TreatmentTalk – Addiction

How to Help Yourself and Get Your Life Back

This is a guest post by Todd Branston.

Having a difficult time staying sober?? Maybe it’s not you – maybe it’s brain chemistry.

You know the drill: you have spent countless hours in meetings, on the phone with your sponsor asking endless questions about your desire to use. You have worked the steps and you’ve even consulted specialists. In a moment of desperation you found help by attending treatment.

You’re able to rack up six to twelve months, but eventually you find yourself in the throes of your addiction. None of this seems to work. You find yourself questioning your commitment and ability to stay sober. Maybe your sponsor was right when he said you lack willingness.

Not so fast….

What you are likely experiencing is Post Acute Withdrawal Syndrome or PAWS.

PAWS consist of a set of impairments that occur immediately and at times simultaneously after the withdrawal from alcohol or other substances. These impairments affect three distinct areas of functioning and last six to eighteen months from the last use of alcohol or drugs as your brain tries to regain homeostasis.

Some of these impairments include cognitive problems like racing thoughts, rigidity, numbing of emotions, difficulty with abstract thinking and poor attention span, all of which are prevalent during this time. Emotional difficulties include shame and guilt, as well as difficulties with resentments. Depression is common during this time and may lead to relapse as the addict is generally not prepared to deal with the wealth of emotions they experience. The dearth of emotions can lead people close to the addict to believe they might have relapsed.

While some counselors and organizations support 100% abstinence as the only way to resolve addictive behaviors, this approach tends to come across as a ‘one size fits all’ solution to dealing with these impairments. While recovering from addictive behaviors it is remiss to not include an alternative approach without the mention of anti-craving medication as a treatment for PAWS.

Anti-craving medications may be appropriate for some individuals. The use of medication does not represent a weakness in one’s ability to recover from addictive behaviors. If anything, it should represent the idea that there is ‘another way’.

There are various medications that have been found to have efficacy in dealing with alcohol/drug cravings:

Prazosin is often prescribed to deal with PTSD and night terrors. It has been found to be successful among Opiate addicts and individuals using Cocaine and Methamphetamine.

Acamprosate is used to treat Alcohol cravings. In addition to its apparent ability to help patients refrain from drinking, evidence suggests that Acamprosate is neuroprotective. It has been shown that it can protect neurons from damage and death caused by the effects of alcohol withdrawal.

Naltrexone has been prescribed for Opiate cravings but is largely recommended as a treatment for alcohol abuse. It is also available in a monthly injectable form under the trade name of Vivitrol.

Baclofen and Topiramate have found therapeutic utility for Cocaine and Alcohol cravings.

While Methadone and Antabuse have found success in treating addictive disorders, they are not seen as anti-craving medications. Antabuse is a deterrent to drinking as it prevents the breakdown of alcohol. Some 5–10 minutes after alcohol intake, a person will experience the effects of a severe hangover for a period of 30 minutes up to several hours.

Methadone is a synthetic Opioid and has been used as part of an Opiate substitution regimen. The drug has found success in supporting long-term Heroin addicts to wean off the drug. In addition, Methadone has been used as a pain management protocol due to its long duration of action.

There is a fair amount of controversy around Methadone for Opiate substitution as the detractors point to length of time a patient uses the drug, suggesting that addicts are essentially substituting one drug for the next. Conversely The Addiction Recovery Institute points out the following benefits of Methadone Maintenance Treatment:

Reduced or stopped use of injection drugs
Reduced risk of overdose and of acquiring or transmitting diseases such as HIV, hepatitis B or C, bacterial infections, endocarditis, soft tissue infections, thrombophlebitis, tuberculosis, and STDs
Reduced mortality – the median death rate of opiate-dependent individuals in MMT is 30 percent of the rate of those not in MMT
Possible reduction in sexual risk behaviors, although evidence on this point is conflicting
Reduced criminal activity
Improved family, employment and pregnancy outcomes

It is important to reinforce the notion that an approach of 100% abstinence as a singular modality is not for everyone. Medications can provide additional support but they should not be seen as a complete solution. The goal of the medication should be to offset cravings and free up “emotional space” for the newly recovering person to add support in the form mutual aid groups, group or individual therapy, connection with a community of faith, exercise or involvement in an alcohol and drug treatment program.

Todd Branston has been working in the field of addictions for over 27 years, within the inpatient and outpatient settings, as well as working in the Department of Corrections, the Director of Counseling for a large chemical dependency hospital, to where he’s currently employed doing in-home chemical dependency engagement with (mostly) seniors.

He is part of an experts forum on chemical dependency, and has a contract gig running the chemical dependency program for a long-term transitional program to support people to overcome homelessness. His sense is that sobriety is a skill and that recovery looks different for everybody. Feel free to check out his podcasts at askanaddictioncounselor.com.

5 Non 12 Step Recovery Options (Part 2)

“If you have knowledge, let others light their candles with it.” – Margret Fuller

One thing I have noticed as I have progressed through this world of addiction and recovery, is how important it is for people to find the best recovery options that will fit their specific needs. 12 step is often the first place people turn, but there are many other options out there. It has been so interesting to me to learn about other recovery options that are available.

This is Part 2 on non 12 step recovery options, so if you missed Part 1, be sure to read that post.

Here are four more recovery options including a treatment center that uses a non 12 step approach.

“My makeup wasn’t smeared, I wasn’t disheveled, I behaved politely, and I never finished off a bottle, so how could I be alcoholic?” Betty Ford

Women For Sobriety

Women For Sobriety, Inc. is a non-profit organization dedicated to helping women overcome alcoholism and other addictions. It is the first national self-help program for women alcoholics.

Dr. Jean Kirkpatrick founded Women For Sobriety, Inc. in 1975. What amazed Dr. Kirkpatrick is not that she was an alcoholic, but that in all the years of her drinking, not once was she diagnosed as alcoholic.

From the beginning she felt that women alcoholics had the same problems she did, with little or no self-esteem, depression, loneliness and excessive feelings of guilt. She knew that she had found a way to overcome these feelings and felt other women would benefit from her experience.

Women For Sobriety, Inc. has received over thousands of letters from women and their families that expressed what Jean felt was true; women do have special problems in recovery, and in order for them to have lasting sobriety, programs for them must address these needs, especially the building of self-esteem.

WFS has been providing services to women alcoholics since July, 1976, and have self-help groups all across this country and abroad. Based upon a Thirteen Statement Program of positivity that encourages emotional and spiritual growth, the “New Life” Program has been extremely effective in helping women overcome their addictions and embrace a new positive lifestyle.

Life Ring – Empower Your Sober Self

Life Ring is a network of positive support groups for living free of alcohol and other “drugs.”

“Imagine that inside of each person who is struggling with drug and/or alcohol issues, there is a conflict between a voice that wants to keep drinking/using, and another voice that wants to be free of the drug and lead a better life. We abbreviate these voices as the “A” (the addict self) and the “S” (the sober self).

After each meeting, the “S” in each person is stronger than before. At some point, the person experiences a transformation. The “S” grows stronger than the “A” and rises to the top. Sobriety stops being an uphill battle and becomes almost second nature. So long as people avoid putting alcohol/drugs into their body, they can realize whatever potential lies within them and live full, productive lives.

This “S-to-S” connection is the engine of the LifeRing recovery process that they practice in their meetings, both in person and online. They call it “Empowering Your Sober Self.”

The LifeRing process is strength-based; it works by positive reinforcement of qualities that you already have. You can find a meeting, books, brochures and other information by visiting their website.

Moderation Management

Moderation Management (MM) is a behavioral change program and national support group network for people concerned about their drinking and who desire to make positive lifestyle changes. MM empowers individuals to accept personal responsibility for choosing and maintaining their own path, whether moderation or abstinence. MM promotes early self-recognition of risky drinking behavior, when moderate drinking is a more easily achievable goal.

MM offers a supportive mutual-help environment that encourages people who are concerned about their drinking to take action to cut back or quit drinking early before drinking problems become severe.

They offer a nine-step professionally reviewed program, which provides information about alcohol, moderate drinking guidelines and limits, drink monitoring exercises, goal setting techniques, and self-management strategies.

As a major part of the program, members also use the nine steps to find balance and moderation in many other areas of their lives, one small step at a time.

The program agrees that no one solution is best for all people with drinking problems. There are many possible solutions available to each individual, and MM suggests that each person finds the solution that is best for him or her.

MM is good place to begin to address a drinking problem. If MM proves to be an ineffective solution, the individual is encouraged to progress to a more radical solution.

“One day in retrospect the years of struggle will strike you as the most beautiful.” – Sigmund Freud

Secular Organizations for Sobriety

Secular Organizations for Sobriety (SOS) is an alternative recovery method for those alcoholics or drug addicts who are uncomfortable with the spiritual content of widely available 12-Step programs.

SOS takes a reasonable, secular approach to recovery and maintains that sobriety is a separate issue from religion or spirituality. SOS credits the individual for achieving and maintaining his or her own sobriety, without reliance on any “Higher Power.” SOS respects recovery in any form regardless of the path by which it is achieved.

It is not opposed to or in competition with any other recovery programs. SOS supports healthy skepticism and encourages the use of the scientific method to understand alcoholism.

The organization is a non-profit network of autonomous, non-professional local groups dedicated solely to helping individuals achieve and maintain sobriety. There are groups meeting in many cities throughout the country.

“Your vision will become clear only when you look into your heart… Who looks outside, dreams. Who looks inside, awakens.” -Carl Jung

Passages

Passages is a treatment center located in Malibu, California. Their philosophy is that they do not believe that drug and alcohol dependency is a disease. Instead, they believe that the addiction is caused by:

1. Chemical Imbalance

2. Events of the Past that you have not reconciled

3. Current conditions you can’t cope with

4. Things you believe that aren’t true

The center feels that anyone who is abusing drugs and alcohol is doing so because of one or more of those four causes. Over the years, they have learned through extensive research that addiction is not the problem, but rather a symptom of a deeper underlying issue. You can contact Passages at 866-504-3849.

If you have a non 12 step treatment experience, I would love to hear your thoughts in comments. Have you tried any of these programs? What in your opinion is the best treatment or recovery program?

Be well,