Drug Addiction

Drug Addiction

An Overview of Disease Concept

Addiction can be of any kind, chemical or non-chemical. As far as chemical addiction is concerned, which involves the use of psychoactive substances, it can have a profound effect not only on a person’s health but on his life in general. It’s a chronic, relapsing ‘brain disease’ that is characterized by compulsive use of and searching of an addictive substance despite knowledge about its damaging consequences.  It is considered as chronic-disease because the brain shows distinct changes after substance use that can persist long after the use of that substance has been stopped. Unfortunately, it cannot be cured, but it can be managed with pharmacotherapy and counseling interventions.

Psychoactive substance use continues to be a global problem. With reference to a survey report presented in 2012 by Office of United Nations dealing with Drugs and Crime—UNODC, it was documented that 162-324 million people between ages 15 and 64 used illicit substances at least once in the previous year. A significant number of people who use psychoactive substances develop Substance Use Disorders.

People start using psychoactive substances for a variety of reasons, which includes; curiosity because friends are doing it, to feel good, to celebrate, to feel better and to do better. Moreover, some people use the substance to lessen the feelings of depression, stress or physical pain while others utilize it to enhance attention, to experience spiky, or to achieve the superior athletic feat. No matter what a person’s motive is to start a drug, no individual ever plans to become addicted! People who use psychoactive drugs generally start for the sake of trying one time. Every person who has a substance use disorder starts out as a rare consumption which initially appears as a voluntary act and a controllable decision. As time passes and the use continues, a person can go from voluntary use to compulsive use.

There are four main types or classes of drugs; stimulants, opioids, depressants, and hallucinogens. These substances are based on the substance’s primary effects on CNS. Stimulants like cocaine, amphetamine, nicotine, and caffeine increase the activity of the CNS. They tend to increase heart rate and breathing and offer a sense of euphoria. Opioids e.g.  Heroin, Opium, Demerol, selectively depress the CNS, these analgesics reduce pain and tend to induce sleep. Depressants e.g. Alcohol, Barbiturates, Benzodiazepines, decrease the activity of the CNS, they tend to decrease the heart rate and breathing and offer a relaxed, sometimes sleepy, sense of well-being or euphoria. Hallucinogens like Ecstasy, Mushrooms, and LSD produce a spectrum of vivid sensory distortions and markedly cause changes in mood, temper and thought patterns. The above-mentioned classification has been provided for a general guideline, not all drugs fit neatly into four classes, for example, Cannabis and inhalants don’t fit into any of these four classes.

Moreover, studies have demonstrated that women are more sensitive to the consumption and long-term effects of drugs that are men. For example, women who drink are at greater risk than men for developing cirrhosis and other medical problems.

In a nutshell, addiction is both an individual and a family disease. When one of the family members has an addiction problem, the whole family suffers. The social stigma associated with addiction leaves the person and his family nowhere.


Written By:

Rabia Ejaz

Clinical Psychologist,

Neuropsychology Center Pakistan


Edited By:

Mehwish Mursaleen

Senior Clinical Psychologist


What To Expect When You Start Therapy?

What To Expect When You Start Therapy?

Therapy is a term most people are either unfamiliar with or assign wrong meaning to. I am here today to clear some misconceptions people have when they approach a therapist or think about starting therapy.

First, I will like to talk about the stigma attached to it. Therapy is a process through which you heal and it is not something to be ashamed of. When you fall ill, you take medicine. If you have a fever you don’t hear people say “don’t go to the doctor, what will the society say?” and even if you do hear them, does that stop you from getting the treatment you need? Or if a loved one is ill, do you stop their treatment based on how people will react once they get to know that you went to the doctor for it? No, you don’t do that because doing this is in no way helpful for you or your loved one. Similarly, mental disorders or psychological issues are a problem you are going through. Hear me clearly please, it’s a problem YOU are GOING THROUGH. YOU are not the problem, rather you are GOING THROUGH. Please remind yourself or anyone you know who is going through something.

So basically, therapy is a type of treatment that you need to resolve that problem. Let’s focus on two questions first;

  • Why do I need medication?
  • Why do I need therapy?

You need medication because in some psychological disorders therapy alone doesn’t work. Psychological stress is a real thing and it can and it does alter the chemical balance of our brain. When that happens, the first step is always to restore that balance. And that is why we need medication. Simply take the example of blood pressure. When someone is suffering from chronic high blood pressure, changing their lifestyle or diet is not going to help them immediately. What they need at that time is medication, to control the blood pressure. And once it’s under control that when the doctors tell them to manage their diet, have a healthy lifestyle etc.

That’s why therapy is also important. Therapy is a process that involves you realizing your problem, you realize the changes that need to happen and you implement those changes. One might ask, then why do we need a therapist when all the work is based on us? And that’s a good question. A therapist is fully educated and trained on how to help you realize all these steps. Most of the time people come to therapy based on some basic issues like anger, communication difficulty or stress. However, over the course of therapy, they become aware of what exactly is the root cause of these issues and then they along with their therapist discuss strategies and techniques to resolve those root cause issues. That’s why you need therapy, so you can actually resolve and change. Your therapist will listen to all your thoughts, they will help you realize your difficulties and help you on the way to recovery. Therapy is a safe zone, secure and without any judgment. All your details are confidential. It’s a binding pact with your therapist

Disclaimer: Your therapist is not going to act like a friend or a caregiver. They are there to treat you and heal you. They are not there to judge you. They are not there to gossip with you. They are professionals, your doctors.

Most of the time people start therapy with the idea that it’s going to be about them sharing and their therapist will help them by listening. Well, that just one part of the whole process. Therapy is about slowly and gradually removing all the layers of your personality. You will come to face yourself in a secure environment. I don’t want to sound scary because that’s not really my purpose here. What I want is to let people know that after the sharing part, comes another phase; a phase where you actually have to put in the effort to change. Think of it this way, you travel through specific routes to reach a certain destination, right? How do you expect to change your destination if you never change the route? So yes, in order to take help and get better, you need to put in the real effort to change as well. Change your unhealthy route to a healthier one and reach a better destination.

The change part is tough and needs constant motivation but you can do it. As humans, adapting to change is in our nature. But sometimes, it becomes a struggle. And it requires patience. You cannot expect to change after a week or two. No, it took ages for you to develop some unhealthy habit. You cannot expect to change it in a minute. Be patient with yourself and the process. Motivation and patience are two really important rules in therapy. Always remember that everyone has their own pace. Just because someone did something in half the time, doesn’t make them superior. Take your time but remember to put effort, even the slightest effort counts.

Another important thing is your outlook on your own self. When things are constantly going wrong and your issues are not getting resolved, it’s very easy to come up with a perception of yourself which isn’t that good. As a client, people tend to slide into the “victim” role. They keep on dwelling on the “why did this happen with me?” part. See, this is a spiraling trap. One in which we all fall from time to time, but if you become comfortable here, that’s when the problem starts. Because if you keep thinking that “why this happened or that happened?” or “why bad things only happen to me?” then you are portraying yourself as a victim who lacks control over themselves. This is very far from the truth. You are the only part of your life which you can actually control. You can’t control your situation; you can’t control your family or friends or work life. But you control your own self. Your reactions, your behaviors, your thoughts, and your own well-being, that is all up to you. Another important part of therapy is to realize this control.

Disclaimer (Part Two): if you are someone who has become very comfortable in the victim role, this part will not only be hard to absorb but also hard to work on as well.

Because it’s relatively easy to say that I am helpless and people need to do this and that for me. It’s easier to say that I have no control than to actually start taking responsibility for yourself.

Therapy is a whole process that will help you and heal you for the better. It’s not life won’t have problems once you are done with therapy or there won’t be challenges. But you’ll be stronger mentally and emotionally to deal with all the difficulties in a way that doesn’t leave you reeling but rather makes you look forward to things in life. It’s a treatment like any other treatment for any other medical issue that someone might take. The stigma that people have attached to it makes people not want to take it. But you need to realize that mental health is important and so so so crucial for spending and living a happy, healthy, satisfied life. Your mental well-being or your any of your family member’s well-being is more important than people’s point of view.  Sometimes, we are not even aware of this stigma but trust me it’s those little thoughts like “I don’t need therapy”, “it’s not that serious a problem” and “I can handle this on my own” that show that yes there actually is an issue and yes you are actually stopping yourself from taking treatment due to stigma. I am pointing this out because the stigma is a very real and very huge deal. And it’s not easy to stand up to it, but please put yourself and your family above the opinions of the society or your own fears. Take the proper consultation before the problem gets bigger.

I really hope that this article cleared up some misconceptions about therapy. If there are any other questions, please let me know.

Written By:
Munazzah Mansoor
Clinical Psychologist
Ph.D. Fellow


Treatment approaches aimed at healing psychological problems

Treatment approaches aimed at healing psychological problems

The term “psychological problem” is defined as any kind of mental state in which person feels distressed or disturbed. The psycho-social functioning of the person gets affected such as academics and job performance is not up to the mark, the friendships, social contacts, and family relationships become troublesome and person’s daily life is messed up. This upsetting condition last for longer durations let’s say more than a week or a month. There are different kinds of psychological problems for example depressive state is associated with mood, anxiety relates with worries, adjustment issues are related with long-lasting stress and psychotic disorders are a kind of perceptual disturbance in which person has extrasensory experiences e.g. hearing unusual voices or seeing weird things which others can’t experience.

A variety of psychological treatments is now available for the management of psychological disorders. Behavioural therapy, psychodynamic approach, client-centered treatment, and cognitive behavioural therapy are some of the treatment options one can avail from a psychologist. Among this variety of treatments, cognitive behavioural therapy is proved to be the best treatment for most of the psychological disorders.

Recent researches by clinical psychologists suggest the effectiveness of cognitive behaviour therapy in a long run. Cognitive behavioural treatment in some cases is supposed to be more effective than pharmacological treatments. For example, a study conducted by clinical psychologist Mehwish Mursaleen along with Dr Uzma Ali associate professor at Institute of Clinical Psychology, University of Karachi shows the effectiveness of cognitive behavioural treatment for quick recovery of Panic Disorder with Agoraphobia. They had a client with severe symptoms of anxiety and panic. The client was unable to move out of home due to the fear of sudden anxiety attacks. Her life was limited to the bedroom and she even feared to drive or travel a car. She had not travelled through plane for a long time. The client had three to five panic attacks per day. She had constant nausea and anxiety. With increasing severity of the panic disorder, she also developed symptoms of depression. All these symptoms started after an event of an emergency situation raised during her travelling through an aeroplane. She also had one of her uncles died of heart attack during a plane travel. Before the development of psychological problems, she had a very social and active life but after such incidents, she had confined herself inside her room and she couldn’t run her home due to which all of her family life was disturbed.

She had all her medical test reports showing normal results while she was suspecting to have any heart disease. As recommended by medical professionals, she approached to a psychological clinic where psychologists treated her with cognitive behavioural therapy. She was provided with therapeutic interventions including cognitive restructuring in which thought processes were altered to create healthy thoughts/beliefs. De-catastrophizing continuum offered normal perceptions regarding travelling, minor bodily symptoms, and her ability to control the symptoms. Systematic desensitisation was useful in regulating her anxiety through graded exposure, imagination, and relaxation.

With the completion of treatment within four months, she became perfectly all right and started managing her daily tasks effectively. She had two to three plane travels from Pakistan to abroad and within Pakistan without any single moment of anxiety. She was even able to handle her life situations in a more efficient manner than it was prior to the development of her anxiety symptoms.

With this case study, the researchers showed the effectiveness of CBT in a clinical setting. There are many other instances of treating mental disorders with the help of cognitive behavioural techniques. Psychological management is becoming first-line treatment nowadays, whether it is a hospital, rehabilitation, private clinic or community setting. Therefore, our mental health professionals are acclaimed to include psychological strategies and be committed providing the best services to our people.

Written By:

Dr Mehwish Mursaleen

PhD Clinical Psychology

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