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The Cycle of Addiction: The Physiological Process & the Concept of Homeostasis

Many factors contribute to the development of substance use dependency. One of those factors is a physiological process that happens over time with continued substance use. It may not be noticed by the user because it happens so incrementally. Awareness of a problem only arises when the person experiences an inability to stop using. Therefore, understanding how the physiological development of dependency occurs is important.

We are all born with an internal regulating system that maintains stability in body temperature, blood pH, and glucose levels, among many other things. The body strives to maintain its systems of functioning within a normal range. This process is the phenomenon of homeostasis and is essential to our survival.

Homeostasis is the physiological process that maintains equilibrium in our bodies and allows us to function normally. Our bodies strive to maintain homeostasis when systems fluctuate. The body accomplishes this through “complaining.” For example, one way our bodies complain is to shiver when it’s cold. Shivering produces heat and is our body’s attempt to increase temperature. Likewise, when the body overheats, it complains by sweating to decrease temperature.

When alcohol and/or drugs are ingested, the body tries to return to its normal homeostasis by processing them through the liver, kidneys, and lungs. If substances are consumed to a point of intoxication, the body reacts with an upset stomach or possibly vomiting in order to stop the person from consuming more. This is the body’s effort to buy time in order to process and/or purge what it perceives to be poison in its attempt to return to homeostasis.

The problem occurs when a person continues to use despite the body’s complaints. Through continued use a person’s homeostasis can become “reset.” The same process still happens, but with a new homeostasis set to the substance levels the body has become accustomed to. Now, when the new, reset homeostasis fluctuates, the body again complains. Only instead of complaining when the level of the substance is increased, the body complains when the substance level decreases. These complaints are known as withdrawal symptoms. Common withdrawals from alcohol can be irritability, tremors, clamminess, headache, and nausea. These symptoms are the body’s attempt to return to the new homeostasis. One way to reduce withdrawal symptoms is to re-use the substance, like having a mimosa during Sunday brunch after a Saturday night of drinking in order to alleviate hangover symptoms. The substance has now become the medicine for the symptoms it actually created.

A particularly dangerous withdrawal symptom from alcohol abuse is the possibility of a seizure. Anyone experiencing high levels of continued alcohol consumption should consult a professional for a safe, medically monitored detoxification process.

Nicotine withdrawal symptoms can typically be headache, nausea, anxiety, insomnia, and fatigue. Withdrawal symptoms from marijuana can be headache, nausea, anxiety, insomnia, disturbance of appetite, paranoia, and irritability. Cocaine withdrawal is experienced by tiredness, depression, anxiety, and moodiness. Opiate withdrawal can be all the above, but also include muscle aches, high blood pressure, increased heart rate, and intense cravings. Sometimes withdrawal symptoms are confused with chronic pain. (This list is not exhaustive or definitive.)

Understanding how the process of substance dependence develops is important, but it’s also crucial to listen to our bodies. Our bodies constantly send us information on what is working and what isn’t working for us. It’s an individual experience. We need to ask ourselves if the substances we are using have become the medicine for symptoms they have caused.

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Couples & Family Therapy

RTCC counselors can provide Fort Collins mental health services to address communication issues and conflict management with couples and families. Emotionally Focused techniques, the theory of Virginia Satir, Structural Family Theory, Adlerian, and Gottman Method Couple’s Therapy are employed by our counselors to help clients through their difficulties. For most people in a relationship, conflict is an expected part of the dynamics between two people as their relationship evolves. Examining communication patterns which work, as well as those that do not work or harm the relationship can be essential to the survival of the couple. Managing conflict is one of the keys to a successful relationship as is recognition of destructive influences. Exploration of the couple’s communication patterns, working towards mutual goals, and creating a shared meaning are all essential to the health of the relationship. RTCC counselors have experience in working with couples who are non-traditional as well as traditional and we welcome couples from any nationality or orientation.

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Trauma

Recovery from trauma is a complicated process which can cause many people to feel overwhelmed, disconnected, isolated and helpless as they try to come to terms with their traumatic experience. For some, hyper-vigilance, flashbacks, nightmares, and avoidance of certain situations are a direct result of the trauma. Recovery can be even more complex if the traumatic experience happened in childhood. It is imperative that clients have a safe, trusting and supportive environment in which to work through their trauma. RTCC counselors endeavor to create optimally therapeutic relationships with their clients and employ a variety of techniques to instill hope for the client and to empower him or her on the path to recovery.  Our counselors utilize a comprehensive array of approaches such as Cognitive Behavioral Therapy, emotion regulation, stress management techniques, self-soothing, grounding, and mindfulness, to help clients with the healing and recovery process.

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Anxiety

For clients who experience anxiety, life can be a troublesome and turmoil-filled experience. Anxiety can be experienced in a number of ways: Generalized Anxiety (constant fears or worries as you go through the day), Panic Attacks (an unexpected occurrence), Phobias (an unrealistic fear of an activity, situation, or object), Social Anxiety (unease about being in social situations or what others might be thinking about you), and Post-traumatic Stress Disorder (PTSD). PTSD occurs in the wake of traumatic or life-threatening event and can often include flashbacks or night terrors. People who suffer from PTSD often fall prey to substance use disorders in order to cope with their symptoms.

An anxiety attack can be a traumatizing experience in itself, causing worry or apprehension of the next attack. RTCC counselors will compassionately assist clients with their anxiety and encourage them to utilize relaxation and stress management techniques, recognize the importance of self-care, build confidence and self-esteem, and practice mindfulness and emotional regulation. Exploration of the roots of the anxiety will also be incorporated into treatment in order raise awareness and, hopefully, normalize the presenting situation. The counseling approach will be to focus on the ability to utilize coping skills in the moment to manage the symptoms of the anxiety.

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Depression

According to recent National Institute of Mental Health statistics, 17% of the population will experience major depression during their life time. For many people, depression is situational and can be addressed with brief therapy; however, for others it can be an ongoing struggle requiring longer term care and support. RTCC counselors utilize a holistic approach to address a client’s struggle with depression, whether it is situational or clinical, including discussions about meaning making, gender issues, societal influences, diet and exercise, supplements, spirituality, and family of origin concerns.

Persons who are prescribed medications for depression are often saddled with the task of monitoring the continued effectiveness of those medications. The patience and persistence required of a depressed person as they go through the process of finding the right medication with their psychiatrist or doctor can, and often does, exacerbate the depression. RTTC can provide support and encouragement as the person endeavors to address their depression with the correct medication.

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Aftercare Support

RTCC counselors recognize that clients who have completed a Residential Treatment Program or Intensive Outpatient Program for substance abuse issues are extremely vulnerable to relapse. Clients will benefit with support to create a comprehensive support system including recovery support groups, referrals to other medical and community services, and individual therapy with a therapist familiar with addiction and recovery. With this in mind, RTCC counselors provide a comprehensive program of services to assist the client with the transition back into “everyday life.” Entering a new life after treatment can be frightening and overwhelming. When a person is in a fearful state, he/she is less likely to make recovery sustaining decisions. We will look at things from a “challenge vs. support” lens to help the client learn to hold themselves accountable, to utilize the coping strategies they have learned from their treatment experience, and also add “tools” to their tool box.

The family system is highly valuable to the client in recovery as their inner circle of support. RTCC counselors provide family and couple therapy specific to clients seeking recovery to help those close to the client to tease out the subtle differences between supportive and enabling behaviors. Clients are encouraged to continue to build a circle of support outside of the family which is also an important part of the process of recovery.

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Co-occurring Disorders

Many clients who face difficulties with substance use also have an underlying mental health concern such as depression, anxiety, bi-polar disorder, trauma, or ADHD. RTCC counselors recognize the importance of assessing each client for these underlying concerns and treating the issues concurrently. With compassion and encouragement, we utilize a strengths based, cognitive behavioral perspective to explore how thinking patterns can get in the way of recovery from depression and anxiety as well as cause people to utilize substances as a way to manage their symptoms.

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Substance Abuse

RTCC counselors utilize Motivational Interviewing and strengths-based techniques to serve our clients with substance abuse issues. We provide a safe, supportive environment in which our clients can talk about their substance concerns and explore their willingness to make change from a biopsychosocial perspective. We recognize that each person’s path through the change process is unique and we will draw from other perspectives such as Cognitive Behavioral Therapy, Narrative Therapy, Reality Therapy, Solution Focused Brief Therapy, and Dialectical Behavior Therapy as needed to assist our clients with their goals.

Often times, substance abuse issues are experienced with an array of other co-occurring disorders such as anxiety, depression, trauma, and/or grief and loss. Our counselors are well equipped to create a positive therapeutic alliance with our clients in order to provide treatment to the “whole” person.

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R-BIBSI Biopsychosocial Assessment

The purpose of this mixed-methods applied study was to develop a reliable, valid, and clinically useful brief integrative biopsychosocial assessment screening instrument (R-BIBSI) to investigate influences of alcohol abuse and dependence in college age students. The R-BIBSI is a 30-item, non-diagnostic, brief screening tool developed to aid drug and alcohol treatment professionals in treatment planning for persons experiencing substance abuse or dependence. The R-BIBSI is easily be scored by clinical or non-clinical staff to assess six constructs of alcohol use influence: Biological Influence, Psychological Internally Expressed Influence, Psychological Externally Expressed Influence, Social Family Influence, Social Peer/Work Environmental Influence, and Social Cultural Influence. Item reduction processes included a think-aloud form of cognitive interviewing, predictive validity testing utilizing independent samples t-test, and exploratory factor analysis. Validation and reliability testing for the BIBSI field-test utilized a convenience sample of 63 college age students.

Biopsychosocial Assessment

The R-BIBSI can be an extremely useful tool, especially for raising awareness of a client’s biopsychosocial influences to help guide the therapeutic conversation. The R-BIBSI can also be utilized as a valuable method for addiction counselor training.

Please contact me for more information on access and utilization of the R-BIBSI.

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