questions from newcomers

Why Can’t Recovering Addicts Use In Moderation?

A client asks: If we can change our thinking in order to abstain from using alcohol and other drugs, then why can’t we change our thinking to be able to use in moderation?

Why can't addicts use in moderation?  Think about it: why couldn’t we simply use “in moderation” without all the hassle of detox, treatment, and a program of recovery? If we couldn’t do it then, why should we be able to do it now? Those are the real questions!

The key is “change our thinking.” We don’t think our way out of addiction. We make a decision to get clean and sober, and to follow the suggestions of our program of choice, in order to facilitate abstinence. The thinking and process of our programs of recovery relieve some of the emotional pressures we created with our addiction and equip us to live sober lives, but they do not “cure” the addiction.

Abstinence and the subsequent repairs that our bodies are able to effect in our brains allow our addiction(s) to enter remission. Our brains slowly deactivate the extra receptor sites that clamored for more drugs and caused our compulsion to use, and at the same time the production of chemicals normally found in the brain has to ramp back up from being suppressed by the presence of the drugs. Not until this process is complete — and it can take months — do we reach the point of feeling relatively normal, although we begin to feel better long before the job is done.

Feeling better is part of the problem, too. Because the repairs to our brains depend on abstinence, as long as there are any of a wide variety of abusable drugs in our systems, the repairs can’t take place. And because they also take time, and that means that the desire to use won’t go away entirely for quite awhile; it will come and go. We can easily decide that we’ve been clean for a while so we ought to be able to “handle it.” But if we give in and use, even a little, the repairs to our brain will slow down, prolonging the physical recovery process. It is also quite likely that the combination of reuniting with our old obsession, combined with the indisputable fact that people on drugs do stupid things, will cause us to decide more would be better. Continued use will reverse the recovery process and kick us back into full-blown addiction.

Recovery is not a matter of willpower. If it were, we would have simply ignored the compulsion and stopped. The compulsion comes from a part of the brain that isn’t affected by conscious thought. We can’t think our way into sobriety; we need abstinence too. Here at Sunrise Detox, we see a lot of folks who think that they can use in moderation.  Again, and again, and again….

Sponsors In Recovery — More Questions

Our clients attend group sessions while in detox, and questions come up about sponsors in recovery. Since the subject seems to confuse some folks in the beginning, we like to mention it occasionally with a bit of an explanation. These were a couple of recent questions.

What is a sponsor?

Sponsors in recovery are people with experience in the particular program of recovery, who have completed the 12 steps, and who help newcomers understand and guide them through completion. Along with that, they make themselves available as supports outside of meetings. A sponsor should be of a gender preference that minimizes the possibility of outside entanglement, and the sponsee should remember that age is not a factor in these matters. That is, men sponsor men and women sponsor women, unless the parties are gay.

Most sponsors require that their sponsees call them every day, and want to meet with them on frequent occasions to discuss their program, things that may be on their mind, and help prepare them for the various steps. If they do not have time to do that — and there are many good reasons why that might be the case — then perhaps another choice would be wise.

A sponsor is not a moneylender, legal adviser  marriage counselor or therapist. Their purpose is to help the newcomer focus on the 12 Steps, and to help them come to an understanding of their program of recovery. These other things distract and change the focus of the relationship, and are generally considered detrimental. Furthermore, it is quite likely that they are not qualified in those areas anyway. Although most of us develop friendships with our sponsors, even that is not necessary.  What is required is experience on the part of the sponsor, and our ability to learn to trust them.

The person we choose does not have to like our kind of music, be a sports buff, or even close to our own age, but he or she must show through appearance, actions and words that they are not only working a solid program but are also living a healthy life. There is no such thing as a perfect sponsor, but the best bet is to check out the person at a few meetings or over a cup of coffee, and see that they are not just talking the talk, but walking the walk as well.

Finally, we need to remember that a sponsor’s purpose is to lead us through the steps. If that is not happening, or if they are taking us off on some tangent, we need to understand that we are not married to them, and that we are free to look for another sponsor. We do, however, need to be sure that the incompatibility is real, and not simply a matter of having heard something we did not want to hear. The nature of recovery is change, and a sponsor who is unwilling to dig a little is not doing the job right.

Is it okay to have a sponsor in AA and another in NA?

This is a matter of opinion, to a degree. Generally-speaking, when it comes to those two fellowships, we would suggest that it is best to settle on one or the other for our step work. Every sponsor learns sponsorship from their own sponsors, and styles of sponsorship thus vary quite a bit. Having two individuals risks confusion. For example, one may like to spend more time on a particular step than another, or put more weight on writing as opposed to talking. Neither of those is wrong, but they can conflict.

One of the best reasons for not having two sponsors, however, is the danger that we will play one against the other. In any endeavor, it is best to have only one leader at a time. We recommend that a newcomer choose one fellowship for in-depth work, and attend meetings of the other for identification with those issues as well.

The exceptions to the above occur in the case of specialized fellowships, such as Overeaters or Gamblers Anonymous, or sexual addiction groups. In those and some other cases, the primary purposes are so different (at least on the surface) that it is imperative to have a sponsor who can personally and comfortably address those issues.

Clients’ Questions About Recovery

From time to time we post a few of our clients’ more interesting questions about recovery.

Why do I have to continue this detox?  I am ready to go home.

We are glad that you are feeling better, but that is because you are on powerful medication.  You need further monitoring, until you are off the meds and able to manage without them.

As far as going home is concerned, it is our hope that you will decide to go to treatment instead.  It has been our experience that clients who go back to the old people, places and things don’t do well unless they have a firm foundation of knowledge, some recovery, and are able to take full advantage of available supports. Familiar situations and faces can set off powerful cravings in people who are unprepared.

How do I deal with my baby and wife leaving me because of my addiction?

As we gain sobriety and work on a program of recovery, we learn to deal with problems like this one, and many others as well.

There are only two possible ways of handling this matter.  Either you go back out and use again, continuing the old ways of solving problems that didn’t work so well, or you get clean and sober.

Option number one will certainly be easier, but will accomplish nothing except your eventual death.  It certainly will not help you regain your family and self respect, and will simply add more pain to everyone’s lives.

On the other hand, if you get humble, follow suggestions, and do the things that you need to do for yourself, you have a chance at sobriety.  If you are able to remain sober, you will at some point at least be able to have a relationship with your child, and might actually be able to get the family back together.  Seems to us that the choice is pretty clear.

I would like to know how I get a sponsor.

We find sponsors by going to a lot of meetings, listening carefully to a lot of people, and finding out who is happy, productive, and working a good program of recovery.  Some folks choose “cool” sponsors.  The smart ones look beyond the surface and try to figure out if that person has what it takes to weather the long haul, and whether they can pass it on to others.

Our blogger Bill W. has two full posts devoted to choosing a sponsor, here and here.

How long should you be clean before you can actually go around social events with alcohol?

It seems to us that the issue isn’t so much how long as it is how well prepared we are.  We need to have enough sobriety that thoughts of drinking have pretty much disappeared, along with the nostalgia when we see a beer commercial or drive past a bar.  Beyond that, we need to consider the situation: will it be a gathering when we would have participated heartily and gotten blasted — perhaps a family party or shooting pool with our old buddies — or will it be a situation with less powerful triggers.

Finally, we need to be prepared, and we need to take someone sober with us.  Again, Bill W. has a post here that covers the matter.  Check out his archives for more answers to questions about recovery.

Have a great weekend!

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.