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25 QUESTIONS AND ANSWERS RELATING TO ALCOHOL OR SUBSTANCE ADDICTION

  1. What is the measure of drinking moderately?

Approximately 120 ml wine (roughly one glass of wine) (containing 10-12% alcohol), 355 ml beer (approximately one bottle or one can of beer) (containing 4.5% alcohol) or 30 ml raki/scotch/vodka/gin (approximately a “shot”/half a double of spirits (containing 40% alcohol) are considered one unit (measure) of drink. For men, drinking more 4 units on any day or more than 14 units weekly shows “going over the limit” while for women drinking more than 3 units daily or more than 7 unit weekly is accepted as overdrinking. Usually, defined upper value for men is two measures (units) of drink daily (approximately two glasses of wine, two bottles or cans of beer, two “shots”/one double of spirits [raki/scotch/ vodka/gin]; while for women it is one measure (unit) of drink daily (approximately one glass of wine, one bottle or can of beer, one “shot”/half a double of spirits [raki/scotch/ vodka/gin]. Additionally, it is necessary not to drink at least two days in a week in order for the body to rest.

 

  1. Who are the persons who can achieve to drink moderately?

Those who did not become dysfunctional particularly in terms of working and family life and social responsibilities even though they had some issues due to drinking, those who do not have family members with alcohol issues or addiction, ones who did not experience symptoms of physical deprivation (palpitation, sweating, trembling, insomnia, nausea, vomiting) when they go without alcohol or a sedative drug for a few weeks can be considered as persons who can achieve to drink moderately.

 

  1. How is alcohol addiction (alcoholism) defined?

Using alcohol in greater amounts or for longer times than one desires, being in a struggle to quit using alcohol which yield no result, spending too much time on these, craving for alcohol, therefore not being able to carry out one’s responsibilities relating to work and home, thus keeping on using alcohol in spite of having problems, quitting one’s other significant activities for this reason, using alcohol in situations likely to be dangerous and going on using alcohol despite knowing the problems caused by using alcohol, using increasing amounts of alcohol and experiencing symptoms of deprivation when not used for a while are the symptoms of alcohol addiction. In short, alcohol addiction can be defined as one’s keeping on drinking alcohol even though it disrupts their functionality concerning work and home and their social functionality and although it has caused great problems in other areas.

 

  1. How is substance addiction defined?

While we can speak of drinking moderately when alcohol is in question, there is no such thing as moderate for other substances (marijuana, cocaine, heroin). We call it addiction if one keeps on using these substances.

 

  1. What does physical dependence mean?

If symptoms of deprivation appear when alcohol or drug is not used, it means that physical dependence has developed.

 

  1. What does psychological dependence mean?

Although one does not experience symptoms of physical deprivation when they don’t use alcohol or drugs, if they think that they cannot live, have fun, cope with their problems without using alcohol or drugs and if they are attributing some groundless meanings to alcohol or drug use and thus they are going on using them, it means they have developed psychological dependency.

 

  1. What does deprivation mean?

It is a condition defined by symptoms that appear within a period ranging between a few hours and a few days such as sweating, increase in heart rate and hand trembling, insomnia, nausea and vomiting, visual, tactile and aural hallucinations or illusions and convulsions arising from the substance’s leaving the body after decreasing or quitting use of alcohol. Certain symptoms of deprivations can also be seen after quitting marijuana, amphetamine, cocaine, heroin, morphine, sedative drugs, coffee and cola drinks, cigarette and other tobacco products.

 

  1. Why does one become an alcoholic or drug addict?

There is not a single reason for becoming an alcoholic or a drug addict. It may be caused by human biology (genetics) or various psychological, social and environmental factors and severity of the factors considerably vary from person to person. We can talk about a genetic predisposition related to this. However, it cannot be said that everyone having a family member with alcohol problems will develop alcohol addiction. Here we can only talk about a genetic predisposition. Psychological factors such as depression and anxiety, social factors such as not being (or fearing not being) able to meet expectations or environmental factors such as not knowing another way of having fun or “stringing along one’s friend” also have importance in this respect.

 

 

  1. How can I notice if my child is using drugs?

To have one’s urine screened is the easiest method. However, it should be taken into consideration that some substances cannot be detected in urine. It would be appropriate to consult a psychiatrist in the case that you notice certain significant changes in your child’s behaviors.

 

  1. There are people denying that they are alcoholic or drug addict even though they experience great problems. Why do they not accept they have such a problem and not receive treatment?

Because they try to ignore their problems and they tend to underestimate them or they regard receiving treatment as humiliating.

 

  1. It is said that there are certain phases of making changes in the attitude of drinking alcohol or using drugs. What are these phases?

The following are the phases of change: Pre-planning, planning, preparation, action, maintenance, cession. The phase that the person is experiencing is determined and a treatment method is chosen accordingly.

 

  1. Is there a way to increase the desire for recovering from addiction?

There are ways to increase the desire for healing. Psychotherapy methods developed for this purpose are available (motivational enhancement therapy). The most important thing is to begin and take the first step. “Well begun is half done ” veya “a good beginning is half done”

 

  1. “I want to quit but I can’t because I can’t bear the symptoms I experience in the process of quitting.” What do you recommend?

Symptoms of deprivation can be controlled with medication. Some alcohol and drug addicts continue using alcohol or drugs to relieve the symptoms of deprivation although they want to quit using alcohol or drugs. There are specific therapies for the symptoms of deprivation.

 

  1. Where can one receive addiction treatment?

Outpatient treatment can be administered or one can receive treatment being hospitalized in a general psychiatry hospital. However, the best way is to have treatment at a center that is specialized in this topic (at AMATEM). In our opinion, inpatient treatment is more effective than outpatient treatment in addiction treatments.

 

  1. What kind of treatments are administered in Alcohol and Substance Addiction Treatment Center (AMATEM)?

Treatment centers usually administer drug therapies and provide individual and group therapies and trainings for problem solving and coping skills and trainings for restructuring life to lead a balanced life. For instance, at Boylam Psychiatry Hospital Alcohol and Substance Addiction Treatment Center (AMATEM), Rational Emotive Behavior Therapy, Motivational Enhancement Therapy, Stages-of-Change Group Therapy, Cognitive Behavioral Coping Skills Group Therapy, Problem Solving Therapy, Cue-Exposure Therapy, Nausea/Faradic Aversion Therapy, Dialectical Behavior Therapy, Mindfulness-Based Stress Reduction and SMART Recovery® are used as psychotherapy methods.

 

  1. How long does the treatment take?

Average treatment period is four to eight weeks. However, certain addiction conditions require long-term treatment. Individual who finds even a four-week treatment longer are still recommended to start receiving treatment. As they realize the benefits, they will take pains to complete the process.

 

  1. Do they only deal with the addiction problem in alcohol or substance addiction treatment or do they also deal with other accompanying psychological problems such as depression and anxiety?

Besides addiction problems, other problems which the individual has difficulty in managing such as depression, anxiety, feelings of shame and guilt are addressed as well as developing the individual’s communications and problem solving skills and helping them restructure their lives.

 

  1. Isn’t it possible to enable the person to recover from addiction only by administering medication?

It is not sufficient to merely administer medication. In addition to that, it is necessary for the person to develop the skills of rational thinking, emotion and urge management by means of individual and group therapy methods. There is no magical medication which can be sufficient to eliminate the addiction on its own. Personalized and individualized treatment and therapy methods should be administered.

 

  1. Do they collaborate with the patient’s relatives during the treatment process? Do they guide them regarding what they should do after the treatment? Can an alcoholic or a drug addict be hospitalized against their will? If done so, can they benefit from the treatment?

Being in collaboration with the patient’s family members and relatives has great importance in respect of maintaining the success of the treatment. Therapist and social workers will lend assistance in this respect. The patient having a relative with a sense of responsibility and that person staying strong will influence the treatment process very positively. Pursuant to the article 432 of the Turkish Civil Code, an alcoholic or a drug addict can be hospitalized against their will. (ARTICLE 432.- Any full-grown person who poses danger to society due to any mental disorder, mental defectiveness, alcohol or drug addiction, contagious disease presenting serious danger or vagrancy can detained and be placed into an institution suitable for their treatment, training or rehabilitation in the case that their personal protection cannot be provided in another manner.) For this, one should apply to the domestic Civil Court of Peace and have a decision issued. However, this is not quite a desirable situation. Favorably, it is better that the relevant person wants to recover from addiction on their own accord and puts in effort taking the chance to be hospitalized.

 

  1. Should someone who received treatment for alcohol addiction drink alcohol any longer? Can’t they be a “social drinker”?

Someone who recovered from addiction should admit that they cannot be a “social drinker” anymore. They should find ways to get pleasure out of an alcohol-free life. Therapists will provide “balanced life” training and will lend assistance in this topic.

 

  1. Is the measure of recovering from addiction saying “it’s over in my head”?

The biggest lie told during or after the treatment process is “it’s over in my head”. Even if the problems caused by alcohol or drug use are fully understood, it should be known that the urge to drink may fumble the person from time to time and it is important that one gets equipped with skills to cope with this urge. One can gain these skills only during the therapy process.

 

  1. What does “craving” for using alcohol or drugs mean? How can one cope with it?

“Craving” for using alcohol or drugs means longing for using them very much or having a great desire to use them or feeling oneself forced to use them. One can cope with it by means of methods that they learn during the treatment process.

 

  1. We heard that they attach a “chip” for recovery from addiction. What is that?

There are implant forms of naltrexone, a medication used after in-patient treatment to decrease the desire to drink alcohol or use drugs, and the medication called disulfiram which elicits physical reactions after alcohol use. These are called “chips” colloquially. It is not right to think that the “chip” provides one hundred percent protection. One should participate in follow-up treatment and solidarity groups.

 

  1. If one restarts drinking alcohol or using substances after treatment, does this mean his previous treatments have no benefit at all?

No… You have a big gain during your clean period. Your body will pull itself together to an important extent. However, if you have relapse once, you must go under an efficient treatment process again. Sometimes, a permanent healing comes after several times in AMATEM. An unsuccessful experience does not mean “the end of the world”.

 

  1. Are there any kind of groups that one can participate in after his treatment here ends?

One can participate in Anonymous Alcoholics (AA), Anonymous Narcotics (AN) and Self-Management and Recovery Training (SMART Recovery®) or Arm in Arm Solidarity Group, Turkey version of SMART Recovery®.