Where Addiction Meets Your Brain

The Neurobiology of Addiction

The Revolving Door of Relapse

Many Paths to Sobriety

Addiction is a multifaceted problem. We could spend all day looking at variables that go into addiction and its treatment. Every clean and sober person has a different story as to how they got clean and stayed clean. Sometimes they “just quit.” Sometimes they are involved in a recovery program of some kind. Sometimes something dramatically changed in their lives that “scared them sober.” Sometimes they just don’t know, but they are grateful to be out of the addiction cycle.

Twelve-step recovery programs have come under a lot of fire for reasons that I have a hard time understanding. I understand about the science of trying to figure out what works and what does not. Having said that, I think it is important to look at the essence of 12-step recovery and why, when the principles are applied properly, relapse can be retarded, if not prevented all together.

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During my time as an addictions physician, the story I hear over and over is that “I was doing great, Doc, but I got lazy and stopped going to meetings.” If that is true, and I have no reason to doubt the stories, 12-step recovery was doing something for that person and their addiction while the treatment was being applied. There are many other things that keep people sober, however. I am for whatever works.

I believe that there are many paths to sobriety. I would be arrogant to say one thing works better than another without data, but most people with addiction have the data only for themselves and a few other people that they know in recovery and subsequently “go by what they know. “ I also believe that since there are thousands of variables that go into decision making and even more thousands of variables that go into unconscious decisions, we will never scientifically know what we would like to know about human behavior.

Relapse is a fact of addiction. Sobriety is something of a miracle when you think of all the forces that operate against being clean and sober. Yet sobriety happens. Anyone who tells you he or she knows the reason for someone getting clean doesn’t know the human brain other than the pain got to the level that the transient pleasure was no longer working.

The next time you see persons who have relapsed, please be very kind to them, but don’t do for them what they need to do for themselves.

 

Joseph Troncale, M.D. FASAM, has been working in addiction medicine for 20 years. He is the Medical Director of the Retreat.
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