Why Fighting Addiction Can Feel Like A Game Of Whac-A-Mole™

I remember driving past a church one evening with a colleague. A large group of people stood out front, shrouded in an impressive cloud of cigarette smoke. “AA meeting,” my colleague remarked. He didn’t actually know this for a fact, but this is one of those iconic images of recovering alcoholics: coffee cup clutched in one hand, cigarette in the other.

Treatment programs don’t usually address nicotine addiction; they say it is just too much to take on in the early weeks or months of recovery. It is probably the most common cross-addiction. People who quit smoking years ago will start up within days of quitting drinking, looking for something to make them feel better.

Recovery from addiction can feel like a game of whac-a-mole™, that classic carnival game where you mallet a mole as it pops up from its hidey hole, only to have one pop up from another hole. Whack away; there is always another mole taunting you from another hole.

Cross-addictions are nothing new, but the fact that treatment centers are now addressing them during the first 30 days of recovery is.


Are Recovering Addicts Happier Than Everyone Else?

Anyone who has managed to avoid addiction (whether to drugs, work, sex, food, or some other substance or behavior) is fortunate indeed. But those who have not may not be as unlucky as they think.

In drug rehab, addicts learn life lessons and skills that many people don’t learn until much later in life, if ever. As a result, I believe people in addiction recovery often lead happier, more meaningful lives than the general population (with noted exceptions for those who continue with diseased thinking and behaviors regardless of what they learned in drug rehab).

Here are some of the possible reasons for this turnaround:

#1 Recovering addicts are grateful to be alive.

Gratitude is a recurring theme in 12-Step recovery. Early on, addicts are advised to simplify their lives, making their recovery their primary focus. This clears space for the things that matter most – personal growth, health and family – and drives many to make long-needed changes in their careers, relationships and lifestyle.


5 Didn’t-See-It-Coming Relapse Triggers (and How to Avoid Them)

Some relapse triggers, such as stress, job loss, isolation, the death of a loved one, and other distressing events or feelings, get a lot of attention during treatment, and rightly so.

But sometimes it’s the happy moments (or the seemingly neutral ones) that sneak up and trigger a return to drug use. Here are five triggers that often take unsuspecting recoverees by surprise:

#1 Sex and Relationships

An oft-repeated (and oft-ignored) cardinal rule of early recovery is to avoid dating for at least the first year. This advice is not intended to punish, but to give the recovering addict time to focus internally – to figure out who they are, what they want and how to cope without using drugs or alcohol – before trying to be a source of support for someone else.

At a time when recovering addicts are most likely to want a relationship and least likely to be prepared for one, they are at high risk of falling into the familiar pattern of looking outside of themselves to fulfill emotional needs, escape or relieve stress. Some people rely on the “high” of a new relationship as a substitute for drugs or alcohol. Cross addictions to sex, love, romance or relationships are a major cause of relapse among the newly sober.


Why Do Doctors Prescribe Addictive Drugs To Known Addicts?

In 2011 a group of physicians descended on Capitol Hill to ask congress to help them fight prescription drug abuse. How? Finally require all health care professionals get real training in prescribing addictive drugs, recognizing signs of addiction, and identifying problematic patterns of use.

Most physicians receive little or no training regarding substance abuse and the use of controlled substances that have the potential for addiction. While there are many doctors who prescribe these powerful drugs responsibly, and these drugs are often critically important when used as intended (usually very short-term use or on an as-needed basis), better education will help them recognize drug-seeking behavior and train them to evaluate and refer these patients to treatment the same way they do when they see high blood sugar or blood pressure.

Public Policy

The Prescription Drug Epidemic Sparks Blame Game

Call it human nature. When something goes wrong, we look for someone to blame. When a child gets in trouble, they are quick to point the finger at a sibling. When a product malfunctions, we sue the manufacturer. So it isn’t surprising that “Pharmageddon” would spark its own type of blame game.

Even though the U.S. government’s War on Drugs started more than 40 years ago, in many ways it has been reborn in new formats. Just as the problem of illegal drug abuse has been met by law enforcement with punitive penalties for nonviolent drug offenders, the prescription drug epidemic has provoked its own type of witch hunt.

Who is responsible? Who can be punished for allowing the nonmedical use of painkillers to take second place as the most prevalent form of drug use in America, even as the War on Drugs rages on?

In the past decade, there has been a 400 percent increase in admissions to drug rehabilitation centers for addictions to prescription pain relievers. We have seen a fivefold increase in hospitalizations and a fourfold increase in overdose deaths related to prescription drugs. Teenagers who used to experiment with illicit drugs like cocaine, meth or heroin now prefer prescription drugs like Vicodin and OxyContin.

We are hearing the alarm bells about prescription drug abuse, but the knee-jerk reaction has been punitive – more law enforcement, monitoring doctors and catching people filling too many prescriptions. Is this the new War on Drugs?


The Challenges Of Treating Addicts With Borderline Personality Disorder

Rage. Instability. Mood swings. Impulsivity. These characteristics make people with borderline personality disorder (BPD) prone to substance abuse as well as over-spending, promiscuity, eating disorders and other compulsive behaviors. In fact, studies suggest that 50 to 70 percent of those with BPD also have a co-occurring substance use disorder.

Addicts with co-occurring borderline personality disorder are known as some of the most difficult patients to treat. Here are a few of the most common challenges, along with insights into the most effective research-based treatments:

Treatment Compliance

Addicts with BPD have been described as both treatment demanding and treatment resistant. Research shows more positive outcomes the longer an addict with BPD stays in treatment, yet keeping them in treatment is no easy task. In a study of patients in a detox program, those with BPD were significantly more likely to have an unplanned discharge than those without BPD.

While a number of treatments have proven effective for BPD, therapies for BPD patients with co-occurring substance abuse are less established. Studies suggest that the most promising treatments include dialectical behavior therapy, cognitive-behavioral therapy and psychodynamic approaches. A combination of support and management from an experienced dual diagnosis treatment center can improve retention rates, along with ongoing involvement in self-help groups such as AA and NA.


5 Steps To A Strong (Sober) Social Support System

Human beings are social creatures. Although we may not always like it, we need each other. For recovering addicts, who likely lost a lot of old drug-using friends when they got sober, this can be a particularly painful realization. Without conscious effort, early recovery can be a lonely time.

This is where one tried and true component of addiction treatment – a strong social support system – can bolster long-term recovery. A social network can keep recovering addicts invested in their recovery program even if they lose motivation, get discouraged, or become complacent or over-confident.

Research suggests that social relationships provide emotional support, a sense of belonging and stress relief. While higher levels of social connection improve quality of life, lower levels have been linked to relapse.


5 Tips For Recognizing The High-Functioning Alcoholic Or Addict

In the field of addiction treatment, some of the most tragic stories are those of high-functioning addicts. The friends, neighbors, relatives and co-workers you look up to – envy even – for their beautiful homes, loving children and successful careers may be dealing with a secret addiction that is destroying them from the inside out.

How long do you think it would take to identify the signs of addiction in someone close to you? Most people assume they’d perceive a problem rather quickly, keeping an eye out for major life consequences such as job loss or destroyed relationships. But according to a 2007 study by the National Institute on Alcohol Abuse and Alcoholism, only 9 percent of alcoholics fit this stereotype.

The majority of addicts are high-functioning – high-power executives, surgeons in the operating room, successful professionals, hard-working stay-at-home moms and others you may not suspect even if you know them intimately over a long period of time.

High-functioning addicts are masters of disguise whose struggles with drugs and alcohol may go unnoticed for years, often with increasingly severe consequences. Here are a few ways to unmask the high-functioning addict in your life:


Are You In Recovery But Not Really Recovering?

For an addict, it seems that there is no undertaking more daunting – and no accomplishment more gratifying – than getting sober. With drugs and alcohol out of the way, the possibilities are endless.

While this is true for many people in early recovery, there are exceptions. Particularly in the first year, some recovering addicts experience “dry drunk syndrome” – a period when they become inexplicably angry, depressed and distant and are at increased risk of relapse. Much to the dismay of loved ones, a new way of life that began in treatment can take a reversal, resulting in even greater dissatisfaction and instability than before the addict stopped drinking or using.

Not to be confused with the inevitable ups and downs in early recovery, dry drunk is a high-risk stage marked by drug cravings, distorted thinking and emotional dysregulation. Although the recovering addict manages to abstain from drug or alcohol use, they either haven’t made the changes in other areas of their lives essential for a fulfilling, productive and sober lifestyle or they made progress only to return to long-held negative attitudes and patterns.

A dry drunk is characterized by:


5 Reasons Addicts Leave Treatment Early – And How To Prevent It

Getting an addict into drug rehab isn’t always an easy task. Getting them to stay there can be even harder. Here are five of the most common reasons people leave drug rehab against medical advice, along with suggestions to help the addict stay committed to their recovery.

1. “Detox is too painful.”

Research shows that the first week of drug rehab is the time when most addicts ask themselves, “What the heck am I doing here?” Withdrawal symptoms, drug cravings and an unfamiliar environment can fill the addict with anxiety at the same time they are deprived of their primary coping mechanism: drugs. Some addicts rationalize that they felt better when using drugs and give up on rehab before treatment really begins.

Prevention Tip: Detox can be made more comfortable with medication and alternative therapies such as neurofeedback, acupuncture and massage. Even if the addict isn’t feeling great, they should try to get involved in as many treatment activities as possible.

Rather than isolating, their peers will help them realize they are not alone and see the hope that treatment brings. The earlier the addict develops trust and rapport with a therapist, the more likely they will listen to the therapist’s recommendations and push through the uncertainty.