Hello again! If you are just joining us we are in the middle of a series that’s goal is to answer an overarching question about addiction recovery. What is a Naturopathic perspective on healing and maintaining health and even thriving during early substance abuse recovery?
Previously, I have introduced you to some of the philosophies of a Traditional Naturopath which set a framework for some of the modalities that we will discuss going forward. You can also find Part II here. Next, we will work on another piece of the puzzle which will carry us along as we answer the larger question. The need is great among the culture and community for a greater awareness of addiction, what it is, and how it affects an individual. Here we will discuss what addiction is and how Naturopathy fits within the framework of addiction treatment.
The philosophies of Naturopathy and what is required for sobriety and the aim of addiction recovery go hand in hand. Individuals in addiction treatment are reshaping their lives from their center preoccupation being around drug use and the life style that supports use, to one that is grounded in sobriety. This is a substantial shift for an individual, one that requires much effort and support.
Naturopaths can operate in their role as one essential piece of the client’s support system helping them cultivate a healthy lifestyle. But Naturopaths should be one among many in an individual’s treatment; treatment would not be complete without “education, counseling and other behavioral therapy.”[i] Treatment should attend to the multiple needs of the individual not just the drug use.[ii]
Their support system would not be complete without a supportive community, and their spiritual recovery program such as Alcoholics Anonymous (AA). Without any one of the support systems or modalities the individual would not receive all they need to be successful. .
In order to have this conversation we need to clarify and answer the question what is addiction? Addiction is a chronic disease of the brain. The American Society of Addiction Medicine (ASAM) elaborates in its definition being a “primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.”[iii]
This is a mammoth definition, which brings to light that addiction is a progressive disease, “although the mechanisms may be different, addiction has many features in common with disorders such as diabetes, asthma, and hypertension. All of these disorders are chronic, subject to relapse, and influenced by genetic, developmental, behavioral and social and environmental factors. In all of these disorders, affected individuals may have difficulty in complying with prescribed treatment”[iv]
Addiction is difficult to recover from and is a life-long process. In 1956 Dr. A.E. Bennett in his recommendations to other psychiatrists about how to treat the chronic alcoholic, acknowledged a widely accepted truth among the recovery community; an alcoholic is “never cured because, once an addict, he can never safely drink again, can never become a controlled or social drinker.”[v]
Furthermore, ASAM adds to their description of addiction this statement that captures the struggle of entering recovery: “Addiction professionals and persons in recovery know the hope that is found in recovery. Recovery is available even to persons who may not at first be able to perceive this hope, especially when the focus is on linking the health consequences to the disease of addiction.
As in other health conditions, self-management, with mutual support, is very important in recovery from addiction. Peer support such as that found in various ‘self-help’ activities is beneficial in optimizing health status and functional outcomes in recovery. Recovery from addiction is best achieved through a combination of self-management, mutual support, and professional care provided by trained and certified professionals.” [vi]
The Betty Ford Institute Consensus Panel developed a working definition–The institute says, “Recovery from substance dependence is a voluntarily maintained lifestyle characterized by sobriety, personal health, and citizenship.” They define sobriety as “abstinence from alcohol and all other nonprescribed drugs”, personal health refers to improved quality of personal life, and citizenship refers to living with regard and respect for those around you and embraces the quality of “giving back”.[vii]
Sobriety is defined as abstinence but recovery takes the journey the next step and focuses on the whole person learning to live a new life without their substance of choice. Every area of their life is touched by recovery and spiritual principles that provide a path for the recovering individual to live in the world in a new way.
“Clinicians can enhance the likelihood of recovery both during and after services end by assisting clients in effecting changes in behavior, attitudes and social network to strengthen social and recovery capital and to build a satisfactory social life away from the drug scene.”[viii]
One study illustrates the benefits and challenges of early recovery, “Reasons for sustaining abstinence in problem drinkers include moving away from substance-using friends and support from a partner or friends. Time and abstinence are also important for repairing social relationships.” [ix]
It is plausible that the process of forming and repairing friendships with non-substance users and those in recovery is gradual and comes increasingly central to the ongoing recovery journey, with some of the lasting strong relationships being developed as part of mutual aid or other structured recovery supports. Employment also has positive effects on anxiety and depression. Recovery is not simply about removal of symptoms, but may offer a transformative process that enhances and exceeds what is available in “ordinary” life” [ix]
Recovery begins with abstinence, and admitting powerlessness over the drug of choice. As discussed previously there are many consequences of substance use, and many areas of life that need to change to maintain abstinence, but as this difficult journey of recovery continues quality of life and relationships within community and society improve.
Entering into recovery there are many physical consequences that need to be addressed with in the clients team of support. The Naturopath can be one part of this team to help maintain health in early recovery. Returning to the tree metaphor, maintaining health can be illustrated using the concentric circles in a tree, Inner physical healing progresses outward rippling through a person’s life from inward outward.
[i].Barlow, David, H. ed. Clinical Handbook of Phsycological disorders: A step by step treatment manual. The Guilford press. New York. 2014
[ii].Barlow, David, H. ed. Clinical Handbook of Phsycological disorders: A step by step treatment manual. The Guilford press. New York. 2014
[iii]. American Society of Addiction Medicine, Definition of addiction, Adopted by the ASAM Board of Directors April 2011 https://www.asam.org/docs/default-source/public-policy-statements/1definition_of_addiction_short_4-11.pdf?sfvrsn=6e36cc2_0
[iv]. Mental, Health Services Administration US, and Office of the Surgeon General (US. “Facing addiction in America: The Surgeon General’s report on alcohol, drugs, and health.” (2016).
[v]. Bennett, A. E. “Alcohol Addiction—Problems in Treatment.” California medicine 85, no. 4 (1956): 235.
[vi]. American Society of Addiction Medicine, Definition of addiction, Adopted by the ASAM Board of Directors April 2011 https://www.asam.org/docs/default-source/public-policy-statements/1definition_of_addiction_short_4-11.pdf?sfvrsn=6e36cc2_0
[vii]. Panel, The Betty Ford Institute Consensus. “What is recovery? A working definition from the Betty Ford Institute.” Journal of Substance Abuse Treatment 33, no. 3 (2007): 221-228.
[viii]. Laudet, Alexandre B. “What does recovery mean to you? Lessons from the recovery experience for research and practice.” Journal of substance abuse treatment 33, no. 3 (2007): 243-256.
[ix]. Hibbert, Louise J., and David W. Best. “Assessing recovery and functioning in former problem drinkers at different stages of their recovery journeys.” Drug and Alcohol Review 30, no. 1 (2011): 12-20.