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General interest items edited by Janice Flahiff

Listen to the stories behind substance dependence

English: Most significant possible long-term e...

English: Most significant possible long-term effects of ethanol. Sources are found in main article: Wikipedia:Ethanol#Long-term. Model: Mikael Häggström. To discuss image, please see Template_talk:Häggström diagrams (Photo credit: Wikipedia)

 

From the KevinMD blog of June 27, 2013

 

“You don’t have any idea what you’re dealing with, do you?” asked Mr. Johnson a mere two minutes into my interview. The scene is the Crisis Intervention Unit. The time is 3:00am. I have a feeling my breath is terrible. The hospital pizza I engulfed earlier in the evening has decided to stage a churning acidic protest in my guts. However, far worse than my half-closed eyes, my halitosis or my gastrointestinal distress is the fact that he’s absolutely right. Mr. Johnson is here because he has come to the realization that living sober is about as awful as living as an alcoholic. As a result, he has decided life is simply not worth living.

As a practitioner, patients caught in this double-bind are among the most frustrating to treat. They are living proof that substance dependence treatment can be quite shortsighted. The logic is charmingly simple and irritatingly simplistic: if you’re drinking too much, then you should probably stop. Once you stop, all will be better.

To properly understand the failure of this logic, we need to distinguish the brain from the mind. Although our medications and therapies are effective in removing alcohol from the brain, we are less successful filling the empty space left in the mind. Mr. Johnson’s alcohol use started as a coping strategy and slowly evolved into a way of navigating the world: a drink to take the edge off at a dinner party; a libation or five to take the edge off of a bad day at the office; a quick stop at the corner bar after work to steel himself against a troubled marriage and a wayward teen. Alcohol played prominently in the way his mind functioned for years….

 

Read entire blog post here

 

 

 

July 14, 2013 - Posted by | Psychiatry, Psychology | , , , ,

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