Ken Wilson, executive director of Steppingstones to Recovery in Augusta, recently posted the following on his Facebook page:
It’s not a bad habit.
It’s not about being morally flawed or lacking the willpower.
It’s not about guilt or shame.
When it comes to alcoholism or a drug addiction, it’s all about the brain, according to Ken Wilson, executive director of Steppingstones to Recovery in Augusta.
“There are still people who are suffering from that guilt and shame who don’t realize they are fighting a biochemical issue. It’s a brain disease,” Wilson said, holding up a picture of two CT scans of brains. “When people come in here seeking help, this is one of the first things I show them.”
The CT scan on the left shows a bright, colorfully image of a normal person’s brain.
“This is good serotonin and dopamine found in the brain,” Wilson said, explaining that the bright colors on the left show normal circulation of the chemicals in a brain. “We have to have serotonin and dopamine to feel good. Well, alcohol and drugs halt the production of these chemicals in the brain. It comes to a screeching halt.”
Wilson points to the CT scan on the right side, which is primarily dark blue with only a few bright patches.
“Drugs make the brain think it’s serotonin and dopamine, but it’s really not,” Wilson said. “And, so now, the addict or the alcoholic is relying on drugs to feel good because there is not dopamine or serotonin in their brain. Without drugs, the person won’t want to get out of bed or go to work. They will want to close the door and shut the blinds. Their brain is craving that drug.”
And so the addiction begins, Wilson said.
More than three decades of research has proven that addiction is a complex brain disease characterized by compulsive, at times uncontrollable, drug cravings, according to the National Institute on Drug Abuse.
Basically, dopamine is a neurotransmitter in the brain that regulates movement, emotion, motivation and feelings of pleasure. When activated at normal levels, this system rewards natural behaviors.
However, the overstimulating of the system with drugs produces euphoric effects, which strongly reinforce the behavior of drug use — teaching the user to repeat it, according to Dr. Nora Volkow, director of the National Institute on Drug Abuse.
“When some drugs of abuse are taken, they can release two to 10 times the amount of dopamine that natural rewards such as eating and sex do,” Volkow recently told the U.S. Senate Caucus on International Narcotics Control. “In some cases, this occurs almost immediately, as when drugs are smoked or injected, and the effects can last much longer than those produced by natural rewards.”
Such a powerful reward will motive the person’s brain to tell them to continue to take the drugs, Volkow said.
“This is why scientists sometimes say that drug abuse is something we learn to do very, very well,” she said.
Unlearning that desire to immediately turn to drugs for pleasure is the abuser’s main battle, Wilson said.
“Without any alcohol or drugs in the body, it takes this brain a year to get back to mostly normal,” Wilson said, pointing to the CT scan of the drug abusers and then to the CT scan of the normal brain’s chemical levels. “But it will never come all the way back. And, unfortunately, there are some people who are past the point of no return and you might get half of that back. Which means they are going to feel half as good as you do on your worst day. And that is very sad.”
Desiring change, not the drug
After 27 years in the recovery business, Wilson has seen there is really one thing an alcoholic or a drug addict needs to turn everything around.
“Desire. That is the one single thing,” Wilson said. “If you don’t desire it, forget it. You can go get a million dollars worth of treatment, if you don’t have desire, forget it. And there are people who do it. They go to five or 10 different treatments, but they don’t have the desire. They are using rehab as a Best Western because they know Momma will pay for it.”
Unfortunately, getting that desire to stop abusing doesn’t come easily for most people, Wilson said.
“Most of us don’t have the desire unless we have had a sufficient amount of pain,” he said. “Without pain, an individual will never come out of denial. Pain is a great teacher.”
In order to properly address an addiction, an abuser can no longer deny their problem, Wilson said.
“Denial is not a lie. A lie is conscious. Denial is unconscious,” he said. “And denial simply means that the mind cannot see the truth, though everybody else can.
Therefore, coming out of denial is not a pretty picture because the ego will defend an individual to the cross.”
“So very few people come out of denial on their own,” he said. “I mean, we are talking one in a 1,000 maybe. In order to come to the realization of the problems addiction causes usually other people are the ones who are the mirror for that person
to come to reality.”
But these interventions are nothing like the television show called “Intervention” on A&E, Wilson said.
“That program is entertainment. It’s like watching Judge Judy,” Wilson said. “A real intervention is basically when people close to the addict get together and make a list of all the problems that each individual has experienced, that they have seen with their own eyes.”
The family members and friends then meet with the alcoholic or drug abuser when they are at their lowest, Wilson said.
“You always catch them on Saturday or Sunday morning after a hangover or something like that,” he said. “And you just have a little come to Jesus meeting, so to speak.”
Each person will discuss two or three incidents that they have personally seen or experienced with the abuser.
“They will say things like, ‘I remember when you got drunk at that party and you fell down, passed out and the next morning you didn’t know who brought you home,’” Wilson said. “Or, ‘I saw your credit card bill and 95 percent was purchases from the liquor store.’ Then, they will say, ‘We love you so much and because we love you so much, we cannot continue to see you do this to yourself. We want you to get some help.’”
Inevitably, most drug addicts or alcoholics will respond in anger or continue denying the problem, Wilson said.
“At that point, everybody says, ‘Fine. We are out of here,’” Wilson said. “The spouse says, ‘I’m moving out.’ The mother says, ‘Don’t bring the kids to my house.’ Your boss says, ‘You can’t work here anymore.’”
That’s when, for many people, they are forced to face the reality of the situation and treatment can begin, Wilson said.
The steps to recovery
Professional treatment, along with support from groups such as Alcoholics Anonymous or Narcotics Anonymous, is key to an addict’s long-term success, Wilson said.
“People don’t realize that; AA or NA is a wonderful thing. In fact, it is one of the greatest movements to hit the 20th century,” Wilson said. “However, it is a support group. It is not treatment. Treatment is a professional outlining problems, offering interventions with measurable goals and accountability.”
Recovering alcoholics and drug addicts also need to attend speaker groups and step studies, which are small groups that concentrate on the 12 steps of AA or NA.
But Wilson warns there is a big difference between “speaker groups” and “discussion groups.”
“In my opinion, after 27 years of experience in this field, going to discussion groups in AA or NA at random is a gamble, at best,” Wilson said. “When you get a sponsor, if the sponsor directs you to go to a discussion meeting and they will attend it with you, then go. But about 175 of the 200 AA meetings in town are discussion groups. You’ve got about 10 speaker meetings at best. So hit those speaker meetings first because that is where you get enthusiastic.”
Speaker meetings will inspire people to work on their recovery in order to achieve a better future, Wilson said.
“With those discussion meetings, you have to be careful where you go and who you go with and who takes you home,” Wilson said. “You might not get home and you might not get home in good health. There are some meetings in town that are not good, particularly for females to go to. I see it every week.”
The reality is, some of the discussion groups include people looking to sell drugs, not become clean, Wilson said.
“Drug dealers go to discussion groups,” Wilson said. “Can you think of a better place for a dealer to go? It’s pitiful.”
It is important that those seeking help try to find out as much information as they can about the meetings before they attend, he said.
“Those who go to 8 o’clock morning meetings or take their lunch hour to go to an AA meeting, they are serious about their recovery and do well,” Wilson said. “The later in the day, it becomes more random.”
But, in no way is Wilson criticizing AA or NA meetings, he said.
“We highly recommend AA and NA. We just want people to choose well,” he said. “It’s just like churches. I wouldn’t think of throwing you the Yellow Pages and say, ‘Oh, you want to be more spiritual? Here find a church.’ How irresponsible would that be?
So I try to help people find an AA meeting that will fit them.”
Another obstacle for a lot of addicts is an enabler who will help them slip back into abusing drugs or alcohol, Wilson said.
“Nobody can remain in active addiction or alcoholism without an enabler,” Wilson said. “Somebody who is paying for it, picking up the bills, drying them out and getting them to work. While enable means to help, in this case, it means to help someone drink or use drugs longer.”
Unfortunately, in many cases, the mother of an addict will try to help their child, only to ultimately enable him or her to use again, Wilson said.
“Mommas killing their boys is a huge problem,” Wilson said. “They want to pay the bills, snatch them out of treatment and make their beds when they take them to the residence. It will be stuff like, ‘How’s Johnny? Do you have a nice pillow?’ I mean, come on.”
These individuals in treatment need professional help, not mothering, Wilson said.
In order to prepare families for the long road ahead, Steppingstones offers a free family workshop, Wilson said.
“It’s every Wednesday from 7:30 to 8 p.m. and it costs nothing,” he said. “Many times family members have to come to this meeting, three to six months before they are constitutionally capable of doing an intervention for their loved one to get better treatment.”
The family members need to heal themselves, understand their boundaries and become strong enough to be a real support network for the abuser, Wilson said.
“The family has to get well and the friends and the boss have to get on the same page,” Wilson said. “Everybody has to be on the same page because, left to their own devices, an addict and alcoholic will continue drinking and drugging until the day that they die because, who wants to stop? It feels so darn good.”
Healing the body and the brain
While Steppingstones addresses an individual’s addiction, Wilson says it also looks into other potential health issues, such as mental disorders.
“Statistically, 50 percent of addicts and alcoholics have a dual diagnosis,” he said. “So, about 50 percent of people who come into recovery have another mental health diagnosis that can really complicates things.”
If someone is addicted to drugs but is also bipolar, both issues need to be addressed, he said.
“For example, if you go to the doctor, and you have lung problems, that may not be a big deal,” Wilson said. “But if you have lung problems and heart problems, now we have got to be careful. Which came first, the chicken or the egg? Which should we treat first? How can we treat them simultaneously? The same is true with an addiction and a mental health issue.”
Also, just because an individual has been diagnosed with a mental health issue, if the abuser hid their alcoholism or drug addiction from a physician, it may not be an accurate diagnosis.
“There are far fewer individuals who are bipolar than people really think,” Wilson said. “If you go to any discussion meeting and ask, ‘How many of you have been diagnosed with bipolar?’ About 75 percent will raise their hands. It is because drugs make you look bipolar, but if you get off drugs, you are not bipolar.”
The same is often true with attention deficit hyperactivity disorder, also called attention deficit disorder or ADD, Wilson said.
“I think sometimes if I hear one more person say, ‘I’ve got ADD,’ I’m going to barf,” Wilson said, chuckling. “Because three months into recovery, you don’t need those meds anymore. These young kids that go to school and they are jonesing in the morning because they have been high since school got out last night. Now they are jonesing so bad they need ADD medicine to concentrate.
“Don’t get me wrong. I think there are some cases of true ADD, but I think it’s 90 percent less than what people think.”
With more than 25 years of experience in treating alcoholics and drug abusers, Wilson said one of the toughest challenges people are now facing is the abuse of prescription drugs, specifically opiates.
“Opiates are numero uno,” Wilson said. “Because it is heroin. People don’t understand: prescription drugs like Percocet, Lortab, Tramadol, Suboxone and Methadone, it’s all heroin. It’s just a slightly different shape, like eggs in a carton. And they make you feel just so darn good.”
The fact that these opiates are prescription drugs makes treatment even more challenging, Wilson said.
“The one thing that makes it so difficult is the level of denial because these drugs come in a bottle with cotton in it from a drug store,” Wilson said. “So it is legitimatized.”
But, as more and more people are discovering, getting hooked on prescription drugs can often lead to abuse of illegal street drugs like heroin and methamphetamine.
“I was recently told in Columbia County, people are switching from opiates to meth and meth is very difficult to treat,” Wilson said, shaking his head. “I will say that it is hard to find a garden-variety alcoholic anymore. If I’ve got 20 people in treatment, I’ve got one alcoholic. I’m grateful to have one. I used to have 10. Now I’ve got one.”
Treatment facilities are being filled with people addicted to prescription drugs, heroin and meth, Wilson said.
“It used to be alcohol and crack. In fact, cocaine is hardly out there anymore,” Wilson said. “It’s now all about the opiates. And that’s a difficult, life-long battle.”