July 2007 Archives

Smoking in alcohol recovery can reduce cognitive performance, and may increase the risk of relapse. Should alcoholics try to quit smoking at the same time as they try to quit drinking? Clinical research studies of drinking alcoholics that compared smoking drinkers and non smoking drinkers had previously revealed that those heavy drinkers that also smoked performed more poorly on a host of cognitive tests. Smoking seems to co join with alcohol in the brain in some way and exacerbates the damage done by the alcohol, and as such if you are a heavy drinker you would do well to at least quit smoking, if not quit drinking as well. But no one had ever studied the effects of cigarette smoking on mental recovery during initial sobriety. Researchers at the University of California at San Francisco decided to change that and did a clinical study comparing mental recovery in both non smoking recovering alcoholics and smoking recovering alcoholics; and they found that the cognitive deficits associated with smoking while drinking seem to continue during recovery, with smokers in recovery performing significantly worse on a battery of cognitive tests during the initial 6 to 9 months of sobriety. Testing done on higher processing, on spatial performance, on short range memory, and problem solving skills all showed a much slower rate of recovery for the smoking abstinent alcoholics when compared to the non smoking groups. The study results are especially pertinent to alcohol abuse recovery as estimates put the percentage of heavy drinkers that also smoke at 300% to 500% the national average for tobacco use, and as a result a significant percentage of recovering alcoholics are also smokers, and a significant percentage of these people are having their recovery delayed by their tobacco usage. The study leaders as a result have called for more testing to be done, and since the mortality rates associated with smoking far exceed the mortality rates of drinking, the leaders of the study propose that smoking cessation should possibly be encouraged as a part of the treatment for an alcohol addiction. The study leaders stop short of saying that smoking increases the probability of relapse, but the when considering deficits in problem solving and higher order processing; it seems likely that smoking may play a role in the recidivism amongst recovering alcoholics. One of the best ways to minimize the risk of relapse is through cognitive strategies leading away from abuse, and good healthy problem solving skills designed to minimize life stresses that also make abuse more likely. Since the study researchers claim that the mental processing required for the enactment of these strategies is impaired by tobacco usage, it seems probable that smoking reduces the effectiveness of cognitive modification therapy, and leads to a higher percentage of relapse. Additionally, scientists have discovered that there is in fact a co addiction to nicotine and alcohol together and they suggest that by continuing to use nicotine, you are in fact increasing the mental cravings for the co joined addiction to alcohol. So it seems pretty clear that drinkers trying to get sober should also quit smoking at the same time… which when you think about it may be a pretty tall order. I mean quitting drinking is really hard, and for most people recovery is the most challenging thing they've ever attempted; and since quitting smoking is also no picnic, then isn't combining these two programs of cessation at the same time asking a bit too much out of the recovering addict? I am no longer a smoker, but I was a smoker while drinking, and I remained a smoker through the first two years of sobriety, and I guess that my tobacco usage was limiting my cognitive recovery, but I'm not sure if I could have quit these two very addictive habits at the same time. I'm neither a scientist nor an addictions professional, I'm just an addict with a bit of experience on recovery, but it would seem to me that by asking too much you increase the odds of failure. I would say quit smoking if you can, but worry about the drinking more, and even though quitting smoking seems to improve your recovery, if the stress of the smoking cessation drives you back to alcohol, it seems a pretty pointless exercise. I'm sorry for the somewhat conflicting information and opinion of this post, but this…like so much else about addiction and recovery, seems to be less than crystal clear. If you can quit smoking, you should do it, and you'll feel better, and recent clinical data indicates that you may even think better; but if you can't and you’re just barely holding on in your battle against alcohol, I'd think you might want to wait a few months before taking on another stressor, and another battle against addiction. Just my 2 cents worth!

European researchers, in a multi year study involving thousands of participants; have conclusively linked alcohol consumption with an increased risk for often fatal colon cancer. Even the consumption of small amounts daily increases the likelihood of cancer, and when only 2 drinks are consumed each day, the increased probability of cancer is almost 25% higher than for non drinkers. Alcoholics tend to drink huge amounts of alcohol daily, and as such they are at incredible risk for this and other cancers, and this is yet another reason to stop drinking...before it's too late. A new British study has linked alcohol consumption to an increased risk for colon cancer. The study found that the consumption of a glass of wine or a pint of beer each day increases your risk for colon cancer by 10%, and two drinks a day increases your risk by as much as 25%; and this is pretty scary stuff since the mortality rate for colon cancer is quite high, with 35 000 Britons each year diagnosed, and 16 000 each year dying from the disease. I'm not sure what the increased colon cancer risk is when drinking 20 or more beers daily, but I imagine my outlook is not particularly promising. I do have faith in the body's recuperative powers, and I believe that with each passing year of sobriety I minimize the risks of my previously very unhealthy lifestyle. No one who drinks is under the illusion that they do so for their health, but in addition to the well know health risks like cirrhosis and heart disease, it seems with every passing year clinical researchers unearth more evidence to the damage done by problem drinking. If you drink to excess you should be aware of the damage you are doing to your body, and think about how long and with how much health you'd like to live. Every day you continue to drink increases your probability of contracting a serious and possibly fatal condition, and the sooner you quit the better your prognosis. If you drink, try to stop, and if you can't, or won’t, try to minimize your consumption. If you drink, or did drink to excess, you should be aware of the increased risks for certain diseases, and make sure that your doctor is also aware of your history of abuse, as to ensure you get the needed prophylactic testing that might just save you life. I don't know how much damage I did to my body while drinking, but I do know that my GI tract was a mess; and although I now feel fine, I think I may have to speak with my doctor about colon cancer, and determine if any testing may be required. Just one more reason to be thankful for a life of sobriety.

Although clinical researchers have been aware for some time of the cognitive and psychiatric consequences of heavy and long term ecstasy use, researchers had no idea how much consumption was needed before brain damage started to occur. A new research study has given the answer, and that answer is surprising; it appears that even small and initial doses of ecstasy can cause brain damage and decreases in mental performance. Ecstasy has now been proven harmful, even when taken in small doses by new users. While previous clinical studies have proven that usage of MDMA, the serotonergic acting drug commonly called ecstasy, can have profound and lasting implications; Dutch researchers have found that even initial and limited exposure to the drug causes brain damage and leads to decreases in cognitive testing performances. Heavy ecstasy use can cause depression, insomnia, irritability, confusion, poor cognition and poor memory performance; and this is not entirely surprising since the drug acts through a process of serotonin modification, and serotonin is uniquely important for mood and memory in the brain. Researchers previously however had no idea how much ecstasy use was required to cause these deficits, and how much impact a small amount of the drug would have. A Dutch research group aimed to change this and undertook a before and after study of 188 volunteers who had never previously tried the drug, but were deemed at a high risk to try the drug in the future. Researchers performed brain scans on the volunteers before exposure to the drug, and additionally performed cognitive and memory testing on the subjects. After 18 months, 59 of these subjects had tried ecstasy, and they had consumed an average of 6 tablets each during this time period. The rest of the volunteers had not. The same scanning and testing was again performed, and researchers were surprised to find that even this small and initial exposure to ecstasy had caused significant impairments in cognitive testing, particularly in verbal memory performance, as well as in blood flow to certain regions of the brain. The damage was not severe but was significantly evident, and had occurred after the consumption of relatively small amounts of the drug. The research leaders have as a result reported that in their clinical opinion, any exposure to ecstasy is harmful, and people should avoid experimenting with the drug due to the probability of long term brain damage. A recent survey of American high school seniors indicates that almost 5% had tried the drug, and the usage of the drug seems to be on the rise. There is a mis perception as to the safety of the drug, and the public needs to know that ecstasy is not a safe drug, that long term use can cause serious damage and greatly increases the risk of experienced depression, and additionally that the damage to the brain starts occurring even after only small doses of the drug have been used. I've never tried ecstasy, I guess I'm a bit of an old timer now, but I have no doubt that I would have tried it were I a teenager today. Ecstasy is perceived as a fairly safe and non addictive drug, and it's unfortunate that this perception is false. The risks of the drug are high, and although I've no doubt that it's a lot of fun; is one night of fun worth the risk of a life time of depression and other cognitive and affective side effects? If you use ecstasy regularly, get educated as to the health consequences of use, and consider stopping, or at least reducing your usage. Ecstasy can be addictive, and professional treatment may be required in some cases.

Italian researchers testing the efficacy of Chinese sage for the treatment of alcohol abuse have revealed some very exciting and promising results. The researchers gave some pretty hard drinking mice this Chinese sage, and it caused a significant reduction in their alcohol consumption. Human trials are to follow, and I for one am very hopeful on the promise that may be offered by this common herb. A variety of Chinese sage, long used in traditional Chinese medicine for the treatment of insomnia, heart problems and blood disorders, has been found promising in the treatment of alcoholism by Italian scientists. Alcohol dependent mice treated with the Chinese sage drank less, and those mice that had been taken off alcohol drank far less than normal when again given access to alcohol after a period of enforced sobriety. The results have excited the Italian researchers, and they are investigating the herb's safety before moving on to possible human trials. I'm not much of an alternative therapy kind of guy, and I've never had much belief in acupuncture cures and using hypnotism to cure addiction and all that kind of homeopathic stuff; but if clinical testing indicates that a common herb seems to ease the cravings for alcohol, then I can't help but get excited about its potential. Because something is natural of course doesn't mean that it's healthy, (after all, morphine is natural…but I certainly never felt healthy when abusing it!) but a common herb, and an herb that's been used in Chinese medicine for millennia, has a good track record of legitimate safety and is something I would not hesitate to take. Imagine a natural herbal tea, drank daily, that reduced the urge to drink. That would be very good thing and I for one will be awaiting the next stage of testing eagerly.

Cocaine and meth are powerfully addictive, and the treatment for an addiction to either can be very difficult. Newly developed anti drug vaccines may make things just a little bit easier. These vaccines, administered while the addict is still using, gradually reduce the amount of cocaine or meth that make it to the brain, and as a result gradually reduce the level of dependency and addiction. I was just reading about a pair of vaccines being developed for the treatment of both cocaine addiction, and addiction to crystal meth. These are two pretty powerfully addictive substances, and if these proposed vaccines can do anything to increase the odds of success, then they would be very welcome additions to the current addictions treatment arsenal. The way they work is that drug addicts are given a series of injections over three months, with each injection increasing the level of antibodies in the blood stream. These antibodies are designed to recognize, target and attack the drug, preventing it from reaching the brain. As more antibodies are released into the blood through further injections, decreasing amounts of the administered drug (cocaine or meth, each vaccine works for only one specific drug) actually make it to the brain. The vaccines are given over three months, and levels of the antibodies rise very gradually. The vaccine's effects become noticeable after a month, and by three months, most of any administered drug is destroyed before reaching the brain. Because the process is so gradual, addicts feel little discomfort from the process of getting weaned off of their drug of choice. Basically what these vaccines accomplish is that they allow addicted people to continue to use their drug, and get gradually less dependent on it through the action of the antibodies on the blood. As less and less of the drug actually makes it to the brain, the level of dependency falls, and it is far easier to ultimately quit using, with minimal or even no withdrawal symptoms experienced. These vaccines are not designed for prophylactic use across the general population, but are specifically to be used for drug addicts trying to stop using. These drugs are reported to greatly help with the ability to get off a drug, but do nothing to prevent a relapse, and as such they must be combined with other treatments if the individual is to remain drug free over the long term. I think that these vaccines are really exciting, and if people motivated to stop using could get to rehab already virtually off the drug, they could then really expend all of their energy and focus to the learning needed, and a lot less to the discomfort and anxiety of withdrawal. These vaccines have one more step of testing to go before being submitted to the FDA for approval, and lets hope that all goes well, and before long meth and cocaine addicts can benefit from this new medical treatment for addiction.

A recent study on the harm reduction drug Nalmafene, that researchers claim allows alcoholics to reduce their drinking by as much as a third, has me thinking about the relative merits of harm reduction versus abstinence as theories of recovery. This new drug has showed an ability to reduce quantities consumed, but alcoholics using the drug still drank to excess once in every three days. Is harm reduction as a treatment framework acceptable, and should we be satisfied with any treatment philosophy that does not solve the destruction caused by drug or alcohol addiction, and only reduces it? A new Finnish drug called Nalmafene, has shown good results in helping chronic alcoholics to drink less. The drug, which is used as a part of a harm reduction framework for the treatment of alcoholism, doesn't call for complete abstinence as a goal, and only tries to reduce the amount and frequency of drinking; and under this philosophical framework, the new drug seems to be moderately successful. Nalmafene is a drug that is taken only as needed. When an alcoholic feels a strong desire to drink, the drug is consumed, and the cravings are reduced. Clinical data shows that study participants taking the drug reduced their days of heavy drinking from an average of more than 15 to just over 9 days a month. The study leader was previously employed by the pharmaceutical company now marketing the drug, and the study was funded by that company. Harm reduction proponents argue that any reduction in the quantity and frequency of consumption is a victory, and I can see their point; but when I succeeded in quitting treatment through abstinence, rehab and aftercare therapy, I can't help but wonder why if I could do it, every one else couldn’t as well. While a 30% reduction in heavy drinking as reported by the drug study is noteworthy; the data still indicates that each of the participants was still drinking heavily almost once in every three days, and the social and physical costs of this abuse as a result remain terribly high. Should we settle for a treatment that boasts that people using it are drunk only once in three days as opposed to once in two days…better to be sure, but is it good enough? The drug has yet to be approved for use in the US, and if it is it will surely fuel the debate and controversy between proponents of abstinence and harm reduction, and this constructive and healthy debate is beneficial to all. I fall firmly in the abstinence category though, and I would argue that any alcoholic should at the very least strive for complete abstinence, and only if this proves completely impossible, settle for anything less.

A recent Cardiff University study has linked marijuana usage to far greater odds of psychiatric conditions involving psychosis later in life; and yet for every one study such as this, it seems that there are two studies extolling the virtues of medical marijuana. So should we be burning fields of grass, or planting more? The issue surrounding marijuana to me is quite clear...people that need it deserve access to it, and people that don't...well they don't! Marijuana users are 40% more likely to develop psychosis later in life. Long perceived as a relatively harmless drug, marihuana continues to show its complicated colors with yet another study pointing to the dangers of illicit consumption. Yet for every one study that shows the dangers of illicit consumption, it seems there are two that show the benefits of marijuana for medical usage. Perhaps we need to demarcate the lines between treatment and fun a little better, and get this "medicine" into the hands of those that can benefit from it, and this "drug" away from those to which it may do harm. University of Cardiff researchers analyzed long term clinical data on marijuana usage and later incidences of psychosis, over a period of many years, and have linked the two with the data giving statistically strong causal results. Marijuana users have a 40% greater chance of developing psychosis later in life, and the more marijuana is used, the greater that risk becomes. Psychosis is defined a psychiatric condition in which delusions or hallucinations are present. Marijuana today is a very strong psychoactive substance, and it is not surprising that heavy usage of this substance would have some long term consequences. We need to educate kids as to the potential dangers of the drug they are smoking, and get people to realize that today's marijuana is serious stuff, and can cause long and lasting health implications. Too often I see the marijuana issue clouded by those that wish to smoke it illicitly, arguing for the benefits of medical marijuana…and to me this is apples and oranges; and just because something is medically appropriate, it doesn't mean that's it's a good idea to use it on a recreational basis. Policy makers, out of compassion and mercy, let cancer patients, AIDS wasting sufferers and glaucoma patients have the marijuana they need to make them feel better. To politicize the drug at the expense of these people is shameful. To everyone else, stop using the medical argument when all you really want to do is to use the drug to get high. That's my 2 cents worth anyways.

I was reading a risk assessment by the Mayo clinic on the probability of being addicted to painkillers, and while I agree with much of what they report, I feel that their ultimate assessment that these pills present a low risk for abuse is false and I feel that the many millions of Americans currently battling pain pill addictions should prove as a powerful testimony about the addictive properties of these drugs, and their potential for abuse. The Mayo clinic states that the probability for abuse is low, if the pills are taken exactly as directed…and that is a big if! Anyone who has battled pain pills knows how seductive these medications can be, and when taking the legitimate dosage takes away the pain, and also makes you feel so good, it's pretty easy to flirt with disaster by occasionally taking just a bit more than the recommended dosage. Too often, occasionally upping the drugs leads to continually upping the drug, and before you know it you are hopelessly addicted to these medications originally prescribed to heal. It's a complex issue, and these medications do serve a valid need for people with extreme pain, and often these medications are the difference between normal functioning, and chronic bedridden pain; and as such doctor's groups have repeatedly lobbied against attempts made by drug regulatory agencies to increase monitoring and regulations to access. Doctor's say that any increased regulations will make it too hard for legitimate pain patients to get the medications they need for their very real pain needs. So what’s to be done? It seems clear that these medications do serve an important role in the pain management for many, but they also prove debilitating and addictive to millions, surely there must be some middle ground. I feel that the responsibility for the alleviation of the problem should ultimately begin with doctors, and they must start to prescribe these addictive drugs with less frequency. Using risk assessments such as issued by the Mayo clinic as a basis for a decision to prescribe powerful pain pills does not seem to be working, and while it is true that when used exactly as directed the risk of addiction is low, we cannot and should not ignore the reality of the situation. Millions of people rely on these pain pills every day just for normal functioning and these people are hopelessly addicted, suffer many of the social and health problems associated with an addiction to any drug; and this must be regarded as powerful evidence requiring a change in our current pharmacological practices. I don't know what the answer is, but I do know that ignoring the reality, and ignoring human nature is naive. If you give100 children a box full of cookies, and tell them to eat just one every four hours…some may follow the instructions, but a lot sure won't; and it seems that even as we age into "responsible" adults, we don't change too much when temptation and pleasure is involved. People in every society in the world get high, it's in our nature, and doctors must consider the possibility for abuse versus the real requirement for medication when evaluating a person's true need for pain pills. I was addicted to pain medications; and while I was in pain, and the medications prescribed worked very well for that pain, the pain they ultimately caused was far worse than pain they healed. I could have survived with less potent and less addictive medications, and while it would have been slightly less comfortable at the time, it would have been far better in the long run. If someone has unbearable pain, then surely they need access to the best possible medications, but if the pain can be managed through any other means, perhaps addictive pain medications are not the best or safest choice.

Everyone knows that only the addict can make the choice to get sober, and to stay sober...but what does this mean? Clinical statistics show that your motivation to enter a rehab or treatment program is not nearly as important as your successful completion of this program, and your continuing involvement in aftercare programming. If you can convince anyone that needs help to get it, they should go...no matter what they say at the time! The statement, "I don't have a problem and I'll go just to prove it!" may change to "Thank you very much for caring enough about me to get me the help I needed." by the end of treatment. A common refrain of therapy and treatment is that ultimately only the addict can make the choice, and change their behaviors to get and stay sober…and this is true, but the key word in this last phrase is ULTIMATELY! If you have a sister, son, father…whoever, that you know has a dependency issue, that you are concerned about, and that you care enough about to encourage that person to get the treatment that they need, then no matter what the terms, if they agree to get help, they should go! It doesn’t matter if they maintain that they don't have a problem, or that they're just going to treatment to appease you, to show you that they really don't have a problem; if they agree to go, it's a great first step towards recovery. During the haze of abuse, too many of were not, or are not, thinking clearly; and dependency can cause subconscious changes in thought processing. A period of sobriety, reflection and therapy can be a very powerful thing and many people that enter rehab swearing that they don't need to be there, exit singing a different tune; and change their behaviors and lifestyle as a result. Many addicts enter rehab having spent a long period away from real sobriety, and have even forgotten what sobriety feels like. Sometimes just getting the metabolites out of the system, and getting enough time to get the head together is enough to change a way of thinking, and to get an addict to see the forest for the trees. If it doesn't work, no one is worse off then they were before, but if it does, it's a great thing. Getting someone the help they need can be very difficult and emotionally draining, but it shows how much you care for that person. If you can ever convince a person who needs help to get it, then you've done a very good thing…no matter what they may think at the time; and more often than not, they'll thank you for it later. I was convinced to enter rehab through an intervention, and I would suggest that anyone thinking about how to get a loved one the help that they need consider this method of encouragement. They are never easy, but they are remarkably effective.

While I was drinking, I figure I was spending 70+ hours a week drunk...and the rest of my waking hours were spent recovering from the previous nights indulgences. I went to work, did the minimum, went home and got drunk, and repeated this process for years. There was no room in my life for much other than alcohol, and although I never truly realized it, my alcoholism was stealing my life away, one hour at a time. Now that I'm in recovery, I have the time to live my life, and the sobriety to enjoy it. One of the things that really surprised me about sobriety was all the time I seemed to have on my hands all of a sudden. Even with making a genuine contribution to the household, and the raising of the kids (very different from the contribution I made while drinking) I still seem to have a lot of extra time to fill. I used to start drinking every night after work (earlier on the weekends…much earlier) and although I might have done a little something during the first 5 or 6 beers, after a couple of hours of drinking I was pretty glued to the TV and concentrating on working myself into a stupor. The next day was pretty much a write off as well, and although I could do my job (just barely) I certainly never gave it more than the minimum required, and weekends involved sleeping as long as I could…and then starting to drink as soon as possible. I spent more time drinking and recovering from drinking than I spent on anything else, by a lot, and once I stopped drinking I had hundreds of extra hours a month that needed to be filled with something other than beer! Most people wish they had more time, but for the newly recovering addict, all this extra time sure feels like a lot of work, and it takes effort to fill that time with anything other than drinking. It didn't take long to begin to appreciate the possibilities all this time afforded me, and I dove into family, work, projects and hobbies with a passion I had previously reserved for intoxication. I got to know the kids again, I helped out around the house, I got back into wood working (much safer without whiskey!) and I even completed a guest house out back over two summers. My work performance has improved dramatically, and instead of just barely hanging onto a job, I'm busy weighing out my options for career advancement! I love waking up on a weekend morning, knowing I have the whole day ahead of me, feeling good and feeling healthy and rolling leisurely out of bed to meet a full and productive day. I never saw it while I was drinking, but my abuse was stealing my life. It was stealing my health, it was stealing my family, and it was stealing my time. I wish I could have it all back, but I'm just grateful for the time I have left. If you're reading this, and thinking about getting help…do it! You'll never regret grabbing your life back, and all of a sudden you'll have the time to enjoy it!

One of the greatest risk factors for relapse when initially recovering is boredom. Without the internal fun of intoxication, it can be tough to know quite what to do with yourself. A recovering addict needs to plan for these leisure times, and have activities set up to stave of the boredom that can increase the cravings to use. It's pretty tough at first, but like everything else, it get's easier. The secret is to force yourself to do it, and even though the club may sound like more fun, bowling it shall be! When you're abusing, boredom is not much of an issue. Sure some days are more fun than others, and while high, you can sometimes have some great times, other times not; but basically the answer to fun comes in a bottle, or in a pipe or in a vial…and you don't have to put much though into how to entertain yourself. With drugs and alcohol, all of the entertainment is internal, and although when people start using, the environment and situation is important, the farther use progresses, the less important the environment, and the more important the drug. Most people don't start using cocaine in a crack house, but for a real junky with a bit of money, that's a pretty good place to be. So once you get sober, you're left with a bit of a problem, and Friday night's fun can't simply be bought in a bag any longer. Boredom sounds like a trivial problem, but the boredom experienced when newly sober is a big issue, and greatly increases the risk of relapse. When you're bored out of your mind, it's easy to convince yourself that you can go to the party, you just won’t use, and from there…well it's a slippery slope to say the least. The boredom as experienced is partially real, and occurs as a result of having forgotten how to have fun without intoxication, and is also partially a result of your brain's recovery from the damage of addiction. A lot of drugs can leave the brain a bit subdued, and while it's not getting the regular doses of fun chemicals it's accustomed to, it not yet making quite enough of its own. This will change in time, and the brain is remarkable able to recover from abuse, but during the initial period of sobriety, this can make things a bit tough. So what can be done? Sitting at home alone pacing is not a healthy response to boredom, and recovering addicts are trained that they need to make a plan for their leisure time, and fill it with rewarding, low risk activities. It can be difficult to stick to your plan once home and Friday night mini put starts feeling a little bit ridiculous, but it's necessary to get out of the house, into the company of good and sober friends and family, and keep yourself busy, and while you're at it, keep yourself sober. The surprising thing is that what happens pretty quickly is that you start to really enjoy these hokey activities, and realize that it's not what you do, but who you do it with and how you do it that's important. You'll start to look forward to Tuesday's at the movies with Mom and that weekend walk in the woods with your best friend, and with time, you'll realize that you are no longer doing these activities to keep yourself from using, but for the pure enjoyment of being sober and being in the company of people you love. With time, it gets easier. You find some things you really enjoy doing, and your brain starts to recover from the effects of addiction. Make a plan and stick to it. Keep busy, and try to enjoy the company of friends and family. It gets easier, and it's worth it.

I believe in God, but I'm not much of a church goer, and so when I needed to go to rehab, my family arranged for a secular facility. I can't complain about my rehab experience; it worked and does work for me still, but a Christian Rehab offers some compelling features, and If I ever need to go again, I'll consider a Christian rehab. I'm a Christian, but I doubt my minister could pick me out a lineup...which is understandable, as I'm more of an Easter and weddings and funerals kind of church goer. Because of this, when my family was arranging for my first stay in rehab they decided that I'd benefit from more of a secular facility, one that removed the word God from the equation; and I can't argue with success, it worked and I learned a lot of what keeps me sober every day during that month away. But still, when you look at the recovery statistics offered by Christian rehab facilities, they offer a powerful argument for their philosophy of treatment. Additionally, when most recovery programs are using some form of the 12 steps program as a part of their treatment philosophy, it's not much of a stretch to start calling "higher power" Jesus Christ, and start praying to someone specific. If you believe in a Christian god, you may want to consider a Christian rehab facility. Christian rehab works in many ways very similarly to a conventional rehab, and there will be elements, such as a medically supervised detox, cognitive training and drug education that will be almost identical, but where these Christian programs differ is through the use of the bible. A Christian rehab program will incorporate the bible into all aspects of the therapy; and prayer, scripture study and bible group classes will be as much a part of the healing as group sessions are in a conventional rehab. A Christian rehab program uses the bible to offer the faithful a concrete and lasting guide book to behavior and against temptation. Using the bible as strength and solace, Christian recovery hopefuls learn that the lessons they're learning are the lessons of the ages, and that even though they may have acted very badly, they can find redemption in the Christian church and in the eyes of God. Christian rehabs don't ignore what's good and what's proven effective in a conventional rehab, but they tend to the spiritual as much as to the physical, and they try to heal the soul as they heal the sins of the body. I've never used a Christian rehab, but if I ever need to go again, I'll think long and hard about going to a facility that offers the kind of lasting training and spiritual guidance that have proven so effective for so many. You need not be a Christian to participate, but you must be ready to accept Jesus Christ and to use His strength for your salvation. There are many hundreds of Christian rehab facilities and programs across the nation.

I made it through. I've never been to prison, and I survived...and those two victories put me well ahead of too many of my old friends. Why am I now enjoying the sunshine when they do not? It's not that I was in any way better or stronger than most of them, but I had a family that cared, and I got lucky; and I wonder how much better our nation would be if the billions now spent on incarceration were diverted to treatment and rehabilitation? I hate drugs. I mean, I love them too, but mostly I hate them; and I certainly hate the pain and suffering and heart break that they cause for so many. If you can name a drug…I've probably tried it, and although I was always mostly a boozer, and by the end that's all I was, I've had lots of friends lose their personal battles to drugs, and a few of them are in jail, and a few of them are gone; and but for the grace of god I could be with them. I was no better or worse than those that lost their battles, and they were all human in the same ways that all of us are. They had their strengths, their kindnesses, their petty weaknesses and character flaws…but not one of them was a truly bad person, and not one of them deserves what they got. I am currently a fairly well regarded and upstanding citizen; a family man, a member of my Rotary Club and someone who tries to do a little more good than bad each day. Not perfect, but basically good. Yet I've done bad things, and I am certainly guilty of the same crimes that leave some of my friends imprisoned, and the same crimes that leave some of my friends dead. I don’t know why I made it and they didn't, and although I credit my family for getting me the help I needed, I can’t help but feel that the difference between me and them was basically a flip of the coin of fate, and that our situations could easily be reversed. For this reason, the American Government's massive war on drugs gives me chills. I hate drugs, but I hate to see the people already suffering from drugs punished more than they need be. People seem to have no sympathy for the unfortunates addicted to drugs…until those unfortunates become their sons, or sisters or their wives; and then things change, and then they understand. And while I would never wish the pain of addiction on any family, I would wish the clarity of understanding on everyone in this country so our misguided war on drugs could be transformed into something positive and good. If only the billions spent on incarceration became billions spent on educations and treatment…how much better would our country be?

Today's marijuana is many times stronger than the marijuana of even a decade ago; and with increasing potency comes increasing addiction and increasing social problems. We now know conclusively that marijuana is addictive, and that the withdrawal symptoms of heavy marijuana usage can be very unpleasant. Marijuana use needs to be taken seriously, and marijuana addicts will often need professional treatment. Marijuana is no longer the relatively harmless drug it is perceived to be. Whether any drug is ever harmless is open to debate, but since a third of adults in America have tried marijuana, and the vast majority of these adults never grew addicted, nor ever had any problems with it, most people don't consider it to be a very frightening substance. But today's marijuana bears little resemblance to what many of us may have had. No longer an innocuous weed, today's marijuana is heavily laden with white crystals of THC, and in fact the potency of today's common marijuana is many times stronger than even the strongest pot of a decade or more ago. With increasing strengths, also comes increasing problems, and while it used to be argued that marijuana wasn't addictive, medical professionals can now conclusively state that it is. Regular marijuana use causes both a development of a tolerance to the effects of the drug, and as well causes physical withdrawal symptoms when usage is stopped. Withdrawal symptoms can include anxiety, insomnia, a loss of appetite and even aggression, basically the opposite and negative symptoms to the intoxicating effects of the drug. People developing an addiction to marijuana will progress in their behaviors comparably to other drug addictions. There will be an increasing fixation on marijuana, on getting, paying for and smoking the drug. There will be a dramatic development of tolerance to the effects of the drug, there may be changes in behavior and users will feel a need to smoke the drug at regular intervals. When they try to stop using, they will feel withdrawal effects, and this can make cessation problematic. Most people, who use the drug occasionally will not get addicted, but the risk of addiction for regular users is high; and an addiction to marijuana can have similar social consequences as an addiction to other drugs. There is a cognitive deficit, and memory loss is common, and work or school performance will often suffer as usage of the drug increases. Frequent and excessive marijuana use is not to be taken lightly, and the long term consequences of this usage can be quite severe. Users who have developed a physical and psychological addiction to the drug will often need professional treatment and long term support and care to be able to quit using for good. If a loved one is suffering from a marijuana addiction, it needs to be taken seriously, and that person needs access to professional help to allow them to quit using for good. What always starts out as recreational can too often turn tragic, and an addiction to any drug is never enjoyable. Today's pot is not what it was, and it needs to be taken seriously.

With the FDA announcement that 2.4 million American teens have tried dextromethorphan, and that the drug was now available in pure capsule form at the street level, parents have cause for concern. How can we protect our kids when the "dealer" is only as far as the local pharmacy? How can parents protect their kids from drugs, when the drugs are available for sale at the local pharmacy? Firstly, I'm going to preface this posting with an apology, I don’t know how to protect my kids from this new threat. I've talked about the dangers of drugs until I've grown hoarse, and they've grown bored, and they are some pretty well educated kids on the dangers and realities of drug abuse. But when the FDA reports that 2.4 million American teens have used dextromethorphan (the active ingredient in a number of cough and cold medication) I'm not to sure how much effect my words can have; I mean surely at least some of those parents had warned their kids about the dangers of drugs too!?! Dextromethorphan (DMX) when taken in large quantities can cause euphoria, slight hallucinations, slurred speech and uncoordination, and when taken in very large quantities can cause out of body experiences like with ketamine or PCP; and in a new and disturbing trend, street dealers have started selling pure DMX in capsule form. A quick browse on the web should be enough to scare parents, and all the information needed on how to use DMX, how to extract it, which brands to buy, the dosage by body weight…everything is there. If only kids worked as hard in biology as they do at self pharmacology! The FDA reports that at least 5 kids have died from overdose, it can cause brain damage, seizures and heart arrhythmia, and the really scary part is that nobody really knows what the long term consequences of this drug will be. Kids are taking it and they're taking a lot of it, and it's probably going to do them a lot of harm. Common parental guidelines suggest watching the medicine cabinet, and watching for intoxicated behavior, but how much does this really do? The amount needed to get high is more than most people stock in their medicine cabinet, and kids are pretty good about hiding things when they want to? I guess it just comes down to being involved in your kid's lives, to watching for the warning signs, being ready to help, and hoping for the best. Good luck to parents everywhere, and this is just one more thing to add to that long list of worries.

AA works for me, and it works for most of the addicts I know...but because it helps me doesn't mean that it will help you, and you need to find an aftercare program that supports you and allows for your continuing sobriety. AA is not a cult, and is only offered for the benefit of recovering alcoholics, you are free to come and go at your discretion, and you are not required to pay for any of the services offered. It does require a belief in a higher power, but many members find a way to make the AA philosophy fit within their existing beliefs, and many agnostics and even atheists can still find success within the interfaith organization…others cannot. I don't think that AA is for everyone, but because it has helped so many, it's worth it to try a few meetings out for yourself, and decide whether AA might just offer you the support you need to stay sober. Firstly, I have to say that AA has worked and is working for me, and I always recommend that people struggling to get or stay sober give the meetings a try. I find the support of other alcoholics and the 12 step program empowering and strengthening, and it really helps me to live one day at a time without drugs or alcohol. But, I recognize that it's not for everyone, and if it doesn't work for you there is no point in beating a dead horse, just try something else. In my opinion there is far too much internal debate amongst both addicts and professionals about the relative merits of AA…or whether AA is a cult, or the only answer or whatever! AA works for a lot of people, and has a long track record of success, and that should be enough. AA doesn't ask for your money or your life, and you are free to go or not go to a meeting at your discretion. I don’t feel that AA is cultish in any way, and am grateful that there have been meetings available for me as I've struggled through some dark days and nights trying to stay sober. Although AA maintains an interfaith philosophy, there is a requirement that members call for strength from a higher power, and this can be problematic for some without a belief in God; while others in AA, even those that are agnostic or even atheist, find a way to make the AA credo work for them, within their own particular framework of beliefs. AA isn't a missionary organization, and isn't trying to convert you to Christianity. Believe what you believe, and if you can make that fit within the framework of AA, all the better. What I say is give it a try. The meetings are very welcoming places, and new members are encouraged to open up at their own pace. You've got nothing to lose by attending a meeting or two, and possibly everything to gain. Like any organization, the meetings at one location, with certain attendees, will vary greatly from the meetings at another, so try a few out, and find the one that feels best to you. Go as often as you need to and take the advice of others that have succeeded and are in control of their alcoholism. If after giving AA a real attempt, you don’t find it to be right for you, don't get discouraged; simply try something else. We're all very different, and there is no such thing as a stereotypical addict; and as such what works well for one, or even for most, won't necessarily work well for everyone. If AA isn't working for you, seek advice on other available alternatives, and keep trying aftercare support programs until you find the one that feels right, and works for you. If AA isn’t a good fit, you may find regular counseling with an addictions specialist or addictions therapist helpful. Other organizations that offer after care support are S.O.S. (Secular organizations for Sobriety) that concentrate on recovery without a religious element, Christian recovery groups, that increase the use of Jesus Christ in recovery, Women for Sobriety, a woman's only organization, Rational recovery, and many others. Find what works for you and stick with it. Getting at least some aftercare support really increases the likelihood of long term sobriety, and as your period of sobriety increases, you may be able to taper down your need for support services. AA is there to help, and it works for a lot of people when nothing else does. Because AA has proven so successful for so long, even if you feel unsure about the organization, or have heard some negatives about the philosophy, I would urge you to give it a try and make up your own mind. At the end of the day, it doesn't matter what works, as long as it does; and you just need to keep on searching until you get the support and inspiration you need to stay sober and live a happy life without abuse.

Today's heroin addict can be anyone, and heroin is no longer found only in the inner city. Today's heroin is cheap and it is pure, and it's so good that no longer more injection is required. Today's heroin is pure enough to be snorted and this is appealing to a lot of people that would never dream of sticking a needle in their arm. But make no mistake, heroin is heroin, and whether it is injected, snorted or smoked, the end result is far too often addiction, suffering and sometimes early death. If you use heroin recreationally, you need to stop now. If are addicted, you need treatment now; and if you've never tried heroin, don't get fooled by "heroin chic" or any such glamorization of the drug, and never start in the first place. Heroin pulls you in, and once you're addicted it's very tough to break free. OK so all heroin is pretty scary stuff, but the heroin that's been hitting the streets…and the school yards lately, is more likely than not coming up from the south, and is cheaper and stronger than ever before. This cheap and potent heroin can be snorted effectively and this is making heroin seemingly less frightening to a lot of people that would never dream of injecting. There's also the heroin chic factor, and the coolness of heroin has been glamorized in film and music, and certainly adds to the temptation to at least give this drug a try, if only once. Unfortunately, only once often turns into once in a while, and from there to just about every minute is a pretty easy transition when you consider just how seductive, pleasurable and addictive the drug is. In general, the faster the effects are felt after administration, the more addictive the drug is considered, and as such the relatively slow effects onset of snorting when compared to injection should make it a safer way to use; but new research indicates that this doesn't seem to be the case, and snorting heroin appears to be every bit as addictive as injecting. The profile of the average heroin user has changed considerably in the last five years, and heroin, once the king of the urban inner city, has crept into the suburbs and the night clubs, and today's heroin addict can be just about anyone. Snorting heroin does cause nosebleeds, and can cause permanent nasal damage, but the risks of overdose and the contraction of Hepatitis C or HIV are lower than with injection drug use. Unfortunately, a significant percentage of heroin abusers, who start out snorting heroin, will eventually progress to the more efficient means of injection administration, and are then faced with all of the health risks associated with IV usage anyways. The risks of heroin are incredible, and in addition to Hepatitis C, HIV, abscessed veins, decreased immuno functioning and a host of other serious health disorders, heroin is far and away the drug most likely to cause an accidental overdose. The variable purity of the drug as it is sold at the street level makes dosing pretty tricky, and it only takes one mistake to kill you. Heroin is heroin, and it doesn’t matter if you snort it, smoke it or inject it, it's one of the most dangerous and destructive drugs known, and any heroin use needs to be taken very seriously. If you or someone you love is taking heroin recreationally, it needs to stop now, while it still can. It's so easy to become physically dependent on the drug, and once hooked, it's not easy to get off. If you or a loved one has become dependent, it's time to consider getting clean. The first step is detox, and heroin detox is no joke (I've done an opiate detox, and I can tell you how rough it can be!). There aren't many people with enough determination to detox on their own, and if heroin is available, most will get it and use, if only to take the pain of detox away. The only way most people can ever detox off of heroin is to get professional help, and get out of the environment of use and access to the supply of heroin. Professional detox can also ease the symptoms of detox, and is make the days of withdrawal as comfortable as is possible. But detox is only the beginning, and the pull of heroin is strong. Most addicts will need the period of sobriety, of learning, and of counseling as offered in a drug rehab facility; and even then long term abstinence is no guarantee. But recovery is possible, and it's the only acceptable goal. If you or someone you love has a heroin problem, get professional help and take as long as is needed to learn how to live without heroin abuse. The easiest way to avoid heroin addiction is to never start using, and as such people need to get educated about the dangers of snorting heroin. Heroin, whether it's snorted smoked or injected is very dangerous and very destructive, and trying it once is often the first step to a life of addiction. There is no such thing as heroin chic…there is only heroin pain and heroin suffering.

While Californian doctors could previously receive drug and alcohol treatment without their patient's knowledge, and while retaining their medical licenses, this program of professional rehabilitation has been suspended, and abusing doctors will now be required to forfeit their license to practice until they can demonstrate that they are no longer a threat to their patients. While this may seem a very logical policy, by increasing the barriers to rehab and the costs of treatment, the number of abusing doctors that do get help will decrease, and in fact more patients will be at risk from an intoxicated doctor. The state of California recently overturned a mid nineties decision that allowed doctors with substance abuse problems to receive treatment without their patient's knowledge and while retaining their medical licenses. Under the new policy, doctors with substance abuse problems will be required to forfeit their license to practice medicine until they can conclusively demonstrate that their substance abuse no longer presents a danger to patients in their care. Obviously, this is a contentious and difficult issue, and patient's advocacy groups have been celebrating the policy reversal as a major victory for the citizens of California, and their right to receive care under both a sober and qualified doctor. I disagree with their reasoning and in fact feel that by reducing the treatment options available to doctors with substance abuse problems, patients are now under greater threat than they were previously. Doctors are statistically a very likely group to suffer from addiction, and the stress of the job combined with very easy access to potent pharmaceuticals can prove far too tempting and too often lead to abuse. No one wants intoxicated doctors practicing medicine and endangering the lives of their patients, but this new legislation will decrease the ability of doctors to receive the help they need for their own benefit, and also decrease their motivation to admit to substance abuse. As a matter of public safety, addicts practicing medicine is generally a bad idea, and instead of increasing the barriers to recovery and rehabilitation, we should be lowering them. When admitting to a substance abuse problem means forfeiting a career based upon many years of study and expense, the price of recovery is raised exponentially. Doctor's are human like the rest of us, and when the personal cost of treatment becomes too high, they will react in the interest of self preservation, and continue their self destructive behaviors, as they also endanger the community. As a matter of personal compassion, doctors also deserve our help and care. Anyone suffering through the pains of addiction deserves good access to life saving treatment, and this treatment should be equally available to all. By increasing the personal costs of rehab, you decrease the perceived availability of the treatment, and decrease the percentage of doctors that will get the help they need. This new policy endangers doctors, and endangers the public. Addicts are very good at hiding their use when they need to, and although the use of some will be detected, the use of many will not, and the continuation of medical treatment by intoxicated doctors will increase. At a glance, it seems very logical that doctors should not be allowed to practice medicine while abusing drugs, but since the alternative harms both the doctor, and the patient; allowing "secret" treatment is both the most compassionate policy, as well as the policy that best protects public health.

Meth addicts need up to two full weeks of detox before they are able to fully participate in rehab, and get any benefit from the programs and counseling offered. Faced with the increasing devastation of crystal meth addiction, University of Iowa researchers examined what features were most successful in the treatment of meth addiction, and concluded that the standard drug rehab programming was appropriate and beneficial for meth addicts, but that longer term stays were necessary due to the destructive capacities of the drug. The university researchers recommended long rehabs and also recommended that government shift funding away from incarceration for meth offences and towards funding treatment for addicts of the drug. Faced with the rising epidemic of meth usage and addiction, particularly in the Mid West, researchers at the University of Iowa took a look at what exactly was needed for successful meth addiction treatment; and they concluded that standard drug rehab therapies are effective for meth addicts, but that longer programs are especially beneficial when dealing with the devastation of crystal meth addiction. A single usage of crystal meth can have physical implications for as long as 6 months, and as such it's not surprising that heavy meth use can devastate, and that the physical and mental repercussions of this abuse can take a long time to heal. Meth is uniquely damaging and uniquely addictive, and is truly one of the saddest stories of modern American drug addiction. The University of Iowa researchers concluded that almost two full weeks of medically supervised detoxification were required before a meth addict was clear headed enough to even begin to benefit from the therapy and education offered at a rehab facility. A two week rehab does little other than detoxing the meth addict off of the drug, and offers no education or skills for future drug taking avoidance. Using a variety of drug treatments and therapies together was deemed most effective, but meth addicts benefited uniquely from cognitive training and temptations avoidance counseling. Cognitive and behavioral strategies are emphasized to teach the addict how to minimize the temptation to use. Cognitive therapy requires of addicts to discover the triggers that lead them to abuse, to think about how best to avoid these triggers, and teaches what to do if faced with the temptation to use once out of rehab. The university researchers ended their report with a recommendation for government to move funding away from incarceration for meth possession offenses and towards better funded facilities geared towards meth treatment, and at least partially funding stays appropriate to the severity of the addiction. Meth justifiably strikes fear into the hearts of parents across the country, and the devastation of meth is such that if anyone you know and love is using meth, the time to get them help is now. The damage of meth abuse can become irreversible, and even a few months of heavy use can devastate for years to come. Meth is so addictive, and the damage to the body, the mind and the spirit is so encompassing, that treatment should never be delayed a day longer than necessary. Rehab for meth addicts needs to be comprehensive, and needs to be long enough for a couple of weeks of detoxification, followed by a period of counseling, sobriety and drug education. Detox alone should not be considered an acceptable goal for meth rehab, and the recidivism rates on detox only treatments are unacceptably high. Meth treatment is tough, but it is possible, and people recover from the devastation of meth abuse everyday. Happy and sober living begins with a serious rehab stay; and the sooner done the better.

The news that Lindsay Lohan was once again heading to rehab got me thinking about celebs, and the current trendiness of the star rehab experience. It seems that rehab has become a career move, and that any sins can be wiped clean by a public apology and a couple of weeks of country club rehab. Any of us that have gone through the process know that rehab isn't just a place, and simply by attending a rehab you are not cured. Rehab requires dedication, hard work, and a heartfelt battle with the demons inside. Sometimes the trivialization of rehab by Hollywood celebrities makes me angry, sometimes I'm just glad that I'm not them, and never had the worst of my abuses photographed; but mostly it just reinforces my belief that rehab is only as useful as the energy and dedication you put into the process. I was just reading the news about Lindsay Lohan and her latest brush with the law, and yet another announcement made by her publicists that she was once again checking into rehab. Rehab seems to have become a career move in Hollywood, and any misdeed can be wiped clean with an expression of regret, punctuated with a brief stay in rehab seemingly to convey sincerity. The stories of celebs using and abusing rehab always provokes some complex emotions when I consider my own painful battle with addiction, the journey through rehab (twice) and my struggle to stay sober each day. Firstly, I guess it's easy to feel angry that stars seem to be trivializing a process that for anyone that has really done it right is a long, tough, and very emotionally difficult period. Rehab isn't supposed to be country club or a spa, and the tears of my rehab experience certainly weren't caused by an over exuberant shiatsu masseuse! When stars talk about their experiences at rehab, I wonder how much they really got out of it, and more importantly how much they really put into it. I can't help but feel that their trivial attitudes belittle the hard earned gains of anyone who has battled and conquered an addiction. I also consider how difficult it must be to suffer with addiction while having your every move documented by a trailing team of paparazzi. Anyone who has battled with addiction has a long list of shameful behaviors, and most of us are pretty glad that most of our shame is for private and family consumption only. I can only imagine what it must feel like to have the worst days of your life, and the worst of your abuses and behaviors splashed across the tabloids for all to see. I feel sympathy for anyone who suffers addiction and also has an occupation that makes their private battle public fodder, and I'm grateful I don’t live their lives. I guess what I really feel is that the stories of stars battling their addictions, repeatedly entering spa style rehabs, and repeatedly suffering the embarrassment of very public intoxicated humiliations; teaches us all that rehab is only as valuable as you make it. It doesn't mater how much money you have, how admired you are or how much power you've got, if you don't make a personal commitment to change, and put in the work required to learn how, then you'll never succeed no matter who you are. Rehab isn't just a place, it's a state of mind, and unless you're ready to confront your personal demons, to really look inside yourself and make a determined effort to change every part of your life that might led you back to abuse, you can't succeed. It doesn't matter if you drive into rehab in a Ford Pinto or a Mercedes, you'll be driving out an addict unless you suffer through the changes needed. I feel sorry that anyone has to feel the pain and suffering of addiction, and ultimately I don't feel angry that these "silver spoon" stars, who can afford the best of everything, seem to be making light of rehab. I know what they still need to learn, and that is that rehab only works if you do.

Rich or poor, young or old, pharmaceuticals are very addictive. Addiction doesn't mean that you're weak, and it doesn't make you a bad person, but it does mean that you need to get help, and break free from abuse. The drugs we are prescribed for valid medical reasons can too often prove seductive and it's so easy to take more than is truly needed. Addiction to pills can happen fast, and family and friends never know when our use has become abuse. Addicts don't have to look like junkies, and a drug addict may just as easily be a kindly grandmother or a soccer mom. Drugs don’t discriminate and the devastation of abuse can affect anyone. If you're abusing pills, you need help, and you need it now.

My last stint in rehab was for a pharmaceutical addiction, and my peers in recovery sure did look like a cross section of America! Drugs don't care about your gender your sexual orientation or your race; drugs devastate equally. I can't tell you how many people end up addicted to a medication originally prescribed to heal, and let that addiction grow for far too long, thinking that they could never become a drug addict! If you take drugs, whether prescribed or not, for any purpose other than explicitly recommended, you are abusing them, and once you start abusing a drug, it's a hop skip and a jump to dependence. The problem with drugs of course is that they feel so good. At least at first, and when they're prescribed we tend to minimize the dangers and justify our usage, and all the while we slide ever closer to dependency. Thinking that drug addiction only happens to other people, people with weaker morals or that come from bad families, is partly why so many people end up with problems of their own. Like I said, a drug doesn't discriminate, and if you abuse it, it will grab a hold of you. Dependency doesn't make you a bad person, you may do things you’re ashamed of while dependent, but becoming an addict can happen to the best of us. Prescription pills are really dangerous, and I never met a single person in recovery that didn't wish they had never started. Some people are using to get high from the start, but most are just regular people, with a medical problem, that just happen to be prescribed a seductive, pleasurable and addictive drug in the treatment of their symptoms. You don't feel like a junky when you buy your drugs at the pharmacy, and family and friends can rarely tell when your use has crossed into abuse. A pharmaceutical addiction can remain hidden for a long time, ever deepening its hold, and ever increasing the difficulty of rehabilitation. If you are abusing pharmaceutical drugs, now is the time to stop, not tomorrow…now! Every day you wait makes what must ultimately occur more difficult. If you are abusing a medication, and you are physically dependent on that medication, you are a drug addict. It doesn't make you a bad person, but it does mean that you're going to need to admit to your weakness and get the help you'll need. The detox from pharmaceuticals can be very tough, and for some drugs, can even be dangerous. It's best to get professional help when you decide to finally break free. A sequestered detox and rehab worked for me, but you'll have to decide what's right for you. Have the courage to admit your problem, and get the help you need. Admitting you need help doesn't make you weak, it proves that you are strong and determined and won't let a bottle of pills diminish your life anymore. Whether it's originally prescribed for pain, to help you sleep or for anxiety, once you cross the line you have to accept the reality of the situation, and if you are dependent on any drug, you should consider getting the help you need to take back your life, and live with clarity and sobriety once again.

Using methadone to break free from heroin abuse is relatively painless, and will allow you to function normally in society. But methadone is in itself a very addictive substance, and a lot addicts who try to get off methadone remain users many years into treatment. Methadone therapy is a synonym for methadone addiction, and is not a real cure from drug dependency. The best way to get off heroin is to do it the hard way, and the honest way. Suffer the pains of detox, do the counseling, and then begin your life in recovery. It's never easy, but it can work, and it can really free you from your heroin addiction. Any addiction to opiates is tough (I know firsthand!) and the dreaded agony of the pains of withdrawal make the thought of getting clean a pretty scary proposition. So when avoiding detox is coupled with some pretty impressive long term success rates when on methadone, it can be tempting to go the opiate substitution route, and try to get clean through a very long process of tapering down. Methadone maintenance therapy has addicts trade their heroin use for safe doses of methadone. Doses that will keep the pains of withdrawal well away, but will not serve to intoxicate and will allow the user to function normally in society. The downside to this of course is that some people that entered methadone maintenance 10 or even 20 years ago remain methadone addicts, and although they are not using heroin (and as such are a part of the success rates as advertised by the statistics) they remain addicts, and much of their time and energy remains devoted to maintaining enough opiates in their blood to keep the pain of withdrawal away. Better than heroin abuse, but I wouldn't call that a cure. When using methadone, you need to visit a registered methadone clinic every day, or every other day, and take your oral dosage of methadone under supervision. You need to spend hours almost daily in the process of getting your drug, and remain in the company of other opiate addicts during all that time spent waiting around in methadone clinic waiting rooms. Additionally, many doctors are now arguing that the addiction to methadone is in fact more potent than the addiction to heroin, and as such the withdrawal, and the pains of withdrawal, are longer and more severe with methadone than with the original problem drug. So why is switching to a more addictive drug considered a medically sound policy of drug cessation? I think that it comes down to a matter of public policy. In the view of the greater good, it is better to have heroin addicts functioning well in society, and receiving regular and free doses of a drug that keeps withdrawal away; but for the individual addict, this may not be a positive outcome. Much better is to endure the painful days of withdrawal, get the therapy and counseling you need, and try to rebuild your life without the need for any drug. It's not the shortcut to "sobriety" that methadone is, but it's a real cure, and it offers a life free from drugs and free from addiction. Detox is hard, and it is painful, and it's understandable that addicts would try to avoid it; but if the alternative to a few days of discomfort is a lifetime of addiction to methadone, then isn't the price of withdrawal avoidance too high? On methadone, you're not taking a trip out of town, you're never going to Disneyland with the family and you're always in the company of the people that remind you of what you once were. Get clean the hard and honest way, and learn what you need to live free from drug abuse, and stay sober over the long term. Not many addicts can resist the cravings and temptation to use during the first days of rehab, and the best way to detox is under medical supervision. A supervised detox makes the process as safe and comfortable as possible, and at the very least, keeps you well away from access to drugs until the metabolites have been cleansed from your body. Detox alone is very rarely an effective cure, and most addicts will need the help of professionals, counseling, and education to have a real chance of staying clean for good. Heroin addiction is tough, but a life in drug recovery is a life full of hope and promise, and is surely better than a life of continuing addiction with methadone.

Staying sober takes dedication and a constant vigilance to avoid the people and situations that trigger an urge to abuse. The triggers are not always obvious, and things like camping, watching football and making ribs are now off limits to me as I battle one day at a time to stay sober. Only I can know when I feel the urge to drink, and therefore only I must be responsible for staying away from temptation. It's not easy to change your life, but when you get sober, you relearn what's really important, and avoiding the rest doesn't seem so bad. One of the best ways to ensure long term sobriety is simply to minimize the temptations, and make the daily battle as painless as possible. It sounds easy; I mean how tough is it to not walk into a bar right? But the reality is different, and the triggers to abuse can be very subtle and pervasive things. It sounds funny, but I can't watch football anymore. I spent every Sunday for years at home with a case of cold beers, enjoying the games of the day. The memories of what I used to do, combined with more beer commercials than I can count, make a seemingly innocuous pastime a pretty dangerous thing for me. I can't even read the box scores without thinking about a drink! I also used to make some pretty mean BBQ, but although no one makes ribs like I do, I always drank while tending the cue, and even the smell of wood smoke gets me thinking about cracking open a cold one. Like everything else, these triggers to use are strong at first, and gradually fade in intensity, but I still pay heed to the teachings of my therapist, and I still avoid any situation or environment that has even the slightest possibility of temptation. Rehab taught me to really examine my life, and to think about the situations that put me at risk to take that first drink. Not only the obvious triggers to abuse, like not hanging out with old drinking buddies and not visiting the places you used to abuse, but also the more subtle, and therefore more dangerous triggers. I know the responsibility to steer clear of temptation lies only with me, and only I can know when I start to feel that urge. No one would think less of me for wanting to go camping, but I know that in my mind, the great outdoors will be forever linked with Jack Daniels, and only I can know that camping is a very dangerous place for me. To stay sober, you need to be vigilant and responsible for your own actions. Rehab taught me that I need to be accountable to myself and that only I could keep out of dangerous places. One of the best ways to stay sober is simply to avoid temptation, and for me that's meant a lot of changes. I'd rather be at home watching the game, but on a Sunday afternoon, you'll probably find me out with my wife, at an antique show, at the mall, or in the park…anywhere but home! I may not love these pastimes, but I love my wife, and if I can make her happy while keeping myself free from temptation, it’s a pretty good thing. The sound of my kids laughing, and waking up clear headed to bagels, sunshine and a paper on a Saturday morning; for this…I'll pay any price.

With all the choice available, it's easy to get overwhelmed when trying to select a quality rehab facility. You desperately want to make the right choice, and because achieving sobriety is so important, the pressure to choose correctly can become very stressful. The perfect facility for one might be a disaster for another, and as such you need to choose the facility that's the best match for the addict and their personality. As follows are 8 criteria I've used when evaluating rehab facilities and these criteria may offer you a starting point when thinking about how to pick a rehabilitation facility. Remember that any rehab is better than no rehab, and by taking a bit of time, and selecting with care and the needs of the addict in mind, you'll almost certainly make a great choice. While choosing the best available program of course sounds good in theory, in practice, when faced with the hundreds of available options, facilities, and programming structures; it's easy to get overwhelmed by the complexity of a decision that you feel pressured to get right. The stakes are too high, and no one wants to make a mistake at this critical stage in the process. I've been through the process twice, and I know that the sheer variety of options make the choice problematic, but by thinking about the criteria that you value most, you can generally eliminate the majority of the facilities from contention and then just pick the one that feels best to you after that. I know it doesn't sound very scientific, but it comes down to your comfort level with the facility and with the staff, and ultimately, you just have to choose one and hope for the best. Remember that getting into a rehab is always better sooner than later! The programs and facilities that I value may not match your needs and wants, and everyone has unique requirements, but the list of evaluation criteria as follows may help to get you thinking about the kinds of programs you might want to see in a facility. 1 Are medical professionals available around the clock? Going through detox is a tough experience, and you don't want to be at a facility that doesn’t offer the professional and certified doctors and nurses you need to help minimize the pain and increase the safety of this transition into sobriety. Additionally, even after detox, most addicts remain in a state of somewhat compromised health from their period of abuse, and having medical professionals always on staff ensures that the period of rehab improves the physical health of the body as it also leads you on the path to sobriety. Obviously a facility that employs doctors and nurses around the clock will reflect this level of care in their fee structure, but I feel that during the initial month of rehab, constant medical attention can be very beneficial. 2 Is individual counseling a priority? Substance abuse doesn't occur in a vacuum, and for most of us the most necessary accomplishment of a month's rehab is to work through the emotional or social difficulties that led us to abuse, and keep us abusing. Self awareness occurs during meditation and self reflection, and also during peer therapy, but it's really during the individual sessions with a therapist that resolutions to these problems arise, and the strategies necessary for healing are developed. A regular period of individual counseling must be considered a priority in any rehabilitation facility. 3 Does the rehab facility offer cognitive and behavioral teaching? Unfortunately no one strategy of rehabilitation will work for everyone, and as such the best facilities will offer a variety of strategies and teaching tools designed to give the recovering addict a number of recovery options on the path to sobriety. One of the most widely successful methods for long term sobriety is cognitive modification. Cognitive modification therapy aims to teach the addict to change the way they think in certain situations, to recognize the triggers that lead them to abuse, and to take responsibility for getting themselves in any situation that makes further abuse likely. This cognitive therapy gives a recovering addict the concrete skills they'll need to resist the temptations that will inevitably arise after rehab has ended. 4 Is family counseling incorporated, and is the facility close enough to make family involvement feasible? Continuing sobriety is more probable when the recovering addict receives the educated and empowered support of the family; and as such the family should participate in the rehabilitation process. Look for a facility that offers at least a few days of family involvement, and that will ideally teach the family about addiction, help the family heal some of the pain that the addict has caused, and teach the family how they can best help the recovering addict stay strong and stay sober. Only the addict can choose to remain sober, but a family that supports, and never enables, makes sobriety a lot easier to sustain. Because the family will be involved in the process, the location of the facility becomes important. The facility should be within an easy day's commute from the home, and should never be so far as to present a barrier to family participation in the process. 5 Is