Wednesday, October 22, 2014

Comment Response on Dopamine & Working With Medicated Addicts

     Um, yeah, so I had to post a comment response from the previous post because it exceeded the character limit allowed by Google. Please forgive, as one wouldn't normally expect to violate 4,049 characters on a regular basis.

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     Ah yes, indeed. Well thank you so much for reading and reaching out. I'm grateful. And you're certainly right about the fact that addiction crosses all lines, as all drugs act on what neuroscientists refer to as the dopaminergic system. There are some rather distinct differences between the drug action of certain classes of drugs. Opiates, for instance, tend to produce greater degrees of physical dependence as they (if I remember correctly) act on the mu and delta opioid receptors (as opposed to the localized kappa receptors) and essentially shower our CNS with relief, allowing for some pretty vicious physical withdrawal.
     
     However, these bio-chemical details are actually what cloud the judgment of many clinicians, but that said, you'd be right, physically speaking, to tell your clients they are all addicted to dopamine. And of course, the statement will most likely be met with total indifference, or perhaps some feigned interest at best. 

     A larger problem are the scientific presumptions we make regarding treatment, such as the implied notion that a lack of dopamine must be met with a more dopamine, and even with healthier actions that raise dopamine levels... when the truth is that increasing dopamine production is not a solution, and is actually one of the primary causes of addicts failing in recovery.

     For one, it is the exact wrong frame of mind, which is to continue to find ways to feel better in sobriety. It is precisely our addiction to comfort that must be dissolved in order to accept life as it is, on life's terms, as a human being that suffers from time to time. Two, it fails to address the crux of the mental component of addiction, the reason we cannot stay stopped, which we can refer to as the mental obsession. Addressing addiction scientifically fails to remove our condition of insanity, a condition that may sit latent for months or even years, and then suddenly we go and pick up again for no reason at all. This is where you get all of that 'relapse is part of recovery' bullshit, which fails to understand addiction or how to treat it. I became recovered overnight, as did hundreds of others I know personally. None suffer from even a thought to use, and in fact we now repel those things which take us away from God.

     The reason I'm okay and will always remain sober is because this obsession has been lifted. As well, I put my relationship with God before all else. And the reason why I'm not only sober but also successful in life is simply the result of hard work. Addicts who refuse to work hard (in all facets) will fail. Nothing outside of the addict is responsible for them becoming addicts, and nothing outside can fix them. Same is true for people who fail in general. And there are no grey areas. We're either okay or not okay. Sane or insane. Chip restored or chip still missing. Completely recovered or not at all. It is all or none for us. 

     So considering addicts are essentially preoccupied with self and self-comfort, the trick is to be okay without depending on this adjusted homeostasis, if you will, the condition of needing above-normal amounts of dopamine to be okay.

     Finally, I personally would never work with with anyone who was smoking pot, let alone on suboxone. That combination guarantees that your client is high as shit (which I'm assuming isn't news to you), and therefore, nothing can be accomplished, in my view. I read certain parents who blog say that we must help medicate the addicts while they undergo therapy and learn how to think straight. But the statement alone is so ridiculous on its face. There is no thinking straight when an addict is medicated. And even then, the mind of an addict is generally so warped and twisted that we must usually begin to act our way into right thinking and not the other way around, as CBT would have us believe. 

     My experience is that really bad addicts must have some sort of profound spiritual experience to fully recover, some sort of transformation or conversion, whether sudden or gradual. These experiences often defy scientific theory and yet, they are real. Many such experiences have been documented. In fact, William James', The Varieties of Religious Experience, contains many ;-)

Bless you. Hope that helps...

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