Today I write from my heart based on my clinical knowledge and research in the behavioral health field and my own years of field experience. My latest book, Addiction in The Family: Helping Families Navigate Challenges, Emotions and Recovery is the guidebook I wish I had when I was first learning about substance use (addiction and mental health disorders) when I was a young woman. Addiction and mental health are subjects that are close to my heart so much so that when the phone rings I always answer. Most of the time on the other end is a concerned person calling because they just don't know how to respond to a loved one or client who is spiraling out of control due to a substance use disorder.I know those feelings because I grew up in a family where one never knew what would happen next, as addiction, mental illness, tragedy, and trauma prevailed.When I was approached to write this book about substance use disorders and the family, I felt energized, honored, and humbled. Little did I know that I would be writing in the midst of a global pandemic and widespread racial and civil unrest. Both matters have great consequences, and not unlike addiction, can hold one hostage. However, we all have steps we can take to remediate, to change and transform.Truth is, I was highly motivated to write—to make a difference. And now that it's written, I wish that someone could had given me this book when I was struggling to figure out what was going on in my own family, and provided me with guideposts that were easy to understand and use. I am humbled and grateful that I am able to do this for others through Addiction in the Family.This book is Family Focused and practical in that it teaches one how to set boundaries, deal with strong emotions, and teach you the best ways to communicate with your loved one. It is hopeful and full of real-life examples to help you understand your experience.The book is divided in to six easy-to-read chapters, which I invite you to skim or skip around. Each chapter is self-contained, offering education, real-life vignettes, talking points, and an easy self-care activity to try. The vignettes are based on real clients I have worked with, yet all personal information, names, and identifying characteristics have been changed to preserve and protect their privacy and confidentiality.Chapter 1 explains what substance use disorders are and how they affect everybody. In chapter 2, we'll discuss the many behaviors and family roles that one may assume in the face of a substance use disorder. Here we'll explore the addictions arsenal of denial, blame, manipulation, and secrets, as well as the differences between codependency and prodependence, as we learn how to empower our loved ones in healthy ways.Exploring treatment options is a mighty task. There are so many different options, and it's hard to know which is the right path to take. Chapter 3 will help you discover the many options available, and the benefits of consulting with an unbiased professional to help you make the right decision. We'll also explore ways to talk with a loved one about seeking help.We all know life is messy; it's no surprise that the road to recovery is likewise full of speed bumps, hiccups, and green, yellow, and red lights. Chapter 4 offers insights as to the meaning of recovery, the emotional roadblocks to recovery, and how to grow as a family member and best support your loved one. Chapter 5 discusses the importance of self-care in the midst of a loved one's substance use disorder, and how to incorporate self-care into daily living. Finally, chapter 6 celebrates the hard work you and your loved one are doing, and sets the stage for building resiliency, celebrating yourself, and discovering joy.Along the way, you'll be invited to experiment with some effective self-care activities, ranging from developing a gratitude practice, hitting pause, taking five, and breathing, to mindful meditation, walking, journaling, and being of service.While Addiction in the Family focuses primarily on substance use disorders, it is also relevant for those whose loved ones experience process disorders (for example, digital, shopping, gambling, eating, or sex addictions), as well as those who experience co-occurring mental health disorders.Thank you for reading, I am honored and humbled that you stopped by today. I invite you to share your journey with me. Please contact me at 619-507-1699, DrStanger@allaboutinterventions.com. You have my word that I will always greet you with kindness and professionalism. It is my goal to inform, inspire, education, and help your family heal.Addiction in the Family is available on Amazon.
Sunday, January 31, 2021
Thursday, January 28, 2021
A Temporary Suicide
“Men intoxicated are sometimes stunned into sobriety.”- Lord Mansfield (1769)Today marks five years since I had my last drink. Or maybe yesterday marks that anniversary; I’m not sure. It was that kind of last drink. The kind of last drink that ends with the memory of concrete coming up to meet your head like a pillow, of red and blue lights reflected off the early morning pavement on the bridge near your house, the only sound cricket buzz in the dewy August hours before dawn. The kind of last drink that isn’t necessarily so different from the drink before it, but made only truly exemplary by the fact that there was never a drink after it (at least so far, God willing). My sobriety – as a choice, an identity, a life-raft – is something that those closest to me are aware of, and certainly any reader of my essays will note references to having quit drinking, especially if they’re similarly afflicted and are able to discern the liquor-soaked bread-crumbs that I sprinkle throughout my prose. But I’ve consciously avoided personalizing sobriety too much, out of fear of being a recovery writer, or of having to speak on behalf of a shockingly misunderstood group of people (there is cowardice in that position). Mostly, however, my relative silence is because we tribe of reformed dipsomaniacs are a superstitious lot, and if anything, that’s what keeps me from emphatically declaring my sobriety as such.There are, for sure, certain concerns about propriety that have a tendency to gag these kinds of confessions – I’ve pissed in enough alleyways in three continents that you’d think the having done it would embarrass me more than the declaring of it, but here we are. There’s also, and this took some time to evolve, issues of humility. When I put together strings of sober time in the past, and over a decade and a half I tried to quit drinking thirteen times, with the longest tenure a mere five months, I was loudly and performatively on the wagon. In my experience that’s the sort of sobriety that serves the role of being antechamber to relapse, a pantomime of recovery posited around the sexy question of “Will he or won’t he drink again?” I remember sitting in bars during this time period – I still sat the bar drinking Diet Coke during that stretch – and having the bartender scatter half-empty scotch tumblers filled with iced tea around the bar so that when friends arrive, they’d think I’d started drinking again. Get it?! So, this time around I wanted to avoid the practical jokes, since in the back of my mind I’d already decided that the next visit to the bar wouldn’t necessarily have ice tea in those glasses. Which is only tangentially related to my code of relative silence for the last half-decade – I was scared that the declaration would negate itself, and I’d find myself passed out on my back on that sidewalk again. So, at the risk of challenging those forces that control that wheel of fate, let me introduce myself – my name is Ed and I’m an alcoholic. Here's the thing though: for many addiction specialists, five years marks long-term recovery. Very few who try get here, and not everyone who does stays here, but by some strange combination of luck, contemplation, and white knuckles I’ve strung together one day after another and if not exactly proud (well, a little) I’m more than anything amazed. Because had you asked me even a weekend before my last drink, when I purchased an old-fashioned cocktail shaker for myself as a gift marking the start of a new semester, if I could have conceived of a month without drinking, much less five years, it would have been unimaginable. During a previous attempt to dry out I contemplated the idea of having a designated wet weekend each month when I’d lock myself away without computer or cell phone and get shit-faced black out drunk because the idea of a life without alcohol seemed so impossible, and now I’m the sort of person who wakes up every day at dawn (and not on the sidewalk this time). I can count the days before my sober anniversary each year like part of the liturgical calendar, often made possible by social media’s annoying tic of reminding you of every bad decision you’ve ever committed, so that I can chart the last time I drank with this or that drinking buddy, the last time I went to the bar after work, the last time I drank on the patio of my apartment complex. What always strikes me is how that morning of the last drink, when I got up, I was looking forward, as I always did, to go to the bar. My quitting, thank God, was never planned. Had it been I doubt it would have taken.If you detect a hint of nostalgia like the tannins in a glass of chianti, you’re not amiss. They call it euphoric recall, the way a brain the consistency of Swiss cheese can edit out all of the bad things, the embarrassments, the traumas, the pain, but only remember the conviviality, the solidarity, the ecstasy. The way in which you recall the electric hum in the skull when sitting like a god with your broken shoes on the brass rail, staring at a neon sign and feeling infinite; but not the pile of vomit on your chest, surprised that you haven’t choked to death. The memory of all of the friends you made at dives around the world, but not that nothing either of you said was worth remembering. The feeling of instant, almost supernatural, relief the moment a lager, a shiraz, a scotch hits your tongue, but not the shaking hand that brought the glass to your lips. The sense that accompanies drunkenness which holds that within the next fifteen minutes the most amazing things were going to happen, that limitless potential always was about to occur, but not that it never did. Sobriety becomes possible when you begin to remember the bad that outweighed the good – when you continually force yourself to understand that.Now some people may wonder why you don’t just avoid all of that stuff, why you can’t just moderate. As the dark joke goes, if I could moderate my drinking, I’d get drunk every day. I used to make a big deal about how angry I was that I couldn’t just have a drink or two, that there was such privilege in being able to wax poetic about the vagaries of hopiness levels in India Pale Ales without publicly shitting yourself, of being able to savor the peatiness in a single malt Laphroaig without stumbling back home unremembered to yourself and the world, but I never really wanted those things. Anger was performative for the counterfeit stints in sobriety, when the real thing happens and you know it’s dryness or death, then different emotions emerge. And the truth is that because I have no interest in drinking that way, in moderation, I begrudge nobody who wants to do it, who can do it. I suspect that moderate drinkers have never concocted baroque rules of order around drinking based in how much of which thing you can drink in what location for what amount of time (which you still break anyhow). I suspect that moderate drinkers never fear that the moment alcohol hits their lips that they’re ceding part of their sovereignty, not the part of their soul which keeps them from stumbling out into traffic so much as the part of their soul that cares. I suspect that moderate drinkers always know for sure that, barring the regular kind of calamity, they’re certain to come home safely at the end of the evening (probably before the nightly news).I’m not angry – at all – over the existence of the moderate drinker. What I am is confused. I don’t understand that aspect of them, I can’t grasp their reality. Once you started drinking how could you not want to keep doing it? How could you not pursue oblivion or extinction unto joy, or at least the pretending of it? For me, the thought of half a pint is anathema, the idea of not sucking the ice cubes clean of whisky is confusing. This is not to say that I was completely incapable of putting the glass down, of leaving the bar at four in the afternoon and being able to twitchily abstain until dinner drinks. This is not to say that responsibility, or duty, or love couldn’t compel me to stave off a binge, nor is it to say that all drinks (or, honestly, even most) would result in a mad spree of boozing. You don’t necessarily pour the bottle down your throat every time. What it says is that once the cork comes out, there’s always a sense of being not-quite-right unless you’re chasing your chaser with a chaser, playing the drinking game of taking a shot for every time you take a shot. You can force yourself to not take that next drink (except of course for those times when you can’t), but you’re forever itchy, at least until the djinn is out of your system.There has always been a sense, as I think Carl Jung (or somebody similarly evocative) put it, that alcoholism is a physical solution to a spiritual problem. While I’m loathe to romance the affliction that much, for it simply exonerates too many assholes, I doubt that anyone who is an addict doesn’t at least share in some sense of incompleteness, that liquor plugs a hole in the spirit which of course comes rushing out all over the floor. For most people, I’ve heard, alcohol is something that accompanies food, or celebration, or unwinding, that occasionally there’s a bit of giddiness at having imbibed a bit too much – that some of these folks even have stories about that time, or even a dozen, when they had a bit too much in college, or at a birthday party, or a wedding. Alcoholics have a different relationship to liquor, an understanding of why spirits are called such. “I had found the elixir of life,” Alcoholics Anonymous founder Bill W. wrote in recounting the first time he got high from some Bronx Cocktails served at a party in 1916. Later, in the “Big Book,” which constitutes the scripture of AA, he writes that “Gradually things got worse.” Same as it ever was.Every drunk is in an abusive relationship with this thing they think they love, and which they dangerously hope loves them back. A lot of fantasizing, mythologizing, and philosophizing can surround justifications of drunkenness (or then again, not); a lot of denial, and the assumption that you have any agency in this thing tend to be even more universal to the disease. But the result is all the same. I’ve heard a lot of people in recovery say that they hated drinking, but that was never exactly my experience. I hated what it resulted in, the ruined friendships, the uncertainty, the physical ailments, the strange fear at 25 that 30 might not come, the knowledge at 30 that 35 definitely won’t. But here’s what I loved – the fraternity of talking, talking, talking (even if it’s nonsense), the courage to belt out the lyrics to “Thunder Road” at inopportune moments, feeling the almost mystical materiality of the bar’s surface (every warp and swirl imbued with infinity), the sense of adventure and limitlessness, even while doing nothing. Here’s what I hated – shaking, shaking, shaking (never nonsense), being surprised that you’ve woken up again, laying hungover in bed and pretending to be a corpse, the delirium tremens for when you try and dry up a bit and you see those flickers of blackness in the corner of your eye, checking your shoes for evidence of what route took you home, checking your email outbox to make sure you didn’t send the wrong message to the wrong person (or the wrong message to the right one), the shame at having gone out for one or two and having imbibed twenty. The dangerous situations, the emergency rooms, the police. How do you square that madness of loving what it does to you for a few hours while suspecting that it’s killing you? I’ll have another round. The best description I know comes from my fellow Pittsburgher Brian Broome in an essay from The Root: “I miss getting drunk, but I don’t miss being a drunk.”I’ve put that into my arsenal of magic incantations which I carry around in my skull and as of yet have prevented me from picking up a drink in 1,827 days: “Play the tape forward,” “I’m sick and tired of being sick and tired,” “If drinking caused you problems then you have a drinking problem,” “A pickle can never become a cucumber,” “One drink is too many because all of them is never enough,” “Lord grant me the serenity…” If recovery is built out of anything, then it’s built with the bricks of cliché and the mortar of triteness. That’s not a bug, it’s the feature, and it’s why it works. I’m obviously not the first person to notice this; David Foster Wallace says as much in Infinite Jest when he observes that the “vapider the AA cliché, the sharper the canniness of the real truth it covers.” Recovery slogans are like axioms from some ancient wisdom gospel, they’re a jingle-jangly hard-boiled poetry written in a noir vernacular, and as dumb as some of them are the knowledge that “Nobody wakes up wishing that they’d drunk more” has miraculously kept me from picking up that first bottle.When I drank, and had that resentment of recovery language that only an alcoholic with a bit too much self-knowledge can have; those sayings seemed like the bars of a cage to me. Now I know that they’re the ribs in the belly of a life-boat. That’s not to say that I’m endorsing any program of recovery, or admitting to being in any myself, other than acknowledging that I’ve read wide and long on the subject, and I try to approach it with some humility, take what works for me and leave the rest. What I’ve found is that intentionality is crucial, for it’s the cavalier, the laid-back, the lackadaisical that caused me such grief. Again, I tried to “quit” thirteen times before it seemed to stick a little; I tried to moderate almost every time I drank (except when I didn’t try). There is a tendency towards amnesia, a valorization of the good times, and the bracketing out of the awfulness was a wet brain’s survival strategy. Everything was an exception, an extenuating circumstance, an anomaly. The obviousness that drinking was at the core of virtually every awful, dangerous, or depressing thing in my life since I started drinking at the age of 17 was easily overlooked in favor of the idea of a beer (beers) at a ballgame or a shot (shots) after last call.Because the idea of choice is so complicated in alcoholism, I’ve long interrogated at what point the desire to drink became a compulsion. In every evening there is the drink that saturates you, the hinge point when you’re already strategizing which bar you’ll grab another six pack from on your perambulation home from the first bar (the third one, maybe), but I wonder if there is one cosmic drink in life that shifts you from the weekend warrior into the sort of person that people wouldn’t be surprised to hear had choked to death on their own puke. Was it the first Bloody Mary that I had after that time an ex-girlfriend passed out face down on a Pittsburgh sidewalk, a crowd of our best friends whom we’d met for the first time just that night standing around a half-remembered house somewhere in Shadyside, an ambulance spiriting us both through the summer night? Perhaps it was the Yuengling I had a few days after I nearly broke my ankle on a slick of Pennsylvania ice, forced to walk on crutches for two weeks because I chose to protect the six pack that I was walking home with rather than bracing my own fall. Or maybe it was that Guinness that I drank in about a minute in a Greenwich Village pub, after nearly five months of sobriety, convinced that I was all better, even though that summer a liver sonogram had indicated that there were fatty deposits surrounding that beleaguered organ like a ring of gristle around a raw steak. You’d think that the indignity of sitting in that waiting room, in the presence of joyful expectant mothers and framed pictures of new born infants on the office wall, to learn that my dangerously high liver enzyme levels were a sign of exactly what my doctor was worried about, would have staved the need to drink. And it did, for a bit, for around twenty weeks, until a New York bar convinced me otherwise. I drank for three more years after that. Poet Denise Duhamel writes about the sort of spirit that animates that madness in her appropriately named lyric “The Bottom.” She recounts a drunken late-night stumble to a liquor store for (another) handle of Smirnoff, when two men in a truck try and abduct her off the street. The narrator is able to dodge the men, running up the hill (and away from El Prado Spirits), suffering at worst some trash thrown at her and screamed obscenities. When she makes it to the store, the clerk at the counter asks if she is alright, and the narrator lies, since the possibility of having to file a police report will only stall the entrance of ethanol into her blood stream. “I stopped drinking,” Duhamel writes, “when I realized I was fighting/for the vodka at the bottom of the hill/more than I was fighting against the terrible/things that could have happened to me.”That’s the most succinct and truthful encapsulation of the disease which I’ve ever read. There is finally that very unsweet spot of fearing that you can’t live without alcohol while also knowing that it will eventually kill you. Sobriety is the strange inverse of drunkenness, and as every person in recovery is haunted by the ever-present threat of relapse, so I remember that while an active drunk I always wondered what was going to be the drink that finally brought it all to a close (in any sense of that phrasing). My last summer of active drinking certainly felt more extreme to me – I’d seen my father die of cancer only a few months before I quit, I was mired into the sort of depression that doesn’t even allow its own philosophizing (or indeed recognizes its own face in the mirror, mistaking falling for flying) and even the general mood of the country seemed to shift towards something darker (that same something that we’re all still in). In that apocalyptic summer of receipts found in my pockets from bars that I didn’t remember having gone to, and of scraps and scabs from falls barely considered, there was a sense of rushing towards something – and so I was. As Duhamel writes, “I stopped drinking even before I had that last sip, /as I ran back up the hill squeezing a bottle by its neck.”Rock bottoms are a personal thing, but the stories, in an archetypal way, are strangely similar. That’s one of the things you learn to appreciate in recovery; a respect for narrative’s elemental basicness. In various Midtown church basements I’ve heard stories of last drinks that were precipitated by things as dramatic as manslaughter and DUIs, to one Upper East Side socialite who admitted that she had to quit after she forgot to feed her beloved Yorkshire Terrier (I understand this, innately). The nadir of your drinking is, as they say, when you quit digging, and there’s a final freedom in that defeat. What distinguished that final drink, the one that I can’t remember (it was either a G&T or a beer, based on that summer)? Certainly, it was the consequences, the being shepherded to the hospital. But worse things had happened to me. When I called a friend to pick me up at the ER an hour or so before dawn, I can still remember keying into my building and thinking about what a great bar story this would make for all of my drinking buddies next time we went out.The morning was like a thousand other ones; my mouth dry and my head pounding, I would lay in bed and cinematically pretend to be dead, mildly surprised to still be alive. I was in the early stages of dating a woman who would become my wife, and I knew that continuing in this way would kill the relationship; I had been languishing for the better part of a decade in a doctoral program, and I knew that continuing in this way would kill my career; I had been harboring moleskin fantasies of being a writer, and I knew that continuing in this way would keep those dreams forever embryonic. Because the drinking itself was worse than normal, I called a friend of mine from back home who was never one for knocking them back, and I recounted the usual litany. How my intestines were embroiled and my hands shaky; my memory incomplete, and my guilt unthinkable. Of how I was greeted every hungover morning by “The Fear,” that omnipresent specter of shame, fear, and uncertainty. This friend (he knows who he is) was used to these phone calls, having fielded dozens of them over the decades, and he was always uniformly supportive and sweet, listening with concern and seemingly devoid of judgment. On this day he said something that if he’d mentioned it before, had never stuck – “You know, you never actually have to feel this way again.”I'm not big on Road to Damascus moments, but that simple observation clarified, explained, and encompassed everything. I haven't had a drink since. When you're an active alcoholic, you always expect that something great is going to happen in the next 15 minutes, but that that moment is forever deferred. It’s also true that sobriety delivers what drunkenness promises. There are things bigger than me, more important than me. My relationship with my wife (who has made this possible); now my relationship to my son. Sobriety isn't always easy, but it's always simple. My life is such that I could have scarcely imagined it that shaky day in 2015. My life isn't just different because of sobriety - it's possible because of it. There are certain conventions to this form, what people in recovery sometimes lovingly (or not so lovingly) call the drunkalogue. It’s a venerable genre, the redemption narrative, the recounting of how it was, what happened, and how you changed. Your experience, strength, and hope, etc. The didacticism is precisely the point, but the broad interchangeability of the form is also crucial. Because in all the ways that I’m different, I share something with all of these other people, with the people who got clean, but crucially also with the ones who didn’t. It’s that ultimately this beast inside you is so thirsty, that soon it’ll devour you as well. For those of you reading – the drunks, the junkies, the addicts, the alcoholics, the dipsos, the losers, the hopeless cases; to the ones who can't quite remember coming home or who need an eye opener, to the ones who’ve alienated everyone they know and most of the people that they don’t, to the ones the ones who scarcely know a sober night, to the ones who need a drink to turn the volume down and are scared of putting the glass on the counter forever – I understand you. What you need to know is that you never need to feel that way again. Be well.
Monday, January 25, 2021
Breaking Free from Codependence
Do you find that you’re always the one giving — to friends, strangers or loved ones? If you’re always giving but getting little back in return, you might be in a codependent relationship. Many people who are in treatment for addiction or who come from families with a history of substance use disorder develop codependency, which can last even after their substance use has been addressed.Getting treatment for codependency can help you develop healthier, more balanced relationships. Here’s what you should know about this condition, which often goes hand-in-hand with addiction.What is codependence?The American Psychological Association defines codependence as “a state of being mutually reliant.” While that might not sound too bad, that mutual reliance often morphs into the second definition of codependence: “a dysfunctional relationship pattern in which an individual is psychologically dependent on (or controlled by) a person who has a pathological addiction.”Of course, we all rely on our loved ones to some extent. Identifying the line between a healthy relationship and a codependent one can be tricky, particularly if you haven’t grown up with examples of what healthy relationships should look like.Co-Dependents Anonymous (CoDA) maintains a list of behaviors that are common for people who are codependent. People who are codependent will often:Minimize or deny how they feel: “Oh no, it’s fine that you borrowed my car and returned it without gas.”Struggle to make decisions, and seek others’ approval: “I don’t know what to wear. What do you think of this outfit? Will it be acceptable?”Put other people’s needs ahead of their own: “I don’t want to go to that party, but I know that my friend will be upset if I RSVP no, so I’ll go anyway.”Codependence isn’t just in romantic relationshipsPeople often think about codependence when it comes to romantic relationships. However, codependence can manifest in any relationship, or in multiple relationships. You might be codependent with your romantic partner, but repeat those patterns with friends, siblings or children.Oftentimes, codependence is linked with addiction. The codependent person — often a partner or parent — might think that they alone can keep the person with substance abuse disorder from succumbing to their disease. They often provide support, without setting up healthy boundaries and consequences. While this is done under the guise of being supportive and loving, it can be harmful to both people in the long term.The link between codependence and domestic violenceCodependence often comes into play in relationships that experience domestic violence. But it’s not just the victim of the violence who can be codependent — abusers can also display this unhealthy relationship trait.Some people mistake codependency for passiveness, but that isn’t always the case. People who are codependent can exhibit a range of behaviors found in abusive relationships, according to CoDA, including:Using blame and shame to control or influence what their partner is feelingStaying in dangerous situations too long out of loyaltyBelieving that they’re above or better than other peopleExpressing pain as angerDemanding that others meet their emotional needsOvercoming codependencyWorking with a qualified professional can help you understand the role of codependency in your life. Oftentimes, treating codependence means learning new ways of expressing love, and unlearning harmful relationship patterns that may be as old as you.Peer support is also available to people who are navigating codependency. CoDA is a 12-step program that’s specifically for people experiencing codependence. However, there are also other options that might be more readily available in your area. Programs like AlAnon, for people who love someone with substance use disorder, aren’t specifically for codependents, but touch on the importance of healthy boundaries.It can be scary to seek treatment for codependence. It’s important to know that learning a healthier way of having a relationship doesn’t mean that you have to give up on your loved ones. In fact, with boundaries and coping mechanisms in place, you can have healthier, more emotionally fulfilling relationships with the people you love.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.
Friday, January 22, 2021
Understanding Dependence Versus Addiction
Opioids are powerful substances, whether they’re being used in a medically-sanctioned way or abused. Any opioid is likely to have an impact on your health and wellness, but how that plays out will vary greatly. Most people who use opioids regularly will experience some level of physical dependence, and others will develop opioid addiction.Understanding the difference between physical dependence and opioid addiction can help you find the treatment that you need.What is opioid dependence?To understand physical dependence, you need to understand a bit about how opioids work in the body. Opioids attach to opioid receptors. Normally, these receptors can be used to send pain signals; having opioids bound to them prevents pain signals from being sent. That’s why opioids are commonly prescribed for pain.However, over time your brain adjusts to the opioids that you’re taking — even if you’re following doctor’s orders. You might need more opioids to experience the same pain relief.The brain changes that happen as a result of taking opioids can lead to opioid dependence. The Centers for Disease Control and Prevention defines dependence as experiencing withdrawal symptoms when you stop taking an opioid medication or using illicit opioids. Symptoms of opioid withdrawal can include anxiety, nausea, diarrhea and sweating.Over time, if you continue to take opioids — whether prescribed or illicit — you’ll likely need more and more opioids to feel normal and avoid the symptoms of withdrawal. This is because your opioid tolerance has increased. That can lead to addictive behaviors.What is opioid addiction?Opioid dependence is a physical condition brought about by brain changes, whereas opioid addiction is a condition that can happen as your physical dependence becomes more acute, according to Waismann Method® Opioid Treatment Specialists.Addiction to opioids is a pattern of physical and emotional responses that stem from your physical dependence on opioids. As you try to avoid withdrawal symptoms, your behaviors can change. This can have a devastating impact on your life and impact your career, friendships and family relationships.People who are experiencing opioid addiction can display uncharacteristic behaviors, like:Ignoring responsibilities to family or work because you are focused on obtaining opioids.Having trouble controlling your emotions or behaviors.Fixating on how and when you will next be able to obtain opioids.With time, these symptoms of addiction can erode the bedrock of your life.Treatment for opioid dependence and addictionWhether you are struggling with opioid dependence or full-blown opioid addiction, the first step toward treatment is detoxing from opioids. Detox is the process of removing opioids from your body, so that you no longer need opioids to function at a normal level.Detox can be painful, because it brings about the symptoms of withdrawal. However, there is a medical detox option that provides the highest level of comfort available. Rapid detox allows your body to be flushed of opioids while you are under anesthesia in a fully-accredited hospital. Because you’re sedated, you don’t feel the acute symptoms of withdrawal. Using a combination of medications, detox can happen much more quickly than it would under normal circumstances if you tried to detox on your own.Addressing physical dependence is only one step toward recovering from opioid addiction. After you have detoxed from opioids, you can address the pain — whether physical or emotional — that drove you to use opioids in the first place.At Waismann Method®, people who undergo detox receive continued care at Domus Retreat, where they can make a plan for an individualized approach to life in recovery. There are no set schedules or required meetings, but there is space to rejuvenate and recover, and guidance toward the next steps that are right for you.A dignified approach to treating opioid dependence and addictionWaismann Method® understands that opioid addiction is rooted in the physical brain changes that take place when opioids enter your body. Furthermore, addiction often results from using drugs to cope with underlying physical, emotional or mental health issues. There is no shame or blame in treating opioid addiction — just an understanding that no matter your past, you can have a new opioid-free beginning.
Tuesday, January 19, 2021
The Role of Psychedelic Plant Medicines in Addiction Treatment
Psychedelic plant medicines have the potential to help many people who are in recovery from substance use disorder dig deep into the roots of their addiction and come out of the other side. Plant medicines like psilocybin, ayahuasca, and particularly ibogaine, have demonstrated unprecedented results for those who use them as a tool on their recovery journey.While the legal status of many of these substances is still murky (depending on where you consume them), the ongoing research, decriminalization efforts, and shift in public narrative is promising. Hope lies on the horizon for wider access to these medicines, but right now, what’s needed is raising awareness and informed decision-making around their consumption.Here is how psychedelic plant medicines can help those that struggle with addiction and what people should consider before choosing this path.Ancient healing practices reconcile with modern sciencePsychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. Research around the potential of ibogaine to treat opiate addiction is still in its infancy, but shows promising results. Ibogaine, which comes from the Iboga shrub, has been used historically in ceremonies in West Africa by practitioners of the Bwiti spiritual tradition since the late nineteenth century. The roots and bark of the tree are consumed ceremoniously in large doses to provoke a near-death experience, and in smaller doses during rituals and tribal dances. It is not considered a recreational substance by users, yet is classified as a Schedule 1 drug in the US.One 2017 study funded by the Multidisciplinary Association for Psychedelic Studies (MAPS) observed opiate addiction treatment delivered by two independent ibogaine clinics in Mexico. One month after the study, half of participants reported using no opiates in the month following the study. The researchers found that “ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful.” Another study on the long-term efficacy of ibogaine-assisted therapy in New Zealand found that a single ibogaine treatment reduced opioid symptoms and resulted in no opioid use or reduced use in dependent individuals over 12 months. Healing that gets to the rootAyahuasca is a psychoactive Amazonian brew traditionally used in the indigenous communities of South America. Research on the brew is grounded in its potential to support healing by allowing for a deeper connection to oneself and due to the spiritual context in which it is taken. One 2017 study published in the International Journal on Drug Policy used qualitative analysis through long-term field work and participant observation in ayahuasca communities, as well as conducting interviews with participants with problems of substance abuse.The study found that “ayahuasca’s efficacy in the treatment of addiction blends somatic, symbolic, and collective dimensions. The layering of these effects, and the direction given to them through ritual, circumscribes the experience and provides tools to render it meaningful.”Researchers from a 2013 Canadian study, sponsored by MAPS, concluded that ayahuasca-assisted therapy for stress and addiction was correlated with improved mindfulness, empowerment, hopefulness, and quality of life-outlook and quality of life-meaning. The same study found that ayahuasca, when administered in a ceremonial setting, may have contributed to reduction in cocaine use in dependent participants.There have also been studies that show the benefit of psilocybin mushrooms in allowing people to overcome addictive or damaging behavior. A 2014 study from the Johns Hopkins Center for Psychedelic and Consciousness Research found that 80% of previously addicted smokers abstained from smoking six months after they were administered psilocybin. Remarkably, 60% continued to abstain two and a half years after the study.“Institutions like MAPS and the Imperial College London are pioneering the way forward with this evidence-based approach to psychedelic medicine—a necessary effort if these compounds are to be integrated into the mainstream,” said Gaurav Dubey, clinical biologist and content editor at Microdose Psychedelic Insights.“Though, we have a lot of catching up to do,” said Dubey. “We need to do better in understanding the psychotherapeutic mechanisms of these incredibly unique compounds and the only way to uncover that is through science and research.“The clinical data that strongly supports the therapeutic use of these compounds in addiction treatment will be fundamental in making them accessible to recovering addicts around the globe,” he added.Journeys to an addiction-free life, supported by plant medicinesKat Courtney is the founder of AfterLife Coaching, a trained ayahuasquera, and has been working with the plant medicine ayahuasca for over a decade. Courtney first began her journey with ayahuasca in Peru in 2006, while suffering with alcoholism and bulimia.“Not only did ayahuasca help me face and deal with the traumas and programming that created these destructive behaviors, she helped me access an authentic space of self love and gave me tools to work with in lieu of the addictions,” said Courtney.“They fast-track the healing and awakening process and ground us into our bodies so we can move past stages of self-destruction. They help us to move the trauma that is stored in the body through crying, purging, and all kinds of different forms of release.”But Courtney stresses that the act of taking these medicines is only part of the deal: “We absolutely have to be committed to integrating these experiences and making the life changes that support sobriety,” explained Courtney. “Otherwise, plant medicine ceremonies can become distant memories.”Alternative approaches offer a chance for healingAeden Smith-Ahearn is the founder of Experience Ibogaine Clinic, based in Mexico. Aeden first tried ibogaine in an effort to overcome his dependency on multiple substances, including heroin. “Ibogaine got me comfortably off opiates,” said Smith-Ahearn. “I had almost no withdrawal symptoms, and I had a very profound experience which helped give me a motivational boost in the right direction.“The medicine put me in my place, and that’s exactly where I needed to be. I got a fresh start, on top of a head start into my recovery,” he explained.Prior to his ibogaine experience, Smith-Ahearn had tried several programs in an attempt to break free from his addictions, which he describes as “cold turkey, three meals a day, and a therapist once a week.”“These programs work for many people, but they didn’t do the job for me. The problem was that I did not want to change, and was therefore unwilling to work towards something I didn’t want,” he said.Smith-Ahearn credits ibogaine with huge potential for recovering opiate addicts specifically because of how it interacts with the brain’s receptors. “The hardest part about breaking out of opiate addiction is getting over withdrawals,” he said. “The medicine alleviates withdrawal symptoms [for some patients], which is a godsend for someone who is in over their head with opiate addiction.”Like Courtney, Smith-Ahearn stresses that ibogaine is not a cure-all. “It’s crucial that patients of the treatment put their effort into a quality aftercare plan.”Charles Johnston, director of client success at Clear Sky Recovery, has also historically struggled with opiate addiction and subsequently used ibogaine as a tool to help him overcome his dependency.“Ibogaine was the medicine that interrupted my addiction, and for the first time let me fully witness the root cause of my addiction: self-hatred. It provided me with a path, purpose, and mission to support others and see that addiction is a blessing of self-discovery,” explained Johnston.“Ibogaine allows the individual to feel how they would after months of detox with conventional methods and if supported properly, encourages a whole new paradigm of accountability and acceptance,” he continued.With these and other accounts of personal transformation, it’s clear that ayahuasca and ibogaine have potential to assist people struggling with addiction on a path to recovery. However, these treatments should not be treated lightly and come with a number of risks to the patient if not administered responsibly.What you need to consider before trying psychedelic therapyPsychedelics generally have very little risk of abuse, but when taken in the wrong setting, or without proper guidance or structured preparation and integration, they can result in negative consequences.There are some short term health risks which are important to consider. “Using ibogaine comes with risks to your physical health, such as seizures, gastrointestinal issues, heart complications, and ataxia,” says board-certified psychiatrist and addiction specialist Dr. Zlatin Ivanov. “There have also been unexplained fatalities in people who have ingested ibogaine, which may be linked to the treatment.”Charles Johnston of Clear Sky Recovery explained that “if someone has heart issues, liver problems, other major health complications, serious psychological issues, or are expecting a quick fix, ibogaine may not be the right path.”The same largely goes for users of other plant medicines, including ayahuasca. Users of SSRI antidepressant medication have run into an adverse reaction while drinking the medicine with the drugs still in their system.“People need to do careful research and not fall foul of misleading things that they see on the internet. A lot of people have expectations that the medicine may not offer, like profound psychedelic experiences guaranteed to change them or no withdrawal whatsoever,” said Aeden Smith-Ahearn of Experience Ibogaine.Those seeking treatment with psychedelic plant medicines should make sure they go to a reliable and reputable center. In recent years, the number of tourists flocking to Peru to drink ayahuasca has boomed, resulting in illegitimate retreats run by people lacking in the experience required to administer the medicine.In many countries, including the US, these substances are illegal to consume. Many people do however seek out treatment in countries where the medicines are not outlawed, such as Mexico, Costa Rica, Peru, and Colombia. In the US, ayahuasca is legal within specific religious groups, such as the Santo Daime.A path to accessibilityLooking ahead to the future of psychedelic treatment, progress is being made on the legalization front, with Oakland and Santa Cruz, California, and Denver, Colorado, voting for decriminalization of psilocybin-containing mushrooms in 2019 and 2020. Oregon and Washington D.C. also have votes ahead on the decriminalization of psychedelic-containing plants and fungi.Meanwhile, Canada is seeing a number of legal ayahuasca centers open up, on the part of religious groups who have special permission from the government to use the medicine. However, ultimately, it will be a continuation of the scientific research that paves the way for increased access to psychedelic therapy.“We need more large scale, gold-standard clinical trials examining these compounds in the context of addiction treatment, such that their impact can no longer be ignored—even by the most stubborn of policymakers and world leaders,” said Dubey.“There needs to be a shift in global drug policy so these powerful medicines can be reclassified and reintegrated into our society in an effort to heal the masses.”In essence, psychedelics need to go mainstream and lose the stigma that they have held for decades so that the public appetite can develop and further drive policy changes. In addition to research, diverse voices and experiences, along with mainstream support, will be key in the psychedelic renaissance maintaining its momentum.The value of psychedelic plant medicines for addiction recovery is difficult to overstate, but is a path that should be explored carefully, mindfully, and while armed with the right information and support. And there’s hope that a future where accessibility isn’t an issue is on the horizon: The ongoing research and changing societal attitudes towards psychedelic plant medicines demonstrate promise. Education around these medicines and their proper use is vital for this renaissance to continue.By shining a light on the potential of psychedelic plant medicines to help and heal, we can contribute to forming more pathways to change and legitimate channels for people to benefit from their treatment.
Saturday, January 16, 2021
For Pregnant Women, Stigma Complicates Opioid Misuse Treatment
New and expectant mothers face unique challenges when seeking treatment for an opioid use disorder. On top of preparing for motherhood, expectant mothers often face barriers to accessing treatment, which typically involves taking safer opioids to reduce dependency over time. The approach is called medication assisted therapy, or MAT, and is a key component in most opioid treatment programs.But with pregnant women, providers can be hesitant to administer opiate-based drugs.According to a study out of Vanderbilt University, pregnant women are 20% more likely to be denied medication assisted therapy than non-pregnant women.“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak of the Wright Center for Community Health in Scranton, Pennsylvania.The health center serves low-income individuals who are underinsured or lack insurance altogether, many of whom struggle with opioid misuse.“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak, who is a board certified addiction medication specialist.On this episode of the podcast, we speak with Dr. Hemak about whether medication assisted therapy is safe for new and expectant mothers and how the Wright Center is helping women overcome opioid dependency during pregnancy.Direct Relief · For Pregnant Women, Stigma Complicates Opioid TreatmentListen and subscribe to Direct Relief’s podcast from your mobile device:Apple Podcasts | Google Podcasts | SpotifyDirect Relief granted $50,000 to The Wright Center for its extraordinary work to address the opioid crisis. The grant from Direct Relief is part of a larger initiative, funded by the AmerisourceBergen Foundation, to advance innovative approaches that address prevention, education, and treatment of opioid addiction in rural communities across the U.S. In addition to grant funding, Direct Relief is providing naloxone and related supplies. Since 2017, Direct Relief has distributed more than 1 million doses of Pfizer-donated naloxone and BD-donated needles and syringes to health centers, free and charitable clinics, and other treatment organizations.Transcript:When it comes to getting treatment for an opioid use disorder, pregnant women have an uphill battle.Most patients undergoing opioid treatment are prescribed safer opioids that reduce dependency while limiting the risk of overdose and withdrawal.This kind of treatment is called medication assisted therapy, or MAT.But with pregnant women, providers can be hesitant to administer opioids.According to a study out of Vanderbilt University, pregnant women are 20% less likely than non-pregnant women to be accepted for medication assisted therapy.“In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak.Hemak is a board-certified addiction medication specialist and CEO of the Wright Center in Scranton, Pennsylvania.“Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak who has been practicing in the state for several years.In 2016, the health center launched a comprehensive opioid treatment program to address the growing crisis in their community. They quickly realized a number of patients were pregnant—and had specific needs, from prenatal care to job support. And so, a new program was born.“The Healthy MOMS program is based on assisting mothers who are expecting babies or have recently had a child, up until the age of two,” explained Maria Kolcharno — the Wright Center’s director of addiction services and founder of the Healthy MOMS program.“We have 144 moms, through the end of August, that we have served in the Healthy MOMS program and actively, we have enrolled 72.”The program provides new and expectant moms with behavioral health services, housing assistance, educational support; providers have even been delivering groceries to moms’ homes during the pandemic.But the crux of the program is medication assisted therapy.Moms in the program are prescribed an opioid called buprenorphine—unlike heroin or oxycodone, the drug has a ceiling effect. If someone takes too much, it won’t suppress their breathing and cause an overdose.Nonetheless, it’s chemically similar to heroin, which may raise eyebrows. But while some substances, like alcohol have been shown to harm a developing fetus, buprenorphine isn’t one of them.“Clearly there are medications, like alcohol, that are teratogenic. And there’s medications like benzodiazepines that have strong evidence that they are probably teratogenic. When you look at the opioids that are used and even heroin, there is no teratogenic impacts of opiates on the developing fetus,” Dr. Hemak explained.So, opioids like buprenorphine can be safe for pregnant women. What’s not safe is withdrawal.If someone is abusing heroin, overdose is likely. In order to revive them, a reversal drug called Naloxone is used, which immediately sends the person into withdrawal.But when a woman is pregnant and goes into withdrawal, it can cause distress to her baby, lead to premature birth, and even cause a miscarriage.Which is also why these women can’t just stop taking opioids.“Stopping cold a longstanding use of an opiate because you’re pregnant is a very bad idea and it is much safer for the baby and the moms to be transitioned from active opiate use to buprenorphine when pregnant,” explained Hemak.Because buprenorphine has a ceiling effect and is released over a longer period of time, women are less likely to overdose on the drug.Regardless, there’s still a risk their baby goes through withdrawal once they’re born. For newborns, withdrawal is called neonatal abstinence syndrome or NAS.Babies may experience seizures, tremors, and trouble breastfeeding. Symptoms usually subside within a few weeks after birth.Fortunately, the syndrome has been shown to be less severe in babies born from moms taking buprenorphine versus those using heroin or oxycodone.That’s according to Kolcharno who has been comparing outcomes between her patients and those dependent on opioids, but not using medication assisted therapy.“Babies born in the Healthy MOMS program, we’re finding, that are released from the hospital, have a better Apgar and Finnegan score, which is the measurement tool for NAS and correlates all the withdrawal symptoms to identify where this baby’s at,” said Kolcharno.But NAS is not the only concern women have post-partum.During and after delivery, doctors often prescribe women pain killers. For those with an opioid dependency, these drugs can trigger a relapse.Dr. Thomas-Hemak says preventing this kind of scenario requires communication.The Wright Center works with their local hospital to ensure OBGYNs are aware of patient’s substance use history.“We want the doctor to know that this may be somebody that you’re really sensitive to when you’re offering postpartum pain management,” said Hemak.That way, doctors know to tailor patients’ post-partum medication regimens. Instead of prescribing an opiate-based pain killer they can offer alternatives, like Ibuprofen or Advil.Maintaining an open line of communication between addiction services and hospital providers also helps to reduce stigma.Women with substance use disorders have long been subject to discriminatory practices by both providers and policy makers.From denying them treatment to encouraging sterilization post-delivery, women struggling with opioid dependency can be hard-pressed to find patient-centered health care.But Dr. Thomas-Hemak says, she’s learned to set her opinions aside.“I think one of the magical transformations that happens when you do addiction medicine really well is, it’s never about telling patients what to do.”It’s about allowing them to make informed choices, she says, and understanding it’s not always the choice you think is best.This transcript has been edited for clarity and concision.
Wednesday, January 13, 2021
How (Not) To Date in Sobriety: My Dinner with Steve, the Movie
I thought, “I’m building intimacy!” He called it stalking. I said I was sharing. He said oversharing. Through ten years of sober dating in New York City on the heels of a devastating divorce, I tried it all—from celibacy to the polyamory scene to IRL meetups. Along the way, I made every mistake possible. To my surprise, I’ve landed in a happy marriage, but I will never forget the stories that brought me here. Such tales are at the heart of My Dinner with Steve.As someone with long-term sobriety, I never tire of addiction stories. Likewise, I’m always interested in stories about flawed women. When I sat to write my own film, I wanted to see these two worlds come together. There are so many movies that deal with battling addiction, but there are very few that portray the experience of living in recovery. If the recent #WeDoRecover challenge is any indication, I’m not alone.The hashtag was born during the first presidential debate, when the incumbent spewed a poisonous—and untrue—tirade about Hunter Biden, a recovering addict. His father, former Vice President and current presidential candidate, Joe Biden, was not rattled. Instead, he rallied to support his son, and all of us recovering from addiction, by first affirming Hunter's recovery and then stating, “I’m proud of my son.” In the wake of that, there’s been an avalanche of support for people recovering from addiction, much of it in the form of people sharing their own #WeDoRecover stories.Into this hunger for content comes the short I wrote and starred in, My Dinner with Steve. The film tells the story of Jen, a newly sober, 40-something woman whose divorce has left her shattered. She’s finally landed a date with her teacher crush, but mistakes Googling with familiarity and turns their dinner into an addict's confessional. We shot it in St. Petersburg, FL, over two days in March, just before the Covid-19 lockdown. Already the movie has been seen all over the world in festivals, with more to come.My approach to the film was something I’d learned through recovery—I asked for help. I’d never written a film before, let alone acted in and produced one, so I turned to people in the industry for guidance. I’m lucky that several key team members, notably our director Eugenie Bondurant, were early supporters of the project. The work has been so gratifying that I’ve already written more, a series with recurring characters offering humorous tales to convey serious messages—primarily, that overcoming addiction is not only possible, but just the beginning. One of my greatest fears about getting sober was that it would mean the end of fun. As the recent #WeDoRecover challenge has shown, that’s been far from true for me and countless others. And it made me reflect on why I felt compelled to write these episodes.First, the longer I’ve stayed sober, the more clearly I’ve seen that sobriety is a gift. It wasn’t bestowed upon me through some kind of deserving behavior, far from it. It was grace alone. Through my recovery, I’ve met many wise, humble, and generous people. Many have given freely of themselves to show me a better life, one free of blackouts, institutions, health crises, destroyed relationships, and enslavement. These interactions are at the heart of the films I want to write. Because no one recovers alone. There is no single wise influencer, leading us all to an Instagram-worthy photo shoot. Our lives continue, in all the mess and glory. But if we stick together, we do recover.These experiences are what I want to commemorate in film, and My Dinner with Steve is the first outing in that effort. While the story is based on actual experiences, it’s not a true story. And as much as this short speaks to the recovery community, I see these stories as having a broader audience, in the same way that a film like Requiem for a Dream – just now celebrating its 20th anniversary with a re-release – wasn’t intended for drug addicts only.We all experience obstacles in life, but those of us in recovery need to refrain from using our drug of choice to cope, whether that’s sugar, sex, or a substance. So, it’s important that this film look like others out there, and speak to a broad audience. And there’s no better way to foster empathy than through storytelling. For more information and to see the trailer, visit the website for My Dinner with Steve.
Sunday, January 10, 2021
The Role of Trauma in Treating Addiction
The word trauma is used today more than it ever was ten years ago. While some people might feel like the word is overused, many mental health professionals would say that we’ve just become better at recognizing the lasting impact that events — from losses to abuse — can have on our psyches.Many people with substance use disorder have trauma in their backgrounds. Trauma causes residual lasting mental pain. If you don’t address the trauma, you might find yourself self-medicating to escape the mental pain. Although that might work for a moment, using drugs or alcohol to cover your mental pain will just cause more difficulties in the long run. That’s why it’s so important to find a treatment center that understands the interplay of trauma and addiction.Understanding TraumaThe American Psychological Association (APA) defines trauma as an emotional response to a terrible event. What constitutes a terrible event varies from person-to-person. An event that is traumatic for one individual might not cause trauma for other people, even if they experience the very same event. Anything from abuse to a natural disaster to an accident can cause trauma.It’s normal to experience some psychological distress after a major event. Consider the stress that we all experienced early on during the pandemic. But, for most people, the stress gets better with time. If you find that your stress continues to interfere with your life, you might have trauma. Symptoms of trauma can include flashbacks, headaches and nausea.Sometimes, trauma can evolve into post-traumatic stress disorder (PTSD). PTSD is characterized by lasting effects of trauma that impacts life. People with PTSD might have flashbacks or nightmares; they might avoid certain situations that remind them of the traumatic event.The Connection Between Trauma and AddictionThere’s a close connection between trauma and addiction. A 2019 study compared people who were getting treatment for opioid abuse disorder with healthy individuals. It found that the people in treatment reported more severe traumas and more instances of trauma in their lives. The study found that the more trauma people experienced, the more likely they were to experience addiction.The connection can be particularly strong for people who experience trauma as teens or children. Among teens who needed addiction treatment, 70% reported trauma in their backgrounds. In addition, 59% of teens with PTSD go on to develop a substance abuse problem.Research like the ACEs study — which looked at adverse childhood experiences — have solidified the connection between trauma and addiction. Even seemingly minor ACEs, like growing up with divorced parents, can increase the risk for substance use disorder later in life.Treatment for TraumaIf you have experienced trauma or ACEs, and particularly if you believe you may have PTSD, you need to access a recovery center that is trauma-informed. Trauma-informed treatment centers have knowledge about the ways that trauma impacts the brain. They are able to help you address your substance abuse disorder, while also helping to control your trauma.Of course, it is also a great idea to get specific treatment to help you overcome PTSD, if you are experiencing that condition. EMDR — Eye Movement Desensitization and Reprocessing — is a type of therapy that is particularly effective for treating PTSD. During EMDR, you recall your traumatic event while doing to back-and-forth eye movements. Scientists don’t understand exactly why this is so effective at reprocessing the traumatic event, but research shows that people make huge improvements in just a few sessions.The TakeawayTrauma is extremely common: up to 70% of American adults have experienced a traumatic event in their lives. Some people recover on their own, while the trauma lingers for others. Too often, people use drugs or alcohol to try to numb or escape the trauma.Oftentimes, people need help to overcome trauma in their lives. Finding and utilizing a treatment center that has a trauma-informed approach to treating substance use disorder can help you understand the role that trauma plays in your addiction. Then, by addressing the underlying cause of your addiction, you’re better able to stay sober long-term.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.
Thursday, January 7, 2021
Help Without Hurting
When problems from drug use begin to mount, such as relapses, lost jobs, school suspensions, neglect of responsibilities, DUIs, etc., friends and family members sometimes provide certain types of help that can actually be harmful. That’s right, they harm their loved ones by bailing them out or doing too much at times when these folks would be better served by learning from the consequences of their behavior and standing up on their own.For example, after binges or serious relapses, friends and family members often make excuses and try to clean up the mess. When this happens, they unwittingly teach powerlessness.You don’t have to think about what happened or make an effort to change. I’ll take care of it. You can keep doing what you’ve been doing, and everything will be ok.They also deprive people of an opportunity to learn from the experience; to figure out what was happening before the relapse, how they responded to the circumstances, and what consequences resulted from their use of drugs.Less obvious but equally damaging are subtle meta-messages that undermine self-confidence and manufacture dependence:You can’t handle this. You really need me to step in.(You don’t have to grow up or take responsibility for your life.)Sometimes, it’s important to back off and allow a person room to grow. Of course, there is a fine line because we definitely want to be kind, supportive, and give help generously. We certainly don’t want regrets, as in, “I wish I had done more.”On the other hand, we can end up saving people who don’t need to be saved; people who would be better served by investing more of their own effort and depending on their own initiative, with less help from loved ones.Saving people who don’t need to be saved is called a “rescue.” It should be distinguished from times when we save people who actually need to be saved, like throwing a life preserver or diving into the water to save someone who is drowning, or giving first aid at the scene of an automobile crash.The key to help without rescuing is to ensure that people with a problem want to make changes and are willing to do their part. We can provide support and match their efforts, but not be a “fixer” who does it all. And, we should be willing to back off when the people we are helping are not making a full-blown effort to do their part.Guiding Principles for Avoiding Drug Problem RescuesFind out if the person with a drug problem is sincere and committed to working on the problem. (Not lip service or oft-repeated promises).Find out what the person plans to do differently in the future. Get specifics.Ask if the person wants help and if so, how you could be helpful.Be clear that you are not trying to fix the problem yourself. You are providing back up.Watch to see that your effort is matched. Never do more than half the work.Watch that change is occurring. If not, discuss what further measures loved ones need to take so that your combined efforts can bring results.Be willing to back off in a kindly way, without negative judgment.Model Statement for Backing OffIf nothing is improving, your help is of no value. It’s best to back off and open a dialogue.You don’t want to discourage the person with a drug problem, but also don’t want to fail to notice the reality of the situation. You can make a statement about the lack of progress without blame or any negative judgment. You can show your love and enduring desire to help. Before backing off, make sure you have allowed time for the change to take hold. However, if you wait too long, you will probably end up angry and alienate yourself from the person you want to help. Timing is important.Here is an example of a model statement for avoiding a rescue when the person you are helping is not making changes.I’m doing (or “I have been doing” or “I have done”) what you asked. But it doesn’t seem that things are getting better. I think you may need to invest more energy or find a different strategy. There’s no point in me continuing to help until you have revised your plans. I love you (or “really care about you”) and remain ready to help when you update your approach to this problem.Signs You Might be RescuingYou feel like you’re saving someone from themselvesYou keep giving help and nothing is changingYou feel angry when you are trying to be helpfulThe same problems keep recurringDifficult and Unpleasant ChoicesPeople with serious drug problems often face exceedingly difficult and disastrous circumstances that make it hard to distinguish between help that is urgently needed (a legitimate rescue) or simply a harmful rescue that will reinforce powerlessness. For example, we may have loved ones who are about to lose their job or need transportation to maintain employment or could lose custody of a child or find themselves homeless, living under a bridge. Caring people will have an urge to jump in. Sometimes we must. These are painful and unpleasant choices with no simple answers. At these times, we have to ask ourselves: What sort of rescue is this? What will happen if I don’t step in? What are the consequences? If I do step in, would it be disempowering? Would I be resentful? Am I fostering dependence? Has the same problem been happening over and over again?Sometimes backing off means being terribly scared and uncomfortable, knowing the risk that bad things might happen, but believing it is the best choice and the only possible way things might change. It’s never easy.Help and “Help”Avoiding harmful rescues is an act of love. You want to help people when it can improve their lives, but avoid providing “help” that disempowers them, promotes dependency, and allows problems to persist. Ideally, our message should be: “You can do it. Work hard and I’ll back you up, all the way.”
Monday, January 4, 2021
Opinion: The Opioid Crisis + COVID-19 = The Perfect Storm
Addiction - a chronic relapsing brain disorder, and a disease that gets deeply personal. It gets low-down and dirty, too.If you’re not an addict yourself, you surely know someone who is.You know someone abusing their opioid prescriptions, not because it’s a barrier to their pain, but because it’s a potent way to make them feel happier. You know someone whose alcohol consumption is dangerously high and verging on alcoholic - if they’re not already there, of course. Your kids will certainly know someone who abuses recreational drugs like they were going out of fashion. They’ll also know other students who swallow ADHD prescription tablets (as a study aid) because it makes them get their grades, and keeps their parents, people like you, happy.Among the people who are in your extended family, among your circle of friends, or someone within your workplace - at the very least, one, probably several more, will be a secret drug addict or an alcoholic. At the very least.It doesn’t discriminate. It certainly doesn’t care where you live either, just like most other diseases, and now this new coronavirus - COVID-19.Arizona & The Opioid CrisisOver the last 3 years, in Arizona alone, there have been more than 5,000 opioid-related deaths. Add to that the 40,000-plus opioid overdoses that have taken place during the same period, and you realize that COVID-19 has never been the only serious health issue the state continues to face, or the rest of the U.S., for that matter.In our “new reality” of social distancing and masks, more than 2 people every single day die from an opioid overdose in Arizona. Nearly half of those are aged 25-44 years old - in their prime, you might say.Opioids are not the only addictive group of substances that is costing young Arizonan lives right now either.From the abuse of “study aid” drugs, like Adderall and other ADHD medications, to the “party drugs,” like cocaine and ecstacy, and so to opioid prescription meds, and, if circumstances allow, a slow and deadly progression to heroin - addiction is damaging lives, if not ending them way too soon.These drugs did so before anyone had ever heard of COVID-19, and they’ll continue to do so after, or even if the world ultimately finds another drug - the elusive coronavirus vaccine - it is hoping for.Opioids + COVID-19 = The Perfect StormWe now live in this time of coronavirus. With the ongoing opioid epidemic, the question arises:How can the addiction treatment community continue to assist people who are now being left even more isolated and desperate, still with their chronic desire to get as high as they can, or drunker than yesterday?Furthermore, coronavirus has raised questions itself about the ongoing mental health needs of our population as a whole, and drug addicts and alcoholics continue to feature heavily in any statistics you offer up about those in the U.S. living with a mental health disorder.In fact, around half of those with a substance use disorder (SUD) or an alcohol use disorder (AUD) - the medical terminology for addiction - are simultaneously living with their own mental health disorder, such as major depression, severe anxiety or even a trauma-related disorder like PTSD.How are these predominantly socially-disadvantaged people able to receive the treatment they really need when they have been directed to isolate and socially distance themselves even further?This is why I believe the conditions for a “perfect storm” of widespread deteriorating mental health and self-medication through continued substance abuse are here now, with overdoses and fatalities rising across the addiction spectrum.There will be many drug or alcohol abusers living in Arizona who will be lost to us, and the majority will be young people in the age group of 25-44 mentioned previously, left isolated and unnoticed by an over-occupied medical community.The U.S. opioid epidemic plus the global coronavirus pandemic.A deceitfully isolating disorder in a time of generalized social isolation. For some, there will be no safe harbor from this, and it will wash them away from the lives of their families and friends without any chance of rescue whatsoever. The perfect storm - our perfect storm.Today, the truth is that successful addiction recovery has become exponentially more difficult. Apart from ongoing isolation to contend with, there exists an unfounded but very real distrust of medical facilities per se, and a real personal problem in maintaining good physical and mental health practices, eg. through nutrition and physical activity.Innovation: The Ideal Recovery Answer for Isolated Substance Addicts?Digital technology has advanced far further than its creators and financial promoters ever envisaged - or has it? We have become a society where it doesn’t matter where you are in the world, you’re always close by to loved ones you wish to talk to, friends you want to have a laugh with, and colleagues you need to share information with.Communication anywhere with anyone is as simple as the proverbial ABC.However, if you think that innovation and digital technology - sitting in front of your laptop or tablet, in other words - can provide the answers to the questions raised earlier about the timely provision of professional addiction or mental health treatment to those that need it, then you’re wrong. If only it were all that simple and straightforward.Online meetings of 12-Step organizations, like Alcoholics Anonymous, Narcotics Anonymous, and others, have been available for many years. However, all of these support organizations realize that an online or virtual 12-Step meeting is not the real thing. They are a temporary substitute and no more.In fact, they are a poor substitute when compared to the face-to-face and hands-on meetings that continue to be held successfully all over the nation and all year round.The various “sober aware” and “sober curious” communities that are present online do not provide a realistic treatment option to any substance addicts whatsoever, whether their SUD or AUD has been clinically diagnosed or not. Furthermore, the current crop of online addiction treatment and recovery programs available are currently statistically unproven in terms of successful outcomes, and with no official accreditation.That said, there is limited evidence that “telemental health care” does have several benefits in terms of more timely interventions in those with mental illness generally, particularly when these people are located in isolated communities.I honestly wouldn’t know, as there is no official patient outcome data for these services. In fact, by the time that data is able to be impartially and officially collected, these groups and so-called programs may have already lost their internet presence.Online “help” (you honestly couldn’t call it an actual treatment) with addiction is severely limited and nowhere near approaching the answer. Here’s exactly why…Substance addiction is an utterly isolating disorder. It can obliterate close family bonds, destroy what keeps us close together as friends, and will happily rampage unabated through any social life you may still hold onto, accepting no prisoners. Bleak isolation like you’ve never known before.Corona has little on addiction.Addiction is the catalyst behind premature death, the end of families and their marriages, long-term unemployment, and endless legal issues. It costs financially too - countless billions of dollars every year are lost to this disorder, over double that of any other neurological disease.Let me be absolutely clear and concise - there exists no replacement whatsoever for your hand held by another when lying in an intensive care bed, scared you’ll become just another coronavirus statistic, and there exists no replacement for the smiles, warmth, and openness of fellow recovering drug addicts meeting in a daily support group, especially on those days when you came so close, so very close, to using or drinking again.There’s little difference between the two either.The online addiction treatment industry is still in its childhood. It truly is an industry too, as you’ll only buy the brand and the product; you’ll never actually meet those telling you how to best change your life.At present, it falls woefully short.Really, what would you prefer? A mask-wearing addiction professional, clinically qualified to assist with your detox, your medication if needed, and your psychological needs, located in an accredited treatment facility (formally certified as being coronavirus-free), among peers, fellow addicts, and trained medical staff?Or a video image on a computer screen of someone you will never meet, who is telling you to do things you’ve never done before? At least, successfully?As society moves towards a more home-orientated existence, with WFH (working from home) the new norm, consider this:Would a specialized medical professional treating your disease ask you to consider “getting better from home,” as an alternative to the hospital?All we can hope for - the best that we can hope for - is that coronavirus soon leaves the state lines of Arizona, and that can continue all of our recoveries as successfully as before. Until then, the advice is simple - take the best help you can from wherever you can get it. Sadly, you are yet to find it on a computer screen.One last thought before I sign off…Protective masks may well become standard attire in our unknown future. So why, oh why, can they not make these transparent? Just take a moment... We’d be able to see each other - our friends, our colleagues, even complete strangers in the street - smile again.
Friday, January 1, 2021
The Five Pillars of Recovery from Trauma and Addiction
In my forty-five years, I enjoyed twelve years of quasi-normal childhood, which ended abruptly when I was raped. I spent the next ten years in a dangerous dance with addiction, suicide attempts, and more trauma. But then I reached a turning point, and my past twenty-three years have been spent healing and learning what works for me in building long-term recovery.There is no standard set of blueprints for long-term recovery, as everyone is different, but I have identified five pillars that have enabled me to build on a strong foundation of recovery. My daily choice not to use substances forms that foundation, and these rock-solid pillars stabilize that recovery into an impenetrable structure. These five pillars are not unique, and they do require work, but once built, they will stabilize your recovery fortress.1. Maintain rigorous honesty. In addiction, our lives were built upon lies and false narratives we told ourselves and others. But recovery demands honesty—only when we can admit the truth can we begin to heal. I had to get honest with myself about my addiction. I had to own it and then take a brutally honest assessment of my life. We cannot build a sustainable recovery on a false narrative. When we lie, we enable sickness, secrets, shame, and suffering.Dishonesty makes us vulnerable in all the wrong ways, but honesty conjures the true vulnerability we require to discover authenticity. Start practicing honesty in all your interactions—beginning with yourself. This must be the first pillar because without honesty, the rest will crumble. Anything created in a lie is chaos, and anything created in chaos will end in chaos.2. Expose your secrets. You cannot soak in the joy of today if your soul is still filled with yesterday’s garbage. Take out that trash. For me, this meant diving deep and pulling forth all the trauma, pain, and sorrow that I had packed tightly away. I thought this was for my benefit—why bring up old stuff? But in fact my secrets were keeping me sick. They were smoldering under this new foundation I was building in recovery, threating to burn it all down.Secrets require silence to thrive, and they allow shame to fester inside of us. Shame is an emotional cancer that, if left untreated, will destroy our recovery. I began by slowly exposing my secrets in my journal. At first, it was the only safe space for me. As I began to trust others in recovery, I began to share those secrets, and the smoldering was extinguished by their compassion and understanding. Begin exposing your own secrets. What thoughts and memories are you afraid to give voice to? Those are the secrets that will keep you sick if you do not get them out.3. Let go. All those secrets take up a tremendous amount of space in our mind, body, and soul. We must find ways to process that pain into something productive, useful, and healing. You must unleash this pain so it no longer occupies your mind, body, and soul. When you do this, you make room for hope, light, love, and compassion.Writing is my release. But when physical emotional energy rises in me, I need more intense physical activity to push the energy out of my body. I use a spin bike and weightlifting, but you might run, walk, or practice yoga—any activity that gets your heart rate up and helps you sweat, which I think of as negative energy flowing out. When I do this, I am calmer, I am kinder, and I am more the person I want to be. Meditation is another way for me to simply let go and sit with myself when my thoughts are plaguing me or I feel stuck emotionally. I often use mediational apps, guided mediations, or music to help me meditate. When you find what works for you, do it daily. Recovery is like a muscle; when it is flexed, it remains strong.4. Remember you aren’t alone. Connection is core to feeling hopeful. By interacting with other trauma survivors and others in recovery, you become part of a group of people with similar experiences who have learned how to survive. Being able to share those pieces of your past with others is incredibly powerful. Seek out support groups in your area, attend meetings, reconnect with healthy people from your past, and pursue activities you enjoy to help you meet like-minded people. Create the circle of people you want in your life—the ones who will hold you accountable yet provide you with unconditional support and love, without judgment.In our addiction, we push these people away. We run from them because they act like mirrors to our dishonesty. In recovery, these people become the ones we turn to when things get hard. Even one such person in your life—a family member, friend, sponsor, or trusted colleague—can make a difference. Surround yourself with those who seek to build you up.5. Know you matter. In order to grow, heal, and build upon your recovery foundation, you have to believe you are worth it, that you deserve joy and love. At some point in your recovery, you will have to rely on yourself to get through a rough patch. When this happened to me, I had to really dig down and get to know myself. I had to strip away all the false narratives I used to define myself, all the ways I presented myself to the world and to myself. Who was I? What did I love about myself, and what brought me enough joy to feel worthiness?I now know what I need to feel calm, to feel beautiful, and to feel deserving of this amazing life of recovery. I matter, and my life in recovery matters so much. It is this core truth that makes me fight for my recovery, my sanity, my marriage, and my job, because they are all worth it. I am worth the fight, and so are you. Believe in yourself. Tell yourself that you deserve happiness, joy, success, and a life free from the pain of trauma and addiction. You are worth your recovery. It is the foundation on which you build your new life.Building any structure requires hard work, and recovery is no different. While we each require different tools and plans to create them, these five pillars will sustain our recovery from trauma and addiction. Jennifer Storm's Awakening Blackout Girl: A Survivor's Guide for Healing from Addiction and Sexual Trauma is now available at Amazon and elsewhere.
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