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World Drug Day Blog: Treating the Addiction Not the Drug

27/06/2013 11:50 BST | Updated 26/08/2013 10:12 BST
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The mistake we all make when treating addiction is to fire fight and call that treatment.

Rehabs and addiction programmes tend to treat the manifestation of the addiction, not the condition itself and so of course people relapse.

Manifestations include drugs, alcohol, gambling, eating disorders, self-harming, sex and love addiction and there are 8 more which are treated worldwide. Abstinence is a necessary PART of treatment, in fact it's the easy part, and it must not be the goal.

Then there is the adult child of the addict, where growing up in an environment of active addiction qualifies a diagnosis. No one gets away scot free, though many may look like they do to the untrained eye. The adult child displays particular characteristics that will inevitably attract a partnership in addition, perpetuating patterns, reinforcing dysfunctional emotional rhythms. Thus this sickness is allowed to pervade society, spreading through families and social systems, unseen until it emerges as a drug addiction or alcoholism.

But there are earlier signs that I believe can be effectively treated. We cannot wait until the boil erupts to diagnose the plague. We need to tune into the pathology of this sickness so that early intervention is actually possible, but we need a cultural shift to do this and we need to know what we are looking for.

We need to recognise the core characteristics of this sickness of which there are 12, and we have to accept that addiction is a human condition, operating on a continuum. It is not outside of us, but within us. It is affect and behavioural dysregulation, it is self medication, its about neurological sensitivity, its about predisposition and experience of nurture.

Addiction is known as a chronic relapsing condition as were so many other illnesses until we properly understood these illnesses and started to talk about a cure.

I want to begin to talk about a cure for addiction.

The difficulty of course is that addiction happens in a person's interior world so engaging someone to properly get well is the real battle. And how do we know if they are being honest?

We have to challenge, to provide mental and emotional psychotherapy to train the muscles to work in a healthy way. We have to know what we are doing and be allowed to do it

This is easier in the private sector, where I work, as I am able to assert boundaries and take risks that perhaps a state sector organisation would struggle to do. I can take a more bold approach and therefore get better results. The boundary I place in front of my client is transparent and clear and sound, even if often unpopular. When push comes to shove the boundary can hold true. The addiction cannot manipulate me through beurocracy.

It means being able to say 'no' to someone who is psycho-pathologically primed to strive for 'life on my terms', someone focused like a heat-seeking missile to elicit a 'yes, alright then' in order to avoid vulnerability. An addict will not easily accept 'no'. So I have to be prepared to be unpopular, and my client has to be prepared to experience life on life's terms, to get well.

Earlier this week I had to say 'no' to a client and she responded, admitting her surprise, that she felt relief, stating that no one had ever held a boundary for her like that in her life. She became quite moved.

This is where the action is, in the interpersonal relationships with self and others. In that space that doesn't exist until you invest in it. In the experience of self-esteem, in having a sense of your self that is worthwhile. In having boundaries that are true, no matter the negotiation, threat or argument. To feel safe knowing that you are powerless. To feel worth simply because you exist.

This work has to happen in relationship and for that relationship to have integrity it needs to be driven by a moral code. In the state sector I believe that it is almost impossible to hold these kinds of boundaries that challenge the individual in this way as the addict always has recourse to the organisation. So in the game of raising the stakes, the addiction has the trump card. Fatal.

True it is vital that the organisation is accountable but it's a fine line to tread when one is trying to treat an illness with extreme avoidant characteristics, an abdication of personal responsibility and an attitude of learned helplessness. So many who work in the state sector are burned out, frustrated and disappointed, with their generous enthusiasm and inspiration to make a difference thwarted by beurocracy and administration.

What we need is a revolution: Starting today, on World Drugs Day, lets focus on people not drugs,