction, without which they will inevitably return to their drug of choice as their primary coping mechanism.

“For example, a patient called Sarah* had to face up to the fact that despite being wealthy, successful and having a loving family, she had suffered childhood trauma, which was one of the reasons that predisposed her to addiction,” said Spencer. “She drank to fill an emotional emptiness at the centre of her life. In addition, having had an alcoholic parent left her vulnerable to addiction.”

Spencer said that places that treat only the addiction will say “stop using drugs”, but that may be a little simplistic. “Firstly, the person must stop using, but if they only do that they may end up a ‘dry drunk’, that is someone who is ‘white knuckling’ their sobriety. In other words, they may be sober but they’re unhappy because the issues leading to the substance abuse have not been dealt with. Some people get into recovery easily, others have relapses, or substitute one problem for another. They tend to stop using and become compulsive to cope with emptiness and boredom. So, a dry drunk may stop alcohol use, but her personality characteristics do not change without doing some therapeutic work on herself,” she said.

“The support infrastructure for people in this city trying to recover from addiction is very limited, which is why this unit was opened. We offer a three-week structured programme for people struggling with addictive behaviour around alcohol, drugs, sex, over eating or gambling. Addiction can also extend to shopping and electronic media.

“Our treatment philosophy is guided by the 12-Step Minnesota Model which is used in premier addiction treatment centres worldwide. It was originally formulated by Alcoholics Anonymous (AA) in the United States in the thirties and extended by Narcotics Anonymous (NA).

Akeso’s programme includes individual and group therapy, and, if appropriate, family and couple counselling. “Detox, the process of relieving the individual of dependence on a drug is a delicate process, that is carefully managed by psychiatrists and a team of a 24-hour nursing staff. The clinic also offers support for addicts in recovery through AA and NA, plus community and family support programmes through groups like Al Anon for families, ACOA [Adult Children of Alcoholics].

“We help people who have been through our unit to prevent and manage relapse by running a free after-care group called Tag [The Akeso Graduates],” Spencer said.

Spencer said that most medical aid companies will pay for up to 21 days of in-patient treatment for emotional conditions such as depression and anxiety, which underlie the addiction.

Willingness to co-operate on the part of patients is crucial, said Spencer. “Getting sober and/or clean can be excruciating for people as it means facing the chaos and trauma they have caused, which often creates huge denial and causes them to feel great shame. At Akeso we aim to be accepting and non-judgmental, supporting patients through recovery.

“It requires willingness from addicts to deal with some of the aftermath of their addictive behaviour. Because of this, admission to our programme has to be voluntary. Patients need to be ready and willing to participate in their recovery.”

As far as success rates go, Baker said of the core group of people who have continued to attend Tag after-care group, about 50% have maintained their sobriety. “Others have slipped, but come back, while some have to come back six, seven, eight times before they maintain sobriety. We’ve only been going a year, but we are convinced that our psychology-based integrated approach really does work.”

“People mostly enter our Addiction Unit at rock bottom. However, when they leave the three-week programme, they have a tool box of skills and insights about why they are addicts, how to deal with their triggers to relapse, a new sense of self and a feeling that their lives have meaning,” said Spencer.

• www.akeso.co.za

* Not her real name.

 

SUBSTANCE ABUSE IN PMB

• The majority (62%) of Sanca treatment referrals are for alcohol, followed in frequency by dagga, mandrax and cocaine.

• 84% of patients are male, 38% are employed, 24% unemployed and 36% pupils and students.

• 32% of patients are in the range of 22 to 35 years; 25% are aged 14 to 17 years; 23% are aged 36 to 59 years; 16% aged 18 to 21.

• Race: 65% are black; 15% are white; 12% are Indian; 10% are coloured.

• Prices: money bag of dagga = R100. Tablet of mandrax = R80. Match-stick head of cocaine = R50. — Sanca annual report 2010/11

 

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