A three-part series by Guest Blogger Gloria Englund, MA. New Protocols, Addiction as a Progressive Brain Disease.
Old-school Perception & Protocol – the 1990s
My history with MAT goes back to the 1990s when most people considered substance use disorders a character flaw, and/or lack of will power and motivation. Although the American Medical Association (AMA) recognized alcoholism as disease in 1956 which allowed it to be viewed as a diagnosable condition for which insurance reimbursement was possible, most treatment focused on it being a psychological/behavior disorder. This was the treatment protocol I learned in graduate school in the early ‘90s.
Addiction Recognized as a Progressive Brain Disease
Aaron died in 2007. It wasn’t until 2011 that The American Society of Addiction Medicine (ASAM) first stated that addiction is a progressive brain disease that is fatal without intervention.
This meant both of us went through our 20-year struggle with his SUD without knowledge of addiction being a brain disease – as I suspect many have. It was a wake-up call for me to learn that this illness is about underlying neurology, not outward actions.
The NIDA soon after stated that addiction is “a chronic relapsing …brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences.” It was so hard for me to grasp that my son’s was ill not only with a physical dependence – but also a psychological compulsion that would create drug seeking behavior no matter what the consequences.
Abraham Maslow’s Hierarchy of Needs is a theory of psychological health predicated on fulfilling innate human needs in a specific priority. Physiological needs such breathing, food and water are at the bottom the hierarchy. In other words – a human’s first priority is sustaining life. The hierarchy culminates in self-actualization at the top. The compulsion that is characteristic of SUD precludes those basic physiological needs.
This is why many need MAT to get their cravings quelled. If the cravings aren’t under control, they can’t even think about meeting those basic needs of life – so they can go on to recovering their life.
Tapering Off or Long-term Maintenance?
In 2007, most people on MAT methadone programs were encouraged to start tapering off the medication once they had been stabilized for weeks or a few months. The yo-yo effect of trying to taper and failing to find the correct dosage created constant turmoil for Aaron as well as frequent relapses. At that time, both of us attended recovery support groups which promoted that if you were on medication-assisted treatment you weren’t really in recovery because you were still using an opioid medication. And this continues to happen today.
Very few supportive services were offered along with Aaron’s MAT program – which I now know is very important to recovery. You can’t just take a pill or get an injection and recover from this illness. Although behavior and psychological issues may not be a CAUSE of this illness, they do result as we try to SURVIVE the illness.
That’s why MAT needs to be offered along with individual or group therapy, peer recovery support groups, classes on exercise, nutrition – basic life skills – keeping a budget and learning how to seek employment.
Minnesota Recovery Connection, like many other recovery community organizations (RCO) in other states – offer many of these resources on their website and support all pathways to recovery.
Note to readers: Part III will run on Thursday, June 30. We will post the full three-part series in our Resource section.
About our Guest Blogger: Gloria Englund, founder of Recovering u breaks new ground in the field of addiction recovery and support. As an ally of the recovery community, she honors all pathways of recovery. She is a psychotherapist, who holds a Master of Arts degree in Human Development. As a certified Recovery Coach, she works with individuals and families dealing with an addiction to alcohol, drugs, food, and relationships. Gloria has personal as well as professional knowledge of addiction and recovery; her oldest son, Aaron, died of a heroin overdose in 2007. As an accomplished public speaker, advocate and published author, Gloria brings a message of hope and recovery to others.
Guest blog posts are welcome additions to the content on this website. Guest blog posts represent the views, opinions and experiences of the author and do not necessarily represent Our Young Addicts. Together, we provide parents and professionals with a variety of perspectives and information.