Detox Recovery

Posts Tagged ‘relapse’

When money is tight, everything becomes a potential stressor that may trigger relapse. Economic downturns make the recovering addict’s personal situation worse in that there is less perceived help available – either financial, job-related, skills training, and continuing counseling or support.

Foreclosures, bankruptcy, maxed-out credit cards, depleted checking and savings accounts, unpaid bills and past-due notices, collection demands, lawsuits, fines, legal fees and so on can mount up to the point where the individual in recovery sees no way out. Why not resort to the bottle or downing pills or injecting, inhaling, gambling, etc. as a means to cope with the economic calamity? While that’s certainly one way to look at it – escape – as always, the escape is only temporary. The economic problems of the recovering addict, mirroring the downturn in the economy, will still be there. They may even become worse. Thus, the escape is not only a delay tactic of facing the inevitable – it is also worthless as a solution. It simply doesn’t work.
You can’t ignore the economic downturn or your own personal financial situation. So, how can you deal with a worsening economic situation without resorting to relapse?

• First, don’t allow things to pile up or get to the point where you feel you don’t have any hope of coming out from under. Seek the help of a financial advisor – perhaps one of the resources available to you in your 12-step group or a program you can be referred to in the community.

• Work with your creditors to arrange a graduated payment plan, reduced payments, loan modification program, or the like. Creditors want their money, but some money negotiated in advance is better than no money at all. Generally speaking, they will be willing to work with you to create a repayment plan or schedule. You need to at least give this option a try. It will go a long way toward helping reduce the economic stressor that could otherwise do you in.

• Recognize that the economy goes through regular upturns and downturns. The cyclical nature of the economy is such that one usually follows the other. While this may not be comforting when you’re drowning in debt, it at least lets you acknowledge that you will probably be able to overcome your financial and economic difficulties at some point in the future.

• Take a tip from financial planners and organize, pare, and prioritize. Sort bills according to due dates, amount due, and prioritize according to most important. These include your mortgage or monthly rent, car and insurance payments, utilities, food, and recurring medical expenses. Eliminate all but essential expenses – at least until you’re back on solid financial ground. When you get back to work, set up an automatic deduction for the high-priority obligations (mortgage payment, car payment, etc.) from your checking account. This will ensure that there are no late payments and you won’t be tempted to spend the money instead of taking care of those bills. Just be sure that you deduct that amount from your check register so that you don’t overdraw your account – and incur overdraft fees.

Loss of a Loved One

Your biggest support will come from your loved ones – your spouse or partner, your immediate family. When you lose a loved one, however, your entire world is thrown into turmoil. You are at great jeopardy of relapse, as the loss of a loved one is one of life’s traumatic stressors that do the most damage. This is true of nearly every human being, but even more so in the case of those in recovery whose emotional state and ability to overcome cravings and urges is so fragile.

Where you once had the constant presence, love, encouragement and support of your loved one is now a gaping hole. You feel the pain as if it were a physical wound. Nothing cuts the pain – except going back to your addictive ways. This is a common trap that recovering addicts often fall into. They feel that there is no way out except to go back to a coping mechanism they’re familiar with – their addiction.

How do you survive the loss of a loved one without having it trigger relapse? This is a tough situation. There’s no getting around that fact. Platitudes about time healing all wounds will bounce right off you – as they do to most persons in the first stages of bereavement. People utter those words because they don’t know what else to say, and it is also true that time will help ease the pain. But, right now, that probably won’t do you any good.

What you can do to keep yourself on the straight and narrow road to recovery is to surround yourself with others who understand your situation, your addiction, the tremendous desire to escape your pain by succumbing to your addiction. Step up your participation in 12-step meetings. Go every day or several times a day if that will help. Ask for a referral to a grief counselor or participate in online grief counseling meetings, blogs or chat rooms. Ask your doctor for assistance in finding some help for you to cope with your grief.

Other tips to help you in your time of bereavement include:

• Spend time with friends. – Don’t sit at home alone and allow yourself to wallow in self-pity or remorse.

• Stay active. – Get involved in physical activity, exercise, sports, recreational activity, intellectual pursuits, going out to entertainment venues.

• Find solace in spiritual comfort. – Whatever your religious background or spiritual inclination, many persons in recovery find comfort in seeking the assistance of a higher power to help them weather this very emotionally-draining time. Prayer may work for you, or meditation, or going to church or contemplating the power of the universe. Listening to motivational and inspirational tapes may be helpful, or reading books on overcoming grief, especially those that are available through addiction recovery websites.

• Take it one day at a time. – This often-repeated mantra really does work. You can’t expect that you’ll have all the answers for all the days ahead, but you can do everything you can to engage in positive behaviors today. Be sure that you take care of yourself, including eating properly, getting enough sleep, and tending to your physical and emotional needs. Cut yourself some slack as well. You don’t have to be perfect, and there’s no timetable that you need to adhere to in terms of when you’ll start to heal from the loss of your loved one.

Source: Drug Addiction Treatment

The human brain is an extraordinarily complex and fine-tuned communications network containing billions of specialized cells (neurons) that give origin to our thoughts, emotions, perceptions and drives. Often, a drug is taken the first time by choice to feel pleasure or to relieve depression or stress. But this notion of choice is short-lived. Why? Because repeated drug use disrupts well-balanced systems in the human brain in ways that persist, eventually replacing a person’s normal needs and desires with a one-track mission to seek and use drugs. At this point, normal desires and motives will have a hard time competing with the desire to take a drug.

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