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Addiction is a multifaceted illness with physical, mental, social and spiritual components that lead to grave consequences if untreated. Addiction is a pathological relationship to a substance. The pathology is in the compulsive, repetitive and obsessive features that lead to the creation and maintenance of a destructive relationship with the drug.

The most utilized substance abuse treatment approach in the United States is the medical model that characterizes addiction as a disease and requires total abstinence from addictive substance(s). Achieving abstinence is a delicate process and for some individuals it requires medical intervention. Few people realize that withdrawal from alcohol for some alcoholics can be fatal. Therefore, medical detoxification is necessary to ensure the safety of the patient.

Many alcoholics begin abstinence without medical assistance. However, the early stages of recovery from addiction require careful regulation of basic physical needs. For example, a person in recovery should guard against missing meals because it leads to a state of low blood sugar. For many recovering individuals, a low blood sugar is a trigger for relapse. Lack of sleep is another trigger for relapse. Equally important is the necessity to take all medications as prescribed by a physician. It is crucial that a recovering person consult with their physician when problems arise rather than resorting to self medication or medical advice from family and friends. Recovery is a delicate process that requires a careful coordination of effort between the recovering individual and the professionals in his life.

Themental and emotionalcomponents of addiction are also targeted in treatment. Addressing maladaptive belief systems, thought processes and behaviors is complementary to regulating physical needs. The most complex psychological symptom of addiction is denial of the problem despite glaring evidence. For many addicts, denial is supported by many erroneous beliefs and thoughts that lead to self defeating behaviors. Addiction treatment is a means by which beliefs and therefore behaviors can change. Together the recovering individual and his clinician draw the blueprint for a new path in life that excludes the use of alcohol and drugs.

The social component of addiction is equally important to the physical and the mental/emotional. The substance of use becomes central in the lcoholic’s or addict’s life such that he or she loses touch with self and other. A disconnection and isolation emerges for the addict through his obsessive relationship with alcohol and drugs. The reconnection back to self and others is an extremely important factor in promoting recovery. The proliferation of 12 step programs is evidence to the importance of this key component to recovery.

Finally, spiritualhealth is necessary for the maintenance of recovery on a day to day basis. This area of an individual’s life relates to existential quandaries that are part of the human condition. Spiritual health in this sense means coming to terms with life as it is and not as one wishes it to be. It is about learning to distinguish between circumstances that call for surrender and circumstances that require an action to change things. With addiction, spirituality is about knowing that surrender is necessary for recovery to begin. The admission of defeat by the alcoholic or addict is a radical change in thought processes. With the act of surrender, one opens up to new ways of coping with life.

Arpi Hovaguimian, LCSW is the Executive Director of the Alcohol & Drug Council. The Sober Talk column is published in The Ithaca Journal on the first Thursday of each month.