THE ROLE OF ADDICTIONS AND TWELVE STEP PROGRAMS IN ACHIEVING OPTIMAL HEALTH
By Dr. Randy W. Martin, OMD, PhD, LAc, QME
Introduction
Twelve Step Programs are extremely effective for many people in helping to control addictive behaviors. But there are four parts to any recovery program. The reason 12-Step recovery programs work for some people and not for others, is that some people are very strong in one or two of the four areas, but weak in the others. The four components to any recovery program are emotional, spiritual, intellectual and physical. The problem with 12 Step recovery programs is that they are very weak in the area of physical tools for recovery.
The tools and steps of the twelve step programs (TSP’s) focus primarily on the emotional and spiritual areas of the recovery process and to a lesser degree on the intellectual level. But they offer almost no tools for the physical aspects of recovery.
How to pray, meditate, take a personal inventory, connect with others in the form of fellowship, community and sponsorship, inner dialogue and on-going assessment of how one is “working the program”, are the hallmarks of successful recovery.
But on the physical level of recovery, only a few behavioral tools are discussed. “Abstain no matter what”, is a common saying. “Abstinence comes first”, “First things first”, etc., are also common slogans. “Use the phone”. “Call before that first bite or first drink”, are other favorite sayings.
If one is in a substance abuse program, one is warned of the evils of breaking abstinence on that particular substance, whether it is alcohol, drugs or food. And if it is a type of behavior one is trying to abstain from, such as obsessive sexual behaviors, co-dependence, or compulsive spending or gambling, one attempts to get some abstinence from these obsessive-compulsive behaviors by following the steps and using the tools of the program as well.
The program basically only offers a “white knuckle” or behavioral approach to physical abstinence. If you diligently follow the steps and incorporate the tools into your life, the “white knuckle” approach is workable. But often a person is unsuccessful at abstinence, especially at the beginning of the program. In fact, a very large segment of people who try to use the 12-Step Programs drop out at an early stage.
In many cases, people who “fail” at 12-Step Programs are “working” the Steps and using the Tools of the program as diligently as anyone. But these “failures” are due to the fact that they are experiencing more physical imbalances which are controlling them and limiting their recovery and ability to succeed using only this method of recovery.
It is common to judge one’s success in the TSP’s by how long one has achieved abstinence. This is based on the assumption that if one is “working” a strong program, he or she will also be successful at abstinence.
Yet there are many people who have a very strong connection to a “higher power” or God, and who have had a lot of therapy and who really try to work the TSP’s correctly, yet who are failures at permanently abstaining from their obsession or compulsive behavior.
Why is this? Why do some people succeed in TSP’s where others fail? If people are working just as hard at the same program, why do some have an easier time of it than others?
There is a missing link, a hidden dimension, and a mysterious factor, which the TSP’s do not address. What is this missing element?
I believe the missing element is the physical component. Without all four components being addressed, many people are doomed to failure. The program assumes everyone is biologically equal and the that “white knuckle” method will work for everyone.
But some people cannot abstain, and cannot alter their behavior no matter how hard they try, and no matter how good their connection with God, or no matter how well they “turn it over” and work the TSP steps to recovery.
There is also another category of “failure” in the 12-Step Recovery Programs. This is the person who has long-term abstinence and recovery in their program, but is still as obsessive-compulsive as they were before abstinence or sobriety. They have just substituted one compulsion or obsessive behavior for another. Still yet another type of failure in the 12-Step Program is the person who has achieved long-term abstinence or sobriety, and yet is physically not very healthy.
This is because all these people are ignoring the physiological aspects of the addiction process. There is a joke in Overeater’s Anonymous about the mother who keeps telling her overweight child that she doesn’t have an eating problem, it is just that her thyroid is under active. Most people in OA think this is a joke.
The general thinking in the TSP’s is that the program is a complete system and it is all one needs to achieve sobriety or abstinence. This is sad, because there are so many tools that are available and which are very compatible with the program, yet come from other resources outside the program’s twelve steps and traditions.
Most compulsive overeaters (CO’s) hope and pray that their problem is as simple as an under active thyroid gland. This “joke” is actually no joke at all. Most CO’s do have a weak thyroid, just as most alcoholics have liver and other endocrine gland problems, co-dependants have adrenal gland problems and sexaholics have pituitary gland imbalances. Virtually all compulsive and addictive personality types also have serious imbalances in one or more hormones. Additionally, all people with addictions or compulsive behaviors also have imbalances in their brain neurotransmitters.
The purpose of this article is not to downplay the importance of working a strong 12-Step program as a pivotal key to recovery. But I want to fill in the missing link for those people for whom the program is not enough. Those people who most need the information in this article are the following:
First, people who despite well-intended behavior and motives, fail at TSP’s. Second, people who succeed and then slip back into their old behavior. Third, people who succeed but don’t get as far as they would have liked to have gotten in the program. They only achieve their goals in part. And finally, people who succeed at the program, and achieve their program goals, yet are still not in good physical or emotional health, even after two or more years of strong abstinence, sobriety, and recovery.
The common aspect of all these people’s problems may be the same: i.e. a lack of understanding as to the role the body plays in addictions and the addictive process. Understanding addictions and the physiology and anatomy of addictions, can help people in all of these categories to succeed at achieving their goals more effectively and efficiently.
Given the four levels of reality with which an individual must live, it is very possible for the difficulty, or the cause of the addictive behavior, to exist primarily on any or all of these four levels: spiritual, emotional, intellectual and physical.
As I said above, the 12-Step Program is very effective at addressing problems on the first three levels, but if the primary place of imbalance is on the physical level, which it often can be, then the TSP is very weak and will offer very little hope in terms of recovery.
Often if one is successful at working the program, the physical imbalances will take care of themselves over time. The liver will naturally detoxify and regenerate and become healthier if given the opportunity through healthy diet and exercise. Prayer, meditation and visual imagery are also very helpful in this regard.
It is also very important not to take the addiction as the reality. In other words, an addiction is only a symptom of imbalance on a deeper level. The addiction is not the root cause of the problem. The magic of the holistic approach, which takes into account the physical imbalance, is that often in removing the physical imbalance, the addiction is inadvertently cured as well. Patients always have an easier time giving up alcohol, tobacco, sugar, drugs or caffeine if they are being treated using holistic methods.
Oriental Medicine and Addictions
According to the law of five elements in traditional Chinese medicine, each person is born with some weaker and some stronger elements, organs, and meridians. And depending on the particular weakness, it predisposes a person to a particular addiction. So when Western medical research speaks about children of alcoholics having a higher chance of becoming alcoholic because of being born with a particular enzyme in their body, this is something that Chinese medicine agrees with very strongly.
If one’s father was an alcoholic, then that person inherits a liver meridian (or wood element) that is more likely to be a precondition for substance abuse in the child. Similarly, if a parent was obese or underweight, the child has inherited a weak earth element or fire element.
Depending on the particular weakness you are born with, a person can be successfully treated using Chinese herbal formulas and acupuncture to strengthen that particular problem. In strengthening the weak organ and accompanying acupuncture meridian, the predisposition to the addiction will be removed, or at a minimum, it will be significantly reduced.
Endocrinology
Another area where the holistic approach is very effective is in treating weak endocrine glands and hormonal levels in the body. A weakness of any gland in the body can predispose a person to a particular craving and subsequent addiction. This predisposition to imbalance and disease is a key to diagnosis and treatment.
Utilizing blood, saliva, and urine tests and questionnaires, we can quickly and easily determine the weak endocrine glands, which are contributing to addictive behaviors. Using various minerals, glandular supplements, herbs and homeopathic remedies can significantly strengthen these glands. There are also specific exercises that can be recommended to strengthen each particular gland.
But please remember that any holistic program should always be untaken with the advice and supervision of your medical doctor. And never take yourself off of any medications prescribed by your medical doctor, without his or her knowledge. Some people will also do much better with prescription medications rather than Chinese herbal or natural products. This is something I discuss with my patients at their first visit to the office.
Amino Acids
Amino acids are the building blocks of our body. Recent research has shown that a lack of specific amino acids can contribute to emotional stability, or be a root cause of obsessive or addictive behaviors. Supplementing the diet with specific amino acids can reduce cravings or addictive desires.
Example of Recovery from an Eating Disorder
As an example of one patient I treated for an eating disorder I will share the case of Rebecca. She had been overeating and compulsively binging for many years, and came to me with a goal of loosing about 40 pounds.
The first step for her was to bring in her blood test results and to take the saliva and urine tests to assess her neurotransmitter levels. The results of the two tests showed that she was very low in mineral/electrolyte levels and in her assimilation of protein. Late at night, when she was binging, her excitory neurotransmitters were much too high. This explained her need to sedate herself with carbohydrates.
I put her on a regimen of Chinese herbs and supplements to balance her serotonin and relax/turn off her brain, so that she could more easily unwind at night. We also used a homeopathic remedy to control her sugar and chocolate cravings. The remedy was called Sepia. This homeopathic remedy is a “cousin” to Natrum mur, and Natrum mur is a great remedy for water retention. Both remedies are great for ailments which began with sadness, loss or grief. And she had mentioned to me at her first appointment, that she began to overeat when she lost her mom many years ago.
Acupuncture helped her to control her cravings by balancing her nervous system, and to strengthen her Spleen meridian. She also started on an herbal Chinese tea designed to burn fat each time she ate a meal.
After two months, she had lost most of her weight and was put on a maintainance program. She also continued her 12-Step Program of Overeaters Anonymous. Her subsequent blood and neurotransmitter tests showed vast improvement.
Recovery of an Alcoholic
Gene had been attending Alcoholics Anonymous meetings for about five years, and his cravings for alcohol had disappeared after about he first two years of sobriety. But he still felt out-of-control and was in danger of loosing his wife due to his frequent outbursts of anger.
This is fairly typical, because alcohol creates what we Chinese medical doctors call Stagnant Liver Chi, or Toxic Liver Syndrome.
When I performed blood tests, his liver enzymes were on the high side, so we started him on a program of Liver Detoxification, using herbs, teas and acupuncture. In addition, he was put on a homeopathic remedy call Lycopodium. Lycopodium is a great homeopathic remedy for the liver and kidneys. It has a keynote symptom of anger expressed at those loved best, although at work or with friends, he or she may appear to be very sweet and communicative.
After about 6 weeks of treatment his wife reported he had become more gentle, and was willing to start couples therapy. About a year latter, I saw him for lower back pain, and he said his marriage had been completely transformed and that he had never been happier.
This is a great example of how homeopathy and Chinese medicine can help someone with an addiction, even many years after they have stopped using the particular substance they were once addicted to.
Recovery from Smoking Cigarettes
I have been told by many of my patients that to stop cigarettes is the hardest addiction to break. They have all also told me that of the many different methods they have tried to stop smoking, that using acupuncture, Chinese herbs, and homeopathy, was the easiest time they ever had.
My program uses detoxification herbs, relaxation herbs, amino acids designed to increase serotonin levels in the brain, and acupuncture to relax and create a post-exercise feeling of relaxation or “high.”
I have been told by many ex-smokers, that acupuncture works quite well to help them get over their cravings. The entire process usually takes about 6 weeks, and most people have stopped smoking completely by week three.
The homeopathic remedy Tabaccum works great for many people to decrease their cravings, and eliminate toxins in the lungs. For others, I might use Rescue Remedy, Magnesium phos for relaxation or Kali phos for the nervous system. Still others require a more individualized approach to homeopathy, called “Classical” or “Constitutional” homeopathy. Bottom Line: There is simply no single treatment that is right for everybody.
Summary and Conculsions
“This stuff really works,” is most often the remark people make after they are on their supplements and acupuncture for a week or more. “Yes, it does,” is my response. Though I have been in private practice since 1983, I am still astounded and amazed at the magic produced by a good diet, a nice relaxing acupuncture treatment, and the correct homeopathic remedy.