Clinician Resource

I Will Not Relapse Cover

Addiction destroys lives and families, hopes and dreams. Addiction is a disease, and everyone hopes for a cure. Why wouldn’t they? A cure is easy; it is, by definition, a one-time event. Who wouldn’t want to take a pill, get a vaccine, or even have surgery if it meant they would never again have to fear that vicious cycle of recovery and relapse?

Unfortunately, there is no cure for addiction, and those who promise one are charlatans and liars. In fact, many people relapse because they confuse recovery with cures. When they start feeling better or go a few days without cravings, they think they have beaten their addiction. All too soon, they find it has come back, often with more punch than before.

The key to recovery is recognizing that it is not a cure. Recovery isn’t easy. It requires daily recognition of and respect for the power of addiction. It requires an ongoing commitment to living a life in which it is easier to not use. When successful, recovery can keep addiction at bay, reducing it to a feeble voice that no longer sabotages the lives of good men and women.

Lasting recovery demands change. The addicted person must think, act, manage his or her life, and express his or her feelings in new, healthier ways. To help the addicted person make these changes and establish a strong recovery, St. Joseph Institute has prepared a workbook: “I Will Not Relapse.  We encourage you to download this free workbook or contact us for a free printed copy.

Our goal is simple. We want addicts and alcoholics to embark on a path of life that looks and feels as good as a cure.

Addiction treatment can be discouraging.  As a healthcare professional you can invest huge amounts of energy and passion into helping someone enter into recovery, only to see them fall back into the old patterns of using.  The addict or alcoholic comes to understand their disease, learning techniques to manage their urges, triggers and weaknesses. You help them build a support network and emphasize how important it is to reach out to others in times of trial.  Yet, even though they have the tools, they often fail to use them in times of crisis, or resist making the changes necessary to create a life where it is easier not to use.

There are many reasons why people relapse and the outcome of treatment is not under the control of the provider.  However, that does not exempt the rehab program from ensuring that it is doing its best to lay the foundation for a strong recovery.  In this regard, there is a need for addiction treatment to be holistic, focusing on the whole person and the many reasons why they use drugs and alcohol.  There are times when it is not inappropriate to view addiction as the symptom, a means by which the underlying problem is being medicated. If treatment does not address these deeper issues, recovery from addiction is significantly impeded.

The co-occurring conditions must be addressed.

It is estimated that more than two thirds of the people with an addiction have a diagnosable co-occurring condition.  Our experience at St. Joseph Institute would confirm that statistic, and encourage the search for other underlying conditions which might not merit a diagnosis, but nonetheless are important issues that must be addressed. Listed below are ten of the “companions” to addiction that we frequently encounter.

  1. Anxiety. Studies of drug and alcohol use on university campuses highlight how often addiction grows out of a desire to lower anxiety.  Treatment must recognize the importance of equipping the individual with techniques and strategies to manage anxiety without self-medication.
  2. Depression. Sadness is a feeling that we want to avoid and too often drugs or alcohol become the answer.  Depression must be treated if the cycle of addictive behavior is to be broken.
  3. Bipolar Disorder.  Many people affected with bi-polar dislike the way they feel when taking prescription medications for their condition.  Drugs may offer relief from the symptoms, but lead them down a destructive pathway.
  4. Pain.  Addiction is all too often the result of pain medications that were prescribed by a physician.  Natural ways of managing pain must be taught if the dependence on narcotics is to be broken.
  5. Relationship problems.  Nothing creates more “psychic pain” than relationships that are not working well.  Learning to build better boundaries, resolve conflict, and establish trust are important for everyone, especially those who are tempted to self-medicate when relationships become hard.
  6. Stress. Too often managing stress is considered an optional activity.  For people with addiction, finding ways to keep their stress at a low level is a mandatory part of recovery.
  7. Boredom.  A surprising number of people use drugs and alcohol to cope with boredom.  For this group, finding new hobbies, outlets, and ways to get involved is an important part of the healing process.
  8. Sex. Many addicts have used drugs or alcohol as part of their sex lives for as long as they can remember.  They are afraid of the impact of sobriety on their sex lives, because of inhibitions, or because they fear the performance or the experience will change.
  9. Self-worth.  Some many people treat their feelings with drugs and alcohol.  When they have been hurt by others, or are unable to forgive themselves, addiction becomes a place of safety.
  10. Trauma, abuse, PTSD. It is estimated that 1 in 4 women addicts has been sexually abused.  Addictive behavior has become a way of coping, and recovery demands that these underlying issues find resolution.

These are but some of the reasons why people become attached to their drug of choice and are reluctant to let go.  If we are to treat these people, and help them break free from their addiction, we must help them address these driving reasons and adopt new behaviors.  If we treat the addiction, but ignore the co-occurring conditions that provide its fuel, we will almost always witness failure.  Recovery demands that the whole person find healing.  As healthcare professionals, we can offer nothing less.

 Michael Campbell is Co-founder and President of St. Joseph Institute for Addiction, a rehab center located near State College.

gunpointFor a parent, a spouse, or a friend, it is incredibly hard to watch someone you care about sink into addiction without taking action.  The destructive behavior must stop.  They must get help now.  Any leverage seems fair, and appropriate, if it gets the addicted person into treatment.

Unfortunately, while you may be able to force someone into rehab, the effort is often wasted, and the good intentions frequently backfire.

I remember the young man whose father promised him a truck if he agreed to seek treatment.  He had a smile on his face for 30 days of rehab, and then picked up his new wheels and headed off to meet friends and get some drugs. A young woman who had been forced into treatment by her family made no effort to change, and relapsed soon after discharge.  The stories could continue for pages, but the message is clear.  Addiction treatment only works if you want it to.

Motivation is an essential ingredient to a successful recovery.  If there is no internal desire, no passion to live life differently, the best efforts are usually futile.  External motivation may force someone into treatment, but it won’t keep them there, and it rarely sparks the “awakening” that is necessary to change the way an addicted person thinks and acts.  Sobriety comes from within; rehab at gunpoint is not the way to go.

So what do you do if you are frantically worried that someone you care about will soon end up in jail or the morgue?  If you can’t kidnap them, and take them to rehab, what can you do?

The starting place is to make addiction a very uncomfortable place to live.  Every action that enables the addicted person to continue to keep using their drug of choice needs to be withdrawn.  Free rent, covering for them at work, offering to help solve their problems, must come to an end.  When friends and family make it difficult to be an addict, thinking often begins to shift.  When there is no support for someone in addiction, they see more clearly the cost of their behavior, and the desire to change takes root.  Many people have come willingly to St. Joseph Institute after a heavy dose of “tough love” made them rethink their lifestyle.  Addiction loves a sucker and hates a scrooge.

The hard part about allowing the addicted person to take ownership for their problems is that they are often great manipulators — with the skill to make others feel guilt.  Mothers will hear the line “its cold outside and I have nowhere to live.”  Spouses will hear the explanation of how their marriage vows require that they “don’t give up” on the drunken partner.  Friends may hear the statement “if no one cares about me I might as well kill myself.”  Addicted people are good at finding and taking hostages.

It is important to realize that addiction craves enabling just as a fire needs oxygen.  Remove the supports that allow an addiction to continue, and the best possible conditions for recovery are created.  It doesn’t always work, but often when the addicted person feels the pain of their situation they willingly reach out for help.  In that act of surrender, the potential for success changes dramatically, because the desire to be sober has started to burn from within. And by the way, while you are practicing tough love, don’t forget to say a few prayers.  They help too.





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