Addiction treatment can be discouraging.  As a healthcare professional you can invest huge amounts of energy and passion into helping someone enter into recovery, only to see them fall back into the old patterns of using.  The addict or alcoholic comes to understand their disease, learning techniques to manage their urges, triggers and weaknesses. You help them build a support network and emphasize how important it is to reach out to others in times of trial.  Yet, even though they have the tools, they often fail to use them in times of crisis, or resist making the changes necessary to create a life where it is easier not to use.

There are many reasons why people relapse and the outcome of treatment is not under the control of the provider.  However, that does not exempt the rehab program from ensuring that it is doing its best to lay the foundation for a strong recovery.  In this regard, there is a need for addiction treatment to be holistic, focusing on the whole person and the many reasons why they use drugs and alcohol.  There are times when it is not inappropriate to view addiction as the symptom, a means by which the underlying problem is being medicated. If treatment does not address these deeper issues, recovery from addiction is significantly impeded.

The co-occurring conditions must be addressed.

It is estimated that more than two thirds of the people with an addiction have a diagnosable co-occurring condition.  Our experience at St. Joseph Institute would confirm that statistic, and encourage the search for other underlying conditions which might not merit a diagnosis, but nonetheless are important issues that must be addressed. Listed below are ten of the “companions” to addiction that we frequently encounter.

1. Anxiety. Studies of drug and alcohol use on university campuses highlight how often addiction grows out of a desire to lower anxiety.  Treatment must recognize the importance of equipping the individual with techniques and strategies to manage anxiety without self-medication.
2. Depression. Sadness is a feeling that we want to avoid and too often drugs or alcohol become the answer.  Depression must be treated if the cycle of addictive behavior is to be broken.
3. Bipolar Disorder.  Many people affected with bi-polar dislike the way they feel when taking prescription medications for their condition.  Drugs may offer relief from the symptoms, but lead them down a destructive pathway.
4. Pain.  Addiction is all too often the result of pain medications that were prescribed by a physician.  Natural ways of managing pain must be taught if the dependence on narcotics is to be broken.
5. Relationship problems.  Nothing creates more “psychic pain” than relationships that are not working well.  Learning to build better boundaries, resolve conflict, and establish trust are important for everyone, especially those who are tempted to self-medicate when relationships become hard.
6. Stress. Too often managing stress is considered an optional activity.  For people with addiction, finding ways to keep their stress at a low level is a mandatory part of recovery.
7. Boredom.  A surprising number of people use drugs and alcohol to cope with boredom.  For this group, finding new hobbies, outlets, and ways to get involved is an important part of the healing process.
8. Sex. Many addicts have used drugs or alcohol as part of their sex lives for as long as they can remember.  They are afraid of the impact of sobriety on their sex lives, because of inhibitions, or because they fear the performance or the experience will change.
9. Self-worth.  Some many people treat their feelings with drugs and alcohol.  When they have been hurt by others, or are unable to forgive themselves, addiction becomes a place of safety.
10. Trauma, abuse, PTSD. It is estimated that 1 in 4 women addicts has been sexually abused.  Addictive behavior has become a way of coping, and recovery demands that these underlying issues find resolution.

These are but some of the reasons why people become attached to their drug of choice and are reluctant to let go.  If we are to treat these people, and help them break free from their addiction, we must help them address these driving reasons and adopt new behaviors.  If we treat the addiction, but ignore the co-occurring conditions that provide its fuel, we will almost always witness failure.  Recovery demands that the whole person find healing.  As healthcare professionals, we can offer nothing less.

 Michael Campbell is Co-founder and President of St. Joseph Institute for Addiction, a rehab center located near State College.