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Every Path to Sobriety is Unique

An essay by Paul Carr in last weekend's Wall Street Journal which describes how he stopped drinking and what he learned along the way, is a great example of a harm reduction approach to an alcoholic figuring out what he needed to do to get and stay sober and the changes he’s made in his life that have worked so far. He talks about his ‘relationship’ with alcohol and the positive and negative aspects of that relationship leading to the changes that he made in his life.

Many of the comments/responses on the website following the article are disheartening to me because they reflect the gigantic gap in the recovery and treatment community about what elements are helpful for people to get and stay sober. Sadly, there’s an air of arrogance and even contempt from both treatment professionals and those in recovery for this man who found a way that works for him.

How to Have Happier Holidays

The holiday season is upon us in full force, and if we believe the media good-times advertising blitz, they'll be full of unlimited joy and good tidings. (I was never sure what tidings are. If anyone knows, let me know!)

Families with addicts usually dread the holidays, the constant worry of their struggling family member spoiling the family's  good times with unpredictable behavior.

Here are some suggestions for not just  'getting through' the holiday season, but to help you and the rest of your family to enjoy it more.

Set firm and  respectful boundaries. This guideline for boundaries hold true 365 days a year, but re-establishing them during the holiday season will lower the likelihood of your holiday being disappointing.

Look at the larger picture. The fact that there are many other occasions down the road to celebrate, reflects an aspect of addiction and recovery that my clients often have a hard time grasping: addiction and recovery are a process that unfolds over time, with progress and relapse, ebbs and flows.

Manage your expectations is another important concept. Having a realistic and flexible sense of what to expect can make adjusting to the normal slips and slides of life in recovery easier.

Pace yourself. Getting better at pacing ourselves with the expected ups and downs so we don’t lose sight of the larger picture of our lives is the idea. It’s easier said than done, for sure, but once we get the hang of it, we don’t feel as overwhelmed all the time, leaving more energy to enjoy ourselves.

HAVE A SAFE AND HAPPY HOLIDAY SEASON!

People in Addiction Recovery Struggle to Manage Chronic Pain

Many people in addiction recovery also have chronic pain associated with illnesses or injuries. The stigma and public ignorance about addiction and recovery, combined with the epidemic of prescription opioid abuse, create frustrating barriers for many people to get quality, effective care for their pain management.

A recent article in The Philadelphia Inquirer by an anesthesiologist at the Hospital of the University of Pennsylvania identifies the problems built into our healthcare system and culture that contribute to the struggle that people with chronic pain have in getting relief. She describes chronic pain as "a staggering burden, reducing overall quality of life, social functioning, and psychological well-being". She cites a dated but significant research report estimating that pain costs the U. S. public $100 billion a year in associated health care, lost wages, and legal costs. And we know that with as we live longer, the problem is likely to get worse.

How Do I Know If My Child Has A Drug Or Alcohol Problem?

The answer isn't the most important thing...

As an addictions specialist, I get lots of calls from worried parents. It’s usually a bad news/good news scenario. The bad news is that most of the parents calling are beyond the point of wanting to know if their child is getting high--they’ve known it for a while by the time they finally pick up the phone to call.

The good news is that even though addiction is a progressive and chronic problem, without a commitment by the addict to maintaining a sober lifestyle, it can be a very treatable problem, especially with early intervention. And that initial call inquiring about a problem is a very important and necessary step in the process of getting help.

I use the word “process” because people come for help for a substance abuse problem with varying levels of motivation and ambivalence. Most people I see initially are being prodded or coerced to attend treatment: by a parent, spouse/partner, friend, doctor, or a lawyer.

Even parents, who are usually feeling terrified and often desperate when they are calling about their troubled teenager or young adult, have some level of ambivalence about seeking help. They’re scared, or guilty, or embarrassed or usually a combination of these or other uncomfortable feelings. They’ve probably put off for a long time making that first call. The process of reaching out for help mirrors the process of addiction recovery itself: it’s not a straight line but a series of steps: two forward, one backward, up and down, ebbing and flowing.

The importance of that initial call by a parent is not based so much on the content of the discussion--the specific information shared--but the fact that the first call represents two crucial factors that need to occur in the early recovery process to increase the likelihood of a successful parental intervention: the willingness to educate yourself about addiction and recovery; and taking steps to reclaim control of your parenthood.

Education

Accurate information is a front-line weapon in the battle against the disease of addiction. Addiction is a complex interaction of biological, psychological and interpersonal (social, family, peer relationships) factors. The more information you arm yourself with--for example, what addiction is, about the specific substances of abuse, types of addictions, the nature and process of addiction and recovery--the better position you’ll be in to figure out the action steps to take to feel more control of your child and his/her problem

Reclaim Control of Your Parenthood

I like to view that first call for help as the first step by a parent to get back in the driver’s seat of the family and reclaim control of parenthood.
An important shift in family functioning occurs when a family member is struggling with addiction. The addict is an expert at deflecting responsibility away from herself. Family members, out of love and concern, will be often willing to accept some (or a lot!) of the responsibility and even blame for the addict’s inability to take care of herself. So in addition to giving parents some specific information during that call, I’ll have them start the process of figuring out how they can begin to focus on which aspects of the problems associated with the addict’s behavior that they can control, or actually do something about. This is the first step in the parent’s own recovery.

Taking steps towards reclaiming your parenthood will begin the process of shifting the family functioning towards a healthier state and reduce the fear and helplessness for parents.

FYI: Elsewhere on PARC, I share some basic screening tools for getting a better sense of the difference between use and abuse:

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