This Month in Psychopharmacology

Refreshing Perspectives on Recovery: September is National Recovery Month with Dr. Nzinga Harrison

NEI Podcast

Refreshing Perspectives on Recovery: September is National Recovery Month with Dr. Nzinga Harrison

What does it mean to say that someone is in recovery from addiction? What are some behavioral addictions that most people don’t think about? Are there such things as healthy addictions? September is National Recovery Awareness Month. We recently sat down with Dr. Nzinga Harrison, an addiction expert and founder of the In Recovery podcast, in our most recent NEI Podcast episode, “Refreshing Perspectives on Recovery: September is National Recovery Month with Dr. Nzinga Harrison. Here is part of the transcript:

Transcript

NEI: Dr. Harrison, what is your view on addiction and how does it differ from the mainstream way of thinking about it?

DR. HARRISON: Thank you for opening with this question. I would say the way my view of addiction differs from the mainstream, first is that addiction is a chronic medical illness. And I think if you talk to people who practice addiction medicine, or who practice addiction psychiatry, that will be a very commonly known fact, but you just talk to people kind of in the general public who, are not kind of in this space professionally, then often people think of addiction as a series of choices, a series of bad choices, a personality issue. So one of the most common questions I get is like does this person has an addictive personality?

Or a moral failing? And so I think the very first, most important is that addiction is a chronic medical illness. And then, the second part that I'll just emphasize about that it's really that word, chronic, which is like high blood pressure, like diabetes, like asthma. You will hear folks say like, Oh, that person used to be an alcoholic or that person used to quote be an addict.

And the way you really have to think about it is, not in the first place that that person is or was. But that, that person has an illness. So that person has alcoholism or that person has addiction. And also that just because that alcoholism is in remission right now doesn't mean they don't still have it, or just because that addiction is in remission right now, it doesn't mean they don't still have it the same way when your blood sugars controlled doesn't mean you don't have diabetes.

NEI: Right, right. I'd love that. What are your thoughts on the current treatment approaches for addiction? Cause there's quite a lot out there now. What can you tell us about that?

DR. HARRISON: So I could take you down a lifelong rabbit hole on my thoughts about current treatment approaches. So, I'll mention here that I'm co-founder and chief medical officer of Eleanor Health. And at Eleanor Health, one of the biggest things that we're trying to turn on the head is the way we treat people with addiction.

And so, many of the current treatment approaches are quite frankly, punitive and lacking in compassion. And what we know is that. Any animal human beings included when you're hurting, when you're sick, when you're vulnerable, the number one thing you need is compassion. And the number one thing you do not need is judgment and a punitive approach.

And so part of that comes out of how it was answering the first question which was the stigma that we have against people who develop the disease of addiction. And part of it also goes back to my emphasis on that word, chronic. And so many of the current treatment approaches are born out of this, I'll call it, erroneous idea that the only way to get to recovery is through complete and utter abstinence. And if a person is not able to reach complete and utter abstinence, then somehow they are not worthy of receiving treatment for that addiction. And I think the, the other mistake that current treatment approaches are making — so that's the first one is just like complete and utter abstinence or bust — the other mistake is this idea of that treatment is somehow short term. So that goes back to what I was saying about addictions being chronic medical illnesses, which means you have to be working on those illnesses at every phase.

So when you, you know, when your blood sugar is so high, that you have to be in the ICU, the ICU is the right phase of care for that. But when you get discharged from the ICU, nobody discharges you from the hospital without insulin and says, and good luck staying alive. It's not, it's, it's not the way works. And even, even when your blood sugar is like well-controlled and your, you know, your diabetes is firing on all cylinders, like you're A1C is low and your oral medication is stable and your diet and exercise is great. And your stress is low. You are still periodically checking in with your physician to make sure that that diabetes stays in remission.

And so we have to get that same concept for addiction. Like, yes, you may need a five-day detox and that's the appropriate level of care. You're not done. When you get discharged from the hospital. I want everybody to have been talked to about the medications that we have that work, the psychological interventions we have that work, the importance of reducing stress, the importance of relapse prevention.

And even when you're five, eight, 10 years in recovery, you still have to be working on all of those factors that help that substance use disorder getting remission in the first place or else, a relapse will come. And so it's that longitudinal support and compassion and working what I call that magic formula to keep that illness in remission, that I think is missing from many current treatment approaches.

For more on this topic, click on the link for the full podcast episode: Refreshing Perspectives on Recovery: September is National Recovery Month with Dr. Nzinga Harrison

    More Resources:

    >> Dr. Nzinga Harrison’s In Recovery Podcast

    >> Eleanor Health


For more information on treating patients with substance use disorder:

Alcohol Use Disorder: Treatment in the Context of Mental Illness (NEI Members only)
CME credits: 1.25

Addiction/Reward
Cases of Comorbid Substance Use (NEI Members only)
CME credit: 0.75
A Toast to the Treatment of Alcohol Misuse and Abuse (NEI Members only)
CME credits: 0.75