Integrated Treatment Solutions February 2012

Dear Clients and Colleagues: Its that time of year of Mardi Gras alias "Fat Tuesday," - a day of indulgence in food, drink, music and parties; tossing self-control to the wind and letting go before a long stretch of fasting, denial of indulgences and restraint through the Lenten season. We seem to look forward to opportunities of letting go and not need to apply the restraint that everyday life requires. Mardi Gras in New Orleans certainly demonstrates this a day of indulgence and revelry. But, at the end of that day the party is over, streets get cleaned, and things migrate back into a form of order. There is an end to it. But, what happens when a person loses control of their behavior and can no longer apply restraint? When there is no end? This month our attention is focused on Understanding Addiction learning the difference between problem vs. addictive behavior, identifying the types of addictions, as well as risk factors. Whether you are a client or healthcare colleague, the odds are that you, a family member, or someone you know is currently suffering or has been affected by addiction. Identifying addictive behavior is both a preventative measure as well as an intervention. Unidentified and untreated addictions can lead to a myriad of health concerns and highrisk behaviors which are life-threatening and often impact individuals, families and their communities. We offer clients Sustaining Lifetime Recovery programs, specifically for overeating and addiction recovery. Treating healthcare professionals is one of our specialties; we offer specialized group programming to address their occupational and treatment needs. Contact us for an e-brochure detailing these programs at info@myintegratedtx.com. Treating healthcare and other professionals is a specialty and we offer specialized group programming to address their occupational and treatment needs. Warm regards, Paula Tropiano, M.A., L.P.C., CCDP-Diplomate Director

Problem vs. Addictive Behavior

Human beings are designed to survive. We are built to avoid conflict, conserve energy, avoid pain, and seek pleasure. We seek ways of feeling better to cope with stress related to unpleasant experiences; tending towards behaviors that feel soothing and eliminate discomfort.

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Integrated Treatment Solutions February 2012

These maladaptive coping behaviors, however, are short-term relief oriented fixes and are generally not helpful in the long-run. In fact, they often end up creating more problems, suffering and stress. But when do these attempts to feel better cross the line and become problematic? Any time we repeat a behavior we make way to do it again at another time. Repetition leads to the development of habits, and over time, habits become part of our lifestyle. Lifestyle behaviors become part of our everyday lives and identity. Lifestyle behaviors that are positive add structure, focus and meaning. For instance, our daily rituals of waking, washing, and eating. We also have holidays and family gatherings, which could be pleasant and positive rituals. However, addictive ritual is very different. Addiction is about dependency and causes a loss of behavioral control the feeling of becoming powerless. Addiction can be as subtle as overeating or as intense as binging on alcohol, drugs, gambling or sex. Regardless of the kind of addiction, it is harmful to ones health as well as the health of those around them. Addiction carries intensity a deep craving, desire and urgency.

Two Types of Addictions

There are two main categories of addiction: 1. Substance Addiction, and 2. Process Addiction. We are most familiar with substance addiction, specifically with alcohol and drugs. Food, tobacco and caffeine are also included as mood altering substances. Process addictions can present more subtly, but no less harmful. It is similar to compulsive behavior which is related to activities including: internet, sex, relationships, and shopping, gambling, self-mutilation. Medications are readily available -- for pain, sleep, anxiety, or attention issues. We must be aware of the misuse and abuse of these substances: Opiate pain medications such as Vicodin, OxyContin, Codeine, Morphine, and Hydrocodone. Benzodiazepines , sedatives, hypnotics, including medications such as valium, Xanax, Adivan, Klonopin, Librium and Valium. Psycho-stimulants such as Adderall, and Ritalin.

Over-the-counter (OTC) sleep aids & medications, such as; Sonata, Ambien (Benzodiazepine), and Lunesta. These drugs are generally intended for shorter-term use or as needed and can easily be abused, resulting in increased tolerance leading to dependence. Without titration (weaning off) can result in withdrawal effects, including nausea, sweating, shaking and

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Integrated Treatment Solutions February 2012

in some cases, seizures. Also, mixing these substances with other medications or with alcohol can intensify mood altering effects accelerating the addictive process and can lead to psychosocial, psychiatric and medical deterioration. The increased use of technology lends itself to addictive behavior as immediate gratification needs are met through easy access to information. A click of a mouse can initiate a shopping spree or gambling run which can create havoc for a persons finances. Some of these addictive behaviors may come as a surprise to you. In thinking these addictions through, is there anything that stands out for you? Or do you notice any of these in someone else?

Risk Factors
Risk factors mark the increased probability of developing a specific disease or illness. For addiction, these risk factors include: Genetics: Temperament, family history (addiction, medical, psychiatric disorders). Social / Environmental: Exposure to and availability of substances, level of stress, isolation, adverse childhood experiences (including poverty), or loss. Psychological / Emotional Problems: Depression, attention-deficit / hyperactivity disorder or post-traumatic stress disorder. Medical Problems: Underlying neurological, endocrine-immune issues, fatigue, unresolved chronic pain, post-surgical complications, obesity, insomnia and other sleep problems, and depression.

A comprehensive evaluation includes each of these components as it relates to the client history and presenting addictive issue. Treating an individuals addiction generally involves working through multiple problems. Not identifying and not addressing the underlying issues opens the way for relapse as well as cross-addictions (the development of new addictive behaviors / replacements). It is not unusual, for instance, that the recovering person turn to food or work upon abstinence. It is also not unusual that other co-addictions, those which coexist with the presenting addiction, such a sex, food and shopping not be identified upon evaluation. Addictive behavior is an individuals style of approaching life, and is a pattern that must be addressed to ensure long-term recovery. Integrated Treatment Solutions provides addictions counseling and treatment that is integrative and holistically based. Through collaboration with our clients, we establish practical solutions in support of long-term recovery with the goal of extinguishing addictive behavior while increasing wellness.

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Integrated Treatment Solutions February 2012

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