“I have a higher education, a successful job, family, children, I run marathons… this can happen to anyone” Javier, patient with alcohol use disorder

“Looking back, I realize that my consumption had always been high, but I wasn’t aware of it. I was what is called a functional alcoholic”, says Javier. “This doesn’t happen all of a sudden, it's a progressive thing”, he adds.

In alcoholic use disorder, or alcohol addiction, changes occur in the brain circuits that cause the person to drink compulsively, despite the negative consequences. Just like other substance use disorders, tolerance to the substance develops. In other words, increasing amounts of the substance need to be consumed to achieve the desired effect. "You realize that you have a problem when drinking alcohol no longer makes any difference, but you simply need it to get through the day", explains Javier. On the other hand, withdrawal syndrome often appears, a set of physical and psychological reactions that occur when a person suddenly stops consuming or reduces the consumption of the substance.

Stigma and false beliefs, the major pitfalls of this disease

Although there are factors that can increase the risk of developing an addiction, there is no specific social profile of patients with substance use disorders. They are illnesses that can happen to anyone. “I have a higher education, a successful job, family, children, I run marathons… this can happen to anyone”, explains Javier. Despite this, addictions continue to carry a significant social stigma. “Many people may think that it’s a matter of weakness, that you can get through it just by giving it your all, but that’s not true. No illness can be cured by simply giving it all you’ve got”, says Javier. “It’s complicated, but the person needs to be aware and ask for help”, he concludes.

The environment can play a key role in motivating people with substance use disorders to start and stay in treatment programmes. However, it is important that they seek advice from specialists. “Often you can’t get by on your own and the family, no matter how much they want to, cannot or don’t know how to help you”, explains Javier.

The Addictive Behaviours Unit’s approach, a motivational and patient-centred philosophy

In 2018, Javier arrived at the Hospital Clínic Barcelona’s Addictive Behaviours Unit. “There came a time when my alcohol consumption was unsustainable, and I decided to ask for help. After looking at several centres, the Hospital Clínic was one of the few public referral centres with a team specialized in this area”, explains Javier. “I felt that they weren't judging me. They told me that this was an illness, and that this has a positive side, that it can be treated”, adds Javier.

The Outpatient Drug Dependency Monitoring Centre (Centro Ambulatorio de Seguimiento de Drogodependencias, CAS) of the Addictive Behaviours Unit, takes in patients with different characteristics who have problems related to substance use. These include substance use disorder, which involves substance abuse and dependence, and also psychiatric problems related to these addictive substances. “At the CAS we have over 1,000 initial visits a year and we monitor over 1,500 patients”, explains Dr. Pol Bruguera, psychiatrist at the Addictive Behaviours Unit. The main disorder treated at the unit is alcohol use, followed by cannabis and cocaine use.

There is no standard treatment, but the unit focuses on a motivational philosophy, where treatment is adapted to each patient’s interests and peculiarities. “Here we provide patient-centred treatment and we adapt to the patient’s characteristics, objectives and motivations in order to support them during the process. The aim is to reduce or avoid the consumption of addictive substances, but also to improve other aspects of their lives that have been compromised by the disease”, explains Dr. Bruguera.

The patients treated at the Addictive Behaviours Unit receive psychological and psychiatric follow-up, as well as monitoring by the nursing, and social work and social education team. This treatment and monitoring is usually done on an individual basis, although the patients can also attend group therapy sessions “to share experiences at the different stages of the disease in order to prevent relapses", says Dr. Bruguera.

The duration of these treatments varies greatly and depends on the characteristics of each patient. “Now I’m well and I realize that, although life can present difficulties, facing them calmly and with awareness is much better”, concludes Javier.