Treatment of Cocaine Addiction
Damián Ruiz
The treatment of cocaine addiction constitutes my second line of therapeutic intervention with regard to specific problems.
If I had to identify the principal and most notable factor in this model, it would be the decision not to rely on the patient’s willpower.
Obviously, at a certain point this willpower must emerge, but not during the early stages, in which we aim to activate it without depending on it.
Why is this? Because addiction has generally become what, in Jungian terms, we might call an autonomous complex (a kind of internal chip that activates, at times, even randomly).
It is very difficult for the sheer influence exerted by substance use on the psyche to be countered solely through firm willpower.
I should clarify here that a psychological treatment of this kind — individual, weekly or fortnightly — is only possible when consumption levels are not excessively high; for example, in someone who uses the substance when going out, at most once a week, and without exceeding roughly one gram.
For the daily user who consumes higher doses, it is preferable to enter a public or private detoxification centre.
And, of course, in most cases the involvement of a psychiatrist will be required for the prescription of appropriate psychotropic medication.
What, then, is the basis of this therapeutic approach?
It is the awakening of consciousness, meaning that the patient does not give up the addiction through willpower, but through rejection, because they no longer feel the need for it.
And how is this achieved? Through a process of self-knowledge, psychological maturation, and the activation of dormant elements of one’s own identity that lie closer to the conscious level.
The aim is for the person to reach a point where an inner conflict arises, making continued consumption lose its meaning.
Another important point is that not all patients are capable of stopping consumption from one day to the next, unless they are in a detoxification centre with no access to the substance; therefore, it will often be necessary to consider a progressively decreasing pattern of use agreed upon with the patient.
The effectiveness of the therapy may be assessed when, after several sessions — the first ones provide a novel stimulus and therefore cannot be used to determine whether treatment is working —, the patient begins to feel that they “do not want” to consume, which is very different from “wanting” to consume but repressing that urge.
This distinction is not minor: “not wanting” but still giving in to temptation is always better than “wanting” and consuming.
In any case, as with any therapeutic model, there are people for whom it works very well and others who may require a different approach, perhaps a more restrictive one, in a residential setting and with much more behaviourally oriented guidelines.
But for many patients, this therapeutic model has proved valid, effective, discreet, and has also helped them to discover many other aspects of themselves.
Damián Ruiz