Regardless of the trauma or mental illness, the type or its origins, once the person with the mental health disorder becomes addicted ALL BETS ARE OFF. You can no longer treat the mental illness first, and assume the addiction is secondary. The addiction has now overcome and imprinted the mental illness. Everyone and I mean everyone, both professional and amateur, have this completely in reverse. Because they assume the addiction is the sufferer's reaction to the mental disorder (true) and they are "self medicating" (true), people assume that is a sign of increased urgency to treat the underlying mental disorder (not true). The minute the sufferer becomes an addict to any substance, including "huffing" as this poor man in the linked article, or "minor" substances such as weed or beer, treating the substance must be the NUMBER ONE PRIORITY.
There are two reasons for this. One is that the addiction now changes the nature of the underlying causal mental illness. Here's an analogy. Suppose you get a thorn stuck in your finger. It hurts but you refuse or are mentally incapable of going to a doctor to get the thorn removed. So in your mental distress you set fire to your finger, figuring that it will "get the thorn out." You now have a charred, infected second or third degree burn on your finger. So what do your friends and family do? Hire someone to "get the thorn out." Um, you now have a charred thorn inside a charred finger. You need a burn specialist, not the original prescribed "thorn remover."
So the addiction now fundamentally changes the underlying illness and causal factors and the odds are YOU CAN NO LONGER FIX THE ORIGINAL ILLNESS OR DISORDER BEFORE FIXING THE ADDICTION. In an ideal set up you can do both at the same time, but that almost always involves complete long term hospitalization, and there are very few facilities for this nor does the mental health profession, or the public at large, understand this. The guy in this article would have needed what we used to call a "sanitarium," where he is placed in a locked down low stress place (no PTSD inducing potential noises, visuals or surroundings) and treated for both the PTSD and the huffing or other substances. And this would be long term, for example a year or more, not a few weeks in the free wheeling revolving door.
So here is the second reason that the addiction must be treated first. I have told people this over and over and you MUST start believing me. When you speak to a person who has an active addiction, you are no longer having any conversation with that person; you are speaking to the actual substance, even if they are sober or not drugging at the moment. Yes, you read this right. When you speak to someone hooked on weed, for example, you are having a conversation with the weed. You are asking the weed who he is going to vote for. You are asking the weed who he thinks will win American Idol. You are asking the weed what he is doing the next day, and what his plans are. You are absolutely literally having a conversation with the weed, not with the person, no matter how sensible any one answer may be or how sober or clean the person is at that moment. So long as they are actively addicted you are literally-do not think I am exaggerating or using symbolism-you are literally having a chat with a pile of mind or mood altering green leaves. This is because the substance changes the brain wiring and also the person's perception of reality, even when they are not drinking, huffing, puffing, snorting or injecting at that moment. In fact, it takes months or years after being completely clean that you stop having conversation with the substance, and the original person starts to re-emerge. So the poor family and friends of this sad medic in the linked article were having conversations with the gas he was huffing, even during the days or hours he was not huffing. Once he began an addict he stopped being the person on the other side of the conversation, and the huffing gas took over 24x7.
So yes, he needed to be treated for PTSD before he became addicted. However, I'm willing to bet that he became addicted very quickly and it is difficult for underfunded mental services anywhere, whether armed forces or civilian, to get a full treatment of mental illness diagnosed and run before the person is addicted to something. I've told all of you repeatedly that drug and substance abuse are the fifth column scourge that is destroying individuals and this country, and much of the world. I've warned about this since the 1960's, even as a teenager I warned adults about this. Once a person with a mental illness has an addiction you are no longer discussing your love for him or her, and their treatment options with that person. You are discussing your love for him or her and their treatment options with a pile of junk, a syringe, a nose full of substance, the alcohol waiting to be drunk, even if that person is not actually imbibing at that moment. The conversation is lost the moment they become an addict because like I said in my example, an addict thinks that setting fire to his finger to remove a splinter makes perfect sense.
What would I have done if I could? The minute he started reading his Bible I would have had him committed in a sanitarium like setting (if one still exists), and not because he is Bible reading but because that's a sign that he was overcome by forces he could no longer control and was turning to God. And God has created smart and caring people who presumably can then render the best medical care. Oh, wait, that's right. Underfunded and misunderstood psychiatric treatment ruled by insurance companies and "do gooders" who do not understand either mental illness or addictions. And yeah, I know all about not being able to afford the best; I've had no medical insurance for around seven years now. And yes, the pharmaceuticals have manipulated public health so that while vital and life saving medication is developed and provided, they have stomped out the long term residential talking and behavior oriented treatment that is ALSO needed. They would want to drug a guy like this soldier, yet still allow him to roam around in what he perceived as Iraq in his hometown.
This country MUST go back to the concept of sanitariums, but kindly and good ones (not Victorian flashbacks, so don't accuse me of advocating that.) But PTSD, for example, cannot be treated in a PTSD inducing environment, which is basically all of society right now. A PTSD guy cannot even turn on the TV or radio without it screaming at him, and forget actually driving on the roads. A PTSD guy or gal must be put in a serene lock down and be treated for all their problems at once in an environment that does not reinforce ANY of the stimuli at all. How about some tax and oil money going to THAT instead and actually saving some lives, souls and sanity? Sheesh. And those who say "exposure based therapy" is right for PTSD are totally wrong and irresponsible. Exposure to trauma was what "broke" them in the first place. They need to be returned to an anti-trauma setting to allow their internal wiring to mend. Then they can gradually return to environments with potentially trauma inducing stimuli. Let me use an example. A hurricane broke the levee in New Orleans. Gosh, I guess that levee needs more and more hurricanes to hit in after that, you know, to "cure it" by "exposure." You know, get the levee "used" to be broken by a hurricane. Instead of oh, you know, actually first rebuilding the levee when there is NOT a hurricane roaring? I mean, some common sense people, please. But medicine has become all about ego and money and secular measures of "satisfaction", nothing else. [Reminder of special place in hell for bad doctors and their enablers. Oh it's not nice there, really].......
Families, you must understand what I am telling you. Do not be taken in by phony counselors who tell you the propaganda that the underlying must be treated before the addiction. Don't let them only dig for the thorn once your loved one has burned his finger to char.
http://news.aol.com/article/soldier-in-famous-photo-never-defeated/90519?cid=12
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Another thought to fill those of you in on the "stinking thinking" (to use an AA term) that is rife among both addicts and their erstwhile counselors. Many addicts who do not attend AA meetings but do go to addiction counseling (or who refuse to go) will insist that they "be treated by a former addict because if you ain't been addicted you don't have no cred with me." Wha? How stupid is that? But the perception of the addict thinks (burn the finger of that thorn) and the counselors co-dependent and enable them (so they can get employment) and also because "the stoned patient is always right" mentality. I fully understand addicts who are cured and who want to give back to the community, and think they have some solutions that "worked for them." Fine, give back to your community in an area other than substance abuse counseling, and share your ideas offline with non-addict counselors. I'm sorry that sounds hard but your setting yourself up as "teachers" and "guides" and "counselors" by virtue of being "ex addict" feeds the stinking thinking of the addict. They receive reverse validation when they think that "well, see, everyone is a reformed addict; no one can resist addiction." They need to hear loud and proud from people who NEVER WERE addicts, in order to learn how to live like fully functional and healthy human beings again. I'm sooooooooooooo fed up with well meaning AND self serving "recovered addicts" who "give back" by "being counselors." Give back in a food bank and get out of the way. Stop enabling recovery chic. And don't call me a racist or bigot. A woman of color, one of my grad school professors, told me about this, as she was undermined by her patients because she had never been an addict herself. Wow, that's stinking thinking in action, but like I said, be compassionate and understand that it is the substance telling her that she has no street cred to counsel addiction, not the person whose lips were moving. The addictive substances are making those accusations, not the person who "was" before the addiction. It's the same logic that makes recovered addicts think they are the best addiction counselors. Their ex-substance is still doing the "thinking" for them. Give it a rest and don't allow the substances to have all of the conversation themselves, or this world is a goner for sure; trust me on that.
