CHEMICAL DEPENDENCE AND TRAUMA
Traumatic stress conditions are highly correlated with chemical dependence. At CTT we believe that most chemical dependence begins with self-medication of anxiety and distress, and is not the result of a moral failure or weakness of will. We also know that no treatment for anxiety, mood, or behavioral problems will be successful unless substance dependence is identified and addressed first.
Signs of Chemical Dependence:
- The need for more of a given substance to produce the same effects (drug tolerance)
- Impaired judgment: driving while under the influence; reckless or risky behavior (e.g. unprotected sex), exposing children to inappropriate behavior
- Accidents while using chemicals
- Black outs
- Problems in relationships at home and work because of the use of addicting substances
- Financial problems as a result of needing drugs or alcohol, or failure to pay bills and other debts
- Being “fired” by a physician over issues involving medications
- Repeated inability to quit using on one’s own volition
- “White knuckle quitting” — abstinence for short periods of time to “prove” to oneself or others that chemical dependence is not a problem
- Efforts by family members, friends, and others to “explain” or cover for behavior that is correctly attributable to substance abuse or dependence (“he is just upset,” “this usually doesn’t happen,” “he is sick and can’t come to work,” “I will talk to him about it””I can make sure that he doesn’t drink””I will dole out his medication”)
- Efforts by family members, friends, and others to convince the person to “cut down,” or quit
- Comparisons: “I’m not an alcoholic! I never lost my job!” “I’m not addicted — I’ve never had a DUI.””I only use after five o’clock.””My doctor said I could use marijuana to help my anxiety and reduce my need for alcohol.””I only drink wine.””I went to an NA meeting, and I’m not like thosepeople.”
- Obtaining medications from multiple sources, either from more than one doctor, or from a doctor and from illicit sources
- Making up stories: “I lost my prescription.”
- Using more than one type of chemical, including alcohol and prescription medications
- Changes in social behavior: Socializing only others who use drugs and alcohol, or having two circles of friends — “users” and “non-users”; isolating and withdrawing from others
- Minimizing: “It’s not that bad. You are exaggerating.” “I didn’t drink that much.” “I only had two beers.””It’s not the drugs, it’s my trauma/pain/insomnia”
- Denial: “I didn’t have the accident because I was using Percocet, it was because the car pulled out in front of me.” “I sleep in in the morning because my back pain is worse. It doesn’t have anything to do with the wine I drink at night.””My family and kids aren’t affected by my drinking.””I lost my job because they don’t like me.””My doctor quit seeing me because I missed an appointment.””I have no idea why my liver enzyme score is so high; I haven’t had a drink in a month.”
Dr. Norton does not specialize in the treatment of chemical dependence, but we can help clients understand when detoxification or substance abuse treatment is needed, and direct them to the best resources. When chemical dependence is a consideration, CTT creates a support team that includes the client, family members, counselors, doctors, and others who can help the client achieve full recovery.
CTT strongly recommends 12-step recovery programs for the treatment of drug and alcohol problems. AA, NA, CA, and their sister organizations, Al-Anon, Al-A-Teen, and Adult Children of Alcoholics and Dysfunctional Families (ACOA), have been extensively researched for more than 50 years. Outcome studies show that long-term sobriety can be achieved and maintained free of cost for individuals from all walks of life, socio-economic status, and differing degrees of addiction. For those for whom chemical dependence presents a medical concern, in-patient treatment may be needed. In these instances, the CTT doctors can discuss various options and make suggestions about the best placement.
Once chemical dependency is successfully addressed, CTT can initiate its treatment phases, including proper medication, trauma resolution, and individual, couples and family therapy.