Author Archives: Summit Estate

Defining Recovery: Reconciling Mental Illness and Positive Mental Health

mental health
A curious and dynamic dance revolves around the definition of recovery from mental health disorders in the 21st century. On the one hand, consumers of mental health services tend to define recovery as the presence of positive behaviors and mental states – known as the salutogenic model – while members of the scientific and medical communities tend to define recovery as the absence of disease and negative mental states – known as the pathogenic model. In order to reconcile and synthesize these two disparate points of view into a workable, useful, and inclusive definition, a group of researchers, spearheaded by Helene Provencher of Laval University (Quebec City, Quebec, Canada) and Corey L.M. Keyes of Emory University (Atlanta, Georgia, USA) propose a comprehensive definition of recovery under the label complete mental health.

First explored in the 2005 article “Mental illness and/or mental health? Investigating Axioms of the Complete State Model of Health” and expanded over the course of the past decade in close to a dozen related, follow-up studies, the idea of complete mental health – and its relationship to recovery from mental health disorders – is novel in that it recognizes the following:

  1. The absence of the symptoms mental illness does not automatically mean positive mental health.
  2. Positive mental health does not require the total absence of the symptoms of mental illness.

Instead of viewing positive mental health and mental illness as mutually exclusive states of being, Provencher and Keyes consider them as “two separate continua rather than the opposite ends of a separate continuum.” It’s important to note that while these initial studies focus on mental health disorders such as depression, schizophrenia, PTSD, and mood disorders, the value of the complete mental health model applies with equal validity to recovery from addiction and substance abuse disorders. Professor James Jackson (University of Michigan) elucidates the transfer of this Provencher/Keyes model to include recovery from addiction and substance abuse disorders in the 2016 publication Measuring Recovery from Substance Use or Mental Disorders:

“…one commonality between substance abuse and mental disorders…is that people with substance abuse problems often have cravings that could be described as conceptually similar to symptoms. In both cases, such a craving may be fine as long as the person is not acting on it.”

Both professional substance abuse counselors and individuals in active recovery from substance abuse disorders know cravings are not the only persistent symptom-like phenomenon challenging successful recovery. Counter-productive psychological coping mechanisms such as denial, anger, and rationalizing not only contribute to continued substance abuse prior to recovery, but also follow the recovering addict throughout life and often lead to relapse. Recovery does not mean the total absence of these life-interrupting coping mechanisms; rather, recovery means having the awareness, self-efficacy, and practical tools to identify and counter these mechanisms as they recur over time.

Substance Abuse Recovery: Process and Outcome

Recovery from addiction and substance abuse disorders is complex. It’s tempting to measure recovery with a single, yes/no criterion wherein abstinence signifies recovery and indulgence in intoxicants signifies non-recovery or abuse. However, substance abuse counselors and individuals in recovery alike identify this black-and-white approach as a reductive oversimplification that ignores the subtleties and nuanced challenges involved in creating a life free of substance abuse.

Relapse is a reality, yet relapse does not always mean a total collapse of the recovery effort. Nor does it mean a return to square one. The functional truth is that recovery is a non-linear process filled with advances, setbacks, successes, and failures. It includes in-between periods that are neither highs nor lows. The lifelong process of recovery happens on a dynamic continuum, and the precise location of an individual in recovery on that continuum rarely remains fixed. A recovering individual responds to the stresses and gifts of daily life with relative degrees of efficiency. Hard days are as much a part of recovery of good days. Navigating the extremes while maintaining a commitment to the process is the hallmark of a sustainable approach, as opposed to a static mindset that relegates an individual to a restrictive binary with sobriety on one side and substance abuse on the other.

An Multi-Faceted, Inclusive Model of Recovery

The complete mental health model advocated by Provencher and Keyes allows for the non-linear nature of recovery from addiction and substance abuse, and accommodates the formation of an analog for the two features of complete mental health previously described:

  1. Abstinence alone does not automatically mean complete recovery.
  2. Recovery does not require the absence of addiction-related symptoms.

Abstinence is, of course, the ultimate measure of sobriety, yet for individuals struggling with addiction, recovery means more than abstinence. It means the restoration – or in some instances, the discovery – of a way of life that supports happiness, health, and well-being. The model designed by Provencher and Keyes integrates a pre-existing model of mental illness described by Liberman and Koplewicz with their own model of positive mental health. The combination of these two models results in a multi-dimensional rubric containing six states of relative and interconnected positive mental health and disruptive mental illness, ranging from an initial state of being non-recovered from mental illness and languishing to a final state of being recovered from mental illness and flourishing:

  1. Non-recovered and languishing. This phase is characterized by severe impairments in mental health and extreme symptoms of mental illness.
  2. Non-recovered and moderately mentally healthy. This phase is characterized by fewer symptoms of mental illness combined with moderate levels of positive mental health.
  3. Non-recovered from mental illness and flourishing. This phase is characterized by the significantly reduced presence of the symptoms of mental illness, combined with concrete and identifiable attributes associated with positive mental health and flourishing.
  4. Recovered from mental illness and languishing. This phase is characterized by the absence of the symptoms of mental illness, combined with an absence of the attributes of positive mental health.
  5. Recovered from mental illness and moderately mentally healthy. This phase is characterized by the absence of the symptoms of mental illness, combined with moderate levels of positive mental health.
  6. Recovered from mental illness and flourishing. This phase is characterized by the absence of the symptoms of mental illness, combined with high levels of positive mental health.

[For the purposes of this article, the states are described here in sequence, whereas the rubric created by Provencher and Keyes situates them on an x/y axis, with the x axis representing the mental health continuum, and the y axis representing the mental illness continuum]

Substance abuse therapists and individuals struggling with substance abuse will immediately recognize the value of this expanded view of recovery. It asks both to understand that the process of recovery – the goal of which is complete mental health – is neither wholly salutogenic nor wholly pathogenic, but a combination of the two. It also asks those therapists and individuals to understand that recovery is neither solely a process nor solely an outcome, but again, a combination of the two. It gives therapists the tools to identify a client who’s abstinent, yet displaying mental health behaviors that may lead to relapse, and provides the vocabulary to discuss what they see with their client. It gives individuals in recovery the means to understand that it’s possible to be sober, abstinent, and diligently following a recovery program, yet still experience negative emotions and signs of poor mental health.

The Intersection of Theory and Practice

The Provencher/Keyes model gives treatment professionals the groundwork for situating traditional and complementary therapeutic modes side-by-side in pursuit of a greater whole: complete mental health. Awareness and application of the model particularly benefits individuals with co-occurring disorders, in that an array of therapies can be deployed – with the six states of recovery as a guide – to address both addiction and mental health disorders simultaneously. For many therapists and individuals in recovery, the Provencher/Keyes model verifies what they know already: recovery can be a messy process, filled with peaks and valleys. What works for one individual might not work for another, and what works one day for one individual might not work the next day for the same individual. The ability to bolster a recovery plan in one area, ease off in another, and stay steady in still another is something experienced practitioners and those in recovery have cultivated for decades. Until recently, however, these types of tweaks, and the insights that instigate them, have been a matter of instinct and the result of experiential knowledge – not the result of standard prescriptive practice. The introduction and adoption of a model that integrates the salutogenic and pathogenic theories of recovery into an adaptive, holistic, inclusive, and seamless whole unites theory and practice in a way that gives individuals in recovery a greater chance of therapeutic success, and ultimately, more options on the path to personal well-being and total mental health.

Why is it so Easy to Get Addicted to Pain Pills?

Pain Pill Addiction
Let’s get two things on the table right away.

First, anyone can get addicted to pain pills.

Anyone.

Me, you, your doctor, your neighbor, and anybody in your family or circle of friends.

Remember Brett Favre, NFL Hall of Fame quarterback, Super Bowl winner, star and starter for the Green Bay Packers? He got addicted to pain pills while recovering from a shoulder injury. How about music legend Prince? Yes, the Purple One, famous not only for his music, but for avoiding – and criticizing – the use of drugs by his peers during his thirty-five years in the celebrity limelight. He got addicted to pain pills while trying to manage problems with his hips. Then he died from an accidental overdose in his own home. How about Rush Limbaugh? Yes, the fiery, often-controversial conservative talk radio host. He got addicted to pain pills while trying to manage pain after back surgery. He battled the addiction for years, checking in and out of rehab, and even got tangled up in a criminal investigation related to obtaining prescriptions illegally.

That’s the first thing, worthy of repeating: no one is immune to opioid addiction.

Second, getting addicted to pain pills has absolutely nothing to do with your character. Getting addicted to pain pills doesn’t make you a bad person. Not getting addicted to pain pills doesn’t make you a good person. Addiction does not care about your good deeds or your bad deeds. It doesn’t care if you’re a good parent or a deadbeat dad. You could be as good as Mother Theresa, or as bad as Jack the Ripper. It doesn’t matter. It simply happens.

That’s the second thing, worthy of repeating as well: getting addicted has nothing to do with your value as a human being.

Getting Addicted is Easy: The Biological Reasons

Let’s get another thing out of the way: when we talk about addictive pain pills, we’re talking about opioids. Here’s a short list of pain medications being prescribed today whose pain-relieving properties rely on our endogenous opioid system:

  • Codeine
  • Oxycodone
  • Oxycontin
  • Fentanyl
  • Percocet
  • Vicodin
  • Lortab
  • Lorcet
  • Dilaudid

These familiar drugs are the opioids that have been in the news so much lately. They’re the pain pills that are currently ravaging our nation, sparing no population. Rural, urban, suburban. White, black, Latino. Young people. Old people. Rich people. Poor people. The opioids that caused the new President of the United States to sign an Executive Order forming a Special Commission to handle the crisis – a commission which, in its first public report, recommended that the President declare national emergency because of the crisis. It’s that serious, and it’s happening to everyone, everywhere.

Why?

Because it’s natural.

That’s right. Getting addicted to opioids is almost as easy as getting addicted to food, sex, exercise, or anything that feels good. Synthetic opioids contain the most powerful pain-relieving molecules known to medical science because of a quirk of human physiology: the endogenous opioid system present in the human nervous system. Synthetic opioids relieve pain by leveraging this naturally occurring pain-relief system, and they’re so easy to abuse because they hijack this naturally occurring system. Opioids are problematic because this internal pain-relief network is linked, at the cellular level, to how humans experience feelings of pleasure, satisfaction, and reward. When we do something that makes us feel good, our brain guides us back to that behavior. That’s how our neurobiological reward system works. Our brain remembers what feels good, and when the opportunity to experience that good feeling presents itself again, our brain tells us to go for it – even if another part of our brain knows we shouldn’t.

This is an oversimplification, but it’s true: we get addicted to opioids because we’re hard-wired for them.

The Problem(s) With Opioids:

Long-Term Effectiveness

Opioid pain medications have a significant set of limitations and complications that are neither widely known nor publicized. While they’re incredibly effective at relieving acute pain and there are many situations for which opioids are the logical and appropriate choice for pain management, the effectiveness of long term use of opioids for chronic pain management is not supported by medical research.

That may come as a surprise to most people, but it’s true. In 2016, the Centers for Disease Control (CDC) released CDC Guideline for Prescribing Opioids for Chronic Pain, a comprehensive and systematic review of existing scientific evidence “to identify the effectiveness, benefits, and harms of long-term opioid therapy for chronic pain.” The study defines long-term as use of opioids for over three months. The conclusion as to the effectiveness and benefits of opioid therapy for chronic pain management is concise and unequivocal:

“…no study of opioid therapy versus placebo…evaluated long-term (≥ 1 year) outcomes related to pain, function, or quality of life. Most placebo-controlled randomized studies were ≤ 6 weeks in duration. The body of evidence…is rated as insufficient.”

Risks and Harms

The absence of clinical support for long-term opioid therapy in chronic pain management may come as a shock, but the complications of long-term opioid use are well-known and broadly publicized in online, print, and television media. The statistics reveal a pattern which, taken at face value, should cause a complete re-evaluation of the long-term use of opioids for chronic pain:

Getting Addicted is Easy: The Problem with Prescriptions

Prescription opioids are big business. Experts estimate the value of the North American opioid market at $12.4 billion for 2015, a figure which quadrupled between 1999 – 2014, and is projected to grow to over $17 billion by the year 2024. This enormous increase occurred even though the amount of pain reported by Americans during the same period did not change.

When correlated with CDC data indicating a dramatic surge in opioid prescribing between 2007 – 2012, and the steady increase in abuse, overdose, and opioid-related fatalities since 1999, a clear picture of the past decade and a half emerges. Profit, expediency, and our cultural tendency to trust physicians and the prescriptions they write combined to create a perfect storm in which medication developed to alleviate suffering has arguably done more harm than good, and likely caused more pain than it has relieved.

If you’re addicted to pain pills, it’s likely your addiction happened something like this: you had a surgery, an injury, or a condition that caused you so much pain your day-to-day life became difficult. Your doctor prescribed you an opioid pain medication, and you took it as ordered. You didn’t realize it, but by taking the pills every day, you built up a tolerance, meaning you had to take more pills, or a higher dose of the same medication, to achieve the same analgesic effect. You didn’t think much of it. You simply took an extra pill, or asked your doctor to prescribe something stronger. Then, after a few weeks, you started getting cranky between doses.

You didn’t know it, but that crankiness has a medical term: anhedonia.

Anhedonia is the opposite of euphoria, the pleasurable sensation that accompanies opioid pain relief. You probably didn’t know that anhedonia is an early symptom of opioid withdrawal. You didn’t make the connection because addiction probably wasn’t on your radar. Why should it have been? You trust your doctor, and you were following orders. Besides, your crankiness disappeared when you took your medication – as ordered by the doctor. After a couple of months, you crossed an invisible line: you started to need the pills just to feel normal.

You tried to quit, but couldn’t.

And now there you are: addicted to pain pills, and all you did was follow doctor’s orders.

It’s an awful situation, and you’re not alone. It’s playing out every day across our country. The media attention and the new CDC guidelines for prescribing opioids have caused many doctors to scale back their prescription writing practices, which is a double-edge sword: of course, it’s a good thing that they’re not prescribing as many opioids as in the past decade, but they’re also leaving many people in the lurch. Their patients are addicted, and they’re cutting off their supply of drugs. People are quite literally left out in the cold. Sick, in withdrawal, with no idea what to do next.

Desperate, they turn to street drugs like heroin or black-market knock-offs of the prescription medications they began with. The problems with street drugs and illegally produced pills are numerous, but can be distilled down to three basic issues:

  1. There’s no way to guarantee what you’re getting.
  2. There’s no way to be sure of your dosage.
  3. They’re illegal. If you buy them, you can get arrested and thrown in jail.

But that doesn’t have to be you. You don’t have to go down that road. There’s another option. A much, much better option.

You Can Get Help

At Summit Estate, we understand opioid addiction. We’ve spent years on the front lines, helping people detox, helping people rebuild themselves from the ground up, and helping people take control of their lives. We don’t want you to become a statistic. We want to offer you a way out. We want you to explore our Medical Drug and Alcohol Detox Center, our Residential Programs, our  Day Programs, and our Outpatient Programs. We want to work with you to create a custom treatment program that meets your needs. We’ll help you find your way back to a healthy, sustainable life, free from the cycle of addiction you find yourself trapped in – through no real fault of your own.

The Physical Effects of Long-term Alcohol Abuse  

surgeons performing surgery

The statistics on alcohol abuse in the United State are alarming. According to the 2015 National Survey on Drug Use and Health, 15.1 million adults over the age of eighteen meet the criteria for an Alcohol Use Disorder (AUD). In addition, roughly 88,000 people die each year form alcohol related causes, and alcohol-impaired driving incidents cause close to 10,000 deaths per year. More troubling than these raw numbers is the fact that only about 1.8 million of individuals who meet the criteria for an AUD receive appropriate treatment at a specialized facility – less than ten percent.

That’s not all. In 2010, Americans spent an estimated 249 billion dollars on health issues related to alcohol misuse.

Worldwide, the toll of alcohol shows similarly scary numbers:

  • In 2012, alcohol consumption contributed to 3.3 million deaths.
  • In 2014, the World Health Organization reported that alcohol misuse caused over two-hundred diseases and adverse health conditions.
  • Alcohol misuse is characterized as the fifth leading risk factor for premature death and disability in the 15-49 year-old age group, while close to 25% of total deaths in the 20-39 year-old age group can be attributed to alcohol.

If you’re a drinker and you’re worried about your risk of developing an AUD, the first thing to do is determine your level of drinking. Heavy drinkers are at far greater risk of developing an AUD than low-to-moderate drinkers. The Substance Abuse and Mental Health Services Administration (SAMHSA) defines heavy drinking as the consumption of five or more drinks on the same occasion on each of five or more days over the period of one month. In plain language, that means if you’ve had more than five drinks – probably meaning you got pretty drunk – more than five times in the past thirty days, you’re at high risk of developing a potentially life-threatening AUD.

Check Yourself, Check Your Health

Maybe you know you have a problem with drinking. Maybe you drink heavily every day, but still manage to keep it all together. You show up for work, you manage your family obligations, and your health hasn’t started to suffer – yet. Maybe you know some form of treatment for your alcohol use is in your future, but you’re not quite ready for treatment yet. You’re not ready to take the plunge into rehab, therapy, or even weekly support group meetings, because, despite your heavy drinking, everything seems to be going fine.

The operative word in that last sentence is seems. In the case of chronic alcohol misuse – the kind that takes place over years – what you don’t know can, quite literally, kill you. That’s why it’s in your best interest to get checked out by a physician, even if you know you’re not going into treatment any time soon.

If the statistics haven’t convinced you to at least consider a visit to the doctor, perhaps this next set of facts will.

The Effects of Alcohol on Your Major Organs

You probably know alcohol wreaks havoc on your liver, but that’s not the only organ that suffers under chronic alcohol use. Let’s take a look at the other organs negatively impacted by alcohol use, starting at the top.

The Brain

Alcohol can damage the function and structure of your brain. Recent technology in brain imaging shows significant decrease in brain tissue. Chronic over-consumption of alcohol can also lead to Wernicke’s-Korsakoff Syndrome (WKS) a condition caused by vitamin B-1 deficiency. WKS is no picnic: effects may include alcoholic dementia, short-term memory loss, the inability to learn new information, cognitive impairment, eye problems, poor physical coordination, and difficulty walking.

The Heart 

Most people have read or heard that moderate alcohol consumption – say a glass or two of wine a day – is good for the cardiovascular system. What most people haven’t heard is that heavy alcohol consumption can damage your heart. Chronic, excessive drinking can to cardiomyopathy, which is a heart disease with symptoms like dizziness, fainting, shortness of breath, swelling of the lower extremities, fatigue, abnormal pulse, and cough accompanied by a frothy, pink discharge. Unfortunately, the symptoms of cardiomyopathy can stay hidden until it’s too late, and heart failure is imminent.

The Liver

Alcohol-related liver disease comes in three primary forms:

  1. Alcoholic Cirrhosis. Cirrhosis means scarring. Therefore, alcoholic cirrhosis, simply put, means severe scarring and liver damage, with symptoms similar to severe alcoholic hepatitis. You cannot reverse cirrhosis, but if you catch it early enough you can prevent further damage. Left untreated, cirrhosis causes permanent damage which can only be improved by a liver transplant. In 2013, over 30,000 people died from alcohol related liver disease, and close to one-third of liver transplants were alcohol related.
  2. Alcoholic Hepatitis. This condition causes an increase in fat, inflammation, and mild cirrhosis. People suffering from alcoholic cirrhosis often experience nausea, vomiting, poor appetite, stomach pain, fever, and jaundice. Statistics show that close to 35% of heavy drinkers develop alcoholic hepatitis. While mild cases can be reversed if you quit drinking, more extreme cases may develop quickly and can lead to severe complications, including death.
  3. Alcoholic Fatty Liver Disease. This condition is characterized by a buildup of fat in liver tissue, which impedes optimal function. Occasionally there are no symptoms at all. Of the three liver diseases caused by excessive alcohol consumption, alcoholic fatty liver disease is the least damaging, and can be reversed – but only if you quit drinking.

Alcohol and Cancer

Liver disease is the most common and well-known health risk associated with heavy drinking, but it’s not the only serious, chronic illness related to excessive alcohol use. The American Cancer Society (ACS) links the following forms of cancer to alcohol:

  • Mouth
  • Throat
  • Voice Box
  • Esophagus
  • Colon
  • Rectum
  • Breast

The message from the ACS is clear and simple: the more you drink, the higher your risk of getting cancer.

Our message to you is also clear and simple: if you know you have an alcohol problem, but you’re not ready to enter treatment, you need to go to a doctor and get a full health examination. You may not be showing symptoms yet, but beneath the surface, things may be headed in a very bad direction.

We understand not wanting to enter treatment for an Alcohol Use Disorder. Detox is hard, sobriety is harder, and recovery is a lifelong process. We understand you might not want to improve your psychological and emotional well-being, because right now, you’re functioning just fine. However, that body you’re living in is the only one you’ve got. We want to make sure you know, in no uncertain terms, that chronic, excess drinking can cause many conditions that are permanent, irreversible, and in some cases, fatal.

Summer 2017—The Opioid Epidemic:  Where Are We Now?

The good news is that the number of opioid prescriptions being written by doctors is starting to decrease. The number peaked in 2010, but since then, prescriptions for high, dangerous doses have dropped roughly 41 percent. To put that in perspective, the prescribing rate in 2015 was triple the rate in 1999, when the current opioid problem began. The reasons for the decrease range from tighter state and insurer limits on how many pills can be prescribed, to stricter regulations concerning pain clinics, to a new set of prescription guidelines released by the CDC in 2016.

However, there’s still much work to be done – and that’s putting it mildly.

Many people are looking to President Trump and the new administration in Washington to help end the epidemic. When he was elected, President Trump said he’d make the opioid crisis a priority, and addiction experts raised their voices in support of swift and forceful action. On March 29th, 2017,  two months after being sworn into office, he signed an Executive Order establishing the Commission on Combating Drug Addiction and the Opioid Crisis, and appointed New Jersey governor Chris Christie to head the commission. Christie convened the commission’s first meeting in June and recently issued an interim report. He promised to deliver a final report in October.

The commission advised Trump to declare the opioid crisis a national emergency. The report does not shy away from the facts, stating “The opioid epidemic we are facing is unparalleled. The average American would likely be shocked to know that drug overdoses now kill more people than gun homicides and car crashes combined.”

The report makes several recommendations, including:

  1. Mandating prescriber education and training for both opioid prescribing and the risks of developing a substance use disorder.
  2. Rapidly increasing treatment capacity.
  3. Eliminating barriers to treatment resulting from exclusions within the Medicare program.
  4. Expanding access to medications that help treat opioid addiction.

(Read a full draft of the interim report here.)

It remains to be seen where all this will lead. Not everyone is hopeful. Michael Fraser, the executive director of the Association of State and Territorial Health Officials, recently told The New York Times, “It’s really about drawing attention to the issue and pushing for all hands on deck. It would allow a level of attention and coordination that the federal agencies might not otherwise have, but in terms of day-to-day lifesaving, I don’t think it would make much difference.” One governor called the report incomplete because it doesn’t do enough to ensure that people with mental health and substance abuse issues have access to healthcare.

In another development, a report appeared this summer describing a new legal tactic to battle the opioid crisis: in one area on the east coast, prosecutors began charging drug dealers with second-degree manslaughter and criminally negligent homicide if they could prove the dealers were responsible for an overdose death. In such cases, prosecutors are required to provide evidence that the accused “knew the risks of the drugs yet provided them anyway.” Observers point out that this requirement could be problematic, since defense lawyers might argue that drug dealers want to cultivate customers, rather than kill them.

Meanwhile, the epidemic rages. The CDC estimates that 142 people die every day from drug overdoses. As with most bureaucracies, organizations like President Trump’s new commission tend to move slowly. Unfortunately, where the opioid epidemic is concerned, there is no time to lose.

How Your Addiction Affects Your Children

child alone with teddy bear

There are countless reasons to seek treatment for a substance abuse or addiction disorder. First on the list is your personal health and well-being. If you aren’t aware of the consequences of addiction, you should know it affects all aspects of your life: physical, emotional, and spiritual. Physically speaking, the consequences of untreated addiction and substance abuse disorders are devastating. Long-term addiction ravages your central nervous system, your musculoskeletal system, your endocrine system, and all your major organs. Left untreated for long enough, a severe substance abuse disorder can lead to disability and death.

If those reasons aren’t enough to convince you to seek treatment for your substance abuse or addiction disorder, next on the list is the effect your addiction has on your loved ones. Your parents, siblings, and spouse or partner all suffer when addiction takes hold of your life. This article won’t address any those people, though. Instead, it will focus on the innocent and often forgotten victims of addiction: your children.

Warning: this article won’t pull any punches. Spoiler alert: exposing your child to addiction dramatically increases your child’s risk factors for many of the leading causes of death in adults. No, we’re not talking about actually giving your child drugs or alcohol – we assume most adults know better than to do something so reckless and harmful. What we’re talking about is this: children of parents struggling with addiction have a far greater chance of experiencing long-term physical, emotional, and social dysfunction than children of non-addicted parents.

Addiction, Parenting, and Adverse Childhood Experiences

Twenty years ago, the Centers for Disease Control launched a study on the effect of adverse childhood experiences on an individual’s long-term health. Known as the ACE Study, this paper launched the beginning of what’s now commonly referred to the mental health profession as trauma informed care. Over the past two decades, extensive research has verified that children exposed to adverse, traumatic experiences have an increased risk of the following life-threatening health conditions when they become adults:

  • Heart disease
  • Obesity
  • Alcohol Use Disorders
  • Substance Abuse Disorders

In addition, children exposed to adverse experiences are more likely to:

  • Develop learning disabilities
  • Display behavioral problems
  • Develop cognitive issues
  • Develop mood and/or anxiety disorders
  • Begin sexual activity early
  • Become pregnant during adolescence
  • Initiate domestic or intimate partner violence
  • Adopt risky behaviors

Now that you know what can happen as a result of adverse childhood experiences, it’s time to define what they are. The CDC Study identified all of the following as ACEs:

  • Physical, emotional, or sexual abuse
  • Physical or emotional neglect
  • Domestic violence
  • Living with an individual struggling with substance abuse or a mental health disorder
  • Living with an individual who was incarcerated
  • Experiencing racism and/or bullying
  • Living in foster homes
  • Living in an unsafe neighborhood
  • Witnessing violence

You may have noticed the fourth item on the list:

Living with an individual struggling with substance abuse or a mental health disorder.

If you’re a parent currently struggling with an untreated alcohol or substance abuse disorder and your children live with you, then it’s critical for you to understand that you might – emphasis on might – be exposing them to an adverse childhood experience. We warned you: we’re not pulling any punches. We’re talking about serious stuff, and the numbers don’t lie. However, none of this means you’re a bad person, a bad parent, or that your child is automatically going to grow up into a depressed, anxious, addicted adult struggling with obesity and heart problems. What it does mean is that your child does – according to the statistics – have a greater chance of developing one or all of those conditions, especially if there’s not another adult in the household to provide the necessary protective buffering needed to mitigate the effects of your addiction and related behaviors.

How ACEs Impact Children

The reason ACEs cause so much damage to children – and the mechanism by which this damage manifests as mental, emotional, and physical dysfunction in adulthood – is simple: stress. A reasonable amount of stress is healthy. Challenging and stressful experiences teach children to handle adversity and develop the positive coping mechanisms and problem-solving skills they need to become successful adults. The Center on the Developing Child at Harvard University defines three categories of stress in growing children:

  • Positive Stress is an essential part of typical, healthy development. Examples might be the first day of school or a difficult athletic event. Physical symptoms include increased heart rate and a slight elevation of stress hormone levels.
  • Tolerable Stress triggers a greater physical response. Heart rate and hormone levels increase dramatically. This level of stress might be caused by the death of a loved one, a natural disaster, or a serious injury. The negative physical and emotional effects of tolerable stress can be alleviated if the stressor does not last too long and the child has positive relationships with adults who can help the child adapt to and process the stressful situation.
  • Toxic Stress occurs when a child experiences extended periods of adversity, such as abuse, neglect, exposure to substance abuse, mental illness, or exposure to violence without positive adult support. When a child’s stress response system is activated for long periods of time, negative consequences include compromised brain and organ development, cognitive deficiencies, and increase risk for chronic disease.

According to the American Academy of Pediatrics (AAP), toxic stress is the primary reason adverse childhood experience have severe consequences. In a paper published in 2012, the AAP states that childhood stress crosses the threshold tolerable to toxic when children experience:

“…strong, frequent, or prolonged activation of the body’s stress response system in the absence of the buffering protection of a supportive adult.”

You just read the most important words in this article: “in the absence of the buffering protection of a supportive adult.” It’s possible for children to bounce back from exposure to your substance abuse or addiction disorder. It’s possible for them to live, grow, and thrive in the face of extreme adversity. It’s possible for them to succeed in life despite your addiction disorder. They can develop the coping skills and resiliency necessary to survive as long as the adverse experience – in this case, exposure to addiction – is balanced with positive, secure, protective experiences. But there’s a catch: they need a clear-headed, responsible, supportive adult to chaperone them through the tough times.

Be The Adult Your Child Needs

If you’re struggling with an untreated substance abuse or addiction disorder, it’s likely you’re not able to be that adult right now. We can’t give you parenting advice without meeting you, and we don’t know the details of your situation, but if you’re a parent struggling with an untreated substance abuse or addiction disorder and your children live with you, then for their sake, find a way to place them in a healthy, safe, and sustaining environment while you get help. When and if you embark on your journey to recovery, the life you save may not only be your own – it may also be the life of your child.

Silicon Valley Burnout: When Stress Leads to Self-Medicating

 stressed out silicon valley worker

You’re a highly paid, successful professional working in Silicon Valley’s legendary tech industry. You regularly work 80 + hour weeks because:

  1. Everyone in your firm does it.
  2. Your bosses expect it.
  3. Elon Musk does it, Jeff Bezos does it, and Steve Jobs did it.

At this point, your mom would ask you this question:

If Elon Musk jumped off a cliff, would you do it, too?

To which you might answer:

Yes, because I’ll land in the electric flying car I designed during my marathon weekend work sessions. It’s synced with the altimeter app (the one I designed) on my smartphone, and will catch me at just the right moment.  

All jokes aside, have you thought much about your work habits?

Granted, when you signed on the dotted line or took the plunge and launched your own startup, you knew exactly what you were getting into. You knew full well the dominant cultural paradigm in the Silicon Valley tech world is like Max Weber’s Protestant Work Ethic and The Spirit of Capitalism on super-sized doses of Adderall. You knew there’d be fierce competition to succeed, and once you achieved success, you knew you’d have to turn yourself inside out to stay on top. You knew you’d get emails after midnight and your manager would expect you to reply immediately. You knew half the employees in your company would compete to see who’d stay at their desk after 6:00 p.m. on Friday, and the other half would compete to see who’d arrive at the office before 5:00 a.m. every other day of the week.

You knew you’d have to sacrifice to make it.

So, perhaps a better question for you is this: have you though much about your relaxation habits?

Stress Management and Self-Medication

Since you work in a high-stress environment in an industry characterized by obsession with profit and progress, it makes sense that at the end of the day – even if the end of your day is technically the middle of the night – you may have a hard time winding down. It makes sense that front and center in your mind is the project you’re working on. It makes sense that all you can think about is the product review meeting you have bright and early the next morning.

It makes sense you pour yourself a stiff drink when you get home.

You need something to help turn off your brain. Something quick and effective that doesn’t require more work on your part. You don’t have time for yoga or meditation. Your company has napping pods but you have no idea what the inside of them looks like. Your company has a gym but you’re not even sure if your key card works on the door. The only new-age extras you take advantage of at your cutting-edge company are the free lunches and the espresso machines, and you only use those because they help you maximize your productivity.

Besides, typical stress management techniques just sound like another thing to add to your to-do list, which – paradoxically – stresses you out.

The stiff drinks work much better, anyway. And the fact you need to take a sleeping pill every so often is no big deal, because it helps you get the rest you need so you can get your shoulder back to the wheel the next day.

The thing is, the drinks and the sleeping pills aren’t a big deal until they are. And when you finally realize what you’ve been doing all along is called self-medication, as opposed to stress management, it might be too late. You might be smack dab in the middle of a toxic Alcohol Use Disorder or an unexpected benzodiazepine addiction. You may have become a daily marijuana smoker without even realizing it. A functional drunk, a pill-popper, an accidental pothead: it’s hard to imagine any of those things were on your list of long-term life goals.

Get Help at Summit Estate

We understand why you work as hard as you do. We understand you’re driven to succeed. We get that there are million and one reasons you spend so many hours at the office. Maybe you’re striving to provide for a family. Maybe you want to retire early and travel the world. Maybe you have a sick relative you need to care for. Or maybe you want to make a name for yourself and leave your mark on the world.

All that makes sense – and all we’re asking is that examine your work habits and your relaxation habits sooner rather than later. We want to make sure you’re not slowly working yourself into a set of self-destructive patterns that have the potential to consume you, sabotage all your good work, and have negative effects on your health and well-being. We want you to understand that if your work has driven you to extremes, and those extremes include an unhealthy relationship with alcohol or other substances of abuse – we’re here for you.

We offer full service luxury addiction treatment services convenient to the Bay Area and San Francisco Peninsula. If you need help, you have options: you can choose the level of care that works for you and your specific situation. From our state-of-the-art Medical Drug and Alcohol Detox Center to Residential ProgramsDay Programs, and Outpatient Programs, we’ll work with you to create a custom treatment program that meets your needs. We’ll help you find your way back to a healthy, sustainable life, free from the cycles of addiction we’re sure were never on your to-do list in the first place.

Call Us Now. Our counselors and psychotherapists are standing by, ready to listen to your story.

Getting and Staying Sober in College

sober living dorms

The Rise of Collegiate Recovery Programs

There is no easy time in life to start your recovery journey. When you’re struggling with any sort of Substance Abuse Disorder (SUD), whether the substance is alcohol, illegal drugs, or prescription medication, you have a tough, life-changing, and possibly life-saving decision to make. Once the decision is made and you commit to taking positive action to address your SUD, you realize getting sober is only the first step on a long road. You quickly understand that in the grand scheme of things, the detoxification period – a.k.a. quitting your substance of choice and surviving withdrawal – is relatively short, whereas recovery is forever. There’s no real debate about this. If you don’t come to this conclusion on your own, it’s one of the first things you hear from addiction counselors, therapists, and people in support groups: recovery is a lifelong process.

Any new beginning is delicate, and can set the tone for whatever phase of life you’re entering. That’s why getting and staying sober is especially challenging if you’re a college student. The deck is stacked against you both socially and culturally. The college years are widely accepted as the period of life when you can experiment with alcohol and drugs without experiencing major consequences. It’s almost expected that a typical college student, living away from home for the first time, with easy access to alcohol and drugs – possibly for the first time – will dabble with drinking and smoking marijuana. College students who get caught drinking under age or with small amounts of marijuana are often let off with little more than a slap on the wrist, often delivered with a knowing smile, a friendly wink, and an understanding nod. Even extreme behavior, such as binge drinking and forays into harder drugs like cocaine, methamphetamine, and hallucinogens, tends to be overlooked or readily forgiven.

For many, this de facto acceptance does not present much of a problem. You go to college, you get a little wild, then something happens to pull you back to earth. You have some sort of near-miss – maybe a scrape with the law, maybe an automobile accident, or maybe a sub-par academic semester – and you see it as a wake-up call. You get your act together, cut back on the risky behavior, and get on with your life.

For others – meaning anyone prone to substance addiction and abuse – the permissive status quo is a recipe for disaster, particularly where alcohol is concerned. The NIAA College Fact Sheet reveals that the drinking habits of college students make them particularly vulnerable to developing an Alcohol Use Disorder (AUD). The facts speak for themselves:

  • Close to 67% of college students who reported drinking at least once a month also engage in binge drinking
  • Binge drinkers who consume alcohol at least three times a week are six times more likely to perform poorly on a test due to drinking, and five times more likely to miss a class due to drinking
  • Roughly 25% of college students report alcohol negatively impacts their academic performance
  • About 20% of college students meet the established criteria for an AUD.

In an environment where the majority of your peers drink regularly and the overwhelming preponderance of social activities revolve around alcohol, getting sober is tough- but staying sober is even tougher. The prospect is so daunting you might feel like you’re in a no-win situation, and you think your only options are to drop out or suffer through four years of self-destructive behavior. If we’ve just described you, then don’t despair. There’s real help out there for you. It’s closer than you think, and it’s gaining momentum with each passing semester: The Collegiate Recovery Movement.

Collegiate Recovery Programs and Collegiate Recovery Communities

What began as a small program at Brown University forty years ago is now a bona fide, evidence-based, time-tested approach to achieving and maintaining sobriety for college students. Today, over 150 institutes of higher learning across the country provide alcohol and substance abuse recovery services for students. These programs revolve around four core elements:

  1. Academic Support. Tutors and guidance counselors assist with the transition from treatment programs back to the rigors of daily class work and studying.
  2. Recovery Support. Collegiate programs help connect students with on-campus support groups such as AA, NA, or SMART Recovery, when available, or local support groups if none exist on campus.
  3. Crisis Management. Many programs connect students with mental and behavioral health support through on-campus clinics or hospitals. The presence of qualified health professionals is particularly helpful for students with co-occurring disorders, those who overdose, or those who haven’t yet entered recovery seeking information or advice on the best steps to take.
  4. Relapse Prevention. Successful collegiate recovery programs provide resources for sober social activities, offer workshops on how to manage peer pressure, and advice on navigating tricky social situations.

These four components are critical in helping college students get and stay sober, but there’s another piece of the puzzle that can make all the difference: your living environment. If you’re doing everything right, recovery-wise, i.e. abstaining from alcohol or drugs, going to support group meetings, seeing a therapist or counselor, and avoiding alcohol-centric social functions, your recovery may be more difficult if you live in a college dorm. When you’re surrounded by peers actively engaged in the party-hangover-class-party-hangover-class cycle, you probably feel like you’re swimming upstream, because you are.

Thankfully, there’s an additional option to explore: recovery housing.

Sober Dorms: The Missing Link in Collegiate Recovery

A study on social support for recovering alcoholics published in 2009 reveals a key data point:

“Those who added at least one non-drinking member to their social network showed twenty-seven percent increase at twelve months post-treatment in the likelihood of treatment success, and sustaining abstinence.”

This insight is critical: it proves that a sober social network can drastically increase your chances of maintaining sobriety. If adding just one non-drinking member to your social circle can increase your chances of staying sober by twenty-seven percent, then imagine what it would be like to live in a dorm surrounded by dozens of sober peers.

It could be a game-changer.

The best example of a sober dorm is the Recovery House at Rutgers University, located on their main campus in New Brunswick, New Jersey. Established in 1988, Recovery House was the first recovery residence hall in the country, and it’s set the standard for sober dorms ever since.

Here’s how it works:

  • Students must be sober for at least 90 days to be eligible
  • Students must attend at least two support group meetings per week
  • Students must attend a monthly house meeting
  • Students have access to a dedicated substance abuse counselor employed by the university
  • Students have access to 140 sober social activities over the course of the school year, organized by the house staff

And it does work. The statistics on residents of Recovery House are compelling:

  • The average GPA is a solid 3.23
  • Students living in the house for more than one semester have an average GPA of 3.4
  • Students living in the house for more than ten semesters have an average abstinence rate of 95%
  • Each semester, 98% of house residents either return or graduate – 13% higher than the university average
  • Over its thirty years, roughly 600 students have passed through the house

College Students: Find Your Community, Find Your Recovery Peers, Find Your House 

If you’re a college student working a sobriety program but feel your recovery is in jeopardy because you’re surrounded by non-stop alcohol, drugs, and partying, please don’t give up. You may be right: your recovery may be threatened by your current environment, and your best option may be to look for a different place to finish school. As mentioned above, over 150 colleges and universities across the country offer recovery services for students, and of those, 50 offer sober residence facilities. You might not find your recovery community right away, and it might be necessary to take a semester off while you get everything in place. While it might be hard to leave your school and your friends, consider this: making the move sooner rather than later might just prevent you from relapse. Which, if you’ve been listening to your counselors and recovery partners, might just save your life – not to mention graduate with that degree you’ve worked so hard to earn.

For Therapists: Does My Client Need Residential Treatment?

therapist and client

As a therapist, sometimes you have to make a tough call and recommend your clients for residential treatment for their addiction or substance abuse disorder. You may be hesitant to do so for a variety of reasons:

  • Residential treatment involves a total disruption of life-as-usual
  • You believe your client will resist the idea
  • You may need to stage an intervention
  • The cost may be prohibitive, even if you client is fully insured
  • Finding the right program in the right location may be difficult

There’s another big reason you may not want to recommend a residential program: you suspect your client may need one, but you’re not entirely convinced you’re correct. If you specialize in treating addiction and substance abuse disorders, you typically know by the end of a session or two if your client is a good candidate for residential treatment. You’re trained to see the signs and symptoms right away, and your recommendation is based on both training and experience.

If addiction isn’t your specialty, however, there are specific things to watch for if your client is suffering from a substance abuse disorder. The following list contains the primary indicators your client needs more than weekly therapy, support group meetings, or outpatient therapy:

  1. Habitual Relapse: If you’ve worked with your client through several failed attempts at sobriety, then you may need to consider the residential option.
  2. Failed Attempts at Outpatient Programs: If you client has been unsuccessful in Outpatient, Intensive Outpatient, or short-duration Inpatient or Partial Hospitalization programs, you may need to consider the residential option.
  3. Lack of Support: Your client may live or work in an environment that’s not conducive to sobriety, or they may have tapped out their available support systems. Often families and peers do everything they can to help a loved one trying to get and stay clean and sober, but their support is finite – and they’re also not trained professionals. If your client’s family has reached the end of both their energy and abilities, then you may need to consider the residential option.
  4. Dual Diagnosis: If you’re treating your client for a mood disorder or other emotional/psychiatric issue and you discover they’re been covering up a substance abuse problem, then a period of detox followed by residential treatment will help both of you get to the root of their behavioral disturbances. Sometimes it’s impossible – even for a trained and experienced therapist – to understand what’s really going on with a client, emotionally and psychologically speaking, when their symptoms overlap with those associated with substance abuse disorders.
  5. Safety: If your client’s behavior is rapidly escalating in a way that creates a safety risk for them or their immediate family, then a residential program may be necessary – sooner rather than later.

Finding the Right Program

In the 42nd edition of their “Treatment Improvement Protocol Series” published in 2005, The Substance Abuse and Mental Health Services Administration (SAMHSA) established the following nine criteria for evaluating the quality of residential substance abuse treatment programs:

  1. Screening and Assessment: Any potential program must have adequate pre-intake screening and assessment programs in place.
  2. Mental/Physical Health Exams: All examinations must be performed by fully qualified physicians and/or psychiatrists
  3. Onsite Prescribing Psychiatrist: Residential programs should have an on-site or on-call board-certified prescribing psychiatrist on staff in order to meet your client’s medication needs.
  4. Medication and Monitoring: Residential programs should staff either licensed nurses or physicians with the training to monitor and adjust medications as needed.
  5. Psychoeducational Classes: All residential programs should include solid addiction education and rehab prevention classes.
  6. Onsite Double-Trouble Groups: Each potential program should include support groups for individuals with dual diagnosis/co-occurring disorders.
  7. Offsite Support Groups: Residential programs should have direct connections to peer support groups such as A.A., N.A., SMART Recovery, or others.
  8. Family Education: A residential program should have formal systems in place which include your client’s family in the recovery process.
  9. Discharge planning: Quality residential programs create exit strategies – or re-entry plans – for all clients. These plans should include follow-up medical and psychiatric visits, support group resources, and emergency steps to take in case of relapse.

After Rehab: How You Can Help

The work of easing your client through the step-down process from residential treatment back to day-to-day life starts before they enter the program. The first step for you, as their therapist, is to find out which individual, within the administrative hierarchy of the treatment center, should be your primary contact. Reach out to them by phone or email and have a frank and honest conversation about your client’s history and immediate needs. Make yourself available as a resource while your client is in treatment and stay abreast of which treatment modalities are working and which aren’t. This knowledge will be crucial for your client’s continued sobriety upon discharge. If possible, collaborate with the treatment center staff to design a realistic and sustainable post-residential sobriety plan. Be ready to support your client when they begin the step-down process.

There will be challenges, of course, but if your client feels supported by everyone involved, their chances of avoiding relapse increase dramatically. The most successful recovery is one in which everyone involved – client, families, and therapists – have all the information they need to make good decisions before, during, and after residential treatment.

Call us at 800-701-6997 to learn how we can help your client.

Healthcare Insurance: What’s Our Future?

health insurance claim form

Pity the average citizen trying to figure out what’s going to happen with healthcare.  During the week of July 9, proposed legislation changed in a day.

Before July 13, this is where things stood:

BCRA—the Better Care Reconciliation Act of 2017, released on June 22—was still waiting to be approved by the Senate before being sent to the president’s for signing. More than a few people were worried, especially those concerned about healthcare coverage for those suffering from addiction. Ask anyone—those working in addiction and recovery, to families of loved ones caught up in the disease, to anyone who has been through an insurance coverage nightmare or who has heard tales from friends—how difficult it can be to navigate the system when the problem is addiction and mental health, it hasn’t been easy.

For years, a number of people had been working for parity in coverage for mental health and addiction disorders, and Obamacare —the Affordable Care Act —achieved that, according to The Fix.  The ACA was passed in 2008 and by 2014, what so many people dreamed about came into being, starting with increased access to healthcare for many “by expanding Medicaid and offering low-cost insurance through the ‘Health Insurance Marketplaces’.” The law also stopped insurers from denying coverage because of pre-existing conditions, such as substance abuse.

BRCA benefits are listed at https://www.dpc.senate.gov/healthreformbill/healthbill61.pdf and explained at sites like http://www.benefitspro.com/2017/07/12/breaking-down-the-senates-bcra-proposal. (The latter is a resource for benefits professionals.) Even Wikipedia does a good job of explaining them.

Addiction experts were sounding off about what it would mean should BCRA pass. A July 6 opinion column on an independent Park Forest, Illinois website included comments from over 60 experts who opposed the proposed healthcare act. The Senate’s version of healthcare repeal would cripple national efforts to address this public health epidemic, the article said, and the piece backed that statement up with several arguments. Two are below.

1 “Research has clearly shown that substance use disorders are complex, chronic medical conditions, best treated with comprehensive and integrated care” (and we cannot go back to financing them separately and treating them the same way, as before the ACA.)

2 Medicaid reductions and caps in BCRA mean that many substance abusers will lose coverage for treatment designed to save their lives.

On July 13, the Senate introduced a revised plan:  

As CNN reported:

1 The new bill has an amendment allowing inexpensive, deregulated insurance plans

“as long as Obamacare-compliant plans are sold.”

2 States will receive more money for their healthcare initiatives, including $45 billion for fighting drug addiction.

There is more, but those seem to be the changes most important related to addiction treatment.

Two moderate Republicans immediately took issue with the revision, saying that it will “hurt people with pre-existing conditions…who got coverage under Obamacare” and adding that the reductions in Medicare funding will hurt low-income families and others.

The revised bill also increases the number of people who will be left without insurance.

The finishing touches to the plan are due July 17, and now, Senator Lindsey Graham and Senator Bill Cassidy have yet another proposal.

If you’re not following all this, it’s understandable. There will not be a quiz.

Rehab After Relapse: Motivating Yourself to Make the Right Choice

upset young woman

Every person who commits to recovery from alcohol or substance abuse must face the fact they may relapse. That’s why all quality treatment programs design a re-entry plan for their clients meant to last past the first few days after discharge. Clinicians, counselors, therapists, and psychiatrists all understand one crucial thing about recovery: it’s a life-long process.

Substance abuse treatment professionals know that creating a custom, multi-layered, comprehensive post-treatment support system is the key to sustained sobriety. If you’ve been through rehab yourself – whether your program was residential, outpatient, partial hospitalization, or intensive outpatient – it’s almost certain you spent hours in classes, workshops, group therapy, and individual sessions on the subject of relapse prevention.

Why?

Because the statistics on relapse are scary: The National Institute on Drug Abuse (NIDA) reports that 50-90% of alcoholics and 40-60% of people recovering from substance abuse relapse in the first four years after rehab.

That’s the reason you learned how to identify your triggers. That’s why your counselors and therapists taught you how to rebuild your social network and stack it with people like sponsors or recovery partners who are as committed to recovery and sobriety as you. That’s why you learned how to set healthy boundaries with family members and old friends from your use and abuse days, and that’s why you learned stress-management techniques from yoga to meditation to exercise to sleep hygiene.

That’s also why you need to understand that relapse is not the end of the world – but you do need to do something about it.

What Should I do if I Relapse? Do I Need to Return to Rehab?

The answer depends on you.

The first thing you need to do is identify what really happened. Meaning you need to understand the difference between a slip and a full relapse. A slip is typically a very short, one-time occurrence where you drink or do drugs for one day or one evening, but quickly realize the danger you’re in and get back on your sobriety program right away. A full relapse, on the other hand, is when you fall back into your addictive patterns for days, weeks, months, or even years.

Don’t misunderstand, though: a slip is serious. It’s an indication you need to shore up your sobriety plan, identify why you slipped, and recommit yourself to recovery. If you slipped and righted the ship immediately, then it’s unlikely you need to return to rehab. If you truly relapsed, however, that’s a different story. The hard truth is that if you went down back down the rabbit hole, you probably need help getting back out.

You need to get back into rehab.

Returning to Rehab: How to Do It

Intense feelings of guilt, shame, frustration, and anger typically accompany relapse. All these feelings are valid and reasonable. They also don’t help. Yes, you need to work through them. Yes, a bit of anger can act as a catalyst and get you back on track. But the important thing to remember – something you most likely learned when you were in rehab the first time – is that you need to let go of what’s done, focus on where you are now, and commit your recovery.

Here’s a list of things to help you get back into rehab after relapse:

  1. Own it. If you relapsed, it’s done. You can’t go back in time, you can’t undrink a drink, you can’t unsmoke a joint, and you can’t untake a pill. Take personal responsibility for your relapse. Don’t try to shift accountability to other people or circumstances. Face reality and move forward.
  2. Don’t beat yourself up. If you need to, go ahead and re-read the relapse statistics above to remind yourself that relapse is part of recovery. You’re not alone: people have been there before and you can use their wisdom to help you move forward. Spending time wallowing in your shame and sorrows will exacerbate the downward spiral. Don’t do it. Remind yourself of how good it was when you were following your program, and know – really know deep inside – that it’s possible to get back to that good place.
  3. Use the phone. If you went into an extended relapse, it’s likely the people in your support network know about it. They’ll be ready to help you get back on track. Pick up the phone, dial those numbers, or go to a support group meeting and talk. Don’t wait: do it now.
  4. Evaluate Your Sobriety Strategy. That may seem too obvious to say, but it’s important: if you relapsed, something went wrong with your long-term sobriety plan. You need to take a long, serious look at what went wrong and what you can do to shore it up to decrease the chances of it happening again.
  5. Take action. Get yourself back into rehab. Quickly. You may want to go back to your original treatment center, or you may not – that’s up to you. Some people find comfort in working with familiar faces in familiar places, while others may want to start new, with a completely different approach and a new set of doctors, counselors, and therapists. Both choices are equally valid. It all depends on you.

Returning to Rehab: A Learning Experience

Committing to treatment and recovery the first time was probably the most courageous thing you’ve ever done in your life. It’s time to tap into that same courage again. You know you can do it because you’ve done it before. This time around, you have the advantage: you know what works, what doesn’t, and you know you’re not immune to relapse. Recovery is like a muscle. If you slipped or relapsed, it’s time to strengthen that muscle again – and the only way to do that is to get to work.

You may be humbled, but there’s also reason for optimism: you can take all this knowledge back to rehab with you, and get more out of the process this time than before. Every relapse prevention workshop you attend will have that much more meaning. You’ll understand – and hopefully embrace – the entire concept of relapse prevention in ways you never did before. If you had doubts, they should be gone now: this time around, you can take the insight of your therapists and counselors, the collective wisdom of your recovery partners and support system, combine it with your personal experience, and create a post-rehab sobriety program that significantly decreases your chance of another relapse. Even better than that, you can pay it forward, and use your experience to help others in rehab for the first time, the same way your recovery partners helped you during your first rehab experience.

If you’re reading this article and you’re in the middle of a relapse, call us here at Summit Estate now at:

800-701-6997

This is your chance to get back on track.

Don’t let it slip by!