UNDERSTANDING SUBSTANCE USE DISORDER. INTERVIEW WITH DEAN GUSTAR, RELAPSE PREVENTION SPECIALIST

What is substance use disorder?

We all have different strategies and ways that we navigate life, different ways to have fun or manage stress or get through uncomfortable times in life. A lot of people take substances, and it does support them and does help them have fun, get through difficult times, but there are a group of people that take substances for such reasons and then find themselves locked in a pattern of taking substances. And generally, what happens with this particular group of people is they cross a line whereby the pattern becomes habitual. They find it difficult to stop. The strategy, that initially was making their lives easier, starts to create problems.

How does substance use disorder usually begin?

I mean, usually it begins as a fairly harmless, fun recreational activity; it usually begins very innocently. And in the early days, is usually very little consequences to it.

What are the signs of developing substance use disorder?

You may expect to see somebody kind of withdrawing from family life. Maybe they're spending a lot of time away from their family house. They’re keeping strange hours, not turning up for important appointments. These kinds of things we would expect to notice as substance use disorder is developing, in particular being defensive when maybe lightly challenged by people, and definitely swings in mood would be one sign.

Is there a psychological aspect to substance use disorder?

I mean, generally speaking, substance use disorder is both psychological and physical. The body adapts to taking a substance every day. So when you take away that substance there will be some physical withdrawal symptoms. These vary from substance to substance. Similarly, psychologically, the comfort and relief maybe one gets from a substance, when that's taken away there can be a feeling of unease that can have a detrimental effect on how we manage different emotions.

What are the underlying causes of substance use disorder?

There can be many different underlying causes to substance use disorder and they vary from person to person. They would include such things as trauma, adverse childhood experiences, maybe undiagnosed psychiatric conditions. They can include the developmental factors and the environment that the person has grown up in or lived in.

Is drug addiction influenced by genetics?

New research has shown that there is, or there probably is a genetic component to substance use disorder and alcohol use disorder. That doesn't necessarily mean that it's going to develop, but that's, some people may have a propensity toward it. There's also a behavioural or a social component to it.

What are the consequences of substance use disorder?

I think once a substance use disorder has developed, then it starts to monopolise a person's time and energy. This will affect their relationships, their family life, possibly their professional life or their studies.

How is substance use disorder treated at The Kusnacht Practice?

The first stage of treatment at The Kusnacht Practice is the assessment phase, really. So once a person has made contact, key members of the team would speak to the client, assess where they're at, what their goals are? What they want to do about their substance use disorder? And we would start to assess how we can support them on that journey. This is the phase before they even arrive at The Kusnacht Practice. It's very important for us to understand where their clients at and really understand what their goals are. Once they arrive at The Kusnacht Practice, the initial phase of treatment is usually a detox phase, where they get the full support of the medical team, the psychiatric team, the BIO-R® team to ensure as smooth a detox from the substance as possible. Once that phase is completed, then all the teams at The Kusnacht Practice will work together to help the client achieve their goals around their substance use disorder. This may involve the medical team, the psychiatric team, psychotherapy, relapse prevention, rebuilding their life, getting them on a healthy track and helping them to establish a set of tools that they can use to make the changes that they want to make in their life.

What is the average duration of substance use disorder treatment at The Kusnacht Practice?

We would usually recommend an inpatient duration of a minimum of six weeks to give somebody the best opportunity to complete a safe detox and start to establish new patterns in their life. And then we also recommend a strong Continuing Care component to the treatment.

How can individuals with a drug addiction be encouraged to consider treatment?

Educating yourself about the options is important. And then, during the discussion, you can make suggestions or float ideas about how they can best access support. You go at a pace that's going to suit the person that you're talking to, your loved one. Probably in the early stages of when these conversations are happening, it's probably not going to help to give the impression that someone's being forced to accept help or forced into a treatment pathway. It should be more of a team approach.