What is addiction?

Addiction is a disorder that causes a patient to become dependent on a substance or activity. Most addictions involve drugs, such as cocaine or heroin. However, it’s also possible for patients to become addicted to sex, gambling, and other activities that may interfere with their lives.

Without treatment, addiction can pose many problems for patients. Some addictions are dangerous on their own because of the side effects they cause. Other addictions are illegal and/or cause financial problems for the patient. Many patients struggling with addiction will also experience difficulties in relationships with family and friends.

Is addiction really psychological?

Nearly every addiction has a psychological component. While some addictions, such as addictions to heroin, have a significant physical component as well, others are purely psychological. Regardless of whether a physical addiction exists, patients must address the psychological addiction before they can recover successfully.

What causes addiction?

Addiction can have different causes. However, some patients are more prone to developing addictions than others. Researchers believe that both environmental and genetic factors can make a person more likely to develop an addiction. Patients who have risk factors for this disorder should avoid drugs and activities known to cause addictions.

What are the symptoms of addiction?

Some of the symptoms of addiction include:

  • Intense cravings for a substance or activity
  • Needing more of a substance or activity to get the same effect
  • Skipping social functions to engage in a certain behavior or take a drug
  • Failed attempts to stop a certain drug or activity
  • Withdrawal symptoms

Our Personalized Approach to Addiction treatment

At Wholesome Psychiatry we offer individually tailored treatment for alcohol and substance abuse, a unique alternative to traditional “one size fits all” addiction treatment programs. Our substance abuse treatment services are private and absolutely confidential. We provide sophisticated treatment that is tailor made for executives, professionals, and other high functioning adults with busy schedules and demanding careers. Flexibility, choice, and total confidentiality are the hallmarks of our clinical approach. We respect our patients’ freedom to choose their own treatment goals, and above all, we place great value on developing a confidential therapeutic partnership with each patient, seeking this method rather than aggressive confrontation as the best way to motivate and empower change. We offer abstinence-based treatment aimed at helping patients who want to completely stop using alcohol and other drugs. We offer moderation management and harm reduction for clients who want to learn how to moderate their substance use and reduce the risk of experiencing substance use related consequences.

How can we help with overcoming addiction?

The first step to overcoming an addiction is recognizing that substance abuse problem exists. The provider at Wholesome Psychiatry can help patients identify and accept their addictions so that they can begin their recovery journey. Wholesome Psychiatry offers medication management and psychotherapy to help patients eliminate the drug or behavior from their life, deal with cravings, and restore their health.

The medication assisted treatment at Wholesome Psychiatry provides substance abuse treatment for individuals with addiction and/or physical dependence to opioids, such as hydrocodone (Vicodin), oxycodone (Percocet), heroin or fentanyl; alcohol, and benzodiazepines, such as alprazolam (Xanax), clonazepam (Klonopin) or lorazepam (Ativan).

Wholesome Psychiatry provider is a licensed and board-certified clinician with experience in prescribing buprenorphine/naloxone (Suboxone) and intramuscular naltrexone (Vivitrol) for treatment of opiates abuse. In order to start intramuscular naltrexone, an individual needs to be 7-10 days opioid free, which can be difficult for some to achieve. Wholesome Psychiatry provider can work with you to obtain those days of sobriety. For alcohol abuse treatment, the provider at Wholesome Psychiatry have experience in prescribing naltrexone orally or intramuscularly (Vivitrol), acamprosate (Campral) and disulfiram (Antabuse).

Medications for Relapse Prevention

Naltrexone. Naltrexone (Trexan, ReVia, Vivitrol) blocks the euphoria (“high”) and all other physical effects of opioid drugs for at least 24 hours after each oral dose. It was developed in the 1970s mainly to prevent relapse to heroin and methadone, the most widely used opioids at that time. Naltrexone itself produces no euphoria and is completely non-addictive. More recently, naltrexone has been shown to significantly reduce binge drinking episodes in people trying to remain abstinent from alcohol. It partially blocks alcohol’s pleasurable effects so that drinking is less rewarding and less likely to get out of control. Naltrexone is usually taken in pill form on a daily basis. A longer-acting injectable form of naltrexone, known as Vivitrol, works for up to 30 days after each implant of a time-release pellet.

Antabuse. Disulfiram (Antabuse) is one of the oldest and most widely known medications for preventing relapse to alcohol. Similar to naltrexone, disulfiram is neither psychoactive or addictive. However, unlike naltrexone, it does not block the effects of alcohol, but causes a highly unpleasant reaction when combined with alcohol. It works by blocking enzymes involved in alcohol metabolism so that drinking while on Antabuse causes an extremely noxious physical reaction that may include nausea, vomiting, sweating, etc. The ability of disulfiram to cause this reaction lasts for approximately 24-36 hours after taking each dose of the medication. Antabuse is most effective in preventing an unplanned or impulsive return to drinking. Because Antabuse can be discontinued at any time with no ill effects, drinking can be resumed within a day or two after stopping the medication. The beneficial effects of taking Antabuse include a marked reduction in obsession and cravings as a result of knowing that alcohol will produce no positive effects. As with other medications used to prevent relapse, disulfiram is most effective when used in combination with counseling or therapy.

Topamax. Topiramate (Topamax) recent studies indicate that this anticonvulsant medication, can reduce the frequency of heavy drinking episodes in people trying to abstain completely from alcohol and in those trying to moderate but not abstain completely from alcohol. Results from several studies indicate that patients given Topamax:

  • Report fewer days of heavy drinking
  • More days when no alcohol was consumed at all
  • Consumed fewer drinks per drinking day

Gabapentin. Gabapentin (Neurontin) researchers have found that patients given the anticonvulsant medication, Gabapentin, refrained from heavy drinking twice as often as those getting the placebo. They abstained completely from drinking four times as often. Those taking Neurontin also cut back on the number of drinks they consumed in a given drinking episode by a significant amount. They reported experiencing less depression, fewer cravings, and better sleep.

Suboxone. Buprenorphine (Suboxone, Subutex, Zubsolv) is a prescription medication that blocks other opioids (narcotics) from attaching to receptors in the brain. Buprenorphine is a “weaker” narcotic than standard opioids (heroin, oxycodone, hydrocodone, etc) and also can block the effects of these other drugs. It can produce mild euphoria (usually limited to the first few doses, if at all), but fortunately is less likely to suppress breathing to the point of causing overdose. Buprenorphine produces enough of an opioid effect to eliminate cravings and prevent the emergence of an opioid withdrawal syndrome. It is often used to help people withdraw (detoxify) from other opioids and it can also be used as a substitute medication that is taken over a longer period of time to prevent relapse to other opioids. Many patients report that in addition to preventing withdrawal symptoms and drug cravings, buprenorphine also helps to reduce anxiety and depression.