Substance Use Disorders

There is a saying in the recovery world: “drugs and alcohol are not the problem, they are the solution. They are just a really crappy solution”. Nobody intends to become dependent on a substance to feel normal. This rings as true for coffee as cocaine. Substances alter the way our brain works, which is why it can seem like a logical solution when our thoughts and feelings feel off.

The substances can step in, provide a sense of relief or even euphoria, and for that time, those negative thoughts and feelings are quiet. While it is tempting to hit that snooze button, the reality is that the negative thoughts and feelings do not go away, and when the effect wears off, the relief does too. The negative thoughts and feelings return, sometimes with a vengeance as we are now plagued with the guilt and mounting sense that we are losing control. Too often, this is when we double down, use more to try to maintain that strangled silence that the substance provides. The thoughts and feelings are overwhelming when they return, too painful to even acknowledge, much less actually address.

And so begins the shame spiral. We use to feel better, then feel worse for doing so, so use to feel better, and so on and so on. As this spiral expands and begins to impact each part of life, fear makes us cling to it even more desperately. It takes enormous courage to be willing to let it go and reach for a hand to hold.

Officially speaking, there are medications that are FDA approved to help manage opiate and alcohol dependence. While there are not FDA approved medications for other frequently used substances like cocaine and methamphetamine, sedatives, tranquilizers, cannabis and nicotine, there are some that have shown promise and can help with both symptoms from not using as well as symptoms that may have led to use initially. What did the substance provide? What were the underlying thoughts and feelings that needed treatment?

Drugs and alcohol interact with receptors in our brain that provide pleasure, but those are not the only things that can press those pleasure buttons. In addition to substances, there are behaviors that can become unmanageable including shopping, gambling, gaming, pornography use, sex, and social media. Even something incredibly vital to our survival, eating, can become a way to tickle those receptors to try to feel better. In the same way we approach treating self medication with substance use, we can approach maladaptive coping behaviors with compassion and curiosity to help you achieve a better understanding of yourself. When we know better, we tend to do better!

I understand that recovery is a very personal path and the decision to begin it should be yours and yours alone. Only when you do this truly and authentically for yourself will the power to do so be present. I am here to support you in whatever way I can, even if that means that you are not choosing specific options. Perhaps in working together, we can help get you to a place where you are.