Demystifying Psychiatry

A resource for patients and families

Stopping Drug Use, Once Started

A recent study looked at illicit drug use over a 3-year period. Nearly 5% of those who were initially abstinent began using drugs during the study; over half of these people developed problematic drug use behaviors. On the other hand, about half of those exhibiting problematic drug use behaviors at the beginning of the study stopped abusing drugs over the study period. Read More

The treatment can be worse than the disease

Drug use is a big problem, but unfortunately the main treatment for drug addiction (12 Step/AA/NA) can actually exacerbate the drug use for young people, by requiring that they admit powerlessness to the drug. Furthermore, they are introduced to others in the drug culture, and the treatment (choosing a god and praying to it) will have little appeal to a young person who is more interested in fun than spirituality/religion.

I think that drug use is more of a symptom than a cause. For example, a young person who feels insecure about their appearance may seek sexual validation (risky behavior) using drugs as a disinhibitory tool. Or a person with few work skills may engage in criminal behavior because they feel that is their only option, and use drugs as a tool to screw up their courage for the big hit. So in both cases it's important to look at the underlying problems, even though it might seem like the problem behavior was caused by drugs.

If you only treat the symptom (drug use) then this can have the perverse effect of allowing the person to neglect their underlying problem and blame everything on their 'addiction'. In fact I see this all the time at AA meetings, and it can cause years of relapsing (cycles of abstinence and binging).

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Eugene Rubin, M.D., Ph.D., is Professor and Vice-Chair for Education in the Department of Psychiatry at Washington University in St. Louis - School of Medicine.

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