Things Clients Say In Detox — Denial On The Hoof

We thought we would list some of the things that we hear clients say.  You can substitute any drug for any other drug in any statement or comment.  Denial ain’t just a river in Africa, remember?

I don't even know why I'm here.  I'm not an addict.

You're here for some reason.  You didn't just walk in to see what it was like.  Some major problem in your life got you through the doors.  You may as well hang out for a while and see if we can help you with the problem — whatever it is.

Marijuana isn’t addictive, because there’s no withdrawal.

It is true that years ago there was no noticeable withdrawal from marijuana use, but in those days cannabis had only about 1/10th the active ingredients that today’s hybridized varieties have.  Even then, chronic users often had trouble quitting.

Today, there is acute withdrawal that involves irritability, sleeping difficulties, mood swings, loss of appetite and other issues.  We also know that there is a post-acute withdrawal syndrome (PAWS) that  includes depression and cognitive disorders, and that can last for many months.

I'll stop drinking, but I'm still going to smoke a blunt now and then.

Recovery requires abstaining from all mood-altering drugs.  We cannot pick and choose.  All drugs work on our reward system.  Addiction occurs when the reward system loses the ability to make us feel good without the extra stimulation of drugs.  If we continue to stimulate the reward system so that it cannot return to normal, then we will continue to have cravings.

I only drink wine or beer.

All ethyl alcohol (ethanol) affects the human body the same way, and one six-ounce glass of wine, one 12 ounce beer, and one shot of 80 proof liquor all contain roughly the same amount of alcohol.

I only drink on weekends.

It is not important when we drink.  What matters is how much, and why.  If we are waking up with a hangover, which is really alcohol withdrawal, we are drinking enough to cause changes in our brains, even if we only do it two or three days out of the week.  And are we really remaining totally abstinent the rest of the week, or are we having a couple to “relax” each evening?  If that is the case, why do we need alcohol to relax?

I only use (pick a drug) occasionally, so I won’t become addicted.

There are millions of addicts who have found out the hard way that, despite their denial, the occasions tend to get closer and closer together until they have merged, so that we need the drug to be comfortable.  When we are more comfortable under the influence of drugs than we are without them, we are well on the way to addiction.

Alcohol doesn’t bother me; I can drink all my buddies under the table.

Increasing tolerance for alcohol or any other drug is the first sign of addiction.  If we can drink, snort, swallow or shoot more than we used to be able to handle, we’re in trouble.

“I can take it or leave it.”  (I just choose to take it.)

Put it down and don’t touch it for two weeks.  Let us know how that works for you.  Try it again.  Learn anything about denial?

I only have a couple of drinks at home, just to relax.

There is nothing wrong with that, unless we cannot relax without the drinks.  In that case we need to do some hard thinking.  We also we need to look at what we consider a “couple of drinks.”  A standard drink is one shot of 80-proof liquor, one six-ounce glass of wine, or one 12-ounce beer.  “Topping off” is cheating.  So is filling an iced-tea glass with ice and booze and calling it “a drink.”

My whole family drinks like me.

Alcoholism has a strong hereditary component, as do some other addictions.  Need we go on?

The bottom line is this: If drugs, including alcohol, are causing problems in our lives, whether they be hangovers, missing work, “discussions” with our spouses or partners, DUI’s, or any other issues, then they are a problem.  There are no two ways about it.  Either they cause problems or they don’t.  Then the big question becomes why we are continuing to do something that continues to cause us problems.

Now that is a good question — a very good question.

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!

Why Should I Stay In Treatment?

Bored In Treatment

If you hang around treatment centers for any length of time, you will eventually hear someone say (or say yourself) something on the order of “I already know this stuff.  Why should I stay here?”

This makes perfect sense, from the standpoint of someone in very early recovery.  In treatment, there are things that get repeated over and over.  That’s because we learn by repetition.  If we were studying for a part in a play, we would think nothing of going over our lines and actions repeatedly.  In recovery, we’re trying to replace old ways of instinctive thinking with new ones.  Repetition helps, but it can be the “same ol’ same ol’” after a while.

We know, however, that addicts often need a second or third trip through treatment before they actually learn what they need to know to change old behavior and stay clean and sober.  It takes some people that long to absorb some recovery principles, and apply the insight they bring to the changes they need to make.

Sometimes the things that we are asked to think about in therapy are painful, or involve feelings that we’ve suppressed so long that we can’t even identify them when asked.  The old “Yeah, yeah, yeah, I’ve heard it all before” reaction is often a form of denial to help protect us from the pain of confronting issues that may be hampering our recovery.

We need to pay attention to the details, and grab hold of new ideas when we can.  No one, not even an old-timer, knows all there is to know about recovery.  The more we know about how our own heads work, the easier it is for us to know when they’re leading us in the wrong direction.  If we listen to other clients when they share, pay attention to outside speakers, and instead of criticizing actually consider how their experiences and solutions might apply to our own situation, we can remain not only interested, but actually engaged in our own treatment.

The same is true of new ideas and therapies that may be suggested by staff.  We need to give those things a fair chance.  If we had cancer and the doctor said she thought we needed to try a new therapy, we’d at least give it a long, hard look.  Why shortchange ourselves when it comes to getting clean and sober?  After all, addiction is a deadly disease too, if left unchecked.

If we keep an open mind, treatment can not only be tolerable, it can be fascinating as we learn more about who we are, and about how to become the people we would like to be.

Romancing the Relapse: Relationships in early recovery

U. S. Library of Congress

One of the first things we hear in recovery, both in treatment and around the rooms of the support groups, is “No new relationships in the first year.”  If it’s not one of the first things we hear, it’s certainly one of the first things that get our attention.

That’s hardly surprising.  Emotions that have been suppressed by alcohol and other drugs are suddenly bubbling to the surface with none of the edges knocked off.   Add to that the fact that we’re feeling at loose ends, with all that time on our hands that we formerly spent using, and the fact that we really don’t want to face life directly yet, and we’re ripe for distraction.  Since rehab romances are one of the most common issues in early recovery, it crosses our minds, “Why not, as long as the other person is in recovery too?  We’ll have so much in common!”

Human beings are hard-wired for romance.  We are wired to be attracted to “our kind of people,” and to become obsessed with them to the virtual exclusion of everything else until we have consummated the relationship and are well along the way to creating a family unit — at least theoretically.  That’s nature’s way of making sure we continue to produce little people.    One of the most basic things we have in common with other people in early recovery is addict behavior.  We speak the same language.  If we find them sexually attractive as well, of course we want a relationship.

Because such relationships are so all-consuming, in early recovery they create the ultimate distraction at a time when all of our attention needs to be focused on learning how to exist and progress without our drug(s) of choice.  Anyone who has been “in love,” (lust) knows how the other person consumes our thoughts and — with opportunity — our time.

The bare facts of the matter are (a.) we need to give our full attention to our program until we have mastered the skills of sober living; (b.) we need to learn to have healthy relationships with ourselves before inflicting them on someone new; and (c.) any relationships we enter so soon after getting clean and sober will almost certainly fail as we grow in different directions from the significant other.  Last, but hardly least, relationships in early recovery are, in the opinion of many, the number-one cause of relapse.  That’s what you’re likely to have most in common.

Make sense now?

Do I Really Need A Program Of Recovery?

If there is one form of denial that is common to most folks who aren’t sure if they really want to stay clean and sober, it’s “I don’t need a program.  I can do it myself; all it takes is willpower;” or, “I have plenty of support at home, I don’t need to go to meetings.”  Hard on the heels of that idea is “I don’t like (insert 12-step program here), it’s too (insert excuse here).”

You don’t have to spend much time in recovery to hear folks make these statements, and if you work in the recovery field, you hear it all the time.  It usually doesn’t take too long for those people to fade out of sight, and sometimes we see them come back, weeks, months or years later, with a better attitude.

Often we don’t.

There are a couple of secrets to making it in recovery.  One is to do whatever we can to get over the habits, both mental and physical, that led us to, or reinforced the use of, our drugs of choice.  Without going into detail, some of those are:

  • using at certain times and in certain places, or with particular people
  • making excuses to justify our using (“I deserve it; If you were married to her, and so forth)
  • “drinking at” people, using booze or drugs to withdraw and let them know we don’t need them
  • always smoking a cigarette when we’re on the phone, if that’s the addiction we’re working on
  • we could continue the list ad infinitum.

The other — perhaps the biggest — secret, isn’t really a secret at all.  It’s bounced around the rooms all the time, but somehow some of us manage not to hear it.  That’s to keep an open mind!  If we don’t like what we’re hearing, we need to remember two things:

  • there are no rules in the 12-step rooms, only suggestions; no right and wrong way to do it, only ways that we have found — through 70-odd years of experience — work for most people; and
  • use common sense.

The common sense part is obviously open to interpretation.  For example, the “no romantic relationships in the first year” suggestion is a good one.  A new relationship is about the most distracting thing that can happen to anyone, and we don’t need distractions.  On the other hand, if we’re already in a relationship that hasn’t soured completely, that suggestion obviously doesn’t apply.   However, if we used with our partner, (or used them as an excuse to use) maybe we need to re-think that, too.

Another example would be the “Higher Power Issue.”  If you want the god of a particular religion as your higher power, that’s fine.  If you don’t, that’s fine too.  The thing is, we need to admit that we can’t do it alone, and surrendering to a higher power has terrific symbolism.  It works for a lot of people.

If it doesn’t work for you, great.  Just remember that part about not doing it alone.  It’s nearly impossible to recover without the support of other recovering people.  We need to remember, too, as long as we’re on the subject, that just as we have a right to choose what we believe is right for us, so do others.  So if they want to talk about their god, that’s OK.  It isn’t catching.  If we can’t be that flexible, we’re in trouble already.  After all, tolerance is the first step toward a spiritual life.

Ask yourself these questions: Do I really want to get clean and sober?  Do I want to have a full, satisfying life?  Do I want to improve my self-esteem, clean up some of the wreckage, and generally become a productive human being — or do I want to die in my active addiction?

That, my friend, is the most important question you will ever ask yourself.  Don’t answer too hastily.

Why did I have so much spirituality before I got clean, and now I can’t seem to get it back?

We go through a lot of changes when we get clean and sober.  After all, our whole world is turned around.  We go from total self-involvement to learning to depend on and to help others.  Our priorities shift from finding mood-altering chemicals to trying to get them mostly out of our minds.  We begin to look at our past realistically, and we start learning to forgive ourselves and move on with our lives.

We also have post-acute withdrawal syndrome (PAWS) to deal with.  Those issues can range from an inability to sit still and think about much of anything, to depression — occasionally both in the same person.  They are caused by changes in our brain as it repairs itself and returns to something like normal, and they can go on for months, alternating relatively good periods with some pretty uncomfortable times.  But millions have gotten through PAWS successfully.  With the help of our program, so can we.

Recovery takes time.  Getting to something like normal takes time.  And time takes time.  We are accustomed to getting what we want when we want it, and having immediate results from the getting.  Suddenly we are being told that we’re “right where you’re supposed to be,” and we don’t like hearing it one bit.  We still what what we want, when we want it.  As the old joke goes, “God, please grant me the gift of patience…right now!”

So it’s not too surprising that we find ourselves unable to focus on spiritual things.  In fact, our concepts of spirituality may themselves be undergoing changes, and considering the other changes happening in our lives, that’s hardly a surprise either.

The best thing for us to do is follow suggestions, remember that we have the rest of our lives to develop both our sobriety and a spiritual way of life, and simply not worry about it for the time being.  If we get up in the morning with the realization that we’re not hurting, and are grateful for it; if we try to do the next right thing as often as we can; if we sit down at the end of the day, consider our successes and failures, and remember that we have tomorrow to improve; if we remember to be thankful for a day without getting high and the prospect of another one tomorrow, then we have done all we need to do to insure that our spiritual life will develop, in it’s own time.

Just like recovery, spiritual growth is a process, not an event.

I Don’t Like Identifying Myself As An Addict At Meetings — Do I Have To?

Q.  I do not like identifying myself as an addict. I feel it is something I have, not something I am, and saying it constantly just reinforces the mistake, in my opinion, that we are addicts rather than that we have an addiction. Is it appropriate to abstain from identifying myself that way in AA or NA meetings?

A.  I have diabetes, so I’m a diabetic.  That’s not all of what I am.  I am many other things: a writer, a father, a husband, a photographer, a recovering person, a brother, a geek, a lover of nature, a birdwatcher, a friend, a person who attempts to sustain a spiritual life, and so forth.  However, if I forget that I am a diabetic, I’m in trouble.  If I fail to practice the behavior appropriate to my condition, then the quality of my life will be far less, and its length substantially shortened.

The reasons we in the 12-step fellowships have evolved the tradition of identifying as alcoholics, addicts, or what have you, are several.  We do it to let others in the meeting know that we belong there.  We do it because humans love ritual, and little rituals like that build cohesion in the fellowship, as do others like reading How It Works in AA, the several excerpts from the Basic Text that are read at NA meetings, and similar customs at other fellowships.  We do it because it shows a willingness to identify ourselves as one of the group.  But the most important reason is precisely the one that you allude to above as being an undesirable thing: we do it because it reinforces the self-knowledge that we are addicted — a fact that, should we forget it or begin to question it, could kill us.  It is one more defense against the denial that comes along with addictions of all kinds.

By nit-picking at little details, we distract ourselves from the initially uncomfortable fact that we are, in the most important respects, just like the other people in the room.  We make pious statements about “labeling,” when in fact if we were — for example — a PhD, we would have little resistance to labeling ourselves at the drop of a hat.  So, if saying I'm an addict makes me uncomfortable, I have to ask myself why. Is it because I’m “different?”  Is it because I’m still not convinced that I have a chronic disease?  Is it because, deep down, I don’t want to be associated with “those people” because of pride?

As our denial lessens, and as we begin to identify with the reality of our dilemma and realize the safest path out of it, we become less resistant to calling a spade a spade.  In the meantime, if we need to be just a little bit different, we can identify as a person who “desires to stop drinking,” or is “addicted to smack,” or something that we believe suitable.  They will serve the purpose.

But let’s not kid ourselves about why we’re doing it.