Drug and Alchohol Rehab – The Cure for Alchoholism
Dr. Michael Sosteric | Nov 19, 2011 | Comments 9
Here are two books that bring the notion of drug and alcohol rehab and treatment into personal control and away from expensive treatment centers. Both books eschew moralistic therapies that focus on character weakness or genetics and instead focus on the actual brain mechanisms involves in alcohol and drug rehab. It is not quite sociology, since environmental precursors (like abusive childhood environments) are not considered, but it a fascinating approach to rehab nonetheless.
Two books that I have recently read deserve attention today. One is My Way Out and the other is The Cure for Alcoholism. Both are great books and both detail a pharmacological cure for alcoholism. I know that if you are someone who suffers from alcoholism or some other form of addiction, you’ll be skeptical at the whole notion of cure. For decades Alcoholics Anonymous has been advising there is no cure while preaching a powerful abstinence that just doesn’t seem to work for most people unless it is reinforced by constant monitoring and control. Traditional pharmacological therapies have been equally ineffective, helping a few but leaving most out in the cold.
These books are both different. You may be surprised to learn that neither of the books require (or even advise) total abstinence from alcohol, and both strip out the heavy duty demonization and moralization that often goes a long with this disease (like you are someone weak and deficient because you are an alcoholic). Instead they advise, in an open and sensible manner free of the prohibition like frenzy that often surrounds this social problem, change in diet, lifestyle, and attention to whatever social or emotional pathologies may encourage addictive behavior. Recognizing that alcohol, like other addictive substances, provides an endorphin rush (i.e. they make your brain feel good), the books develop treatment strategies that deal with that. Treatment involves a pharmacological intervention that interferes with the uptake of endorphins in the brain (thus robbing you of the feel good properties of alcohol) and dramatically reducing craving over time. The book authors claim success rates as high as 80% which is incredible considering how difficult addictions are to treat. I haven’t seen these treatments in action yet, though I do have a client who I’m hoping will try them out. They do, however, seem highly promising, and they are backed by serious scientific research.
alchohol treatment
Now as a sociologist I usually don’t buy into biological or genetic explanations of anything. For me traditional psychology has too narrow a focus and it misses a lot of key causal factors when it approaches psychological dysfunction. I understand the power that advertising, the media, and our social groups have to determine our behavior and personality so from my sociologically sophisticated perspective, even something as “genetic” as IQ isn’t really genetic at all, but social. Still, what I found most interesting about the books from a sociological point of view was the emphasis on the relationship between alcohol and endorphins, a biological process. Endorphins of course are the natural “feel good” drugs in your brain. Similar to morphine, the body releases endorphins in responses to both positive and negative stimuli. Stress and pain cause endorphin release, but also laughter and orgasm. In addition, long distance running has long been associated with endorphin release (the so called “runner’s high”). Endorphins are the body’s “feel good” system and lack of endorphins may lead to depression. Drinking alcohol is a way to encourage endorphin release in the brain.
But why do you need alcohol to encourage endorphin release if it is released by other activities?
Well, probably because you don’t feel good about things. I have a client, an alcoholic, who is embedded in an extremely toxic family environment. His wife yells and screams and judges, his children are dealing with the effects of long term psychological, emotional, and physical abuse, he is struggling in his business, and he turns to alcohol to help him cope–and we can see why that would work. Because of the stressful environment he lives in, his body is not releasing enough endorphins to keep him feeling good and so he is encouraging additional release through the abuse of alcohol. It’s a bad habit to get into of course because once your brain builds the chemical association between endorphin release and a shot of the Knob Creek, the addiction is extremely hard to break. Of course, nobody can survive when they are made to feel like dirt all the time.
So what are you going to do about this? Well, if there is an addiction present the implications are clear, you have to break the chemical association and change your environment so your body is not so overwhelmed that it needs additional medication. We now know how to break the chemical association in the brain (both books reviewed here provide a solution). The harder part is cleaning up our social environments; but at least now you know where to start looking.
Filed Under: Book Reviews • Featured Articles • Michael Sosteric
About the Author: I'm a professor of sociology at Athabasca University with interests in the transformation of scholarly communication, spirituality and sociology, inequality, gender, ethnicity, and social problems. I was the founding editor of the Electronic Journal of Sociology but realized the limitations of scholarly journals a couple of years ago. The Socjourn is a recent attempt to leverage the "sociology.org" domain to provide an alternative window into the world of sociology that does not depend on the staid and stuffy world of traditional scholarly journals.
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Having both certifications in mental health and addiction treatment (working in both for over 15 years), the link between endorphins and addiction is neither new nor a suggestion of a cure. We’ve been educating clients for years about how addiction depletes the body’s natural ability to produce endorphins when using chemicals or alcohol. The idea of recovery is to get the body producing endorphins rather than relying on a chemical to trigger them (ie. alcohol or drugs). While I am not philosophically wedded to the idea that there is no cure to addiction, the endorphin theory has been around for awhile.
Cheers, Associate Professor of Sociology, Dept Chair Psychology, Sociology, and Social Work Vincennes University
Thanks for the comment Rob. I have a question. In the books they claim quite high success rates. By blocking the ability of alcohol to release endorphins, and by paying attention to lifestyle, they attain very high success rates. How is this not a “cure.” If a certain conditions goes away after a certain treatment, can we not say that the condition has been cured?
Mike S.
I am responding as an individual who has experienced life as an alcoholic (13 years), experienced life through AA and abstinence ( 13 1/2 years), experienced relapse, (6 months) and then experienced abstinence without AA (3 years). I began drinking at an early age of 14 and connected alcohol with socializing and interacting with peers being a shy person with low self esteem among other dysfunctional traits that developed in early childhood. Somewhere nearing 20 and through my early 20′s alcohol became the endorphin replacement, (although I wasn’t aware of it at the time). I ended up in recovery at 27 years old and also discovering I was soberly depressed. In AA we learned that there is some disconnect in the brain that alcoholics experience that normal drinkers do not which allows them to continue to drink when they have ‘had enough’. I also learned a fear of alcohol, that it had control over my body,( which I no longer believe), and that a reintroduction to alcohol could lead to death, prison or insanity. There are a number of other personal power binding ideas that AA promotes but I have come to believe through my personal experiences, leaves the individual stagnant and bored. For me, it seems that I could only go so far with AA and its 12 steps and then it became repetition. I stopped following the AA program and going to meetings and ended up relapsing a few years ago. The initial drinking episodes were social and controlled. I felt excited about going out to social settings where when I went abstinent I found myself as being bored. But then it became a tool for self medicating due to poor social relationships a few months later. This only leads me to believe that these books have something to offer in linking social experiences, personal mental health and alcohol use. I think a mentally healthy individual who may have had problems in the past with alcoholism might be able to drink socially again taking into account healthy environment, healthy body and healthy social connections. I am interested in reading them to see another perspective on alcoholism. Thanks Michael.
ANY suggestion other than AA is apperciated!!! I am not a religious person and resent a treatment that heavily relies on a superstitious belief for help and healing.
RE: Jill’s comment
I agree, I have always had “god” issues, and depression. The testament from others of “Happy Joyous & Free always made me feel like a failure.
Being Pagan, I had problems with the god issue, and the negative associations of AA. I plan to try this program and hope for the best.
thanks for being here
Storm
As a person who also works in a residential treatment facility I find it very interesting that these books are trying to promote some sort of biological answer to curing addiction. To set the board straight 12 step programs encourage you to have a god of your own understanding. it is not a requirement. I do not participate in a 12 step program but will not deny that avenues such as treatment and 12 step meetings can be helpful and almost life changing for those WHO PUT FORTH THE EFFORT. An 80% rate of success is statistically ridiculous. Take an elementary stats class and anyone will find out the means and the ways as to how some groups get their high success rates. while many are worried about endorphins, it is serontonin and dopamine which are the neurotransmitters which dictate isssues such as depression. Once again there is no cure for addiction. Anyone who is vulnerable to certain situations are susceptible to relapse. The problem many have with understanding addiction, is that for many who suffer from it, the use of drugs and alcohol are symptoms of larger problems. If one does not deal with other issues, to which the article does not include, then a relapse of alcohol or drugs is a possibility depending on how effective your coping skills are how effective you are at recognizing a relapse, and how much effort you put forth to remain sober. There are also plenty of pagans who participate in a 12 step program. Fact of the matter is if this works for you then good for you. but do not discount areas such as treatment or 12 step (coming from a non 12 step member)..Addiction is not as simple as quitting. you have to put forth the effort to change your life, just like with any ohter issues that may complicate or disrupt our lives.
HI Danielle
I don’t disagree with you. Addiction always emerges as the result of attempts to cope with toxic and abusive environments, so it is senseless to advocate a purely chemical approach. As you say, you have to deal with the issues that lie beneath the surface.
That said, an 80% success rate is not ridiculous if it is true. You cannot simply discount these statistics because your experience does not back them up. Perhaps the fault is not in the statistics, but in the treatment rubrics used by your treatment facility. You at least have to consider the possibility that there may be room for improvement in the way you folks do things.
Also, I do want to take serious issue with this notion that there is no “cure.” I was a heavy smoker for many years and I quit. I have no desire to go back and I’ve even had a cigarette in my mouth a couple of times, only to find myself sickened by the toxic gasses. I consider myself “cured in the full sense of the word.
Finally, I’m not too enthused about the way you seem to be individualizing the problem. Yes people have to put in the effort, but ultimately it is not just about them. If addictions are to be cured, toxic environments have to be addressed as well. Heck, if the person you are treating beats their addiction, but then goes back into a psychologically or emotionally violent environment, do you really think the “cure” will stick?
Reducing alcoholism to a mere physiological problem displays a lack of understanding of what alcoholism is.
I am an alcoholic (drinking for 18 years), and have been for almost 10 years around alcoholics in treatment. Alcoholics don’t just have a problem with alcohol. It is more of a syndrom. It has multiple causes and multiple symptoms. Alcoholics have usually major psychological problems that do not get resolved by simply staying dry. Not drinking is just the start. Therapy, AA meetings, or other form of tratment is necessary after the last drink. And it can last years and years before the alcoholic gets psychologically better.
I understand very well the endorphin issue. But this is certainly not the main issue for alcoholics, in my conception.
I think you are probably right Josh. But I wouldn’t discount the power of the physiological. We all start drinking for different reasons, peer pressure, parental modelling, emotional numbing, etc. and all that stuff plays into it for sure. But once you are “hooked,” a big part of the problem is physiological. I treat addicts, and I smoked and drank for a long time too, and one of the things I notice a lot is that the “other things” become an excuse for the physical addiction. When I was trying to quit I always had an excuse, i’m so stressed, i’m so tired, i hate my life, etc. It was like my body/mind was coming up with “outs so I could feed the addiction. I was able to quit with acupuncture, cold turkey, never went back. All acupuncture did was treat the physical craving and that worked.
That said, a lot of the treatment involves removing excuses and precursors. Healing toxic environments, dealing with toxic relationships, repairing self esteem, and all that jazz. Ya, a lot going on, but don’t discount the power of the physiological addiction, or the significance of treating that.
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