During an appearance on the Dick Cavett Show in the 1970s, John Lennon was asked about drug use. He commented: “The basic thing nobody asks is why do people take drugs of any sort…why do we have to have these accessories to normal living to live? I mean, is there something wrong with society that’s making us so pressurized we cannot live without guarding ourselves against it?”
Good question. What is it that drives some people to crave a substance or activity so much that they are willing to risk losing everything of real value in their lives. This is what mental health professionals try to uncover as they work with people who are struggling to overcome substance or behavioural addiction.
At William Osler Health Centre, which has hospitals in Brampton and Etobicoke, addiction treatment is a three-pronged approach: a Substance Abuse Counselling Program, a Problem Gambling Counselling Program, and an inpatient short-stay Withdrawal Management Centre. All three programs are confidential, fully voluntary and available without physician referral.
Patients come from across the region and cross all boundaries of gender, income, education level, age and social strata. While an alcoholic homeless person may be more visible, the treatment programs are just as likely to be filled with well paid executives or middle-class suburbanites who take great pains to keep their habits hidden.
Many clients in the problem gambling program for instance are professionals who usually begin gambling in a social way, with an outing to a racetrack or casino as a way to relax. But as with all addictions, what really draws them in is the sense of release and excitement that they get from feeding their habit.
“It’s a form of escape, a coping mechanism,” said Versa Dean, addiction counsellor. “We all have a set of behaviours that we’re addicted to, we all have things we do to deal with issues in our lives. And addictions can begin so innocently!” She gives an example of a young woman who was dealing with the stress of a new job and having trouble sleeping. The girl started having a drink at night to relax, which soon became a habit and eventually snowballed into a full-fledged drinking problem.
In addition to the mental health aspect, substance abuse – alcohol, tobacco, glue, illegal and prescription drugs, etc. – causes physiological changes that affect both mind and body. This can pose a danger to the addicted person or people around them and add to the difficulty of the treatment process.
In times of crisis or when there is an urgent need for inpatient treatment, Osler’s Withdrawal Management Centre provides crisis support and non-medical care for adults on a short-stay basis. The centre provides a safe supportive atmosphere for both men and women who need immediate help. Clients initially spend a few hours in a monitored area until they are stable enough to move to a room (there are a total of 20 beds in separate male and female wards). Most people stay at the centre from four to five days. The staff provides support with physical withdrawal and also works with clients to develop a longer term treatment plan. This may include referral to one of Osler’s counselling services and/or referral to residential treatment programs. The centre’s coordinator, Theresa Riehl, said, “It’s hard to define success when you’re talking about addiction. It may be someone who never has another drink for the rest of his or her life, or perhaps someone who goes a year without drugs. It could be getting someone back to work. We try to work with each person to help them achieve their goals.”
Kamali Sampathkumar, addiction counsellor in the Problem Gambling Counselling Program, agreed that it is the clients themselves who hold the keys to overcoming their addictions. She noted that the root causes of addiction are innumerable – lack of self-esteem, depression, relationship issues, a stressful job or episode in a person’s past, for example. Self-knowledge – understanding the causes and recognizing the ‘red flags’ that trigger cravings – is the first step on the long road to recovery.