Although it has been many years since my personal journey of recovery began, I can distinctly remember nearly everything about my inpatient treatment experience. One of the moments I most vividly remember is the moment the in-house psychiatrist informed me that my clinical team had decided to prescribe me Lexapro.
“What? Excuse me? You must be mistaking me for someone else. I am a happy person. I am living my best life. How dare you.”
I remember being highly offended that they would even suggest that I needed medication – and an anti-depressant, nonetheless? I had never taken a psychiatric medication before in my life, and I had certainly never been depressed. I mean, sure, I had been drinking large quantities of vodka morning, noon, and night for several years, but… depression? Please. Give me a break.
I put up quite a fuss, but was somehow unable to convince my therapist that I knew what was best for me. Begrudgingly, I agreed to take Lexapro short-term. And I did. I took it for about 3 months, and (in retrospect), it certainly seemed to help alleviate some of the depression and anxiety that I was feeling when I first entered treatment. I learned to trust my primary therapist, and I continued seeing her for over three years after I graduated from the inpatient program. Looking back, I can see that trusting my clinical team to take good care of me was beyond important. They were licensed, experienced professionals, after all – and I was a 23-year-old mass of unresolved trauma who had been drowning her melancholy in cheap liquor since high school. Excessive drinking had done quite a number on my brain functioning, and my poor little neurological pathways had been tread down and worn out.
Short-Term Neurological Damage
The reality is, when an alcoholic abruptly stops drinking, the brain becomes unable to adequately process dopamine (a chemical messenger that carries signals between brain cells). Ultimately, an abrupt cessation of substance use completely alters the way that the neurological reward system is wired. This harsh reduction of dopamine levels leads to a decrease in dopamine receptor sites, which in turn decreases the brain’s ability to respond to any influx of feel-good chemicals. Essentially, regular alcohol consumption will (over time) dampen the reward center in the brain, and alcoholic individuals will be compelled to continuously seek stimulation through booze. When an alcoholic gives up drinking entirely, the brain is left in this dampened state – meaning, basically, that it will be difficult to feel good until the dopamine levels (and receptors) are restored. This is where pharmaceutical intervention comes into play.
Relapse and Brain Chemistry
Individuals who are very new to sobriety have an increased vulnerability to relapse, seeing as their brain chemistry has yet to normalize. In many cases, pharmaceutical intervention is used as a short-term approach to help prevent relapse in those who have damaged their brains as a result of substance abuse. The short-term use of certain non-habit forming medications can be extremely useful, though it is important that prescribing physicians use extreme discretion when prescribing any medication to an individual with a recent history of substance abuse. Addiction is a cunning, baffling, and powerful disease, and even non-narcotic medications can be abused. It is crucial that those who are prescribed medications while in inpatient treatment continue to see a psychiatrist after transitioning out of the residential program. This way, progress can be closely monitored, and the concerned individual can safely taper off of the medication once he or she is stable enough to do so.
Addiction Recovery and Unresolved Trauma
Many of the patients we treat are experiencing symptoms (such as substance abuse) as a direct result of unresolved trauma. We often find that intense therapeutic intervention is sufficient, and that 3 months (or more) spent in a safe and supportive environment will give our patients the foundation they need to transition back into their day-to-day lives – and successfully maintain their recovery. We use extreme discretion when it comes to pharmaceutical intervention, and though we do have a prescribing psychiatrist on staff, we exhaust every option before turning to medication. Of course, we also treat mental illness as a primary diagnosis. In cases where mental health is the biggest concern, medication may be a necessity. We treat men who struggle with depression, anxiety, personality disorders, and a wide range of other psychiatric issues. Before making any pharmaceutical-related decisions, we carry out a thorough and prolonged assessment, and monitor behavioral patterns closely for an extended period of time.
Our highly individualized program was designed to provide each of our unique patients with the very best available treatment – not only while they are attending our inpatient program, but long after they graduate. Aftercare is extremely important, and we make absolute sure that each of our men is equipped with the resources he needs to maintain fulfilled recovery for years to come.