12 Steps

Joy Training for the Addictive Brain!

Joy Training for the Addictive Brain!

Joy training for the addictive brain? Yes, it’s possible I’m happy to say. I was at my brother Lee’s 12 Step N.A. meeting when he got his 1 year chip. Yeah Lee!!  There were 100 people in the room celebrating each other for their hard work to stay sober from 1 year to 28 years.  It was amazing to see and feel the hope, love and JOY in the room.

We Must Do Better with Alcoholism Treatment - Remember Smoking?

We must and can do better to prevent and treat alcohoism and addiction. We have had success with another addiction - smoking. The U.S. reduced smoking rates from nearly 60% in the 1950s to about 20% today. We did it with a collective will to stop that killer and with a focus on prevention and treatment through Public Service Announcements, early education in the school system, and government supported smoking cessation programs.

Alcoholism is the 3rd leading cause of death in the United States and it's an expensive illness both emotionally to those struggling with it and their families. Financially, alcoholism is incredibly costly. "Each year medical problems caused by addiction, along with lost earnings, accidents and crime, cost Americans more than $500 billion."* 

Very troubling to me as an addiction counselor is that the failure rate for long term sobriety is a grim 70%. This is a shocking statistic because treatment success rates have remained virtually unchanged for the 30 years I've been in the counseling profession. The majority of addiction professionals and the medical community treat the problem primarily with behavorial and psychosocial approaches meaning group therapy, 12 Step meetings and education. This is important, but the newly sober brain often can't process or remember well until the brain has had time to heal - 4-12 months for most.

Part of what gets in the way of better treatment is that society still views addiction as a moral rather than a medical issue. But there's plenty of scientific evidence that concludes "...addiction is a chronic, progressive disease of the brain with many simiarities to other chronic diseases such as diabetes, hypertension and asthma..."*

Cutting edge treatment for alcoholism includes medications such as Vivitrol and Campral. Vivitrol is a once a month, extended-release injected medication (naltrexone), approved by the FDA in 2006. Vivitrol reduces the high that someone gets from drinking, and it decreases cravings. Because it's prescribed once a month, it eliminates the daily decision making that goes with Antabuse.  

Another effective medication is Campral approved by FDA in 2004. Campral also reduces cravings and "...restores the balance in certain neurotransmitter pathways altered by chronic use." Campral can accelerate brain healing which normally takes 4-12 months after someone stops drinking. Vivitrol and Campral can be prescribed together to enhance the effects according to Dr. Urschel* and he recommends usage for 18 months on average. 

Society needs to get over judging alcoholics and drug addicts as moral failures, treat addiction as the medical problem it is and spend the right kind of money on prevention, early education and treatment. We can change the course of this disease as we've done with smoking.  


 

*Healing the Addicted Brain by Harold C Urschel, III, MD, MMA, Advances in Addiction and Recovery Magazine Spring 2013

Tips to Handle Holiday Stress, Anxiety & Depression for Addicts & Alcoholics

Holiday stress, anxiety and depression are relapse triggers for the newly sober and just plain stressful for recovering folks depending on the health and sanity of your family.

While the Holidays can be a fun, family time, for many, they are also a sad, depressing, no family time.  See picture - is this your family?  Perhaps - but remember we can all pose for a picture...

Family celebrations can also be stressful if you're newly sober and there's alcohol around. Or, stressful and anxiety provoking because of family "stuff" - you know - Susie always comes late to dinner and Mom makes excuses for her. Sam's kids get the best presents - obviously mom and dad like them better. Our head tapes can get very active during the Holidays.

Here are some suggestions to keep you sane and healthy during the Holidays: 

1) Think about what kind of Christmas Holiday you'd like to have. Then make decisions about whether you'll be staying home in your cozy little place or venturing out to parents or other family. Really, you have a right to choose where you want to be for the holiday, and yes, sometimes that creates a wave of upset with family. However, in my experience, they are able to move past it with time.

2) If you're going into a Holiday celebration that's stressful or anxiety producing, consider setting a time limit and letting folks know ahead of time.  "I'm looking forward to being with you all and we'll need to leave by 7 p.m. - or whatever).  This allows you to feel you have some control and and will cut down on anxiety.

3) For Family Gatherings:  

If you're at a family gathering or office party and you're feeling uncomfortable or anxious ask yourself what's up - what's pushing your buttons - take a breath (you don't have to solve it, just become aware) and then decide if you want to stay or not.  If not, find the host, thank them for the party and gently excuse yourself. You don't have to give a reason. "Thank you so much for the party. I'm going to need to get going." (If you need to make up an excuse to politely leave - just say I have to get home to take care of my pet, grandmother, ...)

4) Attend more 12 Step Meetings during the Holidays if you have been going. 12 Step is still the MOST effective treatment approach for addiction because the commaraderie replaces the isolation, the meetings give you a safe place to go instead of drinking or using, and as you build friendships and connections you build trust - in the group and in yourself to stay sober.  

5) If you haven't tried 12 Step meetings. Do.  See #4 above.

6) For anxiety - breathe - really - take 10 breaths - here's a FREE MP3 that shows you how. Also see Lucinda Bassett's work http://tinyurl.com/nmsudo8  Midwest Center for Anxiety & Depression

7) For depression the path out is with medication for some - talk to your doctor - and by looking at the quality of your thoughts. Part of the illness around addiction are the negative thoughts that generate depression. Resources:  Intentional JOY: How to Turn Stress, Fear & Addiction into Freedom and Happy for No Reason Marci Shimoff.

Pills for Problems: What To Do Instead

Pills for problems - can't take just one. Pills, pills, pills. By pills I mean Vicodin, Lortab, OxyContin. So many pills for so many problems. Got pain? Feeling sad or blue? Not happy enough? Or, do you just want to get high? Take a few pills.

As an addiction counselor I've seen the number of folks with pain pill problems increase over the years.

"Prescription drugs account for about three-quarters of all drug overdose deaths in the United States, with the number of deaths from narcotic painkillers, or opioids quadrupling since 1999, according to federal data." (Modesto Bee 10-25-13)

We know painkillers can be appropriately prescribed and used, but we also know there's a lot of street selling or these same drugs. I would say most of the clients I've worked with that are taking painkillers aren't getting them through their doctors. They get some pills at a party, then they raid their parents pain prescription bottle, then they start buying them off friends or the street or ordering online if they have the money. 

Here are a few assessment questions and suggestions for slowing down or stopping.

1) Be honest with yourself first about how much you're taking a day and for how long. 

2) Talk to a friend, family member about what's going on - how much you're using and for how long. If you're not willing to do this, you're probably not ready to get help.

3) If you don't have a SAFE family member or friend to talk to, find an addiction counselor, or go to 12 Step meetings like Narcotics Anonymous. You can find them listed online. 

4) Before you go stop using here are some SAFETY guidelines:  Talk to your doctor about your usage and that you want to stop or wean yourself.  Going cold turkey is dangerous - I don't recommend it.  iI you've been using for a number of months and want to wean yourself do so with your doctors help, or talk to your counselor.

5) 12 Step Meeting Suggestions:  Go to 6 meetings before you decide if you like them or not. You don't have to speak if you don't want to. Just say I pass. Pay attention to the positive things said in the meeting. Focus on getting 1 thing out of the meeting that is helpful for you. If you keep attending and following the program you will make new friends and you will start to feel different.

6) If 12 Step meeting aren't working for you then check out Out-patient treatment, In-patient depending on the length of time and dosage you've been taking or Long Term Sober Living Environements. These are community based, inexpensive treatment options to help people develop a schedule, have daily support and education about their illness.

7) Opioids affect the feel good chemicals in the brain so once you've stopped using it takes time for the brain to heal - 4-12 months. I know. During this time exercise helps you feel better. Eating well is helpful. Not eating to many sweets will help. You can also try Amino Acid therapy as recommended by another addiction expert Julia Ross in her book Mood Cure.  Amino acid therapy helps you feel better.

8)  Stress and anxiety increase in early recovery so check out my FREE 7 1/2 Tips to Reduce Stress & Anxiety - they're easy and short audio tips that come every couple days and help you practice stress reduction.

Email me with questions - lynntelfordsahl@gmail.com

PTSD & Relapse Prevention – Emotional Freedom Technique Will Help!

Relapsing is really hard and not any fun. Going to 12 step meetings, having a sponsor, all those things help but sometimes you need more.  Emotional Freedom Technique is a weird little technique millions have used to help themselves feel better fast. You really can tap yourself to what feels like freedom because you have a way to reduce cravings, stress or anxiety - all releapse triggers.

Traumatic Stress and addiction go hand in hand. Pain seeks relief and relief can come in many forms; alcohol, pot, vicidin, sex. You name it, people have used it to distract themselves from pain. Post traumatic Stress Disorder was first named after Vietnam veterans came home traumatized from war.

Here’s how Emotional Freedom Technique might help you:  If you struggle with staying sober, if you keep relapsing after a regular amounts of time – 90 days, or a year or if you have particular triggers, say, fights with a spouse that give you a good excuse to get drunk,  overreacting to anger or pain, or stress or anxiety that fuel cravings then seriously consider learning  Emotional Freedom Technique.

Emotional Freedom Technique is easy to learn and super effective to release anxiety, stress or upset and it's faster than traditional therapy. As an addiction counselor I’ve used EFT for 15 years with my clients on everything from childhood trauma to car accidents, to snake phobias, to driving phobias to simple anxiety or migraine headaches. One client reduced migraines from over 20 a month to less than 5. EFT was developed by Gary Craig, an engineer. He simplified an older process called Thought Field Therapy.

As an addiction counselor I LOVE that once learned I can send clients out the door with the instructions on how to use EFT in hand and they can go home and practice on real life situations that push their buttons. What that means is say you’re about to pick up the kids from your ex and you’re feeling anxious – you can spend a few minutes tapping to relieve anxiety. Or, let’s come back to relapse – you’re having a craving so you spend 5 minutes tapping and bring the craving down from a 9 or 10 to a 3 or 4.  Having an easy to use tool makes relapse is less likely - of course, you have to use it.

For more on Emotional Freedom Technique check out Intentional JOY: How to Turn Stress, Fear & Anxiety (there's a FREE Mp3 download bottom of page) and/or go to www.emofree.com or call me for a FREE 15 minute Consult to see if EFT is right for what's bothering you.

Cory Monteith - Just Another Sad Addiction Statistic?

My cousin Kim was up in July for my sister Lane's memorial. My smart, sweet, difficult sister who died at 56 from alcoholism. Kim and I were lamenting about Lane's death and Cory Monteith's. Sad, very sad. Cory's death touched a national chord and Lane's our personal one because we have a family riddled with addiction. I’ve also worked as an addiction counselor with clients struggling with alcohol and drug recovery for 25 years.

Tragedy strikes every day with thousands of other alcohol or drug related deaths a year. The National Council on Alcohol & Drug Addiction states 2.5 million a year die from alcohol. Three hundred and twenty thousand young people age 15-29 die each year worldwide.

Addiction is not just a deadly disease but an expensive one. It costs Americans more than $500 billion a year in lost earnings, accidents and crime. The state and federal governments spending $15 billion a year.* That's not including all the emotional devastation to families and friends.

The long-term sobriety failure rate is estimated at 70% according to Dr. Harold Urschel, author of Healing the Addicted Brain. I am very sad to say that statistic hasn’t budged much since 1985 when I was training as an addiction intern.

What has this addiction counselor learned in the last 25 years? That the old model of in-patient and out-patient treatment, for those that can afford it or who have insurance that will cover it, is a very small part of the solution. What happens after a 30 day stay is essential to long term recovery.

The standard treatment recommendations are basically: In-patient or out-patient program for 30 days, after release attend 90 AA or NA meetings in 90 days, get an AA/NA sponsor, don’t drink or use, keep stress to a minimum, get therapy if you can, work the 12 steps with a sponsor and consider that relapse is part of recovery. My sister went through 3 treatment programs and was sober 5 years at one point.

The new standard of care needs to include longer stays at inpatient facilities or sober recovery homes depending on the length of the addiction, the substances used and family support. I recently had a long term heroin addict come to see me. I recommended a long-term (90 days – 6 months) sober living program because he’d already been through a 30-day treatment program. I also recommended he be on one of the anti-addiction medications such as Suboxone or Subutex to help prevent cravings and begin to repair the brain. If this young man follows these and the basic recommendations of his program he has a much better chance of staying sober.  

We collectively need to do a better job treating alcohol and drug addiction. We took smoking addiction from 50% of the male population in the 50s to only 20% today. We did that with early childhood prevention and education, Public Service Announcements, warning labels, and smoking cessation programs funded by the Federal Government and physicans talking to their patients. We can do better with addiction treatment and we must!

(*Source: article: Healing the Addicted Brain from Advances in Addiction & Recovery – Official Publication of NAADAC- Summer 2013 Vol 1, No 2, Intentional JOY: How to Turn Stress, Fear & Addiction into Freedom

Americans Addicted to Legal & Illegal Drugs - Oxycontin Anyone?

Americans are addicted to legal and illegal drugs and by drugs I mean pharmaceutical drugs. Pharmaceutical companies are the most profitable industry in the world. Marcia Angell, M.D. first woman editor-in-chief of the New England Journal of Medicine reports that in 2002 the $35.9 billion the top drug companies earned were greater than the profits of the other 490 Fortune 500 companies combined.

In my city of Modesto, California, (and two other small cities) there are 31 Walgreens, CVS and Rite-Aid pharmacies.  This doesn’t count all the pharmacies within grocery stores, Target or Walmart. Many of these have been build in the last few years.

In 1997 the FDA reversed it’s policy on direct-to-consumer advertising. At that time, 220 million a year was spent by pharmaceutical companies on advertising. In 2002, the amount was 2.8 billion. Big pharma spends twice as much on advertising as research and development and it’s working.

Perhaps we’re buying so many more prescription drugs because we’re being brainwashed to believe we need what they’re selling. “Tv advertising, works by mobilizing the appeal of group morale. "By showing you pictures of beautiful, happy people, they persuade you that everyone else in the world is having a terrific time, only you are left out. Want to stop being a lonely loser? Join them -- just tune into this, or buy that,” says Bill Manville, ex advertising copywriter for Grey Advertising and now NY Daily News columnist.

Pharmaceutical ads subtly increase fear and worry about medical conditions. For example, statins were first prescribed only to those with heart problems. Now, they’re routinely prescribed for anyone with high cholesterol.

As an addiction specialist of 25 years I understand and support the benefits of medications for the right reasons. I’ve seen suicidal clients survive because of the anti-depressant they were taking. I’ve also seen clients so over-medicated they were zombies. Somewhere there’s a healthy meeting place between personal responsibility, the medicine now available and all the seductive advertising. The good news is that many of us are looking for ways to combine traditional with non-traditional medicine. The National Center for Complimentary & Alternative Medicine states that consumers spend 33.9 billion out of pocket on complimentary and alternative therapies.

As consumers we need to ask questions when we see new research come out. To change the control big corporations have on advertising, and us, it will take thinking outside the box. As Einstein said, “You cannot solve a problem from the same consciousness that created it. You must learn to see the world anew.”  

If you're struggling with an addiction or dependence to oxycontin, vicidin or other drugs of this type, there is help available.  Check out AA or NA groups. Try 6 before you decide you don't "like" them - do you "like" being addicted?  And, look for 1 thing each meeting that you can take and use for yourself. The tendency for the mind is to throw the baby out with the bathwater, but a focus on 1 positive thing you can take for yourself is good.  Also, see a physician, or a treatment program in your area, and get help for the withdrawal process. It's not recommended to stop taking the medications cold turkey. Others have quit and created a good life for themselves. You can too!