Tag Archives: addict

A future for addiction treatment

After several blog posts where I have explained how profoundly detrimental today’s drug laws are and how legalization could work, it feels important to write something about addiction treatment after such a paradigm shift.

The question is: what kind of addiction treatment do we want to see in the future? But before I go into that, I first want to say something about addiction and addicts.

What is addiction?

No name by Christian Scheja on Flickr
No name by Christian Scheja on Flickr

I define addiction as something compulsive where the person despite serious negative consequences is not capable of changing their behaviour. Addiction is often surrounded by a lack of awareness about ones problems, or an unwillingness to face them.

Note that such a definition can be applied to very many things in life, not only substances. It is common for people to abuse relationships, sex, games, television or food, just to name a few. It is especially important to emphasize that addiction is never inherent to what is being abused, but is something in the addict him/herself.

When people talk about substance abuse in the public debate, it is easy to get the idea that the substance is the cause of addiction, because as soon as anyone uses an illegal substance they are seen as addicts. That is a profoundly erroneous notion that hinders a sensible understanding and good care. Anyone who has sex is not a sex addict. Similarly, not everyone who smokes cannabis is a drug addict. If there is no compulsive behaviour and serious negative consequences, they are merely using the substance. Sending a cannabis user to treatment is as stupid as treating someone who has a healthy relationship with food for bulimia.

The addiction is always in the person. We relieve addiction by helping people to heal their problems, not by chasing substances. If we manage to remove the substance without solving the underlying problem, then the addiction will simply jump and start using another substance or any other area of life. Then nothing is won, because the process of freeing oneself starts over.

What makes an addict?

One can probably find many features that characterize addicts, but these are two that I have seen in all addicts I’ve met.

Fleeing. Behind the addiction is a fear of meeting something within oneself or in the surrounding. It can often be such things as old traumas, abuse, problematic upbringing, shame or guilt. There may also be a fear of actually being as good as one can be. In such cases the abuse becomes a self-sabotage, which is also a way to flee, even if it is from a situation that is potentially better than the one the person is in.

Loss of control. This is the compulsive aspect that I talked about earlier. The situation has spiralled out of control. However, I think that it is incorrect to say that the drugs or someone else has taken control. All power in a person’s life originates from that person. If anything or anyone else is in power, it is because the person has given it away, but often that is not the case. Instead the power is still there but is not being used. Regardless of which, the long term solution is to rediscover and exercise power in one’s life; that is to reintroduce control.

But moving on to addiction treatment.

Help me outta here! Thanks! by Gerry Thomasen on Flickr
Help me outta here! Thanks! by Gerry Thomasen on Flickr

I want as many people as possible get the help they need to recover from addiction. That is not happening today. Instead the support that is being given is often contradictory, since society stigmatizes addicts and prevents or even sabotages the recovery process.

Education. The best prevention* that I can think of is to give young people the tools to deal with difficult situations, resolve trauma and rid themselves of such issues that might make them want to flee. We need to start working on personal development, so that we can identify and deal with the reasons why people want to flee from themselves. When there is no longer a need to flee, the fleeing will stop.

Our society works quite differently today. We learn to avoid that which scares us, rather than to face and deal with it. We prefer to distract or sedate ourselves rather than facing the discomfort. Antidepressant medication is a typical example of this, as it puts the lid on the symptoms instead of curing the cause. I’m not saying that antidepressants are never needed. They can be a very valuable emergency response, but the prolonged mass medication that we see today is a direct result of people not having the tools to deal with the unpleasantness that they encounter in life.

Addiction treatment. I want to see addiction treatment that is much more accessible and less stigmatizing than the one we have today. Reaching out for help should be a small step and help should be available to anyone who seeks it. The aim of treatment should primarily be to tackle the root causes of the addiction and since it is a disease it should be financed within the health care system, but should include more methods of treatment than those available today.

* By preventative work I do not mean to discourage people from using substances. I mean to prepare people to face life in such a way that they do not need to use substances to flee from themselves and thereby end up in an addiction.

Main photo: The Help by Marina del Castell on Flickr

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A better tomorrow with drugs

Today’s repressive drug laws are at a dead end. The war on drugs harms society and citizens in a multitude of ways, of which I listed some in yesterdays blog post. Ironically it also prevents effective treatments for such things as addiction. But where can we go from here? Let’s imagine that all substances are legal. How can we organize the community to limit the damage and help addicts?

Legalizing all drugs would of course not mean that you could buy them next to the sweets at your local supermarket. And everything doesn’t just fall into place because they come under government control. There would probably need to be a combination of solutions, some of which already exist and others that don’t. Here are some possible parts to such a system.

State control.

hug me by jo marshall on Flickr
hug me by jo marshall on Flickr

In the current situation the entire drug trade is a black economy that is largely controlled by criminal organizations. If all substances were legalized they would become part of the regular economy, where it becomes possible to set up rules for manufacturing and quality control products. The substances would be provided with a table of content, just like any other commodity. The goods may additionally be provided with other labels, such as organic and fair trade.

Those working in the trade would have the same rights as other workers, would have the support of existing labor laws, would have the right to organize themselves into unions and would become tax payers.

Sales could take place within established models, such as the state control (pharmacies/tobacco sales) or as a state monopoly (in Sweden all alcohol is sold by the state run Systembolaget). Age limits could be imposed on substances and they could also be differentiated, so that one would have to be older to purchase some of the more potent compounds.

Taxing substances.

When drugs come under government control it is possible to steer people away from more harmful substances by levying heavier taxes on them. It’s would be easy to see which substances are economically costly for society and adjust the taxes accordingly.

Possibility to withdraw the right to use certain substances.

People should be able to lose their right to use certain substances if they commit crimes or harm themselves or others when they use them. I think it is strange that those who repeatedly get into fights drunk, drive intoxicated or get wasted on the verge of dying, still have the right to buy as much liquor as they can pay for.

When one shows that they aren’t able to handle a certain substance, it should be possible to revoke that person’s right to do so, in the same manner that one can lose ones driving license or license to practice medicine.

The possibility to exclude oneself from certain substances.

40+30 Tutorial by bark on Flickr
40+30 Tutorial by bark on Flickr

Many people are very aware of which substances they should not take. For example I know many who say they have no problem drinking beer, but go berserk if they drink hard liquor. It’s the same with all substances. What is pure bliss for one, can be hell for another. What one is able to take a couple of times a year without developing a craving for, another becomes addicted to after just a few doses.

But then again, many people know perfectly well what substances are dangerous for them. It could be made easy for them to take responsibility with the choice to voluntarily waive the right to use certain substances. They could also be able to set limits for themselves, by specifying how much of a substance they may purchase during a certain time period.

Many addicts will arrive at the point where they want to break free from their habit. During a certain period the window of change is open. The problem is often that they relapse because the substance will continue to be available to them. If they can exclude themselves from the right to buy certain substances, such as if an alcoholic does not allow him/herself to buy liquor, it would effectively help in the recovery process.

Licenses to handle certain substances.

With some particularly heavy drugs such as heroin, it would be possible to introduce a license allowing an educated person to handle the substance. For most substances it would probably be enough with basic education in school and a little everyday common sense, but with substances that carry serious consequences, it is important to be sure that those who use them have proper knowledge about risks and safety. The education for such a license may contain things like responsible management, how to use in a safe manner to prevent spread of infection, and how to deal with accidental overdoses. Such a license may be revoked if the person is irresponsible and for example sells substances to other people or uses them in an unsafe manner.

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In addition to the distribution itself – what can we do to get control of the situation regarding different substances?

Universal education in dealing with drugs and addiction.

I often wonder how drug education in schools can be allowed to be so absolutely worthless. The “education” is basically designed solely to scare people not to try anything. As a teenager I was an exchange student in the United States and the school that I went to worked in exactly the same way when it came to sex education. There was no information about STDs, contraception or sex. The whole message was only “you should not have sex until you get married”, and it was really crammed down the teenagers throats. It is a dangerous kind of indoctrination that creates ignorant and bigoted citizens, while increasing the actual risks.

Instead we should have a proper drug education, which includes such themes as:
∙ What is an altered state of mind and how you can you work with it?
∙ How to use drugs safely.
∙ What to do if you or someone else feels bad under the influence.
∙ How to manage an overdose.
∙ How to identify and get rid of substance abuse.

Use tax revenues for addiction treatment and prevention.

Libby hugging Tomoko by Loren Kerns on Flickr
Libby hugging Tomoko by Loren Kerns on Flickr

A legalization would generate tax revenue that I think primarily should go to addiction treatment and prevention. Even more money is now being spent on hunting, harassing and punishing people.

If we add a substantial part of those resources to create good addiction treatment, we will soon have the best addiction treatment the world has ever seen. Health care should be accessible and able to quickly help addicts who express a desire to receive care. Addiction is a disease and addicts should be treated as patients, not criminals.

There will always be addicts, but it is my firm belief that the addiction is to be found in the person – not in substance. People flee into abuse because they are fleeing from themselves, from the traumas they try to forget or from situations that are unbearable. Good prevention work builds on this understanding and aims to help people face themselves, help them process past trauma and to make their lives bearable. It helps them to stop fleeing and encourages them to take responsibility for their own lives. Much of today’s preventive work lacks this basic understanding.

Make substances available for scientific research, therapists, health care workers and healers.

There are many substances that are currently incorrectly classified as drugs with no medical value. This applies above all to psychedelics that are proven to be extremely effective in curing such things as addiction, depression, post-traumatic stress, empathy disorders and death anxiety. There are lots of stories about absolutely miraculous healing taking place with these substances, and they are at the same time very safe when used correctly.

Another substance that is being discussed greatly right now is cannabis and not only in its mind-altering form, but also as tinctures without the mind-altering properties. It is used with good results for such things as chronic pain, fibromyalgia, depression and end of life care. There seems to be some evidence that it also has cancer fighting properties.

These substances need to be made available to those who need the help and for the professionals who are working on this – from therapists, to regular health care workers, and also in alternative treatments. Today there are plenty of alternative therapists and traditional healers such as shamans, who have the knowledge and who have been passing it on for thousands of years. Here are exciting cross over’s to be made, when traditional methods of healing meet western medicine. Such work is already taking place. To fully take advantage of this scientific research needs to get started as soon as possible.

Making up for abuse committed by the state.

While the intention has probably been good, many people have been abused and badly treated under the current legislation. The current drug laws have stigmatized people, forced them into alienation, punished them, led people into a criminal lifestyle, actively withheld health care for sick addicts and has also led to many unnecessary deaths.

There is a need for redress and reconciliation. The very least the government should do is to apologize for the abuse that occurred under the current legislation.

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This blog post has been inspired by, among other things:
∙ A challenge from a friend who is a politician to show how legalization could work.
∙ The TEDx talk by James Leitzel that does just that: https://www.youtube.com/watch?v=s_Px4nYbJoQ
∙ Organisations and initiatives such as Multidisciplinary Association for Psychedelic Studies (http://www.maps.org/) and Transform (http://www.tdpf.org.uk/).

Main photo: Love by Nicola Romagna on Flickr

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No sex for you

Anal Sex by Thomas Leuthard on Flickr
Anal Sex by Thomas Leuthard on Flickr

– Our bodies fit very well together, but when I had sex with him, I felt defiled.

Eventually she had to end the relationship. I just didn’t work anymore. Now there is a complete ban on Sweden Democrats in her bedchamber.

A modern day Lysistrata.

Personally I’d like to add homophobes, addicts that aren’t interested in getting sober and anyone that my daughter doesn’t like to that list.

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Two drug opponents that I’m having a hard time with

There are two common characteristics among drug opponents that I find particularly difficult.

Ignorance

Navigator by Thomas Abbs on Flickr
Navigator by Thomas Abbs on Flickr

Many drug opponents know remarkably little about drugs and how different substances work and are used. Some have certainly read about drugs, but the “knowledge” that it has provided is extremely thin because it is selective and not derived from their own experience. Nevertheless, they often think that they know quite a lot about drugs, in the same manner that you might think that you know something about Stockholm after having seen a map of Sweden. When I try to discuss substances with such a person, I feel like a senior local historian from Stockholm who meets a lost tourist. It becomes quite odd when the lost tourist, with map in hand, tries to lecture me about the nature of Stockholm.

Projection

lost by 55Laney69 on Flickr
lost by 55Laney69 on Flickr

There is a large group of prohibitionist drug opponents who actually do have personal experiences of drugs. They are often former addicts or family members of addicts who are projecting their own abusive behavior onto others. Since they cannot deal with a substance themselves, no one else should have the opportunity to either.

By the same coin, as a sober alcoholic I could argue that alcohol should be generally prohibited. I don’t think it should. I do not think that my previous addiction and my bad judgement should infringe on anyone else’s right to drink. However, I should probably be prohibited to drink, since I have demonstrated how badly I can handle it.

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