alcoholics anonymous

What are your thoughts about addicts in AA instead of NA?

There is absolutely no reason why addicts shouldn’t attend AA meetings.  However, AA has traditions that are important to the fellowship and to many of the members.  One of those is that they generally confine their discussions to alcoholism and recovery from alcoholism.

Disregarding the fact that alcoholism is an addiction like any other, and disregarding the “a drug is a drug is a drug” of NA, keeping drugs out of the conversation is the custom at the majority of AA meetings.  Everyone attending — cross-addicted people like me, and people not addicted to alcohol at all — should follow that custom in most cases.  It’s simply good manners.

There are, however, situations where a person is in crisis, and simply needs a meeting of whatever kind.  In that case it is perfectly proper — hell, it’s a life-threatening emergency — to say whatever we need to say in order to get whatever kind of support we need.  What I would do in that situation is simple.  I’d raise my hand and say “I’m not an alcoholic, but I really, really need help because I’m about to use.  Will someone come outside and talk to me about it?”  I would probably be invited to stay and say what I need to say, and if not I’d have a horde of people headed for the door with me.

Really, the substance has nothing to do with it.  What matters are the emotions, the behaviors and the solutions.  Those are the same for all addictions, and anyone should be able to talk about them in any meeting without ever mentioning alcohol or any other drug.

Thought: We Are Not Guilty of Addiction

Whose Fault is a Drug Addiction? Parents or Individuals?

Not long ago I was conducting a therapy group at Sunrise Detox when a client shared about how bad he is, how he just can’t forgive himself, and that his addiction is all his fault. When I assured him that the disease is not his fault, another group member raised her hand and insisted that her disease is actually her parents’ fault. Again, I replied that her disease is not her parents’ fault.

We are not responsible for having become addicted; we are only responsible for our recovery.I replied that no one is to blame for addiction. As is the case with diabetes and similar diseases, we are not responsible for having become addicted; we are only responsible for our recovery. Well, that set off a firestorm of controversy, and a great discussion. The questions flew! “Then whose fault is it,” blurted yet another member of the group.

How can this not be my fault when I’m the one who picks up the drink/drug?

My parents make me so mad I just have to use…I can’t help it! How is that not their fault?

I’m an alcoholic and now my oldest son is an alcoholic too. He got this from me and I feel terrible about it.

Sometimes We Feel the Need to Assign Blame

Considering the devastation that addiction causes in the life of a person, a family, even a community, it’s easy to see why there’s a desire to place blame. If it’s not someone’s fault, we feel even more out of control. Humans hate not knowing the “why” of things, and if we don’t get good answers we make up our own. I love it when these questions and comments come up, because I get to give people good news.

not-guilty-quote2We are, I remind the group, accountable for our behavior, in or out of active addiction. Our addictive behavior affects other people, so when the time comes, the right thing for us to do is to make amends: to the best of our ability fix or make right the damage we have done to others. We are accountable, even though we were not in our right minds when we did the damage.

Is Addiction a Disease?

We are not responsible, however, for having the medical condition that caused us to act as we did. Although we may have made some unwise choices along the way, not one of us set out to devastate our lives by becoming an addict. Social, psychological, neurological and genetic factors combined to make what was, at first, a pleasant experience into a perpetual nightmare. We did not choose for that to happen, and would certainly not have done what we did if we had any idea of the real consequences. We are, perhaps, guilty of bad judgement. But we are not guilty of addiction.

Responsibility for an Addiction is Not The Same as Responsibility for Recovery

A parent who may feel guilty for passing the gene along needs to know that we have no more control over our offspring’s addiction than over the color of their eyes. The only control that we have regarding a child’s addiction from this day on is to be an honest example of recovery, a model of living in the solution and of finding happiness without substances.

We Are Responsible for Our Recovery

Just as we are not guilty of our own addiction and have no control over the addictions of others, others have no control over our addiction. We can remain solid in our recovery even if we are stressed, enraged, wounded, or feel uncomfortable about the behavior of someone else. However, we may find that distancing ourselves from people who trigger those emotions is beneficial for us, especially early on. That makes it easier to disentangle our emotions from theirs, strengthen our recovery, and develop some healthy boundaries. No matter what anyone else does, our recovery is our own responsibility.

Addiction— whether our own or that of others — is nobody’s fault. Sometimes stuff just happens, and no one is to blame.

On Anonymity in Recovery

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.

AA Tends To Benefit Women And Men In Somewhat Different Ways

A study to be published in Drug and Alcohol Dependence indicates that both men and women profit from participation in AA (and, presumably, other recovery programs) if committed to their recovery, but that some of the beneficial effects tend to occur in different areas.

According to John F. Kelly, PhD, associate director of the Massachusetts General Hospital Center for Addiction Medicine:

“These differences may reflect differing recovery challenges related to gender-based social roles and the contexts in which drinking is likely to occur.”

According to the study findings, women seem to gain confidence and support in being able to avoid drinking as a reaction to unhappiness and depression. Men, on the other hand, seem to benefit from changes in social situations, i.e., the pressures associated with old “people, places and things.”

More information is available in this article from Science Daily.

What single aspect of your program do you believe had the most effect on your successes?

What Are The 12 Steps?

This is the first in a series of posts in which we hope to acquaint our readers with some of the details surrounding the programs that we recommend.  There are a variety of other programs, but because we and most other facilities shape our treatment plans around the 12 Step fellowships, those are the ones on which we will concentrate.

Twelve step groups have been much in the news over the past few years.  Most people have heard about one or another celebrity who was in AA (Alcoholics Anonymous), NA (Narcotics Anonymous) SAA (Sex Addicts Anonymous), or another of the roughly 200 fellowships more or less based on AA’s original 12 Steps.

The steps as we know them today were first published in the book “Alcoholics Anonymous” (1939). They were a synthesis of the combined experiences of the first roughly 100 members of the fellowship that took its name from the book, combined with principles from other sources.  There are far too many good histories of AA for me to presume to go further.

Essentially, the 12 steps are designed to change the way we look at addiction, our lifestyles, and the problems they have caused. They help us to accept the reality of our problems, identify issues, and guide us in clearing up “the wreckage of the past.” Finally, they provide us with means to continue to nurture our new way of life, and encourage us to help others achieve the same goals.

The steps work — for people who put in the effort.  However, they require quite a bit of work in order to gain the benefits. Many people who give recovery a try find that they are not able to do the work that is needed, for whatever reasons.  That isn’t surprising, because change is frightening, and because we alcoholics and addicts are accustomed to getting what we want quickly.  How long until I can connect to my next fix, pill, or exciting experience?  Is the sun “over the yardarm” yet, so that I can give myself permission to have that first drink?

After all that time thinking in the short term, it becomes difficult to think in any other way. Thus, when faced with several months or years of working on making changes in our lives and thinking, many of us find it difficult to knuckle down and get started.  Combine this with the ability of all addicts to find reasons, excuses and so forth for avoiding unpleasant things, and the ever-present temptations of old people, places and things, and we can see that there are some real obstacles to successfully completing the necessary work. This is true of all recovery programs, not just those based on the steps. As they say in the rooms, “It works if you work it, but it won't if you don't.”

In our Friday post, and those following, we will cover the steps and the rest of the program in more detail.

Newly Sober? PAWS Still Has You In Its Claws!

We all know that most relapses occur in the first few months after we get clean and sober.  Many of them are related to Post-acute Withdrawal Syndrome.  We talked about PAWS in a previous post, but I wanted to go into it more specifically here.

Although there are differences in the way they act, all addictive drugs function by either stimulating or imitating the chemicals of the brain's reward system — giving us too much of a good thing.

In an attempt to return our brain chemistry to normal (homeostasis), the brain builds more receptor sites for those particular neurotransmitters.  This allows it to deal with the higher-than-normal levels, leading to tolerance: the need for more drugs to fill up the additional receptors so that we can continue to get high.

When we get clean and sober, those extra receptors clamoring to be filled up are what causes withdrawal: acute withdrawal while the drug is clearing out of our system, and post-acute withdrawal during the period when the brain is deactivating the extra receptor sites and returning to normal.  Some authorities believe that it never normalizes entirely, which may be why any use usually leads back to full-blown addiction.

There is a double-whammy effect, too. When the drug is removed, there is a “rebound.” We begin to experience many feelings and physical symptoms that are the opposite of the way the drugs made us feel.  Removal of the drugs' stimulation causes the production of the reward chemicals to drop to below normal, and they return to their pre-addiction levels slowly. During this period we may be antsy, anxious, depressed, manic, or combinations of those feelings. We may feel as though our recovery is hopeless, and that we might as well use.

That's PAWS.  The duration  varies depending on the drug(s) used and individual physical differences.  It can — but usually does not — last for up to two years.  Ordinarily it will peak and then slowly subside within the first few months.  During that period (and in most cases for the rest of our lives), use of addictive drugs can put us back on the merry-go-round quickly.  It will also prolong the period of PAWS.  It can even set us back completely, because it interferes with the brain's repairs.

So, in early recovery we need to be prepared for a prolonged period of slowly feeling better, with setbacks when our bodies need that additional bit of natural feel-good and don't get enough, usually when we are under stress.  Stress aggravates PAWS symptoms because the natural “drugs” that help us to cope aren't back to full strength yet.

The good news: it always gets better, slowly but surely.

The best medicine for Post-acute Withdrawal Syndrome is time, aided by mild exercise, good nutrition, rest, stress avoidance, and distractions.  We need to have some fun.  We need the support of people who know where we're coming from, and who know how to deal with people in early recovery.

That's why we recommend meetings, fellowship, halfway houses, long-term treatment, and some time away from the old grind and the old stresses.  They help us deal with PAWS, while we're getting into the habits that lead to long-term recovery.

As George Carlin used to say, “Just because the monkey is off your back, it doesn't mean the circus has left town.”

If you've had your own experiences with PAWS, how about sharing in the comments?  Questions?  Feel free!

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!