Relapse

Shame About Alcohol Use May Increase The Likelihood Of Relapse

The study, conducted by researchers from the University of British Columbia, shows that behavioral displays of shame strongly predicted whether recovering alcoholics would relapse in the future.

http://www.sciencedaily.com/releases/2013/02/130204114246.htm

How Many People Get Into Recovery And Then Relapse?

There are all sorts of numbers you hear bandied about, and none of them are really precise. Here’s why.

Relapse is difficult to measure. Obviously it occurs before we use. If we weren’t already in relapse, we wouldn’t use, would we? So if I don’t use, did I relapse or just come close?

Recovery is about making the physical, social and mental changes that take us away from our old ways of thinking and develop new ways of looking at the world that allow us to live relatively happy, healthy, sober lives. Recovery is a sliding scale, not an event, and we can move in either direction.

It is even possible to stop dead in our tracks and move in neither direction. Some of us stop using but do nothing to change. We call those folks dry drunks, and as the saying goes, “If you sober up a horse thief, all you get is a grumpy, more efficient horse thief.” If they use later on, does that count as a relapse, or were they never really in recovery?

It is reasonable to say that for people who started off making progress, relapse occurs when we begin sliding back to our old ways of thinking and behaving. Using simply makes it impossible to ignore any longer.  This brings up the obvious issue of measuring recovery. How do we do that?

Recovering people clearly move along the scale in a positive direction. Their attitudes improve, they exhibit willingness to change, and do so. They seek out positive relationships and nurture them. They become more truthful and compassionate. They recognize that false confidence is a trap, and try to remain realistic about their progress and prospects. They are willing to share what’s happening in their lives and accept feedback. They make an effort to become a part of the outside world, while retaining their connection to the recovering community. Finally, they help others to achieve the same goals.

Conversely, to the extent that they do not make those changes, or move in a negative direction along the scale of recovery, they are either not in recovery or are in relapse.

The second big issue is counting those who relapse “officially.” How do we do that? We know that a great many people who enter detox facilities do so more than once. But if they don’t return, are they still clean and sober? Did they move? Did their insurance run out? Did they get clean after going “cold turkey?” Did they die?

Many people think that the 12-step programs ought to be able to answer those questions. But how? That word “Anonymous” is a huge barrier. Who keeps the central database? Who takes and validates the surveys? How do we tell one drunk named Bill W. (a co-founder of AA) from another Bill W. who writes for Sunrise Detox? The figure we hear spoken  about in the rooms is usually in the 10 to 30% range for eventual recovery. Is it accurate? No way to tell.

A study by the National Institutes of Health (available here) is of little concrete help, but does point out other complications. How many people went into treatment facilities? How long was the treatment? How many people participated in AA or another self-help group? How many did both? How many used, but participated on a second try? How many of those who participated in groups on the first try relapsed, and how many went to treatment subsequently? You can go on and on with these combinations, and resolve little or nothing. The follow-ups on this particular study were done by phone. How many of those people simply lied out of embarrassment?

The same problem occurs with treatment facilities.  We only have contact with those who return, or who stay in touch.  We have no way of knowing what happened to the rest. A large chain of treatment centers estimates relapses at 70 to 90%, but how is that measured, and how many of those people subsequently get sober? Who knows?

The most accurate figure is probably in the 70% to 90% range. Addiction is a disease, and one of its symptoms is relapse. We can expect anything that is considered a “symptom” of a disease to occur more often than not, and for the numbers to be significant. It also gibes with our experiences in treatment and detox.

The important issue is not how many make it, but whether we, as individuals, are doing everything we can to insure that we continue to move in the right direction. One of those things is helping others to achieve sobriety. If we are doing our absolute best, then the chain builds itself, one link at a time, one day at a time.

And no one can answer that question but you.

No Holiday Secrets

Relapse is a symptom of addiction, just as much as the craving, obsession and withdrawal.  Most addicts relapse one or more times.  That isn't to imply that it's a good idea, but it is a fact.  (This may seem like an odd subject for Thanksgiving Day, but bear with me here.)

Holidays provide two things that are dangerous for addicts: plenty of different kinds of stress, and ample opportunities both to think about using and to actually do so.  Some of us are going to start some additional research over the next day or so.  Some of us have already started.  Those who do will discover that it's not working any better this time than it did before.  Most will find that things are even worse.  Some will die.  Some will make it back into the rooms of recovery.

It is vital that those who make it back share about it — at meetings, after the meeting, and especially with their sponsors.  (If you don't have a sponsor, perhaps you might take your relapse as a sign that you need one, eh?)  There's a saying that we're as sick as our secrets.  It's true.  Secrets lead to lies, and they lead to more secrets, and the first thing we know we're so tangled up and emotionally exhausted that a drink or other drug seems like the only way out.  Once again.

So no holiday secrets.  They lead to the wrong sorts of celebrations for us — and sometimes for our survivors.

How I Became A Junkie

It's no news to any of us that addiction is a disease of relapse.  Thing is, we never know if we're going to make it back.  What struck me about this woman's story is how easily it could have turned out otherwise.

What the fuck was in this stuff? Turns out, nothing beyond drugs; sometimes throwing up and convulsions are just going to happen.

Read the rest at The Fix

Newly-Recovering People Need TLC At Holiday Time

During the Thanksgiving holidays, families come together and appreciate each other while giving thanks for the blessings of the past year.  They are loaded with emotion, and can be particularly stressful for families with members who are attending clean and sober for the first time.  There may be old wounds that have not healed, others in the family may still be drinking or using other drugs, and the emotions and memories of other holidays may make it difficult for everyone to remain calm.

Family gatherings are not the time to discuss old hurts, examine old scars, or hold people accountable for their past.  This is equally true of the non-addict members.  It is difficult to be thankful for your blessings if someone is starting an argument — or worse — at the dinner table.

We need to look at these things ahead of time.  Certainly the one thing that no one wants is for their addict to relapse, and everyone needs to remember that stress is a primary cause of relapse.  It is good if all family members are aware of this, and determine to keep the gathering calm and under control.  Also, be aware that some members may have hidden agendas with regard to the newly-sober person.  They may miss their drinking or drugging buddy, and put pressure on him or her to join them in one last fling.  Try to intervene without being obvious, changing the subject and removing the addict from the line of fire if possible.

As far as the recovering person goes, make them aware that you know they may be ill at ease, but that they should remember that they are loved.  Encourage them to bring a sober friend who can offer support.  Be sure that they have a beverage that does not contain alcohol.  If they have empty hands, someone is likely to offer them something to drink that may not be good for them.  Make sure that they have transportation, if they are not staying at home, and that they can be assured privacy if they are.  Let them know that you understand that they may have to step away from the party for a few minutes, or even leave early, and that it is fine if they do so.

Thanksgiving means homecoming.  In many ways, this will be your addict or alcoholic’s first homecoming in years.  If there are to be others, it is a good idea to make this one as pleasant as possible.

Pain In Recovery

This has been an interesting few days.  On Wednesday I felt some pain in the back of my mouth.  I figured it was TMJ joint pain due to tension, since I'd been a bit uptight for a few days while my daughter was in the hospital for a Cesarean delivery.  By Thursday it was clear that it was a tooth, and by that evening, the pain was getting fairly severe.  I began taking prescription strength ibuprofen (Motrin), and called the dentist.  To make a long story short, by the time the penicillin took effect on Saturday morning some time, I'd spent about 24 hours in fairly severe pain, kept partially in check by the pills and swooshing cold water on the tooth.  Missed a night of sleep, but I made up for it later.

I'm okay now, and waiting to make an appointment to see the dentist, who will likely remove the tooth.  Been there before.  No fun, but not a big deal.  I got to thinking, though, about what a dangerous thing it would be to be in a situation like that in early recovery.

I don't know about you, but back when I was active in my addictions I saw every potential malady as a source of drugs or an excuse to hole up and drink.  A cold — no problem!  I knew how to handle that.  Fortunately I never had a problem that required heavy duty painkillers, or I would likely have been able to add that to my list of addictions.  Martial arts bruises, sprains, aches and pains were all chances to get messed up, and excuses to stay that way for a couple of days or more, but nothing ever happened that required opioids, thank goodness!

This toothache episode could have been another example of that trend.  If it had occurred in the first few months of my recovery, I could very well have been off to the races, because back then I really believed that I needed powerful drugs to kill pain.  It had never occurred to me that painkillers, for some kinds of pain, are like hunting rabbits with an elephant gun.  Since dental problems go part and parcel with addiction, it's an issue that all addicts need to consider carefully.

Alcoholics and addicts are, almost by definition, folks who don't know that it's okay to not feel okay.  We start out thinking that every little twinge means terminal pain, and that each needs that elephantine response.  The fact is, most pain can be adequately handled with non-addictive drugs that pose no threat to our sobriety.

We need to find doctors who understand addicts, and what meds are off our list of remedies.  We need to consult with our pharmacists about possible side effects, and  need to research the drugs themselves online and elsewhere.  We need to discuss the matter with our sponsors and significant others.  We need to avoid secrets.  Even if our pain is such that more powerful drugs are necessary — and sometimes they truly are — we need to get others involved who can monitor our use and help us stay on the straight and narrow to the extent possible.  Most importantly, we need to be upfront with all of them about our addiction(s) and our inability to use mood-altering drugs.

There is no reason that anyone who is serious about his or her program of recovery has to relapse because of pain.  We need to be proactive, getting dental and other problems dealt with before they become emergencies.  When emergencies do arise, however, there are tools to handle them without giving up all we've gained.

Smoking Reduces The Chance Of Successful Early Recovery

Given the number of us who are also addicted to nicotine, this could be huge.  It reinforces the rapidly-spreading practice of rehabs prohibiting smoking (during primary treatment, not detox).

…smoking while kicking the alcohol habit impairs memory, learning and other cognitive skills–ultimately making it more difficult to weather the long storm of sobriety.

http://www.sciencedaily.com/releases/2012/10/121012141838.htm