In my view, addiction is neither a choice nor a disease nor due to genetics, but a symptom of what happens when people loose their true selves. Drug use should not be criminalized, ever. Criminalizing drug use increases drug abuse.
Addiction is a fundamental disconnection of the individual from their true self. Addiction, most of all, is an attempt to sooth inner suffering. As an escape from suffering, addiction offers a dissociation from pain. It makes you feel alive, comforted, and euphoric on the short term. On the long term it is devastating to the self and to relationships.
Drug addicts have difficulty accessing their natural systems of pleasure and reward, and I believe that every single addict learned in childhood. These blocks to experiencing pleasure through non-addictive sources are – in every case – first learned through lack of attunement with parents and caregivers, leaving the person poorly equipped for dealing with life stress. This explains, for example, why for every 1% rise in unemployment, there is a 3% rise in opioid addiction: the stress of poverty results in parents tuning in poorly to their children, and this lack of parental attunement leads to addiction. Again, this path of causality is well established by excellent research. But of course this kind of suffering and addiction is not limited to the poor.
Every 3 weeks, as many people die from overdose as we lost in the 9/11 attack. Addiction in our country causes trauma on a scale greater than 9/11. IT is a national trauma that is ongoing, vast and unremitting. This crisis affect Americans of all incomes, all races, all gender and sexual orientations, and all religions.
Criminalizing drug use fills American prisons with unrelieved pain and suffering. It disrupts families, leads to an 80% recidivism rate, and more addiction. Countries that do not criminalize drug use but provide treatment do much better than us. For example Portugal has NO laws against ANY kind of drug use and also has much lower levels of addiction than the USA. Like many countries, Portugal’s rate of drug addiction went down when they stopped jailing addicts and started treating them.
My approach to addiciton is neither 12-step nor Smart Recovery, although I believe that engagement in either of those approaches may help in addition to the treatment I provide. My approach is grounded in the research and practice of attachment theory.
I follow the lead of Gabor Mate, a compassionate therapist who has worked for many years with heroin addicts on Vancouver’s east side and who has written extensively on addiction. There is now a vast body of research literature supporting this approach. It is “the new wave” of addiction treatment, based on attachment theory. I reference some of Gabor’s writings here.
We generally break down “Addictions” into two types: “substance addictions” and “process addictions.” I talk here about the substance addictions. On other pages of my site I talk about process addictions. In fact, whatever the type of addiction – substance or process – the cause is an escape from inner suffering and the treatment is to relieve that suffering.
Substance addictions, when severe, may require medically supervised withdrawal. Some examples are:
- legal and illegal drugs
Process addictions include things like:
- compulsive shopping
- unsatisfying, repetitive sexual behaviors
- repeatedly “falling in love for love”
Drugs and addictive behaviors are prevalent and seductive.
In the 1980s and early 90’s I taught in the undergraduate and graduate psychology programs at National University. Among my duties in the Chemical Dependency Program was to provide clinical supervision to graduate students who were learning to be therapists.
Many of my students were in recovery themselves. I discovered that students held strong beliefs about the kind of treatments available, and those in recovery were the ones most likely to hold most strongly to their beliefs. Each would swear that the best approach for their clients was the particular approach that had helped him or her. The experience taught me how important it is to make an individual assessment of each client, and select the treatment approach that aligns with their beliefs, character, weaknesses, and strengths.
I have included a page here that compares the two best known approaches to the treatment of substance addictions. My main approach is neither of these approaches, but I use them as an adjunctive treatment when they are aligned with a client’s needs and character.