Detox

Phillip Seymour Hoffman was a Son, Partner, and a Dad for 3 Children

Superbowl Sunday started with some negative news here on the east coast. Academy award winner Hoffman had died due to a suspected overdose. Hoffman was in detox last year after a heroin relapse following 23 years of sobriety. He was found on Sunday with a needle in his arm.  The harsh reality of heroin always seems to come to the forefront when a celebrity overdoses.

The truth though is that Hoffman was a dad of 3 young children. He lived with his long time girlfriend and mother of his children since 1998. That's the pain.  That's the part of this that hits home for all of us. Take the celebrity out of it, and there are 3 children who won't have a dad anymore. There is a single mom asking why, why, why.

Details are unclear as to Mr. Hoffmans detox last year, but stories claim  he went to detox and returned to work. At Sunrise Detox we advocate strongly for clinical care after detox to deal with the emotional struggles usually associated with heroin addiction. There is no quick fix for opiate use.

While the world will miss a great actor I am thinking of another family destroyed by heroin!

Change is less scary if we take our recovery one day at a time.

I received this comment about change on an article that I wrote about getting through post-acute withdrawal from alcohol and other drugs:

I am 3 days clean, and after reading this. I feel totally hopeless and want to go blow my brains out. Exercising, eating healthy, none of that is me and will never happen. I give the fuck up.

Here was my response:

Hi L…..,
Recovery is about changing many things, but it doesn’t have to happen all at once. That’s why we say, “One day at a time.” When you decide to really change your life, things will get better.
In the meantime, good luck and best wishes.
Bill

So many of us felt that way when we looked too far ahead during those first few days and weeks!  They say around the rooms that “recovery is simple; all you have to change is everything.” The prospect of making changes in our lives can seem so daunting that folks who aren't yet committed to recovery often find it a great excuse to go back out and drink or use other drugs. Change is scary, but it doesn't need to be terrifying.

As I wrote to the young woman, in recovery we say “One Day At A Time.” Thinking about all the details of any major project can be alarming, especially for us addicts. We’re accustomed to thinking no farther ahead than the next drink, or the next meet-up with the guy down on the corner. Ask us to consider big changes early on, and many of us are just not emotionally able to handle the prospect.

All I have to do is stay clean and sober today. If I can do that, I can make some plans. I can go to a meeting this evening. Between now and then I can get a little laundry done, buy some groceries, and call another recovering person. (Oh yeah, maybe I’d better take a shower, too.) After the meeting, maybe someone will want to go for coffee. Then I’ll come home, thankful for one more day, and crawl into bed. Tomorrow will be another day.

Obviously, we do have to make some long-term plans, and when the time is right we can do that. But worrying about the details of our future is a good way to (and a good excuse for) deciding we’d be better off doing what we used to do. At least we know how to do that. All too well.

The secret is to make little changes. It gets us used to change and gives us practice. As long as we stay clean and sober and work our program, one day at a time, the bigger changes will happen — often without our even noticing.

Change Is The Key To Recovery

Yesterday I was at the new Sunrise facility in Ft. Lauderdale, helping prepare for an accreditation inspection. I was working with client records, and noted once again how many addicts relapse and return to detox. This isn't surprising; one of the symptoms of addiction is relapse, and virtually all addicts do it at least once. Noticing it just brought the fact back to mind. It’s a good thing for us addicts to keep in mind, whether we are in recovery or just think we are. Alcoholics and other addicts relapse. All the time. So can we all, even us old-timers. I’ve seen it way too many times.

I found myself wondering how many of those folks who returned multiple times for detox actually went on to primary treatment or the 12-step groups (hopefully both), versus how many went back out to The World with the same old ideas and habits.

Detox is certainly the first step in the direction of recovery, but it's not the whole answer.  If it were, our repeat business would be zip.  Recovery is about willingness to change: to change how we think, how we relate to others, how we look at our lives, our approaches to problems, and how we solve them (or don’t).  It's about deciding how badly we want to have a life free of drugs.

Woodrow Wilson once said, “If you want to make enemies, try to change something.” We don’t like change. Hardly anyone does. Humans like predictability. We’re like the musician who said he was going to get his guitar tuned and have it welded. We want to get everything in our lives just the way we want it, and then weld it in place.

Welcome to the real world. The only thing that’s certain is change, and if you don’t want to keep on being miserable — regardless of the cause — you have to do what you can to make the changes reasonably predictable. As addicts, alcoholics, or whatever we call ourselves, if we don’t change all the things I mentioned above, and learn the skills to move forward afterward, then we’re going to see detoxes, jails and other institutions, over and over again. Until we die.

Detox is about getting alcohol and other drugs out of our systems, so that we have a shot at making good decisions about the rest of our lives. The secret's not in quitting — it’s in  learning to live in a way so that we can stay quit. We don’t learn that overnight. We don’t learn it from gurus, or New Age books (no matter how many we read) or preachers, or well-meaning friends.  We learn from other addicts and drunks, and we practice.

Staying sober is about practicing the skills of recovery until they become second nature, just like being an addict was second nature. Until that happens, we’re at risk. And if we forget how to live sober lives, slipping instead back into our old ways of thinking and behaving, we’re at risk again.

Some kinds of welding are worth the effort.

From A Drunk Who’s Ready To Dump Alcohol

On a different site, I often get comments and letters from folks with questions about alcohol and their recovery.  The one I'm reproducing below, along with my answers, was especially interesting.  Since the writer gave me permission to use it, in the hope that it might help others, I answered with publication here in mind.  As they say around the Interwebs, “I hope it helps!”

Bill: Dear Joy,

Thanks so much for writing, and for your thoughtfulness in specifically making your letter available to others.  It is so long, and so chock-full of commentable (word?) material, that I’m departing from my usual format of simple Q&A and will address each paragraph or so as they come.

Joy: I’m a 38 year old female with a long history of being a drunk. I started drinking in college and it was often binge drinking. After college, I continued to drink, sometimes binging, but usually mostly on weekends. I was in a bad relationship for 2 years and drank more often than that. Then my relationship after that was better, but I still drank. This was still weekend binges and sometimes during the week as well. My next relationship was with a non drinker, so my drinking was cut way down, but that was only for a year. Then for the next 2 years (about age 26-28), I was more of the weekend binge drinker with sometimes some drinking during the week.

Then from 28-38 (now), I’ve basically drank every night. My boyfriend of a decade is also a drinker. The first 5 years it was mostly beer (5-6 a night), with some hard liquor on the weekends. Some weekends I would drink more than 5-6 a night. Then I developed a wheat allergy (so bloated and horrible stomach and digestion problems, as well as infections), and switched to vodka about 5 years ago. I also have a history of bladder and yeast infections. I would have 6 or 7 shots a night, pretty much nightly (often mixed with club soda because it’s without calories). Sometimes I would take 1 or 2 days off and felt even worse, so started drinking again. I continued to have bad digestion and stomach problems, but not as bad and the bloating went away quite a bit. But I continued to have infections, and almost 4 years ago was sick with one for 2 months. They think it was my colon. No antibiotics worked and I got a yeast infection in my mouth. I should also mention I had infections even as a kid (ear and acne) and was frequently on antibiotics. So that history mixed with the booze equals disaster.

Bill: Your progression down the road to alcoholism closely parallels my own, except that it took me about another five years to catch on to the fact that I had a problem. That’s not unusual, BTW. Alcohol damage progresses more rapidly in women, because you don’t produce as much of the enzyme that breaks down alcohol. Your BAC rises faster, and the drug stays in your system longer.

Four things: [Read more…]

Geographic Cures and Denial

Q. I've heard people at meetings refer to “geographicals,” or “geographical cures.” What's that about?

Hand-drawn map of North America, 1811 -- Library of Congress, Geography and Map Division

A geographical cure is an attempt to avoid the reality of our addiction by changing location.  They are a form of denial, a defense mechanism in which we are faced with a fact that is too uncomfortable to accept and so we convince ourselves that it is not true despite what may be overwhelming evidence.

Excuses are a major form of denial. We learn their usefulness as small children: “She hit me first!” We usually grow out of that phase, but for addicts the need to make excuses and convince ourselves and others that we're really okay is our way of protecting the addiction. We say things like, “If you were married to that bitch,” or “If you'd seen the things I've seen…,” all of which, we have convinced ourselves, justify our drinking, drugging or whatever we may prefer not to look at too closely. (If we did, we might have to do something about it.)

So, when things get rough, we sometimes convince ourselves that all we need is a fresh start in a new place, and we'll be able to get our lives back under control. However, unless our geographical cure has also involved detox, treatment and a program of recovery, we discover that it doesn't take long for the things that we thought we'd left behind to hop out of the trees and right onto our backs again.

We failed to consider one of life's major truths: No Matter Where You Go, There You Are!  We need to change our way of living, not where we live.

Hitting the road doesn't solve our problems, it just means that we have to face them in a strange place, among strangers.  If, however, we decide to get out of the old neighborhood and get some help, that's not necessarily such a bad idea.

What Percentage Of Recovering People Never Relapse?

What percentage of recovering people never relapse?

This is one of those questions that we would love to be able to answer, but we can't.  It would be great if we could keep track of people's successes, because the ability to do so would be useful not only in evaluating treatment programs, but also for developing a better understanding of addiction itself.  Relapse is very much a part of addiction.

There are programs, and a variety of other sources, with figures that range from 15% to 75% for eventual sobriety — not necessarily on the first try.  However, there are several factors that tend to make us look toward pretty low figures for sobriety without a relapse.

One of those is simple observation.  While perhaps not statistically valid, all of us who have spent time around the 12-step rooms and/or worked in the treatment field have seen the number of folks who come in looking for help, contrasted with those who are around a year or so later.  Although those who have been through treatment seem to fare better than those who have not, it is also true that the folks with forty and fifty years clean and sober have rarely been through what we would call “treatment” today, simply because it didn't exist back then.

Another indicator is the number of people who repeat detox and other treatment.  Again, this is not statistically significant because we don't know what happened to those we never saw again.  Did they stay clean?  Did they relapse?  Did they die?  And if they didn't stay clean, how long were they abstinent before using again?  Did they get clean again?  We simply don't know, unless they tell us.

Equally, the rooms of AA, NA and the other recovery groups are not useful for gathering information.  It's that doggone “A.”  How do you track people who are in anonymous programs?  The 12-step programs don't even keep track of membership, beyond the occasional list of (voluntary) phone numbers.  If you're clean, and going to meetings, you're a member.  You resign when you leave.  If a person who has been attending meetings disappears, they may have relapsed — or they may simply be going to a different meeting.

Finally, there's the question, “What is relapse?”  It's not correct to say that it's simply picking up a drink or other drug.  It occurred before that, or we wouldn't have picked up.  Using just makes it official.

So there's no way to answer that question with accuracy — in numbers.  But I can tell you who is least likely to relapse.  It's the person who wants sobriety and recovery more than anything else in the world.  Because recovery isn't about abstinence, it's about dealing with life without using, and those who aren't willing to work at learning those skills are unlikely to make it in the long run.

A Look At Sunrise Ft. Lauderdale, Our New South Florida Facility

Today I was able to stop in at the Open House for our new facility at 2331 N.E. 53 St., in Ft. Lauderdale.  I snapped a few pictures, and I thought you all might like to see how it looks.  We expect to begin receiving clients in mid to late June.

Click the thumbnails for larger images.