Why The Recovery Industry Is Paying More Attention To Dual Diagnoses

By The Fix staff 06/06/18

Addressing addiction means healing the underlying cause of substance use with a gentle approach.

Two women sit on a couch; one is a therapist, treating the other.
Trauma treatment requires a specialized and thorough approach.

For decades, addiction recovery was focused on helping people get clean and stay sober. There was lots of talk of willpower and surrendering, but not much discussion of mental health, past trauma and adverse childhood experiences.

Today, that has changed dramatically, says Hanna LeBaron, the clinical director at Maple Mountain Recovery, a trauma-informed addiction treatment center outside Salt Lake City.

“We all agree there are underlying issues to substance abuse and addiction,” LeBaron says. “We’re actually looking into them now and starting to treat underlying issue.”

LeBaron says that in her 18 years of working in the treatment industry, providers have begun paying more attention to the root cause of addiction. For many people with substance use disorder, that is mental illness. In fact, the National Institute on Drug Abuse estimates that 60 percent of people with substance use disorder also have a diagnosable mental health disorder.

Understanding this can help practitioners treat substance use disorder more effectively, equip people with tools to stay in recovery long term, and help people without addiction empathize with those who are struggling.

“What we’re looking at is this [addictive] behavior as an adaptation,” LeBaron says. “It’s a strategy, a way to cope.”

Understanding the root cause of addiction can also help the person with substance use disorder understand their own actions, LeBaron says.

“A lot of time people who are using don’t understand why they are doing it,” she explains. “When you think about it logically, everybody knows it’s super dangerous to abuse drugs and alcohol. People die from using drugs, alcohol and tobacco even. So why do we put ourselves in danger? It’s because at that moment it gives us relief.”

Once the brain has experienced that feeling of self-medication it is hard to give up.

“The brain quickly learns this is an easy way to cope,” LeBaron says. “At that point, when we get that quick dopamine release, we’re not thinking about the longer term consequences.”

Viewing addiction as a maladaptive coping strategy has changed the way that substance use disorder is treated. Old methods — like tough love and confrontation — are now seen as dangerous, since they can further isolate or harm people who are already vulnerable.

“Those just don’t help because in the end they shame the client more,” LeBaron explains.

Still, many treatment centers don’t understand trauma, which requires a specialized and thorough approach, particularly when it is being treated alongside substance use disorder.

“At Maple Mountain Recovery, we have the understanding and the know-how,” LeBaron says. “We know it is important for our clients to do their trauma work while in treatment in order for them to have long term recovery.”

At Maple Mountain, the program involves treatment professionals taking a more gentle approach. The first step, LeBaron says, is teaching clients healthy coping mechanisms that can replace their use of drugs or alcohol.

“Before we go and deal with the trauma they have to have some ways to cope,” she says. Exercise, meditation and therapy all provide healthy ways for clients to handle the discomfort that they’ll be facing during treatment.

It’s important that these new coping strategies be introduced before more in-depth trauma and mental health work starts, so that the client is able to process their feelings during their recovery.

“They have to have coping skills first and have to learn to relax,” LeBaron explains. “Often, clients have so much toxic stress that their brain isn’t even capable of relaxing: they’re always in fight, flight or freeze. We have to get them out of survival mode by helping them learn to relax.”

In addition, clients need to learn to be able to tolerate positive feelings. Many have spent years completely numbed by drugs and alcohol. Coming out of that, even positive feelings of joy, hope and contentment can be deeply uncomfortable, LeBaron explains. Here again, activities like yoga, time in the sauna or deep meditation can all be helpful.

“These activities may sound luxurious, but there is a reason behind all of them: We’re trying to reset the brain and get the brain to function in a more in normal way,” LeBaron says.

Maple Mountain Recovery is a trauma-informed addiction treatment center in Mapleton, Utah. Learn more about their program at http://www.maplemountainrecovery.com/ and follow them on Facebook.

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