New Drugs — Does Lifestyle Intervention Still Count? Part 8

Just by the very nature of contemporary life, mental health treatment is not often conducted in person. Apps and devices that monitor physical vital signs have been around for a long time, and now increasingly all kinds of care are administered online or through smartphones. An incredible number of quite respectable podcasts are sponsored by a company that connects potential clients with therapists and facilitates change if the first match is not satisfactory.

Meanwhile, more troubled people come to understand that the day may never come when they will be “fixed.” They may continue to need an impartial listening ear, at least occasionally. Sometimes a person can sail along for years, but then an accident or physical illness may happen, or the death of someone close. When a new relationship begins or an old one ends, a person often needs extra support.

Some people benefit from help for the rest of their lives, and there is nothing wrong with that. We don’t blame people with diabetes for continuing to need insulin, and we don’t blame people who need long-term mental health support. This is especially true of those who aspire to more than just not being sick. For people who want to continue to get better, and then even better than that, there is no limit.

It’s a lifestyle

In an earlier post, we talked about how important it is for a treatment program to embrace every part of life — family, peers, work relationships, and the larger community — as well as a person’s spiritual foundation and ethical standards. Now to any of these factors, add the continuing and ongoing need to manage a substance abuse tendency, whatever that substance may be.

A recent Childhood Obesity News post quoted a man who says, “I spend five hours a day minimum working on staying sober for that day.” Daily attendance at a meeting, for instance, is a definitive lifestyle intervention, and for some people, that’s what it takes.

The quirks of addicts

Author and late-night TV personality Alexander King, who was popular more than half a century ago, had been incarcerated in the federal addiction recovery center in Lexington, Kentucky. While in withdrawal himself, King watched a fellow inmate kneel by his bed as if in prayer, and prepare a hypodermic needle, tie off his arm, and inject a shot of heroin into the vein — all just expertly mimed, of course. The haunting glimpse into another’s sickness made a lasting impression, and King included it later in Mine Enemy Grows Older, one of several best-selling autobiographical volumes.

More recently, for Medium, Eric Allen Been interviewed Judith Grisel about her book, Never Enough, which is pretty much the motto of all addicts everywhere since the beginning of time. Unlike many addicts, however, Grisel has been “clean and sober” for more than three decades, during which time she became a professor of psychology and neuroscience.

When her interviewer suggested that many heroin addicts are addicted not just to the drug, but to the process, “the ritual of being dopesick, scoring, shooting up, etc,” Grisel replied,

Craving is to a point kind of fun. I think the paraphernalia, the bag in your pocket, all those things elicit a sort of anticipatory wide-awake brain state.

Confirming this, comedian Joey Diaz talked on a podcast (reference unavailable) about how the happiest he ever was, was in the car on his way to score (buy cocaine) and then while driving home with it.

Your responses and feedback are welcome!

Source: “A Neuroscientist Explores Addiction, the Brain, and Her Past,”, 03/05/10
Image by Robert Miller/CC BY 2.0 DEED

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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