An Interview with Dr. Murali Krishna about Arcadia Trails Center for Addiction Recovery

Oklahoma is plagued by the epidemic of addiction. It is the leading cause of unintended death for Oklahomans between the ages of 25 and 64, but we are ranked worst in the country when it comes to available treatment options. This month INTEGRIS broke ground to begin construction on a state-of-the-art addiction and mental illness treatment center in Edmond, Oklahoma. The INTEGRIS Arcadia Trails Center for Addiction Recovery, as it will be called, is scheduled to open in early 2019.

"There are nearly 600 Oklahomans on a statewide waiting list for residential substance abuse treatment services, on any given day," said Terri White, Oklahoma Commissioner of Mental Health and Substance Abuse. "These are individuals who have asked for help and have been assessed to need this level of care, but we simply do not have the resources to respond. And, we know, that when appropriate services are not available, other negative consequences occur that further compound the problem and cost more to address. Oklahoma’s death rate due to alcohol and drug poisonings has more than tripled over the past 15 years."

Couple that with the fact that one in four Oklahomans suffers from some sort of mental illness, and it is easy to see that there is an undeniable and urgent need for more addiction and mental health services in our state.

Recently, On Your Health spoke with Dr. Murali Krishna, who has committed his life’s work to the science of brain diseases. Dr. Krishna is the co-founder and president of the INTEGRIS James L. Hall Center for Mind, Body and Spirit and past president of INTEGRIS Mental Health. He is one of the visionaries who is helping bring the dream of Arcadia Trails into reality.

Why is it important to treat addiction, mental illness and trauma together?

One of the big misunderstandings we have in this nation is that addiction is a moral failure or a weakness or a lack of willpower. It is none of those. Addiction is a brain disease -- a mental illness -- where genes and environment play a role. Studies have shown that up to 90 percent of addicts also struggle with mental illness and trauma. It’s difficult to treat just one aspect without treating the others. Arcadia Trails will focus on the mental illness of addiction and how to treat it. Treating all components together will significantly increase recovery rates. When all aspects are evaluated and treated concurrently and comprehensively, that is the ideal environment for the brain to heal.

At Arcadia Trails, we plan to deliver a comprehensive medical approach to treating addiction, mental illness and trauma. Patients will receive a diagnosed evaluation of their addiction, which will include psychological testing and neurocognitive evaluation. They will receive evidence-based, scientifically proven medical treatment to improve their brain function and capability and we will provide a comprehensive discharge plan as they face the world newly sober.

What can you tell us about the science of addiction?

Addiction is ingrained in a person not just psychologically, but physically. When an addict doesn’t have the drug, his or her entire body is hurting: the GI tract is hurting, the heart is hurting, bones are hurting. No one enjoys or plans on being an addict.

It’s a psychological and a physical disease that needs to be treated like any other disease. For example, if 100 people were to take a narcotic or a drink of alcohol, 75 of those people can go back to normal life and resume daily activities. However, 25 people have a predisposition to the disease, and will start having a psychological and physical reaction to the substance, causing changes in their bodies in a subtle way.

These changes hijack the pleasure, reward, joy and contentment feelings in the brain. Normal activities they used to enjoy in the past become less enjoyable without the drug. The best way I can describe it is they feel like a square peg trying to fit in a round hole. Without the drug they feel uncomfortable, and that’s what drives them to the addictive behavior. It’s the physical addiction that make recovery difficult. Their bodies are telling them they need to take away the pain and numb or calm themselves with the drug.

Can you talk a little more about the treatment phases at Arcadia Trails?

First, it’s important to note that addicts don’t sequentially go through each stage of recovery easily; they often go in and out of phases. Aside from the physical and psychological pain, they are also experiencing a loss of control over their lives, relationships, ethics, their workplaces, finances, judgment and decision-making. They are battling these issues constantly which makes a linear recovery difficult.

Phase One: Acceptance and Willingness.

In this phase we detox and focus on the stabilization of the patient’s body, and the mind and spirit, too. Then, we fully evaluate every aspect of the addiction and perform a psychological brain scan. Up to 90 percent of patients that have addiction also have a mental illness that stems from trauma in the past. In this very important phase, we educate patients about the illness and help them understand this is a brain disease. It’s also important that they understand the powerlessness they have over this brain disease and the unmanageability of that life. 

Phase Two: Inward Assent and Discovery.

In this phase we have patients reflect on their lives and family history. This is an honest account of challenges, feelings of guilt or shame, and unresolved trauma. We develop a custom treatment plan and start discussing a possible discharge plan. It takes between 45 to 90 days to begin “rewiring” the brain. This is the stage where the patient starts moving from problem to solution.

Phase 3: Understanding and Experiencing Spiritually.

In this phase we discuss religion and finding a spiritual path for our patients. Discovering the power of prayer and meditation is key, and we help them develop a spiritual development plan.

Phase 4: Mending Relations and Living Sober.

In this phase we evaluate how addiction and mental illness affected life at home for an addict and his or her family, relatives, friends, coworkers, bosses and more. We help patients understand the impact the illness had on their relationships. We discuss how family relationships were impaired by the addiction and how they can mend and improve those relationships. Here we also discuss triggers and develop a prevention and sober-living plan.

Phase 5: Returning to Life and Recovery.

In this final stage, we reevaluate brain health and develop a continued care plan for when a patient leaves the treatment center. This includes community resources and support groups. We also refine the discharge plan and discuss the plan with the family. After a patient departs, we periodically check-in to see how the plan is evolving.

Everyone’s journey is unique, but these are the important milestones that help mark progress along the path. These milestones are incremental steps to a healthy mind, body and spirit, and together they are the recovery steps that form Arcadia Trails.