Meth is not a myth

Methamphetamine, or "meth," as it commonly is called, is a highly addictive brain stimulant. Nationwide, over the past five years we've witnessed a dramatic increase in addictions to this deadly, illegal drug.

Because methamphetamine easily is produced in rural clandestine laboratories using extracted ephedrine and other easily-obtained chemicals, there has been a significant rise in its manufacture in this geographic area. In response, local pharmacies are eliminating easy access to all over-the-counter medications that contain pseudoephedrine.

Methamphetamine is versatile. It can be produced as a powder, paste or crystal, and may be injected, snorted, smoked or taken orally. Meth produces a terrific "high" that is extremely addictive. The drug eventually causes dramatic health and social consequences for the user.

National statistics raise serious concerns, and many feel we are experiencing an epidemic. Last year, more than 9,000 labs were reported in rural areas, and in 2004, more than 12 million people reported they had used meth at least once, a 25-percent increase since 1996.

Not only is the use of methamphetamine itself dangerous, but its production poses great risks to neighborhood children. Young people living in areas of meth production often are exposed to the drug and its toxic byproducts. Sadly, more than 80 percent of children in meth-producing homes tested positive for the drug.

Methamphetamine causes serious mental aberrations, including confusion, hallucinations, memory loss, insomnia, violent behavior, paranoia, panic reactions, depression and psychosis. Users also experience significant physical deterioration, such as skin lesions, burned lips and intractable sinus infections. These visible reminders, however, do not reveal the hidden effects: damage to virtually every organ in the body.

Treatment for the methamphetamine addict poses unique problems because of the impact on brain chemistry from long-term use. Once meth has been withdrawn from the addicted individual, he or she experiences intense cravings while the brain struggles for months to return to normal functioning. This means the addict will experience an extended period of not feeling well, and will suffer from depression and anxiety. Recovery often is slow, so treatment for methamphetamine addicts must be intense and prolonged. And that is expensive.

Methamphetamine addiction is creating serious challenges for the community. Child protective service agencies are struggling with the increase in child neglect; emergency rooms are laboring with the multiple health problems associated with addiction; and law enforcement agencies are overwhelmed by meth production and the violence resulting from its use.

But as with any drug addiction, there is hope for recovery and a return to sanity. The solution always begins with our willingness to acknowledge the problem and rally community resources.

For additional information, please contact Ed Hughes at The Counseling Center Inc., 1634 11th Street, Portsmouth, Ohio 45662, or e-mail ehughes@thecounselingcenter.org. I welcome your comments here too.

Beating eating addiction

March's article discussed the general nature of food addiction. Some people experience problems with food as much as an alcoholic does with alcohol.

We know a large percentage of overweight people do not respond well to traditional diets because these plans focus on food restrictions. Yet, the food addict finds it impossible to reduce the amounts of certain foods because they result in intense cravings. So, food addiction is a progressive, physiological condition characterized by the inability to control the consumption of certain foods; the persistent craving for those foods eventually leads to physical, emotional and social crises.

Here is a list of the most common signs and symptoms of food addiction:

• secret eating
• rapid eating
• using food to alter mood
• purging and fasting
• excessive exercising
• growing concern over weight
• disappointment over many failed attempts to diet
• preoccupation with food
• emotional problems and mood swings
• neglecting proper nutrition to pursue certain addictive foods
• feeling defeated and powerless
• negative feelings toward oneself

The substances that usually fall into the category of addictive foods include refined sugar, flour and other refined carbohydrates. Food addicts report an obsession with foods that contain sugar. On ingredient lists, these may appear as corn syrup, dextrose, honey or molasses. Flour in any form poses a problem for the food addict, as do other refined carbohydrates such as white rice, corn and potato chips.

This explains the obsession with pizza, ice cream, candy bread, cake, pie and essentially any food that contains sugar, flour and high fat. Food addicts will never be able to control their intake of these foods. The only solution is abstinence.

Caffeine and nicotine also are problematic for food addicts. These drugs further destabilize their blood sugar level, which in turn intensifies cravings. Alcoholic beverages similarly are detrimental because of their alcohol and sugar content.

So, if you're a food addict, what can you eat?

You'll need to focus on quality carbohydrates such as fruits (which contain natural sugar that can be eaten in moderation), vegetables and lean meats. Substitute brown rice for white rice and use oatmeal as a primary source of grain.

Because food has been a focal point for years, your biggest challenge involves a change in lifestyle. Attaining abstinence will bring on a period of discomfort, much like the drug addict experiencing withdrawal. Your body will react to the absence of the addictive foods; there will be cravings, sleeplessness, irritability and anxiety for several days.

But one thing you don't need to experience is hunger. You should eat whenever you are hungry, avoiding big meals in favor of frequent smaller meals. And finally you will be pleasantly surprised. The craving for addictive foods will end and you will discover the difference between hunger and craving.

To learn more about food addiction, I recommend you read Food addiction: The Body Knows, by Kaye Sheppard. This is an excellent source for beginning your recovery from food addiction.

Fighting Addictions to Food

Millions of people suffer from the symptoms and consequences of America's most common, undiagnosed and untreated obsession -- food addiction. In response, innumerable supposed "cures" in the form of diets, weight-loss programs and pills have made their way to the marketplace. The history of food addiction treatment is similar to the sad history of drug addiction treatment: confusing and questionable theories backed by money-making scams that have been perpetrated upon vulnerable, suffering people.

A Mixed-up Message

The next time you pass through the checkout lane at the grocery, take notice of the magazine covers. Each highlights a diet promise such as, "Lose 10 Pounds in 10 Days," "Get Ready for the Beach with the Grapefruit Diet" or "Lose that Tummy with our Movie Star Diet." And on the same cover, you'll find a picture of the biggest double-chocolate layer cake you've ever seen. The conflicted message here is the same consumer who wants to lose 50 pounds also wants to eat that cake.

The World of Diets

In all fairness, some overweight people who adopt one of the hundreds of diets promoted by magazines, books, physicians, dietitians and the media will be successful, at least in the short term. But there are many more who have tried many of these diets and yet continue to struggle with their weight. Are these people weak-willed or emotionally unstable? No, they suffer from food addiction.

Food addiction is the result of an abnormal metabolism of certain foods, which produces a mood elevation that, in turn, creates a craving for more of those same foods. So, just like drugs, certain foods in certain people produce a "high" that is then repeatedly pursued. The problem with most popular "diets" is that they include these addictive foods, which assures the continuance of craving and the ultimate failure of the diet.

Unfortunately, but understandably, most people blame this failure on a lack of commitment, poor will power or emotional instability, without realizing that the effort was ill-fated from the start. In the same way, the drug addict's plan for quitting cocaine by using marijuana instead, and the alcoholic's plan to give up whiskey by drinking "just beer," are doomed from the beginning.

Research has revealed the cause of food addiction resides not within one's personality, but within the brain. For some people, refined carbohydrates such as sugar and flour cause an abnormal rise in certain "feel good" brain chemicals, and dopamine appears to be a primary culprit in this process While everyone experiences the benefits of dopamine in various ways, certain people produce an abnormal amount of this chemical after eating certain foods.

This explains why some people can comfortable eat just one piece of pie, while others experience the phenomenon of chemically-driven cravings. The cravings them compel them to eat even more of those mood-altering foods. However, When that rise in dopamine comes back down, the person is left with feelings of fatigue, anxiety, depression, restlessness and, yes, cravings. The natural response, then, is to eat more of those addictive foods to relieve those uncomfortable withdrawal symptoms. And so the vicious cycle continues.

In the next installment, I will discuss the diagnosis and treatment of food addiction.

What Does Recovery Mean?

In the addiction counseling world, "recovery" is the word most often associated with successful treatment. But we also hear that someone has "recovered" from alcoholism or that someone has just entered a "recovery program" for drug addiction. Those "in recovery" often refer to themselves as "recovering" from their addiction. So what do these variations on the word "recovery" really mean?

In Alcoholics Anonymous (published in 1939 and known as "The Big Book"), the word "recovered" refers to an AA promise: If a person applies the principles of the program, the desire to drink will be removed -- and will remain removed -- if the person continues to participate in the recommended program of recovery.

So in Alcoholics Anonymous, the term "recovered" has significance beyond simple abstinence. Its extended meaning relates to the essential psycho/social/spiritual changes that must occur in the life of the recovering person. AA stresses that abstinence alone is "but a beginning." The alcoholic must be willing to fortify his recovery by taking responsibility for past mistakes, repairing relationships, developing a commitment to spiritual principles and helping others.

While the continued maintenance of sobriety is best served through attendance and commitment to AA or NA (Narcotics Anonymous) meetings, treatment programs play a vital role in the early stages of recovery.

These programs should offer access to detoxification services for those needing assistance with the symptoms of withdrawal. Because many drug addictions pose health hazards during withdrawal, the professional addiction counselor must first assess these risks. Physical withdrawal from cocaine, for example, is terribly uncomfortable because of cravings, but it is generally not dangerous. However, withdrawal from alcohol or benzodiazepines (Valium, Xanax and Ativan) can be life-threatening and must be closely monitored. Opiate (heroin and Oxycontin) withdrawal is physically less dangerous, but painful symptoms make it nearly impossible to successfully withdraw without medical intervention.

But detoxification alone only readies the individual for the next step in the healing process: treatment. While many addicted people and their families believe that a few days in a detox center will cure them, without continued treatment the vast majority will quickly relapse.

So, following detox, a counselor must determine the level of treatment needed. Choices include intensive outpatient (three to five days a week), short-term residential treatment (30 to 60 days), or long-term residential treatment (more than 60 days). The decision is based on the individual's duration of addiction, drug type, physical status, home environment, family support system, and access to other necessary resources, such as AA or NA meetings. Once the level of care has been determined, an individualized treatment plan is instituted, which outlines the course of treatment and expectations of both the treating facility and the client.

A final segment of treatment provides an aftercare program that allows the client to continue receiving services as long as necessary to ensure continued sobriety. Addiction is a devastating disease, and while the physical body may heal quickly, the healing of relationships takes much longer. On-going counseling and attendance at AA or NA meetings offer the newly recovering person the best opportunity for continued success.

The aftercare plan also should outline what actions will be taken in case of relapse. Relapse is a reality with any addiction, and relapse prevention services are particularly beneficial to recovering addicts as they work toward reintegration into their families, jobs and community. Family members and other concerned persons also should develop a relapse plan. Handled appropriately, relapse actually can propel an addicted individual into stronger commitment toward recovery.

The recovery model developed by Alcoholics Anonymous is alive and active today. Effective professional treatment programs strongly recommend active participation in Alcoholics Anonymous, Narcotics Anonymous, and related family groups of Al-Anon and Alateen.

The concept of recovery as expressed in the program of Alcoholics Anonymous offers the hope -- and promise -- that if a person follows the directions outlined in the program, his problem with alcoholism (or any drug addiction) will be "removed." To be sober and free of the desire to use alcohol or drugs is the great promise of recovery.

Addictions are diseases

Although addiction has been recognized as a disease for several decades now, much of the general public still views it as a problem of moral weakness. Even those who are more "enlightened" continue to struggle with identifying addiction as a primary, progressive disease that significantly impairs a person's ability to quit using alcohol or drugs and remain abstinent.

If we were to accept that addiction is a disease:

• We would provide treatment for the lifetime of the addict because addiction is a chronic disease and has no cure. A diabetic, for example, does not suddenly cease needing to see his doctor or receive medication.
• Health insurance coverage for addiction would be the same as for other diseases. Yet today most insurers provide no addiction treatment coverage. How would we react if our insurance company balked at paying for insulin or chemotherapy?
• We would know that relapse is often a part of the disease and recovery process. We don't deny patients continued treatment if their cancer recurs, nor do we put a time limit on the treatment of diabetes.
• We would not make alcoholics or addicts the butt of jokes. Heard any good jokes about cancer patients lately?
• There would be no shame associated with addiction. Families would not view addiction as an embarrassing secret.
• Recovering alcoholics and addicts would not be fearful of disclosing their disease. Currently, recovering people experience discrimination in employment, housing, adoption, medical insurance eligibility and many other areas.
• We would not send addicts to jail or prison solely because of their disease. Many are incarcerated not because they have committed a new crime, but because they have been unable to stay clean and sober, of which the vast majority have received little or no treatment.

Recognizing and treating addiction as a disease allows sufferers to obtain help much earlier in the diseases progression. Imagine what could be accomplished if we could totally rid addiction of its remaining stigmas. But that would be a perfect world.

Families can help addicts

Because alcoholism and drug addiction are family diseases, everyone in the family is affected. Unfortunately, while well-intentioned family members go to great lengths to try to help their addicted loved one, much of that help is misguided. Efforts are often directed toward getting the addicted person out of trouble rather than addressing the drug problem itself. Here are 10 things that family members can do (or avoid) to provide the type of assistance that will increase the likelihood that their loved one will obtain help.

1. Do learn the facts about alcoholism and drug addiction. Addiction is mystifying and baffling and the addicted individual is a source of confusion and manipulation. Families must find out what they are dealing with.
2. Don't rescue the addicted person. Consequences are what lead a person to seek help. When family members remove the consequences, they remove the motivation to get help.
3. Don't support the addicted person financially. Addiction is expensive and, in the end, most of the cost is burdened by the family. In one way or another, money given to the addicted person goes for the purchase of alcohol or drugs. Paying for the person's rent, utility bills and legal fees is enabling and supports continued drug use.
4. Don't analyze the person's drinking or drug use. Neither the family nor any other situation caused the person to become addicted in the first place. So, because no one is at fault, no one is to blame. Remember: addiction is a disease.
5. Don't make idle threats. Families must say what they mean and mean what they say. Addicted people do not respond to threats; they have a history of being rescued by the family and therefore do not believe that the family will follow through on threats.
6. Don't extract promises. There is a strong tendency for family members to elicit promises from the addicted person while they are rescuing. Addicts are unable to keep promises. They may sincerely wish to, but their disease prevents them from following through.
7. Don't preach, lecture or try to reason. No one can talk an addict into recovery or make him feel guilty enough to seek recovery. These tactics just don't work. Remember that only consequences are powerful enough to break the hold the disease has on the person.
8. Do avoid reactions of anger and pity. However angry a family member gets over the addict's behavior, there will follow a corresponding feeling of pity. Also, anger is easily endured and manipulated by the addict's disease.
9. Don't accommodate the disease. Addiction is a subtle foe. It will gradually infiltrate a family's home, lifestyle and attitudes in ways that often go unnoticed. Examples of accommodation include locking up valuables, not inviting guests for fear that the addicted person might cause embarrassment, adjusting one's work schedule to be home with addict, and not taking a vacation for fear of not being available for the addict.
10. Do focus upon your own life and responsibilities. Families must identify areas of their lives that have been neglected because of their focus on the addiction. It is important to reclaim one's life or the disease will hold the family hostage as well.

There is much reason for hope for those addicted to alcohol or other drugs, but it is important for families to deal effectively with their loved one. I encourage families to attend my Loved Ones Group as a way of obtaining some basic information and guidance. The group meets each Wednesday from 6 until 7 p.m. at The Counseling Center, Inc., 1634 Eleventh Street, Portsmouth. You can also call me at The Counseling Center at (740) 354-6685.

Dealing with alcoholics

It is a rare person who has not agonized over someone else's drinking. Whether it involves a friend, family member or co-worker, there exists a great deal of confusion regarding what a person can or should do to help.

The first barrier is the stigma associated with alcoholism and other drug addictions. We are hesitant to approach problem drinkers because we don't want to embarrass or shame them. Yet we don't feel that way about other diseases. Perhaps we have heard that "only the alcoholic can decide if he has a drinking problem" This is nonsense; quite the opposite is true. Because alcoholism is a disease that tells the afflicted person that he or she doesn't have it, the alcoholic is often the last person to recognize his or her own problem. And that, as in any addiction, is the nature of denial.

So, we should not hesitate to discuss our concerns with someone who appears to have an alcohol problem. At the same time, understand that the alcoholic, when initially confronted, will likely dismiss your concerns and become angry. But don't let this deter you. Share your thoughts honestly and lovingly.

Choosing to talk about our concerns is a great step, but we must go further. We need to become fully aware of the basic facts about alcoholism and other drug addictions. Free educational brochures offered at The Counseling Center provide a good start, and among them is a self-test that can assist someone in seriously considering his or her drinking as a problem. Specifically, answering "yes" to two or more of the following questions is indicative of a problem with alcohol.

1. Can you handle more alcohol now than when you first started drinking?
2. Have you ever been unable to remember part of the previous evening's events?
3. When drinking with other people, do you ever try to have a few extra drinks that they don't know about?
4. Do you sometimes feel uncomfortable if alcohol is not available?
5. Are you in more of a hurry to get your first drink of the day than you once were?
6. Do you sometimes feel guilty about your drinking?
7. Has a family member or close friend ever expressed concerns about your drinking?
8. When you are sober, do you sometimes regret the things you did or said while drinking?
9. Have you sometimes failed to keep promises you made to yourself about cutting down on your drinking?
10. Have you ever had a DUI or other legal problem related to your drinking?

I remember hearing a recovering alcoholic tell his story.

"A good friend," he said, "told me one day that he thought my problems were caused by my drinking. I told him he was crazy. I got mad and I didn't speak to him for several days. But you know, I never forgot what he said. I know his words eventually helped me to get sober. In fact, his words haunted me."

Just as important as what words are spoken is how they are spoken. Words spoken in anger or with a judgmental attitude are never helpful. We must always remember that we are dealing with a sick person who needs to get well, not a bad person who needs to be good. Our message must be loving. Our message must bring hope and recovery.

For more information, visit the main office of The Counseling Center and select any of our free brochures. You also may email your questions or comments to ehughes@thecounselingcenter.org.

The art and science of addiction counseling

What is addiction counseling? First let's look at what it is not. It is not classical or contemporary mental health counseling. Because an ever-growing number of professionals have moved from the mental health field to addiction treatment over the past twenty years, much confusion surrounds this issue.

What was the basis for this movement? Addiction treatment, as drafted and provided by a fledgling group of recovering alcoholics, addicts and enlightened mental health professionals, WORKED! It was successful. Or, in the current vernacular, it produced positive outcomes. And what fueled these early professionals and para-professionals? It was the disease model of addiction; abstinence-based treatment; collaboration with and referral to Alcoholics Anonymous, Al-Anon and Narcotics Anonymous; and courage. Upon the shoulders of these historic workers, the current treatment system was built and expanded. They had the courage to develop a treatment approach that was not based upon mental health strategies or theories. They possessed the strength to stand up to psychiatrists, psychologists, and other highly-degreed mental health professionals who attempted to abort or divert the recovery movement. They said "no" to aversion therapies. They said "no" to controlled drinking approaches. And they said "no" to the Valium and Librium treatment models. Thus they resisted efforts that attempted to integrate addiction treatment into mental health treatment models.

Regarding the nature of addiction, there is a basic disparity between the fields of mental health and addiction treatment. James Milam, Ph.D., author of Under the Influence, outlines this disagreement in his position paper entitled "The Alcoholism Revolution," In this paper Milam states that the psychogenic model, as followed by most in the field of mental health, sees addiction as "a symptom or consequence of an underlying character problem, a destructive response to psychological and social problems, a learned behavior," In contrast, the biogenic model "recognizes that alcoholism is a primary addictive response to alcohol in a biologically susceptible drinker, regardless of character and personality."

My own professional career is an example of the difference between the treatment of addiction and the treatment of mental illness. My master's degree is in Public Service Counseling, which is similar to most of the master's programs in counseling or social work; it offers training in the provision of counseling services. I studied counseling theories and techniques and followed that with internships and work experiences that yielded additional training in working with clients. My first employment was in a family life counseling center, which focused primarily on services for the development of parenting skills. I next worked for a community mental health center with a primary focus on services to the severely mentally disabled. Later I worked more as a generalist, treating outpatients who presented with a variety of problems, such as marital difficulties, depression, and anxiety disorders.

In each of these work settings there were alcoholics, drug addicts, and family members impacted by addiction. However, they were rarely treated for their addictions. We instead tended either to ignore the addiction problem or tried to treat the addiction by approaching the symptoms of the addiction. Then, in 1981, I was introduced to the work of Milam and others, who were focusing on the disease model of addiction. I was attracted to both the research and the utility of this model and eventually devoted myself to providing treatment solely to alcoholics, addicts and their family members. I soon discovered that many, or perhaps most, of the skills I had developed in the field of mental health were not only ineffective in treating addiction but were, in fact, harmful.

Although the addicted person often presents with symptoms of mental illness, attempts to treat these symptoms as part of the initial treatment of addiction are distracting, ineffective, and potentially harmful. Any treatment that does not focus on the acute health and social issues associated with drinking and drug use is detrimental since the consequences of continued drinking and drug use are serious and potentially fatal.

I often use the example of the emergency room. If you had a loved one admitted to the emergency room with a severed artery following an accident, and you found the treatment provider asking questions about the patient's marital life, problems with depression, conflicts with parents, etc., you would probably become very upset. Although these problems may be real and even serious, shouldn't someone be doing something about the bleeding?

Alcoholic and drug-addicted clients need help first to stop drinking and using drugs. The process of stopping, however, does not mean not drinking or using for a few days. Instead, it means an extended period of time to allow the body and mind to heal from the long-term trauma experienced from addiction. Treatment strategies need to focus on the problems and challenges of sobriety. In my case, I had to learn new skills and abandon the approaches I used as a mental health professional. Because the treatment of addiction is not similar to the treatment of mental illness, the approaches, skills, techniques, and strategies must be different. So while mental health treatment should be applied to those who have a primary mental health problem, addiction is primarily a health problem. Now let?s explore some of these more significant differences.

Exploring versus Accepting Emotional States

Emotional states exist. A person is happy, sad, glad, angry, etc. Mental health counseling seeks to explore these states as a way of uncovering issues that could be beneficial in helping the client. However, the newly sober client's emotional state is too volatile to explore and is most often related to withdrawal or organic brain dysfunction associated with chemical use. Attempting to investigate these emotions and yield understanding or insight from them is futile and harmful. It is harmful in that to explore them while in early counseling suggests that the exploration will somehow maintain sobriety. Addiction treatment strives to help the client accept the presence of these emotional states, begin to recognize their volatility, and thereby stay sober in spite of them.

Medication-Reliant versus Abstinence-Based

Depression, anxiety, and mood swings are all expected symptoms of the chemically-impacted brain. Effective addiction treatment strives to attain a period of abstinence from alcohol or drugs before even attempting to determine the presence or extent of these problems. Addiction professionals who understand the biogenic nature of the disease generally believe that a period of several months is required before attempting to determine the need for treatment of other disorders. These professionals have historically been at cross-currents with other professionals regarding the issue of medication. Addiction specialists have been courageous in past efforts to educate the public and other health care professionals about the dangers of benzodiazepines, sedatives, and other mood-altering medications that may hinder or exacerbate the recovery process. Addiction professionals believe that counseling and the life-changing power of Twelve Step recovery principles are the only appropriate options for interventions into life problems.

Problem-Focused versus Abstinence-Focused

There is considerable personal and social "wreckage" when someone begins a recovery process. The number of difficulties, problems, issues, and stressors can be overwhelming to both client and counselor. There is a temptation to attempt to solve, or least address, all of these problems. And the client adds to the counselor's dilemma with his normal obsession with his litany of stressful problems. However, addiction treatment should focus on helping the client stay sober through the stress of the problems that have accumulated. Trying to address these complicated issues in early recovery, with a chemically-impaired brain which is producing varying and unpredictable emotional states, is non-productive and will generally cause an apparent worsening of the problems. Effective addiction treatment addresses the need to stay sober. It tackles only those problems that may pose an imminent threat; the counselor must decide which problems must be addressed first.

Client-Centered versus Counselor-Centered

A health care professional treating a brain-injured client in the emergency room would not rely on the client to design his own treatment plan or establish the hierarchy of services to be provided. Addiction treatment, especially for those clients in the first months of recovery, is counselor-centered, meaning simply that the counselor knows how the recovery process works and the client does not. Because of the impairment caused to mental and emotional functioning, the client needs direction and assistance to stay sober. The power of addiction, with its components of craving, lifestyle and withdrawal, is the central governing influence for the newly recovering person. The power of the addictive thought process will almost always lead to the wrong decision if the client is left to his own devices. Addiction counseling is directive, inspirational, and based upon the successful experiences of others. It is focused like a laser beam on the actions that lead to continued sobriety. As the mind and emotions heal, so does the process of decision-making improve and develop, allowing the recovering person finally to rely on and trust in his own thinking and judgment.

Promoting Dependence versus Promoting Independence

The ultimate goal of any counseling or treatment is that the client will eventually not require the service. Addiction counseling is directed toward this goal. It is abstinence-based, non-medication dependent, and realizes that the recovery process leads to healing and personal transformation, which creates a person of greater strength, confidence, ability, knowledge, and wisdom than existed prior to the onset of the crisis. It is no accident that so many recovering people are working in the field of addiction: their lives have been restored to wholeness.

Uncomfortable with Pain versus Understanding the Utility of Pain

It is very difficult to be with someone who is experiencing pain, be it physical or emotional. The symptoms of addiction are painful to experience and painful to watch. The tendency for the professional -- in fact the very reason why many people enter the field of counseling -- is to try to remove the pain. This tendency leads many professionals to go to great lengths to solve long-developing personal problems, build up the client's ego and self-esteem, or remove the symptoms with psychotropic medications. All of these efforts fail in the treatment of addiction because pain has a great utility in its treatment. Every recovering person can attest that it was the pain of addiction that motivated him to ask for help, to take direction, and to go to an AA meeting. When the counselor attempts to remove this natural consequence of addiction -- pain -- she may be inadvertently removing the motivation to stay sober. To be comfortable in the presence of the pain of addiction, the counselor must have the utmost confidence in the recovery process and his ability to promote that process. And this is where recovering counselors are so effective: they are not intimidated by the painful consequences of addiction. They are not overwhelmed by the apparent hopelessness of the situation. They know the client can recover through the pain and the problems that permeate his life.

Finally, if a miracle is an outcome that cannot be explained by the sum of all the treatment efforts, addiction treatment not only believes in miracles, it relies on them. Not surprisingly, miracles often exceed the counselor's imagination. The counselor can participate in the celebration of these miracles if he is willing to learn the skills and undergo the personal and professional development required for this dynamic and challenging pursuit.

Ten ways family members can help a loved one with a drug or alcohol problem

The pain and suffering of addiction is not limited to the alcoholic or drug addict. Family members share a tremendous burden as well. Shame, guilt, fear, worry, anger, and frustration are common, everyday feelings for family members concerned about a loved one's drinking or drug use. In most cases, the family has endured the brunt of the consequences for the loved one's addiction, including the stress of worry, financial costs, and life adjustments made to accommodate the addicted person's lifestyle. Addiction perverts the positive influences of the family. The disease twists love, concern, and a willingness to be helpful into a host of enabling behaviors that only help to perpetuate the illness.

Family and friends are usually very busy attempting to help the alcoholic or addict, but the help is of the wrong kind. If directed toward effective strategies and interventions, however, these people become a powerful influence in helping the loved one "hit bottom" and seek professional help. At the very least, families can detach themselves from the painful consequences of their loved one?s disease and cease their enabling behavior.

Here are ten ways family members can help their loved one and themselves:

1. Do learn the facts about alcoholism and addiction. Obtain information through counseling, open AA/NA meetings, and Al-Anon. Addiction thrives in an environment of ignorance and denial. Only when we understand the characteristics and dynamics of addiction can we begin to respond to its symptoms more effectively. Realizing that addiction is a progressive disease will assist family members to accept their loved one as a "sick person" rather than a "bad person," This comprehension goes a long way toward helping overcome the associated shame and guilt. No one is to blame. The problem is not caused by bad parenting or any other family shortcoming. And attendance at open AA/NA meetings is important: families need to see not only that they are not alone in their experience, but also that there are many other families just like theirs involved in this struggle. Families will find a reason to be hopeful when they hear the riveting stories of recovery shared at these meetings.
2. Don't rescue the alcoholic or addict. Let him experience the full consequence of his disease. Unfortunately, it is extremely rare for anyone to be "loved" into recovery. Recovering people experience a "hitting bottom," This implies an accumulation of negative consequences related to drinking or drug use which provides the necessary motivation and inspiration to initiate a recovery effort. It has been said that "truth" and "consequences" are the foundations of insight and this holds true for addiction. Rescuing the addicted person from his consequences only ensures that more consequences must occur before the need for recovery is realized.
3. Don?t support the addiction by financially supporting the alcoholic or drug addict. Money is the lifeblood of addiction. Financial support can be provided in many ways and they all serve to prolong the arrival of consequences. Buying groceries, paying for a car repair bill, loaning money, paying rent, and paying a court fine are all examples of contributing to the continuation of alcohol or drug use. Money is almost always given by family members with the best of intentions, but it always serves to enable the alcoholic or addict to avoid the natural and necessary consequences of addiction. Many addicts recover simply because they could not get money to buy their drug. Consequently, they experience withdrawal symptoms and often seek help.
4. Don?t analyze the loved one's drinking or drug use. Don't try to figure it out or look for underlying causes. There are no underlying causes. Addiction is a disease. Looking for underlying causes is a waste of time and energy and usually ends up with some type of blame focused on the family or others. This "paralysis by analysis" is a common manipulation by the disease of addiction which distracts everyone from the important issue of the illness itself.
5. Don?t make idle threats. Say what you mean and mean what you say. Words only marginally impact the alcoholic or addict. Rather, "actions speak louder than words" applies to addiction. Threats are as meaningless as the promises made by the addicted person.
6. Don?t extract promises. A person with an addiction cannot keep promises. This is not because they don't intend to, but rather because they are powerless to consistently act upon their commitments. Extracting a promise is a waste of time and only serves to increase the anger toward the loved one.
7. Don?t preach or lecture. Preaching and lecturing are easily discounted by the addicted person. A sick person is not motivated to take positive action through guilt or intimidation. If an alcoholic or addict could be "talked into" getting sober, many more people would get sober.
8. Do avoid the reactions of pity and anger. These emotions create a painful roller coaster for the loved one. For a given amount of anger that is felt by a family member in any given situation, that amount -- or more -- of pity will be felt for the alcoholic or addict once the anger subsides. This teeter-totter is a common experience for family members: they get angry over a situation, make threats or initiate consequences, and then backtrack from those decisions once the anger has left and has been replaced by pity. If anger can be avoided, then so can pity. The family can then follow through on their decision to not enable.
9. Don?t accommodate the disease. Addiction is a subtle foe. It will infiltrate a family's home, lifestyle, and attitudes in a way that can go unnoticed by the family. As the disease progresses within the family system, the family will unknowingly accommodate its presence. Examples of accommodation include locking up money and other valuables; not inviting guests for fear that the addict or alcoholic might embarrass them; adjusting one's work schedule to be home with the addict or alcoholic; and planning one's day around events involving the alcoholic. (A spouse recently confided that she would set her alarm to get up and pick her husband up from the bar.)
10. Do focus upon your own life and responsibilities. Family members must identify areas of their lives that have been neglected due to their focus on, or even obsession with, the alcoholic or addict. Other family members, hobbies, job, and health, for example, often take a back seat to the needs of the alcoholic or addict and the inevitable crisis of addiction. Turning attention away from the addict and focusing on other personal areas of one's life is empowering and helpful to all concerned.
    

Each of these suggestions should be approached separately as individual goals. No one can make an abrupt change or adjustment from the behaviors that formed while the disease of addiction progressed. I cannot overemphasize the need for support of family members as they attempt to make changes. Counseling agencies must provide family education and programs to share this information. They must offer opportunities for families to change their attitudes and behaviors. The most powerful influence in helping families make these changes is Al-Anon. By facing their fears and weathering the emotional storms that will follow, they can then commit to ending their enabling entanglements.

The disease of addiction will fervently resist a family's effort to say "no" and stop enabling. Every possible emotional manipulation will be exhibited in an effort to get the family to resume "business as usual," There will always be certain family members or friends who will resist the notion of not enabling, join forces with the sick person, and accuse the family of lacking love. This resistance is a difficult but necessary hurdle for the family to overcome. Yet it is necessary if they are to be truly helpful to the alcoholic or addict. And being truly helpful is what these suggestions are really about. Only when the full weight of the natural consequences of addiction is experienced by the addict -- rather than by the family -- can there be reason for hope of recovery.

I also find it very helpful to tell family members that these suggestions offer the best opportunity for the alcoholic/addict, perhaps motivating them to seek help for their problem. In the beginning, family members are extremely focused on helping their sick family member and have very little interest in helping themselves. So, a strategy of ending enabling behaviors and withdrawing inappropriate support that is designed to help their love one become more willing to seek help will be more readily accepted by the family and will provide them with incentive to take these difficult actions. The family will eventually recognize the positive effect their changed behavior is having on them as well.

Alcoholism is a disease

Alcoholism is a disease, and so are other drug addictions. The common perception that those addicted to alcohol or drugs are weaker, less moral, more prone to mental illness, inconsiderate, or deviant is false. The disease of addiction effects an individuals behavior, attitudes, values and lifestyle. The addicted person is continually and progressively losing control of their behavior, thoughts and feelings. To family, friends and co-workers, this downward spiral is both painful and frustrating to watch. To the addicted person, the disease becomes an overwhelming reality which is best described as powerlessness.

Considered first and foremost physiological problems (meaning that the disease rests in the body), the brain and liver function have been identified as the primary culprits for the phenomena of craving, increased tolerance and mental obsession associated with the disease.

Our goal is to help a sick person get well rather than a bad person get good.

Recovery from addiction requires an individual to engage in a meaningful and in-depth course of self-appraisal, education, behavioral change and commitment to activities that support and nurture their resolve to be alcohol and drug free.