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WHAT IS SUBSTANCE ABUSE?

Heartland Recovery Center offers holistic treatment for substance abuse. The level of treatment is determined after a formal intake, a client presentations and needs review, and a meeting with the prospective client and a family member. Treatment is voluntary. We offer levels of care from IOP (Intensive Outpatient Treatment) as well as PHP (Partial Hospitalization Program). It is important to find the best clinical fit for the individual at the right time.

One may ask, “What is substance abuse?” Regardless of one’s theory, understanding, or beliefs about cause and effect, there are universal markers and presentations that identify the problem. The disorder is characterized by loss of behavioral control, craving, the diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional, maladaptive, or negative emotional response to life and all the stressors it presents. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, the disorder is progressive and can result in disability or premature death.

The disorder creates distortions in thinking, feelings, and perceptions, which relates to people behaving in ways that are not understandable to others around them, causes harm to self and others, and compromises the levels and quality of life functioning.

We at Heartland Recovery Center believe that the core issues that support the symptoms of substance abuse are marked by patterns of avoidance. Avoidance refers to the disengagement, detachment, and avoidance of uncomfortable people, places, feelings, and things. While the abuser is responsible for his or her initial choice to use a substance, he or she is no more responsible for the progression and compulsions than someone with a medically defined chronic illness when they suffer a relapse or medical crisis. The disorder is not just all about ones’ chosen behaviors. The Heartland Recovery Center treatment team understands that there is no one correct definition of what substance abuse disorder is, but rather we treat the whole person.

The DSM-5 does not use the word “addiction” as a diagnostic code or label, but rather defines the problem as the compulsive and habitual use of substances.

The disorder may often be defined as a primary, chronic disorder of brain circuitry that includes: reward, motivation, memory, and related circuitry. Dysfunction in these circuits leads to the shift in biological, psychological, social, personality, and spiritual displays. The dysfunction in these circuits show up when the individual compulsively seeks and pursues reward and/or relief by substance use and other behaviors.

The problem may be further described as a condition that results when an individual ingests a substance (e.g., alcohol, cocaine, nicotine) or engages in an activity (e.g., gambling, sex, shopping) that can be pleasurable, but the continued use/act of which becomes compulsive and interferes with ordinary life responsibilities, such as work, relationships, or health.

Substance abuse disorder may also be described as a maladaptive pattern of substance use or process activity that leads to clinically significant impairment or distress, as identified by the following symptoms:

  • Recurrent substance use that results in the failure to fulfill major role obligations at work, school, or home (e.g., repeated absences or poor work performance related to substance use; substance-related absences, suspensions or expulsions from school; neglect of children or household)
  • Recurrent substance use in situations in which it is physically hazardous (e.g., driving an automobile or operating a machine when impaired by substance use)
  • Recurrent substance-related legal problems (e.g., arrests for substance-related disorderly conduct)
  • Continued substance use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance (e.g., arguments with spouse about consequences of intoxication, physical fights)
  • Tolerance to or need for increased amounts of the drug to get an effect
  • Spending a lot of time to get, use, and recover from the effects of using drugs
  • Withdrawal from social and recreational activities
  • Continued use of the drug even though you are aware of the physical, psychological, and family or social problems that are caused by your ongoing drug abuse

Society accepts that chronic illnesses such as diabetes, heart problems, asthma, COPD, and arthritis are chronic in nature, will get progressively worse without treatment, and that the individual will generally need re-evaluation, changes in treatment, and support. Society, in general, simplistically believes that once a person enters treatment for substance abuse disorders, that, regardless of placement or duration, the problem is over. We understand that a relapse from any disorder does not have to indicate full regression or treatment failure, rather, it indicates that treatment should be reinstated or adjusted or that an alternative treatment is needed to help the individual regain control and recover.

Moral criticism does not provide relief or management of the problem or illness progression.

Many hold true to the belief that someone entering addiction treatment should be cured and able to maintain lifelong abstinence following a single episode of specialized treatment. As with any chronic illness, we know this is incorrect. Chronic diseases such as diabetes, asthma or heart disease spring from and are complicated by, multiple biological, psychological and social factors, some of which cannot be clearly identified.

“Lifestyle” or personal behavioral choices are intimately involved in the onset and course of these disorders.

All chronic treatments, regardless of disease, share three significant attributes:

  1. Symptom management occurs, but the causes or core problems are not addressed or explored and cannot affect the root causes of the disease. The recommended treatment seeks to restore the affected individual to normal or improved quality of living with on-going managed care and support.
  1. All chronic treatments share the understanding that significant changes in lifestyle and behavior must occur to achieve and maximize benefits.
  1. The complexity and nature of the chronic illnesses all share the need for ongoing medical care, frequent evaluation for changes in treatment levels, and understanding that relapses are very common, but do not signify the end.

Similarities between substance abuse dependency and chronic illnesses are:

  • Both are influenced by family genetics and other personal, family and environmental risk factors.
  • Can be identified and diagnosed using well-validated screening questionnaires and diagnostic checklists.
  • Are influenced by behaviors that begin as voluntary choices, but evolve into deeply ingrained patterns of behavior that, in the case of addiction, are further exacerbated by neurobiological changes in the brain that weaken decision making skills over these contributing behaviors.
  • Are marked by a pattern of onset that may be sudden or gradual.
  • Have a prolonged course that varies from person to person in intensity and pattern.
  • Are accompanied by risks of profound pathophysiology, disability and premature death.
  • Have effective treatments, self-management protocols, peer support frameworks, and similar remission rates, but no known cures.