Addiction is not always diagnosed in the early stages so more intensive help is needed
One of the problems that seems to be escalating – in terms of the mismanagement of addiction diagnosis – is the large number of people that are being prescribed anti-depressants by their GP when in fact their primary diagnosis should be addiction and not depression. This is because they have had a consultation about their depressive episodes (rather than about their drinking / drug habit) and have been prescribed medication to help with them. In fact, the reason for their low moods is because they have an addiction such as to alcohol and their lives are spiralling out of control.
The prescribed anti-depressant medication which usually takes at least two weeks to be effective under normal circumstances is simply nullified by the use of alcohol. The individual thinks they should be feeling better but are not and they in turn become even more depressed. This example highlights the problem that can occur when the person seeing the GP is not honest about the quantities of alcohol they are drinking and / or not accepting that they have an addiction. It is also compounded by the limited amount of time the GP has such that they cannot do a full and probing assessment.
Addiction is an illness
So what is an addiction? An addiction is described as a neuro physical disorder characterised by a persistent and intense urge to use a mood altering chemical such as alcohol or drugs or to engage in a behaviour such as gambling or eating that produces a mental reward effect despite causing substantial harm to all our life areas. This can be further evidenced when we have tried to cut back, control, or stop this behaviour and have continually relapsed back, making our life situation even worse.
There are no restrictions on age, gender or sex when it comes to having an addiction and, partly due to Covid and the new work from home regime, there has been a distinct rise in the younger population being affected. This could simply be put down to the previous restraints of travelling to work and working in an office being removed and this has given people the opportunity to, for example, drink more alcohol, gamble openly, mess around with food, at any time of the day, within the home – and more private – environment.
It is difficult to ‘just stop’ or cut down
Any addiction is therefore now medically classified as a brain disease, whether that is alcohol, drugs, gambling or eating disorders. Overcoming an addiction isn’t as simple as just stopping. It is how we stay stopped that is the key. With an addiction there needs to be an acceptance that, as with an allergy to something, we need to be totally abstinent from whatever it is that we have become addicted to.
A person develops an addiction as the brain starts to change: our behaviour sparks the brain to produce more of a chemical known as Dopamine which creates a pleasurable feeling – and to get that feeling again we repeat the behaviour. However, over time the brain will realise that it is producing excess Dopamine and will reduce the levels of Dopamine produced. Therefore, we in turn will increase the amount of alcohol we drink, gamble more often or use more drugs to try and get the same pleasurable effect. This will lead to our becoming physically tolerant to our drug of choice and the body ultimately needing more of the substance which leads to an increase in addictive behaviour regardless of the detrimental effect on all our life areas.
We finally admit that we need help but NHS help is hard to come by
There is a time – and that time will be different for everyone – when there will be a need for help, as every way that we have tried to stop or cut back on our behaviour has not been sustainable. We may have stopped but will then relapse back often after a very short period of time. We finally admit that trying to change on our own is too difficult.
Some addictions – such as to alcohol, opioids (codeine) or opiates (heroin) will require a medically overseen and assisted detoxification. However, your own GP will not now be able to prescribe a “home detox” as there are now medical restrictions on the amount of medication that can be prescribed. Hospital A and E departments will usually not admit anyone with issues around alcohol or drugs and will normally rehydrate the individual and discharge them. There is little help with the local community Drug and Alcohol teams due to poor funding. Therefore the single option left available is to be admitted to a residential addictions unit such as The Haynes Clinic and come under the care of their doctor for a medicated detox.
Advantages of going to an addictions rehab clinic
There are several advantages of going into residential addiction treatment, one being that when someone asks for help there is a “window” before they change their mind and it can be months before they ask for help again. Usually, there is bed availability within a 48 hour period and thus people can be admitted promptly. Another advantage and certainly for someone with an addiction who doesn’t require a medicated detox, such as for a gambling addiction or eating disorder, is that being away from the home environment they are able to break their addictive cycle within a safe environment.
The recommended residential rehab treatment period is 28 days but 14 days is an option for those with more restricted time or financial means. It is worth noting that residential addiction treatment in any addictions rehab centre is completely confidential and no medical or therapy notes are shared with a person’s place of work or their own GP unless requested.
No one is going into treatment for a rest: the time is spent participating in a daily structured therapy programme, gaining an understanding and accepting the changes we need to make to our thinking and behaviour in order to start to live a more normal life. In a way, going into treatment is like taking the first step of getting on a “bridge to normal living.” Ongoing support through the respective 12 Step support groups and weekly Aftercare that is offered once a week at The Haynes Clinic for 12 months, following discharge, are critical. These will enable us to maintain the changes that we need to make through the ongoing help of others.