Addiction and Relapse
As of 2016 we still aren’t really sure what “addiction” means. There are many schools of thought regarding recovery from drug dependence, the model currently accepted by the AMA (American Medical Association), views addiction as a complex brain-based disease, which is chronic, progressive, completely irreversible and incurable.
In short, the currently accepted model of addiction is very similar to other chronic illnesses such as heart disease or diabetes. You have an acquired, brain-based illness, which requires ongoing and continual management and attention to remain in remission. You will never be healed, you will never be whole, you will never get better. Once an addict, always an addict.
And that’s the good news. It took decades of ongoing effort to even reach this state of awareness, wherein clinicians stop blaming people’s drug dependence on their moral failings, and acknowledge that addiction is a medical condition (which is still criminalized in most parts of the world).
In the 21st. century, the current paradigm is coming under fire and being questioned by many researchers and clinicians involved with addiction treatment. Neuroscientist Marc Lewis, a former addict himself, expresses a considerably different school of thought within his book, The Biology of Desire: Why Addiction Is Not a Disease.
To summarize this school of thought: yes, addiction does change the way in which the brain functions, however, so does almost everything else. If addiction is a “disease” you could make a credible case for learning anything new, also being a disease. In either case, your brain is responding to new stimuli and neuroplasticity and brain remodeling kicks in, and some changes take place.
In his book, Realm of the Hungry Ghosts, physician Gabor Maté takes a much more holistic approach to dealing with addiction. Dr. Maté doesn’t view “addiction” as a discrete phenomena or medical condition, distinct from the lives of those it affects, but rather the end-result of a complex series of interactions between an individual’s personal history and background, emotional and neurological development, unique brain chemistry, and the interplay of molecules an addict is introducing into their system.
At the end of the day, all of this is very interesting, but often quite useless in helping you solve the immediate problem of being drug-dependent. This is where ibogaine detox presents a completely new paradigm for dealing with the complex issue of addiction.
A single dose of ibogaine is extremely effective in interrupting drug-dependence syndromes, and returning the patient’s brain and body to a pre-addicted state. Following ibogaine therapy you have a window of time wherein you have the opportunity to establish new patterns of behavior and make edits in the story of your life, and what you perceive yourself to be.
Dealing with Relapse
Nearly everyone who has ever been drug dependent and managed to get on the path to recovery, will at some point within their journey have to deal with relapse. This is a complex issue that can have devastating psychological consequences.
Terence Gorski with his CENAPS Model of Relapse Prevention, outlined the overall pattern of behavior leading to a relapse as being filled with many progressive warning signs that denial is being reactivated, as the level of pain and discomfort increases, until it reaches the stage where self-medicating with drugs or alcohol, seems like a rational choice.
This is the part where having some sort of support system, including group support, is very important, and for most people, critical, at least in the early stages of their recovery. Relapse prevention planning is almost completely useless, when the individual in question isn’t sober and lacks a locus of control.
The single biggest problem with group support in the 21st. century is: for nearly all treatment professionals, “group support” equates to the 12 steps.
While the fellowship and the rooms of NA, AA, and all their attendant sub-organizations, have probably helped more people than any other group support system that presently exists, this really isn’t saying very much, because the long-term treatment outcomes obtained with conventional drug treatment are very poor.
The main problem with the 12-step paradigm of relapse is the tremendous deluge of shame and guilt that gets dropped on top of a person who is already drowning in self-hate. Utilizing the 12-step belief system, if you were a heroin addict for 20 years, managed to get clean, and then have drinks with dinner… you’ve just wrecked everything. Your life is over. Go get a white chip.
The real issue with this belief is: thoughts are things. If you believe something is true, you make it so. If you believe that having a drink with dinner, has destroyed the sobriety you’ve worked so long and hard to attain, well, it’s all over, so you may as well go get your drug of choice, because you’re going to stop doing it tomorrow. Or next week. Maybe next year. Go get a white chip.
The concept that all drugs are the same, and a person who has been addicted to one specific molecule, or class of drugs, is automatically addicted to everything else, is called the theory of convergence in neuroscience. The theory of convergence is… wrong, or at best, incomplete. Within the context of the 12-steps it’s also complete nonsense.
We’re never going to take another drug again! “Oh hey, let’s all go drink coffee, chain-smoke cigarettes, and eat some candy bars in the parking lot! Say, is it time for my meds yet?”
After participating in ibogaine therapy, our licensed cognitive psychologists will work with you, and help make reasonable suggestions for what kind of support system may be optimal for your particular situation. You will need some kind of support, especially during the early stages of recovery.
What’s just as important as maintaining your sobriety, is carefully selecting what you want to fill your mind with. Your beliefs about yourself and who you are, will shape the future that you choose to give yourself. If you fill your head with the belief that you are powerless, flawed and diseased… then unfortunately for you, this is what you will become.
On the other hand, if you fill your head with the belief that you are whole, you are intact, you’re a human being with some maladaptive behaviors you’re working on changing… then having drinks with dinner doesn’t necessarily signify your own personal apocalypse.
SMART and the Rational Recovery movement, provides an alternative to the 12-steps, which includes group support and meetings are available in most larger cities. Within the context of SMART, finding your sponsor is easy, just go look in the nearest mirror, because that’s the only person who is ever going to prevent you from making the choice to become drug dependent again. And yes, post-ibogaine it is a choice. It’s not a good one, but you are still making choices. Once you get back on the treadmill, the concept of choices will vanish pretty rapidly as you get pulled down, back into active addiction.
While you are in a state where you’re capable of making choices… Take some time, and write out your thoughts. The only person you’re writing to, is yourself. Define what relapse means to you. Define what the concept of “sobriety” even means. And for once, be kind to yourself. Write yourself an exit. What do I do if I relapse? It’s not really a great mystery, just get over it, pick yourself back up, and keep going.