The Recovery Blog

On Anonymity in Recovery

May 22, 2013 by Recovery Blogger Leave a Comment

Submitted by Bill: I was at a 12 step meeting a few days ago where one of the participants’ remarks showed that he had no real idea of what anonymity meant, or the reasons for it. So I thought I’d weigh in with a few ideas on the subject.

I tell people that I have no anonymity; that I drank and drugged publicly and I consider it a privilege to recover publicly. Despite that, however, I do not advertise my membership in a particular 12-step program. I often mention attending meetings, in my writing and elsewhere, but not which meetings. I speak knowledgeably about AA, NA, and other fellowships, but I don’t talk about membership. I have what I believe are good reasons for that, and I’d like to share my thoughts with you.

As I see it, there are two basic reasons for anonymity in a program of recovery: protection of the recovering alcoholic/addict, and protection of the program itself.

First of all, if we wanted to tell people we were members of AA, that would be our business, and ours only, provided that we did it on a personal level. We might do so when speaking to people one-on-one, or in small groups under conditions where privacy can be presumed, because friendships are enhanced by such honesty under most conditions. Then, too, that revelation might raise opportunities to bring the 12th Step into play.

Another area where we need to be careful is in speaking to outside groups. We need to be sure that we’re not thought to be speaking for a particular fellowship. If we set ourselves up as some sort of recovering guru, how is the program going to look if, six months from now, one of those folks sees us passed out behind a dumpster, or in the ER being treated for an overdose?

Could happen. If you don’t think it could, speak to your sponsor.

There are excellent reasons, however, for us not breaking your anonymity. You might be hindered in your employment if word got out. You might be an airline pilot with 20 years clean and sober who had neglected to tell the FAA about her problem — required by law — and lose your livelihood due to our big mouth. It could simply be an issue that you find embarrassing. It’s no one else’s business. Our business is to keep what we have learned about others in the rooms to ourselves, period. (Whether or not the airline pilot is behaving ethically in that situation is not the issue; it’s our behavior we’re discussing — and that is not a hypothetical example.)

The last, and perhaps best, reason that I can think of for sticking with the tradition of anonymity is humility. It makes me just “another bozo on the bus.” If I’m going try to be a guru, it’s going to have to be on my own merits, not those of the program. That’s good for me and for the program, because my opinions often vary somewhat from more traditional positions. When they do, I need to take the credit — and the criticism.

Anyway, those are a few of my thoughts about the issue, and I’m only speaking for myself. Your mileage may vary.

Filed Under: Treatment, Twelve Steps Tagged With: 12 Steps, alcoholics anonymous, honesty, narcotics anonymous, Recovery

Why Can’t Recovering Addicts Use In Moderation?

May 14, 2013 by Recovery Blogger Leave a Comment

A client asks: If we can change our thinking in order to abstain from using alcohol and other drugs, then why can’t we change our thinking to be able to use in moderation?

Why can’t addicts use in moderation? Think about it: why couldn’t we simply use “in moderation” without all the hassle of detox, treatment, and a program of recovery? If we couldn’t do it then, why should we be able to do it now? Those are the real questions!

The key is “change our thinking.” We don’t think our way out of addiction. We make a decision to get clean and sober, and to follow the suggestions of our program of choice, in order to facilitate abstinence. The thinking and process of our programs of recovery relieve some of the emotional pressures we created with our addiction and equip us to live sober lives, but they do not “cure” the addiction.

Abstinence and the subsequent repairs that our bodies are able to effect in our brains allow our addiction(s) to enter remission. Our brains slowly deactivate the extra receptor sites that clamored for more drugs and caused our compulsion to use, and at the same time the production of chemicals normally found in the brain has to ramp back up from being suppressed by the presence of the drugs. Not until this process is complete — and it can take months — do we reach the point of feeling relatively normal, although we begin to feel better long before the job is done.

Feeling better is part of the problem, too. Because the repairs to our brains depend on abstinence, as long as there are any of a wide variety of abusable drugs in our systems, the repairs can’t take place. And because they also take time, and that means that the desire to use won’t go away entirely for quite awhile; it will come and go. We can easily decide that we’ve been clean for a while so we ought to be able to “handle it.” But if we give in and use, even a little, the repairs to our brain will slow down, prolonging the physical recovery process. It is also quite likely that the combination of reuniting with our old obsession, combined with the indisputable fact that people on drugs do stupid things, will cause us to decide more would be better. Continued use will reverse the recovery process and kick us back into full-blown addiction.

Recovery is not a matter of willpower. If it were, we would have simply ignored the compulsion and stopped. The compulsion comes from a part of the brain that isn’t affected by conscious thought. We can’t think our way into sobriety; we need abstinence too. Here at Sunrise Detox, we see a lot of folks who think that they can use in moderation. Again, and again, and again….

Filed Under: Addict, Alcoholic, denial, Questions From Newcomers, Recovery Tagged With: addict, alcoholic, denial, questions from newcomers, Recovery

Why Does Sharing Experience, Strength and Hope Work?

May 11, 2013 by Recovery Blogger Leave a Comment

In order for me to recover, I have to understand at least some of the ideas flitting around in my head. Telling someone else is the best way to get the mess organized. Saying what’s happening to me in a way that others can understand — putting it into words and sentences — removes the secrecy, the mystery, and clarifies things in my own mind. My thoughts have to stop running around in circles (at least a little bit), and that allows me to see through my own mental static. But there is another powerful reason for sharing our experience, strength and hope.

No one gets into recovery by accident. We used alcohol, other drugs or behaviors — often all three – because they made us feel better about ourselves. After they stopped working we kept using them because we were physically and emotionally addicted, and because we didn’t know what else to do. Eventually something happened that made us willing to take a terrified leap into the unknown, because we could no longer tolerate what was going on in our lives. I didn’t get up one morning and say to myself, “Hey, it’s nice out; I think I’ll go to detox!” Neither did you.

But what got us into recovery doesn’t really matter. What matters is that we have to repair the damaged thinking that made acting out our addictions seem preferable to facing reality. As many have said, “I’m not responsible for being an addict, but I am responsible for my recovery!” Back then, we didn’t know any better; now we do.

And that’s where the experience, strength and hope of others matters. In order for us to have faith in the program, we have to see that it works. Listening to other addicts tell how it was with them, what worked for them, the results and their hopes for the future — or maybe just how scared they are — tells us that we’re not alone, and gives us hope. I may not believe that I can do it, but if I see and hear that there are people who felt the way I felt, who had many of the same or similar experiences, who suffered the same shame, guilt and despair, and that they’ve managed to get beyond all that, turned their thinking around and begun to live, then just maybe I will begin to believe that I can do it too.

Further into our recovery, we may listen with a changed ear and be able to hear how we can apply the experiences of others in our own lives. In the beginning, though, we simply need the reassurance that we are not the only ones who behaved the way we did, that others have recovered successfully and are willing to share what they’ve learned, and that we are not alone.

That’s why we’re told to identify with the lives and feelings of others, and not compare. The details don’t matter. The feelings, fears, and humanity that we share with our fellow addicts are the keys.

Experience. Strength. But, most of all, HOPE!

Filed Under: Addict, Alcoholic, Recovery, Support Groups, Twelve Steps Tagged With: experience strength and hope, self-esteem, self-image

People, Places And Things

May 8, 2013 by Recovery Blogger Leave a Comment

Many of the folks who attend the groups at Sunrise Detox wonder about “people, places and things,” and question how merely seeing someone, or being in a particular place, can trigger a powerful desire to drink or use other drugs.

Maybe the best way of understanding this is to consider a number of recent experiments that studied the brain activity of subjects while they were exposed to certain stimuli. Rats, rabbits, and non-human primates will seek the same drugs that we humans abuse, and will begin seeking them again — even after months of deprivation — when exposed to the drugs themselves or to visual cues that they have associated with drugs in the past. Along with these, brain-imaging studies on human addicts indicate that visual cues can cause the addict to recall the pleasure of drug* use, and can cause enhanced activity in areas of the brain that are associated with cravings.

This research shows scientifically what people in the rooms have known for a long time, often demonstrated in sayings like “If you don’t want to slip, stay out of slippery places.” It doesn’t take a rocket scientist to figure out that if you want to stay sober you don’t go into a bar, order a drink, and sit and look at it. There’s a technical term for folks who test themselves that way: relapsers.

It shouldn’t take a lot more thought to see how less obvious things can have similar effects. Ordering a club soda and hanging with our drinking friends, seeing our dealer in a crowded club, passing the shop where we purchased our wine, even sitting in front of the TV with our buddies watching a game — all of these thing can trigger a desire to use, the “just one won’t hurt” thought that has killed so many of us .

Stress

Consider that stress is one of the greatest causes of relapse, because it was one of our biggest excuses for using. Family arguments, the presence of people whom we believe disapprove of us, being around other people who are behaving the way we used to, animosity from people we harmed during our addictions — all of these things are powerful stressors, along with financial, legal and romantic complications. Some of these things are going to be parts of our early recovery, but it certainly makes sense not to complicate the problem with temptations and stressors that can be avoided. Of course these things are part of live, and of course we’ll have to deal with them eventually, but that doesn’t mean we should try when our brains are still in early recovery and the likelihood of relapse is at its greatest.

Thus, to the extent possible, we need to avoid the old people, places and things until we have enough sobriety under our belts to deal with the stress and temptation. Even then, smart addicts moderate periods of tension by attending extra meetings, calling people in the program, and generally stepping up their involvement in recovery.

Many sensible strategies, such as living in halfway houses, staying out of home areas, putting off jobs, relationships and other potential stressors can seem counter to the idea of recovery. After all, isn’t it about carrying on with life? That it is, but carrying on with life means doing so effectively, which means clean and sober, with some good recovery under our belts. Recovery is difficult enough without standing at the plate begging for curve balls. Trying to “make up for lost time” is an excellent way to lose even more of it, and perhaps our jobs, families, or even our lives along with it.

*When the writer uses the term “drug” he includes alcohol, which is simply a legal drug.

Filed Under: Addict, Alcoholic, Family and Friends, Relapse Tagged With: People Places Things, relapse, triggers

Zoloft Put the Pleasure in My Sobriety

May 3, 2013 by Recovery Blogger Leave a Comment

I’ve recently run across the old bugaboo in the rooms related to taking antidepressants. Because not taking them when needed can not only impact our ability to work a program but can also lead to serious debilitation and even suicide, I think this article is a must for everyone in recovery.

“Better living through chemistry” isn’t just a slogan: I’ve been on antidepressants for 20 years, and can still remember exactly when the first one started to work—allowing my recovery to begin for real.
By Maia Szalavitz

Marijuana In Recovery — Why Not?

May 2, 2013 by Recovery Blogger Leave a Comment

“If caffeine and nicotine are accepted in the program, and they are both mood-altering substances, how come weed isn’t? Pretty soon doctors will be able to prescribe it. They already can prescribe it in some states.”

Most drugs are useful and manageable when properly prescribed and used, but history has made it clear that such is often not the case. Doctors can prescribe Oxycontin, and you can buy beer at the gas station. However, legality has absolutely nothing to do with addiction. (And it has never been shown that doctors are the best source of ideas for staying sober, except in the very rare cases when they are specifically trained to treat addiction.)

The First Step reads, “We admitted we were powerless over (alcohol) (our addictions) – that our lives had become unmanageable.” It doesn’t say and that our lives had become unmanageable. Our lives were unmanageable because we were powerless over a drug.

There are many different kinds of mood-altering substances. Some are clearly problems, some less so, some aren’t problems at all, and some are problematic over such long periods that we tend to think they’re not major issues. Nicotine is an excellent example. Tobacco products are the number-one preventable cause of death in the world, yet the next cigarette, cigar, chew or dip isn’t likely to be the one that kills us – as far as we can know. Obviously there is, at some point, a level of exposure that makes the difference, but we can’t see it and it’s easy to ignore.

Denial, as they say, is not just a river in Africa. And, for the record, many treatment centers no longer permit nicotine use during treatment and strongly encourage newcomers to quit smoking. Their position is that an addiction is an addiction, and that we are either ready to be clean or we are not. While nicotine may be an “outside issue” in AA, it certainly isn’t in NA, but in both cases the fellowships take the position that the drugs with the most serious immediate effects need to take priority, and experience has shown that to be the case. No fellowship that I know of, however, has ever stated that they believe nicotine to be harmless.

Caffeine, in anything like reasonable quantities (200-250 mg. a day, not five energy drinks), is unlikely to make our lives unmanageable. Small quantities, in fact, are now believed to be good for us, especially if gotten from brewed coffee.

Drugs like alcohol, opioids, barbiturates, benzodiazepines and – yes – weed, are a different story. All have been shown, in repeated scientific studies that have been published in reputable scientific journals for the review of any expert who wishes to challenge them, to have both short-term and long-term effects that can negatively affect both users and the people around them.

Marijuana works on the same pathways in the brain as other drugs of abuse. As long as those pathways are kept active, the brain cannot make the repairs that allow long-term recovery to be successful. From that standpoint alone, there is no place for marijuana in recovery. Nicotine works in a slightly different way, and does not seem to impair recovery as much. However, recent research has indicated that it may have more undesirable effects than has been believed.

From an overall point of view, consider that the purpose of recovery is to learn to live a healthy, productive life without the crutch of drugs – to face life on life’s terms, to learn to live, love and prosper in a healthy way, and fit into the rest of society.

There are many things that can block that progress, from eating disorders to sexual obsessions, shopping, gaming and any other activity that can be used – to excess – to keep us from having to deal with life. When we depart from our purpose of living life on life’s terms, and need to use things outside ourselves to make us feel good, we are not truly in recovery. The exception, obviously, are medications such as antidepressants, which do not affect the brain in the same way as drugs of abuse.

Sobriety is about getting sober. Either you’re on board that flight, or you’re not.

Filed Under: Addiction, Cannabis-Marijuana, Marijuana, Recovery, Support Groups

What Is Cross-Addiction? Why Can’t A Pill Addict Drink?

April 29, 2013 by Recovery Blogger Leave a Comment

One of the more common questions around treatment centers and the recovery fellowships goes something like,”I’m addicted to prescription drugs, not alcohol, so why can’t I have a drink? What’s this cross-addiction I’ve heard about?”

That’s really not an unreasonable question. Why do addicts who don’t seem to have problems with alcohol need to stay away from it anyway? Why can’t a prescription drug addict have a few drinks?

There are really two reasons:

Alcohol reduces our inhibitions and increases the likelihood that we will make bad choices; and
Just as they say in the rooms, “A drug is a drug is a drug.”

Number one is pretty much self-explanatory, and can be attested to by anyone who has regretted something he or she did while they were drinking. The parts of our brains that are responsible for taking in information and allowing us to make reasoned decisions are among the first functions to be depressed by alcohol, along with some motor skills. (See any relationship to drunk driving problems there?)

We make poor decisions about driving, about kissing the boss’s wife at the Christmas party, about arguing with large men who carry guns and handcuffs, and all sorts of other things, including whether or not to drink more or use other drugs. “It seemed like a good idea at the time” can become a major problem when we’ve had a couple of drinks. Essentially, booze makes us dumber while convincing us that we’re smarter.

The second reason, known as cross-addiction, is a bit more complicated but makes perfect sense when you understand a few things. Cross-addiction refers to how we addicts, once addicted, are far more likely to get hooked on other drugs or behavior in addition to our drugs of choice.

Why do we drink or use drugs? We may say we like the taste of whiskey, but the fact is that we like it because we associate it with the way alcohol makes us feel. We use alcohol and other drugs because they change the way we feel. They make us feel “good,” or they “relax” us, or they (insert own reason here). Sometimes we use because we’re happy and we want to feel happier, but most of us use drugs and mood-altering behavior because they distract us from reality. Trouble is, the drugs always wear off, and we’re always there, wishing we still felt good. It doesn’t take us long to figure out how to make that happen.

Certain activities stimulate the production of chemicals in the brain that make us feel pleasure. Generally, these relate to things that are mostly beneficial: seeing a loved one or good friend, eating, exercising, playing games — especially if we win — fun, daydreaming, getting a good grade in school, a compliment, sex and so forth. They are quite literally our bodies’ way of insuring that we keep on doing things that are good for us. We refer to the portion of the brain that is stimulated as the reward center.

Alcohol and other drugs also stimulate the reward center, and they do it extremely well to begin with. When we start drinking and using drugs, the feelings are phenomenal. They are much stronger than the normal sorts of feelings, because the drug causes the production of extra quantities of feel-good neurotransmitters or, in some cases, stimulates the receptor sites in the reward center directly. Now that’s a reward, we think (sort of) — a powerful reward for using the drugs instead of our natural system of feeling good. Doing it again seems like a very good idea indeed.

But the goodness doesn’t last. As our reward centers become accustomed to the higher levels of stimulation, they become pretty much immune to the natural reward chemistry. We begin to need chemicals in order to get any sense of pleasure, and eventually just to feel normal. As we increase the levels of drugs, our brain attempts to compensate for the high levels of stimulation in two general ways: first by reducing the production of the natural feel-good chemicals, and also by building new receptor sites to deal with the excess chemicals floating around. It does this in an attempt to keep things to something like normal, but it’s doomed to lose the contest. Eventually, we have to have the drugs in order to function at all. We’re — guess what — addicted.

Now some of you are going to think, “Man, they oversimplified that big time!”, and you’ll be right. Others are going to think, “What crap! I drink…use drugs…whatever…because I want to!” Well, if you only have have a couple of whatevers a week you may be right, but if you’re reading this because you think you might have a problem, you’re wrong and you’d best pay attention.

So what does all this have to do with a prescription addict having a drink? Everything. At the end of the day all drugs, including alcohol, act on the reward center. We get our good feelings from the reward center, and the reward center doesn’t know the difference between one drug and another. We can tell the difference in our conscious mind, because we feel the physical changes in other parts of our brains — stimulation, depression, whatever those effects may be — but the reason we enjoy them is because of the effects on our reward center, which operates mostly below the conscious level. Really now, who would want to get all jittery…or dumb and sleepy…or stupid and hungry if it didn’t feel good?

So, when we take a drink, our reward center is like, “Hello? This feels good, and we know how to make it feel even better, don’t we?” If we’re in early recovery — the first two years or so, say — our brain hasn’t even gotten back to normal yet. It has to deactivate all those extra receptor sites that it created to handle the extra stimulation, and it also has to have time to reactivate the systems that make the natural neurotransmitters. During that time we’re sitting ducks for relapse. Even after the repairs, the receptors are still there waiting to be reactivated by the presence of the drugs. We’re talking repairs here, not new brains.

Any mood-altering drug or activity can affect the reward center, and so any of them can become addictions. Cross-addiction normally refers to substances, but it can also apply to behavior.
People often replace alcohol and other drugs with mood-altering activities like gambling, which is especially dangerous because of all the booze and drugs around (they know it makes people stupid). Other behaviors include relationships, porn, other sexual acting out, exercise, thrill-seeking and other activities that heavily stimulate the reward center. The fact is, you can get addicted to almost anything, if it causes pleasure or distraction from life issues.

That means that the name of the game in recovery is avoidance of all mood-altering substances — okay, not caffeine (in reasonable quantities) — and excess in other areas of our lives. Fun is fine. Pleasure is fine. But when the feelings become the reason for what we’re doing, to the exclusion of the activity itself and the people involved, we are headed for trouble.

The aim of recovery is not eliminating fun, it’s moderating our behavior and learning to live without mood-altering in unnatural ways. Four generations of alcoholics and addicts have demonstrated millions of time that it’s the most reliable way to remain clean. Until someone comes up with something better (and our bet is that it will be a long time) abstinence and a good program of recovery are the best, if not the only, way to go.

Filed Under: Addict, Alcoholic, Recovery Tagged With: cross-addiction, Recovery