Monday, April 21, 2014

Treating the Beast of Addiction

Tangled vines and branches near my house.
One Sunday at Redeemer I asked people who believe they have been freed from an addiction to share, in a sentence. About 20 shared, and a typical sentence was this: "I was addicted to prescription drugs, but have been free from them for 5 years." As many heard these words of testimony there was much applause directed to God.

Addiction is, as one drug addict once told me, "a beast." The addict is "attached" to a substance, or a behavior, that will not take its claws out of them (the French word for "addiction" is attache). I have met addicts who said they were set free only to see them return to their addiction. I've also seen people pray to be released from addiction who either have not been or not yet been. And, over the years, I have met many who were once addicted, turned to God for help, and were declawed and set free. I personally know many of these people. I find their testimonies credible.

Clinical psychiatrist Gerald May, in Addiction and Grace: Love and Spirituality in the Healing of Addictions, writes of the place of faith in God in the battle against addiction. He says:

"For the power of addiction to be overcome, human will must act in concert with divine will. The human spirit must flow with the Holy Spirit. Personal power must be aligned with the power of grace. How does this happen? It is surely impossible by autonomous willpower alone; the addicted systems of the brain are too numerous and overwhelming."

May's book remains beautiful and important to me in the struggle with addictive bondage, both my own and others. I mostly attribute any person's freedom from addiction to the grace of God. I've seen the "12 Steps" work, accompanied by the grace of God. But I have rarely seen pure clinical treatments to be of much help.

If someone who is an addict comes to me for help, I'll do any or all of three things:
1) Pray for God to graciously free them (because, again, I have seen this happen). My counsel here includes leading them into the presence of God where spiritual formation takes place. This is about a lifestyle.
2) Refer them to a counseling clinic, like this one (because I've seen God work here, too).
3) Refer them to the University of Michigan Addiction Treatment Services (U-Michigan Medical Center is one of our nation's great hospitals).

Regarding #3, how effective is this? Nora Volkow is the neuroscientist in charge of the National Institute on Drug Abuse. She's interviewed here - "A General in the Drug War." Here's her take on the effectiveness of a purely scientific, clinical approach to treating one kind of addiction - to prescription drugs.
  • Addictions all "boil down to the same thing" - dopamine.
  • "All addictive substances send dopamine levels surging in the small central zone of the brain called the nucleus accumbens, which is thought to be the main reward center. Amphetamines induce cells to release it directly; cocaine blocks its reuptake; alcohol and narcotics like morphine, heroin and many prescription pain relievers suppress nerve cells that inhibit its release. Addicts and first-time users alike get the high that correlates with the dopamine wave. Only a minority of novices, however, will develop the compulsion to keep taking the drug at great personal cost, a behavior that defines addiction."  
  • "Addiction requires two things. First is a genetic vulnerability, whose variables may include the quantity of dopamine receptors in the brain: Too few receptors and taking the drug is not particularly memorable, too many and it is actually unpleasant. Second, repeated assaults to the spectrum of circuits regulated by dopamine, involving motivation, expectation, memory and learning, among many others, appear to fundamentally alter the brain’s workings." Addiction causes changes in brain function.   
  • "The overall success rate for curing drug addiction with medications, therapy or both is not high (about half of treated individuals return to active substance use within a year)."
  • Success in treating addiction is partly dependent on the social environment of the addict.        
  • The pace of addiction research is accelerating.
  • Prescription drugs "are lifesaving yet every bit as dangerous as banned substances. “The challenges we face are much more complex,” Dr. Volkow said, “because we need to address the needs of patients in pain, while protecting those at risk for substance use disorders.”"