On December 9, 2014, the Journal of Addiction Medicine released the results of a study that indicated that months of abstinence from prescription painkillers resulted in a reduction of cravings for painkillers.
For the results of this study, visit the science daily site.
In this study, the researchers tested subjects by showing them pictures of painkillers. Those patients who had just a few weeks of abstinence still experienced heightened responses to the pictures. However, the patients who had a few months of abstinence experienced a decreased response to the pictures. This raises important questions about the necessary role of abstinence in recovery. It also points to a particular practice used at the Kiloby Center called “triggering.” This practice is rarely used by other substance abuse centers. Triggering is the process of showing clients pictures of their drug of choice for the purpose of triggering the addictive response so that it can be dissolved and dismantled with the Living Inquiries and other techniques employed by the Center. The researchers used pictures of painkillers in this study merely to test the subjects responses. This is a method of assessment rather than a treatment method itself. At the Center, we use pictures not only to test or assess responses but also to actively help clients recover from the addiction itself. Although this study points to abstinence as the main reason for the decreased addictive response to these pictures, the study begs these questions, “Why only abstinence?” “Why not use these pictures as an active way to dismantle addiction itself rather than just a way of assessing patients?”
Here’s how triggering works at our Center:
Our brains remember the pleasure and stress response of our drugs of choice through pictures, memories and words. Everyone who is addicted experiences this regularly. Driving by a liquor store, walking by a drug dealer’s house or browsing through the shelves of a pharmacy can be highly triggering for someone addicted to substances. Our senses gather information about our surroundings very quickly while our brain simultaneously produces memories that engage the craving for the substance. In daily life, we are inundated with environmental cues that produce these responses by our brains.
When someone comes to the Center for addiction, we don’t want to protect them from these environmental cues because at some point they have to leave our program and go back into the real world, where all of the environmental cues are waiting to trigger the addictive response. During a client’s participation with us, we show them pictures and induce mental images of their drug of choice for the purpose of dismantling and dissolving the mind and body response that makes them crave the drug. This is highly effective in literally changing the brain chemistry that lies behind the whole movement of addiction.
Showing clients these pictures is obviously a great way to assess their addictive response, as the researchers in this study indicate. However, these pictures can be used for treatment itself through the employment of this technique called triggering. The Living Inquiries and other methods used at the Center are designed to un-fuse the memories associated with addiction from the bodily response of craving and stress that arise along with the memories. We call this “undoing the Velcro Effect“. And it can only be done by triggering the addictive response through pictures and other environmental cues. We sometimes even take our clients on field trips to the liquor store, the grocery store and other places where the triggered response will arise, so that we can dismantle it. This prepares clients for their return home after working in our program.
To understand fully the value of triggering, consider this question: When you leave a treatment center, would you rather try and hide from all the environmental cues (which are everywhere) in hopes that you won’t be triggered or would you rather feel free of the addictive trigger even in the face of these environmental cues? Most of our clients believe that the latter is more favorable. Freedom is not freedom if it involves having to hide from everything that might be a trigger. Freedom is being free of the addictive response no matter where you go and what you experience. Because of the high rate of relapse in addiction and the prevalence of sickness and death as a result of addiction, we believe at the Center that preparing clients more fully for life-after-treatment is not only a great practice, but it may just save their lives.