If you have severe alcohol and other drug problems, you should know that successful recovery from these problems involves significant changes over time in:

• personal identity and beliefs
• family and social relationships
• daily lifestyle

It is about where you live, how you work and play, who is included and excluded from your life, and how you cope with the stresses of daily life. Recovery is more than just not drinking or using drugs; it is about putting together a new and meaningful life in which alcohol and drugs no longer have a place. Recovery from addiction is not like getting over an infection for which we can rest and take medication for a week or two and then get back to our otherwise unchanged lives. Those who view treatment for addiction in this way make up the group for whom treatment does not work. Recovery from addiction is closer to how someone successfully manages diabetes or heart disease – conditions that require sustained decisions and actions for life.

The Good News

• The positive effects of addiction treatment are substantial, as measured by sustained sobriety (about one-third of those treated) and decreases in substance use and substance-related problems.
• Active participation in treatment aftercare meetings and recovery support groups such as Alcoholics Anonymous can significantly improve your chance of permanent recovery, improve your quality of life and prolong your life expectancy.
• Combining professional treatment and attending recovery support meetings improve your chances of recovery better than either activity alone.
• Lifetime recovery rates of people with a substance use disorder approach or exceed 50%. There are millions of individuals and their families in long-term recovery from the effects of severe substance use problems.
• There are multiple pathways and styles (secular, spiritual, religious) of long-term addiction recovery
• Recovering people can go on to lead lives of significant achievement and community service

How Does the Brain Become Addicted?

Typically it happens like this:

• A person takes a drug of abuse, be it marijuana or cocaine or even alcohol, activating the same brain circuits as do behaviors linked to survival, such as eating, bonding and sex. The drug causes a surge in levels of a brain chemical called dopamine, which results in feelings of pleasure. The brain remembers this pleasure and wants it repeated.
• Just as food is linked to survival in day-to-day living, drugs begin to take on the same significance for the addict. The need to obtain and take drugs becomes more important than any other need, including truly vital behaviors like eating. The addict no longer seeks the drug for pleasure, but for relieving distress.
• Eventually, the drive to seek and use the drug is all that matters, despite devastating consequences.
• Finally, control and choice and everything that once held value in a person’s life, such as family, job and community, are lost to the disease of addiction.

What brain changes are responsible for such a dramatic shift?

Research on addiction is helping us find out just how drugs change the way the brain works. These changes include the following:

• Reduced dopamine activity. We depend on our brain’s ability to release dopamine in order to experience pleasure and to motivate our responses to the natural rewards of everyday life, such as the sight or smell of food. Drugs produce very large and rapid dopamine surges and the brain responds by reducing normal dopamine activity. Eventually, the disrupted dopamine system renders the addict incapable of feeling any pleasure even from the drugs they seek to feed their addiction.
• Altered brain regions that control decisionmaking and judgment. Drugs of abuse affect the regions of the brain that help us control our desires and emotions. The resulting lack of control leads addicted people to compulsively pursue drugs, even when the drugs have lost their power to reward.

The disease of addiction can develop in people despite their best intentions or strength of character. Drug addiction is insidious because it affects the very brain areas that people need to “think straight,” apply good judgment and make good decisions for their lives. No one wants to grow up to be a drug addict, after all.

Co-occurring Addictions: Compounding Complexities

It is not unusual for an addicted person to be addicted to alcohol, nicotine and illicit drugs at the same time. Addiction to multiple substances raises the level of individual suffering and magnifies the associated costs to society. No matter what the addictive substance, they all have at least one thing in common – they disrupt the brain’s reward pathway, the route to pleasure.

What is the best way to treat people who are addicted to more than one drug?

• Medications. In some cases, medications developed for one addiction have proven useful for another. For example, naltrexone, which can help former heroin users remain abstinent by blocking the “high” associated with heroin, has been found to be effective in treating alcoholism.
• Behavioral therapy or other psychotherapy. Behavioral therapies do not need to be specific to one drug and can be adapted to address use of multiple or different drugs. It is the disease of addiction that the therapy addresses.
• Combined medications and behavioral therapy. Research shows that this combination, when available, works best.
• Multipronged approach. Treatment for multiple addictions should be delivered at the same time. This is especially true because there are always triggers, such as trauma, depression, or exposure to one drug or another, that can put the recovering addict at risk for relapse. In addition, treatment must consider all aspects of a person – their age, gender, life experiences – in order to best treat their drug addiction. Although the type of treatment may differ, it should always strive to address the entire person through a multipronged approach that tackles all co-occurring conditions at once.

Relapse: Part of Addiction as a Chronic Disease

Despite the availability of many forms of effective treatment for addiction, the problem of relapse remains the major challenge to achieving sustained recovery. People trying to recover from drug abuse and addiction are often doing so with altered brains, strong drug-related memories and diminished impulse control. Accompanied by intense drug cravings, these brain changes can leave people vulnerable to relapse even after years of being abstinent. Relapse happens at rates similar to the relapse rates for other well-known chronic medical illnesses like diabetes, hypertension and asthma.

How is relapse to drug abuse similar to what happens with other chronic diseases?

• Just as an asthma attack can be triggered by smoke, or a person with diabetes can have a reaction if they eat too much sugar, a drug addict can be triggered to return to drug abuse.
• With other chronic diseases, relapse serves as a signal for returning to treatment. The same response is just as necessary with drug addiction.
• As a chronic, recurring illness, addiction may require repeated treatments until abstinence is achieved. Like other diseases, drug addiction can be effectively treated and managed, leading to a healthy and productive life.

To achieve long-term recovery, treatment must address specific, individual patient needs and must take the whole person into account. For it is not enough simply to get a person off drugs; rather, the many changes that have occurred – physical, social, psychological – must also be addressed to help people stay off drugs, for good.

Repeated drug exposure changes brain function. Positron emission tomography (PET) images are illustrated showing similar brain changes in dopamine receptors resulting from addiction to different substances – cocaine, methamphetamine, alcohol, or heroin. The striatum (which contains the reward and motor circuitry) shows up as bright red and yellow in the controls (in the left column), indicating numerous dopamine D2 receptors. Conversely, the brains of addicted individuals (in the right column) show a less intense signal, indicating lower levels of dopamine D2 receptors.

by Nora D. Volkow MD from HBO.com

When the time came that I began to go through the twelve steps I had been clean and sober for over three months and still felt disconnected from God.  The first step was to admit that I was powerless over drugs and alcohol and that my life had become unmanageable, which was easy for me.  However the second step was no easy feat, “We came to believe that a power greater than ourselves could restore us to sanity.”  I went over and over the words in my head and tried to think what it meant to me and how I could relate to this concept of a power greater than myself.  My sponsor told me that she had a similar experience when she was a newcomer and that all that I needed at that time was to believe that there was something in the universe that was more powerful than me.  I had heard of people using the fellowship of Alcoholics Anonymous as their Higher Power because they felt that the group was more powerful than they were alone.  That idea made sense to me and for the time being it would suffice.  I was hopeful that in time my relationship to God would blossom and develop as was the experience of others in AA.

1. You have difficulty controlling how much you use or how long you use. For example, one painkiller leads to more pills, or one line of cocaine leads to more.
2. You continue to use even though it has negative consequences to your life. For example, you continue to drink even though it has hurt your relationships.

Those two criteria define all addictions. They are true for alcohol and drug addiction, but they’re also true for gambling addiction, eating disorders, and sexual addiction.

There are different levels of addictions. At one end of the spectrum is the non-functioning addict. They’ve lost their job and have to use everyday. It’s what people think addiction is like, but that stereotype is rare.

At the other end of the spectrum is the functioning addict. They still have a job and their relationships are relatively intact, but their life is suffering because of their addiction. That is the most common scenario. You don’t have to suffer major losses to have an addiction.

The consequences of addiction get worse over time. Addiction is a progressive disease. It’s never easy to quit. But if you’ve already suffered negative consequences and don’t want them to get worse, there’s never a better time to quit than now.

The Role of Family History

Addiction is due 50 percent to genetic predisposition and 50 percent to poor coping skills. This has been confirmed by numerous studies. One study looked at 861 identical twin pairs and 653 fraternal (non-identical) twin pairs. When one identical twin was addicted to alcohol, the other twin had a high probability of being addicted. But when one non-identical twin was addicted to alcohol, the other twin did not necessarily have an addiction. Based on the differences between the identical and non-identical twins, the study showed 50-60% of addiction is due to genetic factors. Those numbers have been confirmed by other studies.

The children of addicts are 8 times more likely to develop an addiction. One study looked at 231 people who were diagnosed with drug or alcohol addiction, and compared them to 61 people who did not have an addiction. Then it looked at the first-degree relatives (parents, siblings, or children) of those people. It discovered that if a parent has a drug or alcohol addiction, the child had an 8 times greater chance of developing an addiction.

Why are there genes for addiction? We all have the genetic predisposition for addiction because there is an evolutionary advantage to that. When an animal eats a certain food that it likes, there is an advantage to associating pleasure with that food so that the animal will look for that food in the future. In other words the potential for addiction is hardwired into our brain. Everyone has eaten too much of their favorite food even though they knew it wasn’t good for them.

Although everyone has the potential for addiction, some people are more predisposed to addiction than others. Some people drink alcoholically from the beginning. Other people start out as a moderate drinker and then become alcoholics later on. How does that happen?

Repeatedly abusing pain medicine or alcohol permanently rewires your brain. If you start out with a low genetic predisposition for addiction, you can still end up with an addiction. If you repeatedly abuse drugs or alcohol because of poor coping skills, then you’ll permanently rewire your brain. Every time you abuse alcohol, you’ll strengthen the wiring associated with drinking, and you’ll chase that buzz even more. The more you chase the effect of alcohol, the greater your chance of eventually developing an addiction.

Your genes are not your destiny. The 50% of addiction that is caused by poor coping skills is where you can make a difference. Lots of people have come from addicted families but managed to overcome their family history and live happy lives. You can use this opportunity to change your life. (Reference: www.AddictionsAndRecovery.org)

If you think that you have a problem with drugs or alcohol visit sunrisedetox.com for medical detox services.  Sunrise Detox offers the highest quality care with a compassionate and understanding staff that will treat you with respect.  They offer a comfortable home like atmosphere in which you can begin the road to recovery.  Detox is the first step to recovery from drug addiction so act now and take control of your life.

Everyone goes through detox differently and what any one individual may go through will depend largely on a person’s age, frequency and amount of use, as well as any underlying medical issues they may have. For the most part, one can expect to experience withdrawal symptoms such a nausea, vomiting, tremors, sweats and anxiety. In extreme cases some people also may have convulsions or seizures. These are just a few of the reasons why it’s important to have proper medical support in order to help with an alcohol and drug detox program. Many of these effects can be lessened with medications and with proper supervision. On the other hand, some people get through it with very few symptoms. There is no way to tell how any one person will react. Supervised detox is always the best approach. It helps knowing that you have support there if you need it.

Once you have gone through the detox part of the program it’s important to realize that this is just the first step. You’ve managed to eliminate alcohol and drugs from your body but there are still steps that need to be done to ensure that you don’t return to drinking or using again. In order to have a complete recovery it’s important to understand that you now will need to make lifestyle changes in order to increase your odds for a sustained recovery. Learning to live without alcohol as a crutch can be very difficult, but the longer-term benefits of a new and happier life are well worth it.

During the first 30-90 days of a detox program is the time when people are most vulnerable. This is why it’s important to effect changes in your lifestyle as well as getting psychological support. Lifestyle changes can mean staying away from friends who are heavy drinkers, and who may not understand what you have gone through and what you are now trying to accomplish. Staying away from bars or other places where alcohol is served, including your home. Your family will be able to understand the need for you to not be around other people who are drinking. It’s also important to understand the meaning of a dry drunk. This is a person who has ceased drinking and eliminated alcohol from their system, but has done nothing to change the emotional aspects of abuse. This is another aspect of how your lifestyle must change. The more you work with a counselor, the more you will understand that it also takes emotional changes in order to remain sober.

Emotional support from friends and family is also crucial when you are going through alcohol detox. Rehab treatment centers that help people detox also provide support for them through counseling or through a 12-step program such as AA. It is important for the alcoholic to take actions to help in their recovery, and going to counseling regularly is a part of that. If you are on medications you need to take them as directed and never stop it without consulting a doctor. It’s also important to include the family of anyone going through alcohol detox, and allow him or her to offer support and help and be a part of the recovery process. In the end though it is up to the alcoholic to do the necessary work to effect a complete recovery, and then take the needed steps to remain in recovery.

People who use drugs experience a wide array of physical effects other than those expected. The excitement of a cocaine high, for instance, is followed by a “crash”: a period of anxiety, fatigue, depression, and an acute desire for more cocaine to alleviate the feelings of the crash. Marijuana and alcohol interfere with motor control and are factors in many automobile accidents. Users of marijuana and hallucinogenic drugs may experience flashbacks, unwanted recurrences of the drug’s effects weeks or months after use.

Sharing hypodermic needles leads to an increased risk of HIV and some forms of hepatitis. That, along with increased sexual activity among drug addicts can greatly increase the incidence of people becoming infected with AIDS and sexually transmitted diseases.

There are over 10,000 deaths directly attributable to drug use in the United States every year; the substances most frequently involved are cocaine, heroin, and morphine, often combined with alcohol or other drugs. Many drug users engage in criminal activity, such as burglary and prostitution, to raise the money to buy drugs, and some drugs, especially alcohol, are associated with violent behavior.

The user’s preoccupation with the substance, plus its effects on mood and performance, can lead to marital problems and poor work performance or dismissal. Drug use can disrupt family life and create destructive patterns of codependency, that is, the spouse or whole family, out of love or fear of consequences, inadvertently enables the user to continue using drugs by covering up, supplying money, or denying there is a problem.

Pregnant drug users, because of the drugs themselves or poor self-care in general, bear a much higher rate of low birth-weight babies than the average. Many drugs (e.g., crack and heroin) cross the placental barrier, resulting in addicted babies who go through withdrawal soon after birth, and fetal alcohol syndrome can affect children of mothers who consume alcohol during pregnancy. Pregnant women who acquire the AIDS virus through intravenous drug use pass the virus to their infant.

Drug abuse affects society in many ways. In the workplace it is costly in terms of lost work time and inefficiency. Drug users are more likely than nonusers to have occupational accidents, endangering themselves and those around them. Over half of the highway deaths in the United States involve alcohol.

Drug-related crime can disrupt neighborhoods due to violence among drug dealers, threats to residents, and the crimes of the addicts themselves. In some neighborhoods, younger children are recruited as lookouts and helpers because of the lighter sentences given to juvenile offenders, and guns have become commonplace among children and adolescents. The great majority of homeless people have either a drug or alcohol problem or a mental illness-many have all three.

Drug addiction has an effect on all parts of life for the drug user, the family, and society as a whole. The time to get help for an addiction is NOW before its effects become so far-reaching, they cannot be recovered.

by Alden Robinson