It's no secret that addiction is a disease. It is primary, progressive, chronic and fatal if not treated. I know this first as a clinician with more than 32 years in the field and second as a researcher of co-occurring disorders and psychiatric substance abuse.

These days, I am very mindful that while we begin 2009 with hope - tremendous uncertainty and fear seems to lurk around the corner. Our safety as a nation is questioned. We are a part of a global village that has to contend with environmental erosion and financial crisis. As a moral people, we have seen our values change - a diminution, if you will, of decency and respect for others. This is not to say that we have gone to hell in a handbag, but we do need to get back to caring a tad more. As Hillary Clinton once said, "it takes a village."

No wonder that first drink or drug is taken to self-medicate! After that, the disease takes over and we are off to an addictive process that spirals down a staircase of pain and suffering biologically, psychologically and socially. As a clinician, I'm keenly aware that human beings are always seeking to self-medicate their anxiety, depression or perhaps guilt or shame.

As the father of "carefrontation" as it applies to dually diagnosed individuals, I advocate for caring - much like a self-help program such as AA does. We need to embrace people with addiction issues and understand the process that leads to that first drink or drug - look for reasons to keep individuals in treatment and not excuses to kick them out!

Although I do not represent AA, it my understanding that one can go to a meeting intoxicated and if they are quiet, are allowed to stay. This should be interpreted as "do no harm" of the highest calling - you can't treat an empty chair. And as long as you are willing to work with someone, there is hope that they might hear what you have to say!

Psychologists learned a long time ago that trying to scare someone into changing does not lead to permanent change, but through care and education, responsibility for one's behavior can begin to be cultivated in the person's mind and real change can develop.

About the Author

Harris Stratyner, Ph.D., CASAC

Harris Stratyner, Ph.D., CASAC, is a Clinical Associate Professor at the Mount Sinai School of Medicine; he is also with Caron Treatment Centers.

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