George W. Bush has very compassionately decided to declare that September is National Alcohol and Drug Addiction Recovery Month, 2006.
That’s wonderful Mr. President, after thirty years of your ‘War on Drugs’, you’ve decided your country needs to focus on treatment and recovery too.
And for a whole month!
If you are trying to cut down your alcohol use, even if you are mostly successful, there will inevitably be times when you will relapse and have a binge. Don’t be put off by this, you haven’t failed. What is important here is to learn from your mistakes and work out how you could do things differently next time.
What was it about that situation that caused you to drink more than you intended? Was it a particular trigger that you couldn’t avoid (birthdays or a bereavement for instance)? Or was it a trigger that has caught you out before? If so, you need to work out some different ways to deal with it.
Many relapses occur as a result of the beliefs you may hold about alcohol. For instance if you believe that you “can’t cope with these feelings” and so you “need a drink otherwise you’ll lose the plot”, or if you believe that the only way you can be sociable is after a drink, then obviously these beliefs will tend to make you relapse.
The beliefs you have about your cravings or urges will also determine how easy it is to avoid relapse. So again, if you believe that once you get a craving, it won’t go away until you have a drink, then every craving you get becomes very risky. Similarly, if you believe that you don’t have the mental strength to cope with your cravings, then of course you probably won’t. Your beliefs are self-fulfilling.
What you need to do now is find out what your beliefs are, and more importantly how accurate they are. This means testing out your beliefs by looking at the evidence. Most of our problems in life arise from inaccurate beliefs about ourselves and how the world works. But this is where you might need a counsellor or a therapist, because it’s very difficult to be objective and impartial about your own thoughts.
» Try this test to see what your negative beliefs about alcohol or drug use might be.
» Then try this one to examine what your beliefs about cravings are.
For most people with an addiction, their over use of alcohol or drugs has arisen from too many unpleasant emotions in their lives.
As such, understandably they yearn for the good feelings usually associated with positive life experiences. These feelings are immediately available through alcohol or drugs, so excessive use can take hold. As many an addict or alcoholic has said -
“I just wanted to feel normal…”
The important thing here is that most of the time addicts or alcoholics do not feel normal, they feel like something is wrong. Sometimes it’s because a part of their personality is not being expressed fully, they are suppressing a part of themselves which may have been buried for years, for so long they have probably forgotten it was a part of them.
What often happens though is that when high, or drunk, these suppressed or forgotten parts of us come out to play - sometimes this is enjoyable, and sometimes not. But the way people behave when they are intoxicated can be very informative. It can tell us a lot about the ‘how’ and ‘why’ of the addiction.
These two aspects of an addict’s personality - ‘the straight’ and ‘the addictive’ are very often in conflict with each other. They don’t like the other part, they don’t trust them and they fear being overpowered by them.
To move forward, there has to be a truce. An acceptance and understanding of both parts of the self. You need to recognise what the positive qualities are about both. Then maybe some of the guilt and self-blame can subside…
» Read this related article on Addiction and Mental Health.
Cocaine use is on the increase apparently - nearly 350 000 people use cocaine every month in the UK alone. This is due to a number of factors - reduced cost, increased supply and a certain tolerance in society towards drug use, especially cocaine with its ‘celebrity’ status.
Unfortunately of course, with increased cocaine use generally there comes an increase in the number of people becoming addicted, especially to crack. Health and support services are doing their best to respond to this, but there are as yet no commonly used pharmaceutical substitutes to aid withdrawal (unlike heroin, which has a whole range).
Having said that, research suggests that a new anti-epilepsy drug (Vigabatrin) has shown effectiveness in blocking cocaine cravings.
Contrary to popular opinion, cocaine is also far more damaging than heroin. The range of physical complications is huge - from gastrointestinal perforation (ouch) or haemorrhage to heart attacks, lung damage (especially from smoking crack) or respiratory failure, strokes and seizures. It’s not a pretty picture. BBC NEWS - Cocaine stomach problem warning.
Then there’s the psychological side-effects like paranoia, depression, anxiety, panic attacks, auditory hallucinations, sleep disturbance, sexual dysfunction and irritability or aggression.
On top of the problems associated with cocaine on its own, whilst high users will also tend to smoke and drink alcohol far more than they would normally. The combination of cocaine and alcohol produces Cocaethylene, which causes more cardiovascular damage than either drug alone. Alcohol also increases the toxicity of cocaine on the liver.
Recovery from cocaine addiction is no easy task, due mainly to the enduring physiological nature of cravings. However, natural herbal supplements have been found to reduce such cravings.
Cognitive behavioural therapy or counselling is also particularly effective in breaking those associations which produce cravings and hence relapse. So don’t give up hope if you are already using too much cocaine, dramatic changes are not impossible, but they do take some hard work.
Coping with cravings is the key to tackling alcoholism. If you can manage to not give in to your cravings, or you can adapt so that you don’t get so many cravings in the first place, then there is no more addiction is there?
How you view your own cravings will determine how much power they have over you. If you believe that a craving won’t naturally go away once it has started, or if you think that the only way to deal with a craving is to drink, then of course you will be fairly powerless over them. This is the cognitive component of your addiction.
Making yourself aware of what things in your life tend to give you cravings, and therefore how you might avoid those situations, becomes a vital skill. For those ‘triggers’ that you can’t avoid, you can learn how to deal with them differently.
Each type requires a different approach to deal with it. And each person’s approach will be unique to them.
“Many of us spend our whole lives running from feelings with the mistaken belief that you cannot bear the pain. But you have already borne the pain. What you have not done is feel all that you are beyond that pain.”
Kahlil Gibran
Is there a genetic component to addiction? It would seem so - the genes for excessive alcohol consumption have been identified.
But how any genetic predisposition can be distinguished from the more behavioural, learnt element is virtually impossible - and when it comes to individual people trying to break out of their addiction, the distinction tells us nothing much of any use.
“Your father was an alcoholic, so unfortunately you inherited that genetic trait.”
“Oh great news, so how does that help me to stop drinking?”
If substances have been used from an early age, then this often becomes the preferred way of coping with difficult feelings. Obviously, we learn most of these skills from our parents, our siblings or our friends as we grow up. So if these people were not themselves dealing with their emotions very effectively, then that is likely to be what we learnt also.
Thus addiction is passed from generation to generation via learning, not just biology.
Not everyone who has addiction problems decides (or needs) to be abstinent. But for those that do, a problem often expressed is - what about all my friends?
Of course, over years of drinking or using, people build up social circles and friendships which are often based partially on drinking or using. So what are people supposed to do with those friendships? How can an alcoholic continue to socialise with their friends when those people are still drinking? Especially when that person probably needs a lot of social support during the change process.
Letting go of old friends is something that most people just don’t want to do, and even if they don’t remove them from their lives, many addicts are worried that their friends won’t like them so much any more - they won’t think they are quite so much fun. Making new friends is just not that simple.
Unfortunately this is not a problem with an easy solution. Unless you want to give AA or NA meetings a try?
This is a decision which many alcoholics struggle with, and some try both approaches at different times. It is of course tempting for anyone who drinks alcohol problematically, to think that they can just regain control and drink more sensibly. And of course this is possible, but it is also very difficult. But then achieving total abstinence is not exactly easy either.
Realistically, there is no way of knowing if you are able to change your addiction into healthier patterns of use, or if you must become abstinent, the only way to know this is to find out. Many people go around this cycle many times - achieving a certain time of abstinence, then trying to drink socially or sensibly again, only for this to spiral out of control back into alcoholism. But there are those who do successfully manage their addiction and achieve healthier patterns of drinking.
The 12-step (AA or NA) philosophy is unequivocal on the matter - “abstinence is the only way”, but more modern approaches are adapting to the fact that there are other options. Similarly, if you are trying to achieve abstinence and you slip, or relapse, then the 12-step crowd would have you believe that you’ve failed, and that you need to start again from the beginning (back to step 1). But of course this just increases a person’s sense of shame and failure, which can itself make even more drinking or using a possibility.
It would seem far healthier to look at relapses as an opportunity to learn from mistakes, and try to do things differently next time.
For most people with alcohol or drugs problems, they often have a number of unresolved difficulties with life generally.
Over-use of drink or substances is often a symptom of other problems. Some of these may be minor of course, like an aversion to being bored, or a lack of confidence socially, or just a limited variety of ways to relax.
Some people have more deep-rooted problems behind their addictions - like anxiety, depression, lack of self-esteem etc. These can all be addressed with cognitive counselling techniques however.
Then there are many people with more serious mental health problems who end up having difficulties with alcohol or drugs. ‘Self-Medicating’ they call it in the medical profession. Basically, if life is unbearable and beyond your ability to cope with it, then people will try anything to feel better, even if it’s only for a few hours. And never mind what happens later.
Say what you like about drugs or alcohol, but one thing’s for sure - they can certainly take your mind off things if you’re feeling distressed. So if you’ve been trying to live with bipolar disorder or schizophrenia for years and nothing the medical profession has suggested has really helped that much, it’s no surprise when people turn to the bottle or to illegal drugs.
However, once that ’self-medication’ turns into dependency, then the situation can spiral out of control. And this is where it becomes more difficult to help people solve their addiction issues. It’s not impossible of course, it just takes more work and perhaps a little more motivation.
The 12-step (AA, NA etc) philosophy includes a tricky concept for some, the idea of a “Higher Power”.
If people have developed a problem such that they cannot control their own use of alcohol or drugs, so that they are in effect disempowered by their addiction, what effect might it have to suggest to them that they should believe in the ability of a “Higher Power” to help them overcome their problems?
Is it not more useful to suggest, and encourage them to believe in their own power again? From this they can work at ways to develop that inner power, so that they have the ability to take back control of their own actions and lives.
Many addicted people are already deeply ashamed of their actions, their self-esteem is in shreds. Rebuilding that confidence in the Self is vital. Not to the point of arrogance or self-centredness obviously, because those extremes are themselves often at the root of many addiction problems. Achieving a balanced personality is the goal.
Beating addiction is not a process of being told what to do differently, or learning the tricks that you were possibly lacking, those secrets which people without an addiction surely must have. No, it doesn’t work like that.
Overcoming addiction is more to do with learning about yourself, learning how you tick, what beliefs you hold, some of which you might not even be aware of, which contribute to your problems.
Most of our behaviours are very automatic, we do things without thinking too deeply about the consequences, most of the time. We are animals, just like the rest of nature, and we respond in the same way they do. Like Pavlov’s famous dogs - if you show us something that we’ve seen before, we often respond to it in a pre-programmed or learnt way. If you smell some lovely fresh food being cooked, you’ll start to produce saliva. You will also probably think certain thoughts as a result, again often automatically (though they might not FEEL automatic). Some of these thoughts are so subtle and you have them so often, you might not even notice them.
With addiction the initial event can be anything - being bored, feeling lonely, angry, disappointed, frustrated, tired. From that thought you might think something like “I can’t stand feelings like this, I must change this feeling”. Again, this thought might not be a loud one in your head, its just a way of dealing with the world and your feelings that has become automatic.
So, in a situation like this, you’ll find something to get rid of this unpleasant feeling you’ve got - “I know what will change my mood, a drink…” or some cocaine, or whatever your problem is with (whereas someone without addiction problems might choose to accept that feeling for a while, or find a less destructive way to change the feeling).
So, to change your addictive habits, you firstly need to understand fully how they work, what you are doing to sustain them. Then you can slowly relearn some healthier ways to deal with life, with your unpleasant feelings.
