Drug and alcohol addiction: Treatment and recovery Part II

By SARAH DOOLITTLE, Four Points News

Drug and alcohol addiction does not discriminate. That is what two local experts have found in their work at Happy Mental Wellness Center in River Place.

“When I first entered the field, I truly thought of the alcoholic as the person under the bridge. And then I (treated) the doctors, the lawyers, the person working at McDonald’s, the homeless person,” said Rebecca Sheehan, a licensed professional and chemical dependency counselor. In other words, no one is immune from the dangers of substance abuse, she added.

Drug and alcohol abuse can stem from a variety of causes: social use, a medical condition, a family history of addiction. However, Nadia Bening, MD, a psychiatrist who treats adults and adolescents, does point out a common condition present in addicts.

“Our research shows that 75 to 85 percent of people with substance abuse problems will have a dual diagnosis (of substance abuse and) a mood disorder,” such as depression or bipolar disorder, Bening said. Substance use may start simply as an effort to self-medicate, she said.

Rebecca Sheehan and Nadia Bening, MD, at Happy Mental Wellness in River Place provide a variety of mental health services including treatment for substance abuse.  Photo by Sarah Doolittle

Rebecca Sheehan and Nadia Bening, MD, at Happy Mental Wellness in River Place provide a variety of mental health services including treatment for substance abuse.
Photo by Sarah Doolittle

Abuse criteria

There is no set level that defines when use has turned to abuse, but there are criteria that can help to determine if someone has crossed the line. The most obvious criteria is if a user self-identifies as having a problem. But it can also be indicated by an increased tolerance to a substance and the need to use more to achieve the same effect. It can be continued use despite serious consequences such as a DUI or DWI, or the substance use affecting someone’s family life. social life or work.

For children, the indicators or abuse include mood swings, a lack of self-care or eating, changes in grades or a significant change in friends or normal activities. As with adults, if a child expresses concern about abuse or if there are any legal consequences, parents should seek help.

For some Four Points kids, Sheehan and Bening point out that substance use can be a response to extreme anxiety from school demands. “There’s a lot of pressure on the kids in this community. Perfectionism is huge here,” explained Bening.

They also believe it is important to talk honestly to your children about substance abuse.

“Especially if there is addiction in the family, they have to know about it as soon as possible. They know if mom and dad have a problem. They know if grandma and grandpa have a problem. Kids are really smart, even at a young age, so they know if something is going on. Just talking about it, saying, hey, it runs in the family, this is what could happen,” Sheehan said.

Whatever the cause, Bening and Sheehan agree–addiction is a disease.

“I’ve never met anyone that chooses (to become an addict),” explained Sheehan. “Yes, it’s a choice to take that first drink, to have that first hit, to snort that first line. But it’s a disease. We see it as a bio-psycho-social, even spiritual disease. It’s all four of those. You do have a choice, but a lot of people have the gene.”


Once an addict is able to recognize the need for treatment, the course of treatment will depend on the substance being abused and the extent of addiction.

According to Bening and Sheehan, those seeking sobriety want to seek the least restrictive treatment first, such as outpatient treatment with individual therapy and medication such as Antabuse, which can reduce cravings for alcohol. But if there are multiple relapses, then a more intensive outpatient program (IOP) may be appropriate.

The next level of treatment, an inpatient residential treatment program, is recommended for those unable to stop abusing a substance on their own, but also for severe addictions such as long term, high volume alcohol use or benzodiazepine addiction. Benzodiazepines, aka benzos, include drugs such as Xanax, Klonopin and Valium, which are prescribed for anxiety.

Sheehan stresses the need for inpatient treatment for these types of addiction because, “If you quit cold turkey, you could die.”

Treatment, whether in- or outpatient, is typically in a group setting, which is often helpful for people in recovery from addiction. This type of treatment differs from a 12-step program in that it is lead by a therapist and not a lay-person. A treatment group provides education, whereas AA offers the support of other recovering addicts.

As for therapy versus medications for the treatment of addiction, Bening explains that “Medicine and therapy alone have the same success rate. But if you put them together it’s going to more than double the rate.”

“There are medications we can provide to reduce cravings. They can be administered here in the office on an outpatient basis. But again, it’s a collaboration between (patients) doing therapy and them learning the behavioral changes they need to make as well.”

Science behind addiction

Science is still struggling to understand factors such as genetic predisposition to addiction. What is know, though, is that, “From a biological standpoint, addiction is related to how a drug increases levels of the naturally occurring neurotransmitter dopamine, which modulates the brain’s ability to perceive reward reinforcement.” Beming goes on to explain that imaging studies have shown that drug-addicted subjects have markedly disrupted dopamine function. These findings have already begun to aid in the development of new strategies for pharmacological and behavioral treatments, with the goal of restoring brain circuits disrupted by chronic drug use.

Science may someday provide a pill to cure addiction. But the bottom line, according to Shehan, will always be that “a patient has to be motivated to want to stop.”

For an addict, addiction can feel like a hopeless condition from which escape seems impossible. According to studies, the average amount of time between an addict realizing they have a problem and seeking help is seven years. But for those living with substance abuse, there is much to look forward to from sober living. Besides their own well-being and that of affected family members, Benning reminds addicts there is, “so much that they’re probably missing out on. Waking up in the morning and feeling energized and productive. Having mental clarity.”

“Letting go of that shame and guilt,” is another benefit, Sheehan adds.

Happy Mental Wellness offers acupuncture, including Acu-detox, therapy and psychiatry. Ask your physician or mental help professional for information about in- and out-patient treatment options in the area. To find a local AA meeting, go to www.austinaa.org. For Narcotics anonymous, visit www.na.org and follow the links to find a meeting.


Do you think someone you know has a problem with addiction?

Bening and Sheehan offer suggestions on how to approach someone who you think may have a substance abuse problem.

  • Make sure to talk to them about your concerns when they are sober.

  • Approach them in a comfortable, non-threatening setting.

  • Give specific examples of why you are concerned.

  • Reiterate message of love and concern.

  • You may offer professional resources if appropriate for the relationship. If they don’t want to talk to you, they may be willing to talk to a professional.

  • Have realistic expectations. 90 to 95 percent of those on recovery will relapse at some point in the process.