Recently, we interviewed Lisa Frederiksen, author of Breaking the Cycles, a blog started to "change the conversations" about drugs and alcohol and their treatment. We asked her to share some her insights with us, which is what follows.
AllTreatment: Tell us a bit about yourself and what you do.
Lisa Frederiksen: I am a researcher, writer, keynote speaker, consultant, and most recently the author of my ninth book, Crossing the Line From Alcohol Use to Abuse to Dependence, which will be published as an ebook in April to coincide with April a Alcohol Awareness Month. I've also written two other substance misuse-related books, If You Loved Me, You’d Stop! and Loved One In Treatment? Now What!, and write the blog, BreakingTheCycles.com.
I have explored a wide-range of topics over the course of my writing and speaking career, including: civil and women’s rights issues, results-oriented workplace initiatives, women’s history month celebrations, and the late 20th and 21st century brain and addiction-related research. Sometimes it's felt too scattered, but the driving force in all of it is my desire to really understand the various aspects of an issue or problem that has either directly affected my life or has had significant ramifications on public policy decisions because of society’s limited understanding of the overall picture.
I am a big supporter of understanding the history or the science of an issue. So it generally starts with my conducting considerable research on a subject to find the “narrative,” and from there, the additional questions that if answered would help make sense of the current issue. Once I start digging, I’m usually hooked — researching, writing, and rewriting until I understand the issue or problem and know that I have the most current information and qualified sources. Then I like to share what I’ve learned in easy-to-understand books, articles, consulting work and/or PowerPoint presentations.
Today my work focuses in the research areas of brain development, addiction, mental illness, substance abuse and the impacts on family members and friends. For fun — I like to scuba dive, hike, travel, go dancing and enjoy time with my daughters, family & friends.
AT: How did you become interested in drug abuse and addiction?
LF: In 2003, one of my loved ones entered a residential treatment program for alcoholism. One of the statements that I had to understand and "prove" to myself was that addiction (alcoholism or drugs) was a disease. The treatment center also had a wonderful family program, and it was through that program that I started to unravel how long I'd been grappling with family members and friends' alcohol misuse (some 40 years). The more I learned, the more questions I had and so I shifted my research focus to "all things alcoholism and codependency," which then expanded to include my own personal therapy with an addictions specialist, participation in a 12-step program for family members and extensive, ongoing research on the underlying risk factors, dual diagnosis, brain development, underage drinking, mental illness and on it goes. It was wanting to share what I'd learned in order to help other family members and friends of a loved one who drinks too much that lead to my writing If You Loved Me, You'd Stop! and subsequent books.
AT:Your website states that its goal is to “change the conversations” about drug misuse and addiction. What do you see as some current misconceptions about these issues?
LF: That addiction is not a disease, that it's simply a lack of willpower.
That underage drinking or drug use is "no big deal" something "all kids go through."
That an alcoholic/drug addict has to "hit bottom."
That there is nothing a family member or close friend can do.
That a loved one's drinking does not impact the family member or close friend — that once the drinking or drug use is stopped, they'll be fine, too.
That you must stop the drinking or drug use and then treat the mental illness (in the case of a dual diagnosis).
That people are born alcoholics; it's "in their blood."
That a 28-day rehab program should do it and that a relapse is because the person just didn't want it badly enough.
AT: Are you hopeful about the near future as more is known about the science of addictions?
LF:Most definitely. I repeatedly see the "ah ha" moments and the ever so slight shifting in attitude once someone understands why and how addiction is a brain disease and why and how a loved one's substance misuse behaviors affect the brain and quality of life for their family members and friends, as well. It's really quite remarkable. They can let go of some of the anger, blame, shame and become more open to understanding what needs to be done to "heal" the brain (of all concerned). I also see a shift in the work I do with community coalitions, students, parents, clinicians, law enforcement, military troops and personnel, family law attorneys… that happens when I use this science as the basis from which to construct change (i.e., "changing the conversations").
“An alcoholic/drug addict cannot drink/use any amount, not ever, if they want to successfully treat their disease.”
AT: How is an addiction a disease?
LF: By its simplest definition, a disease is something that changes cells in a negative way. All diseases – cancer, diabetes, heart disease, HIV-Aids, to name a few – affect some type of cell in our bodies. This is because every organ inside our bodies (heart, brain, liver, eye, kidney, lung, stomach) is made up of cells. Some diseases affect many organs. Some affect one or two. Alcoholism/drug addiction affects cells in many organs, but of particular concern is its effect on cells in the brain. This is because the brain controls everything we think, feel, say and do, and its drugs/alcohol's affect on the brain that changes the way a person thinks, feels and behaves. According to NIDA, NIAAA and many other prominent agencies and organizations, alcoholism/drug addiction is a chronic, often relapsing brain disease.
How is alcoholism (drug addiction) a brain disease? The chemical and structural changes in brain cells and neural networks brought about by substance abuse, coupled with the brain cell and neural network changes brought about by the five key risk factors for developing the disease (genetics, social environment, childhood trauma, mental illness and early use), cause the disease of alcoholism/drug addiction to actually change brain functioning.
With alcoholism/drug addiction (vs. alcohol or drug abuse), the brain embeds addiction-related neural networks around the characteristics of the disease, which include: cravings, loss of control, physical dependence and tolerance. A re-wiring the brain – by returning the brain to health – for which the first step is to stop all alcohol (or drugs, if that's the substance of choice) use entirely – is the only “thing” that can alter the “power” of these embedded brain maps. This is because the alcohol or drug – even after months or years of not drinking or using – kick-starts the addiction-related embedded brain maps causing the alcoholic/drug addict to relapse into their disease. An alcoholic / drug addict cannot drink /use any amount, not ever, if they want to successfully treat their disease. For more information about the disease of addiction, check out The Addiction Project produced by HBO in partnership with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the Robert Wood Johnson Foundation.
AT: What distinctions do you make between abuse or misuse of drugs and alcohol versus being addicted to them?
LF: Both abuse and addiction cause chemical and structural changes in the brain — these are what cause people to behave the way the do when they under the influence of drug or alcohol abuse. Again, that's because the brain controls everything we think, feel, say and do. As for addiction, it is different because the brain no longer can function "normally," due to the hijacked, embedded neural networks around the four key characteristics of the disease, which include: cravings, loss of control, physical dependence and tolerance.
AT:What advice can you offer those struggling with misuse or addiction, and what can their loved ones do to help?
LF: I urge them not to worry about the label at first — whether it's alcohol or drug abuse or it's alcoholism or drug addiction, it doesn't matter because its the behaviors that hurt ALL concerned. Instead, learn as much as they can about the way alcohol and drugs work on the body and brain, as well as the brain disease of addiction. Once this understood, family members and friends can make different decisions about how they'll interact with a loved one who's abusing (or addicted to) drugs or alcohol. They'll understand that once the brain is compromised (meaning once the substance misuse starts), there is absolutely no point in trying to talk to or reason with a compromised brain. It's not their "true" loved one, it's their loved one's compromised brain that makes them behave, say and do the things they do while drinking/abusing drugs in order to cover, excuse, hide, use…. BUT, the brain can and does heal — remarkably. The sooner the better, however, for the brain and physical health of all concerned. At that point they can learn more about changing drinking / drug use patterns, in the case of substance abuse, vs addiction treatment, in the case of alcoholism or drug abuse; what the family member can do to help themselves; and what all can do to heal their brains and bodies.
Thank you for your insights, Lisa! If you would like to know more about how you can change the conversations on drugs and alcohol, please check out her blog.