Mindfulness counseling and Addiction
The EMCDDA (European Monitoring Centre of Drugs and Drug Addiction) report shows that all addiction definitions as to do with “the mindset of a repeated strong motivation to do an activity that doesn’t have any survival value, gotten from doing such activity, notwithstanding the harmful consequence or risk involved” (West, 2013). This definition applies to all aspect of addictions such as nicotine dependence, alcohol abuse, compulsive drug, and behavior compulsions that are regarded as addictions like obsessive gambling. From WHO (2014) report, about 5.9 percent of the global deaths (3.3 million annual mortality) resulted from alcohol abuse, and UNODC (2012) gave an estimate of about 27 million people (0.6 percent of population of the world’s adults) misusing drugs, which has led to the death of about 200 thousand people yearly. The impact of addiction and criminality that results from this act is seen in finances, health, societies, and families and this has increased the damage caused by addiction (West, 203). At least 10% of European is said to be linked to a form of addiction or the other with a negative impact on the health (Andlin-Sobocki, Jönsson, Wittchen & Olesen, 2005).
Dependence on the illicit drug is seen as the least common addiction form while tobacco smoking is cited as the most predominant form (Andlin-Sobocki, Jönsson, Wittchen & Olesen, 2005). A total financial cost of about £36.3 billion has been associated with the harms caused by drug and alcohol in the United Kingdom (HM Government, 2012; National Audit Office, 2010). In the United State, the total cost of illegal use of drug (excluding alcohol) has been valued to cost as much as $193 billion, which includes health costs, crime and loss of , and an estimate of about $3 billion spent on direct treatment addicts and a additional $11 billion on other health costs (National Drug Intelligence Center, 2011). Additional social and financial burden has been caused by other addictive acts like gambling and smoking. It is thereby necessary and a prudent act to see that the harmful effect of addiction is reduced.
Several proven treatments for misuse of the drug have been successfully used to treat different drug problems which have given a positive effect on the levels of drug use, offensive behaviours, overdose risks and the spread of diseases (Department of Health, 2007). Once treatment has been done for about a third or a quarter, the patient may get constant abstinence after 2 years (Gossop, Marsden, Stewart & Treacy, 2001), excess of 60 percent is estimated, when there is relapse to substances in just one year of receiving treatment (McLellan, Lewis, O’Brien & Kleber, 2000). For gambling addiction, there is then a rise in this figure (Hodgins, Currie, el-Guebaly & Diskin, 2007).
Opioid Addiction
A vast impact of the addiction and abuse of opiate on the welfare and health of the individual and the societies globally has become an alarming. A hint to the level of an epidemic caused by this was given by the statistics of the National Institute on Drug Abuse which has helped to emphasize the significance of its impacts. The United States is said to be one of the largest consumers of opiates worldwide, which represent a 100 percent of a medication that has hydrocodone called the Vicodin market and 81 percent of an oxycodone painkiller called the Percocet market. Babies born between the year 2000 and 2009 born with neonatal abstinence syndrome (a medical condition that results from the exposure of prenatal opioid) increased by 300 percent. In 2012, above 5 percent of the population of the adults consume opiate for a non-medical purpose. Opiate medications in 2010 were linked to the death of 82.8 percent of the total deaths resulting from an unintended overdose (National Institute on Drug Abuse, 2014).
A part of the brain called the mesolimbic system is activated by opiates, and this is strongly related to reward and conditioned associations. A release of dopamine (a neurotransmitter related to pleasure) is initiated when a person takes opiates and concurrently activates the brain parts connecting surroundings with pleasant feelings. These feelings result to the fortifying triggers for an opiate addiction relapse (Kosten & George, 2002).
A challenging historical endeavor has been made to provide a reliance cure for addictive behaviors. Considering the societal and financial cost, and the harm caused to the individuals and families, it is very important to invest into researches and come up with a more precise and effective treatment to help recovery from all forms of addictive behaviors. The application of mindfulness training is one of the promising interventions to preventing relapse.
“Mindfulness” here is a modern psychological context, which has its origins in meditation practice shown in the literature of Buddhist from about 2000 years ago. “Mindfulness” has now become the normal translation for the ancient word of Indian Pali “Sati,” which is literarily translated as “memory,” but a new interpretation was given to it in Buddhist teaching as the exercise and situation that Bodhi (2011) described as “lucid awareness.” This practice of mindfulness or “Sati” is regarded as “right mindfulness,” in such a way that a practitioner “dwells to contemplate the body in the body, clearly comprehending, passionate, having taken off covetousness and discontent in respect to the world” (Bodhi, 2000). The mode of reacting to body experience is applicable to four different aspects as; “background” of mindfulness; the feelings, phenomena, body, and mind (Bodhi, 2000). The outlined foundation or background of mindfulness in the earlier texts of Buddhist arguably, either implicitly or explicitly, got into modern definitions given in normal settings for clinical symptoms mitigation and health. Jon Kabat-Zinn, who is a key pioneer of the modern, secular mindfulness, offers a usually quoted mindfulness definition in this context as “Paying attention in a particular way: on purpose, in the present moment, and nonjudgmentally" (Kabat-Zinn, 1994). In the ancient description of mindfulness (Sati), and the modern description there are clear sharing of direct contemplation of the minds, feelings, and body with equanimity (Bodhi, 2011).
Jon Kabat-Zinn had initially developed a mindfulness training program in his Mindfulness-Based Stress Reduction (MBSR) course which is said to be a teacher-led program. Its delivery is done to a closed group for more than 8 weeks, normally 2 hours 30 minutes weekly, in addition to one “retreat” day of practice of mindfulness; and a very important aspect of this course in personal daily practice (Blacker, Meleo-Meyer, Kabat-Zinn, & Santorelli, 2009).
The use of oxycodone, heroin and other drugs gotten from morphine results in abnormalities of the brain which are the fundamental cause of dependence on opioid (which is the constant need to keep taking the drug so as not to have withdrawal syndrome) and addiction (which is the intense crave for drug and uncontrolled use). This abnormality that results in dependence as explained by science tends to resolve once it has detoxified, in days or weeks after the use of opioid has been stopped. The abnormalities resulting into addiction are more complex, long-lasting and wide-ranging. They may include influence from the environment, e.g., stress which is the social context for starting use of opioid and psychological situations and a genetic predisposition such as in abnormal brain pathways even before ever taking opioid. Cases as such can lead to craving that results in relapse months or even years long after the person isn’t dependent on the opioid (Smyth, Barry, Keenan, & Ducray, (2010).
The use of pharmacological therapy added to methadone, naltrexone, LAAM (levoalpha-acetylmethadol), or other medications will directly reverse or offsets some of the changes in the brain related to addiction, influencing the behavioral therapies effectiveness. Even though researchers are yet to know all about the way these medications function, it is yet clear that they are very active treatments, instead of simply addictive opioids substitutes (Smyth, Barry, Keenan, & Ducray, (2010).
Several factors (environmental and individual), affects a person that is experimenting with opioid drugs to continue using them for a long time till he becomes addicted to it. The main reason why some individuals are taking opioid drugs is for the purpose of getting intense feelings of pleasure. Any time oxycodone, heroin or other opiate moves from the bloodstreams to the brain, the attached chemicals to the specialized proteins, regarded as mu opioid receptors, on the (brain cell) opiate-sensitive neurons surfaces. These chemicals linkages with the receptors activate the similar biochemical processes in the brain that gives people feelings of pleasure when they do activities sponsoring basic life functions, like sex and eating. Opioids are therapeutically prescribed for a pain reliever, but these reward processes are activated by opioids in the absence of pain, then the result is a motivation for repeated drug use for just pleasure sake (Smyth, Barry, Keenan, & Ducray, (2010).
The midbrain (mesolimbic) reward system is a part of the circuit of the brain that is triggered by opioid. This system gives signals in one of the brain parts referred to as VTA (ventral tegmental area) which leads to the release of DA (chemical dopamine) in the other part of the brain, the NAc (nucleus accumbens). Feeling of pleasure results from the release of DA to the NAc. Other parts of the brain initiate a long lasting memory or record that relates these great feelings with the situations and the areas where they take place. These memories are referred to as conditioned associations, mostly results to high crave for drugs when the individual re-encounter the people, things or places which drive the individual to seek for more drugs regardless of the obstacles (Smyth, Barry, Keenan, & Ducray, (2010).
Specifically in the initial stages of abuse, the reward system of the brain that stimulates opioid is a primary cause of some persons taking drugs repeatedly. Moreover, there is an increase in the compulsion to take opioids over time to go beyond a simple craving for pleasure. This rise in compulsion associated with the dependence and tolerance. Medically, opioid withdrawal is a major factor that drives the opioid addictive and dependence behaviors. To treat a withdrawal patient, it is important to know the way the withdrawal is associated with the adjustment of the brain to opioids (Smyth, Barry, Keenan, & Ducray, (2010).
A protracted relapsing progression has been observed for several years to come into play as a result of addictive disorders (Rounsaville, 1986). Most of the patients are found to prefer treatments based on abstinence, despite the robust proof of the effectiveness of maintenance of methadone in treating dependence on an opiate. An increasing nationally and internationally body of experts are pleading for the availability of these treatments (McKeganey, 2007). As discovered by international studies, most patients take just a month of discharge (Broers, Giner, Dumont & Mino, 2000). The use of heavier heroine, increased criminal justice issues, incomplete treatment and less coping systems were all seen as factors that could envisage early relapse (Gossop, Stewart, Browne & Marsden, 2002). There is an amount of mortality risk associated with relapse that follows treatments based on detoxification because of accidental overdose, mostly for injectors of heroin (Strang et al., 2003). In order to know if there are enough motivations to give in to the requirement of the course, pre-course interviews are mostly employed. Despite an approved limit of quality studies, it is seen from a meta-analysis that in the reduction of large non-clinical and clinical issue MBSR is very effective (Grossman, Niemann, Schmidt, & Walach, 2004).
Collectively, a variety of psychological issues has been found to be effectively treated with the mindfulness-based approach, specifically in cases where it is used to lessen stress, depression or anxiety; they have displayed lower rates of attrition compared to customary cognitive behavioral treatments (Khoury et al., 2013). The effective treatment of mindfulness training in the misuse of substance is now becoming clear (Chiesa & Serretti, 2014). A pilot was carried out by Bowen and her colleagues, RCT (Randomised controlled trial) (N=168; Bowen et al., 2009) and RCT larger scale full (n=286; Bowen et al., 2014) testing MBRP. This deals with the earlier research criticisms into mindfulness-based meditation methods for addictive behaviors that they don’t have randomized controls (Chiesa & Serretti, 2014). MBRP was compared with TAU (treatment as usual) in the pilot study of Bowen and others which contain twelve step support group given for the same four-month time scale. Comprehensive data on the use of drug and alcohol, crave for it, repercussion, and quantity of practice of mindfulness, its acceptance, scores of mindfulness plus sub-factors and response from contributors were also collected. Several measures were put in place for the exploration of mechanism in secondary or follow-up studies. An increase in the levels of mindfulness is seen in the result so also the significant decrease in the carving as given by the PACS (Flannery, Volpicelli, & Pettinati, 1999). A significant decrease was also seen in the illicit use of drug and alcohol consumption.
Online Treatment and Prevention Plans for Addiction
Technology, especially social media is now being used in treatment of mental disorders. Mental health professionals use variety of ways to provide assistance to people with substance abuse disorder (Maheu, et al., 2005). Psychologists have developed online test for diagnosing the mental disorders and provide psychological counseling and therapies (Copeland & Martin, 2004).
Although widely used, during online counseling it becomes difficult to apply therapy without aural, visual and olfactory cues (Fenichel, 2000). While some psychologists argue that diagnosis and treatment is totally impossible without direct contact to the client (Ragusea & VandeCreek, 2003).
Studies showing treatment and prevention successes for substance abuse disorder are very few in number. These studies have shown that effectiveness of online offered therapies that are used to treat addiction is almost same when used face-to-face. Copeland and Martin (2004) found that cognitive behavioral approach, designed to treat drug addiction, helped people to alter their drinking behavior when provided online. However, rate of ethical violation was found to be higher due to limited privacy during online counseling and therapies. Also, the rate of relapse was higher after one year of treatment.
One main reason for the effectiveness of online prevention plans for drug and alcohol use is the access to the undeserved population, especially female population that can only be accessed via the internet and social media (Postel, de Jong, & de Haan, 2005).
According to Ghelert, in counselors’ advocacy efforts social media can also play an important and vital role and also be used for common good. For instance, counselors’ can post to the facebook pages administrated by the legislators prior to any important event (vote) with an explanation demonstrating that why the topic is of substantial importance and why legislators should vote affirmative or negative. Its advantage would be far reached as it will not just only go to someone’s inbox but visible to massive number of peoples who would be looking for such aspects. As 25 percent of people who are interested in online health information surfing on different social media will get awareness through this health information. Gehlert also believes that counselors’ do have a responsibility of sharing authentic and reliable information as addressing any non-reliable information will be fatal for public and thus it is important to spread an accurate understanding of mental health issues (Shallcross, 2011).
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