Dear Blog Friends,
Craig W. has kindly given me permission to re-post the following musings he shared with LSRSafe, one of LifeRing’s e-mail support groups which he wonderfully moderates, that so clearly describe what it might – what it should – look like if the medical community were to treat addiction as they would any other health problem.
Thank you, Craig!
Imagine, if you will, a time in the not-too-distant future …
You’ve decided to face the fact that you’ve developed a drinking/using problem. Your urges have become cravings and your ability to resist those cravings has steadily lessened. Your use is beginning to affect nearly every aspect of your life. You know it’s a problem that has to be dealt with. So you go to your doctor and discuss it with her.
The doctor has you fill out a questionnaire asking about quantities, frequencies, sleep, diet, etc. She gives you a prescription for blood tests and maybe a liver-function test. She hands you some informational pamphlets and schedules you for a follow-up as soon as the test results are available. At no point does she treat you as anything but a person with a distressing but manageable medical problem. It’s very much the same as a consultation with a primary care physician about, say, depression. Perhaps she suggests a supplement — vitamins, say — but otherwise you’re on your own until the follow-up.
You leave that appointment relieved to have spilled your secret but perhaps disappointed that no treatment was offered. Still, you know you’ve started down a path that might offer hope.
The follow-up appointment comes a week or two later. Your tests show nothing drastically wrong physically — maybe some early warning signs from the liver test and a couple of blood readings slightly outside the normal range. But nothing major. She asks if you’re still drinking/using and when you say, sheepishly, “Yes”, she gives you a referral to an addiction specialist. As you leave, she tries to reassure you that your decision to come in was the right one and that the condition is highly treatable. “You’re going to be fine,” she says. You have trouble believing that, but you do feel a bit of hope.
Two weeks later, you visit the specialist. Again there’s a questionnaire to complete, this one more detailed, covering any family history, asking about certain medical conditions that may seem unrelated and going into considerable detail about your emotional situation and your current life difficulties. You go through the usual pre-appointment routine and then the specialist comes in. You have a fleeting regret that you ever started this process.
But the doctor has a very good bedside manner and quickly puts you at ease. You notice immediately that there is no judgment and no condescension in his voice. He runs through some of the information from the questionnaire, mentions that he has looked at your earlier test results and says, “This is what I suggest we do …”
He mentions a drug useful for controlling cravings, and another one to reduce anxiety; he hands you a book to read, and he suggests participation in a support group and offers some pamphlets about various such groups, including both face-to-face and online meetings. “Many people,” he says, “benefit greatly from support groups. It’s up to you which group best meets your needs. You don’t have to use any group at all, although if you have difficulty quitting on your own, I’ll be reminding you that they can be a big help.”
He goes on to say, “I want you to meet with one of our counselors once a week for at least a month and then less often if you’re doing well. And you’ll see me regularly as well. You do need to understand that your condition is very likely permanent and that you will need to abstain completely from any recreational use of drugs or alcohol. If you were diagnosed with diabetes, you would have to give up, for the most part, making high-carbohydrate diet choices; with Celiac Disease, you’d have to give up any food or products that contain gluten; if you had a serious allergy to something, you’d have to avoid it permanently.
You do have what is in effect an allergy and you have to abstain from recreational use of mind-altering substances permanently. This may be socially inconvenient, but you’ll find that, as time passes, you’ll adapt without undue difficulty. Quitting your use will be hard at first, but will get easier soon. I’ll help you and, if you need more help, you’ll get it from a support group. We have other prescribed drugs that may help, as well.”
The doctor writes a prescription and hands it to you, adding”Millions of people share your condition; it’s nothing to be ashamed of. These drugs will help, but they can’t solve the problem by themselves. We can give a diabetic a drug to help them, but if they don’t change their habits it won’t work. Change is hard, but not at all impossible. Get the prescription filled today and take the first pill tomorrow. And then don’t drink or use! Take the anti-anxiety medication mid-day. The book will give you some ideas for how to change what has become a habit. Here is the phone number of a help-line — don’t hesitate to use it. I’ll see you in a week.”
Why isn’t something like this the practice in dealing with addiction? Isn’t the above procedure what happens with other chronic diseases that spring up during our lives? Take Type 2 Diabetes, for example, which can be caused or made much worse by, among other things, behavioral choices made by the sufferer. You go to the doctor and you’re offered a treatment protocol which will require serious behavior modifications on your part, and then you manage it together.
With addiction, the common protocol now is to be shoved into treatment programs, in-patient or intensive out-patient, that cost a fortune and/or cause enormous upheaval to work and family life in return for very poor results. Or they are pushed towards support groups which refuse to allow efficacy studies that might demonstrate their success rate or that simply don’t work for them.
Treating addiction in a medically sound way — why is that even a question???!!!