In the journey of addiction recovery, there is no one-size-fits-all approach. The path to sobriety is evolving as more treatment options become available for individual healing.
By Greta Stuckey
Upstate Medical University has an Adult Psychiatry Clinic where they help people manage medications to treat substance use disorders. Photo by Greta Stuckey
Sitting at the kitchen table as a child, Emily Nolan drew pictures and listened to her mom's 10 siblings ask for help. They all suffered from alcoholism like her grandfather. As the helpers of the family, Nolan and her mom absorbed everyone's problems. But no matter the advice her mother gave, her siblings never got professional help. Today, only three sisters are alive.
The hours spent at the kitchen table drawing and listening to family problems led Nolan to become an art therapist. Today, she helps people heal through art and creative expression. The work goes beyond painting and drawing, it targets specific behaviors and helps people get to the root of their addiction or mental health issues. Nolan says that creating art helps people externalize the pain they often bottle up inside.
“It's really important to bring the body into art in an intentional way,” said Nolan. “Healing is in the doing. So it's not just about talking at the end, but it’s about the actual process of externalizing pain through art.”
Similar to other chronic diseases such as heart disease or asthma, addiction treatment is not a cure. Treatment is a way of managing the disease and a path toward recovery, according to National Institute on Drug Abuse. Common treatment methods for substance use disorders listed by the NIDA are medication, behavioral therapy and counseling. However, there are a variety of other treatment methods to help people in recovery such as art therapy, pet therapy and eye movement desensitization and reprocessing, according to The National Association of Addiction Treatment Providers.
No matter the approach a person takes in their recovery journey, it's highly individualized. There’s no one-size-fits-all approach to treating substance use disorders, according to the Cleveland Clinic. For some, medication and psychotherapy may work, while others need a combination of experiential therapies and group meetings. Treatment and recovery are also dependent on the substance people are addicted to. While many substance use disorders can be treated through a combination of medical, behavioral and social interventions, some have different medication doses and detoxication times, according to Lantana Recovery.
Although marijuana and alcohol are used by many people recreationally, they can also lead to a substance use disorder, according to Thomas Ringwood, a psychiatric nurse practitioner at SUNY Upstate. One of the most common addictions Ringwood treats is cannabis use. He explained the difficulty in treating a substance use disorder with a drug like cannabis because symptoms present differently in patients and many times, people don’t realize their dependence on the drug until they have trouble functioning.
“There's this idea or wish that treatment is simple,” said Ringwood. “But substance use disorders are chronic and characterized by relapse. And everybody's different so the approach can often take a while to refine and it can take a long time for people to get better.”
The use of different substances for adults 18+ in 2020, according to SAMHSA. Data Visualization by Greta Stuckey
Many times when treating substance use disorders, clinicians also look for co-occurring disorders in patients. Over 20 million people in the United States have at least one substance use disorder and about 38% of those people also have a mental illness, according to NIDA. Treating a substance use disorder with the presence of mental illness or trauma is often more complicated and requires a varied approach, according to Ringwood.
“Some people have a deep trauma underneath the substance use disorder that needs to be worked on in therapy,” Ringwood said. “You know, other people might need medications for things like depression or ADHD. Each person is an individual so I try to tailor the treatment to them and their goals.”
Personalized treatment has become more standard across the medical field as a whole in the last decade. Along with substance use disorders, doctors are doing more research on the progress of personalized medicine in disease areas such as rheumatoid arthritis and Alzheimer’s disease, according to The National Center for Biotechnology Information.
Similar to the goal of treating substance use disorders, doctors recognize that personalized treatment can help the effectiveness of recovery and reduce medical costs. Personalized treatment refers to doctors looking at people’s history, genetic background and disease status to select the most appropriate treatment for them, according to the NCBI.
Today, treatment methods such as art therapy and pet therapy are becoming more common in mental health settings. Art therapy can occur in hospitals, schools, substance abuse rehabilitation centers and correctional facilities, according to the Addiction Center. Jay Peacock, a member of Paws CNY sees the power that pet therapy can have on people’s lives. He frequently visits the adult and adolescent behavioral health floors at SUNY Upstate with his dog Harley.
“All of us have that experience, that joy, the happiness that our dogs bring us,” Peacock said. “It allows people struggling to be a little vulnerable and let their guard down.”
On one occasion on the adult behavioral health floor, a man came into the room to meet Harley and the nurse told Peacock that he hadn’t spoken since he was admitted to the hospital. Within a few minutes, the man was lying on the floor with Harley and began talking and opening up.
“Many of the substance use disorder clients get a lot out of pet therapy, music therapy and art therapy because sometimes it can be tough to talk about their addictions,” said Meghan Haff, a group facilitator at Banyan Treatment Centers in Boca Raton, Florida. “I find that once I get clients to open up, they like to talk about their previous trauma and experiences.”
Pet therapy dog, Harley, with a child. Photo courtesy of Jay Peakcock
As a group facilitator, Haff runs workshops for clients on empowerment, hope, reframing, anger management and shame. Since Banyan is a partial hospitalization program, Haff works with clients who stay there residentially for about a month. They take a holistic approach to treatment where people get exposed to psychotherapy, group programs, art therapy, acupuncture, pet therapy, medication management and more.
It’s becoming more common to treat a substance use disorder with multiple methods. EMDR therapy is a treatment most commonly used to address depression and PTSD. However, in recent years, EMDR has been increasingly studied and used on people with substance use disorders, according to the EMDR International Association. There are eight phases to help people heal in EMDR therapy, according to Dr. Jennifer Fee, an EMDRIA Professional Practice Content Specialist.
“A lot of people think that if you are not doing some kind of eye movement, tapping or talking about trauma then you’re not doing EMDR,” said Fee. “However, there's a lot of preparation that goes into reprocessing trauma and things we do after to help people process trauma.”
EMDR helps treat substance use disorders by reducing cravings and the attractiveness of addictive behaviors. Recent studies also found that EMDR can help reduce the attractiveness of addictive behavior via special protocols designed to reduce cravings, according to the EMDR International Association.
“I think a team approach for addiction is important,” Fee said. “I worked in a treatment center for a while and we had a team approach of detox, partial hospitalization, the 12-step program and group meetings. EMDR therapists would fit nicely into this model because they’re just a piece of the entire package.”
Whether people are trying therapies, medication or being helped in a treatment center, support is almost always necessary for successful recovery, according to NIDA. Addiction can be difficult to quit no matter how much someone wants to cut back. It becomes increasingly difficult if they lack the resources and treatment options to heal. According to SAMHSA, 72% of adults who ever had a substance use problem considered themselves to be recovering or in recovery.
“A lot of people in recovery will tell themselves relapse is inevitable but I have them reframe it to something like recovery is inevitable,” Haff said. “It’s inevitable for us to get sober and live a fulfilled life and the more you say positive stuff to yourself, the more you believe it.”
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