According to National Institute on Drug Abuse (NIDA), “Addiction is a brain disease that affects multiple brain circuits, including those involved in reward and motivation, learning and memory, and inhibitory control over behaviour.” Drug addiction is a complex disease that, despite beginning as a voluntary choice, the addictive behaviour is characterised by compulsive, at times uncontrollable, drug craving which persists even though the extremely negative consequences it has.
Medications are an important element of treatment for many patients, especially when combined with counselling and other behavioural therapies, process that often begins with detoxification, followed by treatment and relapse prevention. Medically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse; preventing relapse is necessary for maintaining its effects. Even though there’s no single treatment appropriate for everyone, it does not need either to be voluntary to be effective.
Medications are used to help with two different stages of the process:
a) Withdrawal: they offer help in suppressing withdrawal symptoms during detoxification, however, medically assisted detoxification is not a “treatment” in itself.
b) Treatment: in this case, medications could be used to assist to reestablish normal brain function and to diminish cravings and to prevent relapse. At the moment, there are medications to treat opioids (heroin, morphine), tobacco and alcohol addictions and are being developed others for treating stimulant (cocaine, methamphetamine) and cannabis (marijuana) addictions:
– Opioids: Methadone and buprenorphine are considered effective medications for the treatment of opiate addiction by suppressing withdrawal symptoms and relieving cravings since they act on the same areas in the brain as heroin and morphine do. Since methadone and buprenorphine are opioids themselves, these treatments for opioid dependence are sometimes seen as just substitutions of one addictive drug for another, to what NIDA affirms “but taking these medications as prescribed allows patients to hold jobs, avoid street crime and violence, and reduce their exposure to HIV by stopping or decreasing injection drug use and drug-related high-risk sexual behaviour. Patients stabilised on these medications can also engage more readily in counselling and other behavioural interventions essential to recovery.” (http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction)
Little remark: Dr. Jacques Mabit, French physician and now also healer after many years of intense study of the traditional use of medicinal plants, says:
“ Ayahuasca does not entail addiction; it is totally assimilated. This is what fundamentally separates it from other drugs. The concept of substitution is therefore totally foreign to the method we have adopted. If there is a substitution, it would only be that of an orderly and controlled practice of ingestion of other plants having similar psychotropic effects, instead of the savage habit of taking mind altering substances. From our point of view, the substitution of one addictive substance by another, even if the latter is a legal one and mellowed by medical prescription, reflects nothing but a therapeutic inability to respond to the basic problem at hand. The use of methadone, for example, is part of a scheme of medical repression. It’s a cover-up, a robe, perhaps elegant with hospital colours, but in reality a barbarous practice. To our eyes, drug addiction demonstrates an attempt, almost always unconscious, to break through the barriers of an individual universe. It is equivalent to an intrusion beyond the limits of ordinary consciousness which, imprison the subject within a too restrictive space, where he cannot find a satisfactory answer to his existential restlessness. Drug addiction manifests a profound aspiration to the restitution of a purpose to existence.”
Tobacco: besides the variety of formulations of nicotine replacement therapies (patch, spray, gum) found over the counter, two prescription medications have been FDA–approved for tobacco addiction: bupropion (originally marketed as an antidepressant) and varenicline. They have different mechanisms of action in the brain, but both help prevent relapse in people trying to quit.
Alcohol: there are three FDA–approved medications for treating alcohol dependence: Naltrexone, that blocks opioid receptors involved in the rewarding effects of drinking and in the craving for alcohol. Acamprosate, thought to reduce symptoms of withdrawal, like insomnia, anxiety, restlessness, dysphoria. Disulfiram interferes with the degradation of alcohol, therefore, produces a very unpleasant reaction when combined.
Behavioural treatments are designed to help patients to engage in the treatment process, by modifying their attitudes and behaviours in regard of the drug abuse, and improve healthy life skills. These treatments can also enhance the effectiveness of medications and help people stay in treatment longer.
These programs are:
These are basically the proposals for addiction treatments suggested by the National Institute on Drug Abuse, which concludes that an “ Addiction treatment must help the individual stop using drugs, maintain a drug-free lifestyle, and achieve productive functioning in the family, at work and in the society. Since addiction is typically a chronic disease, drugs users cannot simply stop using drugs for a few days and be cured. Most patients require long-term or repeated episodes of treatments to achieve the abstinence and recovery of their lives.” (http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction)
Any person can become addicted, dependent or compulsively obsessed with any substance, object, activity or behaviour that produces pleasure. There are no specific causes of any addiction aside from use of a substance or activity, and there is no way to predict who will become dependent on use. Any substance or activity that has the capacity to be pleasurable can provide the conditions for addiction.
It has been implied by different researchers the existence of a similarity between the physical addiction to chemicals and the psychological dependence to such activities as compulsive sex, work, gambling, running or eating disorders. This is probably due to the fact that these behaviour activities may produce beta-endorphins in the brain, which provides the person the feeling of being “high.” Therefore, if a person continues to engage in the activity to achieve this feeling of well-being and euphoria, it´s very likely to fall into an addictive cycle.
Many are the common characteristics among different addictive behaviours. Starting by the obsession for one object, activity or substance, the person will seek it out, even though the negative effects it might bring at work or in interpersonal relationships. The individual wiMedically assisted detoxification is only the first stage of addiction treatment and by itself does little to change long–term drug abuse; preventing relapse is necessary rs are considered to be addictive behaviours with no clear cause behind, though all of them can lead to serious health problems, even death.
Even though the cause of compulsive gambling is not known, most gamblers say it´s for the “high” they get while gambling, fact that allow us to speculate that, as in other addictive behaviours, more beta-endorphines may be produced in the brain, which causes the person to repeat the behaviour to achieve the pleasant feeling. It is remarkable that during treatment, compulsive gamblers undergo withdrawal symptoms similar to the ones of persons addicted to depressant drugs: headaches, abdominal pain, diarrhea, cold sweats, tremor, and nightmares.
There are other activities, behaviours or even hobbies upon which some people can become psychologically dependent. Even though some of these activities may not be as life threatening as chemical addictions or eating disorders, they can still have profound negative effects on the person and society. It is not known why some people compulsively engage in a behaviour, while others can engage in the same activity without becoming psychologically dependent upon it.
Work: Our society rewards hard work, it is implied that the person who spends much time at the office or studying, but brings more money or gets job promotion is “being productive.” Actually, most of people that have changed history and have done the most positive contributions to society, they had spent most of their life time working. By other side, when the “work” becomes an obsession to the point that family, friends or other interests become unimportant or ignored, then the person is thought to be a work addict or workaholic.
Computers: computer addicts have been known to spend hours in front of the screen without eating, bathing, or even sleeping. When deprived of the computer, they undergo withdrawal symptoms of anxiety and irritability. Hackers have similar psychological characteristics to people with other addictive behaviours, tend to have low self image, to feel insecure and out of control over their environment and regularly have poor interpersonal skills. The cause of compulsive computer interaction among young people is not known.
Exercise: like extreme commitment to work, extreme commitment to athletics,has been honoured and rewarded in our society, though that extreme commitment has demonstrated to be self destructive and harmful to the person. Since the obsession with the activity usually begins at stressful times, the elevated mood change or “high” experienced by long distance runners then is thought to work as a reinforcer for the behaviour.
Love and relationships: There are two basic forms of love addiction. In the first one, the relationship is mostly one sided, with the object of love not even interested in, or aware of, the obsession of the person. It also happens of two people that are addicted to each other. These individuals tend to be possessive of each other and jealous of their lover’s interactions with other people. The cause of love addiction is not known, but, as in the other addictive behaviours, the person usually feels insecure, has low self image, is frequently depressed, and undergoes “withdrawal symptoms” when deprived of the object of obsession.
Groups: Throughout history, social movements have been started by individuals who were extremely committed to their causes. However, some individuals may become so involved with religious sects, cults, political or social action groups, even self help groups, as to become addicted to them. Like with other addictive behaviours, the group (or cause) dependent person often has low self esteem, feels insecure, is anxious, and is looking for “something” to give meaning to their life. If they cannot be with their group, they often feel depressed, anxious, and irritable. However, like work and athletic commitment, this type of dedication has often been rewarded in our society and has produced both positive and negative social effects over the centuries on a worldwide basis. (http://www.indiana.edu/~engs/rbook/readabd.htm) Engs, Ruth C. “Addictive Behaviours,” Alcohol and Other Drugs: Self Responsibility . Bloomington, IN:Tichenor Publishing Co. 1987. http://www.indiana.edu/~engs/rbook.
Sex: addiction described as any sexual activity that feels out of control, it could involve sex with a partner, but also include activities such as pornography, masturbation, visiting prostitutes or using chat lines.This addiction is similar to substance abuse because it is caused by the powerful chemical substances released during sex.
Treatments mentioned above do not have a high percentage of effectivity, proved by the already mentioned fact that most of treatments have to be repeated even several times. Probably it is due to the short term effectivity, since they are symptom driven treatments and not cause driven ones.
The North American system in general found two causes for addictions: the socially sanctioned one is that these people are making their choice, even knowing the bad consequences; the other one, held by most medical doctors, is that addictions represent illness of the brain and particularly on a genetic basis. But it is known that people that inherit genes predisposed to addiction, in the right environment those genes are never activated. Genes can be turned on and off by the environment.
Dr Jacques Mabit, founder of the Takiwasi addiction treatment center in Peru and trained ayahuasca healer, has been involved in the treatments of thousands of patients with addictions to drugs and alcohol in the last 20 years. He believes that addiction arises as people search for significance in a modern world that has been stripped of meaningful ritual and sacredness; where many no longer feel a sense of belonging or participation in the spiritual or transcendent realm of life.
Dr Gabor Maté sustains that the power of an addiction does not reside in a substance nor in behaviours like sexaholism, internet addiction, gambling, shopping, work and so on, but in the internal relationship to it, the susceptibility, created by trauma. Addictions of all sorts can be traced to early trauma and abandonment issues in childhood, that leave an emotional hole that neither shaming nor imprisonment will never fill. Drug addicts, almost without exception, and 100% of the prison inmates, suffered severe adversity in childhood, and that’s exactly how addiction arises.
Trauma induces its own set of beliefs and coping styles. One coping style is to shut down emotionally in order not to feel, because of the suffering caused by the early trauma, early emotional loss, that induces certain beliefs. One belief is the worthlessness when child, so there’s deep shame at the core of addictions; there’s also a sense that the world is indifferent and hostile, and that mind, shaped by those early experiences, will have to manipulate and find some way to soothe itself. Those are some of the core beliefs at the heart of addiction. And there’s a deep emptiness there, due to the loss of connection with the own essence. That emptiness can never be filled from the outside. The way through the emptiness is through the inside and from the inside. And that’s where the spiritual and the healing experiences, empowered by ayahuasca come into it.
Dr Maté had experienced ayahuasca himself to search the potential ability to reverse medical issues like cancer and addiction when coupled with therapy. At his very first encounter with the medicine he said that ayahuasca got rid of his coping mechanisms “in a flash”. Even though during the ayahuasca experience, some really traumatic experiences could come up, they take the form of direct memory, direct recall of an image or of what happened to them or really scary images and creatures, but all these images are like dreams. Then the beautiful images come, they represent the core self. These visions appear as in response to the coping mechanisms leading to addiction that have been developed; the core self and the beauty of the world is experienced as it actually is and not through the despair point of view driven by the traumatic early experience. Then, when the individual has the chance to see the origin of their coping mechanisms through the eyes of pure love, truth and compassion, the realisation is that there is no need to cope anymore. Of course, all this work requires of time to put in some practice and follow-ups afterwards, the experiences should be put into context with the life of person, otherwise it will become a beautiful memory with no impacts, with this we mean that ayahuasca could be very transformative and life-changing, only if the person experimenting it allow it to happen. In Dr Gabor Maté own words: “if you can become conscious of your patterns and your beliefs, these core beliefs, and how you attain these beliefs, then you can let go of them. Rigid feeling, thought, and behavioral patterns can unclench; the self can rearrange itself and develop its inner and outer resources more deeply. So there we get to the concept of a true self and one that can be reconfigured, or at least rediscovered with the help of the psychoactive plants, particularly ayahuasca”.