The holiday season is a happy and fun time for some people, and an anxious and nerve-wracking time for others. Many people love this season—the decorations, the well-wishers, the parties, food—the list goes on and on. Of course, this time of year has it challenges, too, such as the unrealistic expectations, the fatigue that sets in after yet another get-together…. But for people early in recovery, as well as those with a substance use disorder who haven’t taken action yet, the days and nights can be especially stressful. Here are some ideas for getting through the holidays with as little stress as possible.
For people in early recovery
— Know your triggers. If you think a work get-together will be too much and you’re not ready to answer why you’re not drinking, you don’t have to attend. Volunteering for a good cause and giving back that day may be a good substitute. Arranging get-togethers with other friends in recovery is another idea.
If you do go to a gathering and you’re offered a drink, you don’t have to look for excuses, you can just say “Alcohol doesn’t agree with me,” and leave it at that. Some experts recommend always having a glass in your hand filled with something like club soda and lime.
— Plan ahead. If you’re worried about seeing extended family or friends you haven’t seen in awhile, have a plan. Think about what you want to say beforehand on the subject of recently being in treatment (and now being in recovery) if people ask. If your family asks if they can have alcohol at the get-together, there is nothing wrong with saying you’d rather they didn’t. Yes, you will eventually have to face the fact that you’ll be in situations where others are drinking, but now is not necessarily the time. Your family may recognize that, especially if they have been in a family program.
— Remember self-care. The holidays may bring up any number of emotions that are difficult to deal such as painful memories, or guilt. Find healthy ways of coping. Take a walk, go to a movie with a friend, or do something else you enjoy. Call your sponsor, or go to a meeting and find a sober friend. Recognize that you may be vulnerable, and be especially mindful about depression. Don’t put your own needs aside. Keep stress to a minimum if you can, and don’t commit to too many responsibilities.
For people in not yet in treatment
If you haven’t yet made the move to do something about your addiction, the holidays can be stressful because of guilt. You know it weighs heavily on your family, and a family member or two may have spoken to you about an upcoming get-together and his or her fears or what’s expected of you. Perhaps you’ve been thinking about contacting a treatment center when all the hubbub is over. Whether you have a problem with alcohol, or suffer from a different substance or chemical abuse problem, think about whether your family would rather have you home with them or getting healthy. You can’t say “the children need you at the holidays,” if you’re not all there.
If you’re being truthful with yourself, you know your family would likely prefer to see you in treatment. This is not to say you should go for them; you should do it for yourself. And if you look at it long enough, you may just admit that saying your family wants you home is an excuse.
Here are the questions to ask yourself to determine whether or not you may have a problem and should seek help:
- Have your friends and family members mentioned they’re about how much you’re drinking, or using another drug?
- Is your drinking or substance or chemical abuse affecting your relationships or your performance at work?
- Do you have an increased tolerance for alcohol or other drugs?
- Do you get defensive when questioned about your drinking or other drug use?
- Are you constantly planning for the next drink or time you can “use?”
- Are you getting into legal trouble because of your drinking or other drug use? (Have you had a DUI, or been charged with disorderly conduct, for example?)
- Have you been inappropriate at office parties or other gatherings?
Don’t wait to make that call or ask for help just because it’s the holidays. It could be the biggest gift you give yourself.
Addiction Treatment Centers
Leave it to California to take the lead when it comes to a group of hospitals trying a new way of helping those addicted to opioids—having ERs administer buprenorphine (aka Suboxone) when someone enters in the throes of withdrawal. (Lest anyone forget, buprenorphine is weaker than other opioids. It activates “the same receptors as other opioids, but doesn’t cause a high if taken as prescribed,” says the article in The New York Times.) A 2015 study by researchers at Yale-New Haven Hospital found that when ERs have done this, the people who get the buprenorphine are more likely (twice as likely, in fact) to be in treatment after a month than people who were only given an informational packet that included phone numbers related to treatment. As a result of the study, an ER specialist who heads the buprenorphine program at Highland Hospital in Oakland convinced the California Health Care Foundation to give his hospital a grant to try the novel method.
Out of the box idea? Sure. But it seems to be working. Now ER doctors are calling the lead author of the study every week, she said in August, and ER departments in Camden, NJ, Brunswick, Maine, Philadelphia, New York, Syracuse, and Boston are also offering buprenorphine.The doctors need training to prescribe the medication, as well as a license from the DEA to prescribe it unless someone is in withdrawal, so ER doctors are in a good position to treat those patients. “I think we’re at the stage now where emergency docs are saying, ‘I’ve got to do something,’” the lead author of the study said. “They’re beyond thinking they can just be a revolving door.”
Treatment in the ER
It’s a rare opportunity to meet people where they need help and get them started on medication for their addiction, the article notes. In some places of the country, it’s not easy to find a doctor who takes insurance AND prescribes buprenorphine. After their ER visit, ideally a person will follow a “wheel and spoke” approach, where they first go to a treatment clinic (the hub), adjust to the medication, and then see a doctor in a primary practice (the spoke). Treatment in the ER involves buprenorphine under the tongue, and usually, a prescription for Suboxone, in the form of strips that will dissolve in the mouth and thus are harder to abuse. Then the person is directed to meet with the head of the addiction program in his clinic, where he’s available one day a week.
Even signs posted in the waiting area of Highland ER reaching out to those suffering from opioid use disorder are helping. A woman there for a respiratory infection saw one and told her brother about the signs, and he decided to enter the program. Recently released from prison, he was hoping to stay clean, especially because he had a job offer. Now he had “a stable source of treatment.” California was willing to provide the grants to have this program flourish. Two-thirds of Highland Hospital’s 375 patients in withdrawal accepted the medication and had an initial appointment at its addiction clinic. Not only that, but California has started to require detox centers and residential centers to allow residents to take either buprenorphine or methadone, medication-assisted treatment, which has had a history of controversy. That’s also ground-breaking.
For more information or to contact our Detox Centers in the Bay Area call (866) 596-9391.
By now you have likely heard of the new book Dopesick: Dealers, Doctors, and the Drug Company That Addicted America by Beth Macy. Reviews are everywhere, and Macy appeared on radio station NPR and a PBS episode on TV this month. A reviewer at the Roanoke Times, where Macy once worked, says the book “humanizes the opioid epidemic.” And here’s the reason why it’s making news: he says “It is difficult to imagine a deeper and more heartbreaking examination of America’s opioid crisis than this new book by investigative reporter Beth Macy of Roanoke.”
A reviewer in the San Francisco Chronicle says: “Macy reports on the human carnage with respect and quiet compassion, but it is gut-check reading.” Dope Sick, for the uninitiated, “is the slang term for being in withdrawal from opiates such as narcotic painkillers (oxycodone, hydrocodone, [morphine, fentanyl, or prescription opioids]) and heroin and refers to the symptoms you experience after stopping or drastically reducing opiate drugs after heavy and prolonged use (i.e., several weeks or more),” according to this website. It’s one of the things about addiction that has users going back to drugs, to avoid the horrible symptoms: nausea, vomiting, stomach upset, diarrhea, leg cramps restlessness, cold sweets, loss of appetite, lack of energy, lethargy, dilerium and …other signs…,” according to the Urban Dictionary. So it’s an apt term to use in the title of a book about the opioid epidemic. And what’s so horrendous, Macy says in the PBS interview, is that epidemiologists say we haven’t even hit the peak of the scourge yet; that’s not due until after 2020. Macy traces the history of the problem, and if you think to yourself, here we go again, you’re in for a surprise.
What she says is really interesting. She points out that middle class Americans were able to hide what was happening longer. Parents didn’t want to tell their neighbors what was going on in their house, so the trouble was allowed “to fester and grow.” If you haven’t heard about some of the early heroes, she mentions a doctor named Art Van Zee who saw what was happening in Appalachia as more people got addicted and tried to get the attention of those in power. They didn’t listen. Macy also discusses the controversy over medication-assisted treatment (M.A.T.), and the TV viewer immediately understands how the “national divide” is not helping in fighting the problem. The PBS program stops in at an M.A.T program run by a former heroin addict to help make her point. Here’s how Macy explained the divide in a 2016 article: “Among public health officials, the effectiveness of M.A.T. has become an article of faith; after all, treatment with buprenorphine and methadone has been found to cut opioid overdose deaths in half when compared to behavioral therapy alone, and it’s hard to argue with that. An addict treating his opioid disorder with Suboxone, many argue, is no different from a diabetic taking insulin.
Addicts & Their Families
But increasingly, law enforcement officials — and many former addicts and their families — are lining up on the other side, arguing that Suboxone only continues the cycle of dependence and has created a black market that fuels crime.” Here is a more recent article Macy wrote about part of her book. She starts with a call she got from a mother whose addicted daughter was found murdered. Macy had been following the daughter’s story for a couple of years. The woman was taking Suboxone again and was supposedly on her way home to Roanoke from Las Vegas, but was found dead in a dumpster after she didn’t arrive. As the mother had said on the PBS program, it’s hard to know when to offer help to an addicted child and when to push away, for your own good and for the good of others. There’s always a story about a mother and a child in this epidemic, and it never gets any easier. At the end of the program, Macy says that she’d like to mobilize people to care. There have been a number of books written about the opioid epidemic, but if you read just one book about it this year, make it this one.
To receive help or for more information please contact Summit Estate, an alcohol and drug addiction treatment center, at (866) 569-9391.
Addiction Treatment Center
Not far from New York City, there’s a little fishing town that oozes quaintness, like so many on our coasts. Historic lighthouse atop a mountain, boats dotting the water below, seagulls diving for fish….you know the ones. Recently a former drug addict (or person in recovery from a substance use disorder) announced his hope to open a short-term treatment center (in a church, no less) in one of these towns on the East Coast to allow people to detox “before transitioning to their next phase of recovery.”
Not surprisingly, some residents are against it, saying that such a facility would “be out of character” for the town and “imperil local residents.” Not in my back yard—NIMBY—is nothing we haven’t heard before when it comes to facilities related to addiction treatment in suburbs. The irony is that this particular town has had more than its share of addiction problems. You’d think, by the way some of the residents talk, that it’s been immune to drug problems, or shut off from world.
Yet several months earlier, on the other side of the country, quite a different event than speaking out against a place for treating substance abuse took place. A former self-described “alcoholic who dabbled in heroin, Ecstacy and cocaine,” was feted with ice cream with a candle in it after announcing in a restaurant that she was 10 years sober. The woman said she had felt a huge amount of shame and a problem with telling her family that she was in recovery. It took her “three years … to speak up among friends and another three for her to do so publicly.”
But that day, she spoke openly about her recovery to the waitress when she turned down wine with dinner, which is the reason the woman brought her the ice cream and candle. And today, as executive director of the Center for the Open Recovery in the Bay Area, she promotes the idea that people in recovery “be open and even celebrated for managing the disease that is plaguing our nation.”
Addiction Recovery Programs
The writer of the opinion article that this anecdote appeared in points to a recommendation in the 2017 report from Trump’s opioid commission that suggests the government battle stigma…”by partnering with private and nonprofit groups on a national media and educational campaign similar to those launched during the AIDS public health crisis.”
She acknowledges that there a risk in speaking up, especially in sensitive occupations like medicine and flying, but the irony is that you can best remove stigma by being open. Yes, AA and other 12-step programs advocate anonymity, she says, but people in these groups can share their stories and still honor the group’s traditions if they just say “I’m in recovery.”
The woman refers to the AIDS epidemic and how initially gay men were blamed for “bringing the fatal disease upon themselves,” and compares that to those who see addiction as a moral failing and thus blame people who abuse drugs for their addiction. But the AIDS support community did eventually make a difference and gain support for more program funding through efforts like Act Up marches, the AIDS quilt, and posters.
Funding for research and treatment programs is sorely lacking when it comes to addiction, and the country needs to step up, stop the denial, and do more, she says. One way to do that and remove the stigma is to be open and speak up. She quotes Jim Hod, the co-founder and CEO of Facing Addiction, as saying addiction “is an illness that nobody is every going to get, nobody ever has and nobody has ever had.”
“Our Voices Have Power” says Faces & Voices. Is there a chance, if enough people speak up, that the stigma can be eradicated?
For more information please contact our Bay Area rehab & addiction treatment center by calling (866) 569-9391
When interventions are successful, a process of Bay Area recovery is started. It is vital that some support network exists and that the network provides positive encouragement for the recovering addict. For a person going through relapse, a change in mindset is needed. Relapsing is not a sign of failure. It is a sign that current treatment methods need to be tweaked or changed so that the abuse can stop again.
Around half of people who enter rehab will relapse at some point, whether in two weeks or 30 years, the point is to be available and help where and how you can.
Find the best course of treatment (and stick to it!)
This will often be done by the Medical Detox / drug rehab program; however, it is vital to help the recovering person to stick to the schedule. More so, if the treatment is not as effective as desired, you as a loved one are often one of the first to notice any regression in the addicts’ behavior. Being alert to changes in behavior and mood can often head off an ‘’episode’’.
A change of lifestyle
Finding out what caused it is the first step to long-term recovery. For some recovering addicts, it was often people or places that would trigger the need for whatever drug they were abusing. Reducing these triggers as much as possible exponentially increases the likely success of a rehab regime.
Reducing the triggers is one thing, however, situations will arise naturally where the recovering abuser will be tempted to use drugs again. In these situations, being available to distract or help the person may be vital, at the same time you could also help take them to get more professional help if needed.
Prepare for the worst.
Hope for the best but prepare for the worst. Accept that relapse may happen and have a plan for if/when it does.
Having a plan of action that the person in recovery agrees to is also just as important, often the abuser will recognize that they will not be in ‘’headspace’’ to make rational decisions. It may even be necessary to have ‘’power of attorney’’ for the person assigned to you, though this is only done in exceptional circumstances.
Most importantly is that you make yourself available! Having a proper support network is vital to a person’s recovery. Every recovering addict will have moments of weakness, getting involved can often be the difference between a bad few days and a death spiral back to addiction.
Knowing that others care for them and are willing to help with their problems can make all the difference to an abuser in the internal fight between substance dependence and the desire to be drug-free. Call Summit Estate at (866) 569-9391 to learn how we can help you win that battle.
The journey from being an addict to becoming a healthy person again is difficult and filled with trials that will be unique to each person. The process of recovery once rehabilitation has begun can only be achieved by each individual. Therapy, rehab programs and support networks are all there to help. But it is up to the willpower and determination of recovering addicts to change their lives for good.
It is an interesting word with so much meaning, but willpower is the fundamental way one breaks with addiction. For whatever reason, many addicts have incredibly low self-esteem, which in turn weakens or destroys their willpower, reinforcing the addiction.
Therapy and Rehab programs are designed to restore that self-confidence and enable a person willpower to take over; No one wants to be an addict, showing people that they have the power to end their dependence is the only way to ensure a viable long-term recovery.
Avoid/Deal with Trigger
Triggers are situations or actions that can lead a recovering addict to crave there for dependence. These triggers are often related to people in the person’s life or in situations they may find themselves in.
Lowering the number of potential triggers and dealing with the few that will inevitably surface is a key factor in avoiding a relapse.
No one person is an island and having people that either care for you (friends/family) or those who recognize your struggles (a support group) is a vital factor for avoiding a relapse.
At this point a potential sore topic; cutting out ‘’toxic’’ relationships; For many recovering addicts, some friends or family will be a trigger for them, in these circumstances, often the only way to avoid relapsing is to remove these people from one’s life.
This will often be an extremely painful process, these co-dependent relationships could be between lovers, or siblings, or parent/child and the severing of them will not be easy, but it may be necessary. In such circumstances, consulting with a therapist or other support networks may be key in facilitating this course of action.
Physical health and Mental health are linked, both affect each other in a feedback loop. If one increases, so does the other, the same for decreases.
This means that exercising regularly is key for all forms of health. Finding a form of a workout that suits each individual is key; for some, it may be running, for others cycling.
Sex is also a great workout, whether it is with a partner or not, make sure to be safe!
The Big Boogeyman
Many recovering addicts view relapse as a sign of failure but it is not. Addiction is a disease that cannot be cured, it is managed. Once you’re an addict, you remain one for the rest of your life. These are hard words to hard but honesty is key to staying healthy.
Many recovering addicts will relapse over the course of a lifetime; some will be lucky enough not to but they are in a minority. If a relapse does occur the key is to pick yourself up again and learn from ones’ mistakes.
If you or a beloved one is in need of rehab programs, please call Summit Estate at (866) 569-9391.
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:
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:
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:
- In the U.S., opioid pain medication overdose caused over 165,000 fatalities between 1999 – 2014. Over 20,000 of these fatalities occurred in 2014 alone.
- In 2013, Substance Abuse and Mental Health Services Administration (SAMHSA) identified an estimated 9 million cases of opioid pain medication dependence or abuse.
- 80% of individuals initiating heroin use report starting with a prescription opioid.
- New evidence indicates that opioids can cause a syndrome called hyperalgesia, in which long-term opioid users become more sensitive to pain over time.
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:
- There’s no way to guarantee what you’re getting.
- There’s no way to be sure of your dosage.
- 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 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:
- Mandating prescriber education and training for both opioid prescribing and the risks of developing a substance use disorder.
- Rapidly increasing treatment capacity.
- Eliminating barriers to treatment resulting from exclusions within the Medicare program.
- 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.
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:
- Academic Support. Tutors and guidance counselors assist with the transition from treatment programs back to the rigors of daily class work and studying.
- 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.
- 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.
- 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.
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.
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:
- 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.
- 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.
- 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.
- 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.
- 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:
This is your chance to get back on track.
Don’t let it slip by!