Stress causes release responses of adrenaline, noradrenaline, endogenous opioids, endogenous cannabinoids and endogenous benzodiazepines. Recurrent stress is known to cause damage at the various related receptors causing anxiety, depression, hypertension, disturbance of the HPA axis, and addiction.
Each time you encounter a person with addiction think of the fact that you are seeing a person with a stress-related disease. The stress-related disease affects not only those with the addiction. It also impacts their direct family and very quickly the whole community.
The science related to addiction is that the repeated use of substances such as drugs and alcohol has the ability to change the structure of receptors in the brain so that eventually addiction leads to substance tolerance in the individual. The person may then be recognised as substance dependant.
The PHREE (pronounced free with an emphasis on EE,) model of treatment has been developed over 25 years. It stands for physiology, housing, relationships, empowerment, entry, education and employment, and represents a series of changes which are essential for recovery from the stress-related disease of addiction.
Physiology – Understanding and changing the physiology of a person with an addiction involves understanding that you are treating a stress-related disease and using appropriate treatment for each individual. This is a crucial stage to ensure that an individual is looked at holistically and that we are treating all possible underlying diseases and factors that may also be contributing to the stress-related disease of addiction.
Housing – In order to reach patients, encourage a safe and stable place to live where substance use is not present. When that is not possible, one needs a short-term accommodation facility for pre- and post-detoxing. When detox is complete many can return home. However, others may progress to city housing or residential rehabilitation.
Relationships – People with addiction have to rebuild relationships with family and the community. A team of GPs, psychologists, addiction counsellors, chaplains, clinical psychologists and psychiatrists as well as addiction specialists work to rebuild these connections.
Entry and Empowerment – Only with confidence can an individual start a five-year plan to change their whole life. Change comes from developing confidence. Initial contact focuses on supporting the patient to work out a plan for this change to occur. From here, Entry is a goal for the patient to resume their role in a functional society.
Education and Employment – Planning and supporting education and employment is essential to help these recovering patients and requires the entire team to be focused on these goals.
With the implementation and development of the PHREE model we are seeing an increased percentage of successful rehabilitations. In turn, this helps support individuals, their families and the extended community.
Author competing interests – the author is involved with Fresh Start which delivers the program described