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Managing Heroin Withdrawal – What You Can Expect

The first steps on the long road to recovery are the hardest to take; you’ve committed to rehabilitation, and it’s time to stop using heroin. But stopping any drug takes a great deal of willpower, strength, and support. Especially when you start going through heroin withdrawals, which come with symptoms and need for a detox.

Symptoms of heroin withdrawal can range in strength and severity, and because of this, it’s always important to not go through heroin withdrawals and detoxes without supervision, especially if it’s a long-standing addiction. While withdrawal from heroin isn’t considered dangerous in of itself, the medical and psychological symptoms can cause complications that may be life-threatening, such as suicide. That’s why it’s best to undergo this process with the help of trained medical and/or mental health professionals.

Here’s what you can expect from heroin withdrawals:

Symptoms can last up to a week or a little longer

So you’ve taken your last dose of heroin, and you’re determined to keep it that way. But after 6 hours, you’ll start to feel the onset of withdrawal symptoms and cravings for your fix. These symptoms will grow in severity as you reach your withdrawal peak, which can happen 1-3 days after your last dose. The severity of this peak can vary based on your history of drug use and mental illness.

You can develop longer-lasting symptoms

For those severely dependant on drugs, there’s a risk of developing post-acute withdrawal symptoms, which is psychological and mood-related. Symptoms like aches, pains, nausea, headaches and cramping can persist for months after using, sometimes even up to a year. This makes it all the harder to stay sober, and it’s highly recommended to stick it out with a rehabilitation program for support.

Symptoms can range from the mild to the severe

Withdrawal symptoms aren’t the same for everyone, and addicts will likely go through their own stages of withdrawal. Depending on the length and severity of your drug use, your symptoms can range from something as mild as frequent yawning to something as severe as hypertension.

Mild withdrawal symptoms can include

  • Nausea
  • Abdominal Cramps
  • Tearing
  • Runny nose
  • Sweats
  • Chills
  • Yawning a lot
  • Muscle and bone aches

Moderate withdrawal symptoms can include

  • Vomiting
  • Agitation
  • Restlessness
  • Tremors
  • Trouble Concentrating
  • Diarrhoea
  • Goosebumps
  • Fatigue

Severe withdrawal symptoms can include

  • Anxiety
  • Depression
  • Insomnia
  • Hypertension
  • Rapid heart rate
  • Muscle spasms
  • Trouble breathing
  • Difficulty feeling pleasure
  • Drug cravings

You can go through a heroin detox program

To help you through your withdrawals, rehabilitation centres and medical professionals will put together a medical detox program for you, attempting to keep it as comfortable for you as possible. It entails medication to counter the symptoms, as well as therapy, to help the body and brain recover from the abuse. For your peace of mind and your safety, your vitals will be measured throughout the process, including your blood pressure, heart rate, temperature levels and breathing. A detox can last for 5 to 7 days, though for more severe cases the detox can last up to 10 days.

If you or a loved one are in urgent need of recovery, don’t do it alone. Find a rehabilitation centre and program that best suits your needs to really stand a chance at achieving sober living. Getting through withdrawals is only the first step towards recovery, and with the right support structure, you can confront your addiction and the underlying causes for your substance abuse head-on.

The Battle Against Tik – How addictive is Tik really?

All drugs are addictive by nature, but some are certainly more addictive than others. And while all forms of substance addiction should be avoided at all costs, it’s not unfounded to warn potential users of which drugs are most addictive and the effects of their use.

Tik, or crystal meth as it’s otherwise known, is one of these alarmingly dangerous drugs. One of the most widely reported substances abused in the Western Cape, Tik is an insidiously addictive substance that affects people from all walks of life, and most alarmingly, people of all age groups.

Here are some of the reasons Tik is more addictive than other substances:

It’s easy to get a hold of

Tik is an unsettlingly easy drug to produce and acquire, with recipes and ingredients readily available. This means tik labs spring up all over the Western Cape, even in peoples homes, and the drug is sold cheaply, compounding its addictive nature.

It causes extreme highs

All drugs produce a high when taken. This high is produced when the substance stimulates the neurotransmitter dopamine, which is responsible for your joy and pleasure. But with tik, in particular, the flood of dopamine is 13 times stronger than normal. Compared to other drugs which increase dopamine levels up to 4 times, this is a clear indicator of Tiks strength.

However, this effect will steadily diminish the more an addict abuses meth. This is because the brain builds up a tolerance to meth, and the addict has to take higher and higher doses to get the same high. This makes the situation all the worse.

It brings with it extreme lows

With the high that all drugs deliver, there is always a low when the drug wears off. And with tik, that low is even more crushing. Due to the severity of the dopamine release, your dopamine levels will run critically low after, and you’ll feel depressed, paranoid, angry and irritable. After the already addictive high and the boost in confidence, this drop makes it even more compelling to use again.

It severely damages the brain and how it functions

The pre-frontal cortex of the brain is where the magic happens, the part of the brain that makes up our ‘selves’. This is where our personality comes from, our rationalizations and our abilities to plan, make judgements and decisions, feel empathy, and allows us to follow social norms and behaviours. This is linked to the amygdala, which is where we store our long term memories and generate emotions such as pleasure, fear, and anger, to name a few emotions.

Tik damages both these sections of the brain, destabilizing function in the PFC (Pre-frontal cortex). The damaged pre-frontal cortex disrupts the amygdala, which results in the chaotic mood swings and erratic behaviour we see in Tik addicts. They become paranoid, violent, and angry, and will even homicidal.

This is only made worse by what is known as methamphetamine-induced psychosis, which makes tik addicts delusional and violent. They experience auditory and visual hallucinations and lose their grip on rational thinking and judgement.

The results? A deadly spiral of addiction and substance abuse

This deadly concoction of psychological chaos is what makes crystal meth, or Tik, so addictive. Against the drug’s highs and its catastrophic lows, it’s incredibly hard to fight against. And the damage it inflicts on the brain is by no means short-lived. Tik addicts will likely suffer from brain damage for the long term, likely even the rest of their lives.

But by pursuing rehabilitation and recovery, an addict can save their life and the lives of others. They can stop this dangerous course, a course that more often than not hurts themselves and those around them.

If you suspect someone close to you is abusing tik, or you yourself want to free yourself from your addiction, don’t hesitate to contact us.

Compliance VS Surrender

There are a few ways we can talk about the battle of compliance versus surrender. The first part relates to clients in treatment.

Some people believe that because they say the right things and do “what’s required” of them in treatment that they are working in the program. We find that these people never actually change their behaviour; nearing the end of their treatment they begin to act the same as or similar to when they first came in. The recovery mask drops and we see the person for who they really are. Compliance is a dangerous dynamic, as most of the time, the person doesn’t really know that they are being compliant. We have often heard people saying “but I don’t understand what the problem is, I’m doing all the right things, getting all my assignments done, participating in group and really dealing with all my issues. So what’s the problem?”

It’s a good question.

The problem is that without surrender you won’t change. So where does the surrender come from and how can we make it happen?

The birth of surrender comes from the acceptance we experience in step one. Surrender to most people implies that they have lost, they are giving up, the fight is over. Addicts are not the easiest people to deal with when it comes to losing or letting go so the concept is foreign. But it is a must; we need to surrender to the fact that within us we don’t have the power or ability to stop using substances. That left to our own devices we will use or abuse substances till it kills us. The second part of that surrender is accepting that we need help from external sources in order to get into recovery.

Counterproductive belief systems in recovery sound like this.

  • I’ve got this.
  • Now I can handle this on my own.
  • I hear what you’re saying but…
  • Yes I know, I know…

There are many signs to people who are compliant; as mentioned before we won’t see any real personal change with their behavior, and when pushed they will revert back to old behavior as a default coping mechanism.

The second part of the battle between compliance VS Surrender is once the client has left treatment.

This type of challenge really does separate the complaint from the surrendered.

Some people say the right things, do all the work and planning for when they leave, and when they do actually leave they take the reins back. They tell the people around them all the new lingo they have learned. They actually start using recovery info as a weapon against their own recovery. They throw around this new info to convince people that they are in recovery, but the moment it is time to act on this new information, they don’t or can’t because it isn’t a subjective reality to them, its objective. Its something outside of themselves. Everything is a farce because the majority of their recovery is not real. The honesty and integrity of the program is only used in front of people and not behind closed doors. This alone is enough to completely undermine everything recovery stands for, relapse will follow shortly after, followed by statements like; “but I don’t understand why this happened. I was doing everything required of me.”

So why does relapse happen? Where does the Compliant falter?

I think part of the problem is people don’t know how to make the real changes, they are not completely willing to make the needed sacrifices or dedicate the needed time to their new way of life. The first year of recovery is very taxing as it takes a monstrous amount of your time to focus on your recovery at that level and I believe that people don’t see recovery for what it actually is.

Recovery isn’t easy, especially in the first few months. Feelings are hard to deal with, we are reminded on a daily basis of the destruction we have caused, no one around us really trusts our change, people are broken because of our past behaviour and it takes time for the relationship to heal. There are a lot of exterior influences that push us to react the way we used to, throwing up a middle finger and destructing.

Another trap that people who are compliant fall into is trying to separate their lives from their recovery. Like doing recovery on the side while still trying to reap the benefits of this new life. Anyone, including myself, that I’ve seen really embrace recovery has made their recovery their life. It’s hard to tell the two apart. People who are compliant often have severely different lives. One side going to meetings and sharing about recovery, then the same night going to a club and pretending to be normal. Like trying to mix oil and water. The addiction culture and recovery culture won’t and don’t mix, one of them will win. Unfortunately, it’s usually the addiction culture that pulls people in because it’s familiar and comfortable.

The majority of people who have long term recovery will tell you that recovery comes, came and will always come first in their lives.

This is the recipe for the surrender I’m talking about.

  • I can’t do this on my own.
  • I need as much help as I can get.
  • I don’t really know much about recovery but I’m willing and open to learning.
  • Recovery is difficult but I’m prepared to embrace the struggle.
  • Please tell me what to do next.
  • I’m accountable for my decisions.
  • I’m responsible for my actions.
  • I can’t, He can. So let him.

Triggers | Associations

What are Triggers?

Triggers and associations are strong reminders of the past. For people in early recovery, a trigger or association can be the influencing factor which leads to a relapse. A few triggers are easier to see than others, for example, the bar you used to drink at is a blatant reminder of your drinking. Most triggers are a lot smaller but just as powerful. For example, that playlist that always played in your car while you were using or drinking might have a strong enough association to make you crave. Something as simple as getting home after a treatment and your house smells a certain way could bring back memories, causing a substantial craving.

Internal Triggers

Furthermore, there are also internal triggers which are harder to prepare for. Certain emotions can trigger a desire to use. If you had a certain dynamic with a family member that caused you to feel resentful which lead to you fighting and eventually using, that dynamic will possibly happen again once you are home. Being aware of your dynamics in relationships might be the difference between you acting out or making the decision to do something differently. You only need to do something different once to see that there is another way.

Preparing for Triggers

Many people underestimate the force that these triggers and associations have on someone in early recovery and just how quickly they can lead to physical relapse. Here at Cherrywood House we make a point to go through triggers in our relapse prevention workshops and in our Transitional Workshops.

The question remains, how do we deal with triggers and associations so that we can be safe when we leave treatment?

TRIGGERS & ASSOCIATIONS: HOW TO DEAL WITH THEM

For most people, the transition will be difficult as not everyone can move houses or towns. You will be confronted with the same situations, with the same people most likely causing the same feelings.

The first step to combating these dynamics is awareness, we need to be prepared for this. Surprises will pop up but the more prepared we are, the less chance of emotionally acting out there is.

Trust your internal messages. Treatment makes us aware of ourselves and of our thought processing. If you think you are at risk, you probably are. Walk away; rather apologise one day for being rude, than apologise to your family because you sold the car again during a relapse. Being true to yourself is going to be far more rewarding than conforming to what others expect of you.

Next Steps

We hope that you found these tips on Triggers and Associations helpful and encouraging.  If you are struggling with an Addiction or know someone who is. Please feel free to contact us and we can help you with your next steps.

Cherrywood House is a rehabilitation centre for people suffering from substance and other addictive disorders. It is situated in the tranquil, semi-rural environments of Constantia, Cape Town, South Africa. We offer  Residential Programmes, Aftercare Support Services, Outpatient Programme, Family Support Groups. For more information. Visit our Website Here.

Do and Dont’s for Early Recovery

Do’s and Don’ts: Early Recovery

DO – Ask for help from people you trust

In Early Recovery this is probably the single most important piece of advice for someone who continues to struggle with drug or alcohol addiction. The reason such a person is struggling is because they are dealing with a problem all by themselves, and they are constantly battling with the fact that they cannot overcome their problem alone. Many of us are very stubborn and believe that we can figure out such a problem by ourselves, but addiction proves to be too much for many of us.

This does not mean that you are stupid….what it means is that you are a true addict or alcoholic. There is a big difference, and one that most “normies” may never fully grasp. It is easier for a normie to believe that addiction is a produce of either mental weakness or moral failings. In my opinion (being an addict myself) it is neither of those things.

Is alcoholism and addiction about lack of information, or is it a moral issue? One thing that should make you raise an eyebrow towards traditional recovery is this interesting double standard: They say that you are not a bad person if you are an addict or alcoholic, but that you are, in fact, a sick person. So they argue that having the disease of addiction is NOT a moral failing. But then if you look at the traditional recovery steps, they specifically address fixing moral defects of character as a means to treat the addiction. This is an interesting turnabout that I have never quite been able to fully grasp and understand. On the one hand it is a disease and not a moral failing, but on the other hand the 12 steps seek to treat the problem by fixing moral defects of character. Can anyone clarify how this is not some form of confusing doublespeak? It’s not a moral failing, but here…fix it by working on your moral character!

So in my experience addiction and alcoholism are not moral problems, and they are not the result of stupidity either. Instead, it is a physical “allergy” that leads to a pattern and a cycle that traps the addict or alcoholic.

As such, the person needs new information in order to escape from this trap. They cannot do this under their own power unless they learn new information that can teach them how to live successfully without self medicating all the time.

This is what should fuel early recovery then: the need for new information. The struggling addict needs to learn something if they are going to significantly change their manner of living. Therefore early recovery is a huge learning experience.

This is what makes this first “do” so important. You are not going to learn anything by having stuffed rammed down your throat against your will or being preached at. You have to want to learn something if you are truly going to experience something new.

And therefore you must ask for new knowledge. You have to ask for help. This is a critical component of early recovery. If you are not asking for help, if you are not seeking new knowledge about how to live without drugs and alcohol, then you are probably not ready to be clean and sober yet.

Early recovery is really about willingness. Your success in the first year of your recovery can be measured based on your level of willingness at the beginning of your journey.

If you are not in a place where you are willing to ask for help then early recovery is going to be a very rocky experience. Most people who try to get clean and sober without any outside help end up relapsing. This is indeed what defines their addiction. If they can do it on their own then they do not even label themselves as an “addict” or an “alcoholic.”

DO – Follow through on advice and suggestions you receive

After you ask for help, what happens next? Obviously you have to do something with the new information that you receive.

For many people, this will play out as a trip to rehab or treatment of some sort. This is perfectly acceptable and is probably the best course of action for most people in early recovery. There are many benefits to going to inpatient treatment. Certainly you could do worse than ending up in a short term treatment facility.

What happens to most people in early recovery who have taken that first step in asking for help is this: They take a few tentative steps towards real change, then they get scared and pull back, sabotaging their recovery effort. This is why they say that you have to let go “absolutely.” People who fail to let go of everything are still hanging on to some need for control. This is a fear based reaction and it is perfectly understandable.

Just checking into an inpatient rehab can be a very scary experience. I don’t blame anyone for backing out of such a deal. It is scary to turn your will and your life over to others. It is scary to check into treatment and be at the mercy of random strangers. This goes against many of our basic survival instincts, to surrender and back off and allow others to dictate our actions for us. In many respects, going to treatment can be a lot like voluntarily walking into prison and putting your hands out to be chained in handcuffs. It takes a lot of guts to reach this level of surrender.

Willingness is one thing, but taking action is another thing entirely. Having the willingness implies that you are willing to take action.

If you were to interview several recovering addicts and alcoholics who have just made it through their first year of recovery without relapse, you could ask them to take a look back at that first year and tell you how much of the solution was “taking action.”

I am sure if you did this then people would emphatically tell you that it was ALL about taking action. They would say that they really dove into recovery, that they took all sorts of action in their life, and that the people who failed to take action were the ones who relapsed. This is just how it goes. Do nothing (or very little) and you will quickly revert to your old using or drinking behaviors. Relapse comes to those who do nothing.

Early Recovery is all about change. When you first get clean and sober your natural reaction to life in general is to use drugs or alcohol. Period. Your solution for everything is to self medicate. This is your baseline for existence when you first get into recovery.

This has to change. The only way it is going to change is if you ask for help and then take action. Because your whole life is dominated by addiction, you are going to have to take LOTS of action. Just changing one little thing is not going to do it. You have to change “everything.” Again, if you interview successful people in recovery they will emphatically state that this is true, you really do have to change everything. To say that this requires action and follow-through is an understatement. You are going to have to push harder than you have ever pushed before in your life. You are going to have to make a supreme effort.

Thus, action and follow through are extremely important to your success. Anyone can say “I want to quit drugs or alcohol” but very few will actually put in the massive work required and get it done. You can be one of those people if you choose to take massive action and put forth a serious effort.

DO – Dedicate your life to recovery

This “do” is really about the level of action, willingness, and follow through that you commit to taking in recovery.

Essentially what you will want to do is to dedicate your entire life to recovery. This should happen for at least the first year or two.

Most people who first dabble with the idea of getting clean and sober do not come anywhere near this level of dedication and commitment. They suffer from a problem that I like to call “compartmentalizing their recovery.”

What this means is that the person is trying to pick and choose how they recover, when they recover, and by what methods they recover. They are trying to say “OK, I can go to an AA meeting here and there, but I certainly can’t live in treatment or do this sponsorship stuff or attend meetings every day for months on end!”

Or they may say “sure, I can quit drinking or using drugs….but there is no way I am going to an inpatient facility in order to do so!”

Or they may simply try to recover from their addiction without disrupting any other part of their life. They try to compartmentalize their recovery and put it in this neat little box, such that it does not affect any other part of their life. They want everything else to continue on as normal, without their recovery having much impact on the other parts of their life.

This is never going to work. This cannot ever possibly work for anyone. You cannot compartmentalize your recovery from addiction. It’s not possible. People who try to do so have not fully grasped just how deeply their addiction infiltrates every part of their life.

There is a reason that they say that “you have to change everything.” They say this because it is really true. If you successfully go through a year or two of recovery, you will look back on it one day and agree with the statement that “yes, everything is really different in your life, everything changed, you had to let go of everything in order to recover.”

People who hang on to a little piece of their old life are only sabotaging their efforts. They have reservations. They cannot let go absolutely.

In order to succeed in early recovery you must let go of everything. You must become willing to change everything.

In order to do this you need to be willing.

Then you need to ask for help.

Then you need to follow through on the advice and suggestions you receive.

And finally you need to dedicate your entire life to learning a new way of life. If you have to slap a time limit on it then give yourself a year. Tell yourself “for one year, I will dedicate my entire life to recovery, to not using drugs or alcohol, and to learning a new way to live so that I can be happy while being clean and sober.”

If you watch people in recovery who end up relapsing, you will notice that they have not done this. They have not dedicated their entire life to recovery. They are stuck trying to compartmentalize their recovery. In a way, they are still trying to have their cake and eat it too. They are trying to hold on to control of certain things while only hoping to let go of other things. You cannot succeed this way. You have to let go of everything (need to control) absolutely. Let go of it all. Surrender fully and completely to your addiction. This is the only way to truly succeed in recovery. You must dedicate your entire life to sobriety, to recovery, to a new way of living.

DON’T – Rely on meetings or therapy alone to keep you sober

Now for some “don’ts.”

My first recommendation can be slightly controversial, because most people in traditional recovery harp on the idea that “meeting makers make it.” Going to daily AA meetings is typically seen as a lifeline to strong recovery. Why would anyone argue against those helpful meetings?

Really I am not arguing against the meetings, I am just putting in a word of caution here.

What I am suggesting is that you do not RELY on the meetings for your continued success in recovery.

You can test this yourself without risking relapse. Simply cut back from your meetings, and see how you feel. If you go to AA every single day, try skipping a day here and there and see if it affects you. Some people find that it changes their attitude and their outlook when they miss a meeting. I used to experience this myself in early recovery, and I could notice it when it happened.

So what changed? I forced myself to solve this particular problem. Why was I dependent on the meetings in order to have a good attitude and feel confident in my recovery? I did not like this after I discovered it and realized that I had just created another dependency (much healthier than a drug or alcohol dependency, but a dependency nonetheless).

What changed for me is that I started to realize that I was complacent in going to daily meetings. I was using them incorrectly. I was using daily AA meetings as a form of ongoing therapy. This is not their intended purpose, believe it or not. But this is largely what daily AA meetings have become for most people.

I vowed to stop using the meetings this way and to stop relying on them as a daily therapy session. In order to do this I started to seek other outlets, other forms of personal growth, and other ways to feel good about my recovery that did not involve “the program.”

What I discovered is that recovery is really nothing more than a continuous cycle of personal growth–a constant reinvention of the self. People could achieve this state of growth both in and out of programs like AA. I also discovered that people could achieve this cycle of personal growth by being in alternative programs, religious based programs, or in no program at all. The key was in the personal growth, not in the specific program of recovery.

So by all means, you (or anyone else) can keep going to AA meetings every day, and I would encourage you to do so if you get value out of them. But do not rely on those meetings in order to sustain your recovery. If you do then this only points to a glaring weakness in your own recovery process. Personal growth outside of AA meetings should be enough to sustain your recovery. If it is not then your dependency is making you weaker, not stronger.

On the other hand, if you can find successful recovery via personal growth without depending on AA, then you can still attend AA meetings and have something much more powerful and meaningful to contribute to them. You can become a message of hope and strength in a venue where most people are dependent on the group therapy aspect to sustain their sobriety, and you will be coming instead from a place of greater strength.

DON’T – Expect early recovery to be easy

Again, this is just underestimating your disease and the recovery process itself. Nearly everyone does this at first, and usually a relapse or two is necessary in order to realize just how powerful the addiction truly is.

This speaks to the level of dedication and commitment that is required. Think back to the greatest challenge of your life so far, and what the toughest thing is that you have ever accomplished. Now realize that overcoming your addiction is probably going to be a full step harder than anything else ever has been for you. This is the struggle of your life and if you want to succeed then you have to realize that this is going to be a very difficult journey.

I don’t like it when people throw around “doom and gloom statistics” in recovery but the fact is that those lousy success rates are basically true. The odds are heavily stacked against the individual in recovery, and most people do not make it to 1, 5, 10 years sober. But obviously many people DO make it in recovery and you can certainly be one of them. You just have to decide and commit to doing so. But realize that you must decide and commit with a level of intensity that is far beyond anything you have ever done before in your life. This is it. Nothing in your past could have possibly prepared you for a challenge of this magnitude, so you would be wise to realize this and adjust accordingly. Don’t make a lazy or half hearted effort and expect to be successful.

DON’T – Set yourself up for future complacency

I mentioned the trap of AA meetings and a possibly dependency there. In addition to this, anyone who is practicing “acceptance” more than they are challenging themselves to grow is also headed for trouble.

Complacency is the trap of laziness. It is a path that says “we are OK now, we are stable in recovery, no need to seek out any more learning or growth experiences.”

Don’t allow yourself to fall into this trap. The way to prevent this is to embrace the cycle of personal growth. Realize that you are always going to be learning new things, and stay open to new growth opportunities. There is a proper “pace” in recovery where you are always looking ahead to that next challenge, and at the same time you are not burning yourself out either. Find that pace. In finding it you will also realize that there is a time for acceptance and reflection in your life. But even after you reach a goal in your life, you should still be looking ahead to your next big project. Thus you can always be learning, always be willing to change and to grow. This is the path of success in recovery.

sourced from Spiritual River

Relapse and what to look out for

Relapse can and does happen.

Relapse is more than just using alcohol or drugs.  It is the progressive process of becoming so dysfunctional in recovery that self-medication with alcohol or drugs seems like a reasonable choice.

The relapse process is a lot like knocking over a line of dominoes. The first domino hits the second, which hits the third, and soon a progressive chain reaction has started. The sequence of problems that lead from stable sobriety to relapse is similar to those dominoes. There are two differences. First, each domino in the line (i.e. each problem that brings us closer to substance use) gets a little bit bigger and heavier until the last domino in the sequence is ten feet tall, four feet wide, and a foot thick. As this 10,000-pound domino begins to fall on us, it is too heavy for us to handle alone. The second difference is that the dominoes circle around behind us. So when the last domino falls, it hits us from behind when we’re not looking.

So here we are, moving along in recovery. We tip over one small domino. No big deal! That domino hits the next, and then the next. A chain reaction gets started. The first dominoes are so small that we can easily convince ourselves that it’s no big deal. We look the other way and start doing other things. All of a sudden a huge domino falls on us from behind, crushing us to the floor, causing serious pain and injury in the process. We need to make the pain go away and we reach for old reliable – the magical substances that always helped us without pain in the past. We’ve now started drinking and drugging.

The answer to avoiding relapse is not to take up weight training so you will be strong enough to lift that last domino off of your now crippled body. Part of the answer is to learn how not to tip over the first domino. Another part of the answer is to develop an emergency plan for stopping the chain reaction quickly before the dominoes start getting so big and heavy that they become unmanageable.

The Relapse Process

The progression of problems that lead to relapse is called the relapse process. Each individual problem in the sequence is called a relapse warning sign. The entire sequence of problems is called a relapse warning sign list. The situations that we put ourselves in that cause or complicate the problems are caused high risk situations.

It’s important to remember that we don’t start drinking and drugging because of the last problem in the sequence. We start drinking and drugging because the entire sequence of problems got out of control. Let’s look at the steps of this process in more detail.

Step 1: Getting Stuck In Recovery

Many of us decide that alcohol or drugs is a problem, stop using, and put together some kind of a recovery plan to help us stay sober. Initially we do fine. At some point, however, we hit a problem that we are unwilling or unable to deal with. We stop dead in our tracks. We are stuck in recovery and don’t know what to do.

Step 2: Denying That We’re Stuck

Instead of recognizing that we’re stuck and asking for help, we use denial to convince ourselves that everything is OK. Denial makes it seem like the problem is gone, but it really isn’t. The problem is still there. It just goes under ground where we can’t see it. At some level we know that the problem is there, but we keep investing time and energy in denying it. This results in a build-up of pain and stress.

Step 3: Using Other Compulsions

To cope with this pain and stress, we begin to use other compulsive behaviors. We can start overworking, over-eating, dieting, or over-exercising. We can get involved in addictive relationships and distract ourselves by trying to experience the orgasm that shook New York City. These behaviors make us feel good in the short run by distracting us from our problems. But since they do nothing to solve the problem, the stress and pain come back. We feel good now, but we hurt the latter. This is a hallmark of all addictive behaviors.

Step 4: Experiencing A Trigger Event

Then something happens. It’s usually not a big thing. It’s something we could normally handle without getting upset. But this time something snaps inside. One person described it this way: “It feels like a trigger fires off in my gut and I go out of control.”

Step 5: Becoming Dysfunctional On The Inside: 

When the trigger goes off, our stress jumps up, and our emotions take control of of our minds. To stay sober we have to keep intellect over emotion. We have to remember who we are (an addicted person), what we can’t do (use alcohol or drugs), and what we must do (stayed focused upon working a recovery program). When emotion gets control of the intellect we abandon everything we know, and start trying to feel good now at all costs.

Relapse almost always grows from the inside out. The trigger event makes our pain so severe that we can’t function normally. We have difficulty thinking clearly. We swing between emotional overreaction and emotional numbness. We can’t remember things. It’s impossible to sleep restfully and we get clumsy and start having accidents.

Step 6: Becoming Dysfunctional On The Outside: 

At first this internal dysfunction comes and goes. It’s annoying, but it’s not a real problem so we learn how to ignore it. On some level, we know something is wrong so we keep it a secret. Eventually we get so bad that the problems on the inside create problems on the outside. We start making mistakes at work, creating problems with our friends, families, and co-workers. We start neglecting our recovery programs. And things keep getting worse.

Step 7: Losing Control: 

We handle each problem as it comes along but look at the the growing pattern of problems. We never really solve anything, we just put band-aids on the deep gushing cuts, put first-aid cream on seriously infected wounds, and tell ourselves the problem is solved. Then we look the other way and try to forget about the problems by getting involved in compulsive activities that will somehow magically fix us.

This approach works for awhile, but eventually things start getting out of control. As soon as we solve one problem, two new ones pop up to replace it. Life becomes one problem after another in an apparently endless sequence of crisis. One person put it like this: “I feel like I’m standing chest deep in a swimming pool trying to hold three beach balls underwater at once. I get the first one down, then the second, but as I reach for the third, the first one pops back up again.”

We finally recognize that we’re out of control. We get scared and angry. “I’m sober! I’m not drinking! I’m working a program! Yet I’m out of control. If this is what sobriety is like – who needs it?”

Step 8: Using Addictive Thinking

Now we go back to using addictive thinking. We begin thinking along these lines: ” Sobriety is bad for me, look at how miserable I am. Sober people don’t understand me. Look at how critical they are. Maybe things would get better if I could talk to some of my old friends. I don’t plan to drink or use drugs, I just want to get away from things for awhile and have a little fun. People who supported my drinking and drugging were my friends. They knew how to have a good time. These new people who want me to stay sober are my enemies. Maybe I was never addicted in the first place. Maybe my problems were caused by something else. I just need to get away from it all for awhile! Then I’ll be able to figure it all out.”

Step 9:  Going Back To Addictive People, Places, And Things

Now we start going back to addictive people (our old friends), addictive places (our old hangouts), and addictive things (mind polluting compulsive activities). We convince ourselves that we’re not going to drink or use drugs. We just want to relax.

A client in one of my groups said he wanted to go to a bar so he could listen to music and relax while drinking soft drinks. And old timer in the group asked: “If you told me you were going to a whore house to say prayers, do you think I’d believe you? Well, when you tell me you’re going to a bar to drink cokes I have about the same reaction!”

Step 10: Using Addictive Substances: 

Eventually, things get so bad that we come to believe that we only have three choices – collapse, suicide, or self-medication. We can collapse physically or emotionally from the stress of all our problems. We can end it all by committing suicide. Or we medicate the pain with alcohol or drugs. If these were your only three choices, which one sounds like the best way out?

At this stage the stress and pain is so bad that it seems reasonable to use alcohol or drugs as a medicine to make the pain go away. The 10,000 pound domino just struck the back of our head, breaking our bones, and crushing us to the ground. We’re dazed, hurt, and in tremendous pain. So we reach out for something, anything, that will kill the pain. We start using alcohol and drugs in the misguided hope it will make our pain go away.

Step 11: Losing Control Over Use

Once addicted people start using alcohol or drugs, they tend to follow one of two paths. Some have a short term and low consequence relapse. They recognize that they are in serious trouble, see that they are losing control, and manage to reach out for help and get back into recovery. Others start to use alcohol or drugs and feel such extreme shame and guilt that they refuse to seek help. They eventually develop progressive health and life problems and either get back into recovery, commit suicide, or die from medical complications, accidents, or drug-related violence.

Other Outcomes Of The Relapse Process

Some relapse prone people don’t drink. They may say “I’d rather be dead than drunk” and they either attempt or commit suicide. Others just hang in there until they have a stress collapse, develop a stress related illness, or have a nervous breakdown. Still others use half measures to temporarily pull themselves together for a little while only to have the problems come back later. This is called partial recovery and many people stay in it for years. They never get well, but they never get drunk either.

What I have just described is called the relapse process and it’s not rare. Most recovering people periodically experience some of these warning signs. About half can stop the process BEFORE they start using substances or collapse from stress. The other half revert to using alcohol or other drugs, collapse from stress related illness, or kill themselves.

It’s not a pretty picture. No wonder we don’t want to think or talk about relapse. It’s depressing. The problem is that refusing to think or talk about it doesn’t stop it from happening. As a matter of fact ignoring the early warning sing makes us more likely to relapse.

But there is hope. There is a method called Relapse Prevention that can teach us to recognize early warning signs of relapse and stop them before we use alcohol and drugs or collapse. That’s what my next article is about. There’s also a process called Relapse Early Intervention that helps us set up an emergency plan to stop relapse quickly should it occur. We’ll cover that in our third article.

References

Gorski, Terence T., Relapse – Relapse Prevention – A New Recovery Tool, Alcoholism & Addiction Magazine;; By Terence T. Gorski September 25, 1989

Enabling

How To Stop Enabling Addiction?

No one who has a loved one with a substance abuse problem wants them to suffer. No one wants a person they care about to be in pain, to descend into the dysfunction of addiction, to lose their livelihood, their family, their life.

How many times have you heard someone say, “I would do anything to help them?”

We protect, we cover, we shelter, we defend and we do so in the name of loving and caring. The problem is that the very things we are doing to help someone, may be things that are enabling the addiction and keeping them from getting well. These may also be things that we are doing because it is more comfortable for us than dealing with the facts of the situation – and it we truly want someone to get well, sometimes we have to get worse first!

So, How Do You Know If You’re An Enabler?

How do you know if you are enabling someone’s substance abuse? We may engage in a lot of behaviors that we think are helpful, or that we are told are necessary but if you start to dig deeper into what that action is all about you find it perpetuating or masking the problem – not solving it!

3 Tips To Identifying Enabling

Here are three tips to help identify enabling behaviors and signs of an enabler. But take hope! You’ll also find alternatives to truly help improve the situation throughout the text!

1.  Interfering

It may seem like pouring out the alcohol, hiding the car keys, or throwing away the pills is the best way to keep your loved one from using. It will certainly force them to get more creative about where they keep their substance of choice and what lies they have to craft to hide their behavior. What is won’t do is cure them of their addiction, or convince them that what they are doing is wrong or harmful.

If their behavior is going to create a dangerous situation for you then you have to make the choice to keep yourself safe, interfering with how they engage in their addiction just provides opportunities for them to get smarter about how they use and you are teaching them how to be a better addict!

2.  Hiding And Lying

Do you cover up for your partner? Do you make excuses for their behavior? Are you doing this for you or for them? Maybe you tell yourself I have to cover for them at work otherwise they will lose their job, then we will lose our house, etc. But deep inside, the true motivation may be fear of change.

In reality, you are helping them hide their behavior for your convenience, and you are helping them carry-on without having to deal with the reality of the situation. Maybe you are going to have to move, maybe you are going to have to ask for help and tell people what is going on, maybe you won’t be able to stay with this person anymore. Those are all uncomfortable situations, and they are all consequences of being involved with an addict. You have to be willing to confront the reality of a situation for everyone involved in order to address whatever that situation is.

3.  Compensating For The Behavior

Money, food, computers, cars – do you give these to someone with a substance abuse problem? How many times do you give someone a computer because they have to have a computer to find a job, and they have to have a job to get sober, but they keep relapsing, selling the computer for drugs and staying in the cycle? How many times do you buy a new car for someone who keeps crashing under the influence? How much money do you give knowing that it won’t be used for rent?

None of us want the people we love to be homeless, to be hungry. We don’t want them to suffer, but when we protect them from experiencing the suffering they are in we take away the opportunity for them to make a decision about changing!

Give An Addict Room To Take Responsibility

REMEMBER: Enabling an addict does not help!

Enabling is really about preventing someone for having to take responsibility for themselves, and whether it is done with good or bad intentions it prevents the other person from fully living their own life. Moving out of enabling behaviors and into a relationship where you let someone experience the natural consequences of their choices isn’t easy, and often it can make it seem like things are much worse. But only if someone experiences for themselves the desire to do something different will there ever be a change, and that experience can’t come if we prevent our loved ones from having it!

Are You An Enabler?

Do the above scenarios sound close to home? Please leave us a message in the comments section below and we’ll do our best to respond to you personally and promptly. We can help refer you to support services, treatment, or the help that you need. Or, we’ll just lend an ear.

Just How Bad Are Energy Drinks for Recovering People?

For those recovering from alcohol and drug addictions, the urge to find a fix seems to be never-ending. To replace their drug of choice, the recovering addict will find other means to soothe their minds and souls. A replacement “high” that has become common among recovering people is the use of energy drinks. Energy drinks’ combination of caffeine, vitamins, and herbs can provide the kick they need, and, it’s legal and can be found at any corner store. Energy drinks can be a healthier alternative to drugs and alcohol, but what most don’t known is that the very things that make energy drinks so popular can also lead to active addiction.

Emotions during addiction recovery

Happy, sad, grumpy, excited, nervous, giddy – these are all things we feel at one time or another and none of them are forever.  Despite the fact that emotions are transitory, we have this sense that they are permanent conditions and we end up spending a lot of time in variations on a negative, either:

  • Feeling like we are stuck and that we won’t be able to ever get out of what we are currently feeling.
  • Being upset because we can’t make a positive emotion last forever.

The first becomes a self-fulfilling prophecy, the second is about accepting what is, being fully present in the moment and just being able to do that can help us feel a lot happier more often.

So, what can you do to address your emotional state in addiction recovery? What can you control? And how do you start to feel better? We review here, then we invite your questions about emotional issues in recovery at the end.

Enabling is not helping !

How many of us have asked ourselves: “If I stopped helping my addicted loved one, what would happen to them? Would they fall apart, would they starve or, even worse, overdose?”  

If you question whether your help is really hurting an addict, this article may help you understand more regarding enabling and addiction. We review enabling behaviors and how to end them here. Then, we invite your questions or comments at the end.