I saw a quote the other day that really stuck out to me: “Addiction shouldn’t be called ‘addiction.它应该被称为“仪式性的舒适寻求”.’”很神奇，对吧?
这句话的出处是 Dr. 丹尼尔Semrok, who treated Vietnam veterans who became hooked on drugs 和 alcohol in the 1980s to cope with the PTSD they developed from the war. His point is simple: addiction is as normal of a response to 创伤 as bleeding is to being cut. When we begin to realize the connection that addiction 和 创伤 have, we can take better steps to meet more of our patients’ needs than what they may have initially come in for.
越来越多的人 不良童年经历(ace) 研究表明， 64%的人至少有一次ACE, which doubles or quadruples their likelihood of using drugs or alcohol, 尤其是在年轻的时候. An ACE score of four nearly doubles the risk of heart disease 和 lung cancer, 你成为酒鬼的可能性增加了700%. 个人 with an ACE score of 5 or higher are seven to 10 times more likely to use illegal drugs 和 become addicted.
ACEs are common 和 occur throughout the state of Arkansas 和 in all types of families 和 communities. Poverty, homelessness, discrimination, violence are some of the most common ACEs. 阿肯色州排名第一 至少经历过一次ACE的儿童 (56%) 和 among the highest for children who have experienced three or more ACEs. Arkansas also ranks highest in opioid prescription rates 和 substance abuse disorders. 你看到规律了吗?
Different combinations of ACEs produce the same statistical results.
Substance abuse by a family member in the home is a cause of significant toxic stress, 家庭功能障碍,, 最常见的, 代际创伤. The family member who is using drugs 和 alcohol to cope with their childhood 创伤 passes on 创伤 to their children in the household. 这种循环似乎几乎不可避免 除非 we consider addressing a patient’s 创伤 in t和em with their addiction.
Many doctors already know that individuals who have suffered 创伤tic stress have higher rates of depression. 更高的抑郁率导致更高的成瘾率. 我们也知道压力会影响身体, 经常导致心率加快, 高血压, 葡萄糖的释放. It’s also important, however, to remember that stress affects the body 和 心灵. In fact, during stress, your body often goes into “fight or flight mode.”
When children are in the crucial stages of brain development within their first five years of life, experiencing prolonged active stress leads to hypervigilance 和 perceived threats that may or may not be real. 这对中国的发展产生了巨大的影响 大脑皮层大脑控制决策、思考和情景记忆. 年轻时过度暴露在压力下也会影响身体 大脑边缘系统, which controls various emotional behaviors such as fear, rage, anxiety.
你对压力的反应始于大脑. 当你面临危险时, 比如你要过马路时迎面驶来的车, 你的眼睛和耳朵(或有时), 两者都向大脑边缘系统的丘脑发送信息, 它在哪里被杏仁核和大脑皮层传递. The amygdala is your brain’s alarm system that detects threats before you’re even aware they’re there. 一旦杏仁核发现威胁, 它向下丘脑发出释放多巴胺的信号, 让你过敏, 提高你的感官, 让你的身体准备好面对前方的危险. 还有更多的事情要做, but I want to focus on one specific part of the body’s stress response.
Addictive substances hijack your body’s reward system, causing your brain to release dopamine. 这就是导致渴望和上瘾的原因. 甲基苯丙胺能使多巴胺的释放增加十倍. 你体内多巴胺含量这么高, your brain’s ability to differentiate the threatening from the non-threatening leads to the triggering of the brain’s survival mechanism.
What we think of as “bad behaviors” are actually maladaptive behaviors that a person has developed to survive when supportive or trusting relationships are non-existent.
在我们的社会中，成瘾通常被视为一种“道德失败”. People who struggle with addiction are often singled out, ridiculed, seen as bad people. What many may not realize is just how powerful addictive substances can be. 对一些人来说, 毒品和酒精变得比食物和水更重要. 上瘾的物质很难戒掉.
A better underst和ing of the impact of 创伤 on the developing brain leads to a better underst和ing of how people become addicted as a response to 创伤. 它还能在医疗服务提供者中建立同理心 创伤-informed转变 而不是问“你怎么了??到“你怎么了??” Underst和ing the science behind the body’s reaction to stress 和 perceived threats improves our treatment for patients dealing with addiction.
病人需要被理解，而不是被评判. Appropriate screening, diagnosis, referral for treatment increase the likelihood of success. 我们努力改善患者的许多结果, 无论是身体上还是精神上, 不解决王牌问题就无法改善吗, 创伤, 和上瘾在一起. Our patients also suffer a myriad of other addictions that need to be brought to life. An ACE筛选 is a good way to assess past 创伤 和 improve doctor-patient relationships 和 outcomes. Appropriate referrals to substance abuse treatment 和 community-based supports increases the likelihood of success.
Adults recognizing 和 addressing their own 创伤 can help the next generation 和 prevent the vicious cycle of 代际创伤. Health care providers should also recognize their own 创伤 和 any concurrent addiction 和 seek the appropriate help. 医生, 护士, other health professionals cannot take good care of patients without taking good care of themselves.
Addiction is a personal struggle that requires not just personal resilience but also the support 和 underst和ing of the resources available in the community. While recovery may be challenging, it is always possible, seeking help is a vital first step. 在一起, 通过理解压力和成瘾之间的联系, 提高意识, 消除歧视, 并伸出援助之手, we can work toward improved empathy 和 health outcomes for our patients instead of judgment 和 isolation.