Of A New Day
Addiction Recovery In The Age Of
Terence T. Gorski
Is it possible that the horrendous terrorist acts of
September 11, 2001 can lead to the dawning of a new day of peace, hope,
and optimism? Can we take the
horror of September 11th and apply the principles of sobriety and
responsibility to create a better world?
It's definitely possible -- but it won’t be easy.
Terrorism, Psychological Problems, &
September 11, 2001 marked the emergence of
terrorism as a clear and present danger to all Americans.
Business as usual came crashing to a halt as the nation went into
an all-out war against terrorism both internally and internationally.
As the nation stabilizes from the initial shock, a wave
of addiction and mental health problems is rippling through America.
More people are going to their family doctors for stress-related
illnesses such as headaches, digestive problems, and sleep disturbances.
There's also an increase in the number of people seeking treatment
for depression and anxiety disorders.
As a result there's an increased number of prescriptions for
antidepressant, anti-anxiety, and sleep medications.
Alcohol sales are going up.
More people are drinking and they're drinking more often and more
heavily than before September 11th. There's
also increasing sales of street drugs. This means that there will probably be a radical increase in
the number of people seeking treatment for alcoholism, prescription drug
abuse, and illicit drug abuse over the next two years.
We can also expect to see an increase in the relapse rates for
people currently in recovery.
By why should this be happening? On the surface everything seems to be going well.
Things seem to be going back to normal.
But is everything as it seems?
The Psychological Consequences Of Terrorism
It's unrealistic to believe that these traumatic events
will pass without creating a wave of psychological consequences,
reactive substance abuse, and addiction in American citizens.
Terrorism is a form of psychological warfare designed to cause a
chronic state of psychological vulnerability and instability in the
targeted population. Death
and destruction are merely a means to achieve these ends.
Here's what usually happens.
Many people experience Trauma Reactions (which are
often called Critical Incident Stress Reactions) & Post
Traumatic Stress Disorder (PTSD). These
are normal responses to experiencing or witnessing abnormal events of
horror, death, and destruction. This
horror can cause a stress overload that
puts people in a state of psychic shock that makes them feel dissociated
or disconnected from themselves.
The horrible memories of the terrorist events keep
intruding into their mind in the form of flashbacks. These flashbacks force the victims to involuntarily relive
aspects of the trauma in their own mind.
The flashbacks can cause people to be retraumatized (traumatized
again by the intrusive memories). As
a result the flashbacks push victims deeper into shock and create a
profound feeling of helplessness, hopelessness, and disconnection from
self and values.
The ongoing trauma reactions lead to hyper vigilance caused
by living with the constant fear of a new terrorist act and increased
stress in routine daily living. Since
the terrorist act was random and apparently senseless, it could strike
anyone, at anytime, in anyplace. Therefore,
it's normal for everyone to feel constantly at risk and to be on
the alert for any sign of danger. It
takes more energy just to get through the day.
So over time, many people begin to burn out.
They become chronically stressed, fatigued, anxious, and afraid.
This sets the stage for an increase in stress-related physical
illness, psychiatric illness, and addiction.
Many people try to manage this increased stress by using repression
to force the awareness of potential terrorism.
Once they deaden their feelings, they use avoidance to keep
themselves from thinking or talking about the trauma by getting
compulsively involved in other things.
This leaves them vulnerable to emotional overreaction that
can activate primitive but powerful emotionally-driven psychological
People can easily be consumed with anger, fear, or
depression. When they become
consumed by fits of anger and vengefulness they get mad and
want to make someone pay. When
they're consumed by fear they try to hide or find some one
to protect them. When they're consumed by depression they feel
helpless and hopeless and start to believe that life's not worth living.
They can easily give up and stop trying to cope.
The combined psychological effects of terrorism can
create a strong need for addictive escape. People start to believe that they have to do something,
anything, to make these symptoms disappear.
Alcohol, prescription medication, and recreational drugs can
provide an effective way to temporarily escape from the stress and pain of
the moment. So many people
start self-medicating with alcohol, prescription medications, or
recreational drugs to find temporary relief from the painful symptoms
caused by living with the danger of terrorism.
Unfortunately, these mind altering substances also block
normal trauma resolution and prevent effective problem solving.
So when people stop using alcohol and drugs, the pain and problems
come back with a vengeance. Many people keep using alcohol and other drugs to cope with
their ongoing grief, pain, fear, and anger.
This regular and heavy use of alcohol and other mind altering drugs
can cause people to become trapped in a progressive pattern of abuse and
addiction. Once addiction
sets in, people experience progressive symptoms of addiction
that cause biological, psychological, and social damage that slowly
destroys their lives.
The stress of living with the ongoing threat of terrorism
can cause people in recovery from addiction or other mental health
problems to relapse. In
the midst of the terrorist threat its easy to defocus from addiction
recovery and stop attending recovery activities. The
stress can also activate Post Acute Withdrawal (PAW) symptoms of untreated
Post Traumatic Stress
Disorder (PTSD) from child abuse and trauma experienced during
adulthood. These conditions
can activate cravings for alcohol and other drugs and cause
powerful urges to use self-defeating
behaviors that keep recovering people from identifying and resolving
The widespread addictive self-destruction caused by new
cases of addiction and an increased rate of relapse among recovery people
can destabilize communities by cutting a path of pain and
problems through families, friends, and work places.
For each person adversely affected by addiction, at
least five other family members, friends, or coworkers will become
seriously disabled. This wide
spread damage can lead to progressive demoralization and interfere with
long-term efforts to combat ongoing terrorism
The Extent Of the Problem
Can this really be happening?
Let's review what really happened and who was affected to determine
the true extent of the problem we are facing.
The Dead and the Grieving: September 11, 2001 marked the sudden, violent, and
unpredicted deaths of over 4,000 innocent victims at the Pentagon, The
World Trade Center, and the plane crash in Pennsylvania.
These horrible deaths, in turn, inflicted a serious grief reaction
in more than 72,000 Americans. These
grief reactions were complicated by the fact that the deaths were caused
by an incomprehensible act of the mass murder of innocents, perpetrated by
unknown assailants, committed for reasons that most Americans couldn't
The Emergency First Responders: Hundreds of emergency responders were killed or injured.
This tragic loss of heroic rescuers touched the soul of the nation
and deeply traumatizing emergency first responders across the world.
Thousands of emergency personnel, many brought in from across the
nation, worked to exhaustion trying to rescue victims, retrieve bodies,
and clean up one of the most shocking and horrendous scenes of violence
that America has ever scene.
The collapse of the World Trade Towers alone was witnessed by over
1.2 million people. At least
90% of these witnesses developed a critical incident stress reaction.
One-third will be unable to resolve the critical incident stress
reaction and will develop Post Traumatic Stress Disorder (PTSD).
The Television Audience:
At least 80% of all Americans witnessed the terrorist acts on
television. Many were
continuously retraumatized by watching the instant replays of the
tragedies. At least half of
these viewers developed a critical incident stress reaction.
We can expect one-third of these traumatized television witnesses
to develop PTSD.
Parents across the nation soon recognized that many children were
affected. Parents and
teachers reported that children were having serious problems with
nightmares, sleep disturbances, irrational fears, and increased behavior
problems. All parents need sound advice on the best way to deal with
the reality of terrorism with their children. Unfortunately, some of these children, especially those who
lost parents or loved ones, will need professional treatment to recover.
The Fear Of Biochemical Attack: All of this was complicated by the real threat of
bio-terrorism. The anthrax
attacks added another level of anxiety and stress.
There is also an ongoing threat of new terrorism that is causing
most Americans to live in a chronic state of low grade emergency.
(As I write this article a "low level threat" of
terrorism against school children in Texas has been announced.
There was also an alert by the Office of Homeland Defense warning
of probable new attacks of the Christmas Holidays.)
The Impact Of America's New War:
Then the nation struck back with the foreign war against
terrorism in Afghanistan. The war raised a specter with two faces.
There was a sense of relief in administering justice.
There was also a sense of new horror at the brutality and death
inflicted by the war. The
internal war against terrorism was launched with massive police
operations and the mobilization of national guard.
This was followed by executive orders and legislation mandating the
compromise of some civil rights. This
sparked new concerns among Americans about where to draw the line between
domestic security and the protection of civil rights.
In reviewing real impact of terrorism, is it
possible we will see a widespread epidemic and addiction and mental health
problems? If we do, how will
that affect our ability as a nation to effectively respond to the ongoing
Addiction Treatment and Homeland Defense
In the dawning of this new day of terrorism
there is some good news -- we already have the technical knowledge and
trained professionals needed to manage these problems.
We can mobilize to respond to the addiction and mental health
problems caused by the war on terrorism.
By doing so we can integrate our addiction and mental health
services into our public health system and move the nation closer to
effectively managing its alcohol, drug and mental health problems.
This will make us stronger as a nation and better able to sustain a
long-term response to terrorism.
Addiction and mental health services are critically
important to homeland defense. Since
a major goal of terrorism is to create psychological disability in the
targeted population, it is critically important that we mobilize our
addiction and mental health professionals to adapt their knowledge and
skills to meet the challenge of defeating these psychological goals of
terrorism. This can be done
in a number of ways:
Critical Incident Stress & Preventing PTSD:
We can provide effective and readily available services to all
Americans suffering from Critical Incident Stress Reactions
and by doing so help people to successfully adapt to the daily stress of
living with the reality of terrorism.
This will prevent critical incident stress reactions from
progressing into Post Traumatic Stress Disorder (PTSD).
It will also reduce the likelihood of an epidemic of stress related
physical illness and mental health problems.
Substance Abuse & Addiction:
We need to educate the population about the dangers of using
alcohol, prescription medication, and recreational drugs to deal with the
stress and psychological problems caused by terrorism.
This is especially important to prevent an epidemic of substance
abuse and addiction in our first -line emergency responders.
Intervention & Treatment: We
need to expand our ability to detect the early signs and symptoms of
alcohol and drug addiction. We
need to educate doctors, hospitals, emergency rooms, and mental health
facilities about the increased risk of addiction associated with the
stress of terrorism. Community
providers need to increase community awareness and screening projects for
substance abuse, addiction, and other stress-related mental health
problems. We also need to
expand our community based addiction treatment resources so adequate
facilities and properly trained professionals are available to meet the
growing demand for treatment.
Prevention: We need to
pay special attention to preventing relapse among the millions of
recovering people in America, especially those in the Armed Forces and
critical civilian occupations. A
federal initiative to develop Employee Assistance Programs for prevention,
early intervention, treatment referral, and relapse prevention needs to be
Treatment Technology: It
is important to update our treatment technology so that the addiction and
mental health professionals can more easily coordinate with
emergency police, fire, and medical professionals in providing a broad
range of services in the event of a terrorist attack of other disaster.
Sobriety For What?
There are millions of sober and responsible people who
have survived the horrors of addiction.
Each, at one time or another, has asked themselves - "Why
me when so many others have died. Why
was I able to recover? What
is my sobriety for? What am I
to do with my life of sobriety?"
Out of the ashes of the national tragedy of terrorism,
many recovering people will find the answer to those questions.
And the answer is simple -- we are sober so that we might share our
courage, strength, and hope with others in order to help the nation apply
the powerful principles of personal recovery to our national war against