Toward a Neurocounseling Paradigm: The Science Behind Step One in Addiction Recovery

Facilitating successful early and sustained remission from substance use disorder remains an extraordinarily difficult puzzle for both clients and supporting persons to navigate. Ninety years since Alcoholics Anonymous developed its twelve step, spiritual approach to recovery from the devastation of alcoholism, initiating and sustaining abstinence from addictive substances remains a tremendous challenge. While the 12-step community continues to support addicted persons at no cost through meetings and relationships, psychology, counseling and medicine are continuing to develop approaches for people to achieve recovery from addiction. To date, there is minimal convergence in these approaches leaving affected individuals with often confusing choices in seeking necessary recovery support. The unfortunate result is the predominant view of substance use disorder as a chronic relapsing disorder whereby relapse is embedded asfundamental to its nature. Greater societal stressors and increasingly dangerous substance access is resulting in death by overdose becoming a major public health issue. Rapid advances in diagnostic and imaging research techniques over the past two decades, have given tremendous insights into central nervous system functioning at cellular and systems levels. Building on pioneering work in the behavioural neuroscience of addiction, this paper enriches and unifies the often-divergent approaches taken by addicted persons and loved ones, supporting professionals, and peer support groups in addiction recovery.Through a systems neurobiological approach, we outline the progressive neuroadaptations in the limbic system which lead tothe condition described by Alcoholics Anonymous as powerless. Understanding the veracity of this central issue in addictionprovides an approach we name as Neurocounseling, providing the opportunity for agreementand synergy across approaches.With neuroplasticity as a guiding principle both in progression of the disorder, as well as in the attainment of recovery, addiction can be more appropriately viewedas a life experience rather than a life sentence.