Those involved in substance abuse need dedicated help to get their lives back. It’s no quick fix, however. [Picture: HSI]
Somewhere in the dark alleys of Johannesburg, two shadow figures snake their way through the maze of the city’s streets to find each other under a dim light post. All of this in the dead of night, while much of the rest of the city reclines in slumber. In the background, smoke billows as a homeless person nurses a fire to keep warm.
The eyes of the junkies lock briefly in between cautious glances over their shoulders to make sure The Fuzz is not watching. Hands trembling, their fingers convey a tiny packet and the deal is done. The silhouette of each scurries off in its respective direction, to complete the business of night and wander aimlessly, stoned, until the sun rises.
That’s usually the picture we get when we speak of substance abuse. Lies, deceit, manipulation, thuggery, evasion. To sum it up, shady behaviour. But the problem of drug abuse transcends the stereotypical depiction of back alley dealings – it can be a perilous mistake to believe it doesn’t.
Sadly, such vices have permeated our communities to the extent that sniffing and injecting goes on under the roofs of the most respectable homes, among the most noble families and often evades the scrutiny of curious eyes. Even in the Muslim community.
When Ramadan comes around, though, the debauchery is often exposed and abusers face the wrath of hostile families, unless they’re still in denial. In no time, the offender is sent packing to the nearest rehab. A few weeks there and the problem will be solved, right?
Not quite. That’s according to Dr. Nazeem Abrahams from the Lighthouse On The Horizon Therapeutic Community Facility based on the western edge of Johannesburg. He says the biggest misconception is that 21 days in rehab is all it takes to kick the habit.
“Let’s say you’ve practised your addiction cycle for a period of 20 years,” he begins to explain, “It’s 20 years of learnt behaviour you need to unlearn and you’re not going to unlearn that in six or eight weeks. You might be able to determine what you need to unlearn, but it will take you much longer to unlearn those behaviours and learn positive behaviours.”
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So, what then is the way forward?
While rehabilitation centres might provide a temporary reprieve from the hostilities of the world that often compel people to resort to drugs in the first place, it is the programme of reform they must undergo if they’re to be helped.
“A big part of our programme is a spiritual side which is based on intellectual enhancement and value systems,” says Abrahams. Patients must follow a three-phase programme, starting at the primary care phase before moving on to an integration phase and wrapping up with an aftercare maintenance phase.
“Each phase has its own Individual Treatment Plan (ITP),” he says, adding that each treatment plan is based around the circumstances of the individual.
“The first ITP would start off with a purification process, an induction process, to educate and empower the individual about the treatment programme and how the programme works.”
The purification process is where “we eliminate all drug metabolic toxins”. This is done naturally, through a particular acupuncture protocol and high dosages of vitamins .
“That could last up to 21 days. During that process we bring the chemically imbalanced person back to a balanced person so that we can be able to determine through observation a treatment plan.”
Patients must also undergo one-on-one counselling sessions, as well as group therapy. This is based on education and the process is built around the strengths and weaknesses of the individual.
“The integration phase will simultaneously be determined by the individual’s strengths and weaknesses and the treatment plan that is devised for him. Before moving on to aftercare and maintenance, that individual will have to be determined by the progress made.
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Does it work?
This really depends on the commitment of the individual himself. So, too, goes the duration of a patient’s treatment.
“All three stages are determined by progress, not time. You could, based on your input as an individual, based on your sincerity and your consistency, work anything between eight weeks to six months just on primary care,” says Abrahams.
Psychostimulant drugs, for example, such as amphetamine and cocaine have the potential to effect neuroplasticity changes. Similar changes also occur with the mere act of substance abuse, when such actions become learnt behaviour.
Dr Abrahams explains that the reformation process involves rewiring the brain to eradicate negative behavioural patterns.
“It’s all about retraining the brain. You’ve got cell memory, you’ve got tissue memory, you’ve got subconscious memories and those are the things you need to retrain. The only way you can retrain that is by changing the negative with the positive. You need to apply that positive [action] long enough so that it becomes a part of you.”
He said, after all, it was possible to live a normal life after years of substance abuse despite substance abuse often causing physical damage to parts of the brain.
“It’s very possible if there’s a continuance of practising healthy rituals. It’s very possible that the brain will be able to rebuild itself. Alternatively, you’ll be able to live a normal life with the condition, because you’re disciplined.”
He concludes, “Change can and will take place if the individual trusts the process and does what is required by them”.
Julie Allie and Dr Nazeem Abrahams also discussed the risks of returning patients home during their treatment plans, even to observe festive occasions such as Eid. Watch the full discussion here.
