Interview with Addiction Author Lisa Frederiksen

LF: In 2003, one of my loved ones entered a residential treatment program for alcoholism. One of the statements that I had to understand and "prove" to myself was that addiction (alcoholism or drugs) was a disease. The treatment center also had a wonderful family program, and it was through that program that I started to unravel how long I'd been grappling with family members and friends' alcohol misuse (some 40 years). The more I learned, the more questions I had and so I shifted my research focus to "all things alcoholism and codependency," which then expanded to include my own personal therapy with an addictions specialist, participation in a 12-step program for family members and extensive, ongoing research on the underlying risk factors, dual diagnosis, brain development, underage drinking, mental illness and on it goes.  It was wanting to share what I'd learned in order to help other family members and friends of a loved one who drinks too much that lead to my writing If You Loved Me, You'd Stop! and subsequent books.

LF:Most definitely. I repeatedly see the "ah ha" moments and the ever so slight shifting in attitude once someone understands why and how addiction is a brain disease and why and how a loved one's substance misuse behaviors affect the brain and quality of life for their family members and friends, as well. It's really quite remarkable. They can let go of some of the anger, blame, shame and become more open to understanding what needs to be done to "heal" the brain (of all concerned). I also see a shift in the work I do with community coalitions, students, parents, clinicians, law enforcement, military troops and personnel, family law attorneys… that happens when I use this science as the basis from which to construct change (i.e., "changing the conversations").

“An alcoholic/drug addict cannot drink/use any amount, not ever, if they want to successfully treat their disease.”

With alcoholism/drug addiction (vs. alcohol or drug abuse), the brain embeds addiction-related neural networks around the characteristics of the disease, which include: cravings, loss of control, physical dependence and tolerance. A re-wiring the brain – by returning the brain to health – for which the first step is to stop all alcohol (or drugs, if that's the substance of choice) use entirely – is the only “thing” that can alter the “power” of these embedded brain maps. This is because the alcohol or drug – even after months or years of not drinking or using – kick-starts the addiction-related embedded brain maps causing the alcoholic/drug addict to relapse into their disease. An alcoholic / drug addict cannot drink /use any amount, not ever, if they want to successfully treat their disease. For more information about the disease of addiction, check out The Addiction Project produced by HBO in partnership with the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the Robert Wood Johnson Foundation. 

LF: Both abuse and addiction cause chemical and structural changes in the brain — these are what cause people to behave the way the do when they under the influence of drug or alcohol abuse. Again, that's because the brain controls everything we think, feel, say and do. As for addiction, it is different because the brain no longer can function "normally," due to the hijacked, embedded neural networks around the four key characteristics of the disease, which include: cravings, loss of control, physical dependence and tolerance.

LF: I urge them not to worry about the label at first — whether it's alcohol or drug abuse or it's alcoholism or drug addiction, it doesn't matter because its the behaviors that hurt ALL concerned. Instead, learn as much as they can about the way alcohol and drugs work on the body and brain, as well as the brain disease of addiction. Once this understood, family members and friends can make different decisions about how they'll interact with a loved one who's abusing (or addicted to) drugs or alcohol. They'll understand that once the brain is compromised (meaning once the substance misuse starts), there is absolutely no point in trying to talk to or reason with a compromised brain. It's not their "true" loved one, it's their loved one's compromised brain that makes them behave, say and do the things they do while drinking/abusing drugs in order to cover, excuse, hide, use…. BUT, the brain can and does heal — remarkably. The sooner the better, however, for the brain and physical health of all concerned. At that point they can learn more about changing drinking / drug use patterns, in the case of substance abuse, vs addiction treatment, in the case of alcoholism or drug abuse; what the family member can do to help themselves; and what all can do to heal their brains and bodies.