Residential and Outpatient Handbook - Plymouth - 26

Residential Services
It's incurable
Substance use disorder cannot be cured. Once a
dependent pattern of use is developed, abstinence
is the best way to control the disease. Many have
tried to disprove this by attempting controlled use of
substances, with disastrous results.
It's progressive
The symptoms of substance use disorder occur in
three stages: early, middle and late. The longer we use
the more symptoms we will experience and the more
rundown we will become.
It's terminal
If untreated, many people with substance use disorder
will die prematurely. Substance use disorder-related
deaths annually take thousands of lives through
suicides, accidents, overdoses and physical problems
related to substance use.
It's identified by loss of control
Loss of control can be defined as ongoing use of a drug
despite harmful consequences. Substance use disorder
can be thought of as a disease because the person
has no control over their drug use regardless of the
problems it may have caused.
Understanding loss of control, or powerlessness, can
help us deal with feelings of shame and guilt. Although
these feelings are often overpowering, it should be
remembered that once a substance enters our system,
we lose the ability to make choices as effectively as
when we are sober. The substance takes control and
dictates our behavior. We are compelled to do things
against our values. Realizing many horrible acts could
have been avoided if we had been sober brings a sense
of hope and dignity and helps us to accept ourselves.
It's a no-fault illness
It isn't true that people with substance use disorder
choose to have the disorder. As a counselor, I have
worked with hundreds of people with substance use
disorder. Not one indicated that their life ambition was
to have a substance use disorder. Many vowed never
to misuse substances. Despite their sincere desire to
control their use, dependence developed.
Rather than a single cause, there are a variety of
predisposing factors-physical, psychological and
social-that ultimately lead to substance use disorder.
Just as some people are predisposed to heart problems,
some people are predisposed to substance use disorder.
If predisposing factors are a major cause of substance
use disorder, should the dependent person be blamed?
Should a heart patient blame themselves for their heart
condition? Should a diabetic blame themselves for their
condition? We might as well say a baby is responsible
for being born lame or malformed. When we realize we
did not choose or desire this condition, a greater level of
self-acceptance usually follows.
Research and genetic predisposition
Research points to genetic predisposition as a
significant factor in the development of substance
use disorder. Dr. Richard Heilman discusses this issue
in Early Recognition of Alcoholism and Other Drug
Dependence.
" How rapidly a person becomes dependent on a drug
depends primarily on whether the response he gets on
taking a drug is exceptionally rewarding. I believe this
is primarily dependent on a predisposing constitutional
condition. This condition is of greater importance, I
believe, than psychological or social considerations. " 7
Understanding that our physical makeup contributes
to the onset of substance use disorder helps relieve the
sense of self-blame many of us have. One strong case
for genetic predisposition comes from researchers D. W.
Goodwin, C. R. Cloninger and N. Bohman, who studied
adoptees of alcoholic parents. They found that adopted
sons whose natural parents were alcoholics were much
more likely to become alcoholics themselves than
adopted sons whose natural parents were nonalcoholic.
This research emphasizes the importance of inherited
physical traits regardless of the environment we grow
up in.
A person's height is determined largely by the parents'
genes. Physical development is also influenced by
diet, social environment, emotional development and
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