Addictions are not necessarily what you think. An alcoholic can be a person who “only drinks beer” or “only drinks on the weekends.” A person who “just takes pills recreationally” can be addicted. A person who watches porn daily can be an addict. One of the widely used questionnaires for determining addiction is called the CAGE. This stands for:
Cutting down: Have you ever felt you ought to cut down on your drinking, drug use or behavior (shopping, gambling, sex, eating)?
Annoyance: Have people annoyed you by criticizing your drinking, drug use or behavior?
Guilt: Have you felt bad or guilty about your drinking, drug use or behavior?
Eye-opener: Have you ever had a drink or used drugs first thing in the morning to stead your nerves or to get rid of a hangover? Or do you find yourself wanting to engage in a particular behavior, say online pornography or online shopping, first thing in the morning or to “start your day off”?
If you answered yes to more than one of these questions there is a good chance that you have a problem with alcohol, drugs, shopping, sex, eating or gambling. Other signs that you may have a problem include lying in order to cover up your use and needing higher amounts of the substance/behavior in order to get the same level of satisfaction (developing “tolerance”). Addictions affect more than 12.8 million people in the United States.
The importance of being evaluated for addiction.
Having an addiction does not mean that you are not trying hard enough to control your behavior, nor does it mean you are an immoral or bad person. It simply means that you probably have some addiction genes that you inherited, combined with certain life stressors, both in childhood and adulthood, that have allowed for the expression of those genes. Addictions can be treated with good outcomes but a person needs to be willing to seek treatment.
When it comes to treating addictions, there are two models: Abstinence, which deals with addiction by recommending that you not engage in the addiction at all ever again and Harm Reduction, which recommends that you work on reducing the consequences of the substance use/behavior in order to reduce its impact on your life (for example, instead of trying not to drink at all, a person might alternate one alcoholic drink with a glass of water and only drink at home to avoid drinking and driving).
We take a psychobiological approach to addictions.
This means we believe your behavior is determined in part by your past experiences as well as by the present state of your brain chemistry and neural pathways. We integrate current brain science into our approach in order to fully understand and manage not only addictive behaviors, but also a variety of social and emotional problems.
When I work with people with addictions, I am not trying to get them to use a particular model for managing their addiction. I am willing to support whatever path seems to work the best so long as the person’s life improves as a result. I also have relationships with several psychiatrists who specialize in addiction, so if a person needs medications to help with recovery or management, I can refer them to those providers and work together as a team.
While we do not offer detoxification services we are happy to work with patients who have completed inpatient or outpatient rehabilitation and are ready to work on maintaining sobriety.