addiction

Are there effective online AA groups and sponsors?

January 2, 2012 by Recovery Blogger 2 Comments

Q. Are there effective online AA groups and sponsors?

[The person asking the question is a public figure, concerned about negative publicity and broken anonymity.]

There are good online AA groups.  Most, if not all, have provisions for connecting newcomers with online sponsors.  Any program of recovery is only as effective as the desire of the individual to work at it.  In that respect, an online program is better than no program at all, and no doubt they do the job for some recovering alcoholics and other addicts.  Consider, however, that the purpose of a program is not only to keep from drinking.  Recovery is about unlearning how to be an addict, and learning how better to function in the world outside of AA, NA or whatever program one has chosen.

During our addictions we learn a great many undesirable habits.  We all lie, to ourselves and to others.  We are all thieves.  We may not take material things, but we steal time from our employers and families.  We steal other people’s pleasure in having a clean and sober family member, friend, or business associate.  We steal the time and resources of courts, social services, hospitals, insurance companies and law enforcement — things that are desperately needed by society to accomplish other purposes.  We steal the health of others by causing them stress, causing accidents, and taking up space in doctors’ offices, emergency rooms and other health facilities.

We also develop dysfunctional ways of dealing with other people, with stress, with personal problems, even efforts to enjoy ourselves.  Those of us who continue to function effectively in society still create our own little worlds of quiet chaos — otherwise, why would we be seeking recovery?

When we first get clean, the habits of addiction are still with us.  We have to unlearn them, and learn other ways of dealing with people, the world at large — and ourselves.  In some cases, we have to relearn skills that we’ve forgotten, or get up to date in our fields of expertise.  We have to clean up the wreckage we left behind, and reestablish ourselves in our families and society.  We have a lot to accomplish.

The Twelve Steps are a template — an agenda, if you will — for getting these things done.  They work exceptionally well, at least as well as any other programs of recovery, and better than the majority.  However, they were developed on the basis of face-to-face contact.  Some “solos” have managed to stay sober by letters and (now) email, but the great majority of successful recovery comes from the meeting halls where we interact with others who can guide us.

Sure, some of that can be done online.  This very article is one of the ways that can occur.  But online does not put us in the presence of others.  Online can’t hug.  Online can’t look at our face and tell that we’re having a crappy day, despite our protestations, and call us on it.  Online can’t give us unconditional love — because we need to see that in the face of another human being.  Online can’t tell when we’re full of b.s. — nor can we tell that about the people we interact with online. Online can’t go out for coffee and a chat, or to a picnic, or just be companionable.  We can’t call online at 3:00 AM, the midnight of the soul.  Online can’t phone us to find out how we’re doing if it hasn’t seen us in awhile.  Nor can we do those things online for others.  In short, it’s a weak substitute for f-2-f meetings.

That’s not to say online meetings can’t be helpful, but in my opinion they should not be substituted for the real thing.  Alcoholics and other addicts need contact with people.  We avoided real interaction by keeping ourselves high and detached.  Now we need to do the reverse.  There are meetings for professionals, held privately, to avoid the issues of unethical media who no longer respect our anonymity as they once did.  A call to our local Intergroup office will probably turn up at least one in our area.

“Rarely have we seen a person fail who has thoroughly followed our path.”  Sitting in front of a monitor, regardless of good intentions, is not being thorough.  This is not meant to take anything away from the good people on line, but merely to say that depending on them alone is likely to be a recipe for disaster.

Filed Under: Addict, Addiction, Alcohol Abuse, Alcoholic, Alcoholism, Recovery, Staying Sober, Support Groups Tagged With: , , , , , ,

If I’m On A Suboxone Or Methadone Program, Am I Clean?

December 17, 2011 by Recovery Blogger Leave a Comment

justice.gov

Q. Is being prescribed methadone or suboxone considered being clean, even though they are addictive, abusable substances?

You’ll get different answers to this question from different people.  Generally the division lies between those who are on maintenance drugs and those who are not.  Both sides of the discussion have their valid points.  However, I believe you answered your own question when you used the expression “addictive, abusable substances.”

The consensus among most professionals and recovering addicts is that “clean”, when used in the context of recovery, means drug-free.  Having all mood-altering substances out of our systems is necessary before the changes that addiction creates in our brains can be repaired.  As long as drugs that modify the reward system (which includes all recreational drugs) are in our bodies, repair and normalization cannot begin.  When we are on Suboxone or methadone maintenance, we are still addicted¹, and our brains are essentially in the same condition as when we were actively using other opioid drugs.  It would seem to be pushing things to call us clean.

That is not to say that there are no benefits to drug maintenance programs.  To the extent that they allow people to cease other drug use and begin to take care of themselves and fulfill their responsibilities, they have some validity.  The problem is that the addiction remains in full force, and relapse — whether to other drugs or simply recreational doses of the maintenance drugs — is only a hair’s breadth away.  Adherence to maintenance programs rests squarely on our willingness to continue to follow them.  That is an extremely dangerous place for an addict to be.

Here at Sunrise, we believe that the proper uses of these drugs are as short-term substitutes for the drugs being abused, with a relatively rapid taper to a completely drug-free condition.  If we wanted, we could easily become licensed to provide maintenance services.  However, we do not believe that is in the best interest of our patients, their families, and the other people in their lives.
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¹If you don’t think we remain addicted on maintenance doses of opioid substitutes, just try quitting.  Both Suboxone (when used for long periods) and methadone have withdrawal syndromes that are worse than the drugs for which they’re being substituted.  Truth.

Filed Under: Addict, Addiction, Addiction Education, Addiction Science, Detox, Methadone, Suboxone Tagged With: , ,

Addicts, Alcoholics and Holiday Parties: What’s A Hostess To Do?

December 10, 2011 by Recovery Blogger

Folks in the addiction and alcoholism treatment fields are often asked about how a host should handle holiday parties attended by recovering friends.  Social occasions that involve people in recovery, especially those in early recovery, can pose some perplexing problems for a host.

On one hand, a host who is aware of a guest’s need to avoid mood-altering substances may wish to do what is possible to keep from exposing them to temptation.  On the other hand, social drinking is a part of everyday American culture. Most social gatherings involve some drinking by some of the guests, and there is certainly nothing wrong with that. Unfortunately, for some of us, it might not be the healthiest of environments, and a host may be at a loss as to how she ought to deal with guests who are in recovery. Here are some pointers on how to handle this delicate situation while, at the same time, being fair to all.

There are some simple things to remember. [Read more...]

Filed Under: Alcoholism, Drug Abuse, Family and Friends, Recovery, Relapse, Support Groups Tagged With: , , ,

How long am I required to stay in rehab?

November 29, 2011 by Recovery Blogger Leave a Comment

Q. How long am I required to stay in rehab?

Assuming that you have not been court-mandated into treatment, you are usually free to leave rehab at any time — against professional advice.  Assuming that you use good sense and stay, the answer varies depending on a variety of factors.

Getting the alcohol and/or other drugs out of our system is only the first of many things that need to happen in order for us to have a decent shot at long-term sobriety. Getting clean and sober (and staying that way) requires time.

I’ve written here often about the physical changes in our brains that cause us to be unable to function without drugs. Until our brains have had time to heal themselves, we are at great danger of relapse, because cravings can return at any time. Along with that danger goes the issue of how we feel physically and emotionally while the repairs are taking place. Post-acute withdrawal can be a bear, and it can last for quite a while. Without a plan and good support, that alone can make us uncomfortable enough to want to use again.

Psychological and emotional damage from our period of active addiction — and perhaps even before we first used, need to be addressed. Getting clean does nothing to deal with those issues, and ignoring them puts us at great risk of using simply to make the bad feelings go away again.

There are social and legal issues to be considered. Getting clean does not prepare us to go back to work immediately, repair damaged relationships with family, friends and perhaps employers, clear up financial and legal problems, and deal with the other situations surrounding our addictions. Only time, along with some support and work on our part, can prepare us to deal adequately with those things.  One of the prime targets of rehab is to help clients develop a plan, a support system, and learn how to use them.

Some help and support for family members and significant others is needed. Therapy, or at least a support group, is highly desirable for them because living with an addict is traumatizing. This is easier to arrange if we are under the guidance of people who know how to help our families and friends begin to heal too, because us telling our family that we think they need help is pretty much a non-starter.

Finally, we get to the addict behavior that we need to change. When we used, we developed behavior that protected our addictions.  Over time it became ingrained. (I like to use the example of putting Kobe Bryant in a basketball game, but telling him he can do anything he would normally do except try to score. How long would it take Kobe to blow that assignment, after spending most of his life working to do nothing but score? His instinct to shoot when the opportunity arises would trip him up, sure as taxes.) The point is, until we develop habits of thinking and responding to the world like a sober person, we are likely to respond to stressful situations just as we did in the past. More than one addict has come back saying, “I don’t know what happened — one day it seemed like a good idea and I just picked up!”

So there’s no way, really, to give a simple answer to this question. A safe one would be “Stay in rehab as long as possible.” Of course we all know that other factors can stymie a plan like that. Best answer: consult with the experts who are handling your rehab, and take their advice if possible. More rehab can’t hurt.  There are very few problems that can be solved if we don’t have the skills to tackle them, and if we relapse — well, let’s just say that’s not the best way to remain out of rehab.

Filed Under: Addict, Alcoholic, Alcoholism, Drug Addiction, Recovery, Relapse, Staying Sober, Therapy, Treatment Tagged With: , , , ,

What if someone I knew in rehab relapses?

November 25, 2011 by Recovery Blogger Leave a Comment

When I was in treatment, I was convinced that all of our little group of roughly 40 would grow old together in recovery.  By the end of three months I had lost track of most of them, and at least one was dead. Twenty-two years later, I know of five who I’m sure are sober, and at least one of those relapsed but made it back.

At a minimum, three-quarters of us in treatment at any given time will drink or use drugs again.  Most of us will do so in the first three months.  That doesn’t mean that rehab doesn’t work, or that we won’t eventually get clean and sober, but it does mean that many from a given group won’t make it that time.  Addiction is a chronic disease, and its most obvious symptom is relapse.  However, the things we learn in rehab are not lost, and they help to build the foundation of sobriety.

There is one thing that can’t be overemphasized: no matter what Junior Therapist qualifications we think we got in rehab, we are in no way qualified to get anyone else clean! Someone a few weeks sober trying to “twelve step” a buddy is a well-intentioned trip back into insanity.  Hundreds of thousands of alcoholics and other addicts who failed to believe that fact have themselves joined their friends back “out there.”

The important questions are, first, how do I stay clean and sober, and how can I help the ones who didn’t.  We’ve covered how to stay sober in these pages more times than I care to count.  We stay sober by utilizing all the tools available to us, honestly, thoroughly and to the best of our ability.  We go to aftercare if it’s available.  We live in halfway houses if we are advised to.  We go to lots of meetings.  We get sponsors.  We do service work, hang out with sober friends, and learn to live a sober life.  Hanging out with someone who’s drinking isn’t service, it’s suicide.  (That goes for anyone who’s drinking, not just people we know from rehab.)

We can most help that buddy from rehab by telling him or her we’ll see them at a meeting.  If our sponsor is willing to go with us, we might pick them up and take them to a meeting — once.  We never go alone!  We don’t loan them money, spend a lot of time on the phone with them, let them crash on our couch, or do anything else that will make it easier for them to avoid their bottom.  If they get clean again, we follow the advice of those with more sober time about hanging out.  If they don’t become abstinent, we say we’ll see them at a meeting, that we’ll be glad to support them in recovery, but that we can’t afford to hang around with people who are using.

That’s what we do when someone we meet in rehab relapses.  Remember: we have to take care of ourselves first, or we won’t be able to help anyone else when the time comes.  When we’re newcomers ourselves, it ain’t time yet.

 

 

Filed Under: Addict, Addiction, Addiction Education, Alcohol Abuse, Alcoholic, Alcoholism, Drug Addiction, Family and Friends, Relapse, Staying Sober Tagged With: , , ,

Hitting the Curve Balls

November 4, 2011 by Recovery Blogger 1 Comment

In our company, I’m the field supervisor.  I’m the one who has to go deal with things when the site supervisors either can’t handle them or aren’t available.  That happened to me this morning.  A call at 8:00 AM changed my day, and practically all the chores (and fun) I had planned for the day are trashed: the price you pay for being a boss.

As I was rushing through the things I had to get done, I was thinking about how easy it was, compared to the way I would have dealt with the same sort of thing when I was active in my addictions.  First of all, I might have ignored the phone call entirely, and claimed I just didn’t hear it ring.  Then, before the next call, I would have put together an excuse that would not only get me off the hook but that (in my dazed opinion) would have made me look good some way: feeble neighbor to the doctor’s, volunteer at the hospice; or attract sympathy: grandmother died (if I could remember how many grandmother deaths I had left), food poisoning — any addict will know where I’m going here, because we’ve all done it.

Then, of course, I would have had to try to remember the details of the excuse for later, if needed, and also remember that I’d already used that one in anticipation of the next need for a story to tell.  Finally, it would have been one more indication to my bosses that I maybe wasn’t cut out for the job — although I wouldn’t have figured out that part, because I was too smart to get caught.

Now, as a boss, I deal with those sorts of things myself.  I see the patterns, the clues, the behaviors that set off all sorts of alarm bells.  I realize, too, how obvious the trend must have been to the people I thought I was fooling, back in the day.  In fact, I know they were obvious, because they ultimately resulted in my superiors forcing me into treatment with the threat of unemployment (thus saving my life — but I didn’t figure that out until later).

It was so hard being a drunk and addict.  All the excuses, all the fumbling for answers, all the (useless) attempts to keep others from knowing about my problems were an incredible amount of work for a mind that was constantly impaired in some way.  It’s so much easier now.  I just tell the truth: I can, or I can’t and here’s why.  It’s just part of the job — one of the things I get paid for, and that helps to keep our company in business so that I keep getting paid.  Nowadays I mostly do what I’m supposed to — the “next right thing” — and it always seems to work out smoothly in the end.  Life’s curve balls are much easier to hit now, and there doesn’t seem to be as many of them as there used to be.

Go figure.

Filed Under: Addict, Addiction, Alcoholic, Alcoholism, denial, Recovery Tagged With: , ,

Questions From Newcomers: Is it possible to have a healthy life right after detox?

November 1, 2011 by Recovery Blogger Leave a Comment

The smart-aleck answer to the question “Is it possible to have a healthy life right after detox” is “What…are you kidding?”  However, the straight answer is “What do you mean by ‘healthy?’”

When it comes to recovery, we speak of at least two kinds of health: physical, and emotional.  Some folks would add spiritual health (which has nothing to do with religion) to that list.  We need to remember that our bodies and minds were subject to the effects of chemicals more-or-less continuously for months — in most cases, for years.  Major changes took place due to the effects of drugs on our brains, as well as their effects on other body systems, especially in the case of alcohol.  It would be unreasonable to expect these changes to reverse and return to normal overnight.  Just as it took years to create the problems, so may it take months to recover from them.  The good news is that it rarely takes anywhere near as long for repairs as it took to do the damage, and improvements begin to show up relatively soon if we’re patient.

Our physical health depends on what condition we were when we came to detox (young, older, fit, couch potato, etc.), what residual effects we may experience from the drugs (post-acute withdrawal), and what other health problems we brought with us.  Many, if not most, addicts suffer from a variety of problems that can range from cirrhosis of the liver and/or viral hepatitis to diabetes, malnutrition, or general poor physical conditioning — often several issues of varying severity that need to be addressed.  Even those of us who styled ourselves athletes during our addiction may find that the reorganization of our internal chemistry leaves us with less get up and go than we figured, or that the drugs were covering up some condition that is revealed by a physical exam when we’re sober.  These things aren’t inevitable, but the possibility of some problems should be anticipated.

Mentally and emotionally, most of us addicts (alcohol is a drug, and alcoholics are addicts) find that for the first few weeks and months we run the gamut of emotions, from manic highs — where we believe recovery is the most wonderful thing that could happen to anyone — to bouts of depression and the thought “If this is all there is, I might as well use.”

But there is good news!  For one thing, though we may feel lousy, physically and emotionally, these things slowly improve if we stay clean and sober and work on a program of recovery.  Furthermore, we have the assurance that, even though it may seem as though it’s happening at a snail’s pace, people who remain abstinent and take care of themselves otherwise always improve eventually.  For us addicts, accustomed to feeling good in a matter of minutes whenever we feel like it, these periods may seem endless.  But they are not, and periods of feeling good eventually occur, increasing in frequency and quality as the repairs take place and we get back into the swing of living.

As time passes, we begin not only to feel better, but to think about getting back to what we perceive as our normal lives.  We want to clean up some of the messes we made, right some of the wrongs, find jobs, begin to save a little money, and try to earn the respect and trust of others.  These improvements are immensely aided by the support and help of other recovering people.  Put succinctly, people who go to meetings and develop a support system, learning to follow directions and do the next healthy thing, tend to recover if they persevere.  Those who don’t rarely remain clean and sober for long.

So the answer is that it is possible to live a healthier life immediately after detox.  A healthy life may be further down the road, but it is attainable.  Millions of people have gotten through the first weeks and months of abstinence, and achieved lasting sobriety.  The secrets are, first, to want it more than anything else, and second to stick with it and — as they say — wait for the miracle.

Filed Under: Addict, Addiction, Alcoholic, Alcoholism, Detox, Medical Issues, Mental Health, PAWS - Post-acute withdrawal, Recovery Tagged With: , , , ,
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