Self knowledge Avails us Nothing, but there is an Upside

Let me say it straight out, so there won’t be any confusion as to what it is I’m trying to say:  In my experience you can’t stay clean based solely on the knowledge of why you used drugs so abnormally and had such an abnormal need for drugs in the first place.  I’m not saying this isn’t valuable information, or that it may not give you peace of mind in other ways, but simply put: being aware of the truth about our emotional makeup as a result of our past, our family of origin, etc., will not in and of itself, keep us clean.  I’m not saying that some folks don’t get clean as a result of the insights they get from treatment, or therapy, or other efforts at self-appraisal.  I am saying that for the vast majority of individuals who have this disease, this is simply not sufficient.  In my experience only through some form of ongoing commitment to your recovery, whatever it happens to be (individual counseling, groups, continuing care, 12 step meetings, etc.), can most of us expect to achieve long-term recovery from the disease of addiction.

There is an upside to this issue of self-knowledge and it’s this.  When in rehab or treatment you hear yourself described in someone else’s story,  the real benefit is not the insight you get as to why you used the way you did, it’s the connection you make with another recovering person, and the realization that you are not as special or unique as you thought. The less different you feel, the easier it is to become part of a recovery lifestyle. While it is deflating at first to accept the fact that you’re not as unique as you thought, there is actually great comfort in knowing that rather than being a very disturbed, highly individual case of severe emotional imbalance (for which you have yet to find a cure), you’re actually a very ordinary, garden-variety addict (for which there are easily available, highly successful cures). This said; let me share with you some things I’ve learned about myself and my addiction patterns.

Addiction has more to do with why you used then what you used. What it is you felt inside that allowed drugs to have a SPECIAL EFFECT on you, an effect that you almost certainly remember from the first time you felt it.  Once having had that feeling, you thought often about having it again and again, and once you started using on any given day, there was no way of actually telling where you would end up- that day, that night, that week.  From the earliest days of your drug use, and for a very long time thereafter, drugs wasn’t the problem, drugs were the solution, and they remained the solution for a very long time, until (to your deepest regret) they stopped working.  For a variety of reasons – no matter the relief they were providing in terms of living in your own skin – they began to cause havoc in every other area of your life (your family; your job; the police).  Then they became the problem.  But before drugs had this special effect on you, and in order for it to meet so many of your unmet needs, you probably had been feeling and experiencing some combination of these things for a very long time:

1. Restless, irritable and discontent. - You may remember having felt this way since you were a kid.
2. Hypersensitive to criticism. - You always felt that everyone had some form of armor that you somehow didn’t get when they were handing it out.  As a matter of fact there was some kind of instructions in general, that were given out to everybody and you must have been in the bathroom, or out somewhere, when the instructions on how to live were discussed.
3. Prone to Resentment. - Capable of holding a major grudge for a very long time, probably unbeknownst to the grudgee.  Although you were sure it’s just killing them that you weren’t speaking to them or were angry with them.
4. Inferiority wrapped in grandiosity - A strange combination of feeling “less than” and “better than” the same people at the same time.  A problem that you specifically remember drugs addressing with a certain special warmth that almost immediately allowed you to feel pretty much like other people – or so you thought. The so-called “feeling on the inside like other people looked on the outside” phenomenon.
5. Uniqueness/Isolation - you often thought to yourself, “As troubled as I am- and I know I’m troubled – nobody could possibly know what I’m feeling inside, or could really understand me. I am completely alone, completely separate. My problems are not like yours, and cannot be solved using your solutions. My situation is hopeless.”
6. Intolerant of flaws in others – You were the director, if everyone simply followed your direction, everything would be just fine.  But of course, everyone refuses to do it your way.
7. Sneaky and self-pitying - When you weren’t planning and plotting, you were feeling sorry for yourself.
8. Immature- Sensitive to even the smallest perceived slight.  You could be crushed if people who you didn’t even care about that much, rebuffed you.
9. Selfish and self-centered- It was always, always, about you; your needs, your problems, your issues. You never got your fair share of attention.
10. Filled with undefined fears- There were plenty of things you knew you were afraid of, but there were others that you could never seem to get a handle on.
11. An actor, A chameleon, leading a double life. What people saw was only what you wanted them to see, what you believed was needed or expected at any given moment. There was no real you inside, and you were the only one who knew it.
12. A worshipper of people, things, money – Jealous and envious of everyone. Especially, but not limited to, anyone who you felt had more than you did. You knew in your heart that they didn’t deserve it. They were fools or worse, yet you desperately wanted to be just like them.

For us, drug addiction has never really been about a few lines, a few rocks, or a few pills drinks more or less.  This was always about a magic potion, one that almost instantaneously made all of this emotional misery and turmoil go away.  All of us had been able to stop using for periods of time; the problem was we couldn’t stay stopped.  And the reason we couldn’t stay stopped was we couldn’t stand living clean.  It was too painful. This was our great dilemma.  We couldn’t keep using, and we couldn’t stay stopped.  It was at this point that many of us landed in residential or outpatient treatment programs, looking for some way not to use drugs, and be able to live relatively peacefully in our own skin, without this cavalcade of personality defects. Of course the question has always been how to make it work. This is no small issue, as we all know.

NOTE: Many of the observations described here have been laid out in accurate detail in the book “Alcoholics Anonymous” (The basic text of the 12 step program Alcoholics Anonymous)

What’s Done Is Done…

What’s done is done. Events, actions, confrontations, cannot simply be undone, because you’re sorry. While it’s difficult to accept, and most addicts don’t want to even think about it at all, some things simply can’t be made right, right away.  If you want to begin a life in recovery, it’s one of the first things you need to come to terms with. The past can’t be remade.  The voices of the committee (you remember The Committee) would like to pull you down with recriminations, useless remorse (addicts are always remorseful), self-pity, and fantasized “if-only”.  If you are fortunate, you will be told that these energies would best (and must) be spent creating the actions, structures, and personality changes that will be required if you are going to prevent these things from happening again.  Things like lost jobs; failed marriages; alienated children; squandered opportunities; bitter friends; and a record of lying, cheating and stealing from the ones we loved most. Years and years of selfish, self-centered, destructive living cannot be waved aside with a wish to start fresh.

The fact is, the notion of forgive and forget is a myth, probably constructed by an addict looking to get an easy pass.  First, people never forget.  And you don’t want them to forget.  Being the kind of people we are, if they were to forget, we’d be inclined to do the same things to them all over again.  Memory is forever, and that is a good thing for us.  “Forgive”, is a bit more lenient. People forgive you for the things you did to them one memory at a time.  That is they replace one bad memory with one good memory, every time you give them a chance to see you in action in recovery.  So if there were fifteen Christmases that you ruined for everyone, if you show up clean and try to be of service to your family on Christmas, now there are only 14 more good Christmases you have to give people to wipe out the bad memories.  Not quite what an addict likes to hear. Of course it isn’t quite this bleak, but people do need to know you’re serious, in more then just a casual way. Years of using makes skeptics out of our biggest boosters.

On the other hand, virtually every one who really loves you is dying to see you make it.  And they have been dying to see you make it for a long time.  So there’s every reason to believe that you will be getting plenty of support and “atta-boys”, every time you surprise people with a good showing.  Remember in general we are people who others expected to go far.  So if we begin to do well you may actually get some “it’s about time” type stuff.  Any adult behavior on our part will be considered a long time coming and just about any response from others is justified.  But because we are developing some personal consistency, persistence and tolerance for others (more about that soon), our ability to handle the gratuitous digs and sideswipes grows as we do.  We become a lot less sensitive.  We learn to take a punch. Try to never react in anger.  Learn to take a good natured ribbing. Normal people have been doing it for decades. They never collapsed because of it, you won’t either. Your sense of yourself no longer needs to be based on what others think of you. For all you know, they may know virtually nothing about you. Worse, they may know nothing at all. The best thing about the past should be your daily commitment (through action), never to relive it again. Looking forward is a lot easier then looking backward; also it’s a lot easier on your neck.

Meet the Committee

Do you think people with cancer wake up in the morning and the disease tells them they don’t have cancer?  Not likely.  Do you think people with heart disease wake up in the morning and the disease tells them they don’t have heart disease?  I don’t think so.  Do you think people with diabetes wake up in the morning and the disease tells them they don’t have diabetes?  Hardly.  But this is exactly what addiction does to the addict if she lets it.  Especially during the first year of clean and sober time, the disease acting as the “committee of one”, speaks to you; gnaws at you; cajoles; reasons; pleads; demands; ridicules; demeans, and in every possible way tries to undermine your efforts to build sobriety.  Why?  Simple, your addiction has a mission. And its mission is to see you dead. And it will not rest until it has succeeded in this mission. How does it do this?  What does it say to you?  Listen.  Does any of this sound familiar?

1. “You’re not really an addict  Although you’ve had considerable problems and consequences, now after a period of sobriety, you really do know how to handle your drug use.  This time it will definitely be different.”

2. “Many of the problems you had when you were using really had nothing to do with drug use.  Now that those problems are no longer around (your wife, your job, your girlfriend), you will be able to use drugs socially.”

3. “Under pressure from others, you’ve really magnified your memory of the problems you had. It really wasn’t as bad as everybody is making it out to be.”

4.  “Let’s be honest. You will never be able to go your whole life without using  (I don’t care what those people say about ‘a day at a time’),so why are you torturing yourself. You’re going to get high at some point. That point might as well be today”.

5. “You’re really too sick to stay clean.  Too much water under the bridge.  While others have been able to get clean, it will never work for you. They’re not as sick as you.”

And this is only the stuff that your disease tells you regarding your drug use behavior.  How about the stuff about resentments, insecurities, perceived slights and rebuffs, the problems of the world, (“everything is so screwed up – the only reasonable response from a ‘caring’ and ‘concerned’ citizen of the planet like me, is to get loaded, and let everyone else go to hell”). Then there’s your own extreme sensitivity (”drugs are my armor- without it I’ll die- or commit suicide- so by using, I’m actually saving my life”).

The voices of the committee are very persuasive and very insidious. They know our deepest fears and weaknesses. They know which messages will resonate and which ones won’t.   If you don’t share these feeling with someone- your counselor, parents wife/ husband, mentor, anyone (which of course the voices are telling you not to do- “don’t tell anyone what you’re thinking. They don’t care. They won’t understand. They’ll think your nuts. They won’t like you”), the implied truth and credibility of the voices will grow. The voices will seem reasonable; you will have very little defense against their perceptiveness.

Never underestimate the power of the illness.  In addition to being cunning, baffling and powerful, it has another killer characteristic, it’s patient.  It has all the time in the world.  It’s not going anywhere.  You’re not going anywhere.  It’s willing to wait as long as it takes.  It will never be happy that you’re sober, and it’s willing to appear dormant and disarmed in order to lull you into the complacency it believes will be required to get you back.

Study Cites Cost Benefit of Counseling Plus Drugs to Treat Alcohol Problems

RESEARCH TRIANGLE PARK, N.C.—Combining medications and behavioral interventions for treating alcohol-dependent patients reduces social costs of health care, arrests and motor vehicle accidents, according to a new study by researchers at RTI International, University of Wisconsin-Milwaukee, University of North Carolina at Chapel Hill, University of Pennsylvania and Yale University.

The study, published in the May issue of Medical Care, looked at the economic impact of combined alcohol dependency treatments, including the treatment costs and the economic costs of other health care use, arrests and motor vehicle accidents.

The researchers found that people who were alcohol dependent and received medical management and a combination of acamprosate and naltrexone medications saved more than $3,800 in the median cost of alcohol treatment, other health care costs, arrest costs and motor vehicle accident costs compared to those who just received medical management and a placebo.

“It’s important to understand the effect of alcohol interventions on future social costs,” said Gary Zarkin, Ph.D., vice president of the Behavioral Health and Criminal Justice Research Division at RTI and the paper’s lead author. “Our study suggests that the combined alcohol dependency therapies have additional long-term societal benefits in terms of reduced health care usage, arrests and car accidents.”

The three-year study analyzed data from approximately 800 patients who participated in the nine alcohol dependence treatments in COMBINE (Combined Pharmacotherapies and Behavioral Interventions Study). Previously, the study team estimated the cost-effectiveness of the COMBINE interventions at the end of 16 weeks of treatment. Clinical results for COMBINE were published in the May 2006 issue of JAMA.

“A strength of our study is that we were able to take advantage of the statistical design of the COMBINE clinical trial, which previous researchers were not able to do,” Zarkin said. “But more research needs to be done to understand the magnitude of social cost savings associated with alcohol dependency treatment.”

Alcohol abuse is the third leading preventable cause of death, and in 1998, according to a report by the National Institute on Alcohol Abuse and Alcoholism, the estimated societal cost of alcohol abuse in the United States was $184 billion.

An Insidious New Addiction

How’s this for the insidious nature of prescription opiate addiction:  Many young people (and others for that mater) get involved with opiates pain pills ( Vicodin , OxyContin) because they like the way the pills make them feel, and they get some consolation in the fact that  the pills are pharmaceuticals, pure, not street adulterated, you most often don’t have to go to sketchy neighborhoods to get your supply, and of course do not carry the stigma of getting involved in heroin (even if you don’t inject it- but smoke it or inhale it). So what happens? These folks take more pills every day, as their addiction grows, and the need for more and more of the drug is driven by their increasing tolerance. Of course the cost grows as well, easily reaching $150-$200 a day. Suddenly they can’t get all they need from their middle class connections, they’re running out of money, or on a given day, or weekend, there is just nothing available in their safe circle of friends and connections. So what do they do: The go to that sketchy neighborhood, and deal with those sketchy folks they wanted to avoid in the first place, and find that they can buy some pretty powerful heroin for a fraction of what the pills are costing them. Now they have come full circle. Heroin now becomes the cost effective solution to their daily addiction needs, and those sketchy neighborhoods, and those sketchy folks, don’t seem so sketchy after all.  Welcome to the insidious world of opiate pill addiction.   Jerry Bayer

NIH Podcast on Prescription Drug Abuse in Women

May 10, 2010

From:
The Office of Research on Women’s Health (ORWH) Prescription drug abuse means taking a prescription medication that is not prescribed for you, or taking it for reasons or in dosages other than as prescribed. Abuse of prescription drugs can produce serious health effects, including addiction. In 2008, according to the National Survey on Drug Use and Health, 15.2 million Americans age 12 and older had taken a prescription pain reliever, tranquilizer, stimulant, or sedative for nonmedical purposes at least once in the year prior to being surveyed.

The NIH’s Office of Research on Women’s Health podcast, “Pinn Point on Women’s Health,” provides updates on women’s health research, and is hosted by Vivian W. Pinn, M.D., director of NIH’s Office of Research on Women’s Health. This month, Dr. Pinn interviewed Nora Volkow, M.D., director of the National Institute on Drug Abuse (NIDA).

Dr. Volkow stated that it is important to understand the sex and gender-based differences regarding drug abuse in order to better target prevention and treatment approaches.

“In general, males tend to take more drugs than females. The exception is the period of time between 12 and 17 years of age. There, we see a higher rate of abuse of most drugs, including psychotherapeutics, among girls than among boys,” Dr. Volkow said.

Drugs of abuse also include pain medications that contain opiates, such as Vicodin or OxyContin, as well as stimulant medications, which are used to treat attention deficit hyperactivity disorder. Dr. Volkow noted that adolescent girls have almost 60 to 70 percent higher rates of abuse of these substances than adolescent boys.

“Adolescents and young adults take stimulant medications to improve cognitive performance, to study for an exam, or to prepare for something that requires a deadline involving intense work,” Dr. Volkow said. In addition, girls take stimulants in order to lose weight. Stimulant medications are anorexigenic; meaning, they reduce feelings of hunger.

Not surprisingly, prescription drug abuse can result in addiction. Dr. Volkow has conducted imaging studies that show how repeated drug use affects the brain.

“Not only are there disruptions in the circuits involved in reward (the ability to feel pleasure), and learning; but also in frontal areas of the brain that are involved with executive control and that enable you to make decisions, to judge, to control your desires and your emotions,” Dr. Volkow said.

There exists a misguided belief that abuse of prescription drugs is less dangerous than that of illicit substances because they are prescribed by physicians. “When you take psychotherapeutics outside the surveillance of a physician, these medications can be as dangerous as illicit substances,” Dr. Volkow said. She noted the importance of educating both the public as well as the health care system about how these drugs work, under what conditions their use is beneficial and under what conditions their use can lead to adverse medical consequences.

Treatment for addiction will depend on the type of psychotherapeutic used. “For opiate analgesics, we have medications that look quite promising. We’re currently conducting a trial to investigate the use of buprenorphine in the treatment of addiction to opiate analgesics, and the results appear to be quite promising,” Dr. Volkow said.

There are also several evidence-based behavioral interventions that include motivation intervention strategies, incentive intervention strategies, and group therapy intervention strategies that have been shown to be effective. For information on treatment options in your area, go to http://www.samhsa.gov/ or call 1-800-662-HELP (1-800-662-4357).

To hear Dr. Pinn’s podcasts, visit the Office of Research on Women’s Health home page. (How to use podcasts)

Men and Women Cite Different Reasons for Misusing Prescription Painkillers

May 5, 2010

Women who misused the drugs also were more likely to tell investigators that they had been abused sexually or physically, and that they had a past history of psychiatric or psychological problems.

HealthDay News reported April 30 that researcher Robert N. Jamison of Harvard’s Brigham and Women’s Hospital and colleagues studied 662 chronic-pain patients who took opioid painkillers. They found that misuse of the drugs occurred at about the same rate among men and women, but that gender differences showed up when patients were asked about what led them to misuse the painkillers.

The findings appear in the April 27, 2010 issue of the Journal of Pain.

Emotional issues and psychological stress often spark misuse of prescription painkillers among women, whereas men are more likely to cite social and behavioral problems, according to researchers who investigated the underlying causes of opioid painkiller addictions.

Number of Soldiers Seeking Opiate Abuse Treatment Skyrockets

Hospital Admissions for Prescription Drug ODs Up 65 Percent

about 71,000 people were admitted to U.S. hospitals for prescription-drug overdoses in 2006, up from approximately 43,000 in 1999, according to a new report.

Reuters reported April 6 that researcher Jeffrey H. Coben of the West Virginia University School of Medicine and colleagues found that accidental poisonings involving opioids, sedatives, and tranquilizers increased 37 percent, compared to a rise of 21 percent for accidental poisonings involving other substances.

The report noted that unintentional poisoning is now the second-leading cause of accidental injury death in the U.S.

Coben and colleagues said that urban, middle-aged women seem especially vulnerable to prescription-drug overdoses.

The rate of intentional poisonings involving prescription opioids, sedatives and tranquilizers also more than doubled during the seven-year study.

Hospitalizations for methadone poisoning increased more than for any other drug.

The study was published in the April 2010 issue of the American Journal of Preventive Medicine (PDF).

What If You Really Hate Yourself – and Your Addiction?

This is a wonderful, anonymously written piece. Enjoy it. jerry

When you rise up out of your stupor or take a brief hiatus from your compulsive behavior long enough to look at your face in the mirror, what do you see? At some point, it is likely that you will have to choke back your revulsion at the image that stares back at you. No, you’re not a Frankenstein. It isn’t necessarily physical changes that give rise to such loathing – although that may be part of it. The source of your anguish is self-hatred. If you’re currently in this position, you want to know what you can do about your self-hatred and your addiction.

Don’t worry. There are answers.

The Good News and the Bad News

Looking at addiction and recovery is a case of good news and bad news. The first is the good news. Hating yourself and your addiction is one of the initial stages on the road to recovery. How can hatred be a good thing? It isn’t the hatred itself that is good, but the fact that you’ve gotten to the point where you recognize that your past actions and addictive behavior have caused so much hurt to yourself and others.

Addicts often have a very difficult time accepting that they are, in fact, addicts. Denial of the problem is the first hurdle to overcome, and once you’re past denying it, the reality of your situation sets in. This paves the way for self-hatred. Look at it this way. You can’t overcome your addiction until you go through the work required.

And it’s tough work, make no mistake about it. That’s the bad news.

But when you’re on the road to recovery, you’re taking the incremental steps to put your life back in order, to regain your self-esteem, self-confidence, and self-respect. The pendulum swings again and it’s another example of good news. The longer you work at your recovery, the small successes you have – a day without giving into your addictive behavior, a week, a month, and longer – all add up to a huge plus.

Allow the Emotion to Pass

At first, all you’ll see is your own self-hatred. You’ll need to give this very powerful emotion time to pass. You’ve already taken the big first step of saying to yourself, “Okay, I hate what I’ve done to myself and the ones I love. I hate that I’ve lied, been untrustworthy, let my loved ones and others down. I hate that I’m addicted to (alcohol, illicit or prescription drugs, gambling, compulsive sexual behavior, etc.) and keep falling back into my old ways.”

There’s a lot of truth in the statement that giving voice to your feelings allows you to get past them. It isn’t just some hokey mantra that psychiatrists, psychologists and addiction counselors dish out. One reason acknowledging your hatred is important is that you are releasing it instead of keeping the emotion bottled up inside you. For that matter, any powerful negative emotion, whether it’s anger, despair, bitterness, spite or hatred, that isn’t released will go on to cause further emotional and even physical problems.

How long do you need to wait before the hatred starts to dissipate? You’ll be surprised at how quickly it will go away. No, you won’t be able to tell that it’s gone in a matter of minutes, or even days. Actually, you shouldn’t think about your hatred after you’ve given voice to it. You need to be moving on, doing the necessary work in your recovery.

To begin with, you may find that these thoughts creep into your mind at odd times. Just acknowledge that they’re there, and then go on to do other things – positive things that are working toward your recovery. Don’t wallow in the emotion or allow it to stymie your efforts at recovery.

Before you know it – maybe weeks or months down the line – you’ll be able to look at yourself in the mirror and it will seem like a different person is staring back at you. It’s the same you, yet different. What’s different is your outlook. Gone is the hatred and loathing that furrowed your brow, drew your mouth into a hard line and stifled your life energy. In its place will be acceptance of the new you, recognition that you are making progress toward your recovery and the glimmer of hope in a better tomorrow.

Do Something About Your Recovery

All this presumes that you are actually actively involved in your recovery. You can’t just sit back and figure that your addiction will somehow magically disappear. It doesn’t work that way, as much as we’d like it. To get started in your recovery, you need to take specific actions. Do them in small steps, so that it doesn’t seem overwhelming.

When you are ready, seek out treatment for your addiction. Start by going to the 12-step websites pertinent to your addiction. There are support groups for alcoholism (Alcoholics Anonymous), drugs, (Narcotics Anonymous, Cocaine Anonymous, Marijuana Anonymous, Methamphetamine Anonymous), compulsive gambling (Gamblers Anonymous), compulsive sexual behavior (Sexaholics Anonymous, Sex Addicts Anonymous, Sex and Love Addicts Anonymous, Sexual Compulsives Anonymous), food addictions (Overeaters Anonymous), overspending (Debtors Anonymous).

If you’re not yet ready to physically go to a meeting, don’t worry. Use this time to go through the websites and gather as much information as you can. You need to learn about your addiction, the signs of it, causes, how to avoid relapse, where you can get help or treatment. Peruse the FAQ sections, questions to ask yourself, and take the self-assessment for addiction (most 12-step sites have these). You can download pamphlets and self-help materials. There are links to other helpful sites and resources that may prove useful to you.

Once you’ve amassed sufficient information and feel a comfort level with the organization, look up where in-person meetings are held in your area. You can also begin with an online meeting or telephone meeting, if those are offered by the particular 12-step group (again, most have them).

You may still have a reluctance to attend a 12-step group. That is perfectly understandable. But you do need to take further action to jump-start your recovery. Participation in 12-step groups is free and is often a very viable first step for those seeking to overcome their addiction. But it isn’t the only way.

Check into Treatment

Let’s face it. Addiction is difficult to overcome. You can’t do it on your own. If that were the case, no one would be addicted. In this respect, we are our own worst enemy when it comes to knowing what and how to take care of what needs to be done. We may tell ourselves that we won’t touch another drop, or do any more drugs, or that we’ll stay away from the track or the casino or stop our other compulsive addictive behavior – but we won’t, not without help.

Make a concerted effort to find out what treatment for addiction is available to you. This will take some time, as you have a lot of research to do. A good place to start is the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Facility Locator. This is a searchable database of more than 11,000 addiction treatment programs, including residential treatment centers, outpatient treatment programs, and hospital inpatient programs for drug addiction and alcoholism. Listings include treatment programs for cocaine, marijuana, and heroin addiction, as well as drug and alcohol treatment programs for adolescents and adults. The information is updated weekly to be as current as possible.

When you click on the locator, it brings you to a map of the United States. Click on the state, enter the city (zip code and address is optional), and click “Search.” You can also change the search radius (the default is 100 miles). Information that you will receive for each facility includes the name, address, phone, distance, maps, primary focus (i.e., mix of substance abuse and mental health services), services provided (substance abuse treatment, detoxification, halfway house, Buprenorphine services), type of care (such as residential short-term (30 days) or long-term (longer than 30 days) treatment, hospital inpatient, etc., special programs/groups (women, men, seniors, persons with co-occurring mental and substance abuse disorders), and type of payment accepted (self-payment, private health insurance, state financed insurance, military insurance, etc.). If the organization or facility has a website, that URL is listed.

Pick out two or three facilities that may offer what you need and do further research. Go to their websites. Look through the types of treatment programs they have. What is their treatment philosophy? Here are some other questions to ask when you are considering a treatment facility:

• What type of licensing or accreditation does the program have?  CARF accreditation is a strong indication of quality.
• How effective are the program’s treatment methods? Have there been studies verifying its effectiveness with your type of addiction?
• What medications does the staff prescribe or support to treat any other physical conditions you may have? Is the staff knowledgeable about and willing to prescribe medications that may be useful in helping to treat your addiction?
• What, if any, type of aftercare program is included in the overall treatment plan?
• What kind of relapse prevention program does the facility have?
• Does the facility accept your private insurance? If not, will they work with you on a payment plan, special financing? Do they offer grants or scholarships, a sliding-pay scale or pay-as-you-go option?
• Is the facility well-run, organized and clean?
• Does the staff do an ongoing assessment to monitor the patient’s progress and adjust the treatment plan accordingly?
• Does the facility encompass the patient’s full range of needs: medical, psychological, social, legal, vocational, etc.?
• Does the program address physical abilities, sexual orientation and also provide age, gender and culturally-appropriate treatment services?
• What type of strategies does the program employ to engage and keep patients in longer-term treatment, thus increasing the likeliness of success?
• Does the program offer counseling (individual and group) and other behavioral therapies to help the patient be able to better function in the family and community?
• What kind of services and/or referrals are available for the family to ensure they understand the addiction and recovery process so they’re better able to support the recovering addict?

Make the Commitment

Once you’ve satisfied yourself that you’ve found the right treatment facility – or, if your loved one or family member has done this for you, and you agree to it – make the commitment and enter the treatment program. No one else can do this for you. It has to be you. Sure, someone can force you into treatment (“If you don’t go in for treatment, I’m leaving you.”) Or, your employer or the courts may mandate treatment. But it still rests with you. Without your firm commitment to give the program your complete and undivided attention and a genuine desire to overcome your addiction, just physically taking up space in a treatment program won’t do anyone any good – least of all you.

You’ve come a long way from the addict hating that vision in the mirror. You need to make good on your intentions to kick your addiction and learn new ways of coping with the stresses in your life. Techniques and tips on how to overcome urges and cravings, how to avoid relapse, and improving your chances for a life of recovery are all part of the treatment program.
Detoxification is often the first part of the treatment program. If you are addicted to alcohol, illicit or prescription drugs, or other harmful substances, your body must first be cleansed of the substance or substances. There’s no other way around it. You can’t heal if you aren’t clean. This process doesn’t take that long, and the detoxification is medically supervised on a 24 hour basis. The staff will make you as comfortable as possible while you are undergoing detoxification and will prescribe medication, if appropriate, to minimize withdrawal symptoms and ease anxiety, depression, insomnia and other unpleasant results of coming off drugs.

After you’re clean, you enter the actual treatment phase. Here is where you gain a thorough understanding of your addiction, what may have caused it, what the triggers are that motivate your addiction, and other contributing factors. You learn coping mechanisms, about relapse prevention, and have individual and group counseling sessions. You will also undoubtedly be involved in 12-step support groups while in treatment. Addiction recovery specialists recommend that patients continue to participate in 12-step support groups after they complete treatment and for at least a year or two afterward. Some addicts in recovery make it a point to go to meetings regularly for years after. They consider it a matter of giving back to others who have helped them so much, as much as it is maintenance, a reminder to always be diligent and mindful of the right steps to take in any circumstance.

Once you are an addict, you are always an addict. You cannot be cured. But you can overcome your addiction. That’s why addiction is considered treatable. And, there is much research going on in the area of addiction vaccines and treatments that may one day revamp addiction treatment even further. These wonder drugs are a few years off, however, and even then they won’t be a stand-alone cure. Counseling and 12-step group support will still be part of an overall, comprehensive addiction treatment program.

Look Forward to a New You

Once you complete treatment, you’ll not only be better equipped to handle situations and issues that formerly threw you, you’ll also be a whole new you. Having come through the tough times, the uncertainty, the self-loathing and self-hatred, the new you can embrace whatever future you want to chart. While your self-hatred obliterated any thoughts of pursuing a dream, now the sky is literally the limit. What you want to do, you can create a plan and work to make it happen. After all, you’ve overcome your addiction, and that’s an accomplishment to be proud of. The new you is quite something, indeed.