Taking Direction in Rehab

Addicts and alcoholics check into a residential treatment center to get the 24 hour a day care they need in early sobriety. Rehab offers a fresh start, new scenery and like minded people working towards the same goal of recovery. Many alcoholics and addicts go to rehab out of state in hopes to avoid distraction and “start over”. Some check in to ritzy places with world class chefs and masseurs while others check into decidedly more modest treatment centers with cot like beds and multiple roommates. In Los Angeles alone there are a plethora of rehab facilities to check into, but one thing always remains the same: the addict is going to live by a new set of rules.

Treatment centers aren’t designed to punish the addict and alcoholic but rather to instill new ideas and behaviors conducive to recovery. While every rehab offers a different schedule, the addict’s day is usually pretty well mapped out. Some may balk at the seemingly rigid schedule as they’re handed a sheet depicting the weekly itinerary. Most alcoholics and addicts are defiant towards structure and have a hard time playing by anyone’s rules but their own. Selfishness and self centeredness are key characterizations of the addict and its not unusual for them to be used to doing things “their way” even if its at the expense of others.

A lot of the rules and guidelines at a treatment center may seen pointless and stringent. Its not uncommon to see an addict try and talk their way out of doing a chore or attending a meeting. Addicts are full of excuses for why they are above the law. This entitled sense of self is another characteristic that defines addicts and alcoholics. Learning to go with the flow of life and work with other people is an important part of recovery. If an addict were to check into rehab and refuse to get out of bed all day they would be missing the experience. This is a time to change and form new habits. Its not going to be easy for someone that’s used to getting their way all the time, but part of recovery is surrendering to a new way of living. It is of no value to the addict to continue to live life on their terms only.

The staff isn’t out to get you, so arguing is futile. Treatment offers us the opportunity to learn how to coexist with other people in a harmonious way. Addicts like to put up a good fight, especially if their egos are threatened. It is not uncommon to see a patient complaining at a staff member or yelling at their roommate. With emotions seen for the first time in years, early sobriety can make us testy and angry. Mending and building new healthy relationships with others is paramount in recovery.

At first the days of treatment may seem to stretch on forever. The “finish line” may be nowhere in sight—but that isn’t the purpose of treatment. In recovery there is no finish line. Yes, the day will come to check out of rehab, but if its given a fair shot, the process will help develop new tools for living a happy, sober life.

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Letting Go of the Past and Staying in the Present

Letting go of the past won’t happen over-night but it is possible. It is a gradual process that can be achieved through communication and honesty with yourself and others.

Remember there is a difference between letting go of the past and repressing the past memories that haunt us. Repression is highly damaging to oneself as everything bottled up keeps building until one erupts both emotionally and physically. Letting go of the past can be simply processing everything you had done when drinking or using. Uncovering the reasons why you had done them and how you can move on from it and not allow it damage your future.

Staying in the present is essential in recovery. We cannot progress until we leave the past behind us. Being mindful of the future is important but don’t get stuck in the future either. Future ‘tripping’ is almost as harmful and being stuck in the past. As AA says; ‘one day at a time.’ Of course it is important to make plans for the immediate future and big changes to keep us occupied each day. We shouldn’t completely ignore the future. However when our concern for the future creates unreasonable levels of anxiety and catastrophe takes place this is when it can become harmful to recovery. Assuming the worst is not uncommon but it can eventually control you and divert your attention away from sobriety and sometimes lead to a relapse.

The best method of all is just to stay concerned with each day as it comes, be aware of feeling in the present as that is what is important. True it is important if you were feeling sad yesterday, but if you are feeling different today then that is the new reality of much more significance. Instead of looking to future and worrying about what’s ahead keep present and tackle issues as they come day to day.

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Welfare Applicants Required to Drug Test to Receive Benefits

As of May 31st 2011 a new law was passed in Florida requiring all those applying for welfare benefits to pass a drug test in order to receive these benefits. Rick Scott, the governor of Florida, and others strongly promote this new law despite controversy from others, most prominent of who are the American Civil Liberties Union. Rick Scott promotes this bill as it gives peace of mind to taxpayers who are currently paying up to 30% of their incomes. Tax payers should be able to pay this in knowledge that they are not simply paying for those unemployed to fuel drug usage. Rick Scott is hoping that in the long-run this new law will give both peace and mind to tax payers while also creating savings from all those who fail the test and don’t receive benefits.

The law works by drug testing all those applying for welfare benefits. If the applicant tests negative then the state pays for the test. If however the applicant tests positive then they may not apply again for a year unless they can prove they have attended a self-paid treatment center. Then they may re-apply after 6 months. If an applicant fails a drug test for the second time they are made ineligible to apply for welfare benefits for three years.

The American Civil Liberties Union strongly opposes the new law; it claims that the bill is a violation of the recipient’s constitutional rights against unreasonable search and seizure. On June 1st the ACLU sued to stop the implementation of this new law which now also requires all applicants for state jobs to be tested for drugs and all existing employees can be randomly tested. Applying for welfare benefits is optional and so there can be no debate as to the violation of recipient’s rights as the application itself is not mandatory. Alongside this all employers are allowed to drug test their employees at random so how is this any different?

The new law only affects actual money benefits not food stamps so those who fail the test are not completely cut off by the state. The Bill also has a ‘protective payee’ system aimed to help children with drug-abusing parents. This happens when an adult supporting children fails to pass the drug test. In this instance then another adult can be drug tested, usually another family member, and if test negative can obtain the money for the welfare of the child.
There are some concerns about the potential financial consequences of this new law. 13 years ago Florida ran a pilot drug testing project targeted at poor residents on temporary cash benefits from the state. Less than 4% of the 8,800 applicants tested positive for drugs. All in all, this venture cost the state and tax payers almost $2.7 million.

According to the Department of Children and Families report since July 1st when this law was implemented only 2.5% of the welfare applicants have tested positive and failed the test. In contrast to this it is estimated that 8.9% of the general population illegally use drugs according to the 2010 National Survey on Drug Use and Health. With drug testing companies charging $10 to $25 per drug test, making them the biggest beneficiaries of this law, it is estimated that this new law could create $515,000 to $1.27 million costs to tax payers annually.

Oklahoma in fact had proposed a similar bill to that of the one Florida has now passed. Oklahoma however withdrew the bill as it was believed it would end up costing more money that it would save.

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Seeking Addiction Treatment Out of State

Some alcoholics and addicts may want to explore the option of seeking treatment out of state. There are many plus sides to checking into a rehab facility away from home. Although the distance can be hard for some parents, some believe that the addict will have less of a chance to leave rehab if they are out of state. The possibility of meeting up with old friends while going to treatment in a familiar city can pose a threat to those in early recovery.

The alcoholic or addict may also find relief knowing they are going to a place far from home. They may feel like they are getting a fresh start. This can help avoid any distractions a facility close to home may offer. An alcoholic or addict may find that a certain facility out of state is more tailored to their needs.

Depending on the client’s experience at their treatment center, they may find the network of sober people in the area reason enough to stay after treatment. Many alcoholics start a new life over out of state because of the positive experience they had while in rehab. They make new friends and find new purpose in life. Regardless of whether or not you decide to seek treatment close to home or many miles away, the most important thing is to attend the facility that will provide you with the maximum amount of recovery.

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People, Places, Things- How Much do We Have to Change?

Being sober doesn’t mean that we have to abandon every relationship we have, nor does it mean we have to change all the things we like to do. It may be helpful to take a look at some of the people in our lives, the places we hang out and the activities were participating in. This doesn’t mean that we become shut ins. Recovery opens up a new world of possibilities and allows us to get back into life.

If we’re honest with ourselves and serious about staying sober, we will be able to see the areas of our life which need changing. You may be going to the bar with some old friends, and while you’re not drinking, what are your motives? Do you have a justifiable reason to be there or are you just trying to catch some of that euphoria from our drinking days. Many of us do go out dancing at bars and clubs in sobriety, but if you’re there every night that may be something worth taking a look at.

We don’t have to get rid of all the people in our life up until our sobriety, however, it’s probably not a good idea to hang out with someone who is a drug dealer. We have to ask ourselves if this is the type of person we want to be spending time with today? Is my sobriety at risk? In trying to form new habits and behaviors and there are often acquaintances from our past that may stifle our recovery.

The “things” category can seem a little vague. This can be characterized by a wide variety of behaviors, often relating to unhealthy or harmful habits from our drinking and using days. For example, stealing would classify as being dishonest, and honesty is a basic principle to live a sober life by. It would be incongruent with our recovery if we still participated with criminal activity.

Some of us have perfectly loving people in our lives and never had a criminal past. The major changes ultimately for all of us must come from within. Participating in recovery means accepting change and practicing a new way of life. It is wise to get a network of sober friends. There is a lot to learn from the people that have come before us if we’re willing to listen to it. There may be new activities you find yourself enjoying in sobriety, or old ones you have neglected due to drinking and using. In recovery, we are able to see the things that aren’t working for us anymore. Some behaviors take more time to change, but we can’t beat ourselves up. The best we can do is maintain honesty and willingness to go to any lengths to protect our sobriety.

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Rebuilding Relationships in Sobriety

Recovering alcoholics and addicts are not going to change over night, therefore relationships that have been strained over the years are not going to be healed or mended right away. Sometimes when we get sober we wish to make right all we have done wrong immediately. We wish that on the basis of our sobriety alone, our friends and family will trust and respect us. This is not reality. Mending relationships can take time effort on our behalf.

Being physically sober is just the beginning of our recovery journey. We have done damage to ourselves and to others. With the help of a sponsor or a therapist we are able to see clearly the ways we have affected the lives of others through selfishness and destruction. Sometimes we have no idea that we have wronged a person until we get completely honest with ourselves.

Family and Friends aren’t always on the one-day-at-a-time program and may not be impressed that you have simply stayed sober. Often they want results of healthy behavior and restitution for the harm we have caused over the years. It’s too much for us to expect to regain trust of our family and friends after a short period of time. Good relationships don’t happen overnight for us, this is something we have to nurture on a daily basis.

How can we expect ourselves to know how to have good relationships if we’ve been leaving a trail of wreckage in people’s lives for years? Recovery is like being reborn and given a new set of tools for living. Of course we’re not going to know what a healthy relationship looks like if we’ve never had one. This is where we trust the experience shared by our friends in recovery to help guide us into better living. With a clear view of ourselves and our behaviors, we can take new approaches to the way we treat people. For some, it may mean consistently calling their relative once a week. For others maybe it means showing up for a friend in a time of need. Sometimes it’s as simple as offering to pick someone up from the airport without expecting anything in return. Our friends and family like consistency. We want to become dependable people.

Don’t be upset if your friend or family member is wary about getting close to you. Our drinking and drugging has caused people a lot of pain and it’s not realistic to think that everyone will be so forgiving. Recovery takes daily effort and relationships need time to heal and grow. Listen to people that have relationships you admire. What are they doing differently?

Because alcoholism is a family disease, our friends and families may chose to go to Al-Anon or other family support groups to help build better skills for themselves. Often alcoholics themselves have found these support groups helpful in recovery as many of us deal with Al-Anon or codependency issues.

While we can’t expect all of our old relationships to be healed in recovery, if we work hard we can build new and healthy relationships.

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Prescription Medication in Sobriety

Life still goes on in recovery and sometimes that means having to endure surgery or hospital stints. The doctor just prescribed narcotic painkillers—now what? Being alcoholics and having learned about our disease, we have found that we can’t safely use alcohol or drugs in any form. One Vicodin may spur what’s known as the physical allergy inside us Alcoholics. But what if we’re badly injured and require pain medication? For us, waking up the beast seems inevitable upon taking Vicodin or other opiates. This is where honesty is key in maintaining sobriety.

Some of us really do require pain medication. If we our honest with ourselves, our doctor and someone close to us such as a sponsor, we are more likely to stay sober. When talking to a doctor it is helpful to inform them of your alcoholism and drug addiction to help protect you physical sobriety and practice rigorous honesty.The doctor will do their best to prescribe you with only what you really need. Some have found it helpful to give their medication to a trusted friend or sponsor to administer to them as directed to prevent slips while under the influence of a narcotic. Sometimes your doctor may prescribe a non-narcotic pain med for you to try first. There have been countless stories of people with long term sobriety relapsing on narcotic pain pills because they failed to be honest.

It is ultimately up to each individual to determine their own sobriety. Staying honest helps us to check our motives when deciding if we really need pain pills or if we are trying to catch a “freelapse” from the buzz. Some find themselves wanting to continue taking their prescription even when the pain subsides. If you are having trouble being honest with yourself, call someone first before making any decisions. We will sometimes come across busybodies that wish to enforce strong opinions on outside issues and medication as it relates to sobritety, but at the end of the day these matters are between you, your doctor and your higher power.

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Sponsorship in 12 Step Programs

The primary purpose of AA is for one alcoholic to help another practice the 12 steps of recovery. These 12 steps cannot be done alone and a sponsor’s responsibility is to guide a fellow alcoholic through them. Helping another alcoholic also benefits the sponsors recovery, a primary example of this is when Bill W. reached out to Dr. Bob which resulted in the formation of Alcoholics Anonymous. Bill W.’s urge to drink diminished as he assisted Dr. Bob, who then went on to help other alcoholics. This demonstrates a key principle of AA which is that in order for one alcoholic to keep his sobriety, he or she must give it away.

A sponsor is typically further along in their recovery program than the sponsee and usually has worked all 12 steps. The 12th step is for one alcoholic to help another and being a sponsor is one way to practice this step. Sponsors should prepare sponsees to eventually take up this responsibility and privilege.

AA meetings are great places to ask questions and gain support, however, this is not enough for the newcomer. Newcomers need constant support; they need someone they can confide in confidentially and comfortably. A sponsor fills that role. The sponsor will also help the newcomer meet other alcoholics.
Choosing a sponsor can be a daunting task for some. They are afraid to “bother” someone or simply have hesitancy to reach out for help. This can be a test of willingness. Those who are truly willing to do whatever it takes to stay sober will ask for a sponsor and begin to work the steps.

It is a general rule that men should sponsor men and women should sponsor women. This assures the singleness of purpose in AA, to help another alcoholic. Many find that having a sponsor with similar background is a useful strategy, however, others find sponsors that are very different from them to be equally helpful.

The newcomer doesn’t have to agree with everything a sponsor says. If a sponsors recommendations or advice sound strange, the newcomer should ask questions and discuss it with them. There should be an open line of communication where both the sponsor and sponsee may speak freely.
It is not solely the sponsor who maintains the recovery of his or her sponsee, it is the whole of the AA program which ensures this. If a sponsor is unavailable to speak with his or her sponsee, there are other outlets such as meetings, calling another alcoholic, calling an AA office, and reading AA books or pamphlets.

A newcomer should not have more than one sponsor, however, changing sponsors is perfectly acceptable. The newcomer should feel comfortable with their sponsor and have belief that they will further them in the progress of recovery. If these needs are not met, changing sponsors is a viable option.
Although it is recommended to attain a sponsor very early on in recovery, usually within the first thirty days, it is never too late for this step. AA is not just a program designed to cease drinking, it is a life changing experience. If one has much time without alcohol but is still feeling restless, irritable, or discontent, a sponsor may assist them in finding true recovery.

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Getting Back into Life: Is Sobriety a Full-Time Job?

The first year sobriety is a full time job, however, it is important to reintegrate back into the work place and other activities. For the first year, sobriety is draining. Most people attend a treatment program and then some kind of sober living or extended care plan. This process alone can take up to a year. Although, treatment is a time to relax and focus just on your sobriety, once you leave a treatment center and enter a sober living it is important to keep busy. Many people for the first couple months after they leave treatment will attend an outpatient program. During this time it is nearly impossible to get a job, but it might interest the individual to start looking for one. Yes, most likely after outpatient while in sober living it will be recommended to go to an AA meeting every day. However, one meeting a day leaves your schedule pretty open, and most places will recommend keeping as busy as possible.

During the first year of sobriety, recovery should be the primary focus, but little by little addicts should begin other activities that interest them. Directly after outpatient it might seem overwhelming to get a job. So take things slowly. Look for one and don’t commit to anything right away. Go to a meeting every day, call your sponsor every day, and use the support system and after care program around you for support in figuring out what to do. A great thing to do during this period is to begin working the steps with your sponsor, and take at least two commitments at meetings you like. Establish a home group and explore AA meetings, NA meetings, and whatever else interests you. Another great way to prepare yourself for reintegration later is to start doing things you love again. For instance, if you love to paint start painting again. If you want to take a dance class do that. Keep busy and do what you love.

After you feel your support system is strong and you are rooted in sobriety it is important to recommit to your normal activities such as work. Work can be a great place to quiet your alcoholic mind, practice living amends, and fellowship with coworkers. The principals of AA say to practice them in all of our affairs; work is a great place to start. Work adds structure to your day, and is a good place to get out of your head. Because many addicts are highly intelligent it is important to engage the mind intellectually and challenge yourself. Boredom is very dangerous in early sobriety. It is also important to find a balance in your life between recovery and other activities. Going back to work gives you a break from recovery, which can be emotionally draining.

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Seeking Treatment for Eating Disorders

Eating disorder is one of the most prevalent chronic illnesses among adolescence and young adults. Eating disorders have the highest mortality rate of any chronic illness and are also the hardest to treat. Eating disorders are difficult to treat because, unlike drugs and alcohol, you need food to live. As a result, very few people receive treatment for eating disorders, and their recent popularity has made disordered eating seem normal. However, there is help and support. Most treatment centers will isolate the multitude of problems an individual struggles with. Very commonly with addiction there is some kind of disordered eating as well. It is important to isolate the individual issues and determine how they interact with one another.

The two main types of eating disorders are Bulimia Nervosa and Anorexia Nervosa. Bulimia is categorized by periods of binging and purging, while anorexia is categorized by periods of restricting. Both of these are equally dangerous and if left untreated can cause death. On this continuum there are many other kinds of behavior that are considered disordered eating. The DSM-4 paints a black and white picture of eating disorders, which diagnostically excludes many individuals who struggle with this issue. For instance, one of the criteria for diagnosis for Anorexia Nervosa is an interruption in the menstrual cycle; this excludes males from the diagnosis. Due to the strict criteria for diagnosis set forth by the DSM many individuals who do not fall into the black and white categories are left without answers. It is hard to determine what is an eating disorder and what is disordered eating with the potential for eating disorder. Many studies show that 85%, the vast majority, of young adults and adolescences engage in unhealthy weight control behavior. The main obstacle to eating disorder treatment is a lack of knowledge.

Treatment centers will ask a series of questions to determine if the patient meets criteria for an eating disorder or disordered eating. Professionals are aware of the prevalence of eating disorders, and will most likely be able to offer support and treatment for this issue. Since eating disorders are especially prevalent among people who have depression, they are also more common among people who struggle with addiction. It is important to determine the interaction of a persons many diagnosis. Treatment will focus on determining if addiction is the problem or the solution. This can be confusing since addiction is obviously a problem if an individual enters treatment. However, the reason most people begin doing drugs or drinking alcohol in excess, is to solve some underlying psychiatric problem, such as depression. It is difficult to determine if addiction causes the eating disorder or if it was used as a mechanism to help perpetuate the eating disorder. For example many people use stimulant drugs to lose weight, however, a side effect of stimulant drug use is anorexia. So, it is difficult to determine which came first, the drug use, other psychiatric problems, or the eating disorder.

Eating disorders are very hard to treat, however, there are options. Eating disorder treatment starts with exposing the behavior and talking about it. Eating disorders, like addiction, thrive in secrecy. It is important for people sharing these issues to come together and heal as a tribe. People need the support of others who understand what they are going through. Even with comrodery to overcome disordered eating, individuals usually need talk therapy, education, and even medication to fully recover.

The use of medication to treat eating disorders is a fairly new concept. Some medications have proven effective in treatment, however, most of these studies are in their infancy. One drug that some studies have proven effective is Prozac. With high enough doses, somewhere around 80mg, Prozac has shown success in stopping the urge to purge in Bulimics. Similarly, some anti-nausea medications, like Zofran, have displayed results in stopping the urge to purge. Again, the use of these medications in treating eating disorders is new, and it is unclear if there is simple correlation or causation. It is hard to determine if the medication directly impacts the eating disorder or if it s a secondary effect from, for example, treated depression.

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