Author: Claudia M. Elsig, MD

Addiction is a chronic psychiatric disorder with many potential causes. Tackling addiction is complex. The road to recovery can be long, painful, and fraught with relapses, especially without the right support.

Without early intervention, addiction can be a hard beast to break. Even when a person commits to addiction treatment, there are lots of potential triggers during the recovery journey that can lead to retraumatisation and relapse. That’s why choosing the right addiction treatment programme is essential.

This blog explains some of the common blocks to addiction recovery and shares some important self-help strategies for the journey back to health.

How addiction works – the dopamine pathway

Before exploring the blocks to recovery, it’s important to understand how addiction works, and how it interferes with brain function. Addictions center around alterations in a single pathway in the brain, commonly known as the ‘reward’ circuit.¹ These actions happen in the brain’s limbic system – the part of our brain that is involved in our behavioral and emotional responses.

This reward system releases the neurotransmitter dopamine along with other chemicals. Dopamine reinforces the brain’s association between certain things and feelings of pleasure, driving a person to seek those things out again in the future. The desire to experience euphoria triggers cravings, especially when specific cues are encountered, such as being at a party or hanging out with certain groups of people.

Then comes dopamine ‘tolerance’, which means the body needs more of it to function normally. At this stage a person can develop a disinterest in other pastimes that would normally trigger a dopamine response, such as hobbies or other day-to-day activities a person normally enjoys.

And so, addiction continues in a cycle – to enjoy anything, to get a dopamine ‘hit’, the addict must have their craving satisfied.

The ‘reward’ pathway is involved in drug addictions of all kinds—not just addiction to alcohol, or illegal drugs such as heroin and cocaine, but also addiction to tobacco, and even caffeine. The same pathway is involved for non-substance addictions, such as gambling, compulsive shopping, internet gaming, sex, exercise, eating etc.

The blocks to addiction recovery

Addiction recovery is a process where the things that block a person from reaching their full potential are addressed and rebalanced. But the road to recovery is far from linear. There are many obstacles to overcome. For substance and alcohol addiction, usually, the physical body, with the right support, can recover quite well.

Within a space of 3 months on a recovery programme, a person can begin to look extremely well again. The 3-month hurdle is a challenging one – when a person looks and feels physically better, it is easy to think they are cured. But at this stage, the real work has only just begun. It is the mental/emotional side of addiction that requires the most work. That is why addiction recovery must always include psychiatric support.

The common blocks to addiction recovery include:

Unresolved childhood trauma

Addiction is only the tip of the iceberg. Most people who turn to excessive and/or persistent use of alcohol or drugs do so to suppress painful emotions – to escape.

Numerous studies show that childhood physical, sexual and emotional abuse (childhood trauma) is strongly linked to substance abuse and early onset alcoholism. A national survey in the U.S., for example, found that women’s experience of sexual abuse in childhood to be an important risk factor for later substance abuse, psychopathology and sexual dysfunction.²

Another study found the severity of childhood trauma, incidents of lifetime trauma, and current experienced stress to be higher in opioid-dependent patients than in healthy controls.³ Results suggest that lifetime trauma and childhood trauma play an important factor in addiction over what can be accounted for by stress.

So, why does this happen? What is the connection between childhood trauma and addiction? Well firstly, traumatic events shape you. Trauma can create a variety of long-term mental health problems, including PTSD (post-traumatic stress disorder). Symptoms of PTSD include flashbacks, nightmares, feeling very anxious and difficulty sleeping. These issues lead many to self-medicate with drugs and alcohol.

You can learn more about the link between childhood trauma and addiction here.

Thinking patterns

Certain aspects of personality and specific behaviors can also present as a blockage to recovery. These include:

• Blaming others
• Self-pity
• Negativity
• Rigid thinking
• Refusing help, or unable to reach out for help
• Demanding of self and others
• Inability to listen to others
• Disconnected from feelings
• Impulsive

Commonly, depression and anxiety get in the way of recovery. Changing addictive thought patterns is a vital component of the addiction recovery journey.

A proper addiction recovery programme addresses thinking patterns. Cognitive behavioral therapy (CBT) is a commonly used intervention as it helps to identify negative thought patterns and beliefs that are contributing to the addiction. A CBT therapist helps to identify these negative patterns and teaches how to replace them with more positive ones.

Cravings and triggers

Almost all recovering addicts experience cravings and triggers that make them want to go back to old ways. The dopamine pathway outlined above explains on a physiological level why this happens. There are numerous coping strategies for helping to overcome triggers, some of which are explained below.

Practical self-help tips during addiction recovery

Recovering from addiction isn’t purely a case of willpower and abstinence. Successful addiction recovery requires a lot of support and self-care. It means treating mental and physical health issues and making changes to lifestyle to build energy and resilience. Importantly, it requires a daily focus on meeting mental and physical needs in a new paradigm of wellness. Failing to do this vital work can quickly lead to a relapse.

Here are some self-help tips and coping strategies for resisting triggers and building wellness and resilience:

• Recognize and manage stress – too much stress has a detrimental effect on the body and can exacerbate both physical and mental health problems. Carve out time to relax. It’s important to break the cycle of getting caught up in a worrying storyline. Try meditation or mindfulness practice – there are lots of Apps offering guided meditations from as short as a few minutes. Subscription-based Headspace is a good place to start.
• Reset to STOP impulsive decision-making – whenever you are having cravings and thinking about giving in, get into the habit of taking a deep breath, changing your physical position – perhaps stand up – and say ‘no thank you’ out loud. Think through the long-term consequence of you making a rash decision now. Increasing personal awareness during the recovery process is essential for putting a stop to old behaviors and implementing new healthy ones.
• Get plenty of rest – when you are well rested, a positive state of mind is much easier.
• Enjoy some fresh air and take regular, moderate exercise – exercise and fresh air are a great tool for resetting the mind and breaking negative thought processes.
• Eat healthily – when you are properly nourished, your body and mind will start to respond differently.
• Keep it real – it’s important not to romanticise your past. Focus on the good results and how much better your life is being clean, sober, or free from the hurt brought on by any other compulsive behaviors.
• Surround yourself with supportive people – now is not the time to get in touch with old friends who you associated with during your addiction. Socialise when you can with people who are willing to support you and help you recover.
• Money – if paydays were a time when you used to binge, plan how you are going to spend your money before you get paid. If having money is one of your triggers, put it into an account that requires notice to withdraw or ask someone you trust (who won’t give in and give you money) to help you manage your finances.

Addiction treatment at CALDA

At CALDA we take a holistic approach to addiction treatment. The programme includes addiction-specific therapy, CBT, clinical hypnosis, and EMDR (eye movement desensitisation and reprocessing), alongside dietary support, micronutrient assessment and supplementation, detoxification and gut cleansing.

CALDA’s full suite of therapeutics for addiction recovery includes Enactive Trauma Therapy. The treatment journey is supported by alternative and complementary medicine.

All programmes are personalized to liberate you from your addictive behavior within the shortest period of time. Our comprehensive treatment programme begins with detoxification to wean your body off the substance. This is carried out in a safe, medically supervised environment. The CALDA RODA program provides a safe, well established and time-saving procedure for opioid detoxification under anesthesia in our partner clinic Privatklinik Bethanien. This enables a full detoxification while avoiding some of the possible severe syndromes during withdrawal.

Our compassionate team of addiction professionals then focus on personalized behavioral rehabilitation. One of our personal coaches will also accompany you for some time at home and support you in finding your way in everyday life again.

Our clients are self-payers, which is the basis to enabling absolute discretion and privacy. If you would like to know more, please get in touch.

References/Resources

1. Powledge T.M. 01Jul1999. Addiction and the brain: The dopamine pathway is helping researchers find their way through the addiction maze
2. Wilsnack S.C. et al. 04Jan2015 Childhood sexual abuse and women’s substance abuse: national survey findings
3. Garami J. et al. 23Mar2018. Examining Perceived Stress, Childhood Trauma and Interpersonal Trauma in Individuals With Drug Addiction