Dr. Tannenbaum's book, The Addiction Conspiracy, allows the community a better understanding of how drugs and alcohol affect the brain and the use of medications in the treatment of addiction.
Click here to read.
Alcohol abuse is one of the most insidious, destructive and self-defeating habits that millions of people struggle with. Many thoughtful, kind, intelligent and good people get caught in the web of alcohol abuse and dependency. You don't have to be an "alcoholic" to have a drinking problem -- but you need to examine honestly whether drinking has led to problems for you and the people in your life.
No one sits down on Tuesday afternoon at 3:30 and says, "I think I'll become an alcoholic." No one wants that as a life problem. But it happens, and it's hard to break free from it.
Many physicians and therapists are reluctant to address the issue straight on. They may not want to offend their patients, they may fear losing the patient's business. Or they may simply not recognize how serious the problem is. But many people with anxiety and depression misuse alcohol -- some become dependent on it. Many use alcohol to cope with situations that make them anxious ("I'm going to a party so I will need a few drinks to loosen up"). But there is no problem that you have that alcohol abuse won't make worse. Whether it's your marriage, your relationship with your kids, your job, your health, your mood or your ability to get anything done -- alcohol abuse will make things worse.
Thinking Yourself into Drinking:
I'd like to discuss in this article the way you "think yourself into drinking" -- what I call "drinking thinking." I would suggest that you have two heads -- the head that wants to drink and the head that is rational that wants to be in more control. In this case, two heads are not better than one.
I've been listening to people for years who overdrink. They always have excellent reasons for drinking more -- convincing themselves that they are in control. Let's take a look -- and ask yourself if you or a loved one is a familiar voice here.
Continue here ...
Do you have a substance-using loved one who refuses treatment? The CRAFT program may help. CRAFT - Community Reinforcement and Family Training - teaches the use of healthy rewards to encourage positive behaviors. Plus, it focuses on helping both the substance user and the family.
The CRAFT goals are to teach you how to encourage your substance user to reduce use and enter treatment. The other goal is to help you enhance your own quality of life. This non-confrontational approach teaches you how to figure out the best times and strategies to make small but powerful changes. And it will show you how to do so in a fashion that reduces relationship conflict.
Experts have based CRAFT on solid science. People from many walks of life have used it successfully to help their loved ones and themselves. Whether you are the parent, spouse, romantic partner, adult child or friend of the substance user, research tells us that you too can succeed with this program. The methods are effective and easy to learn . CRAFT allows family members to feel good about their efforts on behalf of their loved ones.
When a CRAFT Program is Not Available in Your CommunityCRAFT can easily be learned on your own. The 2004 book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening by Robert J. Meyers and Brenda L. Wolfe, was written to bring CRAFT right into your home. It helps you change the way you think about your situation and teaches you how to help your loved one learn to enjoy a sober lifestyle. The authors also help you rethink your own lifestyle to make it safer and saner regardless of what your loved one does. If you are also working with a therapist, we recommend that you alert your counselor to the CRAFT manual for therapists, Motivating Substance Abusers to Enter Treatment: Working with Family Members.
FIVE THINGS TO KNOW ABOUT CRAFT1. CRAFT is a motivational model of help based on research that consistently finds motivational treatments to be superior to confrontational ones.
2. More than two-thirds of family members who use CRAFT successfully engage their substance using loved ones in treatment.
3. Evidence suggests that substance users who are pushed into treatment by a traditional confrontational intervention are more likely to relapse than clients who are encouraged into treatment with less confrontational means.
4. Family members who use CRAFT experience greater improvements in their emotional and physical health than do those who use confrontational methods to try to help their loved ones.
5. People who use CRAFT are more likely to see the process through to success than those who use confrontational methods.
FIVE MYTHS ABOUT CRAFT1. CRAFT's system of offering and withdrawing "rewards" such as your affection and attention is just another way of enabling someone who is using substances. And enabling is bad.
2. No one enters treatment until they "hit bottom" so using CRAFT while your loved one is still functioning is a waste of time.
3. Most substance users overdo it all the time so it is impossible to do anything to lessen the severity of their use.
4. If you love someone, it is cruel to allow him or her to sleep in vomit or endure public humiliation when you have the power to fix those things.
5. Once your loved one agrees to stop using or enter treatment, your job is done.
Click here for original content
Accepting the mantra that "Treatment Works," families, varied treatment referral sources and the treatment industry itself believe that responsibility for any resumption of alcohol and other drug use following service completion rests on the shoulders of the individual and not with the treatment program. This is unique in the annals of medicine. With other medical disorders, continuation or worsening of symptoms is viewed as an indication that the initial treatment is not effective for this particular patient and that changes in the treatment protocol are needed. In contrast, when symptoms continue or worsen following addiction treatment, it is the patient who is blamed and often punished. The stance is, "You had your change and you blew it! You must now suffer the consequences of your actions." And those consequences are often quite dire, including divorce, loss of children, loss of housing or educational opportunities, termination of employment, discharge from the military under less than honorable conditions, loss of professional licenses, loss of driving privileges, and incarceration, to name just a few. Such punishments are often meted out with an air of righteous indignation in the belief that the person for whom we have done so much has failed this chance we have given them. The question I am raising in this blog is: Was it really a chance?
Click here for more
The following information comes from the National Consensus Statement on Mental Health Recovery from the Center for Mental Health Services, Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services.
The Adolescent Brain
Adolescence marks a period of significant neurodevelopmental changes and is particularly sensitive to exposures such as alcohol and drugs. Almost 1/3 of 12th graders and almost ½ of college students report binge drinking and ¼ of teens report past-year marijuana use (Lisdahl et al., 2013). The increased prevalence of substance use during adolescence is partially a product of increased impulsivity and risk-taking behaviors associated with this stage of life. It is particularly important that extra efforts are made to prevent the early onset of substance use and protect the developing brain from damage during this sensitive period of development.
Click here for rest of article.
No matter how fulfilling your work, there’ll be days when you just can’t summon any enthusiasm for it. What makes the experience of undermotivation especially frustrating is that the solution seems as if it ought to be obvious: what you need, you tell yourself, is more motivation.
So you scour the web for motivational tips (visualize your goals! reconnect with your ‘core values’!). You remind yourself about the mountain bike you want to buy, or the family you’ve got to feed. Yet it’s rare that any of this works: instead, undermotivation digs in its heels, making progress harder than ever.
Click here for more
There is evidence to suggest that many people recover without formal treatment. For alcohol specifically, it is estimated that between 50-90% of people with prior alcohol problems recover without treatment, however more severe alcohol problems are more likely to require treatment to facilitate remission and recovery (Cunningham, 1999). Similarly, 80-90% of people dependent on tobacco quit smoking without professional assistance or guidance. Retrospective data suggest that a majority of illicit substance users, irrespective of remission status, had not sought treatment services (Cunningham, 1999). When examining the pathways of recovery between AA members and those who had not attended treatment or mutual help, it was found that there are several similar factors that contribute to abstinence for both groups. These include the utilization of social support, accepting help from God or a Higher Power, a strong desire to achieve abstinence, a desire to be honest with him/herself, a desire to improve self-confidence and remembering the negative consequences of alcohol use (Kubicek, Morgan, & Morrison, 2002).
These findings reinforce the idea that there are multiple pathways to recovery that largely depend on the individual. There are, however, systematic differences in the type of recovery and remission achieved by individuals who recover without mutual help or formal treatment and those who do utilize these services. In a study examining data on approximately 13,000 adults, among individuals who had substance use problems and achieved recovery, 75% didn’t utilize formal help or treatment, however approximately 33-66% of these people continued to drink moderately. In summary, individuals who did not utilize formal help or treatment in their recovery process were more likely to have non-abstinent recoveries compared to individuals who did engage in formal substance use help and/or treatment (Sobell et al., 1996).
The threats to health that occur during active addiction have been widely communicated in the popular media and in the scientific literature, but the health profile of people in long-term recovery from substance use disorders remains something of a mystery. While one might assume that physical and emotional health rapidly improves following recovery initiation and stabilization, a health survey of Philadelphia and surrounding counties just published in the Journal of Psychoactive Drugs reveals a more complex and ominous picture.
In 2010, the Philadelphia Department of Behavioral Health and Intellectual disAbility Services contracted with the Public Health Management Corporation (PHMC) to incorporate recovery-focused items into PHMC's 2010 Southeastern Pennsylvania (SEPA) Household Health Survey of Philadelphia and four surrounding counties. The survey results reveal a recovery prevalence rate in the adult population of 9.45%--recovery defined in the survey as once having but no longer having an alcohol or drug (AOD) problem. That recovery prevalence rate is comparable to U.S. national surveys that have measured the rate of remission from substance use disorders, e.g., the percentage of adults who meet lifetime criteria for a substance use disorder but did not meet such criteria in the past year. The Philadelphia and national studies confirm the presence of a large population of people (more than 20 million in the U.S.) who have resolved a significant AOD problem. This large population of people quietly and invisibly living out their lives in long-term recovery defies the pessimism about recovery fueled by the media obsession with celebrities recycling through rehab or dying from drug overdoses.
The Philadelphia survey goes beyond affirming the significant prevalence of recovery in the general population to provide a detailed profile of the health of people in recovery. The results are sobering. People in recovery, compared to citizens not in recovery, are twice as likely to describe their health as poor and report higher rates of asthma, diabetes, high blood pressure, obesity and past-year emergency room visits. They are also more likely to report lifetime smoking (82% vs. 44%), current smoking (50% vs. 17%), exposure to smoke in their residence, no daily exercise and eating fast food three or more times per week. In terms of resources to address health concerns, people in recovery compared to the general population reported greater family/social isolation, lower income, less insurance coverage, and less likelihood of past year health screenings, primary health care and dental care.
A detailed review of these findings reveals the many burdens all too often brought into the recovery process--burdens that if unattended can plague personal health and quality of personal and family life for years to come. The findings also reveal the roles past and present nicotine addiction plays in these health problems. And they reveal the limited natural resources available to many people in recovery to address these problems. So what do these findings reveal about the state of professional care for AOD problem in the United States?
At a systems level, they expose a model of care that functions as an emergency room to provide acute biopsychosocial stabilization but is not designed to provide long-term health management for people in recovery. The management of other chronic health disorders (e.g., diabetes, hypertension, etc.) is viewed as requiring the management of global health (e.g., management of co-occurring medical conditions, diet, exercise, psychosocial stressors) over a prolonged if not lifelong period of time. It is time--no, past time--the treatment of the most severe and complex AOD problems was reconceived in this same way. Such approaches would move beyond brief episodes of symptom amelioration (recovery initiation and diagnostic remission) to the promotion of global health and quality of personal, family and community life in long-term recovery.
At its most practical level, the survey findings suggest that every person entering recovery should have an ongoing relationship with a primary care physician who is knowledgeable about addiction recovery and who can serve as an ongoing consultant on the achievement of health and wellness. It also suggests the need for addiction professionals and recovery support specialists to serve as a source of collateral encouragement and guidance in this process. It is time we broadened our vision beyond what we can subtract from people's lives in the short run to encompass what can be added to enrich those lives in the long term. And it is time we defined recovery to encompass smoking cessation. People in self-proclaimed addiction recovery continue to die in great numbers from nicotine addiction. They are dying of the conceptual blindness that sees no contradiction between present nicotine addiction and claimed recovery status. Through our silence, addiction professionals and peers in recovery participate in those deaths--collective acts for which we will be judged harshly in historical retrospect. (Can you hear the future voices: "Celebrating addiction recovery in smoke-filled rooms? What the hell were they thinking back then?!")
At a personal level, the Philadelphia survey is a call for each person in recovery to take ownership of his or her health. Such ownership includes a physical inventory of the legacies of addiction and making amends for the injuries and neglect inflicted on one's own body. Those inventory and amends processes often produce a deep and enduring commitment: "With stable feet and cleared vision, I will begin and sustain the process of healing myself--and I will reach out to help heal others."
Timothy Harrington is passionate about sharing information with people on ways to strengthen the link between treatment and long-term recovery.