Dawning Of A New Day - Addiction Recovery In The Age Of Terrorism

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Dawning Of A New Day
Addiction Recovery In The Age Of Terrorism

By 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, & Addiction

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 defenses. 

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 problems. 

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 understand. 

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. 

Traumatized Witnesses:  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.

Traumatized Children:  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 terrorist threat. 

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:

1.    Managing 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.

2.    Preventing 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.  

3.    Early 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.  

5.    Relapse 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 established.  

6.    Updating 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?" 

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