Theories on Addiction

The theories of addiction are a bold attempt that let people unify their understanding of human behavior and pathological refraction. Reviews have already been presented about the existing theories on addiction. With these reviews and shares of point of views, people have already been divided about the theories of addiction. Some people believe that it is a disease while some believe it to be just a consequence of poor choice.

Point of View: It is a Disease

The theory that addiction to alcohol or drugs is a disease is no longer a new concept. In 1784, Dr. Rush already initiated that this condition is a disease. Requiring it to be treated by doctors and physicians. Nevertheless, the theory did not get much attention until Alcoholics Anonymous was established in 1930. Even during the olden days, before the disease theory became popular, society was prejudiced against people who were addicted to drugs and alcohol. Addicts were looked down upon. They were thought to have a lack of morality and discipline. They were presumed to be people who were only after pleasure without regard to other people. Addicts were also viewed as people with deficiencies in their character.

It was then that the theory of addiction being seen as a disease came up. This is exactly the same as diabetes, tuberculosis and Alzheimer’s disease. It helped to say that those who were suffering from addiction were not bad people. They were sick and needed help. With this theory, the public became less judgmental and less critical of those who were addicted.  It was not welcoming to hear that you were afflicted by a disease. But this was a lot better than being regarded as self-centered or immoral. The concept was embraced by almost everyone. The popularity of this theory, led people to explore more into addiction. They were better able to understand the changes that occur in the brain and that are brought on by chemical dependency. When all these physical changes that occur, it can be said that addiction is a disease.

Moreover, Dr. Benjamin Rush believed that addiction is a disease. In his struggle, it was twenty-eight years ago that he went to his first AA meeting. According to him, addiction is surely a disease. He drank and it was who he was. The fun and excitement just stopped along the way. He tried every means he knew of to control his drinking habits. Throughout that struggle he experienced failure after failure to stop drinking. It was not until he asked for assistance from a recovery treatment center that he realized with help he could achieve sobriety. He believed that addiction was just the same as a disease like cancer or diabetes. It was caused by a combination of factors and issues, including predisposition. Studies have also shown that ten percent of the population is predisposed to addiction.

In the year of 1950, the medical field already increased their support for the theory that addiction is a disease. The AMA, the APHA and the ASAM also pushed their position regarding addiction as a disease in both their treatment methods and definitions. In the past few years, psychology, pharmacology and neuroscience have concentrated more on gaining understanding of the physical side of addiction. The American Board of Medical Specialties even recognized another field, called Addiction Medicine.

Point of View: It is a Choice

There are some people who still believe that addiction is actually the result of a poor choice. To understand it clearly, addiction is a behavior and that behavior is a choice. An addict has all the reasons to start using and to start quitting. When one acts purely based on reason, it can be considered as a choice. Addicts are not simply mindless zombies who aim to find drugs at the expense of all else. Many of them are able to go through detox and get sober. They can make the decision to keep away from those situations that will trigger them. Recovering addicts can also enlist the support of their family and friends for them to get through the rough times.

Some people believe that once the brain has gone through a profound change after years of abuse substance, an addict could still be determined and motivated to stop it. This is also even after a short time. In a study conducted by a research group from Hart, it explains that addicts want to recover because of one important goal. For instance, physicians who were told to stop their addiction do so. If not, they will lose their medical licenses. The study uses an incentivizing process that is essential in support and recovery. The brain of an addict has already been chemically and physically altered by drug abuse over a long term period. But, they still have the ability to overcome and make a different choice. Thousands of addicts having proven this.

Some believe that addicts still have a choice to stick to their addiction or to choose a healthier and better life for themselves. There just are not many addicts that know this. It then becomes the job of trusted professionals, loved ones, friends, and employers that will guide the addicts to change for an improved and better life. The people who believe addiction is a choice argue that if it is a real disease, some of your body parts would be in a state of abnormal physiological functioning causing undesirable symptoms to occur. For instance, in cancer, it is the mutated cells that are the evidence of physiological abnormality. The low production of insulin cells is also the culprit to diabetes. And, those who have diseases cannot stop all their symptoms on their own. They also could not stop certain abnormal and physiological functioning that only creates the symptoms. In this regard, they could only stop the abnormality by way of medical treatment.

With regard to addiction, there is no such thing as physiological malfunction. Addiction is described as a chronic relapsing disease and is characterized by a compulsive drug use. Addiction is a choice because of the inability to quit despite the negative consequences. When an addict comes into addiction treatment no one is physically treating or healing their brain. There is medication involved in some cases, but that is simply to provide comfort measures. These addicts were ordered by the court to engage in a treatment program. These programs consist of individual counseling, group counseling, and many with with twelve-step attendance.

Gene Heyman is the author of the book “Addiction: A Disorder of Choice”. In the study presented in the book, it went back to cocaine abusers that were given conventional addiction counseling. They were offered vouchers that could be traded in for rewards like sports equipment or movie tickets. As long as they could prove their abstinence from drug use, through urine tests, they could get all these incentives. In the study, seventy percent of those who were under the program remained abstinent where as twenty percent stayed in the control group. This demonstrates that substance abuse is not involuntary or compulsive. It is actually a choice. After they were presented with a rewarding alternative to drug or alcohol abstinence, they chose to stop it. There were follow up studies that showed how this led to changes in a long-term period.  After a year of following the program, the patients doubled their success rate. Whatever it was they were filling their time with was working. The were able to replace their old bad habits with new, health habits.

In this study there was no evidence that substance or alcohol use is uncontrollable. The subjective report is that drug users cannot stop. The treatment professionals would also insist that the behavior is compulsive because of brain changes. Nevertheless, the promise of giving them an incentive is just enough to increase the success rate of traditional addiction counseling. Some people truly believe that addicts can control their urges. They only relied on substance to feel happiness. When they were introduced to other sources for happiness, they were more likely to choose these options. In the long run, they will stay sober and can practice self-regulation and self-control.

So there you have it. The two theories on Addiction.

 

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LGBTQ in Recovery

by Eric Robert H.

 

When I came to the realization that I could no longer drink, I thought I was greatly disheartened. Anger and resentment against God pumped through my veins. It had only been a couple years since I came out as bi-sexual (which some people just put off as gay) and I was coping with my new lifestyle by working alcoholically and drinking the same. Now, I had to accept the fact that I have to endure the rest of my life on this Earth without drinking. Distressed, bereaved and spiritually enraged, I felt that God was punishing me for a life I never asked for. What I did ask him for was happiness, a mentor, romantic love and success in my career field. Alcohol inhibited any and all of those blessings from arriving.

Investigative journalist Walter Armstrong attests, “Alcoholism is the granddaddy of gay health problems. It may have little of the urgency or newsworthiness of crystal meth, say, or HIV, but it remains one of our community’s (and nation’s) most insidious and intractable destroyers.” (http://www.realjock.com/article/985) The disease of alcoholism is definitely insidious. The progressiveness of the disease in my life gained momentum when the pressures of living “in the closet” became near unbearable. In coming out, it seemed like the news spread like wildfire. I began to lose trust in others. Disclosure with a few resulted in many knowing more about my personal life than I had ever let on before. I could not trust myself with the truth, let alone others. So what did I do? I moved residences, got a new job on my ideal career path and isolated when I drank. The objective was not to drink alone but rather to avoid being disappointed by the lack of gay men at the local dive bars and also not to be overwhelmed with feelings of inadequacy upon entering a gay bar. Alcohol cornered me – putting me right between its menacing grip of destruction, self-pity and isolation.

Upon entering rehab I found great solace and comfort in the support and acceptance I received from most men who were also clients of the treatment facilities. By taking that simply yet bold leap to enter treatment for alcohol abuse and dependence I took myself out of isolation. Rather than entering general population of the world right off the bat, I entered a population of men who knew and understood my pain as an alcoholic. This was one of my first experiences introducing myself not only as an alcoholic but also leading with the fact that I don’t identify as straight – a conversation that seems to arise quickly whenever men socialize. For the first time in my life, I did not feel so different, estranged and alone in a world where everyone else seemed to enjoying their booze in moderation. I thought my drinking was a homosexual problem when in fact I discovered and accepted alcoholism for the tyrannical spiritual malady it truly is. Straight men who stood by me, shared with me and attended groups with me led me to this understanding.

Accepting my sexual orientation for what it is takes courage each and every day. Much of my experience as a man pursuing other men revolved around alcohol. I struggled accepting myself and the struggle to accept other gay men was even greater. With that, I accumulated a lot of guilt and shame from drunken one-night stands with men who identified as straight. The shame and guilt I bore was not mine to bear. According to a study published by The Journal of Social Psychology,  “heterosexual people are more likely to find members of the same sex attractive after consuming alcohol.” The journal furthered the conclusions drawn from the study stating, “men who had more than ten alcoholic drinks were just as interested in the men depicted as they were in the women.” (http://www.newnownext.com/straight-men-drunk-gay-sex-study/05/2017/) In the words of R&B artists Jamie Foxx “blame it on the a-a-a-a-alcohol…”. Rehab gave me the healthy, sustainable friendships with gay and straight men I had always longed for.

In addition to rehab, spiritual and emotional gains have been made for the better due to the acceptance and tolerance I found in the meetings of Alcoholics Anonymous. Two of my sponsors have been straight men and most of the calls I receive daily are from the like. My sexuality doesn’t define me, nor does it define my disease. I drink from the fountain of community with cups of friendship because AA and treatment facilities did not close their doors on those who identify along the spectrum of LGBTQ. Walter Armstrong went on to note that  “AA opened its doors to gay men two years after its founding in 1935, whereas gay-sensitive treatment centers remain few and far between in some parts of the U.S. It’s estimated that there are now more than a thousand gay AA groups nationwide, with 12-step.programs for everything from crystal-meth addiction to sexual compulsion increasing the count by half. “ (Armstrong, “Just a Sip? Gay Men and Alcoholism”, http://www.realjock.com/article/985)

In any discussion revolving around homosexuality it is necessary to address the lack of progressiveness and acceptance in normative culture. Matthew Todd, former editor of Attitude, argues that for gay men it is “our experience of growing up in a society that still does not fully accept that people can be anything other than heterosexual and cisgendered [born into the physical gender you feel you are]… It is a shame with which we were saddled as children, to which we continue to be culturally subjected.” (Owen Jones, “Gay Men Are Battling a Demon More Powerful Than HIV”, https://www.theguardian.com/commentisfree/2016/oct/20/gay-men-hiv-homophobia-lgbt-drink-drugs). I have my own stories of being sanctioned, ridiculed, ostracized and discriminated against for identifying as bisexual. Even in treatment I experienced the pain of being called a “fag” by a fellow client who bore tattoos indicating allegiance to white supremacy. He later apologized and our friendship was built on the foundation of sobriety and clean time rather than our differences.

Recovery and AA have an irrefutable power to bring people who would typically not mix together.  Armstrong notes that “Recent studies have found comparable trends in alcoholism and alcohol abuse between gay and straight men.” (“Just a Sip?”) We alcoholics are not all that different regardless of who we want to spend the rest of our lives. Getting sober not only helps me come out of the closet but also accept myself. I attend AA mens meetings just as much as I attend gay meetings. I pray to a God of my own understanding. And the best part about early sobriety is that I’m not looking for sex or romantics for the next year at least.

So the pressure is off. Be yourself and defy whatever defamations alcoholism is trying to tell you. Getting sober is an affirmation uninhibited by race, creed, sexual orientation or religion. It’s a universal language of love that will endure as long as mankind and alcohol co-exist. If you are struggling with alcoholism and your identifying as anything other than straight, address your disease first and I guarantee the know-how and courage to face life’s other many mysteries will reveal itself.

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Shameless Sex Sober

The Discussion of Celibacy in Early Recovery as Portrayed on Primetime Television

by Eric Robert H.

Seven seasons of egregious acts, lack of concern for others and doing whatever it takes to survive the cold streets of Chicago has immortalized the Showtime series Shameless. The raunchy bluntness of the characters enthralled me while in college and every season finale left me thirsty for more of the Gallaghers. In recent seasons we’ve seen the eldest son of the Gallagher clan, Lip played by Jeremy Allen White rise to the rafters of academia but endure an insufferable demise alcohol abuse. Alcoholics Anonymous maintains an appeal to “attraction rather than promotion” so it’s quite a guilty pleasure to see it depicted in primetime media. As a fan and avid viewer of the show, I identify with Lip extensively – the struggle to balance book smarts with street knowledge; the appeal to better yourself through education despite leaving your family; and the baffling insurgence of alcoholism at all the wrong times.

A standing ovation is due as Season 8 of Shameless has found its stride and brings the viewers into the rooms of AA through the eyes of Lip. The character is an archetype newcomer and chronic relapser. This season we find him clinging to the guidance and mentorship of his sponsor and reaffirming his patriarchal seat at the Gallagher breakfast table. In a September 12 interview with TV Guide White discussed Lip’s character arch this season explaining, “He’s trying to understand himself. He becomes almost childlike in his sobriety. He’s really going to his sponsor and his family members and asking questions, not thinking that he knows it all. It’s nice to see Lip curious, I guess…I’m not gonna say that Lip’s perfect this season because he’s not by any means, but I think you’ll see Lip thinking about his actions a bit more. Lip is obviously incredibly intelligent, but I think emotional intelligence is a completely different thing, and he often struggles with making the right choices.”

(https://www.thefix.com/shameless-star-jeremy-allen-white-talks-characters-newfound-sobriety)

 

“But how many men and women speak love with their lips, and believe what they say, so that they can hide lust in the dark corner of their minds? And even while staying within conventional bounds, many people have to admit that their imaginary sex excursions are apt to be all dressed up as dreams of romance.”

(The Twelve Steps and Twelve Traditions, p. 67)

 

The rise of Lip’s sobriety has brought the icon’s sex life to a dramatic pause, something newcomers can certainly identify with. The suggestion to abstain from sex relations during one’s first year of sobriety is not a popular topic among us recovering. Members of AA share different, individual belief systems about sex relations in early sobriety. Celibacy may not have been practiced by some of the stakeholder oldtimers in your homegroup. The Big Book of Alcoholics Anonymous is infamous for its description and approach to sex on page, but of course, sixty-nine (69). The great text contends that “God alone can judge our sex situation. Counsel with persons is often desirable, be we let God be the final judge. We realize that some people are as fanatical about sex as others are loose. We avoid hysterical thinking or advice.” The reconstruction of one’s sex situation is deeply personal and vital to the success or failure of their recovery.

Here Season 8 is near mid-season and Lip is struggling with celibacy. As a newcomer, I can identify with the temptation to reignite the relationship of an old flame and the sobering moment one experiences upon awakening from a fantastical wet dream. It’s a total mind f*ck. What the hell does me having sex have to do with me not drinking? I lightly identify as a sex addict. The disease of sex addiction is so pertinent, so relative to substance abuse and addiction treatment a Sexual Recovery Institute was founded in Los Angeles in 1995 by Rob Weiss, LCSW, author of Sex Addiction 101: A Basic Guide to Healing from Sex, Porn and Love Addiction (https://www.addiction.com/expert-blogs/understanding-defining-sexual-sobriety/). The institute is now hedged under Relativity at Elements Behavioral Health as its website Sexualrecovery.com offers information pertaining to sex addiction and the treatment thereof. Now, just because someone identifies as an alcoholic or drug addict does not mean they automatically identify as a sex addict, but you tell a person like me to not even consider having sex for a year and yeah, you are going to see some signs of addiction start to surface.

The Sexual Recovery Institute maintains that “Human beings are naturally geared to make sex an important consideration in their everyday lives, and sex is one of the world’s most common pleasurable activities. These facts reflect the core importance of sexual reproduction to human survival. Unfortunately, some people develop a dysfunctional relationship to sex and start to repeatedly use sexual activity, sex-related thinking or sexual fantasy in damaging or inappropriate ways.” From a dysfunctional relationship with alcohol, which was involved in most if not all of my sexual encounters, it is no wonder why my sex drive went into overdrive upon entering sobriety. The pleasure receptors in my brain are accustomed to be appeased, if not by alcohol or marijuana then by what? Sex. Porn. Masturbation. Instant gratification. This is a serious issue. It’s a classic example of an alcoholic replacing one addiction with another: “As with other forms of non-substance-based behavioral addiction, repeated and excessive involvement in sex can trigger long-term functional changes in a part of the brain called the pleasure center, and can thereby lead to the onset of addiction-related symptoms that mimic or mirror the symptoms found in people who have physical addictions to drugs or alcohol.” (https://www.sexualrecovery.com/articles/general-interest/sexual-fantasies-run-gamut-in-both-genders/)

 

“When satisfaction of our instincts for sex, security, and society becomes the sole object of our lives, then pride steps in to justify our excesses… Unreasonable fear that our instincts will not be satisfied drives us to covet the possessions of others, to lust for sex and power, to become angry when our instinctive demands are threatened, to be envious when the ambitions of others seem to be realized while ours are not.”

(The Twelve Steps and Twelve Traditions, p. 49)

 

We are witnessing Lip face a behavioral addiction head-on. Jeremy Allen White told Vulture his character “grew up drinking and is so sewn into the culture that he doesn’t know anything else…The idea of him getting help or not drinking is such a foreign concept.” (http://www.vulture.com/2016/04/shameless-jeremy-white-on-lips-breakdown.html) I’ve concluded that Lip grew up having sex as well. Fans of Shameless have watched Carl Gallagher played by Ethan Cutkosky enter puberty under the advice and in the shadow of his older brothers, Lip the eldest. Thus, it’s safe to conclude that sex is “sewn into” his culture. The thing is, Lip like us newcomers is changing the culture of his life. For some of us it’s an economic bottom, where financial crisis rendered us homeless and without reserve. For others it’s a mental collapse that may have landed us in jail or a padded room on lockdown for 72 hours. Whatever your bottom, it was a direct result of the manner in which we were living. Lip landed in jail as a result of his consumption. He was also admitted to the hospital to be treated for alcohol poisoning. When is enough enough? It’s no wonder why I, like him, am willing to go to celibate extremes in an effort to stay sober.

 

“…our sex powers were God-given and therefore good, neither to be used lightly or selfishly nor to be despised and loathed… In other words, we treat sex as we would any other problem.”

(Alcoholics Anonymous, p. 69)

 

As we courageously “trudge the road to happy destiny” we resolve to stay sober by setting a definitive boundary to abstain from consuming alcohol. In doing so, we work a program of AA under the guidance and experience of a sponsor. When and if that sponsor suggests we treat sex as we would our problem with alcohol, it begs the question: How free do we want to be? See, I think Lip is tired of living below the poverty line. I think he knows a change in his familial environment that results in longevity and sustainability requires a change within himself. I think he’s desperate enough to shower the morning wood away and give himself the attention his sobriety requires. We are witnessing a spiritual transformation and though fictitious, we are watching a depiction of God working in a life so similar and painfully relatable to our own. In a recent article titled “Setting Our Abound-aries: Dating and Sobriety” on Thefix.com, columnist Kelly Neville wrote, “A boundary is rooted in a fixed, stable location. Those of us in recovery recognize the need to hold fast to our unwavering boundaries: not one drink, not one drug, not ever again. But boundaries get complicated when people we invite into our lives and hearts straddle our fence line.” She’s right. Boundaries do get complicated especially once they are explicit, established and present. We invite people into our lives and they invite us into theirs. We need to be prepared and anticipate the rise of mutual attraction. Sobriety is not a cloak of invisibility and nor should it be. It is an opportunity for us to get to know others on a deep, meaningful level absent from the disease of co-dependence that results from NSA or FWB sex encounters.

 

Remember that non-fiction guy who was so compelled to address sex addiction he founded an institute purposed with its treatment? Rob Weiss, LCSW, provides a sensible strategy for sexual sobriety that he dubs “Boundary Plans” or “Circle Plans”. Three boundaries encircle one another: inner, middle and outer. First, the Inner Boundary identifies and prohibits the actual actions that cause us pain. These are the “bottom-line” or “absolutely not” actions like paying someone for sex, having sex with an ex, participating in casual sex and for some of us even masturbating.

Encompassing the first boundary, second we have the Middle Boundary. Weiss describes this phase of the strategy as an honest listing of triggers – people, places, things and ideas that may lead to relapse. This boundary is unique in that is marked by inaction: skipping meetings, missing appointments for therapy and entertaining unstructured free time. Weiss reminds us, “these (triggers) vary widely depending on the sex addict’s goals and life circumstances”.

The third and largest circle providing a perimeter of protection is the Outer Boundary. This boundary lists short and long-term goals pertaining to the person’s aspirations and vision for life. Setting this perimeter of the outer boundary means setting realistic objectives to achieve success as we melt recovery together with daily life. Tangible objectives such as going to a meeting everyday, attending therapy once a week and volunteering on specific dates keep life interesting and enables us to accomplish little things with big implications.  Weiss suggests we also assert intangible objectives that may include things like getting a better understanding of career goals and envisioning where we see ourselves in ten years. (“Understanding and Defining Sexual Sobriety”, https://www.addiction.com/expert-blogs/understanding-defining-sexual-sobriety/).

Ultimately, the boundaries Weiss suggests for an addict of the sexual variety require the same thing Lip, like us, was lacking: discipline. In making a case for celibacy in sobriety, Chris Fici argues, “Discipline has fallen out of fashion in our post-post-modern world. In previous generations, it was seen as a rite of passage, or even a calling… now it is seen as a perversion of our natural desires, of our striving for freedom.” (https://www.elephantjournal.com/2012/06/a-case-for-celibacy-sobriety-sanity/) I will further Fici’s claim and argue that in striving for spiritual and emotional freedom we recovering alcoholics need to inhibit the corporal will of the body. Self-control is required. There’s an undeniable elevation of the spirit when the body is controlled, when it is metered in action and forced to succumb to the will of the heart rather than the mind. Consider a performance artist (a background dancer, pop star or Broadway lead). They were not born with the moves or choreography, but they started to practice. For the moves that were difficult they rehearsed under intense scrutiny in the mirror and under the guidance of the producer. When the show commences from the first act to the closing curtain, there’s an incredible exaltation exuding thru the pores of the performer as they take their bow. The performance of the body freed their spirit and made them an intricate piece of something bigger, higher than themselves alone. Celibacy can be considered a performance art. We the actors, life the stage, sobriety the script and God the Director.

In the Hindu text called Bhagavata Purana, verdic teacher A.C. Bhaktivedanta Swami Prabhupada wrote “By controlling the senses… one can understand the position of his self, the Supersoul, the world and their interrelation; everything is possible by controlling the senses.” The 700-verse Hindu scripture called the Gita maintains:  “But a person free from all attachment and aversion and able to control his senses through regulative principles of freedom can obtain the complete mercy of the Lord.” (Fici, 2012)

In closing, I’d encourage anyone in recovery to grab some popcorn and a soda. Sit back and if you have the means, take a look at White’s portrayal of Lip on Shameless. Maybe you’ll be encouraged like me and discover a sound sense of community that transcends from the Roku of a college dorm to the heights of Hollywood Hills. This disease does not discriminate and neither does AA. Just like the bottle, AA can go anywhere in defiance of the disease that wants to keep us shackled to isolation and social deprivation. In a recent episode, Lip brings members of AA to the door of his friend who just caught his fifth DUI. Upon praying out, let us cater not only to the recovery of our livers but to our hearts by abstaining from the vices of the mind. We turned our sex drive into a weapon. Let’s convert it back into a gift, returning it to our higher power from which we received it. This isn’t about mind f*cking ourselves, it’s about preventing harms and allowing the journey of recovery not to be tainted by other expressions of disease. In closing, there’s a fire burning in all of us – we have the ability to control it rather than let it rage out of control causing destruction rather than utility.

 

References:

“Shameless: What Does Sober Lip Look Like in Season 8?” By Megan Vick | Sep 12, 2017, http://www.tvguide.com/news/shameless-season-8-sober-lip/

“Sexual Fantasies Run Gamut in Both Genders” June 11th, 2015, The Sexual Recovery Institute, www.sexualrecovery.com

 

“Shameless’s Jeremy Allen White on Lip’s Heartbreaking Downward Spiral” By Dee Lockett April 1, 2016. http://www.vulture.com/2016/04/shameless-jeremy-white-on-lips-breakdown.html

“Setting Our Abound-aries: Dating and Sobriety” By Kerry Neville 08/21/17

“Understanding and Defining Sexual Sobriety” by Rob Weiss, LCSW on January 19, 2015 in Sex Addiction Expert Blogs

 

“A Case for Celibacy, Sobriety and Sanity.” by Chris Fici  Jun 7, 2012. https://www.elephantjournal.com/2012/06/a-case-for-celibacy-sobriety-sanity/

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Hannah’s Arrival, The Alcoholic’s Grace: A Theoretical Review of Arrival as It Pertains to Alcoholics Anonymou

By Eric Robert H.

SPOILER ALERT: In an effort to draw comparable conclusions from the film’s screening this article will divulge the story as it pertains to my translation as a recovering alcoholic. This article has no intention to infringe upon any copyrights or trademarks.

 

 

The previews for the feature film Arrival were released almost a year prior to its theatrical debut and upon viewing I knew the film would draw me in with incredible rapture. The International Movie Database (IMDB) summarizes the story, “When twelve mysterious spacecrafts appear around the world, linguistics professor Louise Banks is tasked with interpreting the language of the apparent alien visitors.” (2016) Overarching themes of discovery, courage, the human spirit, reason and power lace the film with a post-modern fabric requiring a keen attention to detail. The protagonist Louise Banks (Amy Adams) guides the audience through the characterizations of her superior Colonel Weber (Forest Whitaker), her colleague and future spouse Ian Donnelly (Jeremy Renner) and most importantly the archetype of innocence, her daughter Hannah (played by various actors). As interaction among the characters is depicted, the story cuts through time and space like a wormhole. I had to watch the film multiple times with pen in hand to not only establish the audience’s perspective in time and space but also take note of the extensive use of communication studies as Louise ascends to the role of heroine.

A palindrome is “a word, verse, sentence or number that reads the same backward and forward” (https://www.merriam-webster.com/dictionary/palindrome). In the film, Louis explains to her daughter that the name Hannah is one of power because it is in fact a palindrome, representative of the heptapod (alien) language she is tasked with translating. That name, Hannah, stood out to me as a Biblical reference and upon inquiry I learned it is a Jewish name meaning grace: simple elegance or refinement of movement. Like Hannah, the acronym AA is also a palindrome. The similarity brings relevance to the nonlinear totality upon which the film plays out. It is reminiscent of a circle with points intersecting its borders. A triangle or pyramid inside of a circle or sphere, edges meeting edges. The logo of AA depicts separation within a whole connection.

A groundbreaking discovery is made when Louise provokes the heptapods to write their language. Rather than words, logograms are displayed. The use of a logogram allows a single symbol to communicate deep, complex meaning – just like the logo for AA. Logograms like words are symbols, representing shared understandings. Those of us in recovery understand one another with a single word – sobriety. A single word conveying lifetimes of meaning and thus rendering understanding which is the objective of communication. The newcomer’s pain and our stories share common pitfalls as well as a single triumph. “I don’t drink,” now a testament that I’ve been brought closer to God than ever before. It’s a statement of solidarity rather than a debilitating confession of isolation.  Just as Hannah battles “a rare disease that is unstoppable” so do members of AA.

The rising action of the film is Louise’ race against the doomsday clock to translate and bridge communications among human and extraterrestrial parties. Upon analysis she determines that the heptapod logograms are “free of time”. The alien language is represented in ‘nonlinear orthography” meaning the rules that dictate their language are holistic and transcendent rather than metered by measurements of time. Louise and Ian discuss the Sapir-Whorf Theory which is the hypothesis that language not only influences thought and perceptions, but may also be responsible for what we are capable of thinking (http://www.nytimes.com/2010/08/29/magazine/29language-t.html?_r=1&scp=1&sq=you%20are%20what%20you%20speak&st=cse, www.sheknows.com). I relate this theory to the negative, destructive self-talk produced by alcoholism. The disease of alcoholism constructs a self-loathing narrative within its host/ victim, negating natural coping skills and leaving them with an inability to stop drinking if left untreated. Fortunately, AA submerses the alcoholic into a new culture, teaching our wet minds a new language, thus changing our perception of reality. The awe-inspiring power of AA is comparable to Louise’ influence as a linguist and her ability to change the narrative of humanity’s introduction to the foreign bodies that conflict throughout the film.

The necessity to negotiate, just as the alcoholic does with himself, presents Louise with another theory known as the Prisoner’s Dilemma. This is a scenario where cooperation and trust wins as blind pursuit of self-interest loses (http://www.businessdictionary.com/definition/prisoner-s-dilemma.html). AA’s survival is dependent upon AA unity. The program requires one alcoholic to work with another – cooperation and trust win. The alcoholics self-interest, “self-will run riot” (Alcoholics Anonymous, p.62), has proven a loss spiritually, mentally and physically. The prisoner’s dilemma is not explicit in the film but director Denis Villeneuve and writer Eric Heisserer made sure to explain a zero-sum game. According to Collins Dictionary, zero-sum game is “a contest in which one person’s loss is equal to the other person’s.” (2017) Sponsorship is a zero-sum game. The sacrifice and loss of free time on the sponsor’s side is matched by the social gain and understanding given the sponsee.

I was compelled to root for Louise as she transforms into a communication heroine by what Bishop T.D. Jakes might describe as the act of rising up and coming out (“Worship Connects Us”, 11/26/2017). Louise’ decision to “rise up and come out” is exemplified upon her entering a single pod extended from the alien’s ship and joining them aboard. Louise had to make herself vulnerable, take a risk and do what no one else would in order to gain the understanding and acquire a solution. Her being aboard the ship, beyond the barrier that initially separated the two species, brought her to a state of weightlessness. She was set on an equal plane with no gravitational advantage or disadvantage. The protagonist was suspended in refuge. This is equivalent to alcoholics entering the rooms of AA and participating in a meeting. Upon returning to the terrestrial plane, Louis carries the message, “Use weapon”. Obviously at face value this message is threatening, but further investigation reveals that the symbol for weapon in the heptapod language is identical to ‘gift’ – “Use gift”. Alcohol threatened our lives: a weapon of mass destruction. AA changes that weapon into a gift that unifies us. Funny how the symbol takes on a new meaning, a new cause and a new effect.

Louise’s acquisition of fluency in the heptapod language grants her the ability to see the future (Sapir-Whorf Theory). SPOILER ALERT: All this time, the audience thought we were flashing back in review of Hannah’s childhood when in actuality the film flashes us forward revealing what is to come of her short yet evasive and meaningful life. Some of us have been advised to “play the tape” when tempted to drink and we conclude that the result of such drink would be nil. We play the tape of sobriety and though the journey of life now extends much longer, narrower and still grieved with pain, we are willing to endure because it is a good fight of faith worth fighting. Now purposed to resolve the rising conflict, Louise states, “Despite knowing the journey and where it leads; I embrace it and welcome every moment.”  

As a member of AA, I could not agree more. See, the weapon of language given to Louise opens time. It unlocks the closed circuit. Alcoholism, a cyclical cycle that has no cure, that is unstoppable, can in fact be arrested. The promises of AA allow the newcomer to perceive time the same way as the old-timer otherwise known as a survivor. Therein we have a reason for unification, a reason to work a program together.

Upon further analysis of character names I found the palindromic theme reinforced as the conception of Hannah is revealed. Her origin like ours required a ‘mom’ and dad’. Both of these words, these symbols of maternity and paternity are examples of palindromes. I probably got way too into this film’s dissection but as a Bachelor of Arts in Communications I discovered that Louise spelled backward is Esioul audibly similar to ‘soul’. Hannah’s father is introduced and characterized as a scientist named Ian- a symbol very similar to ‘I am’. Exodus 3:14 reads “And God said unto Moses, I Am That I Am: and he said, Thus shalt thou say unto the children of Israel, I Am hath sent me unto you.” So for the sake of my argument, let’s refer to our protagonist as ‘Soul’ and her significant other as ‘I am’. In the concluding scenes of the film, Soul embraces I am saying, “I forgot how good it felt to be held by you.” She had never been held by him before, however now that she knew her future she was penitent to have ever gone without him.

Alcoholics Anonymous requires a single penance of temperance. In that inaction, a covenant, a bond, an embrace is formed between us and a Higher Power of our own understanding. Prior to getting sober, “I forgot how good it felt to be held by” God. He’s given me a gift, a new language. That language is spoken and symbolized by abstinence from alcohol. This immersion into a new language changes how I see life. Just as the Sapir-Whorf Theory hypothesizes, my thoughts and perceptions are influenced by my language. The symbol I did not know, the sobriety I did not practice, left me unable to understand a future without alcohol. There was no future in my eyes because I thought I could not bear to live in the present; all I knew was my past and my perception was defined by it. Nowadays I’m having whole conversations in a single word, sober. I thought the film was about the arrival of the aliens but now I know it’s about the arrival of hannah: the arrival of grace.

Grace /ɡrās/

the free and unmerited favor of God, as manifested in the salvation of sinners and the bestowal of blessings.

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Not into the 12 steps but looking to stay sober? Here’s what to try next

By David Heitz

Once taboo, an increasingly heard chorus of addicts and alcoholics in recovery are bemoaning the 12 steps. They say they are ancient, ineffective, and not based on science. In particular, 12-step programs have proven ineffective for many opioid addicts who have a difficult time accepting personal responsibility for their addiction. Many of them were prescribed medication by a doctor, after all, and took it as directed. If the new face of addiction is demanding alternatives to 12-step programs, we must provide it. Everyone deserves to live a happy, sober life. They say that while it is true “the program” has helped tens of millions of people, it’s also true that the program works well for the people it works for. We don’t have statistics on the number of AA “dropouts” who ended up staying sober on their own. Perhaps they took the familiar from AA and discarded the rest. Here are some other groups offering recovery support:

 

SMART Recovery (www.SMARTRecovery.org)

 

Next to AA, this is the next most common choice of recovery groups in the U.S. SMART Recovery bases its methods on self-reliance and evolving science. One of the biggest problems people addicted to opioids face with 12-step programs is resistance to the medication-assisted therapy that many need to maintain sobriety. Elizabeth Brico explains it all too well in an informative piece for Stat.

 

“Sadly, there’s a lot of misinformation out there about medication-assisted therapy for drug addiction. Take, for example, a comment made about medication assisted treatment by Tom Price, who recently resigned as secretary of Health and Human Services. “If we’re just substituting one drug with another,” he infamously said, “we’re not moving the dial much,” indicating his clear preference for faith-based and non-psychoactive interventions. The most recognized providers of those kinds of interventions are the 12-step fellowships, which include Alcoholics Anonymous and Narcotics Anonymous. If that’s what the secretary of health said works best, we should count ourselves lucky that thousands of free 12-step meetings occur every day across the country. Right? Wrong. These programs are making the opioid crisis worse by making recovery from opioid addiction harder than it already is. By turning their backs on people like me on medication-assisted therapy to kick opioid addictions, these programs are prolonging addiction and contributing to overdose deaths.” (1)

 

Harsh words, indeed, but true ones. A “substance use disorder” for DSM-5, the so-called bible of mental health diagnoses, refers to when a substance is interfering with a person’s daily life. When a person on medication-assisted therapy is working, in recovery, and rebuilding their life and their relationships, they are not considered to be an active “addict” in the medical sense.

It’s important to note that some NA chapters are more progressive than others about medication-assisted therapy. It is a non-issue in many of them, but you always will encounter “old school” members and the accompanying rhetoric.

 

 

Women for Sobriety

AA is run by unscreened volunteers and is not supported with tending law enforcement or the medical establishment at its meetings. Unfortunately, it can be a playground for predators or just plain mean people. In a 2015 piece on the issue in The Guardian, one woman described her experience. “What I did not expect was to be fresh meat when I walked into AA meetings….Men wanted my number and wanted to date me. I was newly sober, clueless and craving love….“It never caused a relapse, but it did make me question the joy of sober life, and also consider suicide….The world seems like a really mean place when you are surrounded by unhealthy people.” (2)

SOS (SOSSobriety.org)

Secular Organizations for Sobriety (also known as Save Our Selves) is a non-profit group not affiliated with any religious or secular organization, as its website points out. The no-nonsense principles of SOS make it clear sobriety means abstinence from all drugs inside these rooms. The principles also state very plainly the group has no interest in controversy, only in helpings its members maintain clarity and strength in sobriety. From its website:  SOS is a nonprofit network of autonomous, non-professional local groups, dedicated solely to helping individuals achieve and maintain sobriety/abstinence from alcohol and drug addiction, food addiction and more. S.O.S. headquarters began in Jim Christopher’s apartment, as did his early meetings, but later the organization found a home at The Center for Inquiry West (CFI-West) in Hollywood, California.  Today, S.O.S. meetings span the globe, and it’s headquarters can still be found at CFI West.

 

Celebrate Recovery (celebraterecovery.com)

 

Some who enjoy Celebrate Recovery meetings say that unlike what you find in “the rooms” of the 12 steps, members seem more like those “nice Christians” you remember from church, for lack of a better word. Less judgment. More love. Increasingly, research shows the tough love approach to addiction simply does not work. But understand, Celebrate Recovery is based on those same 12 steps but with Jesus Christ font and center.  From its website, explaining in no uncertain terms: The DNA of Celebrate Recovery is non-negotiable because of two pertinent facts: 1. The DNA revolves around the Gospel of Jesus Christ and 2. The Bible and God’s Word are at the very core of everything we do in Celebrate Recovery. The DNA of Celebrate Recovery is all about pointing us back to the Beatitudes; Jesus’ instructions on how to live a good, productive life. By following the DNA, groups will start safe and remain safe.

 

Some may find it odd that a person would turn away from a 12-step program such as NA or AA, yet embrace that same program when narrowed even further to focus only on Jesus Christ as their higher power. However, if someone grew up in a Christian church, the 12-steps practiced inside a Christian church led by clergy can prove enormously useful. The vibe is much different than in a non-denominational, non-religious 12-step group. Real stigma about addiction coming from ‘the rooms’ In a recent VICE piece, famed addiction journalist, author and recovering addict Maia Szalavitz talked about where the stigma surrounding addiction comes from. Writes Szalavitz in a disturbing commentary stemming from allegations of sexual abuse against actor Kevin Spacey:

 

“In fact, much of the stigma associated with the addiction model comes from the way the concept is so often used as an excuse for all types of bad behavior—and the way rehab is viewed as a site to begin restitution and penitence. This is not helped by the fact that the majority of American rehabs are based on the 12 step model, in which participants are encouraged to surrender to a “higher power,” take “moral inventory,” ask God to remove their “defects of character” and make amends to those they have harmed. The fact that so many rehabs have historically used degrading and punitive tactics that assume participants are self-centered manipulative liars also plays into the idea that addiction is really sin.” (3)

 

LifeRing (LifeRing.org)      

 

LifeRing Is another non-secular recovery support alternative. LifeRing focuses on empowerment instead of dwelling on being powerless. From its website: “Our approach is based on developing, refining, and sharing our own personal strategies for continued abstinence and crafting a rewarding life in recovery. In short, we are sober, secular, and self-directed.”

 

Relentless judgment, lack of options leaves bitter 12-step taste

 

In an interview last year with Rehab International, Szalavitz said, “It’s clear (the 12-Step program) does not work on opioid addiction,” Szalavitz said. “If you believe that your method is the best method, you should not have to be forcing people into it.” (4) The model also encourages everyone to keep their “disease,” of course, “anonymous.” How much more stigmatizing can you get, say their critics. Is now really the time to be ‘anonymous’ about addiction? Many people with extraordinarily firm faiths in God or another higher power also have condemned AA. Their reasons often have to do with the “anonymity’ part. While mothers of the dead are calling for openness about drug and alcohol addiction, those afflicted with it are encouraged to stay quiet outside their 12-step recovery rooms. It’s a conflict that makes no sense in the minds of many, particularly during a public health emergency.

 

In a recent New York Times Sunday Review Laura Hilgers writes:

 

“In fact, many recovering addicts are not in a traditional program. Some manage recovery independently. Others join Refuge Recovery, a program based on Buddhist principles, or Smart Recovery, which encourages reliance on self rather than a “higher power.”

No matter the path, why should they remain silent? “It’s like being a vegan but only being able to talk about it in a kitchen or a hospital,” said Fay Zenoff, executive director for the Center for Open Recovery, “or with another vegan.” (5)

Bibliography

 

  1. Brico, E. (2017, Oct. 4) By shunning medication-assisted therapy, 12-step meetings are making the opioid crisis worse.  Stat. Retrieved Nov. 8, 2017, from https://www.statnews.com/2017/10/04/medication-assisted-therapy-12-step/

 

  1. Cunha, D. The Guardian. Retrieved Nov. 8, 2017, from

https://www.theguardian.com/society/2015/sep/22/alcoholics-anonymous-aa-women-dating-addition-rehab

 

  1. Szalavitz, M.  (2017, Oct. 7). Addiction is not an excuse for sexual assault. VICE. Retrieved Nov. 8, 2017, from https://www.vice.com/en_us/article/zmzq48/addiction-is-not-an-excuse-for-sexual-assault

 

  1. Heitz, D. (2016). Author argues shaming addicts is harmful, says most treatments are archaic and all wrong. Rehab International. Retrieved Nov. 8, 2017, from https://rehab-international.org/blog/author-argues-shaming-addicts-harmful-says-treatments-archaic-wrong

 

  1. Hilgers, L. (2017, Nov. 4). Let’s Open Up About Addiction and Recovery. The New York Times Sunday Review. Retrieved Nov. 8, 2017, from https://www.nytimes.com/2017/11/04/opinion/sunday/drug-addiction-recovery-alcoholism.html

 

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It’s open enrollment: Are you or your loved one ready for rehab?

By David Heitz

 

 

 

 

 

 

 

 

With the holidays upon us, you may be thinking now is the right time to sit down that special someone in your life who you have been watching slide down the slope. That alcoholic, that person addicted to heroin, that friend desperately unable to break free from meth addiction. Deciding to have that intervention is a great first step. But what happens once your special someone agrees to rehab? Before you decide to stage an intervention, make it easier by fully knowing your options first. By purchasing insurance for yourself or for your loved one during open enrollment period, either through the healthcare exchange or through your employer, you likely will have decent coverage for most residential rehab plans.

 

One of the biggest things that Obamacare did was to require mental health and substance use disorder treatment to be covered on parity with physical health. That means plans must cover therapy and counseling and inpatient drug and alcohol rehab. According to Healthcare.gov, it amounted for the largest national behavioral health expansion in a generation. If the person needing rehab already is insured, don’t think the march to recovery already has taken its first steps. There are a variety of centers out there. At many places, there are long waiting lists. So, plan ahead, and choose which rehab center you think seems most appropriate for you or your loved one. Visit several. Perhaps narrow it down to two or three from which your loved one can choose. Usually when someone becomes “rehab-ready,” so to speak (is willing to go into treatment), it’s because a crisis has just occurred. During these moments of crises, an addict or an alcoholic often will agree to go into rehab, but only if it happens immediately. Not having insurance when that time comes leads to much higher rehab costs. What’s more, finding a facility with an open bed at the last minute can be difficult, especially when you have not made prior contact.

 

Inpatient v. outpatient treatment; a child who refuses to carry insurance

 

Under Obamacare, a dependent living under their parent’s roof can be covered by their parent’s health insurance until age 26. This isn’t always the case, however. More on that in a second. In a 2006 article published in Health Services Research, scholars demonstrated that in California, substance abuse treatment has a repayment benefit to society. After analyzing data from more than 2,500 patients, the researchers showed a 7:1 cost benefit to society ratio. (1) The benefits to society were calculated based on lower crime rates reflected in available arrest data. The study even looked at residential treatment versus outpatient treatment costs and benefits. It concluded that while the outpatient treatment proved less effective at keeping people sober, it also cost loss. In the end, outpatient treatment actually had a higher net return to society per dollar spent for that reason.

 

When all is said and done, you may be in a situation where your loved one had health insurance through his or her work but stopped paying the premium. Indeed, they could be diverting that money to drugs or alcohol. You may want to consider talking to them about their health, irrespective of drug use, and the importance of having the insurance. It is very important to do this in an extremely non-judgmental and unsuspicious manner. If they insist they cannot afford health insurance, consider paying it for them if you feel you are able (directly of course…not by giving them the money). You could simply ask them for the premium notice or have them provide a number for their employer’s HR department.

 

 

Why choosing a treatment center carefully is so important

 

When searching for a treatment center, the most important thing to ask yourself is this: Does this place have a fair shot at getting my loved one well? It’s important to ask for this cold, hard fact: Rehab often fails. If it fails too many times, insurers will stop paying for it. In a 2015 NPR piece, reporter Ben Allen talked to people whose loved ones were turned down for rehab and ended up dead of a heroin overdose two weeks later. Deb Beck represents the Drug and Alcohol Services Providers of Pennsylvania. She said even with the parity law, rehab centers have to haggle with insurers all the time. “The whole thing about who is worthy to have insurance coverage gets tangled into it,” Beck said. “But if I had a heart problem, and I didn’t do everything I was supposed to do, I would not be denied coverage. In fact, if I got sicker, you would increase the coverage for me.” (2)

 

The good news is that most treatment centers have insurance specialists skilled at handling all that red tape for you. One of the biggest reasons for getting insurance for your loved one before choosing a treatment center is to make sure your plan and your treatment center of choice match up. Under the Affordable Care Act, insurers can’t jack up premiums or co-pays on substance use disorder treatment. Addiction and rehab must be treated just the same as any physical ailment and its corresponding treatment. But that’s easier said than done, according to Clare Krusing of America’s Health Insurance Plans. She told NPR, “When you’re comparing those treatment plans, it’s essentially comparing apples and oranges. And that’s an inherent challenge for health plans, and for their patients and providers.”

 

Plans differ wildly from state to state, from high-quality coverage with low premiums to high-premium coverage that doesn’t offer much. For the most part, fewer and fewer plans are being offered as more and more carriers leave the exchange. The Trump administration has axed the subsidiary given to Americans buying health insurance off the exchange in order to pay for ambitious tax cuts. Whether a person is a fan of the Affordable Care Act or not, it made drug addiction and alcohol treatment available to millions of people. The Republican plan to replace it earlier this year would have “stranded drug addicts without access to care,” according to Vox.

 

In the piece by German Lopez, Richard Frank, a health economist at Harvard, is quoted as saying “Over the last 60 years, 70 years, or so, insurers have scrupulously avoided enrolling people with mental health and addictions as much as possible. That’s because they are more complicated and expensive to treat. And they did so by offering either no coverage or limited coverage.” (3) In such times of uncertainty, having a plan to get your loved one off of drugs and alcohol forever needs to be a top priority. It begins with making sure that person is insured, and then selecting a treatment center.

Bibliography

Ettner, S. et al. (2006, April). 41(2): 613. Benefit-Cost in the California Treatment Outcome Project: Does Substance Abuse Treatment “Pay for Itself?” Health Services Research. Retrieved Nov. 17, 2017, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1681530/?report=reader#!po=35.9375

Allen, B (2015, Aug. 16) When Rehab Might Help an Addict: But Insurance Won’t Cover It. NPR. Retrieved Nov. 17, 2017, from https://www.npr.org/sections/health-shots/2015/08/16/430437514/when-rehab-might-help-an-addict-but-insurance-wont-cover-it

Lopez, G. (2017, March 13). The House’s Obamacare Repeal Bill Would Strand Drug Addicts Without Access to Care. Vox. Retrieved Nov. 17, 2017, from https://www.vox.com/policy-and-politics/2017/3/7/14841876/ahca-obamacare-repeal-opioid-epidemic

 

 

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Checklist for injection drug users after an HIV/Hepatitis C diagnosis

By David Heitz

You just found out you have HIV and Hepatitis C. And, you’re addicted to drugs. Now what? Perhaps no low seems lower – except death – to an injection drug user who finds out they have contracted HIV, Hepatitis C, or even both (not uncommon). But what that injection drug user may not know is that Hepatitis C now is curable, and living with HIV is no different from managing diabetes. Talking about a cure for HIV isn’t even considered heresy anymore. So, don’t turn an HIV/Hepatitis C diagnosis into the end of the world when it isn’t. In fact, it might be the start of a whole new way of life. Now, what should you do next?

Immediately see a doctor and work to obtain the treatment and medications you need. Consider getting sober, it would be a great time to do it.

You might have learned you have HIV and/or Hepatitis C via an outreach worker, at a local testing center, or at a needle exchange. Or, maybe an injection drug use (needle sharing) or sexual partner told you they have the disease(s), and you suspect you do, too. If you live in a rural area and there is no HIV/AIDS service organization near you, call the AIDS service organization in the biggest city closest to you if you’re not sure about where to get treatment. Most people who learn of their HIV status also receive referrals to treatment at that time. It is absolutely critical to get into treatment immediately. Once you get your HIV treated, it drops to levels so low you cannot even transmit it. There are various medication assistance plans sponsored by the pharmaceutical companies. You can learn about those by clicking here: AIDS Healthcare Foundation and HCV Advocate also are great websites for beginning to learn all you can about HIV and Hepatitis C and how to obtain treatment. If left untreated, it is believed the diseases work in entourage to advance disease even faster than one without the other. According to the Centers for Disease Control and Prevention (CDC), “approximately 25% of people with HIV in the United States also have HCV. Among people with HIV who inject drugs, about 50% to 90% also have HCV.” (1) “In people with HIV/HCV coinfection, HIV may cause chronic HCV to advance faster. Whether HCV causes HIV to advance faster is unclear,”(AIDSInfo.gov reports)

Understand that you probably are going to live just as long a life as someone who does not have HIV or Hepatitis C, or both. All the more reason to get sober.

There have been revolutionary breakthroughs in the treatment of HIV and Hepatitis C. Today, there even is a cure for Hepatitis C that is a simple, once a day pill for two months. However, this medication can be very difficult to obtain depending on what kind of insurance you have and where you live. As for HIV, injections that would last 90 days are in the works in terms of treatment. The end of daily pills could be fast upon us. Meanwhile, modern treatments keep the virus at undetectable levels with relatively few side effects. Today, not only is there talk of a vaccine for HIV (we’re not there yet, however) but even a cure. In November, The Scripps Research Institute in San Diego announced their latest HIV research results: Stopping the replication of the virus in mice.

The study was led by TSRI Associate Professor Susana Valente. It was published online Oct. 17 in the journal Cell Reports. Valente used “a natural compound called didehydro-Cortistatin A (dCA), which blocks replication in HIV-infected cells by inhibiting the viral transcriptional activator, called Tat, halting viral production, reactivation and replenishment of the latent viral reservoir,” according to Scripps. (2) “No other anti-retroviral used in the clinic today is able to completely suppress viral production in infected cells in vivo,” Valente said in the news release. “When combining this drug with the standard cocktail of anti-retrovirals used to suppress infection in humanized mouse models of HIV-1 infection, our study found a drastic reduction in virus RNA present—it is really the proof-of-concept for a ‘functional cure.’”

Consider working or volunteering with an organization that helps others know they are not alone

HIV and Hepatitis C via injection drug use has become a national epidemic that must be talked about to be addressed. We can’t just sweep it all under the drug. amfAR has created an online Opioid & Health Indicators database. It shows, by Congressional district, how well prepared our country is in the battle against the opioid epidemic. Some places are better prepared than others. “The amfAR Opioid database provides local and national statistics on new HIV and hepatitis C infections, opioid use, overdose death rates, and the availability of services like drug treatment and syringe services programs,” the organization explains in a news release. “Users will also be able to examine data at the state and county levels to view and compare the differential impact of the opioid epidemic in communities and states across America.” (3)
“This tool was developed with the goal of raising awareness of the opioid epidemic while educating the public on how they can get involved in their communities to minimize overdose rates and maximize recovery rates.”

If you’re reading this, are actively injecting, and not ready to get sober, please make sure to always use clean needles. And don’t judge those who do inject if you don’t.

There is no debate about what is scientifically proven to stop HIV and Hepatitis C among injection drug users: Needle exchanges. As America’s opioid epidemic is thrust into the national spotlight, and so is the public financial burden for treating it, needle exchanges are being looked upon with less judgement. Not only do they save lives that eventually become ready for sobriety, but they also save taxpayers and third-party payers hundreds of millions of dollars by preventing the infection of HIV and Hepatitis C. In an exclusive interview with Plus, Don Des Jarlais of Mount Sinai Beth Israel in New York City explained how needle exchanges have saved injection communities from an HIV/Hepatitis C scourge before. Des Jarlais is known as the “father of the modern needle exchange.” He is Director of Research at the Baron Edmond de Rothschild Chemical Dependency Institute at Mount Sinai Beth Israel in New York City. Des Jarlais has been awarded a $2.5 million grant to help fund research aimed at helping injection drug users break the cycle. They will be taught skills on how to discourage someone who wants to shoot up for the first time. “Almost all injectors are at least ambivalent about injecting. It clearly has created a lot of problems in their lives,” he told Plus. ”Most of them do not want to do that to their friends.” But he added, “They may feel they do want to initiate somebody.”
Des Jarlais also said it’s important to be non-judgmental so as not to further stigmatize the situation. (4)
Bibliography
1. U.S. Department of Health and Human Services. HIV and Hepatitis C. (2017, July 25). AIDSInfo. Retrieved Nov. 7, 2017, from https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/26/88/hiv-and-hepatitis-c
2. The Scripps Research Institute. (2017, Oct. 17). New research opens the door to ‘functional cure’ for HIV. Retrieved Nov. 7, 2017, from http://www.scripps.edu/news/press/2017/20171017valente.html
3. Opioid & Health Indicators Database. amfAR. More information at http://opioid.amfar.org
4. Heitz, D. (2015, May 11). Grant may help needle exchange trailblazer clear new paths. Healthline via Plus. Retrieved Nov. 7, 2017, from https://www.hivplusmag.com/stigma/2015/05/11/grant-may-help-needle-exchange-trailblazer-clear-new-paths

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Narcan’s Role in Opioid Epidemic

by Lindsay Carnick

 

Americans are increasingly dying from opioid-related overdose deaths. According to the Centers for Disease Control and Prevention (CDC), overdose deaths involving prescription opioids have quadrupled since 1999. Heroin-related overdose deaths alone have quadrupled since 2010, and three to four heroin users report having abused prescription opioids before they started using heroin.[1] Opioid overdoses cause life-threatening levels of respiratory depression as well as other severe medical complications. The dangers of accidental death due to opioid overdose are increased when these substances are mixed with other medications, particularly short-acting anxiety medications; alcohol or other drug use; or the presence of other pre-existing medical conditions such as COPD, sleep apnea, compromised kidney or liver function, or a substance use disorder.

Society’s ability to mediate the opioid overdose mortality crisis has been significantly bolstered by the development of Narcan, which is a short-acting, brand name formulation of the opioid antagonist medication Naloxone HCL. Antagonists are medications that bind to the same receptors sites in the body as a given class of substances, effectively blocking the molecules of the substance from binding to the receptor sites. Unlike the actual drug, antagonists do not cause the release of endorphins and pleasurable neurotransmitters that are the driving force of drug use. Opioid antagonist medications inhibit opioid substances from eliciting the classically addictive experiences of opioid drugs from the body, making opioid use unrewarding.

Naracan is an emergency, short-acting opioid antagonist that binds to opiate receptor sites in the body with a higher affinity than actual opiates. By displacing the opiate molecules with imitation molecules that do not have the respiratory depressant effects of opioid drugs, Narcan temporarily reverses the effects of opioid overdoses when given immediately. It is available in intravenous injectable, auto-injectable, and nasal spray forms. It can be given multiple times to an overdosing individual by laypersons until emergency medical assistance is available to the overdosed individual, and can be administered again if a person shows signs of relapsing into an overdosed state of unconsciousness or respiratory depression. Narcan is considered safe for children who are suspected of having overdosed on opioids. It has no effect on individuals who have not taken opioids. Individuals who have opioid dependence issues may experience withdrawal symptoms after Narcan intervention.

 

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The injectable form of Narcan has been used by emergency medical professionals for many years since its inception in the 1960s, but the 2015 FDA approval of the nasal spray formulation, which is easily used by laypersons and available in many states without a prescription, has significantly impacted community efforts to combat the opioid epidemic. Data from the CDC suggests that providing a significant number of opioid overdose deaths—over 26,000 between 1996 and 2014—have been averted by providing laypersons with access to Naloxone in the injectable form (prior to the Narcan nasal spray development and it’s wide availability without prescription. Additionally, like the auto-injectable, the nasal spray formulation is available without the training requirement of the injectable).[2]  It is virtually impossible to tell how many lives are actually being saved by Naloxone in either formulation, as many individuals who receive it from a friend or family member may never seek additional medical care once they are no longer in an acute overdose. Whether administered by emergency medical services or laypersons, naloxone is intended to be used as a rapid intervention until more comprehensive treatment can be accessed in an emergency department. However, due to the cost, legal issues, stigma, and other variables often associated with accessing professional, emergency medical care for a drug overdose (accidental or intentional), it is probable that a significant number of individuals who have overdosed and then been stabilized through the use of Naloxone have not been identified. Furthermore, anecdotal data suggests that due to the extreme challenges of recovering from opioid addiction, many individuals who have been rescued from overdose death with naloxone have had repeated naloxone rescues. If these individuals do not present for the recommended follow up care after overdose or do self-report their number of overdose rescues by laypersons, there is no telling how not just how many individuals have been saved by Naloxone, but how many times they have been saved.

It is readily apparent that the wide and relatively easy availability of naloxone to the public without prescription and at relatively affordable costs has been a significant development in saving lives that might otherwise have been lost in opioid overdoses. However, there is also a general consensus that while saving an addicted individual’s life from accidental overdose is a critical step in recovery, emergency naloxone does not address the larger issue of opioid addiction. Once an individual has been rescued from overdose with naloxone, they still will have the same physical and psychological cravings for opioids as they did prior to overdosing. If relationship, financial, chronic pain, mental health, or legal problems contributed to their opioid abuse challenges, those challenges will still be waiting for them. Naloxone is a life-saving medication and can be an important safety measure as part of treatment plan, but it is not a stand-alone answer for treating opioid dependence or abuse.

The availability and accessibility to the public of Narcan in formulations that require neither prescriptions nor professional medical intervention has made a tremendous impact on the lives of many persons struggling with opioid dependence, and their families. The CDC estimates that the vast majority of opioid-related overdoses are accidental, and Narcan is saving the lives of persons who otherwise might not survive, regardless of if they had been appropriately using their prescribed medications or abusing an illegal substance. Additionally, as prescription opioid medications have flooded the American medical landscape, these medicines are increasingly proliferating into unintended hands such as children, adolescents, and individuals suffering from other kinds of opiate addiction such as heroin and seeking a less expensive, legal alternative. There are a wide range of circumstances under which any of these individuals might accidentally overdose on opioid medications, and as persons regularly prescribed opioids are increasingly encouraged to also store an emergency Narcan kit, the possibility of providing life-saving interventions to those who might inadvertently ingest these medications is greatly increased.

Opioids—even when legally dispensed– can be deadly a under a number of circumstances. Narcan is providing a remarkable and lifesaving opportunity for individuals, regardless of how they opioid use has entered their lives. Narcan is a remarkable development for those working towards recovery, as well as those who rely on opioid medications as a matter of medical treatment for a higher quality of life.

 

 

[1] https://www.cdc.gov/vitalsigns/heroin/index.html

[2] https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6423a2.htm

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Couples Recovery with Family Involved Therapy

by Kendra Winn

Can you relate to having a desire to beat addiction? Has a fear of stumbling and walking alone been a roadblock to your recovery? Is there someone you love who is also struggling with the perils of addiction’s grip? Do they have the same desire to get away from the crippling effects of their lifestyle? You both can enjoy getting your lives back on track with our treatment facility’s couples’ recovery program. We tend to think of addiction recovery as a solitary maneuver with a group of strangers and professionals. However, our ways to help you recover and to be the person you want to be, have changed from yesterday’s traditional approach to an atmosphere of familiarity. Struggling with addiction alone can leave you feeling hopeless and defeated. That’s why we have opened up our center to treating not only the individual but also those who may be going through addiction with you.

 

What exactly does it look like for couples recovering together? We hope to provide you with an outcome that will give you a stronger bond and relationship with your loved one while giving you the necessary tools for gaining triumph over the foe of dependency. Our goals are to establish foundational instructions and objectives tailored to the specific needs of each person. We also want to provide the highest level of care by equipping you with a real person who can empower you both by giving you the resources most beneficial to helping you meet your recovery goals. Couples therapy aims at reducing the tension and conflict that may arise when challenges that test your will to succeed arise. Therapy for couples is truly designed to restore ruptured relationships while stimulating a productive walk forward to meet both people’s milestones.

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Realistically, you can expect our group to take time to listen to each of you. Your needs are why we are here. With confidentiality being our professional priority, having the freedom to allow us to personalize your treatment plan gives you control over how successful you will be. We will be with you each step of the way, and help you at your pace. When one of our counselors meets with you as a couple, you will be allowed to voice your concerns and the expectations you have, and your aide will be able to design a plan that will provide the best possible introduction to wellness. Though the groundwork for the treatment plan specifically made for you may seem too basic, we want you to know that working the plan together will make all the difference. Our staff is carefully chosen based on the highest credentials and working knowledge of helping people. They have the heart for serving people. If it were not so, we would not have them here. A careful review of your needs from our counselors will help them to create better a plan that works for your recovery. They will consider what is most important to you and your spouse, and detail a blueprint which will show you both how recovery is possible not just for one of you: but for both of you! Sometimes the stress of withdrawing can cause emotional disruptions among couples. Because we take a look at every aspect of the healing process, we expect some bumps in recovery, and we are here to help you handle them. Gaining your life back after addiction comes in steps. They are not all smooth, and they are not all easy. The challenges that you face and conquer together will strengthen you in the long run: you just have to trust the process. Withdraw can have some negative impacts on your relationships. At our facility, we support you during every trial and misunderstanding. Getting you to your goal is as important to us as it is to you. As you walk forward with your significant other during recovery, you will find that they may desire the same replacement for addiction as you do, and you may also learn that their weaknesses are your strengths, which make you a great team for recovery!

 

 

Overcoming an addiction alone may feel like an insurmountable task. The one struggling along the side of you may be the only one who completely understands the hardship you face. Does success seem possible if you could recover with that one that you love and trust? Drug and alcohol abuse can leave you feeling very isolated and scared. You do not have to take these steps alone. Recovery from alcohol and drug addiction can benefit you just as just as much as it can provide recovery and healing for those you love. We want you to experience the benefit of recovery with a loved one.
Addiction is hard for every person at any age. It is a subtle darkness that envelops more than just one person before knowing what happened. In most cases, drugs and alcohol begin as a social or medical association. Before long, addiction is blinding and binding. It comes with no rhyme or reason, though it may come with hidden triggers. What is an addiction? It is an escape from reality. It can be a way to overcome your insecurities. The reality of addiction is that it is a trap, bondage, and a heavy chain. Stepping outside of the darkness that veils the truth of drug or alcohol abuse can be similar to finding a previous wound that never healed. You wonder suddenly what the cause of it was, and you question how did it ever get so bad? Whether the addiction forms in a gradual state or rapid succession, there is no doubt of the wounds they will cause. People suffering from addiction come from all walks of life: all backgrounds, all races, all over the world. There is no one immune to having a dependence on drugs or alcohol. What a person does have control over is deciding to end the cycle that can destroy lives.

 

Statistically, 1 in 5 individuals in a recovery program is likely to succeed. That is only 20% of the population who is trying to gain their life back from drugs or alcohol. Those between the ages of 25 and 49 have the highest rate of admission into a treatment facility. Addiction affects millions more, either personally or by relation. Those brave enough to get help are usually ushered through a program without attention to the greater healing aspects of emotional repair and salvaging damaged relationships. Programs will offer the needed group support, counseling, and facility to protect you during your most vulnerable time, but is it enough? According to American Addiction Centers, only about 10% of those who need rehabilitation from drugs are receiving the treatment that will help them. That leaves 90% who have not received help. Without help, their spiral of addiction continues.

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Relapse can often send even the most determined individual into a state of discouragement and even depression. It leads to an attitude of despondency or even hopelessness because the goal now seems unattainable. Recovery takes work and getting back up after a relapse can seem pointless. Reverting to a harmful lifestyle, even once, will have an adverse reaction from those who were skeptical about your plan to succeed. The statistics involved around relapse are tricky, however, because certain variables are used to attain them. Rock bottom must happen before you want recovery, and your recovery depends on your purpose to achieve the life you want. It can happen!

You may be wondering how the average solitary recovery program works. In most cases, trying to recover with the basic tools given to you by a treatment facility leaves you with questions and little to no accountability. Not having someone to talk out your sessions with makes getting answers more difficult than if you were able to discuss sensitive matters with someone you intimately trust freely. Some things are not easy to talk about when it comes to addiction, especially when you are talking with someone you have met only for a few hours. Sharing your burdens with your partner in addiction recovery may potentially aid you in speaking with a counselor at the treatment center and further your progress. Recovering alone can also stimulate relapse. Having someone to guide you through temptations that will hinder you from reaching your goals will help you beat addiction. Doing this alongside a person who will help you remember the importance of the fight and help you navigate those hard turns in the road.

At our treatment facility, we want to offer you the assistance that will be most beneficial to your recovery: a partnering addict. It could be a spouse or a significant other. Couples in recovery have a larger recovery rate than any solitary program in the country. Why is that? With your partner, you will receive tools to help you reach healthy goals, a plan to focus your recreation time toward more productive to recovery, constructively give reasonable guidelines for success, and you will receive accountability by someone who supports your decision. Your loved one will be more than a valuable sponsor to you: they are someone who is willing to go through the battle with you unconditionally. Those in your life who have seen your toughest moments will be encouraged to watch you grow and meet milestones in your recovery: all while cheering you on the right by your side. Together you will focus on your healing first, but before long the relationship between you that was once suffering and revolving around strongholds will begin to be restored. Recovering with the background of a strong personal relationship transitions recovery from the individual effort to a team effort, and it balances out the burden you feel. Attending therapy with your spouse may improve your relationship. What was damaged by mistrust or hurtful words or actions, can begin to repair in a controlled setting. Therapy sessions attended together will grant both parties a chance to connect. It will give you both an avenue to bring pleasure to your relationship once again out of a place of deep pain. Instead of putting the focus on the problem, which enabled the addiction, we like to emphasize the potential of the right direction. Dealing with the addiction together facilitates an atmosphere of understanding and working together for the greater cause. Consider the time you will spend in therapy with your loved one. It will not just be a time of helping your loved one through the challenges of addiction, but you will also be counseled to be the best asset. You will answer pointed questions, but they are not meant to harm. In fact, you may be surprised at the insight they will provide to help you more appropriately respond to symptoms and behaviors related to addictions.

Recovery is just as important for the overcoming individual as it is for your sidekick who wants to see you well again. Your greatest support system is found closest to you: a close friend or partner in a relationship that desires to succeed with you. Why not give the one close in heart to you the chance to change for the better? Your success is very important to the ones who love you and taking the time to recover as a couple is an opportunity to take charge in healing.
Family involved therapy is another opportunity we provide to our clients who want to beat addiction. Can recovery happen when an individual puts his mind to it? Emphatically, yes! Consider how much encouragement boosts confidence. It’s time to overcome the snares of addiction, and you can be the added strength for those in your tribe who need help as not to fight alone.

Given the mainstream pop culture in society today, we can understand the negative influences that pressure America’s youth into a lifestyle of addiction. Glamorizing drug or alcohol use is frequently seen by those idolized by teenagers. When a parent sees a young person through the ups and downs of any addiction, their chief concern is doing all possible to help facilitate a full life of happiness once again. At our centers, we can constructively guide what may seem a tense and uncomfortable situation of heartache into a sensitive design to help your closest relationships restore. Parents attending recovery with a child they love can be viewed as help thanks to the preparation and training of our mentors and counselors.
Watching a parent or parental figure in your life battle with addiction can be just as painful. Consider attending treatment sessions with your parent and letting them know you unconditionally love them and support their need to be independent of the chains of addiction. Reassuring the ones who care the most for you makes recovery very productive and worth the fight.

Fighting the giant of addiction can be overwhelming. Even in a program that offers 24-hour support, sponsors, and hotlines, you can begin to feel alone in high-pressure moments. Trying to change your daily routine to separate from harmful influences would be more manageable having someone else to lean on. Addiction is an enormous villain that can steal away the happiness from life. The uphill battle can be tough when you grow weary. Gentle support from your companion will greatly enhance not only your recovery time but also your resolve to get well. The theory of replacement can act as a rewarding agent to both parties in recovery. For the most fruitful recovery process, you must realize the need to introduce some positive activities into your life where you once may have abused drugs or alcohol. Filling in the time gaps, or altering your daily routine for the better will avert cravings or triggers associated with relapse. Your partner in therapy can not only help you with tools in overcoming your addiction but also participate with you to continue encouraging your commitment to do right.

Bringing someone through recovery with you gives you a sense of ease. The mountain does not look as big when someone is willing to climb it with you. Those who seek help with a companion find it is more helpful to recovering and completing treatment, and even essential to success, versus going through an addition program alone. Whether you are the person seeking help, one who is encouraged to fight addiction’s battle, or whether you are a supportive spouse or family member, we welcome you to take a chance on improving your lifestyle as a whole. Give us a call to find out more of our benefits as we work with families on the road to recovery.

Couples therapy is an amazing way to support someone you care for deeply. Building trust takes a long time to repair once broken; however attending treatment together can bring a fuller understanding to each party. Differences may be resolved, misgivings about truthfulness during a therapy session will be removed, and truth can safely and freely move about the room.

Sources:
Drugabuse.gov
AmericanAddictionCenters.org

 

 

 

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Detox, Withdrawal, and Treatment

detox withdrawal treatment

 

There are a wide range of alcohol withdrawal symptoms (AW) that range from relatively mild to life-threatening, depending on a variety of factors. Recommendations for acute detox, treatment, and ongoing recovery strategies are contingent on individual level variables such as the individual’s overall health, severity and duration of alcohol and other substance use, psychosocial supports, and motivation to engage in treatment. External variables include the availability of resources and financial resources.

Symptoms of acute alcohol withdrawal typically emerge between 6 to 48 hours after an individual reduces their alcohol intake, but there is a great deal of variability as to when any individual may experience the onset of withdrawal due to their unique histories and health. The more alcohol the individual has been consuming, the more severe the withdrawal symptoms are likely to be. Mild to moderate, non-life threatening psychological symptoms may include depression, irritability, nervousness, moodiness, and unclear thinking. These symptoms may last for up to several weeks. Physical symptoms can include headache, nausea, decreased appetite, sweating, elevated heart rate, clammy hands/skin, sweating and insomnia. The most severe form of alcohol withdrawal is called Delirium Tremens, commonly referred to by recovering individuals and healthcare professionals as “the DTs”. These symptoms can include significant disorientation, intense agitation, cardiac dysregulation (uneven or elevated heart rate), fever, hallucinations, severe sleep disturbance, restlessness, and seizures, in addition to varying degrees of the other physical and psychological symptoms of more moderate withdrawal.

Severe alcohol withdrawal symptoms (regardless of whether or not an individual meets criteria for Delirium Tremens) can be lethal. Over time, the body attempts to compensate for the depressive effects of alcohol on the central nervous system by producing higher levels of certain hormones and neurotransmitters (naturally occurring chemicals that help the body regulate life-sustaining, autonomic systems and processes such as breathing). If a person who has been consuming significant amounts of alcohol on a regular basis suddenly stops doing so, those elevated levels of hormones and chemicals are still active. These individuals are then at risk of heart attack, stroke, lethal dehydration, deadly choking on vomit, and fatal errors in judgement.

There are a number of models for safely detoxing from alcohol under medical supervision, including outpatient monitoring and treatment and intensive inpatient care, where detoxing individuals are monitored closely and also may be prescribed medications and other interventions to help stabilize them against the dangers of the more severe symptoms. Inpatient detox treatment is considered the highest level of safety as participants are under twenty four hour observation and care by medical specialists. Some communities offer hybrid detox opportunities that do not provide medical management, but do provide round the clock observation of participants by medical professionals who can intervene and escalate the level of care and intervention if it is warranted or the individual’s symptoms worsen. Mild withdrawal symptoms that are unpleasant but do not pose medical risks may be managed through the assistance of common medications prescribed on an outpatient basis by the individual’s primary care provider, and in conjunction with participation in appropriate outpatient treatments for substance dependence.

Once and individual has been medically stabilized and is no longer experiencing dangerous psychological and/or physical withdrawal symptoms, they should immediately be established in a therapeutic program for long-term recovery engagement and support. There are a wide range of clinical treatment programs available in individual and group treatment formats, and some of these programs offer comprehensive services including medication management and ancillary services such as peer support groups and other mental health services. Often, alcohol dependence has created a myriad of other difficulties in an individual’s life, and therapy can help chart a course towards addressing emotional and relational issues that have resulted from and/or contributed to the alcohol dependence. The support of friends, family, and colleagues is frequently the determining factor in getting an individual to commit to treatment, and the involvement on one’s community can be a critically important part of their recovery success.

Treatment for alcohol dependence is available in a number of different formats, and there is a great deal of variability between individuals as to what may be most helpful to them. Clinical treatment programs are those that are facilitated by recovery professionals who are licensed by the state to provide evidenced-based addictions treatment protocols, and frequently are housed in a medical or behavioral health setting. Clinical treatment is available in individual and group formats. 12 step and peer support programs such as Alcoholics Anonymous (AA) and Al Anon are group sessions facilitated by other individuals in recovery or their family members (Al Anon is for family members), and offer group and individual support (sponsors) to participants. AA and Al Anon have been vitally important parts of recovery for many individuals.

“The Wall” is an expression in recovery that refers to negative feelings arising in an individual who has been sober and feeling well for several months. The individual may suddenly feel as if they have stopped making progress in treatment, after the initial enthusiasm of doing well. “Hitting the wall” often occurs when the an individual who has been feeling the pleasant effects associated with new sobriety (feeling physically and mentally better due to having passed through withdrawals; increased feelings of well-being associated with improvements in physical and mental health due to abstaining; other positive feelings associated with sobriety after heavy and protracted use including social approval and improved functioning overall) is forced to reckon with other, more difficult and lingering issues that may have been obscured by or contributing to the substance abuse. Often, alcohol has been serving as a means of avoiding very painful emotional realities, and facing these issues sober often seems daunting. The “honeymoon” feelings of new sobriety may seem to have held false promise when individuals are faced with the very serious personal, legal, and financial consequences of alcohol dependence and misuse.

Sometimes individuals who have been sober for short or extended periods of time (even years) relapse, which means they briefly go back to using alcohol (or any other substance from which they have been abstaining for an extended period of time). Relapse can happen due to any one of a number of triggering events (which are not necessarily stressors or distress).  Regardless of what precipitates a relapse, this experience frequently elicits strong feelings of guilt, shame, embarrassment, hopelessness, failure, and depression. While regrettable, relapse is a common event for individuals in recovery, and relapsing does not mean that a person is “back at square one” or has in any way “failed” at sobriety. It is imperative that the treatment professionals and personal supports are compassionate and encouraging in the event an individual relapses, as additional guilt and feelings of failure most likely will exacerbate the depth and extent of the relapse. It is important to encourage individuals to immediately resume treatment and continue on their recovery work.

Being established with and engaged a supportive recovery community of peers and professionals can help individuals navigate the challenges of recovery and of dealing with life stressors without the self-medicating and numbing effects of alcohol. Different treatment models have proven helpful for different individuals, and often, it is a combination of supports (medical, professional, peer, 12-step, personal) working collaboratively that offer the most promising pathway to recovery from alcohol dependence.

 

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