Questions From Newcomers

Why Can’t Recovering Addicts Use In Moderation?

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….

Questions In Early Sobriety

I want to share a letter I recently received from a guy in early sobriety, along with the response I gave.  The letter is SO typical of the cares and worries of people in early sobriety that I think most folks will be able to relate.  I edited a bit for brevity, believe it or not.  So…

Hey Bill,

I talked with you once before  when I was about 43 days clean. Today is day 68 and don’t get me wrong I am happy so far.

I have been exercising quite often, mostly running and some weight lifting in the days past, but I still have trouble sleeping at night; I have to wait till like 3 a.m to be able to fall asleep and then I sleep like a hibernating person. At times anxiety comes and attacks me just as depression sets in. From what I have read and researched it seems to point to p.a.w.s. I just really want to be back to normal and never touch the stuff I used to.

Even deep down inside I feel tremendous strength and confidence that I won’t go back to using, some people I know tell me not to be fooled by this deception. I know you have a lot of experience with your own sobriety so I am hoping things will eventually get better for me.

Every day that passes I realize how nice it is to just be alive in the moment even though I have lost everything I have ever owned to this drug. People I have known for ages have distanced themselves, acting as tho they have never known me. I will admit this does hurt, but I try not to let it get to me. Someone once told me that the day we start being clean is the day we start growing emotionally.

Never in my life would I ever think I would be sitting behind the screen typing this and actually counting the days that go by. I count each and every day because it serves me as a reminder of the time I have dedicated towards fighting this disease.

All I want to ask you Bill is if things will eventually get better because depression seems to always be around the corner. There are days when I am happy for most of the day and then there are those times when everything seems dull.

Peace, love and happiness. Take care.

Joe

Hi Joe,

Good to hear from you again, and congratulations on the 68 days and 136 nights!

Sorry you’re having trouble sleeping, but that’s pretty normal in early sobriety. You feel draggy, but rest assured that no one ever died from lack of sleep — at least not when they’re able to “sleep like a hibernating person” once they fall off. It sounds like you’re suffering as much from a disturbance in your sleep pattern as from actual lack of sleep.

Try limiting heavy exercise and caffeine to mid-afternoon at the latest. That may help. Also, never force yourself to stay awake. If you get sleepy during the evening, forget about TV or that book. Go to bed. Sometimes a little discipline on the waking side is all it takes. If you can’t sleep, get back up and do something: eat a light meal or snack, low on carbs with a bit of fat and protein (peanut butter on crackers works well for many) and then read or do something non-stimulating until you think you can sleep again. Lying in bed awake just accustoms you to lying in bed awake.

Your mood swings, likewise, are pretty typical. As long as the depression doesn’t become severe, or last for more than a day or so at a time, I wouldn’t be too concerned. Your brain is adjusting to an entirely new balance of neurotransmitters, and your dopamine production is almost certainly still below normal. As long as you’re not having thoughts of worthlessness, life not worth living, etc., you’re likely just going through normal swings. They will become less severe over time, as your brain chemistry slowly returns to normal.

HOWEVER, if the depressed feelings get worse than just feeling blue, you need to take them seriously and talk to a doctor. You might need an antidepressant for a while. Antidepressants won’t interfere with your recovery.

On the other hand, watch out for antianxiety drugs. The most popular ones are benzodiazepines (Ativan, etc.) and they are poison for recovering addicts. They will prevent your brain from recovering properly, and are highly addictive in themselves (regardless of what your doctor may think). Trust me: I spent three weeks in medical detox for benzos. If you need medication for anxiety, there are plenty of non-addictive alternatives. Mainly, though, you need to keep to your program of healthy living and meetings.  In most cases the anxiety will ease off as you begin to feel more comfortable in your recovery.

Your friends are right: overconfidence has killed many an addict. Relapse is a recognized symptom of addiction, and it can happen to anyone, even us old-timers. I know plenty of people with 10+ years who have relapsed — almost always because they got overconfident and stopped doing the things that kept them sober to start with. Don’t get too confident; it leads to carelessness.  That said, as long as you're working a program and doing what you need to do, you needn't worry.  Just remember that recovery is a process, not an event.  It's a sliding scale, and sometimes it's more slippery than others.

The person who told you about emotional growth is correct as well. If our emotional development wasn’t interrupted by some sort of trauma before we started using, it was most certainly brought to a screeching halt when we began getting high regularly. Then when we get sober — and just when our nerves are at their most jangly — along come all those suppressed emotions that we haven’t learned to handle. It can be unnerving, to say the least. This, too, shall pass. Therapy helps, as do the steps of the program. So does experience living clean and sober.

Recovery takes time, Joe. We spent years messing up our brains and (to a degree) our bodies. Because we’re addicts we expect immediate results when we stop using, just as we got them when we used, but it takes our bodies months to get back to something like normal. That’s what PAWS (Post-Acute Withdrawal Syndrome) is — the period of healing. It takes time, but it does get better.

Hang in there, and

Keep on keepin’ on!

Bill

Step and Tradition, Big Book and Basic Text Meetings

Step (Step and Tradition) Meetings

The Twelve Steps, as originated by Alcoholics Anonymous and adopted by more than 100 other fellowships, are the basis of most programs of recovery. We need to understand them thoroughly, and we ave meetings dedicated to their study. There are also meetings that discuss the Twelve Traditions, which guide members' conduct within the fellowships.

These meetings usually follow a format that involves reading some or all of an article about the step or tradition from the appropriate source. Often the reading duties are shared around the room in succession. This is done in two distinct ways, and it is up to each group how their meetings are formatted. In one case, the entire selection is read and then discussed. In the other, each person reads a paragraph, which is then discussed by all until the topic “runs out of steam,” at which time the next paragraph is read and discussed. Although it takes much longer to get through all the steps and/or traditions in this way, it makes for an exhaustive and illuminating study.

The text for step and tradition meetings in AA is usually the book Twelve Steps and Twelve Traditions, written by Bill Wilson over several years time and based on the input and experiences of AA members. Narcotics Anonymous uses its Basic Text (see below).

Big Book and Basic Text Meetings

The book Alcoholics Anonymous, written in the late 1930’s by William (Bill) Wilson (with input from the first 100 members of AA), is the ancestor of all Twelve Step programs. Were it not for this book, millions of alcoholics and addicts—not to mention codependents and others—would still be suffering today. The “Big Book,” as it is affectionately known, has been on nearly every list of “Most Important” books of the 20th Century.

Big Book and Basic Text study meetings are generally carried out in the same manners as Step and Step/Tradition meetings. Some AA meetings concentrate on only the first 164 pages of the Big Book, the “instructions” section of the volume, while others consider not only that portion, but the 410 pages of personal stories and appendices that follow.

Narcotics Anonymous has seen fit to put into one volume, the information that AA has put into two, the Big Book and the “Twelve and Twelve.” Thus, the Basic Text contains most of the material used for literature study.

What About People, Places and Things?

Q. How can you stay away from people, places and things when they are family or significant others?

Q. If my boyfriend drinks and does coke occasionally, what should I do about it?

These really translate into the same question: How much do I value my sobriety?

Let's first ask ourselves, why did we get sober? Why did we go to AA, NA, treatment, detox or whatever? Was it because we were having fun while we were using? Was it because our lives were completely under control? Was it because we could pick up a drink or a drug and then stop whenever we wanted to? Could we go into a bar, or to a party, hang with our friends, and choose whether or not we were going to get high?

If any of those answers were yes, then there's no need to worry about it. Why should we? Everything's great!

But if we got  clean because our life was in the toilet; if we were afraid we were going to die, or hurt someone else; if we got clean and sober because we couldn't stand the idea of continuing in the direction we were going, then if we want to remain clean we have to put that idea ahead of everything else in our life.  That doesn't mean we have to live in meetings forever, or that we can't ever have fun again, but it does mean that we may have to change the ways we deal with others, in order to protect our sobriety.

Those people who are able to do so will normally take pains to avoid things that might cause us problems. If they are unable to do that, or won't, the reasons don't matter. We can't change them; we can only make changes in ourselves, and the only sensible thing for us to do is to put our welfare first, and stay away from them.

There are family situations that are so uncomfortable for us, even if alcohol or other drugs are not involved, that we are emotionally unprepared to handle them in early sobriety. If our family drinks or uses drugs, if our friends hang out in bars or hit the restroom five times an evening, if our significant other drinks (and does coke occasionally), it's no business of ours. Our business is taking care of us, and if we believe there's a danger in those people, places and things, then we need to distance ourselves until the conditions change.  We can't take the chance unless we're willing to do the detox and treatment thing all over again — if we survive.

Even if we have children, we may need to stay away for a while. Those kids may need us, but if we can't remain clean they may never have us. Let's face it, we were absent even when we were with them. Isn't it worth a bit more time to help insure that we won't be leaving them again?

Stress is a primary cause of relapse. We need to avoid stressful situations until we are able to handle them.  We also know that just the sight of (or merely thinking about) drugs or alcohol can cause changes in our brain chemistry that cause cravings.  The sight of a guy standing on the corner where we used to cop, a bar where we used to drink — even the recliner where we used to collapse — can do the same thing.

The very fact of wondering about it is a pretty good indication that we aren't ready yet. As much treatment as we can afford, a stay in a halfway house or sober living facility, working at a low-stress job for a while — along with a lot of support from our peers — can better prepare us to go back to the “real world.”

If going home right now worries you — or even if it doesn't — it probably should.

When do you know that you don’t want to do any more drugs?

I’ve been skipping over this question for a while, because there is no way that the answer can be anything but subjective. I can’t possibly answer it for someone else. I finally decided that it’s too important just to blow off with an excuse. Someone asked that question because they were still hurting, and someone else out there is too. Subjective it will have to be.

In my own case, I knew it some time before I got clean and sober, but I just didn’t think it was possible. I knew what happened if I went even for short periods without alcohol or a substitute, and there was no way (that I could see) to quit. But did I want to be free? Oh yes, desperately!

That’s the first part of the answer — the bottom that we talk about. The solution was forced upon me by my boss, who had a better grasp of the possibilities than I. After three weeks of detox and treatment, aftercare, a few hundred 12-step meetings and with the help of my newfound recovering friends, I was in fairly decent shape.

But the question still isn’t answered. When did the craving, the need go away? I honestly can’t say. The intensive program I was working kept me so busy that I hardly had time to think about using. At a couple of points down the line I got the impulse to have a drink or use. Looking back, I can attribute that directly to relationship and work difficulties that I still hadn’t learned to deal with in a less self-destructive way. At least one of those was a case of “drinking at” someone (except, thank goodness, I didn’t).

The desire to turn my brain off with drugs just disappeared when I wasn’t looking. At some point, I realized that I hadn’t thought about using for some time, and wasn’t especially interested in thinking about it then — and it’s been that way ever since. I don’t know if I was especially fortunate in that regard or not. Just as one person can never know (nor judge) another’s pain, so can I not relate my cravings, or lack of them, to someone else’s.

What I can do is tell you why they went away. I found better ways to cope with life. My program, the people in the 12-step rooms, the wonderful friends I made, the relationships that I developed with my wife, kids and other family, and the feeling of self-worth I got from helping others were all so much better that I couldn't imagine throwing that all away — again.

I believe there are three stages to recovery. The first occurs while we’re still using, when we decide we want out. The second is early on, when we are taking the first steps toward learning to live without drugs, and the third is the “maintenance phase,” where we keep on doing the things that helped us to begin with, and things keep getting better as a result. That’s exactly the way the 12 steps work, and I reached that point through their help. It’s not the only way, but it has worked for me and a lot of other folks I know.

And I haven’t wanted to do any more drugs for a long time now.

What about you? What was your experience? Please comment!

Sponsorship Stuff (Part 2)

Can a sponsor be an extended relative who attends AA and has been clean for over 10 years?

Most recovering people and recovery professionals consider it unwise for us to choose sponsors with whom we have anything other than a casual relationship.  Relatives (even distant ones), co-workers, and friends are generally thought to be off limits. Put simply, it’s not a good plan to have a sponsor with whom we have a past.

Relatives, even distant ones, have ties to our families.  Friends often do too, and the opinions of both friends and co-workers are important to us.  Because they share our histories to a degree, all of these people will have their relationships, opinions, resentments and so forth — perhaps even  involving some of the same people.  In most cases, that would hinder their listening to us objectively, and would most likely affect our ability to be open and honest with them as well.

Sponsorship, when it works properly, involves sharing many things that we would not necessarily want a family member to know, from things about the rest of the family to our own circumstances.  The same could well turn out to be true of co-workers and friends.  Generally speaking, a sponsor who is completely uninvolved with our outside history is best.  While we might be more comfortable with people we know in the beginning, it is likely that down the line our previous association will become an obstacle, especially when we are being guided through the steps.  That, of course, is a sponsor's primary purpose.

In addition to all of the above, by choosing someone we already know we are depriving ourselves of the experience of reaching beyond our safe space for help — a skill that most addicts and alcoholics need to learn.

My sponsor makes has me spend two weeks or more on every step. I don’t feel that I need that much time to complete a step.  Is this typical, and why?

It is not unusual for sponsors to move us through the steps even more slowly than that.  When I thought things were going too slowly, it usually meant that I didn’t want to look at issues as closely as I needed to.

The purpose of the steps is to help reshape our ways of thinking about life.  They are not simply items to be ticked off a list, but are meant to be put to use.  In early recovery, most of us didn’t have a grasp of our denial, the ways our behavior had hurt others, or how to go about dealing with those things.  Taking our time over the steps allows us to absorb the ideas behind them, and to begin putting them into action in our daily lives.

Another reason for not hurrying is that, as time passes, we inevitably remember other things — other issues to which the step’s principles can be applied.  If we rush through the steps without giving those things time to happen, we greatly lessen the impact of the work we are doing, both immediately and as we move on in our recovering life.

Home Groups, Sponsors, Reservations, and Families That Use

This time we’re combining four questions that don’t require long answers into one post.

How soon should I find a home group?

You need to find a group where you feel reasonably at home.  This may change over time, but you need to look for one where you aren't totally uncomfortable.  Don't look for perfection, because it doesn't exist.  Groups are made up of people — all kinds of people.  Again, reasonable comfort is the key.

There’s no set limit.  Generally, it is suggested that we spend a few meetings in each of several groups, then stick with the one that feels best for a while.  When we’ve made that much of a commitment, making a home group decision shouldn’t be difficult.

How long should I wait to get a sponsor?

Generally speaking, the same rule applies to sponsors.  Listen to what people say.  Look for people who are happy in sobriety, and sound like it — consistently.  Look for people who sound honest.  Avoid people who quote the literature constantly, and look for people who make sense when they’re thinking for themselves.  Don’t wait too long, but try to choose based on those ideas.

There is no set rule, but since a sponsor is your guide through the program and the steps, it’s not good to wait too long.  If you’re doing a meeting a day, you should have a pretty good list of candidates in a couple of weeks.  Then ask them to go for a cup of coffee, and spend some time one-one-one.  If that feels good, then ask.  You're not getting married, but you don't want a one-night stand, either.

What is a reservation?

A reservation is an excuse to use that we make in advance.  Here are some examples:

  • I’m an alcoholic and can’t drink, but a little pot can’t hurt.
  • I’m a painkiller addict, but it’s OK to have an occasional drink.
  • I’ll go to meetings and do as I’m told, but it’s hard for me to trust people so I’m not getting a sponsor.
  • I’ll go to meetings, work the steps, and do as I’m told, but I’m sure that after I’ve been clean and sober for a while it will be OK for me to have a drink now and then.
  • I’ll go to meetings and work the steps, but to heck with that one-year thing.  I’m going to have a relationship if one comes along.

To put it another way, a reservation is a recipe for failure.

How often should I see my family members that still use drugs?

How often do you want to be tempted to use drugs yourself?

Talk about pushing buttons!  Our families hard-wired our buttons for us.  They can push them without even meaning to.  In any case, people who are using around you clearly don’t have your best interests on their mind.  Add to that the fact that seeing you clean and sober may make them uncomfortable enough to actively encourage you to use, and the answer is simple: very seldom, and always in the company of a sober companion. (See “reservations.”)

That's it for this time.  Keep on keepin' on!