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‘Duen Song Lar Suebsan Lanna’ held to celebrate Dr Chao Duangduen na Chiengmai’s 80th birthday

Living with Addiction (Part II)

 

‘Duen Song Lar Suebsan Lanna’ held to celebrate Dr Chao Duangduen na Chiengmai’s 80th birthday

 

Living with Addiction (Part II)

In the second of two articles, the deliberately anonymous author looks at some of the problems associated with addiction and some of the help available to those addicts who want it.
In the previous article we began to see how hard it may be to treat addicts no matter what their addiction may be. What is very common to all types of addiction, including smoking, is that the person soon becomes secretive and lies to self and others.
Most of these people begin to be ashamed of what they are doing, but cannot find a way to stop. Many do try – problem drinkers try switching from spirits to beer, or drug users try decreasing the frequency of their intake, rationing out the pills or the substance over a longer period of time; others try to use or imbibe only at weekends; some make attempts to give up lighting a cigarette until the evening; some switch to smoking a pipe.
Of course, what essentially is happening is that these attempts at control inevitably fail but also indicate strongly that the use of the substance is already beyond any sustained control. Ask yourselves this question – how many of you have successfully cut down on your smoking and even halved the number per day only to find some little time later that you are back to square one? The same applies to drugs and alcohol – the addict is hooked and the disease becomes increasingly progressive.
In the case of the smoker, it appears that a certain level of nicotine in the body is what satisfies the craving and once this is reached, consumption levels off. But not so in the case of the alcoholic or drug addict – it seems that the body requires more and more over the longer period of time.
Addicts in recovery often speak of a descent into an oblivious state of living – often over a number of years, sometimes most of a lifetime; with others, the descent is far more rapid. The lying that sets in is a defense mechanism – the addict does not want others to know of their plight and many go to extraordinary lengths to hide the facts from those closest to them. Doctors have great difficulty in treating cases as the addicts invariably lie.
One psychiatrist, a respected doctor treating alcoholics, once told me that whenever an addict told him how much he consumed per day, he automatically doubled the figure and was usually quite close to the truth. The addict of course often fools him or herself too – if they are drinking heavily, they often cannot remember how much they have consumed over a given period of time – similarly for the drug addict. The smoker has a clearer idea, but still often fails to be honest about their consumption.
Of course, all this lying and secrecy, plus the legal, social and maybe even ethical considerations and implications all add to the difficulties of making treatment effective.
One of the first steps to recovery has got to be rigorous honesty in recognizing and admitting that there is a problem; many people find this too difficult a task in the beginning. This is why so many fall at the first fence and return to their habit.
Scare tactics do not work either – many governments have tried by advertising the risks with shock-horror type images, banning advertising of alcohol and cigarettes, doctors saying ‘you only have six months to live if you go on using like this’ – nearly all fail. Why? Because the person has an addiction which is deep-seated in their psyche and this needs first of all the open-mindedness and willingness of the addict to accept their condition before any real progress can be made. If this is accepted, then sustained and careful treatment may become effective.
Many addicts suffer from obsessional and compulsive disorders (OCD). Treating these recognized medical conditions is also very difficult – going back to a paragraph from the previous article, how do you stop someone from cleaning the house several times a day? How do you convince someone that ornaments do not have to be symmetrical for life to go on normally?
Of course, not everyone who suffers from OCD is going to become an addict, but the chances are greatly enhanced as alcohol, drugs or cigarettes can easily become the obsession. I once had a client who was obsessed with a certain brand of French cigarettes – she had bought a candle in the shape of the packet with the design on; she made coasters with the cardboard packets suitably laminated; she had advertising posters framed which hung on her walls and she also made bookmarks from the packets. We have all heard of people collecting beer mats or drip cloths; and the list could go on.
But once the addict – for whatever reason – turns to whatever source of help is available, and does so voluntarily and without reservation, then a recovery is possible and millions are living proof of this. Many countries now sponsor drug rehabilitation centres, many of which deal with addiction to medicines such as tranquillisers as well as ‘hard’ drugs; there are alcohol treatment centres and other forms of detoxification units worldwide.
There are also thousands of self-help groups functioning internationally, the most widely accepted and successful ones being Alcoholics Anonymous and Narcotics Anonymous, with Nicotine Anonymous, Overeaters Anonymous and Gamblers Anonymous now flourishing as well. And what is the success rate? This is difficult to estimate, and reliable statistics do not exist. There is no ‘cure’ for addiction, only a suspension of the disease, which means total abstinence for the addict – there is no going back to small amounts or substitutes.
It would appear from medical research, as yet incomplete, that ‘once an addict, always an addict’ is the order of the day – the very fact that the person becomes addicted means that some sort of change takes place physically, mentally and spiritually within themselves so that the addict has to accept this fact.
The self-help groups and many of the clinics and rehabilitation centres now preach the doctrine of living life ‘one day at a time’ to help the addict come to terms with this phenomenon. Millions of people world-wide have recovered from being active addicts with the assistance and help on offer.
Most recovering addicts return to a happy social life in a quiet and unassuming manner, rarely letting others in the outside world know of their former addiction, but usually keeping in regular contact with other former sufferers through the self-help groups. In Thailand, these groups flourish alongside those supported and sustained by the government and provide a powerful force in helping newcomers and old hands alike live effectively with their addictions.
There is only one Drug Rehabilitation and Treatment Centre in Chiang Mai at 182, Chotana Road, Mae Rim, Chiang Mai 50180; the centre also treats alcoholism and the phone is (+66) (0) 53 297 976-7; the website for further information is www.drugcare.net.
There is further help through the Fahmai Clinic Out Patient Care Centre, at 2/3-2/5 Sirindhorn Road near to Kwang Sing junction of the Superhighway and Chang Peuk Road, Amphur Meuang, Chiang Mai 50300, telephones: (+66) (0) 53 226 135 and (+66) (0) 53 226 145.
Narcotics Anonymous website for meetings and other information: www.na.org
Alcoholics Anonymous meets over 20 times a week in Chiang Mai and their website is: www.aathailand .org. The national helpline is: (+66) (0) 2231 8300 and the local phone: (+66) (0) 844 850 100. There is now one Thai speaking meeting in Suan Prung Hospital at 1400 on Thursday afternoons.
Nicotine Anonymous can be contacted on (+66) (0) 86194 6300