You are not your addiction

Addiction is a disease of neuroplasticity and not a choice.
Addiction is a disease of neuroplasticity and not a choice.

With approximately 1 in every 18 people in the world using drugs, there’s a growing global prevalence for substance use, according to the latest World Drug Report by the United Nations. While many people are able to use certain substances recreationally, some abuse substances, and others fall into the addiction category.

Addiction, however, doesn’t come down to a lack of willpower or a series of bad choices. Whether you become an addict or not depends on a combination of factors, including genetic loading, early childhood trauma, an adverse home environment, and specific personality traits such as impulsivity, poor emotional regulation and distress tolerance. These all increase your risk dramatically, says Jeané Coetzee, the Clinical Manager at the Harmony Addiction and Psychiatric Clinic in Hout Bay.

At the basis of every addiction, regardless the type, lie similar drivers, as just mentioned. “The drug of choice is just the symptom, but the addiction is the actual disease,” says Siobhan Alford, Hospital Manager at the Harmony Addiction and Psychiatric Clinic.

Neuroplasticity: The hope in the fight against addiction

Addictive behaviour is a result of the brain’s ability to adapt and form patterns, according to a study published in the journal Dialogues in Clinical Neuroscience. Most drugs that are abused activate dopamine (the “happy hormone”) in the brain’s reward system. This novel experience produces patterns in the brain that link external cues; to the use of drugs; to the reward system. Over time, the reward system is automatically triggered by these cues alone, leading to an urge to take drugs.

Luckily, every problem has in it the seeds of its own solution. Coetzee explains that when you start adopting healthy coping mechanisms, rather than unhealthy ones like substance abuse, positive neural pathways can also become entrenched in the brain. “The two ways in which you can rewire the brain and entrench positive coping mechanisms is through repetition and novel experiences,” Coetzee says. “There is hope in recovering from addiction because it is possible to change the real estate (physical structure) of your brain and consequently your behaviour and thinking too.”  

How to identify addictive behaviour

Addictive behaviour usually develops in vulnerable individuals, but how do you know if you or a loved one is at risk of addiction? Although using substances that activate the reward system can contribute to the development of addiction, vulnerability to addiction is influenced by a complex set of variables such as genetic predisposition, environmental circumstances, psychological factors, social pressures or trauma. A strong connection between trauma, post-traumatic stress disorder (PTSD) and addiction has been found in studies by renowned expert Prof. Alexander McFarlane.

A simple way of identifying addictive behaviour in a loved one or yourself is through the presence of the 4 C’s:

  • Cravings: A person starts craving a substance (or activity) more than usual.
  • Compulsion: A person starts compulsively using a substance.
  • Control: A person loses control of the amount or frequency of their use.
  • Consequences: A person continues to use despite detrimental consequences.

In South Africa, alcohol is still the number one abused substance followed by cannabis, methamphetamine and then opioids (which includes codeine, heroine, nyaope and wonga), according to the SACENDU Project. Besides substances, process addictions like gambling, gaming and sex are also very prevalent and treated with the same gravitas as any other drug.

The road to recovery

The first step to recovering from addiction is taking responsibility to become clean. “You don’t choose to be an addict, but you can choose to become sober,” Alford says. Making an appointment at a registered rehabilitation centre is one of the first steps that you can take to come clean. Some centres, like Harmony Clinic, work with medical aids to cover drug and alcohol rehabilitation treatment.

Harmony Clinic takes an evidence-based scientific and medical approach to treating addiction through a biopsychosocialspiritual model. “As a dual diagnosis hospital, patients who are admitted to the clinic see a psychiatrist within 48 hours and a general practitioner within 24 hours of their admission,” Alford says.

Alongside the medical approach, DBT (Dialectal Behavioural Therapy) skills such as mindfulness are a strong foundation of evidence-based addiction treatment. “After eight weeks of daily mindfulness practice, the real estate of the brain can already start to change,” Coetzee says. Although the brain rewires quite rapidly, individuals can still be vulnerable years after they’ve started their recovery process which is why abstinence (or harm reduction where abstinence is not possible) is strongly recommended.

The road to recovery is equally as important for family members as for addicts themselves. “Patients usually show significant progress in therapy and then they go home to where circumstances haven’t changed,” Alford says, which is why experts advise family members of recovering addicts to get their own therapy and to join support groups. Popular networks for family support groups in South Africa include Al-Anon and Nar-Anon.  

This post is sponsored by Harmony Clinic produced by Brandstudio24 for Health24.

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