Addiction Counselling aims to provide support, information and guidance for those who wish to moderate their substance use or abstain completely.
There are different schools of thought about how to best address substance misuse.
There are those that feel that things have started to get out of hand & they need some help to get their attitudes towards chemicals back on track.
The concepts of Moderation Management or Harm Reduction are based on this idea of returning to responsible use of alcohol or other substances.
The Moderation Management approach may be just the thing for the individual who has just begun to notice that they are over serving themselves or starting to experience some negative effects from their use.
Harm Reduction has some similarities to this concept in that the goal is not to stop use entirely but to do it with fewer consequences i.e. health, legal etc. For some clients this may involve taking prescriptions to stabilize their health, something to replace their drug of choice or reduce their use. Some view this as their overall approach. However, many clients that I have seen actually approach Harm Reduction as a stepping-stone to abstinence.
There are those who feel that if it has become such a problem it needs to be stopped entirely. This may very well be true depending on how high the stakes are for the person and what sorts of impact the chemical use is having on their lives.
For many years I worked at treatment programs that were designed to treat addicted healthcare professionals i.e. doctors, pharmacists, nurses. Clearly you don’t want your brain surgeon to be having alcohol withdrawal tremors. We would also treat solicitors and pilots. As you might imagine these are pretty high stakes situations as you could argue that there is a public safety component to their behaviour.
The 12-Step programs e.g. AA, NA are the typical backbone of the approach for those seeking complete abstinence. There are other systems though not as widely known or practiced.
It is pretty common for individuals to participate in counselling in addition to their support group attendance. This may be a really good option for those who feel they need some help to make serious changes but aren’t ready to sign into one of the residential rehab facilities for a few weeks or months.
I also see a lot of clients who come for individual or couples counselling after completing a residential rehab as a way to step down the intensity of treatment but still continue their recovery work.
Support for partners and family members
It should be pointed out that often times the partner or family members of the addict will need some help to get through the process.
AA actually talks about addiction being a family disease since those around the alcoholic also have their lives severely impacted.
Even if the partner is supportive and willing to help there is often some repair work from the damage caused by addiction that needs to take place. Especially in the early phases of recovery the partner may need some education and guidance on how best to support their loved one, what to expect as they begin making changes etc. It becomes an entire lifestyle change not only for the addict but also for their family when they enter recovery.
Making major life changes
The processes of making such major life changes require a multifaceted approach. Often there may be changes in relationships, friendships, employment, living arrangements etc. that accompany the change in substance use.
For all intents and purposes a drug is a drug when talking about addiction. That is to say it doesn’t really matter whether the person’s drug of choice is methamphetamines, alcohol, cocaine, heroin or prescription pills. The impact on their life is similar. There may be a few minor distinctions based on the effect of that class of drug but the destruction looks the same behind the addiction.
To a certain extent the addiction model can also be extended out to what are called behavioural addictions e.g. sex or gambling. There are common elements say between sexual addiction and drug addiction though it requires a bit of a different approach.
For example most people who have developed a sexual addiction would not enter treatment expecting to take an abstinence-based approach and remain celibate for the rest of their lives.
Sometimes the term addiction is used casually to describe someone’s approach to eating, exercise etc. You begin to see more debate in the professional community about whether behavioural issues such as these are best viewed through the lens of addiction or some other conceptualization.
How effective is addiction treatment?
Addiction treatment is very effective. Depending on the study you look at the success rate of treatment can be as high as 90%.
Of course, there would be a host of individual and situational factors that may impact the success rate of the particular treatment episode.
Some of the most successful programs incorporate a variety of elements. In the late 1960s the United States Navy developed a program to treat alcoholic pilots. Their program went beyond the initial physical withdrawal treatment by going on to include individual counselling, group counselling, support groups, as well as an element of accountability by peers, and supervisors. They recorded a success rate of 90%. This sort of model was later adopted by many of the airlines as well as other professional groups e.g. medical boards, lawyers etc. Many of the most successful treatment programs today use an updated version of this approach.
It is encouraging that it is possible for those who do become addicted to alcohol or other drugs are able to get their lives back on track with the right help.