Addiction As A Chronic Disease
We consider addiction to be an illness similar to diabetes and hypertension. This is why we use the word “patient” rather than “client” to refer to the people with whom we work. As with any other illness, in order to fully understand and treat addiction effectively, the biological, psychological, and social aspects of the illness all need to be considered.
Understanding the chronic aspect of addiction is critical. The acute aspects of the illness can be so dramatic that many resources are understandably devoted to it. Frequently the follow up from these acute interventions is insufficient, leading to recurrent acute episodes and wasteful repetition of short-term services. The most common reason for poor treatment outcomes is a premature termination of services. At Kolmac our outcomes are better because we focus on both the acute and chronic aspects of addiction.
Abstinence: The Cornerstone of Addiction Treatment
Many people come to us in the hope of learning to use their problem substance or gamble in a moderate way. Some want to be able to continue to use other addictive substances that have not created a problem for them. At Kolmac, as at other addiction treatment programs, we think the likelihood of such a strategy succeeding is extremely low. We work with our patients to help them achieve a life that they find satisfying without addictive substances or behaviors.
Relapse Prevention: A Strategy For Better Treatment Outcomes
The improved outcomes achieved by specialized addiction treatment programs, such as Kolmac, are based on approaching addiction with a fundamentally different strategy than is done by most non-specialized clinicians. Treatment begins with stopping the use of addictive substances and problem gambling. The focus of treatment then becomes “relapse prevention” — understanding how to avoid returning to use and behaviors.
This approach is in contrast to the traditional “mental health” strategy of working with people while they are still using addictive substances or gambling in order to try to identify the underlying reason why they are doing this. The expectation is that the addictive behavior will become non-problematic or cease entirely through such a process, but the results of such an approach have not been impressive.
One of the tools that we use in our “relapse prevention” approach is the “Relapse Sequence.” Relapses back into addictive behavior are considered to be not a single event, but rather a process that follows a predictable series of steps. The actual use of the substance occurs relatively late in the process. We use a diagram that we have adapted from the work of Alan Marlatt and Aaron Beck to help patients understand and personalize the process so that they can intervene during the early phases of the process before actually returning to substance use or gambling.
Here is what the Relapse Sequence looks like:
What About Tobacco?
Tobacco is the one exception that we make to requiring that our patients abstain from all addictive substances. At the same time, we believe that stopping tobacco at the same time as the rest of the psychoactive substances is the best approach. We understand that you have probably heard contrary opinions being confidently expressed, but believe that the preponderance of evidence supports our approach and that your recovery from other substances will not be jeopardized.
Fortunately many medications are now available to make the process of stopping tobacco easier. We think that while going “cold turkey” is not as dangerous as with other substances, that approach is unnecessarily painful and reduces the likelihood of a long term stable abstinence.
Where Does Spirituality Fit In?
We know that spirituality is an important aspect of recovery within the traditions of 12-Step Fellowship programs. Misunderstandings about this, however, can serve as a deterrent to some people seeking help for their addiction. Addressing this issue can lead to a deepening and strengthening of the recovery process, but our approach is to not press this issue during early recovery.
We invite you to make an appointment online or by calling 301-589-0255 or 410-296-9747 to see for yourself if our approach is the right one for you.