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LOSS OF CONTROL.
OBSSESSION
CONSEQUENCES

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OBSESSION

     CAN THEY STOP USING?  SURE!!  CHEMICALLY DEPENDENT PATIENTS ARE ALWAYS STOPPING.  PEOPLE THAT DON'T HAVE A PROBLEM DO NOT HAVE TO CONTINUOUSLY TRY TO CUT DOWN OR STOP.  PATIENTS THAT HAVE A CONSEQUENCE OF USING SUCH AS "MY GIRLFRIEND (PARENT, SPOUSE, EMPLOYER, CHILDREN, FRIENDS) GOT MAD AT ME BECAUSE I GOT DRUNK AND SAID SOME THINGS THAT I DIDN'T MEAN" AND WHO DO NOT HAVE A PROBLEM ALTER THERE BEHAVIOR I.E. THEY DON'T DO IT AGAIN.

     PATIENTS WITH SUBSTANCE DEPENDENCY (ADDICTION, CHEMICAL DEPENDENCY) ARE RATHER CONSTANTLY AND UNSUCCESSFULLY MAKING EFFORTS TO CONTROL, CUT DOWN, OR STOP THEIR USE OF THE SUBSTANCE.  THIS MAY INCLUDE SWITCHING TO A DIFFERENT SUBSTANCE OR BEGINNING TO HIDE THEIR USE OF THE SUBSTANCE TO GIVE THE IMPRESSION OF CESSATION OF USE. THEY MAY IN FACT STOP FOR A PERIOD OF TIME-A DAY, A WEEK, A MONTH, OR EVEN A YEAR. OFTEN THIS DISCONTINUATION IS ACCOMPANIED BY RESOLUTIONS, A CHANGE IN HEALTH PRACTICES SUCH AS GOING TO THE GYM AND EATING HEALTHY, AND A CONVERSION OR RENEWAL OF SPIRITUAL OR RELIGIOUS PRACTICES I.E." I'M GOING TO START GOING TO CHURCH AGAIN" OR " I ANSWERED THE CALL AND JOINED THE CHURCH".

     ONCE STOPPED HOWEVER THE PATIENT GRADUALLY BEGINS TO THINK ABOUT AND "CRAVE" (A CONSCIOUS OR UNCONSCIOUS NEED OR DESIRE TO USE, A FEELING OF THE NEED TO USE THE SUBSTANCE) THE SUBSTANCE. THIS INCREASES OVER TIME AS THE PATIENT ENCOUNTERS PEOPLE, SITUATIONS, EVENTS, AND MOST IMPORTANTLY FEELINGS THAT WERE PREVIOUSLY MEDICATED WITH SUBSTANCES. HE DEVELOPS IRRITABILITY, DISGRUNTLEMENT, RESTLESSNESS, AND DISCONTENT AT HAVING THESE FEELING OF EMOTIONAL UNCOMFORTABILITY AND NO WAY TO MEDICATE THEM I.E. TAKE THEM AWAY.  THE PATIENT IS BASICALLY THE SAME PERSON THAT HE WAS WHEN HE STOPPED AND HAS NO MORE RESOURCES THAN HE DID BEFORE. HE HAS NO SUPPORT SYSTEM, NO COPING SKILLS, NO BETTER ABILITY TO ASK FOR HELP, AND A SPIRITUAL LIFE THAT AT BEST IS RUNNING ON THE EXUBERANCE OF A NEW FOUND RELATIONSHIP WITH A POWER GREATER THAN HIMSELF. HE IS NOT SIGNIFICANTLY CHANGED FROM THE PERSON THAT HE WAS THOUGH THE PATIENTS DO NOT OFTEN SEE THIS. HE HAS LEARNED NO NEW SKILLS TO CHANGE AND BEGIN TO ALTER BELIEF SYSTEMS AND SUBSEQUENTLY PATTERNS OF BEHAVIOR. HE WILL EVENTUALLY DO WHAT COMES NATURALLY TO HIM.

     THIS EMOTIONAL UNCOMFORTABILITY AND DISCONTENT WITH LIFE INITIATES EVER INCREASING THOUGHTS OF THE SUBSTANCE AND HOW IT WOULD TAKE THESE FEELINGS AWAY.  THE PATIENT BEGINS OBSESSING ABOUT THE SUBSTANCE AND IT GRADUALLY TAKES PRECEDENCE OVER ALL OTHER CONCERNS IN HIS LIFE UNTIL THE POINT WHERE HE CANNOT TOLERATE THE FEELINGS ANY MORE AND HE USES.  PEOPLE WITHOUT A PROBLEM DO NOT HAVE MOST OF THEIR CONSCIOUS THOUGHT AROUND ALCOHOL OR A DRUG.  PEOPLE THAT ARE ADDICTED THINK ABOUT THE SUBSTANCE ALL THE TIME.

     ONCE THE PATIENT USES, HE IS STILL OBSESSED AND THINKS ABOUT HOW TO HIDE THE RELAPSE, HOW TO GET MORE DRUG, HOW TO GET STOPPED AGAIN, AND HOW TO GET OUT OF TROUBLE. AGAIN PATIENTS THAT DO NOT HAVE A PROBLEM DO NOT SPEND SO MUCH TIME THINKING ABOUT A SUBSTANCE.

     THE PATIENTS LIFE IS CENTERED AROUND GETTING, USING, AND RECOVERING FROM THE EFFECTS (OR WITHDRAWAL SYMPTOMS) OF THE SUBSTANCE.

     THIS IS A SUMMATION THEN OF CRITERIA FOUR AND FIVE.