Long-Term Treatment for Alcoholics Addicts
Alcoholics Anonymous (and its offshoots) is the great success story in the treatment of addictions. On any given day, more people go to AA groups around the world than attend any other form of therapy. The message of AA is compelling and translates very well across different drugs, social classes, and cultures. AA groups are so numerous and so varied that almost anyone can find a congenial one that is readily available, conveniently located, and probably meeting that night. AA provides hope, a philosophy of life, a spiritual reawakening, an emotional experience, concrete support, a sounding board, great advice, and help for family members. It is all the more remarkable that it does all this with virtually no bureaucracy or budget.
The goal of treatment must be complete abstinence from the substance for life. Almost always, people with substance problems resist this goal, hoping instead to return to a state of “controlled” substance use. Although there is an occasional person with Substance Dependence who can eventually go back to social use, this goal is totally unrealistic for the vast majority of users. Becoming dependent seems to reflect a fundamental inability— mediated at the brain level—to just have a little bit, without needing more. You may have periods in which you control your drug intake by setting up stern self-imposed limits (“I’m only going to have one joint tonight.”, “As long as I don’t drink alone, it’s okay.” , “No drugs after 10 P.M.”). Invariably, and before very long, there are seemingly endless and irresistible reasons to bend a rule slightly (“I’m under a tremendous amount of stress.” “I’m celebrating a promotion.” “All work and no play make Jack a dull boy.”
“This is a special party.” , “I am cured of my depression and can now control my use.”, “Therapy helped me understand why I lost control.” , “Getting sober was easy—I can always do it again.”)… Soon there is an escalation to the previous pattern of dependency. After another crisis, there may be a new and totally sincere resolve to reassert control, set new limits, and the cycle begins anew. The only way to avoid being trapped by substances is to avoid using them altogether—and this means for your entire life.
Maintaining abstinence is hard work. You may have spent much of your adult life intoxicated or preparing to become intoxicated. It is not just a matter of giving up an old life, it is equally a challenge to create a new one. The good news is that most people feel much better once they stop using drugs. However much fun the substance intoxication was at the start of the game, ingesting a daily quotient of a toxic brain poison takes its toll. The side effects accumulate with time, the highs diminish. By the time people get around to quitting, their substance use is geared to just getting back to neutral, not to feeling good.
Withdrawal is a tough hurdle—and can sometimes last for weeks or months in mild form—but once cleared you will feel better than you have in years. Substance use is a classic case of behavioral conditioning. You become hooked in the first place because the substance reinforced pleasures, you stay hooked because of the punishments of withdrawal, and it is hard to stay abstinent because reminders of the highs provoke powerful craving. The smell of particular smoke, the sight of a certain park bench, being around old friends, the sound of certain music—all of these can trigger memories that induce drug craving and “conditioned” withdrawal symptoms. It will feel as if your brain receptors are crying out to be fed. Identify and systematically avoid such situations to the extent you possibly can because they are a lure that can drag you down. If going to parties or bars gets you drinking, avoid them—or go late and leave early. Stick to food rather than drink. Stay away from people who get you into it.
If you can’t avoid your triggers, at least formulate a plan to deal with the craving once it begins. Immediately contact a trusted friend from your AA group or assistance from Alcohol Rehab Florida. Exercise, leave the party, read a magazine, eat a meal—whatever it takes for you to nip the need in the bud. Even if you have a “slip” from time to time, don’t be too hard on yourself. Recognize that such slips are common (if not inevitable) and do not necessarily signify a total descent back to dependence. Most illnesses have a relapse from time to time. Pick yourself up and start over again.
Family or marital therapy is often helpful, and is sometimes necessary. Family members have often been placed in the role of “enabler” by the person with Substance Dependence. The negative effects of a person’s dependence invariably create enormous strains in relationships, both inter-personally and financially. Recasting family members from victims to active participants in the treatment is crucial for success. Self-help groups for family members of substance users (Al-Anon, for example) provide wonderful support. A total family “intervention” may be necessary to confront the person’s denial about the extent and harmful effects of the substance use.