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founded by S. N. Goenka in the tradition of Sayagyi U Ba Khin

 

 

 

 

 

Drug addiction & Therapy: A Vipassana perspective

-By Dr. R. M.Chokhani

Introduction

Drug addiction or chemical dependency has become a worldwide problem respecting no barriers whatsoever, whether social, economic or religious, with serious ramifications for mankind since it undermines individual health, warps human relationships, torments families, cripples the economy, fosters crime and destroys peace a veritable scourge of society, indeed. Various therapeutic approaches have been resorted to in treating and rehabilitating the addict, the major ones being pharmacotherapy - detoxification, maintenance; counselling and psychotherapy - individual, family, group, self-help groups - alcoholic anonymous, narcotics anonymous. The outcome has been generally unsatisfactory, with the majority of the addicts still trapped in the "revolving door phenomenon" characterized by initiation, continuation, abuse, cessation and relapse.

Trail of Addiction

The realization has now dawned upon the addiction therapists and research workers that craving (tanha) is the root cause of all addictive behaviour; also, that people get addicted not only to drugs but to many other things as well. The word "addiction" is actually derived from the Roman legal terminology; to "addict" meant,"to give over to a master or enslave". The world was subsequently anglicized and used to describe an individual's behaviour when he/she habitually and obsessively surrendered control of his/her life to a particular experience, sensation or activity. It is thus "craving" that needs to be tackled directly and adequately if there is to be a real redemption; Vipassana does just that. "Vedana samosarana sabbe dhamma', said the Buddha, which means; everything that arises in the mind is accompanied by body sensations. This inter-relationship of mind and matter is the key to the practice of Vipassana, which by working with sensations reaches progressively deeper levels of mind to remove the roots of addiction.

Chemical dependency is actually an addiction to the pleasant body sensations (sukha vedana), that arises because of the biochemical flow (asava) in the body specific to the pharmacodynamics of the drug taken. This biochemical flow (asava) influences the mind with more craving (tanha) which, in turn, precipitates subsequent drug intake and vice versa; a vicious circle thus sets in and a clinging (upadana) develops, which leads to a compulsive and repetitive drug usage. Besides, physical dependence on the drug and drug tolerance also set in, the rider being that the more powerful the drug, the faster the deeper trouble occurs. It is, therefore, advised that the addict stops using drugs and negotiates the drug withdrawal phase, much before the due date of his/her Vipassana course, so that he/she is able to derive optimum benefits from the practice of Vipassana.

Progressively, the addict goes beyond the craving for drug-induced sensations and clinging to just craving, that is, desire simply for desire, develops. At this stage, the external stimulation of the drug becomes secondary, manifested by the phenomena of multiple drug abuse and switching of drugs when the drug of choice is not available. This cycle of addiction to craving continues in everyday life, even when the addict is not under the influence of drugs; the memory of the pleasant effects of the drug generates craving, which is accompanied by sensations and the process of multiplication of craving continues unabated, leading to formation of strong conditionings (sankharas) of addiction. This explains the occurrence of chronic relapses even after fairly long periods, say years, of drug abstinence. As the saying goes, albeit modified, "Once an addict, one is still at risk of relapse".

Dawn of Wisdom

The meditator realizes that the addiction is not merely to the chemicals being abused but also to the negativities in the mind like passion, anger, egotism, etc. As with chemicals, the addiction is really to the particular sensations (vedana), that arise because of the biochemical flow (asava) specific to the mental content. The asava of ignorance (avijja) is the strongest asava. It is out of ignorance that one reacts with passion, anger or fear, but drug abuse and intoxication queers the pitch since it multiplies one's ignorance. Therefore, an addict takes more time to feel sensations; some may need to take more Vipassana courses. But if one keeps working patiently and continuously, sooner or later, one manages to break the barrier of ignorance between the 'paritta citta', the conscious mind, and the bhavanga,the unconscious mind, and one starts feeling sensations throughout the body.

Along with this awareness (sati) of sensations, an understanding of their impermanent nature (anicca) is also developed, which enables one to observe them objectively, equanimously (upekkha). By sampajanna - the constant thorough understanding of impermanence with Vipassana, the process of 'vedana paccaya tanha' is reversed and 'vedana paccaya panna'results, that is, with every sensation, be it pleasant, unpleasant or neutral, instead of craving and aversion, now the wisdom of impermanence arises and one remains equanimous; thereby, no new sankharas(conditionings) are produced and layers after layers of the old accumulated sankharas get eliminated. In this way, Vipassana strikes at the root cause of addiction and gradually eradicates it.

Practical Applications

Vipassana is not some magic or miracle. Progress requires a strong will to come out of addiction, as also, to work towards this goal, by observing oneself at the level of sensations. Therefore, prior preparation and motivation of the addict for passing through the Vipassana course, by counselling and by teaching 'anapana-sati' (awareness of the breath) is crucial. That enables one to work properly and get the desired results, as has been observed at 'Cyrenian House' in Perth, Australia and at 'Start Again' in Zurich, Switzerland, the addiction therapy centres for drug dependants, founded and run by Vipassana meditators since 1981 and 1992, respectively. The addict is supported and counselled after the Vipassana course as well, to ensure that he/she keeps working with the technique regularly.

These two centres have also made the time available to their patients as well as their staff, to practice anapana sati(and Vipassana, where applicable) on a daily, in-house basis, as also, to attend Vipassana courses that are held externally. Nearly all the staff members are meditators and many are ex-addicts too, who with their Vipassana experience and its applied practice in their daily life, show empathic sensitivity and effectiveness in helping their clients, as well as serving as excellent role models. Attracted by this novel and effective approach, many drug rehabilitation organizations have evinced keen interest in incorporating the deeper dimensions of anapana-satiand Vipassana in their therapeutic programme and have been deputing their staff members and patients to Vipassana courses.

With the practice of Vipassana, one learns how to lead one's daily life, to gain increasingly more freedom from suffering (dukkha). One tries to observe how one is dealing with various life-situations, whether one is reacting or remaining equanimous. It is only when one reacts that one generates negativity and becomes miserable. A few moments of observing body sensations makes the mind equanimous and one remains balanced; then instead of reacting blindly, one can choose the best course of action. Accordingly, the drug addict is advised: "Do not succumb the moment an urge or craving arises. Instead wait for awhile, for 10 to 15 minutes. Accept the fact that an urge to abuse drugs has arisen in the mind and start observing whatever sensations that you feel at that time, since the two are interrelated. And by experiencing the impermanent nature of the sensations, you will find that this urge weakens and passes away". Thus, the practice of Vipassana helps in times of stress, which could have led to a relapse in the past, and the addict-meditator becomes increasingly more resistant to threats to his/her sobriety.

Conclusion

The Buddha is truly called 'Maha Bhisaka', the great physician, for having given to the world this wonderful technique of Vipassana, by the practice of which, one is liberated from all the ills of life and one's entire being gets suffused with infinite love (metta), compassion (karuna), sympathetic joy (mudita) and equanimity (upekha). Life becomes full, harmonious and fruitful. All this is not achieved though, just by attending a Vipassana course of ten days. There is no short cut. One has to make sustained efforts. A ten day course followed by regular practice sets in motion a process of improvement, which is worth attempting, sublime and elevating. Those who really want to come out of their addiction should take to Vipassana for their own emancipation,as also, for the benefit of others.

Bibliography

Moss J (1985), The Cupid Syndrome: Addiction and Dependency in Perspective, in Eds: Larkins K.P., McDonald D. & Watson C., Alcohol and Drug Use in a Changing Society: Proceedings of the 2nd National Drug Institute, Alcohol and Drug Foundation - Australia, Canberra: 20-32.

Scholtz G. (1995), Vipassana Meditation and Drogentherapic, German Vipassana Newsletter, March 1995, English Translation.

Studer U.M. (1997), Vipassana, Professional Therapy and Science, Under Publication.

Vipassana Research Institute (1990), A Reader: Seminar on Vipassana Meditation, Relief from Addictions, Better Health, November 1989, Igatpuri.

Goenka S.N., Closing Address: 62-69.

Hammersley R. & Cregan J., The Cyrenian House Programme: 45-47

Khosla R., Problems with Current Therapeutic Approaches for Alcohol-Drug Abusers and How Vipassana Helps Them: 48-51

Scholtz G, Vipassana Meditation and Drug Addiction: 36-44.