New proposed therapy for drug addiction
by Rita Strakosha
(Tirana, Albania )
By Rita Strakosha,
There are actually 3 different kind of therapies rarely used for substance use disorders: circadian therapy (or sleep hygiene), REST therapy and nutritional therapy. The careful combination of the three of them can become a much powerful therapy than each of them alone and lead the drug user toward a normal, substance free life.
Circadian therapy (sleep hygiene)
Circadian rhythm disruption has been linked in studies to substance use disorders. Substance of abuse have been found to entrain circadian rhythms. Sleep hygiene is a therapy used with drug users who have sleep problems, but sleep can be subtly disrupted and sleep debt of modest size may pass unnoticed.
The sleep hygiene advises the following:
Have a regular sleep schedule, go to sleep and wake up at the same time each day. Avoid stimulants such as caffeine, nicotine, and alcohol too close to bedtime. Alcohol disrupts sleep in the second half of the night as the body begins to metabolize the alcohol, causing arousal.
Exercise: Vigorous exercise should be taken in the morning or late afternoon. A relaxing exercise, like yoga, can be done before bed to help initiate a restful night’s sleep.
Food can be disruptive right before sleep. Stay away from large meals close to bedtime.
Ensure adequate exposure to natural light. Light exposure helps maintain a healthy sleep-wake cycle.
- Establish a relaxing bedtime routine.Try to avoid emotionally upsetting activities before trying to go to sleep.
- Associate your bed with sleep.It’s not a good idea to use your bed to watch TV, listen to the radio, or read.
- The sleep environment is pleasant and relaxing.The bed should be comfortable, the room should not be too hot or cold, or too bright.
Sensory deprivation therapy (R.E.S.T therapy)
Sensory deprivation therapy is a therapy which aims sensory load minimization through exposing the subject to a dark, quiet environment. It is practiced in isolation chambers in psychiatric wards or in flotation tanks in SPA-s. Studies have shown it to be effective for the treatment of tobacco use, alcohol use and it is advertised as effective against addictions.
Persons suffering from substance use disorders are usually highly arousable. They often experience intense emotional reactions to stressful stimulation, and they are predisposed toward substance abuse. For these individuals Sensory Deprivation therapy (or Reduced Environmental Stimulation Therapy-REST) lowers arousal to comfortable levels, without psychoactive chemicals.
Nevertheless, the Rat Park experiment, by the Canadian psychologist, Bruce Alexander, has shown that prolonged sensory deprivation during the day may bring the opposite effect by predisposing subjects to addiction. Therefore the timing of the REST therapy is important. The REST therapy should have optimal results when applied during or immediately before/after the night.
Circadian rhythm disruption and stress from sensory overload, have been shown in studies to affect the diet of the exposed persons through shifting their appetite toward high calorie, high glycemic index foods like sugar, honey etc. Sugar has been shown in studies to affect the dopamine/serotonin system of reward in similar ways to substances of abuse and may predispose the subject toward abuse of other substances like alcohol etc.
In addition to this, the nutritional status of drug users is often compromised. Alcoholics have vitamin B deficiencies. Some of the substances of abuse, like alcohol and heroin, cause severe nervous symptoms upon withdrawal. This makes stopping the abuse more difficult. Foods high in vitamin B may be used to support the withdrawal process. The foods highest in vitamin B are calf liver, chicken liver, greens etc.
Given the above, an integrated therapy can be devised which would consist of the following:
The drug user will switch off all artificial light sources in his home at 8 o’clock in the evening, or later if the sun sets later, but no later than 9 o’clock. Sunset entrains the circadian rhythm, therefore sleeping near sunset is advisable. He will be free to sleep and wake up when he likes, but he should not switch on the lights up to 7 o’clock in the morning. People will not usually sleep more than 9-10 hours, the drug user will probably wake up in the middle of the night or early in the morning. These 1-2 hours of quiet wakefulness is usually relaxing, and will be also helpful for him to think on his recovery. Why no artificial light after 8 o’clock? This will allow the time to have all the night sleep his body needs (9-10 hours at most), plus some hours of rest and meditation. 12 hours of darkness/daily is the average darkness people living under natural conditions are exposed to, so 11 hours is an amount that we can use as starting point and to which the volunteer will be exposed except for the summer time (10 hours during the long days of the summer). Switching the lights off before 8 o’clock would be more socially isolating, switching the lights later would be less therapeutic, therefore I would use the 8 o’clock as the time to switch off the lights. If and after the drug user has achieved abstinence he can shorten the nights to the level that is enough for him not to relapse. During the year the sunset and sunrise have different daytimes, so during the summer the drug user would keep the window blinds on even after sunrise, until 7 o’clock. If one got to sleep with sunset and woke up with sunrise during the summer, around solstice, (s)he would sleep only 7-8 hours in Albania for example, that is little I think for people who have abused their brains for long. These long days during the summer may explain why substance abuse is more severe during the summer (according to research).
Keeping the above schedule is difficult if someone lives with other persons, it can be done with a supportive family.
This was the circadian part of the integrated therapy. In order to implement the sensory deprivation therapy, the darkness in the room during sleep should be pitch dark. All light sources, however small, should be switched off. The blinds should not allow any light to enter the room, even moonlight. If the home is exposed to considerable noise, the drug user will use ear plugs. Staying in a room with absolutely no light and no noise can be terrifying, so I think noise reduction should be only to a certain level, enough to make the drug user to feel comfortable, but not so that he stays awake just to hear the interesting noise.
-The diet the drug user would follow: he should give up consuming any sugar, honey, dried fruits, white bread, artificial sweeteners, stevia. Consumption of high index glycemic fruits like figs and grapes will be limited to 1 serving per day, but he is encouraged not to consume them at all. When faced with these restrictions the drug user may replace the simple carbs with complex carbs, like bread and potatoes. So he may begin to eat a diet based mainly on starches, like potatoes and bread, by considerably increasing their amount. To limit this skewing of the diet the drug user should monitor the balance of proteins-carbs he consumes.
The diet in general is recommended to be healthy, with additional Vitamin B rich foods, like greens, organ meets (which support the work of the nervous system), with good fats and fresh food.
It helps circadian entrainment if the last meal of the day is not rich in proteins, especially in meat.
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