Category Archives: Recovery

Dopesick the Book

Opiod Crisis

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.”

Dope Sick

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.

Alcohol and Drug Addiction Treatment Center

Addiction Treatment

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. 

When Will We Overcome the Stigma of Addiction?

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.”

 

Bay Area rehab

 

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.”

 

There are other organizations who join Center for Open Recovery in promoting openness: Faces & Voices of Recovery, Shatterproof, and Facing Addiction.

“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

Helping to Stop Relapse at Bay Area Recovery

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.

Helping to Stop Relapse in Bay Area Recovery

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.

Be there!

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.

How to Avoid Relapsing in Rehab Programs

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.

Will Power

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.

How to Avoid Relapsing in Rehab Programs

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.

Support Networks

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.

Keep active

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.

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.

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

The Opioid Epidemic

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.

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.

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!

Social Recovery: The Role of Support Groups in Relapse Prevention

people meeting to share experiences Recovery from substance abuse is all about change. A person trapped in the cycles of addiction must take action in order to free themselves from those cycles. The hard bottom line in recovery is a change in behavior: addictive behaviors must be identified and replaced with non-addictive behaviors. This basic fact implies changes in thoughts, changes in beliefs, and changes in values. These changes, in turn, imply a fundamental restructuring of an individual’s perspective on themselves, the world, and their role in the world. If behavior is understood as the end result of a series of decisions based on thoughts, beliefs, and values informed by personal perspective, it follows that – as difficult a prospect as this may be – a person seeking to recover from addiction must change everything leading to the behavior in question. In short, a person in recovery needs to do more than simply modify behavior: they need to create a new identity. But there’s a rub. No person exists in isolation. Individuals function as the central node in a network of relationships within which they carve out their place and establish their role. This role and place determines their social identity, which is reinforced through a mutual feedback loop created by the individual, their behavior, and the responsive behaviors of the people around them. This complicates the process of recovery, because it requires the recovering individual to change not only their internal sense of self – the sum total of their thoughts, beliefs, and values – but also their external manifestation of self, i.e. their role and place in their social network. A recent vein of empirical research in substance abuse treatment takes this concept one step further, concluding that sustainable, life-long recovery requires restructuring the social milieu of the recovering addict to fully support and ensure their success. The research indicates it’s not enough to change only oneself; full recovery requires participating in groups that reinforce the new self, created during the process of recovery. Without this essential element, the chance of relapse increases, driven by external pressure: the power of the old social group associated with addictive behavior eclipses the nascent, vulnerable self of recovery, and the hard work of recovery is lost.  Whether you join an outpatient treatment program or go to a community support meeting, social connection is critical to long-term success. This article will discuss the ideas presented in the paper “The Social Identity Model of Cessation Maintenance: Formulation and initial evidence” by Daniel Frings and Ian P. Alvery, published in the peer-review journal Addictive Behaviors in October, 2014. It will address the traditional role of social groups in addiction recovery, the way those groups impact social identity, and the positive effect the intentional restructuring of social groups and social identity have on long-term recovery from substance abuse and addiction.

Something Old, Something New

The idea that social support facilitates recovery is nothing new. In fact, social support groups are almost synonymous with recovery: ask a random person on the street what they know about quitting alcohol or drugs, and the likely response will be something like, “Well, most people go to AA (Alcoholics Anonymous) or NA (Narcotics Anonymous) meetings, and if that doesn’t work, they go into rehab.” And that random person would be right. Support groups have long been an accepted component in the recovery process. They function in many ways: they may be an individual’s first exposure to recovery, they may be part of a residential rehab or intensive outpatient program, or they may be a key element of transition from rehab back to day-today life. While AA meetings and the Twelve-Step approach to recovery are widely recognized as the dominant support group paradigm, non-Twelve-Step programs such as SMART Recovery and Refuge Recovery are now widespread and offer equally viable social support options for recovering addicts. The intriguing aspect of “The Social Identity Model of Cessation Maintenance” study is not that social support plays a big part in recovery, but the detailed discussion of the how and why social support groups work, combined with data to support the assertion that in the absence of a social system to support the newly formed sober identity, the chances of cessation maintenance – a fancy way of saying staying sober and avoiding relapse – decrease dramatically.

Why Support Groups Work for People in Recovery

A person with a serious addiction or substance abuse disorder creates a social identity that’s inextricably intertwined with their addiction. They self-identify with their substance of choice: smokers readily say “I’m a smoker,” and drinkers readily say, “I’m a drinker.” When it won’t get them in legal trouble, people who smoke marijuana readily say, “I’m a pot smoker.” The social groups associated with these behaviors reinforce these identities. People who drink hang around other people who drink. Smokers take smoke breaks at work with other smokers, and people who smoke marijuana tend to spend time with other people who smoke marijuana. The person with the addiction may be many other things in life, as well. They may establish aspects of their identity in terms of family, work, or other activities. They may be a mom or dad, a lawyer, teacher, a cyclist, or a musician. When they decide to stop drinking, smoking, or using drugs, however, they’ve usually reached a point where their addict-identity has achieved primacy, interrupted their other identities, taken control of most of their behavior, and made their life as moms, dads, lawyers, or teachers unmanageable. The addict-identity, supported by social groups that validate and reinforce the addictive behavior, does not simply disappear when the addict decides to enter recovery. Nor do the social groups magically blink out of existence. The drinkers are there, drinking. The smokers are there, smoking. And the drug users are still there, using drugs. A person in the early stages of recovery who tries to maintain old social habits and networks fights an uphill battle: the strength of habituated social reinforcement can easily overwhelm the sober-identity they’re trying to create. The social groups may not be consciously or maliciously hostile to the sober identity, but by definition and in practice, they do not help its formation or foster its growth, either: these social groups and the behaviors that signify membership are self-perpetuating. They – meaning the collective will of the individual members – help maintain the status quo. Through sheer inertia, they have the ability to crush dissent and non-conformity without even noticing its happening. That’s where support groups come in: they offer a social system that reinforces both sober behavior and the formation of a new sober identity. They offer shared norms, values, and life-strategies that encourage the sober-identity to flourish. They create a set of standards that protect the newly sober individual in their efforts to escape addiction. Their members offer advice, encouragement, and a sense of belonging. They form a protective shield behind which an individual new to recovery can gather themselves and lay the foundation for a new approach to life. In the words of Frings and Alvery, “Much of group [support] revolves around strengthening the salience of a new social identity of ‘recovery’ and demonstrating its applicability to situations beyond the treatment setting. This involves a transition between an addict identity and a recovery addict identity. Social identity re-search suggests that the transition between identities often leads to a reevaluation of values and behaviors and is potentially a period of stress. Moderators of this stress include social support, continuity (over time) with other identities and a perception that relevant identities are compatible. Relative to addicts quitting on their own, group therapy [or a support group environment] provides these protective factors.” Support groups work because humans are social animals and individual human identity never develops in a vacuum. Human identity is the result of practice, and recovering addicts need a place to practice their new recovery identity until they’ve got a firm grip on what it takes to maintain sobriety. They also need concrete, specific examples to guide them through the tenuous, initial stages of recovery. Experienced members of support groups provide all that, and more. It’s one thing for an addiction counselor to dispense advice on how to handle trigger situations; it’s quite another to sit in a meeting a hear fellow group member say, “I was triggered this morning, and here’s how I successfully handled the situation.”

Social Support and Recovery: Key Points

A revised, retooled, and restructured social network is a crucial component of recovery, but there’s a very interesting point to be made regarding the size and scope of social restructuring necessary to stay sober. First, it’s important to define exactly what recovery means. According to the Betty Ford Consensus Panel on Recovery, recovery is defined as “…voluntary maintained lifestyle characterized by sobriety, personal health, and citizenship.” The Ford Panel further identifies three aspects of recovery:

  • Functional Recovery: Remission of symptoms.
  • Personal Recovery: Getting a job and coping with daily life demands.
  • Social Recovery: Developing strong and supportive social networks.

The first two aspects are obvious: recovery requires the addict to cease the addictive behavior and handle the typical demands of life. It’s also obvious that elements of the previous social network must be eliminated: if you’re a recovering alcoholic, hanging out in bars is not a good idea: eliminate that aspect of your social life. If you’re a pot smoker, hanging around the smoke shop is not a good idea: eliminate that aspect of your social life. The interesting point to be made involves “strong and supportive social networks.” When rebuilding a social world, one may think the new social networks need to be as large – by number – as the old social networks. While it’s true that the bigger and more robust the new social network is, the more support it can offer, a study on social support for recovering alcoholics published in 2009 reveals that size does not matter: “Those who added at least one non-drinking member to their social network showed 27 percent increase at 12 months post-treatment in the likelihood of treatment success, and sustaining abstinence.” This insight is critical: it proves that social interactions are a small hinge capable of swinging an enormous door. The addition of only one abstinent member to a recovering addict’s social network can drastically increase their chances of maintaining sobriety. This is important because individuals in recovery can get overwhelmed by the apparent difficulties of the path they’ve chosen, and reading an article like this, which seems to say “I have to get a whole new social life or I’m never going to make it” might add a layer of difficulty they’re not ready to tackle. But adding one non-drinking, non-drug taking person is not scary. On the contrary, of all the challenges of recovery, it may be the most do-able.

The Path to Change

The role of social identity in addiction is impossible to ignore. We grow, develop, and become experts at particular types of behavior because they serve us well at some point in our lives – even the behaviors of addiction originally developed as survival mechanisms. The addict-identities we create to support these behaviors also served us well at some point in our lives, as did the social networks we participated in that reinforced and perpetuated these identities. If they hadn’t, we never would have developed them, and we would never have sought out the associated social groups that reinforced them. When an individual chooses recovery over addiction, it’s like hitting a reset button on all of the above. Negative, addictive behaviors must be identified and replaced, but that’s not all: the addict-identity behind the behaviors must be identified and replaced, as well. The new identity – the sober-identity, the recovery-identity, former-addict-identity – needs a safe place to grow and thrive. That safe space is a community of sober, social interactions, filled with people united by common purpose working toward a shared goal. Support groups and group therapy are effective spaces for just that: they give the recovering addict a forum in which to practice their new identity and work out the kinks before they take it out for a drive. And you don’t have to be a social butterfly, flitting from one support group to the next: one person can make all the difference.

Mindfulness and Recovery: Theory and Mechanisms

woman practicing mindfulness by the seaThe practice of mindfulness is no longer considered an experimental approach in the treatment of mental health and substance abuse disorders. Once a novelty without much data or evidence to verify its benefits, research into the mechanisms and efficacy of mindfulness practices on health and wellness began in the 1970s, gained momentum in the 1980s and 1990s, and surged in the 2000s. Between 2000 and 2010, the sheer volume of mindfulness studies published in peer-reviewed scientific journals piqued the attention of the traditional medical establishment and forced a shift in the way doctors, therapists, and health scientists view techniques once considered interesting but unverified fluff. Since 2010, wide-ranging surveys and meta-analyses have addressed and verified the scientific basis for mindfulness. The current consensus is that practices such as meditation, yoga, taiji, and basic breathing exercises are practical and effective components in the treatment of mental health disorders of all sorts, and substance abuse disorders in particular.

This article offers a brief history of mindfulness in the U.S., a discussion of the neural mechanisms mindfulness training targets, and a general theory to explain why mindfulness plays an important role in any treatment and recovery plan for individuals struggling with substance abuse and addiction disorders.

Mindfulness in the U.S.

While a majority of the population may view mindfulness as a relatively new phenomenon, history tells a different story. Mindfulness arrived in the U.S. over a century ago, when renowned Indian guru Swami Vivekananda addressed the Parliament of World Religions in Chicago in 1893. Vivekananda represented India, Hinduism, and yoga, but his speech triggered national interest in spiritual and physical practices from Tibet, China, and Japan. In the decades that followed, the secular aspects of Hinduism, Taoism, and Buddhism – yoga, taiji/qigong, and meditation, respectively – slowly worked their way into American culture. The 1960s saw an explosion of interest in yoga with the publication of a popular series of books by Richard Hittleman, and in 1970 yoga made it to television: the show Yoga for Health proved yoga, and by extension, mindfulness practices in general, were here to stay.

Dr. Jon Kabat-Zinn, a researcher at the University of Massachusetts, conducted the first scientific studies on the mental health benefits of mindfulness. He began by examining the effect of mindfulness on chronic pain management, then widened the scope of his research to include stress, anxiety, and depression. He synthesized his work into a system known as Mindfulness Based Stress Reduction (MBSR). MBSR is now a default therapeutic technique in use by therapists, treatment centers, and addiction experts worldwide. It’s been combined successfully with a variety of traditional psychotherapeutic modes, such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP). Evidence for the complete integration of MBSR with these techniques – and its acceptance by the scientific community – is reflected in a new family of acronyms: MBCBT (Mindfulness-Based Cognitive Behavioral Therapy), MBDBT (Mindfulness-Based Dialectical Behavioral Therapy), MBACT (Mindfulness-Based Acceptance and Commitment Therapy), and MBRP (Mindfulness-Based Relapse Prevention). Thankfully, a simpler way of labeling mindfulness-related therapies has supplanted the acronym avalanche: they’re now collectively known as Mindfulness Training, or MT.

Mindfulness Training: Neurochemical Mechanisms

For generations, both the neuroscience community and the general public lived with the belief that after a certain point early in life, neurogenesis, or the formation of new brain cells, stopped. This misconception was debunked in the late 1990s, first by identifying the formation of new brain cells in songbirds and finally by identifying the formation of new brain cells in adult humans in the early 2000s. A growing body of research proves definitively that mature humans can not only produce new brain cells, but the new brain cells can be produced in a relatively short amount of time – as little as eight weeks – by the practice of mindfulness techniques.

Mindfulness training results in an increase in brain matter density (neurogenesis) in the following brain regions:

Hippocampus: The hippocampus is an essential structure in the limbic network, the part of the brain primarily responsible for emotional regulation. The hippocampus also contributes to the formation of memory and cognitive functions like self-awareness, compassion, and reflection.

Amygdala: Part of the limbic network, the amygdala is known to be associated with sensations of stress and anxiety.

Posterior Cingulate Cortex (PCC): The PCC is involved in the process of assessing the relevance of external stimuli to oneself, and contributes to placing these self-referential stimuli in an individual’s emotional and autobiographical context.

Cerebellum: The cerebellum is primarily known for its function with regards to sensory perception and motor control, but it also contributes significantly to the regulation of cognitive and emotional processes.

Temp-parietal Junction (TPJ): The TPJ facilitates the integration of internal and external sensory information, social cognition, and the ability to interpret the desires, intentions, and goals of others. Activation of the TPJ is linked to feelings of empathy and compassion.

The brain structures stimulated and strengthened by mindfulness training combine to form a functional group uniquely relevant to the treatment substance abuse and addiction. Substance abuse disorders compromise and lead to deficits in emotional regulation, stress response, anxiety, self-awareness, social intelligence, and empathy. While these deficits manifest in different ways for different people, their cumulative effect leads to dysfunctional behavior in the form of counter-productive coping skills. Self-medication suppresses powerful emotions, disproportionate stress-response and exaggerated anxiety increase desire for self-medication, distorted perception of the self-in-context normalizes the denial of the self-destructive consequences of substance abuse, and diminished social intelligence and empathy contribute to the tendency of addicts to lose sight of the consequences of their actions on the people around them. Mindfulness training reinforces the neural mechanisms necessary to bolster the perceptive skills required to bring these deficits back into balance, enabling individuals to see and understand their behavior, which in turn allows them to build the healthy and life-affirming coping skills that lead to sustainable recovery.

A Mindful Model of Addiction

A deep dive into the scientific literature available on the effects of mindfulness training on mental health disorders, including addiction treatment and recovery, leads the diligent reader to mountains of data describing positive benefits related to well-being, mood, self-efficacy, stress tolerance, the ability to gain non-judgmental perspective on behavior. However, only one study elucidates the connection between Buddhist philosophy – the theoretical basis of most practical mindfulness techniques – and contemporary theories of addiction. In “Craving to Quit: psychological models and neurobiological mechanisms of mindfulness as treatment for addictions”, a 2012 paper published in Psychology of Addictive Behaviors, researchers apply the Buddhist theory of human suffering to substance abuse disorders, calling it “an early model of addiction.”

The Buddhist Model

The Buddhist theory of suffering is relatively simple. It states that desire causes all human suffering, and therefore, the path to enlightenment – or in the case of regular people living 21st century lives, the path to health and wellness – lies in releasing attachment to objects of desire. Buddhist philosophy also asserts that personal identity is formed, in part, by associations created by habitual behavior. An individual desires an object or subjective sensation and connects fulfillment of that desire to a concept of identity, which reinforces both the habitual fulfillment-seeking behavior and concept of self to the sensations and attendant emotional states achieved by fulfilling the desire. In the case of an individual struggling with substance abuse, pleasurable sensations that follow substance use are the objects of desire. Those sensations become an aspect of identity. When those sensations fade, so fades the habituated sense of identity. The fulfillment of desire, therefore, becomes the search to maintain identity, and identity becomes inextricably intertwined with substance use. 

Mindfulness Training: Interrupting the Craving Cycle

The way to break this cycle is to separate the habituated sense of identity from the cycle of desire. Substitute the idea of craving for the phrase cycle of desire, and addictive behavior can be understood by recognizing that what addicts do is logical: they crave reinforcement of their sense of identity. More simply put, they crave being themselves. In the case of an individual struggling with addiction, the created self is counter-productive and damaging to long term health, function, and survival. When the cycle continues in unchecked, iterative repetition, the self of addiction undermines the true self by distorting emotion, perception, memory, and cognitive function. It supplants and ultimately destroys the original self and becomes the default state of identity.

Buddhist scholars call this cycle “the chain of dependent origination.” Craving is what connects identity to the chain; therefore, breaking the cycle of craving may enable an individual to escape the cycles of addiction. Mindfulness training teaches the skills required to see the cycle as it is – a self-destructive one – and replace it with constructive patterns of behavior. Dr. Lawrence Peltz, author of “The Mindful Path to Addiction Recovery: A Practical Guide to Regaining Control over Your Life”, describes mindfulness training as

“… a powerful accompaniment to the recovery, psychotherapy, and medicine an alcoholic or addict needs. In essence, mindfulness is the quality of awareness that sees without judgment, shining a light on each moment just as it is. This includes physical sensations, feelings, thoughts, and the nature of our experience continually shifting and changing. With practice, it is a skill that can be developed by anyone.”

The first step in developing this important recovery skill is learning to slow the mind down, relax, focus, and “shine a light on each moment just as it is.” There are many paths to this mind-state, such as seated meditation, walking meditation, breathing exercises, and the practice of yoga postures. What all these techniques have in common is their ability to grant the practitioner the ability to clearly see what drives their actions, and the perspective to decide whether those actions help them or hurt them.

Mindfulness allows an individual to observe, for instance, that stress triggers a cascade of emotion that leads to a particular behavior, i.e. substance use. Mindfulness further allows the individual to understand that though substance use temporarily alleviates the symptoms of stress, that same stress, anxiety, and tangle of uncomfortable emotions returns when the substance of abuse clears their system. The clarity of mindful perception can lead to the insight that substance use does nothing whatsoever to mitigate the underlying cause of the stress. This insight may lead to greater and greater levels of understanding. The authors of “Craving to Quit” summarize the benefits of mindful perception in this way:

“By decoupling pleasant and unpleasant experience from habitual reactions of craving and aversion, careful attention to the present moment can function to bring a broadening or spaciousness of awareness that allows new appraisals of life situation. A possible result of this…is the ability of mindfulness to facilitate positive reappraisal.”

Mindfulness in Action

In the context of treatment and recovery, the power of mindfulness lies in its ability to support, complement, and functionalize more traditional modes of therapy. While methods such as Cognitive Behavioral Therapy (CBT), Dialectical Behavioral Therapy (DBT), Acceptance and Commitment Therapy (ACT), and Relapse Prevention (RP) help individuals identify patterns of behavior which undermine health and well-being, they do not offer specific techniques with the strength to arrest craving cycles during the critical moments in which cravings occur. When craving hits, habituated patterns of addiction drive behavior towards that which reaffirms the distorted sense of self and identity caused by addiction. Traditional therapies based on talking and thinking often fail to interrupt these patterns, whereas mindfulness training – through breathing exercises, somatic practices, and the cultivation of non-judgmental detachment – teaches skills to stop the cycle of craving in its tracks, allow the moment of craving to pass without acting upon it, and create the internal space to replace the negative patterns of addiction with the positive patterns of recovery.

For decades, mindfulness training has helped individuals struggling with substance abuse and addiction disorders achieve balance and harmony in their lives. In the early days of the mindfulness movement, these techniques were regularly devalued, ignored, or ridiculed by the scientific establishment. Those days, thankfully, are over. Advances in neuroimaging have allowed researchers to identify discrete changes in brain structure following mindfulness training, offering clear data on the mechanisms by which mindfulness supports recovery. Coupled with a compelling, logical theory to elucidate the role of mindfulness vis a vis identity, choice, action, and behavior, mindfulness training has shed the baggage of unverified novelty and assumed its proper place in the mental health community as an effective, practical, and evidence-based mode of treatment for substance abuse and addiction disorders.