Overcoming addiction – what you need to know
What is addiction?
Addiction occurs when you can’t stop doing something, even when you want to.
Drug abuse is something else…..it does not necessarily imply addiction. Full blown addiction occurs when control is lost and the person has no choice but to continue to self medicate. Of course, this can occur with alcohol, chemicals, sex, food, and so on.
The disease theory of addiction
The prevailing attitude among the substance abuse and medical communities is that addiction is a disease. While this has become fairly widely accepted, the disease model is still a theory, and cannot really be “proven.” On the other hand, other models of addiction have not offered any superior treatment methods, so the disease model is still arguably the most useful way to describe and treat drug addiction.
If you think you are addicted, you could experiment by treating your addiction as though it was not a disease, and see how that works for you. Depending on your results, you could later switch to the disease model, and see if the treatment options get any better for you.
In defense of the disease theory, I personally used to look down on alcoholics as being morally weak and lazy creatures. Then I became an alcoholic, without even giving my permission. This was all the evidence I needed–a switch had been flipped in my brain, and it now makes sense (to me) to label addiction as a “disease.”
Drug addiction is complicated
There is a strong tendency for human beings to try to take complicated issues and simplify them. We do this naturally, in order to process information, and to help us in understanding the world. But addiction is complicated. Period. It is not simple.
We can take two seemingly similar people and give them both a 3 month prescription for painkillers. One will have no problem in walking away from the pills, and the other might develop full blown drug addiction. What is the difference? A lifetime of conditioning, a predisposition of genetics, different environmental factors, the list goes on and on. The truth is that we don’t know and we are a long way from having predictive powers when it comes to addiction. Some would argue that addicts are born, and not made, but that is only a part of the story. Many people don’t develop addiction until much later in life. Clearly, some addicts are made–they become addicts, over time. This is complicated.
We want to put addiction in a box and make it simple. In recovery, the problem gets even bigger, and we want to put the solution in a box and simplify it. This is not realistic. Drug addiciton is complicated, and therefore recovery solutions are necessarily complicated as well.
What does this mean to the newcomer? The key is to stay open minded and receptive to suggestions for help. Sometimes our focus can become too narrow in recovery. For example, I dismissed the idea of having a “balanced lifestyle” early in my recovery, but now it has become a major topic of importance for me now that I’ve been sober for several years. Addiction is complicated. Addiction entangles your entire life–do we really think the solution is going to be simple? It’s not. It’s complicated….but that’s alright. You can still overcome the complexity of recovery and achieve long term sobriety.
Most of us are familiar with the idea of denial. In terms of addiction, a person might be hooked on drugs or alcohol and they don’t see that they are caught up in addiction. Because they are hooked, and want to keep self-medicating, they convince themselves that they are not really hooked because they want to keep using. This is your basic form of denial.
But denial has many levels, and we can find ourselves in denial about any number of things that can block us in our recovery. For example, we might be clean and sober and find ourselves getting into a relationship with someone that–deep down–we know is no good for us. But the idea of being romantically involved with someone feels good and we ignore the red flags and the advice of our peers and we pursue the dangerous relationship anyway. This, too, is denial, and it is more insidious because it doesn’t lead directly to relapse. But it is still denial, and could eventually get us into big trouble, eventually leading up to a full relapse.
Motivation to quit using drugs
How can you motivate yourself to stop using drugs or alcohol (or to quit smoking cigarettes, for that matter)? Anyone who is asking this question in an attempt to better their own life is already on the right path. The key here is willingness. Addicts and alcoholics might start to see heavy consequences in their lives, and decide to ask for help. For a lot of addicts, however, the motivating factor comes down to fear. While the person’s life spins out of control more and more with each passing day, the thought of continuing on the current path becomes scarier than the thought of recovering. I was personally terrified to get sober….but I was also scared to continue drinking like I was, facing a never ending series of blackouts and chaotic episodes. Once the balance finally tipped, I decided to take the journey into the unknown and finally asked for help.
In the search for motivation, some might suggest taking inventory of all of the positive things in your life and honestly assessing how much your addiction is limiting you. This is unlikely to have any real effect. The problem is that a true addict or alcoholic just can’t bring themselves to care about such an argument. This is the nature of addiction–it takes precedence over this type of logical thinking. I knew that I was trapped in addiction and that I was missing out on “something greater”–I just couldn’t bring myself to care. I could not believe in the promise that I could be happy again in sobriety. For me, the only way to be happy was to be drunk (or so I thought). Hence, my only real motivation for giving recovery a chance was to avoid the misery of addiction. If the good times were still rolling for me at the bar I would not have stopped drinking. This gives us a clue to the nature of surrender. Hitting bottom becomes a blessing.
How can you best motivate someone else to stop using drugs or alcohol? While there are no guaranteed methods, there are some things you can do to help. Learning what is acceptable behavior and how you can set limits with an alcoholic is a good place to start. Remember what we just covered about misery being a motivating factor. Think about how natural consequences might affect the addict or alcoholic in your life. Making things easy for them might only enable them to continue a life of destructive drinking.
Here is a comprehensive guide to interventions. It discusses:
1) Whether or not you should attempt an intervention given your current situation
2) Whether or not you need professional help to do the intervention
3) How to plan it, who to involve, when and where to do it, and so on
4) Specifying the goal and outcome of the intervention
5) Setting limits and boundaries
Be sure to check out the guide if you are considering an intervention for someone.
Admitting versus accepting
There are 2 stages to go through when you are trying to get clean in which you have to wrestle with yourself mentally. The first stage is when you are realizing that you just might have a drug problem. In the back of your mind, you believe that you could still control your drug intake if you really wanted to, but you don’t really want to–instead you want to let loose and have fun. This is denial. You acknowledge that it, yes, it looks like you are using drugs like a true drug addict, but you maintain the position that you are choosing to take drugs this way, and that the drugs do not have control over you. Self delusional thinking.
The second stage is when you break through that level of denial and you accept the fact that you are a hopeless drug addict and that you cannot control yourself. Period. The drugs have beaten you. The drugs have control over you and you know it. You know you are beaten. This is called acceptance. You have fully accepted your disease of addiction. You have accepted that you cannot control your drug intake. It is one step further than merely admitting to your drug abuse.
Accepting your addiction is critical because the next step is to surrender. It is through surrendering to a solution (any solution, really) that you can overcome addiction and find recovery. Surrender involves asking for help. The addict needs assistance to stop using drugs. Then they need information to find out how to live clean and sober. Because addiction is such a complicated problem, this generally involves some sort of program of recovery. One popular model is the 12 step approach, though there are alternatives. None of the programs offer outstanding success rates, although many people do recover using a variety of different methods.
Because of the nature of addiction and denial, the only diagnosis that seems to work is self-diagnosis. The addict in question must diagnose themselves to be addicted. This is a crucial concept in recovery. If a doctor tells someone that they are an addict, and forces them to be clean for a while in some sort of institutional setting, the addict might very well start using again once they are back out in society.
However, this doesn’t mean that you can’t tell someone that they are an addict. If you see a friend or a loved one caught in the grip of drug addiction, by all means, communicate this with them. There is nothing wrong with expressing concerns, so long as it is done in a caring manner. Understand that each conversation you have might be a small part of what drives someone to finally look at their addiction. It could take months, even years, of talking with someone in a series of informal interventions. But ultimately, the addict themselves must decide that they are, in fact, addicted, before they can seek any sort of meaningful treatment.
What if an addict won’t admit to their addiction? What if they never accept the fact that they are an addict?
This is not an easy situation to deal with. There are no easy answers.
For starters, here is a good article about how you can best help a struggling addict. But there are no magic bullets. The brief outline in dealing with an addict is this:
1) Understand drug addiction
2) Find some support for yourself
3) Set some boundaries and limits. Communicate what is unacceptable behavior to the addict and explain real consequences for those behaviors. Be prepared to follow through with those consequences.
4) Support the addicts efforts to get clean without allowing yourself to be manipulated (for instance, by just giving them cash when they are in trouble due to their drug use)
5) Practice detachment and not allow yourself to feel responsible for decisions that are outside of your control
6) Don’t enable the addict (doing something that allows them to keep using drugs, such as giving them cash or bailing them out of jail, etc.)
Why are the relapse rates so low?
You have probably heard some of the statistics for how many people stay sober, or for how many people stay clean after leaving treatment. These statistics are shockingly low, and can really be quite depressing to those who are interested in sending a friend or a loved one to treatment.
One reason that relapse rates are so bad is that the pool of possible recovering addicts is so large, and many of them are being “forced” into the statistics. In other words, many of the people who go to treatment centers do so in order to avoid a jail term, and they have no intention of staying clean and sober when they get out of rehab. This type of rehab visit is extremely common, and probably makes up a fairly large percentage of all the people in treatment. Therefore, the statistics are skewed a bit because there are so many people who do not truly want to get clean.
On the other hand, some studies have found that a handful of people who were forced into treatment managed to stay clean and sober, and it turned out that it was the same percentage rate as it was for those who truly wanted to stay clean on their own. The study seemed to conclude that, while the success rates for treatment were indeed quite low, the rate of success was the same regardless of how motivated the participants were. This is in sharp contrast to the general wisdom espoused at 12 step meetings, where they tend to say that “the people who make it in AA are those who want it, not those who need it.”
Because relapse is so prevalent, and success rates are so low, the best strategy for success is to try to quit multiple times. Almost no addict gets clean on the first try and makes it stick. I personally attended 3 treatment centers before I finally “stuck and stayed,” and I know many other addicts who have been to treatment several times and are finally staying clean for significant periods of time. In fact, I don’t know a single recovering addict who didn’t try multiple times to kick their addiction before they finally “got it.”
Success rates are low. Relapse is rampant. And yet, some addicts obviously are blessed with long term sobriety. If you talk to the success stories, you will find that they failed many times before they finally “got it.” Therefore, the key is to keep trying. It almost sounds too simple. But trying over and over again is a real strategy that worked for me.
This is also the exact strategy that worked for me in quitting smoking as well. I failed so many times it was ridiculous. But I made a decision one day that I was going to keep trying to quit until I got it. I also made a point of learning from each quit attempt if I failed. The knowledge I gained through these failures eventually allowed me to come up with a winning strategy for quitting. I knew what things worked for me and what didn’t. For example, I knew not to use the Nicotine patch, but that chewing on toothpicks really helped (for me anyway).
The key is not to let the horrible relapse rates be a deterrent for you. There are plenty of people who have achieved long term sobriety, myself included.
Some people would argue that when an addict has truly surrendered, that virtually any program will help them to recover–that it is the desperation itself that produces a successful recovery, not a specific recovery program with the “right” solution. Others would argue that certain programs (such as the 12 step program of AA, for instance) are crucial in helping people to recover, and can even allow someone to quit drinking before they have truly “hit bottom.”
Acceptance of a solution to the problem
When an addict gets to the point of surrender, they ask for help. This is the turning point. It represents their start in recovery.
Sometimes an addict asks for help, but they are actually still manipulating things, and they are not at the point of surrender. They are not yet ready to recover. You can identify this if they are making demands, and trying to dictate what type of help they want to receive. If they are doing this, they are not ready to get clean and sober. This is the nature of denial. An addict might claim that they are done using drugs–forever–and that they are ready to make big changes. But the key is that they need to ask for direction. The addict needs to be open to new direction. If they are asking for resources and making demands, then they are not really asking for help with their recovery. Therefore, you will know when an addict is truly at the point of surrender, when they are “throwing up their hands” and asking for directions on how to live.
Treatment Centers (Drug and Alcohol Rehabs)
There is no doubt that treatment centers have helped addicts. I personally got clean and sober over 7 years ago by going through an inpatient treatment center (and then living for 20 months in long term treatment). Success rates are low. This is normal, and unfortunate, but no treatment center can claim a huge success rate in helping addicts. However, don’t let this discourage you. Their are still a number of benefits to treatment centers, and the safety and support that they offer to the newly recovering addict still has a lot of value. They don’t always work, but they still afford what is probably the best opportunity for most people to get started on a new life in recovery.
Detox is a medically supervised area in a treatment center where the body is cleansed from drugs and alcohol and returns to stability. This can be a dangerous time, especially when coming off of alcohol. Quitting drinking can literally kill you, so they advise that you try to find a medical facility in which you can detox safely. Most treatment centers also treat withdrawal symptoms for people detoxing from other drugs as well (such as opiates).
Ever heard of a “28 day program?” That is residential treatment. The idea behind most of these short term treatment centers is to take the addict out of the environment they were using drugs in (hence the inpatient stay) and also to teach them how to live a sober life. Unfortunately, funding for these types of treatments has been cut drastically in recent years, and most insurance companies and state programs do not fund addicts for much more than a week or 2 at the most in such a facility. Most residential treatment centers are 12 step based, although there are alternatives out there. Most rehabs also have some sort of group therapy with the residential clients, as well as informative lectures and one-on-one counseling sessions. All of that taken together represents a pretty good picture of what the typical stay in rehab is going to be like.
Statistically, addicts who go to these types of treatment centers do not enjoy great success rates. That doesn’t mean that you shouldn’t go, or that you should give up on them, however. I personally got clean and sober by going to a residential facility, and I know several other people who also got their start in sobriety there. They should not be viewed as a magic bullet, though. They can be the “break” that an addict needs in order to get started on a new and sober life, but keep in mind that it takes most people several trips before they finally “get it.”
Long term treatment
Unbelievably, long term treatment doesn’t necessarily offer higher success rates compared to short term treatment. Once again, this is not a magic bullet for drug addiction. Personally, long term treatment saved my life, and afforded me the chance to finally recover. I also believe that long term treatment is particularly effective for younger addicts, but the likelihood that younger people will go to long term treatment is not so good. Most long term treatment centers offer a similar support structure in that you are typically living with your peers, attending weekly meetings, and having some level of accountability in terms of abstinence. This means that they will usually do random drug tests, and relapse is not generally tolerated. Long term treatment is what finally worked for me.
Living in Recovery
Life in recovery is a blessing. To the struggling addict or alcoholic, living sober sounds as bad as living in prison. But what happens in recovery is that our priorities shift. Instead of the self-centeredness of seeking that next high, we start to take an interest in our friends and family. Relationships become meaningful again. We are no longer using people for drinks and drugs or as a simple means to an end.
When I was still using drugs, I did not want a sober life. I looked down on sobriety. I pitied it. But I got to a point where I surrendered and was willing to do something different. I honestly believed that I would stay miserable in sobriety, because I wouldn’t be able to “get happy” with drugs and alcohol. This is obviously not the case! But what’s critical to understand is that the struggling addict genuinely believes that they can never be happy without their drug of choice.
I’m not sure how to break through this problem–to convince a suffering addict that there is a better life in recovery. I can promise someone the whole world, but the words are meaningless to someone who is stuck in addiction. We can attempt to show a struggling addict that life gets better in recovery–for example, if their best friend manages to get clean and sober. But this is still not enough to convince them, because they believe that they are unique. The addict will think to themselves “well, yes, I can see that so-and-so got clean and sober and is much happier now, but that simply does not apply to me….so-and-so must not have liked the drugs and alcohol as much as I do. People just don’t understand how much I like to get high….” and so on. This “uniqueness” kept me sick and suffering for a long time, because I believed there was no hope for me to ever live a “normal” life in recovery, without using drugs and alcohol.
And still, the problem is convincing the newcomer of this. That there is hope, and that they can have this awesome life of sobriety. How can we pierce through the uniqueness of the newcomer? The best way is to get them to relate to you. Tell them your story, explain that you used drugs and alcohol like they do. Explain that you medicated your feelings the same way that they have been doing. Convince them that you once walked the same road that they have been walking.
Medications – a slippery slope
The use of prescription medication can be a bit tricky for recovering addicts. The best advice is to follow the directions of a physician, except when you have been manipulating them on purpose. That’s why this is always such a slippery slope–because the addict mind can manufacture pain and anxiety that really isn’t there. We can fool ourselves into thinking that we need to try harder to convince a doctor that we are in pain, when we might actually not be hurting so much. There have certainly been plenty of unsuspecting addicts who have relapsed because of prescription medications, and unfortunately returned to full blown addiction.
On the other hand, taking the hard-line approach that you will never use any medication is just as dangerous. Recovering addicts have died because of this mistake. For example, recovering addicts have refused to take any medications at the advice of a misguided 12 step sponsor, and then committing suicide due to the chemical imbalance in their brain. Therefore, when in doubt, side with the medical professionals, not the “unlicensed 12 step gurus.” But be aware that the entire topic of medication represents some genuine pitfalls, so exercise care and mindfulness when dealing with these issues.
Photo by The Master Shake Signal and dpade1337
Medications to help you recover
There are also medications designed to help overcome addiction. Campral for drinking, Chantix for smoking, Suboxone for opiates, and so on. Look for this increasing trend in the future as well: there are a lot of medications of a similar nature that are in testing right now. The substance abuse community could very well shift to a medical approach very soon. Whether or not this is a good thing remains to be seen, but be aware that more medications of this nature are definitely on the way. These medications are a tool. They can help some people, but they are not a cure-all. They might offer that little extra boost that some people need. On the other hand, they might fool some people into relying on this “magic bullet” too heavily. Either way, these new medications are definitely an issue to watch for as things continue to develop and unfold.
Alcoholics Anonymous and Narcotics Anonymous offer meetings almost any where you go. Because of this, there is a strong argument that this is where the support is at. Plus, meetings are free, you are never required to pay anything (although they will “pass the hat” around).
Not everyone will go to AA and NA, nor will they want the solution that is offered there. But if you need support, if you need help from other people who are in the same boat as you, then it would be crazy not to at least give these meetings a chance. That’s where the support is at. That’s where help is available. Addicts and alcoholics helping one another, in cities across the globe. At 12 step meetings.
Maintaining long term sobriety
The whole key for me has been working with other addicts and pushing myself to grow. It has not been about daily meetings or reading recovery literature every day or constantly working the steps over and over again (although those things were important to me in the beginning). My 7 years plus in recovery has been about helping other addicts and pushing myself to grow on a couple of different levels. For example, I continue to push myself to grow spiritually, explore new concepts, and actually use spiritual principles in my everyday living. I’ve also pushed myself to become healthier, by committing to regular exercise and quitting smoking. Perhaps most importantly (in terms of achieving long term sobriety), I continue to work with recovering addicts on a regular basis. This has been critical for me.
Pursuit of spiritual growth
In the beginning, I was constantly seeking….something. I was pushing myself to “become more spiritual,” and reading all sorts of different books in order to gain what I thought would be “special knowledge.” Looking back on this, I don’t regret doing it. And I think there was benefit to a lot of it. But I don’t necessarily think all of that effort was really necessary.
For the first few years of recovery, I was filled with self-doubt. So many other recovering addicts seemed to have so much more confidence than I did, and they seemed to be relapsing an awful lot. This caused me to dig deeper in terms of my spiritual exploration….fear and doubt filled me up.
At some point I moved past this stage, and started connecting with my higher power in my own way. I also stopped letting others judge my program of recovery, and I found new and unique ways to reach out and help other recovering addicts. At some point, I had to start believing in myself and trusting in the path that I was on. I had to stop questioning my own path so much, and letting others dictate what made up a successful recovery program.
I saw a lot of recovering addicts around me who seemed to have a huge network of people in recovery that they associated with. I tended not to put myself out there as much, and stuck closer to a smaller circle of friends in recovery. Popular wisdom in 12 step recovery circles says that you need to have a large network of support. The thinking goes that individuals might fail you, but the fellowship is large enough to always come through for you. While this idea makes sense, it is not enforced by my direct experience, which is that a few good friends in recovery are better than having several dozen associations. I’m glad that my support system was smaller and more intimate, instead of large and mechanical and indifferent.
There is a lot of wisdom in the 12 step fellowships, but there is also a lot of misinformation. More accurately, there is an overabundance of suggestions, a huge laundry list of spiritual suggestions that overwhelms the newcomer. There is a real need to prioritize when you first get clean and sober. Looking back over the last 7 years of my sobriety, I can confidently say that the most important things were:
1) A growing connection with a higher power
2) A shift in my own personality away from self centered drug seeking towards a genuine interest in fellow addicts
3) Working directly with others in recovery
4) Having a small, tight-knit support system (not a large one)
Personal growth and development
I think there comes a time in most people’s recovery where they want to go beyond the “spiritual” growth that is pushed so heavily in the 12 step fellowships (remember, it’s all spiritual….don’t limit yourself with this kind of thinking!)
For me, personal growth outside of “traditional recovery” has included:
1) Going back to school to pursue a degree
2) Becoming an avid runner to get regular exercise
3) Successfully quitting smoking over 2 years ago
4) Finding employment where I can work directly with recovering addicts
5) Pushing myself to explore new recovery concepts on the internet
6) Publishing a recovery website on the internet
Reaching out and helping others
Above all, the most important thing in my recovery so far has been helping others. This is how we live the program; how we work recovery into our daily lives. By helping others–especially other recovering addicts and alcoholics–we help ourselves tremendously. When we help others to recover, we are automatically ensuring our own sobriety.
If you are a struggling addict or alcoholic then please read this.
If you know someone who is an addict and want to help them then please read this instead.
Good luck with your recovery and God bless.