Breaking the cycle of addiction requires continuous support and care. It begins with recognising and acknowledging there is a problem.
Recovery is not linear and comes with obstacles, though these can be overcome with the right support. Addiction is treatable with a turning point occurring when a person works through an assessment to determine the nature and severity of their addiction, how it is impacting their life, and what recovery solutions are open to them.
“It is important to note that addiction is not a one size fits all condition and different addictions require different assessments. Sometimes, people switch addiction faces,” says Donal Kiernan, an accredited addiction counsellor and psychotherapist with more than 35 years practical counselling experience across a range of addictive conditions.
“For example, a problem gambler may stop gambling and engage with alcoholic drinking. Addiction comes from the Latin word ‘addictus’, which translates as enslaved to and is an excessive form of seeking the ‘hit’ from the dopamine producing part of our brain. It is our reward centre.”
Addictions, whether it is alcohol, drugs, gambling, exercise, work, or compulsive shopping, share common characteristics. However, how the brain reacts to the different highs and lows of varying addictive behaviours or substances can have a different effect on a person and their life. Those suffering with addictions may experience uncharacteristic changes in their behaviour, a lack of control over their addiction, diminishing health, anxiety, depression, being disconnected, obsessive, or compulsive, or withdrawing from friends and family.
“As a rule of thumb,” says Kiernan, “if a substance or behaviour is impacting one area of your life, then you need to be aware of it. If it is affecting two or more areas of your life – financial, work, home, relationships, legal, spiritual, and mental – in a negative way, then you have a problem.
“All addiction thrives on secrecy, shame, silence, guilt, blame, denial, lying, anger and threatening or intimidating behaviour. Broken promises are a clear indicator of addiction being very active.”
An addiction assessment is one of the first steps in treatment and towards recovery. Creating an individual treatment plan includes considering a person’s physical and psychological health to find the most suitable treatment available and with access to the right people to guide and support treatment. Assessments are as individual as the person.
“The Audit Tool, which is a self-assessment questionnaire based on the past year of consumption of alcohol, is a good guide,” says Kiernan, who recognises that effective assessment tools include self-reporting by the respondent as well as clinical interviews “which involve a series of structured interviews that evaluate and assess the impact of alcohol on a person’s life, the lives of those closest to the affected person, their work and social life. Observation by those closest to the addicted person are good indicators.”
Understanding the addiction, it’s severity and length, and how it is affecting an individual are all taken into account to find solutions which can include counselling, medication, lifestyle changes or most likely a combination of treatments.
“The type of medication prescribed for addiction depends on the substance or behaviour involved,” says Dr Sarah Anne Bennett, a GP with Webdoctor, an Irish-owned health technology platform founded by healthcare and IT professionals in 2014. “The choice of medication depends on factors such as the severity of addiction, the patient’s medical history, and individual preferences.
“It may be necessary to prescribe medications to help manage withdrawal symptoms and cravings, such as methadone for opioid addiction or nicotine replacement therapy for smoking addiction. Other commonly prescribed medications might be offered to reduce alcohol cravings, along with a vitamin called Thiamine, which plays a crucial role in maintaining brain health throughout alcohol detoxification.”
Bennett does not advise unsupervised addiction withdrawal. “Also known as ‘cold turkey’, withdrawal, can pose serious risks to an individual’s health and wellbeing,” she says. “Withdrawal symptoms can vary in intensity depending on the substance and the severity of the addiction. Attempting to quit addictive substances abruptly and without proper medical supervision can lead to physical, psychological, and even life-threatening complications. Medication is often part of a comprehensive treatment plan that should also include counselling, therapy, and lifestyle changes.”
Darren O’Brien, an accredited counsellor with Addiction Counsellors of Ireland highlights the free programme Smart Recovery that is easily accessed through online or face-to-face meetings. As chairperson of the board of Smart Recovery Ireland, he says that it “doesn’t differentiate between behaviours and is an evidence informed programme that helps people overcome behavioural addictions and substance use issues”.
Smart Recovery is an acronym for self-management and recovery training and views addiction as a behaviour. The programme, which started as a local pilot programme in Bray, Co Wicklow, and was originally developed in United States in 1994, is centred on the self-empowerment of individuals and “enabling self-reliance to address their issues while retaining autonomy through self-directed change and take responsibility over their recovery journey”.
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Meetings are led by trained facilitators, providing a supportive environment for people to share their experiences and learn new skills. A non-judgemental setting allows for honesty and sharing of thoughts, ideas, and experiences.
“Being evidence informed, Smart utilises elements of cognitive behavioural therapy, rational emotive behaviour therapy [and] motivational interviewing of the stages of change,” says O’Brien. “Using cognitive tools helps people identify the behaviours they engage in, the impact of these behaviours and what, if any, changes they wish to make.”
O’Brien highlights that as it is a self-help programme, it allows a person to take control of their recovery. He says the four-point programme is flexible and adaptable to a person’s individual needs as it focuses on building and maintaining motivation, coping with urges, managing thoughts, feelings, and behaviours, and living a balanced life.
O’Brien recognises that “urges to use addictive substances or engage in addictive behaviours can be destructive” and says the programme “helps with distraction, relaxation techniques and other strategies” to cope with urges.
“Using the cognitive tools helps people to address and change their thinking styles that contribute to their addictive behaviours,” O’Brien says. “Learning about themselves, participants challenge the negative and maladaptive thought patterns that contribute to their addictive behaviours and develop healthier behaviours. And when the addictive behaviours have been addressed, it is important to live a balanced and fulfilling life by setting realistic goals and making positive lifestyle changes. This is achieved by setting boundaries, managing stress, and building and maintain healthy relationships.”
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For many people, treatment may last for their entire life as abstaining from the addiction can lead to encountering obstacles. As such, treatment and recovery are not linear and may change as a person manages their addiction as they navigate life.
