Reflections on Addictive Behaviors

Because of Whitney Houston’s recent tragic death, a number of articles have been written about the continuing challenge of helping prevent and treat drug and alcohol addiction.  Not surprisingly, the articles have particularly focused on the failure rate of treatment programs used by entertainers and other celebrities.  As a former CEO, and a 30-year veteran of life in a big organization, I knew, and became aware of, many people with drug and alcohol addictions.  I even have a few long time friends who are recovering addicts.

I am not surprised by hearing that celebrities enter an expensive residential drug or alcohol treatment program, and then experience a relapse relatively soon after finishing the program. The first critical success factor in addressing an addiction is recognizing that the behavior occurs in a particular set of social settings.  Success means removing the addicted person from the social settings supporting the addiction.  Unfortunately, most celebrities return to the same world from which they came, and, even if they disengage from the particular relationships that spawned the addiction, they find other destructive relationships.

The second critical success factor is replacing the habits that made addictive behavior the easy choice with other habits.  For example, whether the addiction is smoking, alcohol abuse, or overeating, the addicted person has to create a new set of routines in which it is no longer easy to lapse into addiction, and it is far easier to do something else.  Relative to overeating, Brian Wansick of Cornell University, in his great book Mindless Eating, has compiled a great deal of research to support the argument that one great strategy for addressing overeating is to create an environment in which less food is available, and what is available is provided in much more controlled settings.  Someone trying to control an addiction has to be placed in environments in which he or she does not have to fight temptations and urges continually.

Third, people have to recognize that addiction alters the chemical composition of the brain.  The substance to which someone is addicted brings physical pleasure, and the withholding of that substance brings pain and agitation.  There is no easy way to address this problem, other than to provide various kinds of palliative measures.  To use a simple example, there have been times when I have had to give up caffeine completely for a period of time.  On the first day in which I withdrew from caffeine, I had headaches, which, over time, went away, but even a mild addiction to caffeine created physiological challenges for me.

Finally, it should be clear that addressing an addiction requires a highly tailored, hand-on management strategy.  While there are great standardized programs like AA for alcohol abusers, Weight Watchers for overweight people, or various kinds of drug treatment programs that have delivered success for millions of people over many generations, each individual has to find the right combination of strategies and tactics that work for him and her.

At Pitney Bowes, one of our nurse practitioners became certified in the Mayo Clinic Motivational Interviewing program to address people with tobacco and other addictions.  Her approach was to interview people with addiction programs in a non-judgmental way and treat the addiction as a problem to be solved.  The essence of the problem solving methodology was to analyze the daily routines of individuals to help them manage a problem in the context of the real-life challenges they faced, as opposed to a “cookie cutter” set of recommendations and guidelines.

For example, one of the common mistakes self-help dieting books and marketing materials make is that they assume that individuals have much more control over where, when and what they eat than is the case.  I am extremely careful about what, and how much, I eat when at home, but when I am traveling, I am at the mercy of what is available at airports, what is served at meetings and conferences, and what is conveniently available at hotels at which I am staying.

One of my most frustrating insights is that, as an executive in a health business, I attend many health and wellness conferences at hotels.  The food and beverages served at these conferences are extremely unhealthy, because the conference organizers want to offer the lowest cost conference fee possible.  I often compromise and overeat less healthy food, gain weight, and feel worse when I return home.

I also have to admit that I sometimes succumb to the temptation to eat a delicious, but decidedly unhealthy, meal when traveling. For example, I cannot resist eating a Five Guys hamburger, with fries, at the U.S. Airways Terminal at Reagan Airport in Washington, DC.  Ultimately, I reduce the damage by eating about half of the fries, but I know I have overeaten something I would never eat at home.

I mention this last point because it reminds me that we should never be judgmental about people who repeatedly fail to overcome an addiction.  It is exceptionally hard work and the obstacles to success are overwhelming and omnipresent.  We should provide support and advice, but, frankly, the person gripped by an addiction will not be turned around by being lectured or condemned.

Finally, whether we like to admit it or not, there are a few intervention points in the lives of people when they are receptive to help in overcoming an addiction.  People who commit crimes to support an addiction are sometimes best served by having to deal with the harshness of the criminal justice system.  Others are shocked into reality by losing a job, having loved ones turn away from them, confronting a life-threatening health problem, or otherwise having something happen that causes them to hit bottom.  Two things must happen:

  • Someone must hit bottom in some very personal and profound way; and
  • Others must be ready to intervene in the right way with the right kind of help at that optimal intervention time.

I wish that Whitney Houston’s death would shock millions of people into realizing that even the most successful people can be gripped by an addiction, but peoples’ memories are short, and the lessons are fleeting.  We need to help those we can help in little ways every day, and feel good about small, positive steps.

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