What are some of the more popular strategies for treating alcohol abuse?
First of all we should differentiate between abuse and dependence.
With alcohol abuse we are really just talking about someone who is abusing alcohol and who may or may not be entirely dependent on it. They have a saying in recovery “If you give a problem drinker some alcohol then they have a problem, but if you take away the alcohol from an alcoholic, then you have a problem.” In other words, with a real addict or alcoholic, the problem is only beginning even after they sober up. The true alcoholic has a disease that goes beyond the substance itself and their dependency on it. Our addictions can manifest in a thousand different ways; abusing substances is just one of them. There are others as well (gambling, sex, relationships, etc.).
What we are really talking about here is how to treat a full blown addiction–someone who is addicted to alcohol or other drugs, and that substance is seriously affecting their life and their ability to be happy.
That said, let’s take a closer look at some of the strategies that might be helpful.
Abstinence and detox
First and foremost is the idea of total abstinence. It should be noted that when we talk about the phrase “total and complete abstinence” what we are really saying is that the person is abstaining from all mood and mind altering chemicals. So an alcoholic who quits drinking booze only to switch to marijuana or other substances isn’t necessarily working on recovery. They are not really getting healthy in any way–all they are doing is switching out one drug for another. In addition, please note that alcohol is just another drug. It is not “separate” from other drugs, it simply is a drug. Period!
So with the idea of abstinence from all mood and mind altering substances, we should consider what this looks like in a professional treatment setting. The process is known as detoxification, or detox for short. This is the medically supervised part of treatment whereby an alcoholic or drug addict is safely taken off of all mood and mind altering substances. Depending on the severity of their withdrawal this may require some medications, but in the end the idea is for the person to be drug and alcohol free. At that point they will need to learn the strategies and tactics to help them to live sober on a day to day basis. With the help of various recovery tools they may learn how to do exactly that, although many people fail at this point after they have left treatment (we will explore those pitfalls, and ways around them, in a moment).
After the detox process most people stick around in treatment for residential services. This generally consists of group therapy, individual counseling, some AA or NA meetings, and generally being educated about addiction and recovery while at an inpatient setting. I highly recommend this for several reasons and it is one of the best strategies that you can use in early recovery.
The first reason that you should consider inpatient rehab is that it generally follows a medical detox, which is the safest path to sobriety. Sometimes the detoxification process can pose medical risk. Better safe than sorry in this case.
Second of all the environmental triggers that the typical addict or alcoholic faces in the first few weeks of their recovery can be enormous. If you are going through your daily routine in life, how many triggers do you face each day? In other words, how many times do you encounter a person, place, thing, or situation that makes you want to use drugs or alcohol? For me that number of times was really quite high. I had a million and one excuses why I should get drunk or high and I also had a lot of natural triggers throughout my day.
Let me give you one example of this in my own personal experience. I noticed when I first got clean and sober that every single person in my life other than my family was someone that I either drank alcohol or got high with. This is not really an exaggeration at all. Every single person at my job either drank or smoked weed with me. Every single friend and acquaintance that I spent any time at all with was someone that I drank or got high with. When I actually sat down and thought about it I was shocked to learn that all of my “normal” friends were long gone. The only sane people left in my life were family members who did not abuse drugs or alcohol, and I basically tried to avoid them because it made me so uncomfortable to be around sober people.
So you could say that this situation, all of my relationships in life, posed a significant trigger and threat to my sobriety. I could not just leave rehab and go back to hanging out with the same set of people in my life, because nearly all of them were getting drunk and high on a regular basis.
This is where residential treatment comes into the picture for most people. Instead of leaving detox and going straight back into my own life, where I was almost certain to relapse, I went instead into residential treatment where I was able to start making new connections with positive people in recovery. I say “positive people” because all of these new peers in my life were also hoping to remain clean and sober, rather than to go get drunk or high.
This is a foundation in early recovery that I don’t think many people can do without. If you refuse to go to inpatient treatment then you are setting yourself up for a much more difficult path through recovery.
Is it possible to get clean and sober without inpatient rehab? I am sure that it is. But is that a smart thing to challenge yourself with? Absolutely not.
Getting clean and sober is hard enough on its own, without any additional challenges thrown in to complicate things. If you want to make things really, really tough on yourself then avoid rehab. But for everyone else who wants a fighting chance at sobriety, I highly recommend going to inpatient treatment. This is where you will find a full medical detox, peer support, and a safe environment where there is no threat or temptation of immediate relapse. Sure, you might be able to walk out of rehab and go straight to the liquor store, but while you are in treatment there is no immediate threat of relapse, and you have a lot of peer support right there, standing by your side. Everyone at rehab wants to see you succeed; everyone at rehab is dedicated to helping each other to achieve sobriety. This is always going to be your best plan and the number one strategy that you should consider for early recovery.
This is doubly true if you are still struggling with drinking or taking drugs each day. Such a person needs detox and inpatient rehab in a major way. Don’t miss out on this critical step in your recovery!
You may be wondering what exactly happens at inpatient rehab.
As mentioned above, detox happens. After that, residential treatment happens when you are well enough to attend it, and there you will find groups.
Why groups? Because groups work. That is what Bill Wilson and Doctor Bob figured out so long ago when they founded AA and the idea of meetings to support each other. NA says “The value of one addict helping another is without parallel,” meaning that one struggling addict is perhaps best helped by someone else who has sobered up before them, someone who knows right where they are, someone who knows the recovery process inside and out. It is one thing to tell someone “stop taking drugs,” it is another thing entirely to tell someone “I stopped taking drugs, and here is how I did it.” The latter is much more useful we have found, and that is one reason that groups are an important recovery strategy.
Here is another reason that groups are important for recovery: Individuals fail.
Ever hear of a sponsor in AA or NA who has relapsed and let down all of the people who were looking up to that person? I have experienced that many times in my sobriety, and I have watched many individuals fail to remain sober.
So what happens if you are putting all (or nearly all) of your faith into one single person in recovery, and that person should suddenly relapse? It can destroy your worldview, your confidence, and maybe even your sobriety.
No, you don’t want to depend on one single person for your own recovery efforts. You don’t want to have a single guru, someone you have put up on a pedestal, someone that you believe to be infallible. As soon as you do that and come to rely on someone too greatly, that person is likely to let you down.
Groups are strong. They don’t usually fail, because there are always strong people to carry the group when weaker people may fall by the wayside. If someone in the group relapses, there are others to fill in the seats while they are gone. The group remains strong even if an individual fails.
Groups also have a special intelligence that you cannot get when you are alone, or even when you are consulting with a single peer. A group can come together and figure things out that you wouldn’t be able to decipher in a smaller meeting. And if you have a particular topic, say for instance at an AA meeting, then you get to hear multiple points of view and you get to hear a wide range of ideas and interpretations. One of those interpretations may be exactly what you needed to hear in order to move forward in your own sobriety. You can’t get that sort of intelligence without a group setting in some cases.
Groups are powerful in recovery. It is a mistake to try to do it all alone, to ignore the power of groups.
Changing your life through stepwork
Another powerful strategy in recovery is to change your life through the power of the 12 steps.
Now before I continue I want to point out that this is just one path of many in recovery. The 12 steps of AA are but one path that you might take in order to change yourself and your life. There are other ways and you do not necessarily have to depend on the 12 steps to change your life if you prefer to seek out an alternative. However, having said that, a couple of key points you should consider:
1) The 12 steps of AA lay down a set of principles. You can avoid those principles if you want, but doing so will probably hurt your sobriety. So in other words, you may not work the 12 steps, but you still need to surrender. You still need to find some faith. You may need to confess, make amends, work on character defects, and so on. The concepts behind the steps are important, and some of them are fundamental to sobriety.
2) Some people in AA are afraid of relapse, and they project this fear on to the newcomer. So they might say something like “if you don’t work the 12 steps of AA then you will drink and you will die.” This is not true, and whoever makes such statements does so out of fear for their own sobriety (they will try to claim that they are only worried about the newcomer, but this statement reflects their own inner fears). The truth is, there is more than one way to get and stay sober.
If you keep those points in mind then you should have a healthier approach to recovery and to the 12 steps. You don’t have to embrace them necessarily, but you don’t want to avoid the principles that they represent either. If you don’t have any other plan for remaining sober then you might do well to look at them, to work through them yourself.
Changing your life situation
I believe that the younger you are when you sober up, the more important it may be for you to change your life situation.
What I mean by that is getting a clean break away from your old friends, your old peers, the people that you got drunk or high with. If those people stay in your life when you get clean then it will be all but impossible for you to maintain sobriety in the long run. You have to have a way to move forward, make new connections, and move past your old life.
For me this meant changing my entire life situation. I moved into long term treatment, stayed there for 20 months, and never saw any of my old drinking or drug buddies again. I had a girlfriend at the time who was still using drugs and I said goodbye to that relationship too. This was not easy to do. In fact, I count that as the hardest decision I ever made, even more difficult than coming to treatment to begin with. This is because I had an idea in my mind at the time that if I walked away from all of my drinking and drug buddies that I would have no friends and I would be miserable forever. What is the point of life if you are that miserable? I told myself that life would not be worth living if I lost all of my “friends” (who were actually just drinking and drug buddies). But that was how I was thinking at the time and I had no idea how to crawl out of that hole of misery. I did not want to lose all of my friends, but on the other hand I could not picture myself remaining clean and sober if I continued to associate with all of them.
Personal growth and your long term strategy
Perhaps the most important strategy for addiction recovery is your own strategy for personal growth over the long term.
You are probably wondering why this is “the most important.” The reason that I believe this to be the case is because I have watched the threat of complacency slowly and silently take many people back out over the years.
Everyone gets into sobriety and they believe that anger and resentment is the biggest threat. This is true to some extent, and it can be true in early recovery. But in the long run there is a much bigger and more sinister threat, and that is the threat of complacency. People get lazy in their recovery. And this eventually leads to relapse.
So how do we defeat that? How do you protect yourself from the threat of complacency, from inaction, from laziness?
One way is to assume that you are complacent. Right now. Just make the assumption, right at this very moment, that you are complacent in your life. That you are not doing enough right now in terms of personal growth for yourself. Assume that you are slacking off a bit, that you could be doing better.
Maybe you have been pushing yourself really hard lately to exercise and to work out. That’s great. But what about the other areas of your life? What about your relationships? Are you practicing gratitude every day? Are you reaching out to others in recovery who might need help? Are you taking care of yourself emotionally? Are you avoiding guilt, shame, resentment, and self pity? Have you looked at your character defects lately and come up with a plan to reduce or eliminate them? And on and on and on.
There is no shortage of work to be done, on yourself, in recovery. If you think that you are cured and 100 percent perfect then you are probably just setting yourself up for relapse. And that is the whole point–we don’t want to fall into that trap today! So what is the opposite of believing that you are perfect in recovery and that you are cured? What is the opposite of that?
I will tell you what the opposite is: The opposite of being “cured” in recovery is to realize that we still have work to do on ourselves. Always. That there is room for growth. Room for personal improvement. In many different areas of our lives.
When you make progress, when you are learning about yourself and growing and changing–that is recovery. When you stop doing those things, you tend to relapse.
Therefore you might consider making this simple assumption in your own life today.
Just assume that you are not perfect. Assume that you still have work to do on yourself. Assume that you need to push yourself a bit more to make some personal growth in your life.
This is a really strong long term strategy for recovery. Think of it continuous and ongoing self improvement. If you stop this process of personal growth then it sets you up for the possibility of relapse. The best way to protect yourself is to make this simple assumption: “I still have work to do on myself.”
Those are the basic strategies that have served me well in my own recovery journey. What has worked for you? Let us know in the discussion forums. It only takes a second to register!