denial

Why Can’t I Drink Or Smoke A Little Weed? I Was A Pill Addict!

Professionals refer to “addiction,” or “addictive disease,” rather than to heroin addiction, cocaine addiction, etc. The fact of the matter, little understood by the world at large, is that we don’t become addicted to drugs, but to the effects that they have on our brains — specifically on the pleasure center. The pleasure center is located in the sub-cortical region of the brain which means, among other things, that we can't control it directly.  (That's why “Just Say No” is a cruel joke.)

US Dept. of Transportation (dot.gov)

Drugs short-circuit the process by either stimulating the production of these neurotransmitters, or by mimicking their actions.  Drugs allow us to control the production of the good feelings. Since we are pre-programmed to seek those feelings, we tend to do it quite a lot. Over time, actual physical changes take place in our brains in order to accommodate the unnatural levels of chemicals.

This occurs in several ways, but we’ll simplify it by saying that our neurons grow additional receptor sites to deal with the surplus. This means, in turn, that we need more of the drug’s effects to reach the levels that give us pleasure. This tolerance is one of the first signs of developing addiction. Eventually we reach a point where we need the stimulation in order to function anything like normally, and we’re hooked for sure.

When we go “cold turkey,” the sudden absence of chemicals causes the syndromes that we call acute withdrawal. The length of the acute phase lasts anywhere from a few days to several weeks, depending on the drug. Simple drugs, like alcohol, have the shortest acute phases, while those that metabolize into other active compounds can take much longer. Methadone is an excellent example.  It has not only a longer but more severe acute withdrawal than other opiates. The symptoms of withdrawal, generally speaking, are the reverse of whatever effects the drugs had. Opioids, for example, calm us and slow the action of our digestive tract, and the withdrawal symptoms are the jitters, nausea, diarrhea and the creepy-crawlies, among others.

Those extra receptor sites slowly become dormant and stop pestering us for stimulation, but the main thing to remember is that while the body and brain recover from the changes, the changes do not necessarily go away, and if they do, it is usually over a period of years.

If we use drugs or alcohol in early recovery, we will interfere with the progression to normalcy. Any extra stimulation, whether by the drug of choice or another, can have this effect; we don’t have to get drunk or high. The neurotransmitters involved are the same combination, and using any mood-altering drug can lead back to an active addiction.  At the very least, it will prolong the recovery process.

Even after our brains are back as close to normal as they're going to get, exposure to drugs can reactivate those dormant receptor sites, and start the cravings all over again.  This is true of marijuana and booze, as well as other drugs, since they all work by stimulating the reward center.  In addition, drugs tend to make us more likely to do stupid things, like use more drugs. 

So we can obviously drink or use cannabis if we wish.  As addicts are so fond of pointing out, “It's my life!”*  However, if we do so even in small amounts, we are likely to end up deep in addiction again.

*How bogus is that?  Like we have no effect on anyone but ourselves.  Addict thinking.

What happens when you relapse? What do you do? (Part 1)

The vast majority of addicts relapse, usually more than once.  Addiction, including alcoholism, is a disease of relapse.  Those who made it the first time are few and far between.  The most important thing for you to remember if you use is that relapse is a normal part of addiction.

Then there’s the matter of what actually counts as a relapse.  Is it picking up and using alcohol or another drug?  Really?  Think about that for a minute.  Wouldn’t you have to relapse first?  If you hadn’t relapsed already, why would you pick up?

The fact is, relapse is a predictable process, just like recovery.  It usually starts with something distracting us from our program.  Because we aren’t taking care of ourselves emotionally, socializing, and doing the other things associated with recovery, we begin to slide back into our old ways of thinking and behaving.  Inevitably, this makes us unhappy, and things get worse.  Perhaps we stop eating properly, stop getting exercise, and generally get sloppy about taking care of ourselves physically, too.

As our physical and emotional state gets worse, our addict thinking starts looking for something or someone to blame.  We manufacture a resentment against our wife, AA, NA, our job (or lack of one), and pretty soon we’re turned off to the whole recovery thing.  Our behavior gets worse, we feel worse, and first thing you know we’re saying to ourselves, “Hell, if this is all there is to recovery, I might as well (drink) (drug) (gamble) (shop) (overeat) or whatever.  It’s only a short step from there to actually doing it.

SOOOOooo, when did we relapse?  It certainly happened at some point before we actually used.  That just made it official.  Actually, there was no specific time.  Just as we get our recovery bit by bit, relapse sneaks up on us the same way.  But in the end, it’s always about not being committed to our program of recovery.  That’s true whether it happens at three months clean, or thirty years.

That’s what happens when you relapse.  Next time we’ll discuss the second part of the question: what to do about it.

Denial Ain’t A River In Africa

One of the most interesting – and potentially deadly – things about addictive disease is the denial. There’s a saying around the 12-step rooms (and around detox units and treatment centers) that addiction is the disease that tells you that you don’t have it.

Denial has a variety of disguises, [Read more…]

Is This An Addiction, Or Just A Bad Habit?

You may have been browsing the Sunrise Detox site while asking yourself, “I wonder if I really have an addiction, or just a bad habit that I ought to take a look at?”

There's a big difference.  A habit is something that we have done so often that we do it automatically, without considering it much at all.  Nail-biting and cursing are examples of habits.  We can stop doing both on our own, if we pay attention to our efforts and continue to work at it.

Addiction is a chronic disease, involving changes in the brain that result in an irresistible compulsion to use a drug.  A combination of many factors including genetics, environment and behavior influence a person's addiction risk, but once addicted a person literally must have the drug in order to be able to function.  Addictions are medical conditions that almost always require professional treatment.  Alcohol is one of the most dangerous drugs, and alcoholism is an addiction.

Denial is a primary characteristic of addiction: stories we tell ourselves, consciously or not, to stay convinced that things aren't all that bad, and that it's OK to keep on doing what we have been doing.  Denial protects our drugs, which we believe deep down we cannot do without.

In order to examine our possible denial, we need to take a look at our lives in an objective way.  The checklist below will help you be objective about whether your issue is a harmless little habit, or a sign of addiction.  If you think you might be addicted to something else, just change the wording accordingly.  Answer the questions honestly.  If you answer “yes” to part of a multi-part question, it counts as a yes for the whole question.

  1. Has your use of drugs or alcohol increased over time?
  2. When you stop using, have you had any of the following symptoms: irritability, anxiety, shakes, sweats, nausea, or vomiting?
  3. Do you sometimes use more or for a longer time than you would like? Do you sometimes drink to get drunk? Do you stop after a few drink usually, or does one drink lead to more drinks?
  4. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?
  5. Have you ever put off or reduced social, recreational, work, or household activities because of your use?  Have you ever stayed away from an activity because you wouldn't be able to drink or use drugs?
  6. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimized your use? Have you ever thought of schemes to avoid getting caught?
  7. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

If you answered yes to at least 3 of these questions, then you meet the medical definition of addiction as defined by the American Psychiatric Association and the World Health Organization.  We suggest discussing your options with an addiction professional as soon as possible.

How Do I Stage An Intervention?

The intervention concept has been popularized by the excellent A & E television series of the same name, several of which have been recorded right here at Sunrise Detox. Many folks have seen the show and are familiar with the basic idea, but I thought it might be a good idea to go over some points here.

First of all, we need to understand that interventions are the “big gun” when it comes to getting addicts (including alcoholics) to turn the corner and become willing to deal with their addictions. Done properly, they can have a terrific effect, allowing the client to see how his addiction has affected others, and getting him into treatment before his denial can kick in and before he can begin to justify his behavior.

On the other hand, an intervention is pretty much a one-shot deal. If it doesn't work the first time, it is highly unlikely to work on subsequent tries. It is, therefore, important to get it right.

A proper intervention involves an addiction professional (leader), and as many of the client's family members, friends and co-workers as can be gathered together at one place and time, including his employer or immediate supervisor if possible.

The leader will, ahead of time, instruct the participants to prepare carefully. Each person will need to think about the way the client's addiction has impacted their life, and be ready to tell the addict about it. A spouse can speak about how she misses the man she married; a child about how he felt when Dad missed his graduation. A friend can tell how much he misses his buddy, the employer about how the client is a valued worker, and how he would very much like to see him become his “old self” again (and keep his job).

It is important that the client not know what is going to happen. Sometimes the group can assemble at a restaurant meeting room. The home might be appropriate, or some other location. Ideally, the client will walk in unaware of anything in store, for maximum shock value.

Most important of all is that the participants talk about how the client's addiction has impacted them, about their feelings, and not direct comments at the client: “You did this to me,” “You ruined our family,” and so forth. The object is to let the person know how his actions have affected others, rather than putting him on the defensive. That can be nearly impossible for angry members, another reason the leader, trained in interventions, is necessary: to act as a guide for the participants and keep them on track, both before and during the actual intervention.

Finally, it is vitally important to have the next step ready to go. If the addict acknowledges the problem and promises to “do something about it,” he needs to be presented with packed bags, an open car door, and a prearranged admission to a treatment facility — another reason the professional is there.

As we saw above, this is a one-shot project. Once the client's denial is broken, the next steps have to be definite — and put into place before he can change his mind. It is easy to see how, once exposed to an intervention, the addict's likelihood of responding positively to a second one is vanishingly small. Done properly, however, an intervention can literally be the difference between life and death.

It was for this addict/alcoholic.