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Monday, December 19, 2016

Coping With Cravings

coping with addiction cravingsAnyone who has ever had issues with substance use certainly understands just how powerful and controlling cravings can be. Once a craving has been triggered, unless one has developed specific techniques or interceptive supports, the craving can become overwhelming to the point where it can dictate a person’s thoughts, emotions, and behavior, which may prove devastating and self-destructive.

So what exactly is a craving? A craving can be a biological, psychological, or social response (or a combination of all three) to satisfy perceived or depleted chemicals, stimuli, or quite simply… pleasure. In a nutshell, a craving is a powerful desire for something. That something varies greatly from person to person, but is commonly prompted by the need to escape from one’s feelings.

Failing to deal with or ignoring cravings can quickly lead to relapse, which may cause devastating consequences such as health issues, emotional instability, incarceration, familial wreckage, overdose, and even death.

The first thing a person should remember when experiencing a craving is that it can and will subside if the right steps are taken, and does not need to be satisfied in order to pass! A craving longs for instant gratification, which is the demise of many addicts, as it initiates reckless and impulsive behaviors that often come with dire consequences. 

There are many ways to cope with a craving. 12-step support is an excellent way to relate to others who understand and can offer hope and practical solutions from their own experiences. Intrapersonal skills or techniques such as prayer, meditation, mindfulness, thought and perception-flipping, and behavioral deviations are all highly effective in combating cravings. Other coping skills can include stimulation diversion techniques such as walking, cooking, and finding alternative methods for diverting the obsessions and compulsions related to cravings. One may also find healthy ways for rewarding one’s self for not acting on the craving. Development of a consistent schedule and a healthy routine is also very helpful. In addition, pharmacological supports may be available if needed. Ultimately, it is a combination of all of these methods that yield the most effective results.

Many addicts may feel shame around experiencing cravings. If you are struggling with addiction and even if you are already on the road to recovery, remember that a craving is not a weakness, it is a natural process that occurs while your neurological and biological chemistries are healing, and environmental factors are stabilizing. With each craving that is overcome, a new strength and awareness is developed. Think of cravings like push-ups… just as they are an exercise that strengthen your muscle tone, dealing with cravings is an exercise in strengthening your recovery!

Friday, December 9, 2016

Recovering From Shame of Holidays Past

recovering shame holidays past"With it being the season for giving, this brings up many different issues that those in early recovery may wonder and even stress about.  As addicts and alcoholics, the daunting thoughts remain of taking for many years, never able to fully being able to give themselves to anything other than drugs or alcohol. So when opportunity comes to be sober and give, it leaves people feeling overwhelmed at years past, which were most likely filled with drama, fights, tears, and sadness. The common memories that fill their heads of years past are when they were late for holiday dinner, huge family blowouts, being completely belligerent, not having enough money to buy presents, spending the money they had on booze or drugs, not showing up at all, stealing from people on those holidays, or the worst feeling of all- an older relative's last holiday, and they weren't there to spend it with them. Really the list goes on, and ignites the shame and guilt of a newly recovering person who is experiencing their first sober holiday. These feelings of guilt and shame are the very feelings that push addicts and alcoholics to want to numb out the pain by self-medicating with drugs and alcohol over the holidays. The person may experience overwhelming thoughts of knowing there have been many years of dysfunctional, addicted holidays where they have been the focus. It's hard to slip into a new role of being "newly recovered." So one must ask themselves- how do I move beyond this?  

Well, the best way to move past these types of feelings is to first give yourself credit for this being a holiday that you are clean and sober. With recovery being a process, you may also have to make amends- not only verbally, but through an ongoing process of living amends as well. Just saying you are a different person today honestly just isn't enough. Action will always speak louder than words. For instance, if you tell family you will be there at a certain time, get there on time, maybe even early. If you feel a family blowout is about to occur, remind yourself of the coping skills you have available today and call your sponsor, friend, pray, or just take a moment to yourself. Do your best to remain calm, and try not to react or respond negatively. Remember, there have been years filled with dysfunction and addiction, and it may take some family members longer then other to fully trust you and not be resentful for holidays that have come and gone. Today you are sober and get to be the man/woman you've always wanted to be. This year you most likely will have been working a job and will be able to buy presents and show up differently, and this will speak volumes to your family members. BUT the greatest gift, even if others can't see it yet, is your sober presence and being available to be a member of the family. Don't get discouraged if people guard their purses/valuables around you as I promise there will come a time when people will be fully trusting of you and comfortable leaving those items out with you around. If Grandpa Joe comes in and wants to play chess, sit down with him and do so, even if you don't like it. If Aunt Cindy comes in and wants to take a ton of selfies with you to show off her amazingly talented and sober niece/or nephew, do it. If your mom wants you to help her cook and you can't seem to not burn a piece of toast, help her anyways. The memory she has of you in that moment won't be about the food, but about the moments she got to celebrate your life with you.

The point is, allow your family to love you up close and personal, as they've had to love you from a distance for a while now. There is always a way to make things different and better than they were before. For some of you it will take years to mend a family that has been destroyed by addiction. But that doesn't mean giving up is an option. You get to be the pillar of change and growth today, and I promise you that stands for something. Acceptance, love, tolerance, giving, forgiveness, and patience are all things you should take along with you this holiday season. Remember to slow down and know that you are enough and that you are fighting the good fight.

Happy Holidays!"

Wednesday, November 16, 2016

Medication and the Recovery Process

medication recovery processSpanning decades now, there has been an argument about whether or not a person who is taking prescription medications is truly in recovery. This argument seems to be based primarily in the realm of non-professionals and a few staunch 12-step hardliners, and may sometimes influence individuals in recovery to avoid or refrain from taking prescription medications due to the negative associated stigma. Considering the many dynamics of prescription medications, their indications, and possibilities for improving one’s life, this argument is nothing less than ignorant and can undoubtedly prove harmful.

Certainly, there are medications that should not be utilized for persons in recovery, including those that are mind or mood-altering and psychoactive in nature. These medications have a high potential for dependence, cross-addiction, and are likely to exacerbate and hinder progress for the individual seeking to obtain an alcohol and drug-free lifestyle. However, there are many times that those embarking upon the recovery process may reap significant benefits from adherence to prescription medications for some of the following reasons, which are but a few of many:

1) Early recovery from alcohol, opiates, and benzodiazepines often require medical supervision. Utilization of mediations in these cases are imperative to prevent seizure, coma, and even death.

2) Clinical trials have proven that utilization of specific medications reduce withdrawal symptoms and cravings in early alcohol and opiate abstinence, thereby decreasing probability of relapse and recidivism.

3) With alcohol and opiate addiction, often without the assistance of prescription medication, abstinence and recovery is nearly impossible to achieve. Not only do these medications alleviate dangerous physical withdrawal symptoms and conditions, but essentially buy the alcoholic or drug addict time while the neurochemical system is attempting to repair itself.

4) Supportive medications utilized in early recovery, or in the maintenance of second and third stage recovery phases, are designed to alleviate cravings, anxiety, depression, and mood disorders. Essentially, these medications allow the person to experience an emotional and mental place where they can finally begin to tolerate the therapeutic processes and begin to redirect their lives.

What many scientists, mental health professionals, and substance use counselors now understand is that more often than not, the addiction itself in many cases is a symptom of preexisting, underlying conditions. These conditions are common, widespread, and are not reserved for the person struggling with alcohol or drug addiction. Depression, trauma, anxiety, chronic pain, and other conditions too vast to even begin to mention, may be addressed with psychopharmacotherapy, and in conjunction with a 12-step program, therapy, and sober living environments, may help to prevent the alcoholic or addict from self-medicating these conditions with drugs and alcohol.

Even the founders of Alcoholics Anonymous, Bill Wilson and Bob Smith, made sure to include in the Big Book specific examples referencing those who suffer from “grave mental and emotional illnesses,” and wrote that it is perfectly acceptable for these individuals to seek outside professional help, not instead of, but combined with their 12-step programs. Keeping in mind that addiction, whether to alcohol or drugs, is often symptomatic of again, underlying or preexisting conditions, to remove the alcoholism or the drug often creates a worst-case-scenario without the assistance of supportive medication. In many cases, if someone has an underlying mental or medical illness, once the self-medicating properties of alcohol or drugs are removed, this illness will quickly surface.

The key in the journey of recovery is to achieve a higher quality of life, and if prescription medications are a part of that journey, then what the individual does not need is to worry about the stigma associated with prescription medication use, by those who do not understand the complex sciences of neurochemistry. Simply put, people do not recover to feel worse. If addiction is combined with mental health or medical issues, it may be imperative to address these issues with medications, or the individual suffers a high chance of self-medication of symptoms via relapse.

Tuesday, October 25, 2016

Boundaries in Relationships

boundaries in relationshipsBoundaries establish a system of what is acceptable and what is not acceptable in our lives and in the lives of those around us. Boundaries in relationships are essential and are of great importance in order to contain healthy communication with your partner, and for maintaining healthy balance in all areas of your life. This is especially important when someone is in recovery as it is by nature that addicts and alcoholics operate as extremists and when in a relationship, it is very easy for the other person to become a “higher power,” or for priorities to get skewed as relationships (especially new relationships) are exciting and feel good. It’s also a part of a healthy relationship where open communication, honesty, and boundaries are essential rather than making assumptions and not being honest which is an easy set-up for resentment.

While in addiction, boundaries can easily be blurred or nonexistent which allows for others to manipulate, take advantage, or even put you in harm’s way. This also leads to codependence which continues to feed one’s addiction. Codependency entails poor boundaries as a codependent person tends to feel responsible for other people’s feelings and problems or blame their own on someone else. Taking this into consideration, while setting boundaries in relationships, it is vital to recognize your own feelings as you must differentiate yourself from the other person. Boundaries also help to determine which responsibilities in a relationship are yours, and which ones belong to your partner. When you take responsibility for your part in the misunderstanding or conflict, and your partner is able to take responsibility for their part, resolution of the problem at hand becomes much easier.

When these lines of responsibility are clear and respected by each person, emotional intimacy has a strong foundation to grow upon. Some of the basic steps for learning to set boundaries are to recognize and acknowledge your own feelings, recognizing how your boundaries have been crossed, and how you need to go about setting a boundary. It is also important to get grounded as it is common for those in relationships with poor boundaries to fear backlash from the other person, or to feel guilty.

The next step is to voice your boundary and make it known to your partner. In this case, if backlash does occur, it is evident that the other person does not respect the boundary you set and rather than engaging in the argument and focusing on the backlash which subconsciously is telling the other person that you are not grounded and confident in what you want, it is best to simply just walk away and take care of yourself.

Boundaries in romantic relationships are critical, because as opposed to other relationships, partners inhabit each other’s most intimate spaces, including physical, emotional, and sexual. Communication is key because when couples are clear about the boundaries for their own relationship, the relationship can be stable and continue to grow in a healthy manner that will allow the relationship to flourish.

Monday, October 17, 2016

Benefits Of Long-Term Substance Abuse Treatment

benefits long term substance abuse treatment Long-term substance abuse treatment, once thought a luxury, is quickly becoming overwhelmingly obvious to be a necessity if one hopes to develop an alcohol and drug-free lifestyle that is not only sustainable, but joyful and fulfilling. Many experts today prescribe to the disease concept of addiction. Alcohol and drug addiction is a disease that affects the mind, body, and social abilities of the individual, all of which require individualized attention and care if the period of sobriety in treatment is to transform into a lifestyle. The individual who refuses or does not receive appropriate treatment and develop recovery often face the same consequences: jails, institutions, and death. The fact that long-term treatment increases one’s ability to achieve sustainable sobriety has become so evident that many therapeutic courts across the nation have mandated their programs to be 12-18 months at minimum. The outcomes focused on by the court systems are mainly decreased recidivism, or a decrease in repeat offenses that brought individuals to the drug, alcohol, and family court systems in the first place.

Long-term treatment has proven effective in application by data collected not only by the courts, but psychiatrists, psychologists, and substance abuse counselors as well. What seems to be most effective in this approach is that it allows for therapeutic change from the biological, psychological, and social perspectives, and facilitates a transitional phase back into societal roles and norms. In the past, the one-stop 28-day treatment was nothing more than a “spin-dry,” merely to remove the individual from the stimuli, but accomplishing very little with regards to re-entry to life, it’s many pressures, and the coping skills required to face those pressures. The challenge does not stem from getting a person sober, but keeping them sober. Short-term programs were helpful in having a person “dry up,” and maybe allow for a brief evaluation of any underlying mental health or medical issues, but fell drastically short in continuum when compared to long-term treatment programs. Once these individuals leave a short-term treatment, they return to the many challenges that most of us face in a day: work, school, bills, familial obligations, deadlines, and commitments, with the same limited coping skills they entered the treatment center with in the first place. In addition, they frequently return to the same social circles which often promote drug or alcohol use, or an inevitable path to relapse. On top of all of these challenges, the majority of addicts will experience up to two-years of post-acute withdrawal, a time of emotional and mental instability that exacerbates relapse motivation and challenges dedication to continue with recovery. This is a period when prescription medication management, psychotherapeutic support, and sober living support, are crucial. It is within this time frame that many addicts will self-medicate via relapse if not properly treated.           

Long term treatment not only allows for the stabilization of biological consequences of use, but also allows for time to develop volition; the ability to make healthy choices, and autonomy; the ability to establish and maintain independence. In long-term treatment, the person learns not only to begin to reestablish healthy habits with regards to self-care, but also begins to learn cognitive skills that help identify emotions – emotions that at one time paralyzed them, but now may be used as strengths in creating positive lifestyle changes through positive behaviors, which create positive outcomes. Individuals learn how to develop healthy communication, healthy assertive skills, the assigning and maintenance of healthy boundaries for self and others, the many dynamics of interpersonal relationships, and how to make positive changes within those relationships.           

There are many families out there who will continue to ask the question, “Why did this have to happen to our loved one,” in reference to having paid the final price for addiction: death. These families may have experienced many bouts with lapse and relapse, treatment center after treatment center, and spent a considerable amount of money. I have spoken to families after such a tragedy, and they all say the same, that they would gladly go through it all again and spend until they had nothing left to spend if it would bring their husband, wife, father, mother, son, daughter, brother, or sister back. I have yet to hear a family complain after a loved one has completed nine months, or even 18-months in treatment, seeming to be relieved of their alcohol and drug addiction, and say, “I wish they wouldn’t have spent that much time in treatment.” In closing, this message not only serves the alcoholic and drug addict that may still be suffering, but their families as well. Always remember, “They didn’t get addicted overnight, nor will they recover overnight.”

Thursday, October 13, 2016

Women and Borderline Personality Disorder: Filling the Void

borderline personality disorder womenBorderline Personality Disorder (BPD) is a severe, chronic, disabling, and potentially lethal psychiatric condition. It is often characterized by pervasive feelings of emptiness that, in turn, provoke reckless and impulsive behaviors aimed at filling this internal void. Individuals who suffer from this disorder have extreme and long standing instability in their emotional lives, as well as in their behavior and self-image. This is a relatively common psychiatric disorder affecting 2% of the general population, however a staggering 75% of BPD individuals are women. Without treatment and support, most BPD individuals are unable to achieve sustainable recovery. Women, in particular, who suffer from BPD require gender responsive treatment that honors the unique needs and complex experiences of this population.

The instability of emotion, behavior, and self-image characteristic of BPD have devastating and sometimes deadly consequences. Individuals with BPD have repeated and frequent difficulties in their relationships and work lives, often experiencing alternating extremes of anger, depression, and emptiness. The borderline person tends to view past and current relationships as characterized by hostility and experiences pervasive social dysfunction and attachment disturbances. Quite frequently they have suffered from serious trauma including sexual abuse, physical violence, neglect, and psychological abuse.

To be borderline is to have little sense of identity. At its extreme it may mean having to turn to others for cues in order to know when to eat or drink, work or rest, or even laugh or cry. It may mean intensely embracing a person, idea, or thing one day and having no use for it at all the next. Descriptions of themselves often tend to be confusing, conflicting, vague, or unidimensional, lacking depth and feeling. They frequently define themselves in terms of how others see them. For example, their interests, values, mode of dress, and mannerisms may shift as the nature of their relationships change.

This discontinuity is further magnified by an accompanying fragmentation of emotion. Borderline individuals may alternate between being flooded with emotion and being numb to all feeling. In addition, whatever feeling-state predominates at the moment seems to last forever, and the BPD individual can scarcely recall ever feeling differently.

When applied to relationships, this same fragmentation of emotion and identity causes BPD individuals to view their relationships with an intensely black and white quality of feelings. This means that the borderline may experience their last encounter with someone as characterizing the entirety of that relationship. For example, if they parted on angry terms, then the BPD individual might only recall the other person as a heartless villain, wishing bitterly for revenge. Borderline individuals also tend to imagine themselves as deliberately persecuted by those who have merely let them down, placing themselves in a constant state of victimhood.

Complicating this fragmentation of relationships is the likelihood that the borderline’s sense of personal value depends entirely upon the current state of their relationships. When borderline individuals lose a relationship they often lose their inner sense of value that accompanied it. Since abandonment brings with it emptiness, it is avoided at all costs. These defects in identity and self-structure leave borderline individuals with a chronic and overwhelming sense of anxiety or dread and contribute to problems in self-regulation, self-control, self-soothing, low self-esteem, and a sense of personal inadequacy.

Typically, borderline individuals ward off their inner turmoil and unstable self-concepts through compulsive activity and self destructive behavior. This seems to reassure some borderline individuals that they are alive and have feelings. All too frequently, 69% to 75% of individuals with BPD resort to self-destructive behaviors such as self-mutilation, alcohol and drug use, behavioral addictions, serious over or under eating, and suicidal acts to escape from their emotional turmoil or to end dissociation. Often these behaviors serve as futile attempts to fill an internal vacancy, to satisfy a chronic and insatiable hunger.

As noted, a disproportionate percentage of individuals within the population of diagnosed BPD patients are women. There are a variety of cultural, social, and gender related factors that place women at greater risk for receiving a diagnosis of BPD. Violence, trauma, abuse, sexual assault, self esteem, gender specific socialization, discrimination, conflicting social expectations, lack of resources, combined with environmental, biological, psychological, and genetic risk factors are a few of many explanations for the tragic overrepresentation of women among those diagnosed with BPD. 

For women with Borderline Personality Disorder, they must cope with a galaxy of feeling that surrounds female socialization and the blend of longing, need, sorrow, and constraint that underlies it. The BPD individual’s yearning for others and her fragmented identity may be intensified by her awareness of its depth and the volume of need it inspires when compared to societal norms often based upon solely male experiences. These women must struggle for ways to cope with being too full of emotion, too hungry, too needy, and with the compulsion to release those feelings while also punishing the self for having them in the first place.

Gender expectations and aspects of female socialization do not make it easy to find available options, possible ways to cope and to express how empty and hungry and fearful these women feel. Many turn to drugs, alcohol, and countless other behavioral addictions in an attempt to find reprieve. For the self-mutilator suffering from BPD, she may cut to make the pain at her center visible, lacking any socially acceptable methods for release. The anorexic starves to make manifest her hunger and vulnerability.

For women with BPD, struggling to cope with the effects of trauma or substance use, a hostile environment, a rapidly dissolving sense of identity, or conflicting social expectations, this can be devastating and, in some cases, next to impossible without long term comprehensive treatment and support. Many BPD women, without help, continue to blame and hurt themselves, remain speechless, or engage, instead, in a pantomime of sorrow and chronic self destruction, an act that can be seen in everything she does if viewed through the right lens. Caroline Knapp, author of Drinking: A Love Story and Appetite, reflects on this very phenomenon with poignant insight,

“Women wanting to eat and slapping themselves for giving in. Teenage girls mastering the art of negative self-scrutiny. A skeletal body forcing itself to run and run. An arm with more scars on it than you can count. This is endlessly sad, this steady, quiet pummeling of the self, women borne along on a river of unwept tears….Way beneath these sensations is an ancient, aching emptiness, a gaping hole so vast you think it could kill you, a longing for comfort…a desperate, driving sadness that comes from feeling unloved, the longing it evokes to be fixed, to be held and needed and valued, to be proven lovable at last.”

The cluster of symptoms that make up the complex and enigmatic diagnosis that is Borderline Personality Disorder are nothing more than an expression of a deeper, voiceless, inarticulate, and pervasive hunger. It is the cavernous void that drives countless women in to the depths of addiction, obscurity, self annihiliation, and untimely death. And yet beneath these symptomatic expressions of need exists a uniquely human (though not uncommon) longing to discover that she is in fact whole and valued…and a fragile hope that through the process of healing she can, at last, be filled.

Thursday, October 6, 2016

Eating Disorders Within Recovery

eating disorders addiction recoveryEating disorders can be a primary catalyst in seeking relief through drugs and/or alcohol. With the consideration of an eating disorder being any range of psychological disorders which are characterized by abnormal or disturbed eating habits, it is safe to say that eating disorders center in the mind-just like alcoholism and drug addiction. Through personal experience and knowledge gained from working in the field of addiction and recovery, it is my belief that the desire to control is one of the primary characteristics of an eating disorder- just as the desire to control is predominant for many people seeking recovery and a better way of life. Although there are common characteristics among those in recovery, the struggle with an eating disorder presents a unique and, at times, difficult challenge. One, for example, cannot choose abstinence from food like one can from drugs and alcohol. This makes the treatment of an eating disorder trickier and more difficult.

Considering that nutrition provides the sustenance for life, the key is to get mental health support whether this be behavioral therapy that will help slowly shift attitudes and behaviors around food, body image, and size, or traditional talk therapy to help resolve underlying issues. A huge part of this process is stabilizing one’s emotions and coming to accept who they are especially in relation to their body image. Getting in touch with those emotions and learning to separate them from body hunger cues is a vital first step. Continued cognitive behavioral therapy and practicing self love and acceptance is an effective means of living in recovery from an eating disorder. Of course, just like any other addiction or disorder, it is necessary to acutely address the addiction/disorder head on with a hyper-focused treatment module in place. This is especially true for eating disorders and it is highly recommended to attend an inpatient facility while continuing with an effective aftercare plan and different way of life afterwards.

For those struggling with an eating disorder you may feel like you’ll never be happy or satisfied until you lose weight, and that your worth is measured by how you look. The truth is that happiness and self-esteem come from loving yourself for who you truly are-and that is only possible with recovery.

Tuesday, September 13, 2016

12-Step Programs for Addiction Recovery

12 step programs for addiction recoveryThere is a reason that addicts who are seeking recovery turn to 12-step programs. Since the program of Alcoholic’s Anonymous was founded in 1935, AA and many other fellowships like it have helped millions heal from addiction and related issues. Alcoholics Anonymous alone exists in nearly 170 countries around the world with an estimated 2 million members. Currently there are over 30 variations of 12-step programs that address issues such as overeating, codependency, sex addiction and more.

How do 12-Step groups work? First, 12-step programs provide a safe place for people to go and share anonymously about their addiction. Meetings follow a general format in which members use only their first name to identify themselves. While some meetings are open to the public, there are many that are closed to members only. This provides an opportunity for members to share openly about their current struggles and seek support from others who have experienced similar issues in a private setting.

In popular 12-step literature, it is stated that the benefit of one addict helping another is without parallel. While doctors, psychiatrists, researchers and other professionals play an important role in helping improve outcomes for someone seeking recovery, there is something uniquely special about the relationship between two recovering persons. When another addict is able to share with someone who is new to recovery about where they were and where their life is now, a unique bond is established, and within that bond hope begins to blossom. There is something very reassuring about hearing someone else that understands exactly what you are going through via their own experience. 

As you listen to others share personal stories of experience, strength, and hope of recovery, you will begin to develop a sense of confidence that you too can recover. The idea behind 12-step groups is that you will feel a sense of inner strength knowing you are with a group of people who are all working towards a similar goal. It is common for people to want to deal with the problem on their own. This form of isolation is one of the major characteristics of the disease of addiction. 12-step groups give a person an opportunity to step out of isolation and ask others for guidance and support. 

Another characteristic of the disease of addiction is suppressing emotions. Most addicts have a fear of being misunderstood about their problem, so they tend to shy away from expressing how they feel. 12-step meetings provide a platform for people to share openly without being criticized or judged. In exchange, members will share with each other how they have handled challenging situations.

How does one get the most out of a 12-step group? By participating! Each group differs in size and members so it may take some investigating to find the group that feels right to you. Once you have found it, stick with it! Find a sponsor, get a service commitment, and reach out to the group members to maximize your benefit. The principles found within the 12 steps offer a guide to living and have helped millions recover!

Tuesday, September 6, 2016

Synthetic Drugs

synthetic drugs rehabWhen family and friends suspect that a loved one is abusing substances, they often think of the usual suspects like marijuana, alcohol, cocaine, and opiates. However, over the past several years, the drug world has made the transition into the 21st century. The prevalence of synthetic drug abuse has grown exponentially. Synthetic drug use is now as severe if not more severe than traditional drug use in American culture, especially with adolescents and young adults.

The goal of this blog is to introduce individuals to what these drugs are, and to identify what to look for if a loved one is using these drugs.

Spice, K2, and other synthetic cannabis: Synthetic cannabis is often marketed under the names of “Spice,” “K2,” simply “synthetic marijuana.” These drugs are often sold over the counter and require no identification to buy them. They are marketed as incense or potpourri, but using them to achieve psychoactive effects is the only real purpose. Synthetic marijuana is chemically similar to THC and is sprayed or mixed with different generic herbs. Due to the variability of the chemical that is sprayed or mixed, producers are able to work around current drug laws. The use of these substances has several side effects that include anxiety, nausea, racing heartbeat, elevated blood pressure, seizures, tremors, hallucinations, and suicidal thoughts. Synthetic marijuana is now the third most abused substance by high school students, with one in nine high school seniors reporting use of synthetic marijuana in the past month.

Bath Salts: Substituted cathinones (or “Bath Salts”) are the second most popular synthetic drug that is now being abused. These cathinones received the name of Bath Salts due to the visual resemblance they share with Epsom salts, as well as them often being labeled for sale as such. Bath Salts are very similar to both amphetamines and cocaine, in that they are very strong stimulants. Currently there are over 70 variations of chemicals that are classified as substituted cathinones, with several other substances being very structurally similar. Bath Salts have several side effects including headaches, racing heartbeat, reduced body temperature, hallucinations, paranoia, and violent behavior. The use of bath salts has been increasing since the mid 2000s, which resulted in over 10,000 calls to poison control centers in 2012.

Kratom: Opioids such as oxycodone, hydrocodone, and fentanyl are some of the common synthetic opioids that are now prevalent in American society. Although these opioids are usually prescription drugs used to treat pain, they have been shown to have a high rate of abuse. A drug that you have most likely not heard of is Kratom. Although Kratom is not technically a synthetic opioid, it still bears mentioning, as it is one of the most abused legal opioids. Kratom is a leaf that comes from Southeast Asia that has been used for thousands of years as painkiller and antidepressant. The leaf is taken from the tree then brewed as a tea, made into a powder, or manufactured into pill form. Chemically, it is structurally similar to morphine. Unlike Spice and Bath Salts, Kratom is usually bought over the Internet and has virtually no regulation in the United States. Side effects of Kratom are similar to other opioids that include constipation, sleep problems, weight loss, and high potential for overdosing. Although popular, there is currently no information available on prevalence of use in the United States.

The use of synthetic drugs presents several unique challenges in prevention, side effects, and treatment. The availability of these drugs is one of the biggest issues. Spice is often sold in gas stations and convenience stores, and is largely unregulated due to it’s unique chemical make up. Immediate side effects from these substances are often even more severe than traditional drug use as well. Psychiatric problems such as psychosis, paranoia, and violent behavior are often common side effects. Unlike abuse of other traditional drugs, negative side effects of synthetic drugs are often apparent from the first use. Finally, due to these drugs being relatively new and all having their own unique chemical makeup, treatment is often complicated. It is ever important for the public to become knowledgeable about newer synthetic drugs as we continue to broaden the scope of addiction treatment!

Monday, August 29, 2016

Uncovering Codependency

uncovering codependency What is Codependency? 
If you (or someone you know) has been involved with substance abuse, there is a good chance that you have heard of the term “codependency.” Like many other Twelve Step terms and treatment buzzwords, codependency is a term that is often thrown around, yet when asked to define it you’ll get hundreds of different answers. So what is codependency? There is no one universal definition, but the Merriam-Webster Medical Dictionary defines codependency as: “A psychological condition or relationship in which a person is controlled or manipulated by another who is affected with a pathological condition (as addiction to alcohol or heroin)” And “Broadly: dependence on the needs of or control by another”

What Does Codependency Look Like?
These two definitions give us a basic outline about what codependency is (or at least how it is defined in the medical field), but what does codependency look like in real life? Well, there are several patterns that are often present in codependent relationships or systems. The key aspect of a codependent relationship is that there are helper(s) and then there is the individual suffering from some sort of pathological disorder.  The helpers in the relationship often maintain a caretaker role in family that goes above and beyond the normal loving, caring and nurturing.

It is important to understand that loving and caring for a family member who is sick is not codependency. Codependency occurs when this caring and love becomes maladaptive and becomes detrimental to members of the family. Once the relationship of codependency is established, several other things occur.

First, the caretaker in the relationship often assumes a martyr and victim role. They will often make sure that the other individuals needs are taken care of ahead of their own, while at the same time making it known that their needs aren’t being met.

Second, the relationship becomes beneficial for the individuals involved in the relationship. One person has their needs being constantly met by another person, while the other person feels that they are needed in order for that person to be functional. Finally, the dynamic of a “50/50 relationship” becomes skewed, with one member often being far more emotionally invested in the relationship than the other person. This creates a relationship where one individual is constantly giving, while the other is constantly receiving. This may be practical in the initial stages of codependency, but as the relationship progresses, it often causes resentment in either one or all of the individuals in the codependent system.

Misconceptions about Codependency
There are several misconceptions about codependency. The first misconception is that codependency only occurs between two people. Codependency can often be viewed in a family system context, meaning that codependency often involves every member of the family or social system. Individuals in the family or system may contribute to the codependent relationship in different ways, but when it is present in the family everyone is affected.

A second major misconception about codependency is that it only occurs in individuals that are affected by substance abuse. This is false as you often see individuals being “caretakers” in other relationships, especially when a family member or friend is suffering from depression, psychotic disorders, or personality disorders. Finally, codependency is not one sided. The individuals who are often being taken care of in the codependent relationship are either caretakers of others, or have been in the past. This dynamic often allows them to both exploit the others caring (while sick) and foster understanding (when treatment is sought).

Treatment of Codependency 
So what is to be done if you or someone you know is currently struggling with codependency? Fortunately there are several options, depending on the severity of the codependent relationship. If you believe the problem is relatively minor and can be worked through without the help of professionals, there are several self-help books such as Codependent No More and Codependence Anonymous which offer both insight and help on how to overcome codependency. Additionally, self-help groups such as Al-Anon, Codependents Anonymous (CoDA), and Families Anonymous can introduce you to others who are working through codependency.

If you believe the problem is more severe, therapy with a psychologist or counselor that is trained in family therapy can often be extremely helpful in understanding complex relationships, detangling the codependency, and teaching how create more functional relationships. Due to a greater understanding of codependency over the past decade, many treatment centers are now trained in treating this problem.

Monday, August 22, 2016

The Value of Consequences

the value of consequences in addiction recovery Life’s consequences can be valuable teachers. You learn lessons from consequences in childhood and this continues throughout our lives. When an incident or event occurs that causes pain, you are likely to avoid repeating the same behaviors that led to that pain occurring. In the case of addiction, consequences can be vital to the addict seeking recovery.

Often times it will take an addict experiencing the same mistakes and pain over and over again to be compelled to make a change. As a family member, this can be a stressful process to watch. Parents have a natural tendency to want to keep their children from experiencing pain and this doesn’t change much when they become adults. Most parents would certainly agree!

As the consequences from active addiction become more serious, it can become more and more challenging for a parent to refrain from bailing their adult children out of trouble. However, keeping an addict from experiencing the consequences of his or her actions can lead them to a dangerous state where they are less likely to initiate change in their own lives. As this destructive pattern continues, the addict learns that there is no real reason cease the destructive behavior associated with their using because they have had no real challenges to face as a result of that behavior.

It is recommended that parents or loved ones of addicts seek their own support, such as Al-Anon, while dealing with a family member in active addiction. Learning the difference between supporting someone’s recovery versus supporting their disease is an important distinction that must be made in order to keep from the dangerous consequences that can result from enabling the addict. Often times it takes years for family members, especially parents, to realize they have been enabling their loved one after all. Many recovering addicts today say that their change for the better occurred when their families stopped “bailing them out” and they were forced to face their problems associated with their using head on.

Monday, August 8, 2016

Dating in Early Addiction Recovery

dating early addiction recovery
It is no question that human beings are going to want to seek out and engage in romantic relationships. We were designed to be in relation with one another! The suggestion to stay out of a relationship for at least one year of sobriety is often discussed, but rarely ever followed! Here are a few reasons why you may want to reconsider this suggestion:

First, your first year in recovery is going to be filled with highs and lows; many describe this time as an emotional rollercoaster. In recovery, we have to learn new methods of coping, and that often takes some hard work and practice! For a person who has just begun to reestablish their self-esteem and confidence, engaging in a romantic relationship can really challenge this. It is risky to add an additional and significant life change such as this as you are much more susceptible to relapse if things go south in the relationship.

In addition, engaging in a relationship diverts our focus from ourselves to someone else. During this important time of self-growth, discovery, and development, being in a relationship can really take away from this crucial process. You may find yourself distracted from your meetings, stepwork, or other aspects of your “recovery routine” because you are more focused on your partner’s.

Don’t worry, though! The goal is certainly not to discourage recovering addicts to ever be in a relationship. Rather, it is to allow yourself ample time to engage fully in your recovery process, improve self-esteem and self-worth, and take the needed time and space for discovering who you are without the use of drugs and alcohol before starting to date. Many find that their hobbies and interests are quite different when they are not using. Recovering addicts will often report that what was appealing about a partner when they had a few months sober to a few years is extremely different. It is worth it to take the time to find yourself before you begin looking to find someone else!

Thursday, July 21, 2016

Adulting in Rehab

adulting in rehabTo most addicts, the idea of adulting in rehab may come as a shock as they begin to sever the enmeshment between their childlike, immature addict selves and their all-to-eager-to-enable parents. Why is it that we insist on clients doing chores? Making their beds each morning? Cooking and shopping for themselves? Paying for their own cell phone?

There are plenty of reasons why “adulting” in rehab is so important—not just to the overall recovery of the addict, but to their entire family system. As we embrace sobriety with a new mindset we do so with an intent on a new way of living. We attempt to move away from old, self-serving, self-seeking behaviors and embrace a life of service and humility. And part of that is allowing mom and dad “off the hook,” so to speak, for the life responsibilities they have been “taking care of” for us for years.

How do we help a family break free of these old habits? Well, it definitely requires work and commitment from all persons involved, but the most important leader in this pathway to change is the recovering addict themselves. We begin by asking how mom is doing when we make our weekly call from treatment, as opposed to belaboring the fact that we have run out of our favorite shampoo and how we simply cannot go on unless mom orders it for us. Or maybe we ask Dad about his recent recovery endeavors, as opposed to going on about how annoyed we felt with a peer the other day in group therapy.

Surely, this type of attitude change—a shift in focus—will take our families by surprise. “Where is my Susie that was always running to mom and dad with problems, asking for money and for us to fix it?!” Mom and dad may even need some coaching in order to embrace the addict’s newfound independence. As we know, the codependent, enabling behavior that came from parents was always in an effort to control the outcomes of the addicts lives, and thus, (in theory) releasing them of the anxiety of the thought of the addict making poor decisions for themselves. This (obviously) did nothing more than create a strenuous relationship between parent and adult child. As the parent tried to control more and more, the addict relied less and less on themselves for solutions in life as they became accustomed to mom or dad “fixing it” for them.

What other ways can we adult in rehab? By simply trying. We are not likely to gain full independence from our families in the short time we are in treatment, but we can surely make a start at it. By offering to pay for our own cell phone bill, being reasonable about our purchases (and requests), and making a commitment to earning and saving our own money, we take a step in the direction of adulting. And mom and dad, the take home message here is: LET THEM DO IT!!! At this point in the game, parents should be used to their children making mistakes—after all, they have wound up in rehab! And they are going to continue to make them throughout life. But parents who continue to try and always “fix it” end up doing their adult children a large disservice and inhibit the addicts “adulting process.” The idea of your daughter being more independent may be scary given her track record, but a little faith, support, and guidance (including attending Al-Anon), can go a long way in helping the addict discover a part of themselves they may never thought they possessed. And with this new attitude and confidence, they will gain momentum and believe that they can achieve their life goals (and then some) on their own after all.