Understanding Addiction: Know Science, No Stigma

Title: Understanding Addiction
Subtitle: Know Science, No Stigma
Authors: Dr. Chuck Smith & Dr. Jason Hunt
Publisher: Visualize Publishing
Copyright: 2021
ISBN-13: 978-1737235200
Format: Paperback (140 pages)
Genre: Non-Fiction

Both of the authors are physicians currently specializing in the field of addiction recovery, and are both themselves in long-term recovery.

Before I get into the content of the book, I'd like to say that it is written for average people. Far from a textbook, it's an easy read, and most people should be able to get through it without a lot of difficulty. The book isn't even very long, but it has a lot to say.

The authors are introduced in the first two chapters, and their recovery and the aftermath are discussed in the last two chapters, including their collaboration in producing this book.

The th
ird chapter examines the conception of addiction as a disease, an understanding that is not without some controversy, yet one that has brought about more effective treatment of substance use disorders, without the added burdens of guilt, shame, and self-hatred.

This and the following chapter also discuss the role of dopamine and other chemicals on the prefrontal cortex of the brain, leading to problems that are inherent in the brain of the addicted person.

Chapter five explores the risk factors for addiction. Just as smoking and genetics are acknowledged as risk factors for cancer, there are known risk factors for addiction, as well.

These include genetics, age, adverse childhood experiences, comorbidity, and a high tolerance to the addictive substance, and a combination of these factors exacerbates the risk.

Considering age as a risk factor for addiction, the authors make the point that adolescents are more at risk than adults because the dopamine reward system (discussed in chapter four) doesn't mature until the age of about twenty-four. At that point, the odds of addiction decrease.

Thus, while other risk factors are in play as well, someone who doesn't drink or do drugs until after the age of twenty-four is less likely to become addicted. Of course, the safest course is to not start at all, particularly if you have other risk factors.

In American culture, and probably others, as well, people who can hold their liquor are sometimes held in high esteem. Certainly, that's been the case in the movies. In actuality, while a high tolerance for alcohol or other substances might be seen as a positive trait, it's a warning sign for addiction.

If you get sick after one beer or are ready to pass out after a wine cooler, you are far less likely to become a person with alcohol use disorder than someone who is able to keep on drinking with relatively minimal effects.

Of course, if you keep trying, you can probably built up your tolerance, but that's not a good thing.

Availability might also be considered a risk factor because if you never access an addictive substance, it's not going to be a problem for you. Unfortunately, while this might have been an option at some point in the past, or in some parts of the country, both drugs and alcohol are available to pretty much anyone who's looking for it today.

There are thirteen chapters in all, and I won't go through each of them.

The doctors do not recommend moving directly to a non-professional recovery program after first deciding to quit your addiction. Although these programs have their place, and have worked for a lot of people, there are many for whom Alcoholics Anonymous (or any of the other programs) are not enough.

As they would have it, the first level of treatment is detoxification, followed by an outpatient program combined with a sober living home or halfway house, particularly if connected to local treatment programs and support groups.

Ideally, according to the authors, long-term treatment of substance use disorder should include a professional program patterned after which is currently available largely to physicians or others who can afford a similar custom treatment programs.

Drawing from their own experiences in a Physician Health Plan (PHP) created to manage the care of addicted physicians, the authors make a strong case for the development of a similar program that would be available to other addicted people.

The airline industry has a comparable program called Human Intervention Motivation Study (HIMS), and there is a similar program for attorneys.

PHPs begin with treatment, followed by weekly peer-group meetings that are facilitated by a professional who is skilled in behavioral health. Monitoring is a part of the PHP, including regular testing, often random, to ensure compliance.

The authors found this program to be effective in their own recovery, and are convinced that such a program would be far more effective than AA alone, or even a combination of detox, sober living, and AA. Citing studies that have found that after three years of abstinence in a controlled PHP-type program, there is a seventy percent chance of long-term success in recovery, they advance the case for expanding these programs to include others in need.

Yes, they get into the financial aspect of it, too, balancing the costs of such programs with the costs of addiction, but I won't go into that here.

Again, it's not a hard read, and you'll be left with a lot to consider.

At this time, the paperback edition is available on Amazon for $14.99. A Kindle version costs $6.99, and if you have Kindle Unlimited, you can read it for free.