Navigating the complex journey out of alcoholism and addiction.
A person in the grip of an alcohol or drug addiction only needs to change one thing to get better — everything.
A simple truth stands behind that sardonic, oft-repeated quip: Just as an addiction wreaks profound and pervasive change in a person, the journey out of dependency — that process known as recovery — requires changes that are equally (if not more) profound and pervasive.
For straight answers about a complex subject, we questioned two clinicians whose combined experience in the field of substance-abuse treatment totals nearly 30 years. They shared keen insights into the arduous journey out of alcoholism and addiction as well as some pitfalls they and their patients have confronted.
Why can’t this person just quit?
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The path to living without chemical crutches is a complex journey that can entail not only physical detoxification but also behavioral intervention, therapy and treatment of mental-health issues and co-occurring disorders, according to Kevin Minor, clinical director at Crestview Recovery in Portland, Oregon.
“There needs to be a plan in place,” he says. “A person cannot just quit addiction due to the same reason someone can not just run a marathon. There are many factors and items that need to be in place to complete and sustain the very complex action of quitting addiction.”
How is addiction a disease?
The American Medical Association defines addiction as a disease. Like other diseases, addiction is progressive, treatable and has a known outcome if left untreated. Additionally, addiction springs from a combination of environmental and biological factors, including genetic predisposition.
In an active addiction, there’s a lot more going on than someone simply choosing to compulsively use substances, according to Minor.
“Addiction impacts parts of the brain that are connected to reward, motivation, learning, judgment and memory,” he says. “It also can cause serious damage to several body systems, as well as creating an unhealthy impact on relationships and other aspects of the individual’s life.”
What is the difference between detox and rehab?
Anyone treating their alcoholism or addiction first goes through three to five days of medically supervised detox, where they can be safely monitored for adverse reactions such as seizures, according to Minor.
Once a patient safely completes detox, they typically move on to a longer-term rehab experience that can last weeks or even months. The typical insurance-paid rehab stay is 21 to 28 days.
What’s life like in rehab?
The rehab stage is an immersive, highly structured experience — think of it as sobriety training.
“People in rehab learn how to practice the real world on a smaller scale, with people that are trained in … managing emotions, personalities and conflict,” says Angela Frye, clinical director at Bayview Recovery in Tacoma. “There is not a lot of downtime in treatment, it is very structured and planned. A person is basically immersed in recovery, 12-step, therapy, and practical stuff like life skills for 10-14 hours a day. Teaching a person a different way to live takes this type of immersion.’’
What are 12-step meetings? What do they have to do with treatment?
Twelve-step programs like Alcoholics Anonymous or Narcotics Anonymous are safe places where alcoholics and addicts share their experiences and build a support system to help them stay sober and accountable to others, says Frye.
The 12-step path helps people address the unmanageability in their lives and open up to a power outside themselves while taking stock of their own moral “inventory” and working to make amends to people they’ve wronged.
Because the 12-step path is among the oldest, most widely adopted and most successful treatments for addiction available, Bayview Recovery considers it an integral part of any 12-step path, when combined with the latest discoveries in medicine and psychology and cutting-edge treatment modalities.
Is AA/NA a religion? Can atheists and agnostics “work a program”?
“The only requirement to be part of the 12-step process is to be honest, willing and open,” says Minor.
“Anyone can work a program that has an interest in changing,” adds Frye. “The ‘spiritual’ emphasis is more about getting humble, asking for help, believing in something, anything, that is bigger than you.”
What is life like after treatment?
Early recovery can be fraught with pitfalls, according to Frye, because once a newly sober person leaves the insular world of rehab, the real world is waiting.
“Families are still broken, financial problems still exist, courts don’t stop wanting what they need, children are growing, and jobs are still just as stressful or finding one is just as hard as it was before,” Frye says. “So a person spends 30, 60, 90 days re-wiring their brain and it can come unraveled really easy because of this.”
Early recovery often entails post-acute withdrawal syndrome or PAWS (lingering cravings, compulsions and withdrawal symptoms) as well as the so-called “pink-cloud” phenomenon (a feeling of eager overconfidence).
“If no one is guiding them through their problems, this is when they are most vulnerable,” she says.
How can families help someone in addiction?
While it is a fact that addicts and alcoholics will continue their compulsions until they actually desire to be free of them, families can help by not enabling the addictive behavior in the first place. Enabling creates an unhealthy relationship called codependency.
Frye calls codependency “addiction’s not-so-talked-about little sister” that shelters the alcoholic or addict from consequences of their actions.
“It is the wife that calls in sick for the husband, the parent that gives their kids money when they know they shouldn’t, it is the daughter that drinks with her dad to be ‘a part of’ because that is the only thing he does,” she says.
The family therapy component at Bayview addresses addiction’s effects on family relationships and helps heal the dynamics of the family.
How should I behave around a person in recovery?
“Despite popular opinion, people with addiction are just people [and] you should behave as you would with anyone you meet. The only thing they can’t do is use,” says Frye. “Be proud of what they have accomplished. Whatever you do, don’t treat them like they are fragile, because they aren’t. If a person has come out of addiction and is living in recovery, they are stronger than you think.”
Bayview Recovery has helped thousands of adult men and women safely navigate their way through addiction and back to sobriety. Bayview Recovery uses the latest treatment modalities and provides care from intake and lifelong aftercare for alumni.