relapse

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!

People, Places And Things

Many of the folks who attend the groups at Sunrise Detox wonder about “people, places and things,” and question how merely seeing someone, or being in a particular place, can trigger a powerful desire to drink or use other drugs.

Maybe the best way of understanding this is to consider a number of recent experiments that studied the brain activity of subjects while they were exposed to certain stimuli. Rats, rabbits, and non-human primates will seek the same drugs that we humans abuse, and will begin seeking them again — even after months of deprivation — when exposed to the drugs themselves or to visual cues that they have associated with drugs in the past. Along with these, brain-imaging studies on human addicts indicate that visual cues can cause the addict to recall the pleasure of drug* use, and can cause enhanced activity in areas of the brain that are associated with cravings.

This research shows scientifically what people in the rooms have known for a long time, often demonstrated in sayings like “If you don’t want to slip, stay out of slippery places.” It doesn’t take a rocket scientist to figure out that if you want to stay sober you don’t go into a bar, order a drink, and sit and look at it. There’s a technical term for folks who test themselves that way: relapsers.

It shouldn’t take a lot more thought to see how less obvious things can have similar effects. Ordering a club soda and hanging with our drinking friends, seeing our dealer in a crowded club, passing the shop where we purchased our wine, even sitting in front of the TV with our buddies watching a game — all of these thing can trigger a desire to use, the “just one won't hurt” thought that has killed so many of us .

Stress

Consider that stress is one of the greatest causes of relapse, because it was one of our biggest excuses for using. Family arguments, the presence of people whom we believe disapprove of us, being around other people who are behaving the way we used to, animosity from people we harmed during our addictions — all of these things are powerful stressors, along with financial, legal and romantic complications. Some of these things are going to be parts of our early recovery, but it certainly makes sense not to complicate the problem with temptations and stressors that can be avoided. Of course these things are part of live, and of course we’ll have to deal with them eventually, but that doesn’t mean we should try when our brains are still in early recovery and the likelihood of relapse is at its greatest.

Thus, to the extent possible, we need to avoid the old people, places and things until we have enough sobriety under our belts to deal with the stress and temptation. Even then, smart addicts moderate periods of tension by attending extra meetings, calling people in the program, and generally stepping up their involvement in recovery.

Many sensible strategies, such as living in halfway houses, staying out of home areas, putting off jobs, relationships and other potential stressors can seem counter to the idea of recovery. After all, isn’t it about carrying on with life? That it is, but carrying on with life means doing so effectively, which means clean and sober, with some good recovery under our belts. Recovery is difficult enough without standing at the plate begging for curve balls. Trying to “make up for lost time” is an excellent way to lose even more of it, and perhaps our jobs, families, or even our lives along with it.

*When the writer uses the term “drug” he includes alcohol, which is simply a legal drug.

Keep Celebrity Worship Out of AA (And the other groups)

I have been sighted coming and going from thousands of AA meetings. The difference…is that nobody knows who I am and nobody cares. This has been very much to my advantage.

I”ve written about this before, and will again.  No one is more aware of this problem than people who work in treatment centers — except, of course, for the victims of the publicity themselves.  We see well-known faces come and go quite often. When we see them again, we have to wonder how much of their relapse was due to being hounded by people who can't mind their own business. Personally, I wonder just how much effect the lack of consideration from other recovering people might have. Do we give celebreties the same shot at sobriety in the rooms as we would anyone else, and how do we think we'd feel if the shoe was on the other foot?

A good article that should make us all think.

Read more: Keep Celebrity Worship Out of AA

Antidepressants In Recovery — Just Another Drug?

Depression is not uncommon in the first year or so of recovery. Some people manage to avoid it entirely, but many of us experience it to one degree or another. That’s because sometimes the ability of our brains to produce the chemicals that make us feel good has been damaged by the alcohol and other drugs, and it takes time for the necessary repairs to take place.

Unfortunately for many of us, the drugs that we used masked underlying problems.  For example, roughly 65% of alcoholics are known to suffer from pre-existing emotional problems, most of them brought about by imbalances in brain chemistry.  Those folks usually find that the removal of the drugs brings out the underlying conditions, often severely so.  Thus, the idea that all we have to do is stop drinking and straighten up is often — sometimes tragically — not the case at all.

Whatever the case, if we end up feeling that we’re worthless, that life is not worth living, and that it’s just not worth the effort, that’s bad. Depression kills people every day — far more than it should, because in most cases it’s treatable.  The problem is that, in some cases, it worsens so rapidly that the time to begin effective treatment can be quite short, so it doesn't pay to wait around.  If you're feeling depressed to the point of not caring about your life, see a doctor.  Right now!  If you're having thoughts — even casual — of self-harm, then you're already in crisis.

Many folks have been on antidepressants, felt that they didn’t work, and stopped taking them. Most antidepressants take from three to eight weeks to have their full effect, and sometimes in the early treatment period they seem to have no effect at all. Combine that with an addict’s conviction that taking a pill should make us feel good right now, and you have a good chance that the patient is going off the meds before they have a chance to help.  Others have found relief, and stop because they believe they're cured.  AD's are not like antibiotics.  They cure nothing, they simply reduce the effects of the depression and allow us to function.

Not all antidepressants work for all patients, and if we toss one before it has a chance to work, we run the risk of missing the one that was right for us. Second, and perhaps more important, is the fact that sometimes the medication was beginning to work and we just didn’t notice. In that case, if we quit suddenly, we can experience a rebound effect that throws us straight into deep depression.

This brings us to the big point we’d like to make here. Depression is nothing to fool with! There is an unfortunate attitude among some of the laypeople in the recovering community that antidepressant medications are just another drug. That is emphatically not true!

Antidepressants (ADs) are not the sorts of drugs that most recovering people mean when they say drugs. They are not addictive, in the sense of creating tolerance and cravings for more. They will not interfere with recovery by preventing our bodies and brains from repairing themselves — in fact, they assist in the process. They do not alter our mood, except for the better, and they do not interfere with our judgement. They do not trigger the addictive process, and they do not make our lives unmanageable.  Quite the opposite: antidepressants in recovery can lift the weight of the world off our shoulders, and contribute to our recovery by giving us the ability to be enthusiastic about it and enjoy its rewards.

The greatest danger of antidepressants is the danger of not taking them when we need to. Depression can not only lead to self-harm in its more severe forms, it can keep us from seeing the gains we are making in recovery, putting us at increased risk of relapse.

That said, there are some downsides. In some people, ADs affect the ability to feel and express emotion. Some have other side effects that can vary with the particular medication. However, none of these are as dangerous as suicidal thoughts or acting out, or as harmful to recovery as a relapse because “Life sucks, so I might as well just use.” And, as mentioned earlier, going off an antidepressant without a physician’s guidance can have devastating results. Any undesirable side effects should be discussed with a physician.  It may be necessary to change a dosage, or switch drugs, but do not stop on your own!

We're not recommending that recovering folks run out and look for a doctor who will prescribe antidepressants, nor are we offering them up as some sort of magic pill. What we are trying to get across is that we need to listen to the experts, and we need to be careful about making medical decisions that we aren’t qualified to make.

For some of us, antidepressants in recovery can be a tool, but they are not the whole answer. The answer, as always, comes from remaining abstinent and learning how to live without addictive drugs through therapy, support groups, and an organized program of recovery, but it makes sense to utilize all the tools if we need them, especially if failure to do so can kill us.

Important Note: This article should not be taken as, nor is it offered as medical advice. You should consult with your personal physician or a specialist, as appropriate, before considering the use of, or ceasing the use of, any medication.

Compassion and Forgiveness

There is a well-known Buddhist lesson concerning two monks who were traveling and came to a muddy stream.  There they observed a woman who was hesitating to cross, apparently concerned about soiling her clothing.

The older monk approached the woman, bowed, and then picked her up and carried her across the stream.  He set her down, bowed again, and he and his younger companion continued on their way.

That evening, while they were eating their rice, the younger monk said, “I don’t understand.  As monks, we are to have no contact with women, yet you picked that woman up and carried her!”

The older monk said, “I put the woman down at the side of the stream.  You are still carrying her.”

That’s how we are.  We cling to thoughts and ideas, worrying them and twisting them around inside our heads, causing all sorts of turmoil and accomplishing nothing in the way of our journey toward spirituality.

To me, spirituality is about things of the human spirit: understanding, compassion, forgiveness, love, willingness to contribute our efforts to help others, humility (at which I fear I’m not all that successful) and things of that sort.  Compassion and forgiveness are especially important, because clinging to the resentments that prevent those qualities from shining forth causes us so much unhappiness.

Compassion is, essentially, seeing things from another’s point of view, and being willing to do what we can to alleviate their suffering.  Forgiveness is compassion toward ourselves.  It is not about freeing the other person from anything, but about freeing ourselves of the unhappiness that is caused by being unforgiving.

Like the young monk, we sometimes carry things along with us after the reality has changed and, in our very human way, often blow it up in our minds until it forms a nearly impassable barrier to true spiritual growth.  Not until we realize that forgiveness does not involve condoning a wrongful act, but is simply choosing to accept, and move on with our own lives, can we expect to get beyond it.  That doesn’t mean that we have to invite the person to dinner, but only that we need to learn to put down our own burden after we have crossed the stream.

Shame About Alcohol Use May Increase The Likelihood Of Relapse

The study, conducted by researchers from the University of British Columbia, shows that behavioral displays of shame strongly predicted whether recovering alcoholics would relapse in the future.

http://www.sciencedaily.com/releases/2013/02/130204114246.htm

How I Became A Junkie

It's no news to any of us that addiction is a disease of relapse.  Thing is, we never know if we're going to make it back.  What struck me about this woman's story is how easily it could have turned out otherwise.

What the fuck was in this stuff? Turns out, nothing beyond drugs; sometimes throwing up and convulsions are just going to happen.

Read the rest at The Fix