Audio Journal

Episode 15 - The Gift of Knowledge

The holidays can be a dreaded time of the year if someone you love is suffering or has lost their battle with the disease of addiction.  This will be my second Christmas without my daughter Laura who struggled for 15 years with addiction but lost her life to overdose on December 21, 2017, right before the holidays. 

It's hard to think about gift giving during this time of year, because the holidays may be filled with regret, grief, or stress.   This Audio Journal focuses on gifts, not for others on your list, but those that you should give to yourself.  Today's episode is devoted to the gift of knowledge.

I've talked to countless parents and family members who are struggling to make sense of their loved one's substance misuse, crazy behavior, and personality change.  We often mistake addiction as a moral failing or a series of bad choices, failing to recognize that addiction is a chronic complex brain disease.  Now, let's figure out how to unwrap the gift of knowledge so you are more prepared to deal with it.

Start with understanding the science behind addiction.  Addiction is a brain disease and there is a scientific underpinning about how it manifests itself and progresses.  Let me take another brain disease that millions of us know about as an analogy, Alzheimer's. There is a scientific and physical reason that people's memories disappear.  It has to do with plaque coating the transmitters in the brain that allow one to process and act on information.   Once there is enough plaque build-up, signals can't get through and memory fails.  People that have Alzheimer's are not being difficult or frustrating' their brain is misfiring.

The human brain is wired to reward us when we do something pleasurable. Exercising, eating, and other pleasurable behaviors directly linked to our health and survival trigger the release of a neurotransmitter called dopamine that makes us feel good and encourages us to keep doing what we're doing.  But the brain can also be rewired in harmful ways when it's exposed to drugs. When someone takes a drug, their brain releases extreme amounts of dopamine causing the brain to overreact, reducing dopamine production in an attempt to normalize these sudden, sky-high levels the drugs have created. And this is how the cycle of addiction begins because the individual will seek those substances to get that dopamine rush.

So that's part of the science of addiction.  It's the brain's rewiring to overproduce dopamine levels that rise and crash, causing the person to seek more of the substance to level themselves out. 

You next level of knowledge should be around the condition itself.  Addiction is not an acute disease that can be treated quickly and cured.  It's a chronic condition that will last a lifetime and requires on-going maintenance and management.  When you treat diabetes, you can't take insulin just once, feel better right away, then stop. You have to manage yourself with medication, diet and lifestyle change over a lifetime.  The same is true of addiction.

People go to rehab to treat the acute symptoms and get stabilized.  They come out looking healthy, but it's a mistake to believe that because their acute symptoms have been dealt with the person is cured.   Without the proper long-term plan, the chances are 85% that they will return to substance misuse in less than a year following rehab.  It's important to know the difference in the characteristics of an acute vs. a chronic disease so you know that you must play the long game.

That brings us to the next knowledge gift which is know how to manage the disease long-term.  This is the most complex part of the equation and requires the most knowledge and research.  It's important that you understand that the recovery and disease management process have many components.  First, there is a need for structure and accountability.  Because addiction has impacted the logic center of the brain, making the smallest decisions on what to do and where to go may be difficult for an addict, so the more help in this area the better.

Then, there is a need for connections.  Addicts need to connect with treatment professionals, connect with each other for support, and connect with family.  The more people that are in the equation, the better the recovery process.  Next, there is the need to maintain a healthy lifestyle.  This involves a good diet, exercise, stress reduction, anxiety management and a commitment to health and wellness.

For some people, medication is helpful, something we call Medication Assisted Therapy or MAT.  This has to be a careful decision because some medications, as with my daughter Laura who used Suboxone, can be misused and counterproductive to recovery.

The bottom line is that having the knowledge of how to manage the disease long-term empowers you to make the right decisions to support yourself or your addicted loved one.

And the final gift you need to unwrap is the knowledge of how you fit into the process.  The family's understanding, support, and role in the recovery process is critical to the long-term health of the person that is addicted.  It starts with understanding that this is a disease, not a moral failing so the addict doesn't feel more shame and guilt than he or she already does.  It then falls to what you can do to help treat the disease vs make it worse. 

If you have a diabetic in your family, you don't feed them cake.  It's important to know what you should do and what you should avoid to help keep your loved one healthy.  The first "to do" on the list is to set expectations and boundaries so the person knows what to expect from you.  The next is to understand the warning signs that your loved one is being triggered to return to substance use coupled with an understanding of how to have that conversation and what they are willing to do to let you help them.  There are many more elements that go on this list, so it's important to understand the "do's and don'ts" of your role in the recovery process.


Knowledge is a powerful gift and with the disease of addiction, it's critical.  You have to understand the science behind the disease, the characteristics of the condition, how to manage it as a chronic disease and your role in keeping the person you love healthy.   It's said that knowledge is power and with the disease of addiction, empower yourself to understand it so you can manage it on behalf of yourself and your loved ones.