Addicts want to be clean but also want more heroin — a contradiction that plagues the lives of thousands in Lorain County.
Resistance to help, or the denial of a problem in the first place, is because “they don’t know how to get out of this,” said Thomas Stuber, president and CEO of The LCADA Way, a rehabilitation center in Lorain.
“Nobody chooses that lifestyle. No addict chooses to be that way,” he said in a talk on the psychology of addiction Jan. 15, part of a series hosted by Church of the Open Door.
Addiction is a disease.
It infiltrates communities, destroys families, and costs governments and health care systems millions of dollars every year.
The American Medical Association has identified addiction as a chronic illness caused by a combination of behavioral, environmental, biological, and genetic factors just like diabetes, asthma, hypertension, and cancer.
Chronic diseases are long-lasting conditions that can be controlled but not cured.
The good news is that with long-term treatment and continued monitoring and support, sustained recovery is possible. The bad news is that healing won’t be easy and the disease won’t go away. Ever.
Relapse or continued drug abuse is an automatic response, like eating when a person’s stomach grumbles. An addict experiences a full loss of control, a result of heroin’s toxicity changing the brain’s wiring.
Just like no one makes a decision to get cancer, Stuber said no one decides to have addiction. “I make a decision not to get high and I get high anyway. That’s a frightening experience,” he said.
The brain cannot function with an overstimulated charge, so it responds by lowering the amount of dopamine — a chemical needed for normal stimulation — it has available. The cravings begin.
Heroin hijacks the brain’s reward and pleasure pathways, erases the brain’s ability to produce its own dopamine, and takes over how the user experiences satisfaction.
Before long, the brain thinks getting high is necessary to survive. The dependency overrides its basic instincts and it demands another surge of pleasure regardless of the horrible consequences, permanent physical harm, and damage to relationships that heroin causes.
Heroin is more addictive to young people “than anything we’ve seen in our lifetimes,” Stuber said.
To someone in their 60s or 70s, narcotics induce sleepiness, he said. But for a someone between 18 and 40 years old, the same drug would cause a large discharge of chemicals to the pleasure center of the brain, inducing a euphoria roughly 26 times more powerful than sex.
Our county is experiencing 10 to 12 overdoses deaths each day and two to four overdose deaths per week, Stuber said. About one out of every 200 high school seniors have tried heroin — that’s 120 young people from Lorain County who are potentially future addicts.
Withdrawal pain is what keeps people using, even though heroin induces less pleasure each time. Stuber said the pain has been compared to the flu times 100 overlapped with an anxiety attack times 100.
The vast majority of heroin addicts suffer severe declining relationships, financial situations, personal integrity, and responsibility.
“We all have values. We learned them while we were growing up. They are the guiding principles that guide who you are, how you behaved, and what you did,” Stuber said. When addicts turn to behaviors that violate their values to keep their habits going — stealing from the community, lying to their family, skipping school, or cheating their employer — they experience emotional pain.”
Addicts will chalk up their problems to everything and anything except their chronic substance abuse, he said.
“Their perception of reality is very different from everyone else around them,” Stuber said. “When one behavior violates a value, followed by another behavior that violates a value, followed by another, addicts end up in a state of free-floating anxiety. To strip away that defense becomes overwhelming to them if they don’t have the therapy to help support them get through all the pain.”
In recovery, patients go through a detox period. In most cases, all organs that were affected by the drugs will again return to balance within five to 11 days.
All organs except the brain, that is.
The brain will go through episodes of readjustment that can last up to two years at at time, Stuber said. During these episodes, the addict “will wake up one morning, after two or three months of doing really well, and it feels like they were using the night before with intense craving and intense anxiety. This is when they are most susceptible to relapse,” he said.
The frequency and duration of cravings will become less and less after one or two years but are highly dangerous, Stuber said. The key to treatment is to teach individuals how manage their illness in spite of a lot of pressure to do otherwise.
Stuber used diabetes treatment as an example to describe the a relapse scenario.
“I have to change my diet, I have to take my meds, and I have to exercise. So I do that religiously and within four months I’m feeling pretty good. I’m thinking I’m normal again,” he said.
That’s when many recovering addicts fall prey to a false sense of security. They wrongly think they’re doing well enough to cut back on support meetings and counseling.
Sustained recovery requires that addicts learn to manage their illness, change how they deal with they world, and diligently focus on preventing relapse, Stuber said.
Rehabilitation is not one-size-fits-all. The LCADA Way offers partial hospitalization, residential, intensive outpatient, and day treatment for men, women, adolescents, and prevention programs for students.
The LCADA Way family treatment program helps families learn to recognize warning signs, personal relapse triggers and how to interrupt them, and how to establish appropriate boundaries.
Family education is offered in Elyria, Lorain, and Medina free of charge.
If you suspect you or a loved one needs help, call The LCADA Way at 440-989-4900.
Laurie Hamame can be reached at 440-775-1611 or @HamameNews on Twitter.