Addiction Medicine Pioneer Leaves Lasting Impressions

addiction

Addiction medicine is – in the grand scheme of things – a relatively new field. The transition from seeing use disorders as a choice or worse a sin, one commonly made by those with shortages in moral fiber for instance, to that of a disease can be traced to the middle of the 20th century.

The first Diagnostic and Statistical Manual of Mental Disorders or DSM treated substance use disorder (i.e., “drug addiction” and “alcoholism”) as most commonly arising from a primary personality disorder. As you can probably imagine, the previous action stigmatized addiction by listing it with other societally disapproved disorders. In 1965, the American Medical Association (1965) recognized alcoholism, declaring the condition a medical disorder. The DSM-II (1968) encouraged separate diagnoses for alcoholism and drug addiction, according to the US National Library of Medicine. The DSM would make several changes over the years regarding how scientists and the medical community conceptualized unhealthy relationships with drugs and alcohol.

  • DSM-III (1980): adopted atheoretical, descriptive diagnoses but required tolerance or withdrawal to diagnose dependence.
  • DSM-III-R (1987): included physiological and behavioral symptoms and reflected the substance dependence syndrome.
  • DSM-IV (1994): the concept of dependence was unchanged, i.e., emphasis on biology.>/li.
  • DSM-V (2013): declares that all substances taken in excess activate the brain reward system.

Pioneers In Addiction Medicine and Recovery

The criteria for addiction have evolved over the years and so have the modalities of treatment. Such changes are owed to the tireless work put in by several individuals, perhaps too many to list. In the 19th Century, an 1849 essay titled Alcoholismus Chronicus, by Swedish physician Magnus Huss gave birth to the disease model. Huss’ essay defines the characteristics of alcoholism (a brand-new term at the time) as disease-like in nature; one that causes severe physical harm and can be fatal. Another body of work of note is E.M. Jellinek’s The Disease Concept of Alcoholism, which splits alcohol addiction into several stages.

In the field of recovery and use disorder treatment, some people come to mind often. Bill Wilson is a notable name, being a co-founder of Alcoholics Anonymous in the 1930s; a program that relies on addressing the spiritual side of the disease. While 12 Step programs are not scientific, many treatment centers utilize them along with other forms of therapy, such as cognitive behavioral therapy (CBT). Nora Volkow is someone who is worth mentioning as she heads up the National Institute On Drug Abuse (NIDA). There are also other names that most people have not heard – even those who work in the field today – whose contributions to addiction medicine deserve mention.

Dr. Herbert D. Kleber is one person who deserves recognition, especially in light of his recent passing. It’s fair to say that most Americans are unfamiliar with Dr. Kleber, even those who have undergone treatment in centers that utilize evidence-based methods. A researcher in the pathology of addiction, Dr. Kleber worked to develop evidence-based techniques to ease the discomfort of withdrawal, The New York Times reports. He also focused on helping such people avoid relapse and achieve long-term recovery.

Evidence Based Therapy

Upon completing his medical residency, Kleber went on to volunteer for the United States Public Health Service. His service took him to Public Health Service Prison Hospital (PHSPH) at Lexington, Ky. in 1964, roughly a year before the AMA’s recognizing alcoholism as a medical disorder. The PHSPH was a jail treating addicts and alcoholics, as part of the Addiction Research Center, NIDA’s predecessor.

Dr. Kleber understood that people with use disorders did not deserve punishment, according to the article. He would instead take a scientific approach; the doctor was instrumental in making the study of addiction into a discipline.

He was at the vanguard of bringing scientific rigor to the area of addiction,” said Dr. Frances R. Levin, director of the division on substance use disorders at Columbia University Medical Center, a program started by Dr. Kleber.

Over the decades, Kleber would continue to influence the field; he started and oversaw the drug dependence unit at Yale, the article reports. With his wife, he founded the division on substance use disorder at Columbia. Kleber was also a co-founder of the National Center on Addiction and Substance Abuse, now the Center on Addiction. He served as deputy to the Nation’s first drug czar during the George H.W. Bush administration. However, his dismay with the “war on drugs” and the lack of funding going towards addiction treatment led to his resignation. At his confirmation, someone asked how he remained optimistic working with addicts; responding by quoting the Talmud he said:

The day is short. The task is difficult. It is not our duty to finish it, but we are forbidden not to try.”

Addiction Treatment

In 2015, Dr. Kleber said, “the last thing in the world I wanted to do was to treat addiction.” It is hard to imagine what addiction medicine would be today if it were not for Dr. Herbert D. Kleber contributions to the field. The Gentleman of PACE would like to express our gratitude for Dr. Kleber.

We invite you to reach out to us if you are struggling with drugs or alcohol and desire to find a new way to live. At PACE, we specialize in the treatment of males affected by use disorders and coöccurring mental illness.

Recovery: Attitude Changes Everything

recovery

Attitude can make or break a person’s recovery! Those who fixate on the negative aspects of their life – there are often many in early recovery – are at a significant disadvantage. Conversely, individuals who do everything in their power to find the positive in every situation find themselves more able to stay on track. As we say here at PACE Recovery Center, Positive Attitude Changes Everything.

It is not uncomplicated to find upsides in one’s life in the beginning; guilt and shame are known to accompany early sobriety. When the thick haze of active addiction first settles the wreckage of the past is usually overwhelming. People begin to see the real impact their mental illness has not just in their life but also the lives of those they love when the dust settles after entering treatment. For most, looking at the big picture of addiction is extremely painful; some may find looking in the mirror too much to handle, at first.

Coming to terms with where your life is when recovery is in its infancy could be compared to an emotional rollercoaster. On the one hand, you have the elation that comes with making the courageous decision to address your disease. On the other, there is the reality that putting down the drugs and alcohol may be the least laborious aspect of one’s recovery; clients quickly learn that they will have to face their feelings and delve into the underlying issues of addiction to achieve their goals.

Treatment and working a daily program of recovery asks much of an individual, but each person can take comfort in knowing that they are not alone. Unlike the experience of active alcohol and substance use, you can take pleasure in knowing that you have support today. Some days will be remarkably difficult and maintaining a positive attitude will make all the difference. When a man sets a course for recovery, he comes to realize that his line of thinking can hinder progress.

Searching for Positivity in Recovery

Once detoxification is complete, the mind is clearer which can reveal some unwelcome aspects about oneself. A person has to contend with the outcome of leading the kind of life they once lived before finding treatment, and face – perhaps for the first time – some of the fallout. Simply put, most find it hard to move the facial muscles into the shape of a smile in early recovery and for understandable reasons. However, it is paramount that such men do not let the upsets of their past prognosticate the future.

Each person in long-term recovery was once a newcomer, and they had to make sense of the same types of realizations that those new to the program are wrestling with presently. The mere fact that they were able to skirt the pitfalls of early sobriety can serve as a source of comfort and hope that how you feel today will pass. If you remind yourself that feelings are not facts and that ‘this too shall pass,’ lasting recovery is possible; but, it is paramount that you surround yourself with positive people. Optimism is a guiding force in recovery and sticking close to the people you meet in the program with good attitudes will help you find the strength to spurn negativity.

Some who work a program swear by the aphorism, “fake it till you make it;” in recovery circles, the statement may be held as a platitude, one that you will hear much over the years. Essentially, the above saying suggests that those who imitate confidence and optimism will one day realize such qualities in himself. Simply put, smiling even when you think there is nothing to smile about can have a beneficial impact on your behaviors. Give it a try; you may be surprised.

Tips for Positive Outlook

A good many people new to the program believe they have deficits that need to be addressed. Some are out of work, while others have lost their license due to a DUI. There are those whose families are no longer conversing with them, and it will take time for their loved ones to notice the changes afoot. Still, others are in debt from years or decades of financial mismanagement; the list can go on and on, but what is missing from one’s life is not the salient matter. What’s essential in the first months of recovery is learning to live life on life’s terms and incorporating the principles of the program into everyday life.

Developing life skills in place of self-defeating behaviors allows people to address all the negative aspects of life leftover from the past when the time is right. Learning what it means to be responsible for your actions and accountable to others is a means of affecting the changes men and women desire.

Take stock of the small milestones each day as you plot a course to your broader goals. Each day that doesn’t involve drugs or alcohol is worth being proud about and may even result in a wave of joy, ride it.

Gratitude is an excellent way to improve your outlook. Be grateful for the things you possess right now, and for some of the things that you lack for they give you something to work towards. Tell those who are helpful to you how thankful you are to have their support. Do something kind, even a minute gesture of kindness, can go along way; when you make another person’s day better, you benefit too. Pay it forward!

No act of kindness, no matter how small, is ever wasted. – Aesop

Positive Changes

Please contact PACE Recovery Center if drugs and alcohol have made your life unmanageable. Our team can assist you in achieving your goals with the help of evidence-based therapies. We offer a safe, sober and supportive environment for making positive changes in your life. We are available at any time to field any questions you have about our program.

It is our great pleasure to be part of your incredible journey into recovery.

Stigma Curing During Mental Illness Awareness Week

stigma

While May is Mental Health Awareness Month, October 7–13 is Mental Illness Awareness Week or MIAW 2018. Naturally, there is some overlap between these two essential observances—namely—ending the stigma of psychological disorders like addiction and depression.

We cover stigma on this blog frequently due to our understanding that there exist forces preventing Americans from seeking treatment. More people need to see the person, not the illness. Nearly 60% of adults with a mental illness didn’t receive mental health services in the previous year. Given that individuals living with untreated mental health conditions are at significant risk of self-harm and suicide, collective action is needed immediately.

The National Alliance On Mental Illness or NAMI chose Cure Stigma as its theme this year for Mental Health Month and MIAW 2018. The organization would like it to be known that: together we can encourage more people to seek treatment. NAMI’s campaign manifesto reads as follows:

There’s a virus spreading across America. It harms the 1 in 5 Americans affected by mental health conditions. It shames them into silence. It prevents them from seeking help. And in some cases, it takes lives. What virus are we talking about? It’s stigma. Stigma against people with mental health conditions. But there’s good news. Stigma is 100% curable. Compassion, empathy and understanding are the antidote. Your voice can spread the cure. Join NAMI, the National Alliance on Mental Illness. Together we can #CureStigma.

Mental Health Facts

Most Americans are more than likely unaware of just how pervasive mental illness is around the world. The World Health Organization (WHO) estimates that over 300 million people are living with depression. What’s more, the vast majority of the afflicted have never undergone therapy, counseling, or treatment.

The truth is that too many people have little understanding of mental disease; lack of knowledge – ignorance – is a contributing factor in persons lacking empathy and compassion. If a more significant number of Americans could appreciate that mental illness affects 1 in 5 adults in the United States, maybe they’d exhibit greater understanding. With that in mind, let’s take a look some of the more recent figures to bring depression, bipolar disorder, and addiction in to focus.

Here are the facts:

  • 60 million people in the United States are living with a mental illness.
  • Among the 20.2 million adults in America who experienced a substance use disorder, 50.5%—10.2 million adults—had a co-occurring mental illness.
  • Depression is the leading cause of disability worldwide.
  • Approximately 1 in 25 adults in the U.S. experiences a severe mental illness in a given year.
  • 90% of those who die by suicide have an underlying mental illness.

Armed with such information, anyone can see that we have a real crisis on our hands when it comes to mental disease. This week provides an opportunity to take to social media and spread the message that stigma hurts us all; that empathy and compassion save lives; and, that together we can affect real change.

Fighting Stigma On World Mental Health Day

Today is World Mental Health Day, October 10, 2018! The focus this year is Young People and Mental Health In A Changing World.

mental health

The World Health Organization writes:

Investment by governments and the involvement of the social, health and education sectors in comprehensive, integrated, evidence-based programmes for the mental health of young people is essential. This investment should be linked to programmes to raise awareness among adolescents and young adults of ways to look after their mental health and to help peers, parents and teachers know how to support their friends, children and students. This is the focus for this year’s World Mental Health Day.

In recognition of MIAW and World Mental Health Day, we hope that more people will open their hearts to friends and family members affected by mental illness. Mental health disorders are not going anywhere, but we can make stigma disappear. As a result, millions of people will find the courage to seek help and go on to lead fulfilling and productive lives.

Co-Occurring Disorder Treatment

We mentioned above that more than ten million Americans are living with addiction and a co-occurring mental health disorder. It is paramount that such individuals receive treatment for their use disorder and dual diagnosis concurrently for successful outcomes. If you are a young adult male whose life is unmanageable due to mental illness, please contact PACE Recovery Center to learn more about our program. Parents of young men are also welcome to reach out to our team to learn how we can help your child break the cycle of addiction and heal from mental illness.

During World Mental Health Day and Mental Illness Awareness Week, PACE is spreading the message that the stigma virus is 100% curable; and, the antidote is compassion, empathy, and understanding.

Addiction and Recovery is the Focus of ‘Beautiful Boy’

addiction

In the springtime, we wrote about a book-to-film adaptation many people in recovery and their family can relate to, being that addiction recovery is the focal point. The movie, which debuts one week from today is titled, “Beautiful Boy.” Some of our subscribers may be familiar with the story of journalist David Sheff’s arduous struggle to help his son Nic find recovery. David Sheff’s effort to get his boy help, and Nic’s resistance to receiving assistance (at first), is a story that millions of Americans are familiar with firsthand. The millions who’ve been witness to the power of a disease that does not go away without a fight, and certainly not quietly.

Nic Sheff’s use and abuse of a host of drugs during his teenage and young adult years brought him to his knees in despair. His addiction to heroin and methamphetamine showed a side of the Northern Californian that his family had never seen before; Nic’s loved ones watched powerlessly as substance use disorder transformed the young man into a stranger. They were witness to Nic’s lies, cheating, stealing, and worse to maintain his addiction; his multiple trips in and out of treatment; his relapses; and finally, his acceptance of his condition and dedication to living a life free from drugs and alcohol.

“Beautiful Boy,” the film, premieres around the country on October 12, 2018, and stars Oscar nominees Timothée Chalamet (Nic) and Steve Carrell (David). While the movie’s name comes from the title of David’s book, the screenplay is based on material from Nic Sheff’s memoir as well. Nic, like his father, is a successful writer with his focus being on addiction and recovery.

Two Memoirs On Addiction

The younger Sheff’s first book is titled Tweak. David’s memoir is essentially about where addiction took his son and the complicated nature of trying to help someone who isn’t ready to help themselves recover. Nic’s memoir covers his experience with addiction and subsequent mission(s) to embrace recovery. Like many young men, Nic’s recovery didn’t take root on his first attempts. Simply put, relapse is a part of the younger Sheff’s journey.

Nic Sheff’s Tweak: Growing Up On Meth was followed by another memoir We All Fall Down: Living With Addiction. Anyone who read Tweak may have sensed that its ending had a “to be continued feeling.” In Nic Sheff’s second read, he discusses treatment, relapse, and what it’s like to be a young man in recovery.

Hollywood doesn’t always get drug and alcohol use and addiction right. One could argue that it takes someone with a history of mental illness to portray such conditions accurately. That’s not to say that screenwriters and directors are never up to the task, just that a lot can go wrong when capturing the harrowing nature of addiction. In a recent interview with Sam Lansky for TIME Steve Carrell shares being reticent even to discuss the movie; he fears that the story is not his to relay. In the interview, both Chalamet and Carrell seem to grasp the importance to get right on screen something that is misunderstood by millions of Americans.

Talking about the movie is almost as daunting as doing the movie,” Carell says. “You don’t want to speak as if you’re an authority.”

Writers In Recovery

Beautiful Boy will likely be affecting for some people to watch, especially those in early recovery. From the reviews published already, one can expect some disturbing scenes. However, it is worth mentioning that while the subject matter in the film will be painful to watch at times, at this point, Nic is leading a life in recovery and has had success writing for and producing television—the Netflix series 13 Reasons Why.

The author of the interview discussed above, Sam Lansky, is in recovery. He understands that when it comes to talking about the disease in book, film, or otherwise it is hard to make sense of everything. Lansky could relate to what it must have been like for his father who, like David Sheff, had to get Sam into treatment on numerous occasions. Lanksy had to wrestle with the emotions that many in recovery who read David’s Beautiful Boy experience, a first-hand account of what one’s addiction does to the loved ones who are trying to help. Lansky says that when he finished the interview with Carrell and Chalamet, he called his father on the way home.

So of course it’s hard to talk about: because when you talk about addiction, there are, maddeningly, no satisfying answers. And even I, after many years clean and sober, never know exactly what to say about it. Which is both the challenge and the triumph of the film: it’s not a movie that claims, Hollywood ending and all, that the love of a parent is enough to save a sick kid. But it’s a powerful reminder that it’s worth trying.”

Addiction Recovery

PACE Recovery Center is here to help men in the grips of addiction and co-occurring mental illness find recovery. Our gender-specific, extended care treatment center assists men in getting to the underlying issues that led to substance use and self-defeating behaviors, and learn tools and skills for leading a life in recovery. Please contact our team to learn more.

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