What Happens After Addiction Treatment?

If you’re planning for life after addiction treatment for yourself or a loved one, there may be many questions going through your mind about what to expect or do. While treatment is a structured, contained environment that provides safety and security, the thought of leaving can often be scary. Since treatment doesn’t last forever, it’s ideal to make some plans ahead of time about what will be in place for you or your loved one before getting out of treatment. I’ve outlined some things to keep in mind in your planning process.

Outpatient Treatment
Outpatient treatment often provides an easier transition to life outside of addiction treatment. Since outpatient takes place on a lesser scale than inpatient treatment, it offers a smooth transition from 24/7 supervision and care to being home or in sober living. In outpatient treatment, you can expect to receive both group and individual therapy which provide an outlet for difficulties that you may be experiencing, as well as the continued learning of coping skills and strategies that can further enhance your relapse prevention plan. It is ideal to set up an appointment with an outpatient provider immediately following your discharge from inpatient treatment in order to improve the continuum of care. See also “What is Outpatient Treatment” for more information about what you can expect in an outpatient program.

Recovery Network
Building a recovery network is an important step in any aftercare plan and in order to continue on in the recovery journey. You can work on building your recovery network by attending local meetings in your area in fellowships such as: Alcoholics Anonymous, Narcotics Anonymous, any other Anonymous fellowship, SMART Recovery or Dharma Recovery. No matter the path that you choose, it’s important to be open and willing to meeting new people to expand your network of supports. By getting involved with these recovery communities, it makes it easier and more beneficial to the recovery process.
A recovery network can also consist of any friends or family members that are supportive of your recovery. Not everyone might be, so it’s important to assess these relationships responsibly. If you have someone that doesn’t support your goals to be in recovery, or maybe doesn’t follow your wishes about not drinking or using near you, then they may not be beneficial to your new journey. Navigating these relationships can be challenging, so before making any decisions on what to do about them I would talk to people that you know and trust. Sometimes we have to completely end relationships, while others we just have to put on hold for a while. It’s up to you and your support network to figure out what’s best for you. For the relationships that are in favor of your recovery, it’s good to incorporate them into your relapse prevention plan so they can help to support you and hold you accountable. It also helps to let them know what your triggers are and also what helps you when you’re going through a difficult time so that they can be there for you and offer some help.
Any healthy recovery network is going to have some variety of people, but if you don’t have anyone right now, that’s okay too. Get to some recovery meetings as soon as you get out of treatment and let people get to know you, and you get to know them. Be open to building new relationships, and your network will grow quicker than you think.

Get Involved
Some people return to work or school after addiction treatment, while others take their time and focus on building their recovery network and system. However, you choose to spend your time, make sure you’re using your time productively. Get involved in something that makes you feel good or useful, whether it’s work, school, volunteer work, hitting meetings, making new friends, getting in service, engaging in exercise, etc. Making good use of your time helps to build self-esteem and also helps prevent idle time that you may find challenging or triggering.

Self-Care
Engaging in self-care is important for any human, but particularly for those in early recovery. Finding joy and peace wasn’t something that came naturally or easily, if at all, for us in addiction. But it is really important for us to find those things in the recovery process. Maybe you had a hobby or hobbies that you enjoyed before addiction, or maybe you have no clue what you enjoy doing. Setting aside time to find things that you enjoy is a crucial part of the healing process. It doesn’t have to cost money either, so if you’re on a budget or maybe lacking income, you can find some things to do that are free or low-cost, like walking in a park/taking a hike, reading a book, people-watching, getting coffee or ice cream by yourself or with a friend, etc.

Your new journey in recovery outside of treatment may feel really unnatural and uncomfortable at times. You may have a lot of questions and feel really unsure about the whole process or what to expect. The bottom line is that there are people and places that are going to support you and your journey in sobriety, and it’s important that you make an effort to find those people, especially if you don’t already have some of them. Developing a thorough relapse prevention plan with the help of your counselor before you leave treatment is important, and following that relapse prevention plan after you leave treatment is imperative. Look within yourself for some open-mindedness and willingness to try new things and put yourself out there a bit, even if it feels weird. Do things that feel good for you. Make time for yourself. And most of all, work really hard on figuring out who you truly are without the use of substances, allow yourself to feel, and don’t beat yourself up for your journey thus far. It doesn’t always feel as uncomfortable as it may feel in the beginning, but the uncomfortability is important for us to grow.
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Ben Affleck on Addiciton- Part 2

Ben Affleck opens up to Diane Sawyer
Ben Affleck opens up to Diane Sawyer on his supportive friends in Hollywood, his sobriety and his new movie “The Way Back.” https://gma.abc/3bQOO2Z
Posted by Good Morning America on Friday, 21 February 2020

Ben Affleck continues to share his vulnerability in discussing his experience with addiction. The interview with Diane Sawyer is bringing a lot of positive attention for Ben, with people thanking him for being open about his experiences with addiction as a man in the spotlight. The fact that Ben’s interview and openness is bringing positive attention provides hope that the stigma on addiction is fading. Ben’s bravery, along with so many others in the spotlight such as Eminem, Robert Downey Jr. and Elton John, is helping to pave the way in showing that recovery is possible and available to anyone.

Addiction and Mental Health
Ben has been struggling with anxiety and depression since his mid-twenties, trying many different therapies and medications to help him with his mental health. As many of us know, addiction is often co-morbid with a mental health diagnosis. As we often see, and is discussed by Ben as well, mental health and addiction often run within family systems and are genetic in origin. For some, the addiction becomes a way to self-medicate the mental health symptoms.
Ben describes his routine in maintaining his mental health and recovery and describes himself as someone who likes to have meaning and purpose. He discusses his spirituality, and although he doesn’t consider himself religious, he finds it important to attend church with his children, a tradition that started during his previous marriage.

Having Regrets
In the interview, Ben talks about having regrets and sometimes wanting to go back and change things in his past, from divorce to not being present for his children. However, he has chosen to learn from his mistakes and move forward in his recovery and is also dedicated to speaking out about his experiences in an effort to help others. Instead of dwelling in his past, he chooses to learn and continue to take steps ahead, as many of us often have to do in recovery as the pain of living in the past is too painful.

Living in Hope
The biggest part of Ben’s message is to live in hope because regret can be the thief of your joy. This is one of the most important aspects for someone in recovery to practice. In order to heal, we need to place our focus not on the things we’ve done or how much pain we’ve caused, but rather how we can take steps to heal that pain in ourselves and others. As Ben discusses, finding joy and creating joy are the two biggest parts of the healing process. In the interview, not only can you feel the pain as Ben talks about his life, you also experience the gratitude in his message. Experiencing addiction or a relapse is painful but getting out of the addiction and using that pain as a motivator to grow and succeed is possible, whether you’re a celebrity in the spotlight or a regular person in an everyday life.
Regardless of your experiences with addiction and mental health, or your family history or genetics, you have a chance to change the cycle and create your own narrative on a new journey. There’s a lot we can learn from Ben’s interview with Diane Sawyer, but the biggest take-away is that the lie is dead, recovery is possible.

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Ben Affleck on Addiction Part 1

Ben Affleck opens up about his battle with alcohol
GMA EXCLUSIVE: “I really don’t want my children to pay for my sins.” Ben Affleck opens up to Diane Sawyer about his sobriety battle and how his dad’s addiction to alcohol taught him “how important it is for me to be sober.” https://gma.abc/32dwcpy
Posted by Good Morning America on Thursday, 20 February 2020

This morning on Good Morning America, Ben Affleck took part in an interview with Diane Sawyer on his experiences with addiction, relapse and recovery. Ben offered his story that mirrors so many of the stories for those that have struggled with addiction. He talks about how he first got sober in 2001, stayed sober for a couple of years, and eventually began to believe that he could drink again at dinner, with friends or at special events.
Guilt, Shame and Relapse
He quotes that “sooner or later your vulnerabilities can find you”, and he found himself drinking more, and telling himself that he could stop again, denying that he was an alcoholic. However, despite his previous experience in sobriety, he found himself nearing a divorce and experiencing the guilt and shame of letting his family down and potentially recreating his family cycle.
Ben describes his upbringing and alcoholic father, a grandmother that committed suicide amidst alcohol and barbiturate use, and an aunt that was also an addict. He also had a history of depression that he struggled with for years. He recalls having thoughts as a child that he didn’t want to end up like his father, that he “was never going to do that.” He now, in his recovery, uses that experience to learn from his father and decided that he wants to be present for his children during their formative years. Drawing from his own experiences, he doesn’t want to repeat the same patterns for his own children.
Finding Recovery Again
He went to rehab twice within the last 3 years, with the hope of not making his children pay for his mistakes, or to be afraid for him. Ben’s relapse was made public via social media and TMZ. He recalls this moment as a wake-up call for him, and became ready to make a change in his life.
In Ben’s new movie, The Way Back, he illustrates the pain and consequences of addiction through his character that plays a basketball coach struggling with addiction, who suffers consequences related to his addiction such as losing his job. The character finds his journey toward recovery, along with the underdog basketball team that he works with who end up finding their own successes as well.
Learning from an Underdog
Ben’s story doesn’t just signify the part of addiction that people like to laugh at or point at or make judgments towards on a public forum like social media, as seen by the responses to his relapse that was made public. Ben’s story paints the picture of any persons recovery story, inside or outside of the spotlight. Not every recovery story is free of speed bumps, relapses or mistakes. Rather, it’s an ongoing process that takes a lot of learning and growing and motivation to believe in yourself. Although relapse doesn’t have to be part of someone’s story, if it is, it still isn’t the end of the road. There is hope no matter how much harm has been caused, or time lost, or feelings of hopelessness or feeling defeated. Although we may not view Ben Affleck as someone that we would consider an underdog, his experience with addiction isn’t any more glamorous or less painful because of his celebrity status. Every underdog has a chance at recovery.

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What is the Difference Between Suboxone and Methadone?

When looking into chronic pain management or Medication Assisted Therapy (MAT), there are many different options that you may come across. Suboxone (brand name for Buprenorphine) and methadone are the most common forms that you may find or hear about. While methadone is approved to treat both chronic pain and opioid dependence, Suboxone is approved only for opioid dependence. There are many important factors to consider when comparing Suboxone and methadone, and it’s really important to do your research before you or a loved one start the treatment process for either one of these medications.

Potential for Abuse
Methadone is considered a Schedule II controlled substance, which means that it has a high potential for abuse and could potentially lead to physiological and psychological dependence. Other drugs in this category that are considered to have the same abuse potential include: cocaine, methamphetamine, oxycodone, Adderall and Ritalin.
Suboxone is considered a Schedule III controlled substance, which indicates a moderate to low potential for dependence. Other drugs within this category include ketamine, Tylenol with codeine and anabolic steroids.
Depending on the method of administration, some forms of methadone and Suboxone are easier to abuse depending on how they’re taken/given and where they’re stored. If someone is on a methadone maintenance program and receives their dose at a clinic, it’s important that the clinic staff have sufficient protocol in place in order to reduce clients diverting the dose to either save for later or sell to someone else. For those on Suboxone, if they’re in charge of their prescription and responsible for taking the daily dose at home, it’s easier for them to misuse the medication or avoid taking doses in order to sell them. As discussed, both drugs have potential for abuse as well as physiological and psychological dependence.

Dosing
Regardless of whether or not someone is on methadone or Suboxone, both drugs require a valid prescription from a licensed physician as well as regular oversight and monitoring from that physician. If the physician that you’re working with isn’t particularly trained or educated in addiction medicine or treatment, I would consider doing some research to find a provider that is, so that you or your loved one can be properly treated and recommended to the best course of action for the individual. Dosing depends on the individual’s history of drug abuse, chronic pain, and/or risk for withdrawal symptoms. Typically, with methadone, someone is started on a lower dose and is then increased in increments to get them to a therapeutic level.
Typically, methadone is provided at a clinic that the individual has to go to every day, usually in the morning hours, to receive the dose. Sometimes participants will be eligible for what’s called ‘take-homes’ which means that they can bring home their daily doses to take on their own. If it’s a quality clinic, they typically provide some outpatient counseling services to supplement the methadone treatment.
Suboxone is most often prescribed on an outpatient basis by an addiction treatment provider, psychiatrist or primary care physician. The prescribing physician will order the medication from the patient’s pharmacy for them to pick up and take at home (usually ordered in 30-day increments). The individual is in charge of taking their daily dose responsibly in this case, although sometimes family members will choose to hold on to the medication and give it to their loved one as prescribed in order to reduce the risk of abuse.
Buprenorphine has recently become available in an extended-release injectable form, which is given on a monthly basis in a physician’s office or outpatient center. This new injectable form makes it significantly more difficult to divert and abuse the medication.
Taking too much of either of these medications can lead to overdose. It’s important to follow physician recommendations in order to avoid overdose.

Cost and Insurance
Both the brand-name Suboxone and the generic Buprenorphine are more expensive than methadone. Both Suboxone and methadone require a prior authorization from your physician to approve payment by the insurance company. If you’re unsure whether or not your insurance provider will cover the cost of either of these medications, you can call the phone number on your insurance card and ask.

Withdrawal/Coming off of methadone or Suboxone
Because methadone and Suboxone are opioids, they’re going to induce a similar withdrawal experience as other opioid drugs when decreased or removed from the body. These symptoms are uncomfortable and sometimes life threatening if not treated properly by a medical professional. It is not advised to discontinue the use of these medications without the assistance of a licensed physician or substance abuse treatment center that can provide a medical detox. These symptoms can include:
Muscle aches or cramps
Trouble sleeping (insomnia)
Feeling hot or cold
Nausea or vomiting
Diarrhea
Goose bumps (also called goose flesh)
Watery eyes
Runny nose
Sweating
Shaking
The withdrawal process for Suboxone can last around one month for complete cessation of all physical symptoms. The first 72 hours of withdrawal are the worst. After the first 72 hours and within the first week, the individual can expect to experience body aches, insomnia and mood swings. While the physical symptoms of withdrawal may subside after the first month, the psychological symptoms may linger, along with cravings and depression.
Complete physical withdrawal symptoms from methadone can last anywhere from several months up to 1 year, depending on the dose and length of use the person was on. This is known to be a very uncomfortable and challenging process for many people coming off of methadone.
Regardless of either substance, it is important for a person to be involved in a medical detox protocol in order to ensure safety of the person. This process needs to be overseen by a physician and trained clinical team that can support and assist in the detox process.

Choosing a method of Medication Assisted Therapy is a big decision and shouldn’t be considered without some information and research on behalf of the individual involved as well as the support of their loved ones that are involved in their recovery process. MAT is not for everyone, but it can be really helpful and beneficial to the recovery process for those that struggle with chronic use and addiction. Before deciding if Suboxone or methadone are right for you, be sure to consult with your physician, counselor or therapist, psychiatrist, or any other professional that may be involved in your life and treatment process. If you’re considering either one of these medications, or maybe already on one of these paths, be sure to follow the recommendations of your physician and treatment team before making any changes in your plan or regimen.
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How to Celebrate a Sober Valentines Day

If you’re new to recovery, or new to dating in recovery, Valentines Day can get pretty stressful when trying to think of something to do with your significant other without drinking. Or maybe you’re single and want to celebrate yourself as a newly sober person! Either way, there are many things that you can do that don’t involve drinking or using on Valentines Day.
Food
Who doesn’t love to celebrate a holiday with food? Whether you’re celebrating with a significant other, a family member or yourself; going out to eat for a nice dinner is always a good option. If you want to avoid places that serve alcohol, Google some local restaurants that are BYOB or alcohol free so you can avoid the option of ordering from the bar. A lot of people are hesitant about going out to eat by themselves, but I can tell you from experience that it’s one of the most empowering and freeing experiences. If that’s not your thing at all, no problem! Order some take-out to eat in the comfort of your own home. Just a reminder for anyone looking to go out to eat – don’t forget to make your reservations, like today!
Movies
Going to the movies is always a good option for a sober activity. I’ll say the same thing I said here that I said about food; take yourself to the movies if you don’t have anyone to go with you! It’s really enjoyable and you don’t have to share your popcorn with anyone (major plus). Unless of course you want to share your popcorn, then bring a significant other, a family member or a friend. Or if you’re on a budget, watch a good movie that you’ve been wanting to see at home and make your own popcorn!
Doing Something Thoughtful
You could do something thoughtful for someone that you care about, like sending them flowers or a box of chocolate covered strawberries. Better yet, you could make your own chocolate covered strawberries at home either by yourself or with someone else. You could also offer to do something for them, like clean their car or help them out in some other way. Acts of gratitude like this go a long way to show your appreciation for someone that’s important to you. If you wanted to splurge a little, you could plan a spa day or a self-care day with a massage, facial, etc.
Cook/Bake At Home
Inviting your loved one over to cook a meal together or bake together is a great bonding experience and a great way to enjoy each others company on Valentines Day. Cooking a meal at home is often cheaper than going out to eat, so if you’re on a budget this may be more doable for you. Find out what they like to eat, go to the grocery store ahead of time to stock up on supplies needed, put a playlist of their favorite music together and have it playing in the background while you cook or bake together.
Sober Events
Many different recovery fellowships will host things like ‘Sober Dances’ or other Valentines Day events for people in recovery. Going to these events not only allows for socialization with people also in recovery, it’s also a great way to make friends and get involved in your local recovery community. Most of the time they’re pretty cheap to attend, or even free, and all you have to do is show up and participate. If you’d like to learn more about events in your area, get to a local recovery meeting and ask around – they will be glad to share the information with you about upcoming events.
Friends
Getting together with a group of friends on Valentines Day can be a ton of fun and a total memory-maker. Have some friends that you like to spend time with? Send them a call or text and ask them if they want to do something together. You can use any of the options listed above, or another option depending on everyone’s ideas and interests. You can get/make them Valentines cards or sweets.
Self-Care/Self-Love
This part, to me, is most important. Finding ways to care for yourself is crucial for any human, not just those in recovery, but particularly for those new to recovery as we tend to not be very easy on ourselves after our addiction ends. Ask yourself, what do I like to do? What makes me feel happy or good? What ways do I like to relax? What helps me recharge? Whatever your answers, find ways to participate in at least one of those things for Valentines Day. Set aside some time to celebrate and enjoy yourself, because after all it’s really hard for us to give love to others if we don’t have enough to give ourselves.
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Ways to Find Sober Friends

Entering into recovery for the first time can be scary, nerve-wracking, anxiety provoking and can sometimes feel lonely. We hear all the suggestions about ‘building a network’, ‘get to know people’, ‘let people get to know you’, as well as the ones about changing ‘people, places and things.’ This often feels overwhelming; especially when we don’t even know where to start in meeting new, sober friends. There is, however, some solutions and suggestions that you can try, whether you’re a social person or more of a private, introverted person.

Attending Recovery Meetings

Recovery meetings, whether they’re 12-step based, SMART Recovery or Dharma Recovery, are full of people that are on the same path as you. Those people too have been new, afraid, and unsure about how to do it all. Because they share this similar experience, it’s easy to find people that are willing to help you feel more comfortable and welcomed. When you attend a meeting, sometimes you’ll find people that will approach you on their own, when others you may have to ask for help or put yourself out there. Either way, there are people that want to get to know you. Often times, people will go out after a meeting to eat or get coffee and may invite you come, or if not you invite yourself (not easy if you fear rejection), but they would be more than happy to have you come along.

Getting a sponsor and a home group

These are two things that are built-in suggestions in any 12-step recovery program, and also happen to be good ways of meeting people and making friends. By getting a sponsor and letting them get to know you and you get to know them, you also get to know their network and group of friends. Your sponsor might invite you to other meetings or get-togethers with their friends, thus giving you the opportunity to get to know some new people. When you get a home group that you show up to on a regular basis, the people in the meeting get to know you and vice versa. Home group members will sometimes go out together before or after the meeting, or have gatherings together and invite you along as a fellow group member. At the very least, they are people that you see every time you go to your home group giving you a regular opportunity to build relationships with them.

Recovery events

Many recovery support groups hold functions such as dances, event nights, speaker jams, conventions, fundraisers, etc. These events are great opportunities to meet new people and also experience fun in recovery. They’re often free or low-cost events, making it easy for anyone to attend. They’re announced at local recovery groups so attendance at meetings will give you information about what’s going on in your local recovery community.
No matter your path to recovery, there are thousands of people that share similar experiences as you and have the same goals of living a life of sobriety. No one has to, or should, do recovery alone. This is why any recovery group focuses on the ‘group’ as a support system, because it is not meant to do alone. If you struggle with meeting new people or letting people get to know you, you’re not alone in that either. Start small if you have to, meet just one or two people to start and begin building those relationships. To start to make friends in recovery, all you need is 1 friend. From there, we build our networks through the process of participation in recovery. If attending meetings is really difficult for you, or not possible at all, there are a number of online recovery support groups that allow you to interact with others across the globe, and even just in your local area.
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Is there a Difference between AA and NA?

There are many differences between AA and NA, and many fundamental similarities as well. Whether you are trying to choose which fellowship is right for you, looking to become more educated in order to support a loved one, or seeking general information, it is important to be armed with the facts. Both NA and AA pride themselves on Anonymity and so you may find it difficult to know where to begin. The best place to start is knowing that both fellowships have the same purpose, and knowing a little more about what they aim to do.
Both NA and AA are 12-step fellowships, whose focus is to help those who struggle with substance abuse maintain long-term recovery. Narcotics Anonymous and Alcoholics Anonymous both focus on community and sponsorship, in conjunction with the 12 steps, to help achieve this goal. They are not allied with any organizations or religions, and are not-for-profit. Both are self-supporting and altruistic fellowships and are open to anyone who thinks they may need help in overcoming their struggle with
History of Alcoholics Anonymous
There are many differences between AA and NA, and many fundamental similarities as well. Whether you are trying to choose which fellowship is right for you, looking to become more educated in order to support a loved one, or seeking general information, it is important to be armed with the facts. Both NA and AA pride themselves on Anonymity and so you may find it difficult to know where to begin. The best place to start is knowing that both fellowships have the same purpose, and knowing a little more about what they aim to do.
Both NA and AA are 12-step fellowships, whose focus is to help those who struggle with substance abuse maintain long-term recovery. Narcotics Anonymous and Alcoholics Anonymous both focus on community and sponsorship, in conjunction with the 12 steps, to help achieve this goal. They are not allied with any organizations or religions, and are not-for-profit. Both are self-supporting and altruistic fellowships and are open to anyone who thinks they may need help in overcoming their struggle with substance abuse.
History of Narcotics Anonymous
Alcoholics Anonymous found its beginnings in Akron, Ohio in 1935. It was founded by Bill Wilson and Dr. Bob Smith, and sprung up out of an overwhelming need for better treatment for alcoholics; prior to this the best and only treatment available to anyone struggling with alcoholism was the sanitarium. AA began with the principal of one alcoholic being able to help another through compassion and understanding, and around that simple principal the steps were created. Bill Wilson began writing the Big Book of Alcoholics Anonymous in 1938 after his own experience with sobriety. In the Big Book he outlines the 12 steps and his own experience with them. From those first drafts and first meetings, an international organization was born. Hundreds of thousands of AA meetings can be found in almost every country on the planet today.
What is Different?
The differences between AA and NA are subtle but definitive. AA uses the Big Book as their guiding literature, and its 164 pages illustrating all of the steps as outlined in its chapters. NA uses a workbook as well as the Basic Text, and there are questions for each step to be answered by the addict. Aside from the Big Book and the Basic Text, both fellowships also have an abundance of other literature specific to their fellowship covering a wide array of topics. NA meetings are sometimes 90 minutes long, depending on the area where you are attending the meetings, while AA meetings are usually an hour. The differences can change from area to area, and are sometimes less or more drastic depending upon where you find yourself attending meetings. AA focuses on Alcoholism, while NA focuses on all narcotic substances (including alcohol) as well as the disease of addiction. Milestones in AA are marked by coins, and in NA they are marked by key tags and medallions.
What is Important to Know
Both of these fellowships, as well as any others you may come across (hundreds of Anonymous fellowships exist today) pride themselves on first and foremost wanting to help and to welcome anyone who is struggling. Sponsorship, community, honesty and altruism are the main focus of most Anonymous meetings. The idea is that one person can help another, and everyone needed help at one time. There is no fee included in participating. No one is too young or too old to join. Often, there are meetings of specific fellowships that are men’s only, or women’s only, or LGBTQ only, but never are they meant to exclude anyone. They are different only so that a person who is struggling with substance abuse can find the place they feel the most comfortable to recover. Both NA and AA can agree that it is not so much the substance that is the problem as the underlying disease of addiction.
The important thing to remember, be it for yourself or for someone you love, is that substance abuse is seldom overcome alone. AA and NA both seek to support those who suffer, and the important thing is that a person who is looking for help finds a place where they feel at home. Moreover, there are also fellowships whose main purpose is to help the families and loved ones of those struggle with addiction but who are not addicts themselves. Alanon and Naranon are subsidies of both AA and NA and offer support to those who are affected but are not themselves afflicted.
Remember, it is important to do your own research as well as remain open-minded. Often, a person doesn’t choose a fellowship until they have tried both AA and NA for themselves. No one thing works for everyone. Both fellowships histories and practices are different but the message is universal; we can recover.
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Codependency & Enabling: Universal to Alcohol and Other Drug Addiction

Codependency and enabling are deep-rooted features of alcohol and other drug addictions.
Effective treatment of such addictions requires that these two behaviors – so common among spouses, family members, loved ones, and friends of the person suffering from drug or alcohol addiction – be identified and addressed, individually and in conjunction with the addicted person’s treatment.
Codependency most often originates once that spouse, family member, loved one, or friend becomes and stays controlled by their loved one’s addictive behavior. Codependents themselves lack a sense of power in their lives and are unable to take responsibility for their own happiness and well-being. They instead turn to manipulating and controlling others. Almost their entire day-to-day focus is external rather than internal. They live for and/or through another person and obsess over caring for and controlling that person’s actions.
Codependents exhibit ongoing anxiety and worry, ‘sell’ themselves out to care for others, ignore or mistrust their own feelings, tend to isolate, and often experience bouts of depression. Difficulty with emotional intimacy and keeping bad relationships and impairing good ones are also characteristic of the codependent person.
Enabling differs from codependence in that it primarily keeps the person suffering from a substance use disorder from having to face the negative consequences of their addiction(s). Enabling behavior occurs when another person (more often than not a codependent) indirectly and/or directly actually helps or encourages the addicted person to continue using drugs.
Solving the problems of someone affected by alcohol or drug addiction makes the enabler feel as though they are doing something good for the person they care about. The truth, however, is that they are further damaging them by allowing them to continue their self-destructive behavior. Enablers essentially perpetuate their loved one’s addiction. The one thing that all enablers seem to have in common is that they love someone who is out of control, and they take more responsibility for the actions of that person than the person is taking for themselves.
We know from experience that codependents and enablers also share at least one mutual trait, which is their almost total compromise of self. Codependents and enablers fundamentally need to reclaim themselves, to achieve rewarding and healthy lives and relationships. Restoration of self is therefore key to overcoming codependency and enabling, and can be achieved through appropriate counseling and its adjunctive facilitation of the establishment and maintenance of peer support systems.
Learning about, adopting, and using some simple tactics with those suffering from alcohol or drug addiction can help codependents and enablers free themselves of their own unhealthy and hurtful thinking and behavior. These tactics include being honest with themselves – stopping ignoring or minimizing facts, and realizing although painful and challenging, they are true; dealing with their own pasts and any unresolved trauma(s) and pain; disciplining themselves to be less reactive and more self-caring; setting healthy boundaries and realistic expectations; and naming and holding to limits.
Overcoming codependence and enabling isn’t free of difficulty nor does it progress obstacle-free or happen overnight. But surmounting them can and does happen. For that reason alone, we urge all who knowingly suffer from codependence and enabling (and those who think they may be suffering from it) to seek help, much as their loved one with a substance use disorder who wants his or her suffering to end likewise asks for help. Doing so more often than not results in the achievement of a healthy and rewarding life, and lasting, meaningful relationships.

Author
Dr. Gregory Serfer, DO
Tully Hill Treatment & Recovery Medical Director

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What is Alcoholism?

There may have come a time where you were concerned whether it is for yourself, a friend, or a loved one where you question, is that too many drinks? Is it normal to feel the way I do? Should I cut back on drinking? Is it social drinking or is it more than that? This can then lead to an internet search for “what is alcoholism?”. Depending on what you read it can be very overwhelming for any person to sit through all the websites trying to understand what exactly does it mean to be an “alcoholic”.

According to the Mayo Clinic, The clinical definition is that alcoholism is the inability to control drinking due to both a physical and emotional dependence on alcohol. An alcohol abuse disorder refers to a long-term addiction to alcohol. Meaning that a person with this condition does not know when or how to stop drinking. They spend a lot of time thinking about alcohol, and they cannot control how much they consume, even if it is causing serious problems at home, work, and financially. It’s important to understand that an alcoholic does not always drink on a daily basis. Alcoholism is characterized by the inability to control the intake therefore you can have someone who does not drink for a week at a time, however, binges for 3 days until they are completely intoxicated and unable to function. You can also have someone who drinks on a daily basis and is unable to function without the use of alcohol. Both examples are possible.

What does Alcoholism look like?
Alcoholism is a disease. Like drug addiction, alcoholism does not discriminate. It can touch any person from any gender, race, religious background, economic background, socioeconomic status, etc. There are multiple theories in regards to how alcoholism can affect a single person; society’s role, the biological contribution, and the disease concept are the three main theories that are discussed today. Regardless of the theory that you may agree with or how alcoholism started for you or your loved one, there are warning signs to be aware of;

The individual begins to neglect responsibilities in order to drink. It is important to understand that it is possible to be a functioning alcoholic. There are many individuals that can maintain their employment, pay their bills, and carry on with normal activities which can cause a concern for their loved ones when it is revealed that the individual is struggling with an alcohol use disorder due to having everything in order. Over time this does not typically last.
Being arrested for DUIs or public drunkenness. Driving intoxicated is not something that most individuals plan on doing however when you have engaged in the use of alcohol so often it becomes to feel like your reality and normal to you. You begin to make excuses for behaviors including driving. This can become very dangerous as not only are you putting yourself at risk but those around you as well.
Self Medicating. The Use of alcohol as a relaxation or stress aid is very common for most individuals who are diagnosed with an alcohol use disorder. When you are having a stressful day, a fight with a loved one, feeling anxious or depressed, and you resort to the consumption of alcohol to help treat or handle these situations that can be a warning sign.
Avoiding family or friends in order to drink. Have you begun to make excuses to not attend activities because you have either felt too sick to attend due to drinking the day/night before or because you would prefer to stay home and have a few drinks? This can also be a warning sign as it represents isolating behaviors as well as the fear of allowing others to witness the increased consumption of the alcohol beverages. There is also another aspect of this warning sign where you may only be surrounding yourself with those that do engage in drinking alcohol.
Unwillingness to stop drinking, even for a short period of time. Whether it is because of your personal choice to not remain sober for a few days or a longer period of time or it is because of the physical symptoms you are experiencing due to the withdrawal of alcohol, the inability and unwillingness to stop drinking is a primary warning sign.
Uncharacteristic changes in behavior. Have you noticed a shift in your behaviors. Are you more irritable, increased fatigue, increased anxiety, or more depressed? These can be contributors to the increased alcohol consumption which in return can cause a shift in your behaviors even more.
Withdrawal symptoms. Have you experienced physical illness when you have refrained from the use of alcohol? Have you had difficulty with feeling anxious, shaky, headaches, stomach pain, etc. physical symptoms of withdrawal from alcohol can differ from person to person however when you have remained alcohol free for a period of time after consuming large amounts of alcohol for a longer period of time, it is highly likely to experience physical withdrawal.

Where do you go for help when you are struggling with an alcohol use disorder? Here are a few helpful tips:
First understand reaching out for help can cause a lot of anxiety. You are not alone. When you abruptly stop drinking, your body is deprived of the effects of alcohol and requires time to adjust to functioning without it. This adjustment period causes the painful side effects of alcohol withdrawal, such as shakes, insomnia, nausea, and anxiety. It is strongly recommended you engage in assistance from a medical provider as alcohol withdrawal can be life threatening. This can be different for each person that is experiencing withdrawal however it is better to be safe. Most alcohol detox programs utilize medications to help allow you to be comfortable through the process. Treatment centers can also provide personalized care for you while you are working on being sober. Everyone is different and every situation is different therefore treatment needs to be individualized. Hospitals, clinics, and local drug and alcohol centers are your best option to help gain more information on where you can obtain help, what to expect, and what treatment would consist for you. Detox services, inpatient treatment programs, outpatient counseling services, and 12 step programs are very beneficial for individuals who are working on living a sober life.

Accepting that you may have an alcohol use disorder can be overwhelming and cause a lot of anxiety. Remember that you are not alone and there are multiple options for you to utilize. Review the warning signs, reach out to a medical provider, and remember there is help available.

Resources:
Mayo Clinic, (https://www.mayoclinic.org/diseases-conditions/alcohol-use-disorder/symptoms-causes/syc-20369243)
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Can You Be Addiction to a Person?

Understanding the origin of codependency, it’s long-term effects and available treatment options
By Alisha Barnes, M.S.

What Is Codependency
Codependency is the reliance on another person for reassurance, validation and security. A codependent person may present with difficulties making independent decisions, struggle with self-esteem outside of the context of the relationship and a value system that is heavily concerned with the thoughts and opinions of others. While a healthy relationship incorporates the input of both parties, a codependent relationship heavily caters towards one party more than another. Codependency can present itself in various contexts, but universally consists of one individual thriving on needing to be needed, assuming a “giver-rescuer role,” while the other individual comes to rely heavily upon the support of the giving individual and adopts the “taker-victim role.” Although this may appear within romantic relationships, codependency is just as commonly found in platonic relationships and may even be the product of a parent-child dynamic. It is unlikely that an individual is born with a codependent personality; rather, it is developed based upon interactions with primary individuals in the persons’ life. Thus, early childhood attachment is critical in developing healthy relationships with appropriate boundaries. Attachment theory addresses the importance of a bond between an infant and caregiver and how this attachment influences the child’s behavior and emotions into adulthood.

Attachment Theory
There are four different theories of attachment, including secure-autonomous, avoidant-dismissing, anxious-preoccupied and disorganized-unresolved. Each attachment style differs in how the individual communicates their needs in a relationship, as well as how they listen and understand the emotional needs of the other person.

Secure-Autonomous Attachment
The child who forms a secure-autonomous attachment is likely to have been raised in a household where their caregivers were in-tune with the child’s needs, sensitive in the ways in which they responded to these needs and further encouraged the child to express their concerns in a healthy manner. This child enters into adulthood able to communicate their needs, willing to address conflict as it arises and able to respect space within the relationship. This individual is unafraid of rejection, as they have experienced a sense of independence that has previously been respected, without creating a challenge to the relationship itself.

Avoidant-Dismissing Attachment
The child who forms an avoidant-dismissive attachment is likely to have been raised by disengaged caregivers. This child develops into an adult who is logical in nature and therefore, responds well in a crisis, but avoids the communication of emotional needs. This individual tends to perceive relationships as interfering with autonomy and infringing upon independence.

Anxious-Preoccupied Attachment
The adult who presents with an anxious-preoccupied attachment most closely resembles the characteristics seen in the codependent personality. This child was likely raised by caregivers who were inconsistent in their parenting style, who may have been unpredictable and whom often either misunderstood or were unable to meet the needs of the child. This child often develops into an adult whom fears abandonment, rejection and remains anxious of these possibilities within the context of the relationship. The issues of the past tend to intrude upon current relationships, leading the anxious-preoccupied adult to seek reassurance, exhibit needy or clingy behavior and present with poor personal boundaries.

Disorganized-Unresolved Attachment
The child who forms a disorganized-unresolved attachment are likely to have experienced significant losses or traumatic experiences in childhood that were poorly tended to by presenting caregivers. As adults, these individuals tend to present with difficulty regulating emotions, a tendency to engage in dysfunctional relationships and an unconscious pattern of recreating past traumatic experiences.
Attachment styles tend to be passed down from one generation to the next, as individuals tend to parent in the manner in which they themselves were parented. While the above-mentioned attachment styles offer insight into how our emotional connections in adulthood are impacted by childhood, this is not an exact correlation. Ultimately, how emotions are managed is more important than the circumstances that led to the presence of said emotion.

The Role Of Boundaries In Relationships
While the knowledge of attachment theory is crucial in understanding the origin of codependent behavior, of equal importance is the role of boundary setting throughout all phases of life. Healthy boundaries serve to determine acceptable and unacceptable behaviors in a relationship. They further identify ones emotional needs, desires, and value system, while establishing limits. Implementing healthy boundaries requires that an individual be open and honest in communicating who they are and what they want, with healthy boundaries being best derived from a firm sense of self. While boundaries can be influenced upon ones upbringing, they are further developed over the course of friendships, romantic relationships and other interpersonal experiences. An individual’s sense of boundaries may expand over the course of these experiences, as the person grows to better understand who they are and what they are seeking through various relationships. In contrast, unhealthy boundaries involve a disregard from ones own emotional needs and limits. The development of unhealthy boundaries may result from poor self-esteem, uncertainty regarding ones needs and a desire to please others. Part of building healthy and stable relationships is through the use of healthy boundaries, with codependent behavior often being further exacerbated through a lack of healthy boundaries.
So can someone be addicted to another person? In short, yes. Codependency often serves to distract from inner pain or emptiness, that may or may not have been experienced through childhood, but is almost always further exacerbated through unhealthy relationships in adulthood. As a result, codependency only continues to grow and intensify, as the behavior does not address the underlying cause for the emptiness. Instead, the codependent individual attempts to fill this void through having emotional needs met through human relationships and interactions, as opposed to working towards evolving on their understanding of their emotional needs and becoming better able to meet these needs through communicating in a clear and healthy manner.

Addressing Codependency In Treatment
Similar to issues experienced through substance abuse, treatment exists for the codependent individual. As addiction commonly presents as a family disease, family therapy is currently one of the leading treatment recommendations to address codependent behavior. This allows for unhealthy patterns of behavior to be explored as a whole, with the family working to break dysfunctional behavior and to learn new methods of coping and interacting. Treatment further involves processing and resolving past interactions that may have further exacerbated the behavior, while developing a better sense of the importance of boundaries.
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