Journey to Sobriety Strategies for Success
Table of Contents Chapter 1: Addiction Treatment: Preparing for Sober Life...3 The Science of Addiction...4 Beyond the Science: Body, Mind, and Spirit...4 What to Expect in Treatment........ 5 Working Through Trauma...6 Family Education...6 Chapter 2: Life After Treatment...7 Recognizing the Signs of Stress and Anxiety...8 Practical Tips for Managing Stress and Avoiding Relapse....9 Sober Living After Addiction Treatment...... 10 Chapter 3: Finding Meaning and Purpose...11 The Benefits of Holistic Therapies...12 The Advantages of Support Groups...13 The Importance of Support from Family and Friends...14 Family Members Need Support, Too...14 2
Chapter 1 ADDICTION TREATMENT: PREPARING FOR SOBER LIFE 3
When life becomes unmanageable because of a drug or alcohol addiction and attempts to quit on your own fail, substance abuse treatment may be the next step. Thousands of people seek out treatment for drug or alcohol addiction in the U.S. every year. Whether you re considering alcohol or drug addiction treatment for the first time or you ve been through it before, know this: Not everyone successfully quits drugs or alcohol the first time, and there s no shame in that. While there are no reliable statistics on the average number of recovery attempts it takes to get sober, rehab can work and addiction can be managed for those who are committed. 1 The Science of Addiction To answer the question of why relapse is so common we need to look at the science of addiction. Today, drug and alcohol addiction is understood as a disease not simply a matter of choice or a moral failing, as previously thought. The National Institutes on Drug Abuse (NIDA) defines addiction as a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences. Drugs change the structure and functioning of the brain, according to NIDA. 2 In fact, long-term use of drugs can lead to changes in the brain that can impact: Learning Judgement Decision-making Memory Behavior Stress Like other chronic diseases, no one factor determines whether a person will develop a substance abuse disorder. There are several risk factors, including genetics, gender, mental health, environment, and even method of drug administration (smoking, snorting, injection, etc.). The good news is that, much like other chronic, relapsing diseases, such as asthma, diabetes, and heart disease, addiction can be managed successfully, given the right treatment and environment. Beyond the Science: Body, Mind, and Spirit While it s important to understand the science behind addiction and its impact on brain chemistry and physiology in general, there are additional factors to consider. A person s environment, family relations, self-esteem, and personal experiences (including trauma and abuse) can all contribute to the development of an addiction. 4
A holistic (whole-person) approach to treatment takes into account not only a person s physical needs, but also their mental, emotional, and spiritual needs in order to provide the best chances of success at recovery. This is why Retreat offers holistic therapies like yoga, art therapy, equineassisted psychotherapy, gardening, and others, as part of a comprehensive treatment program. What to Expect in Treatment How a treatment program is structured depends on the person s specific needs some people will need more intensive treatment than others. Treatment often starts with inpatient detoxification to address physical dependency. Because the process of detoxification can present a number of unpleasant side effects (nausea, vomiting, sweating, anxiety) and even dangerous ones (seizures), it s critical that people going through detox are cared for and monitored 24/7 by trained medical professionals. The medical team at Retreat includes a medical director, physicians, and licensed nurses trained to help patients through the detox process, identify potential medical problems, and provide medicinal therapies if needed. After drug or alcohol detox, patients transition to rehabilitation. Because each person s needs are different, rehabilitation requires a multi-faceted approach. Retreat s rehabilitation program includes all of following, tailored to each person s individual needs: Assessment and detox: Includes a psychological and physical assessment to determine specific needs, including detox, if necessary. Individual therapy sessions: To address psychological issues, often a contributing factor to substance abuse; one-onone sessions offer complete privacy. Holistic therapies: Retreat employs a whole-person approach to treatment, considering all aspects of the individual mind, body, and spirt; we offer holistic therapies like yoga, art therapy, music therapy, equine-assisted psychotherapy, among others. Group therapy: Provides opportunities to hear stories and learn from others; patients are separated into age- and gender-specific peer groups for a more comfortable environment. Medication management: An important component of rehabilitation for some patients, medications can help manage cooccurring conditions (such as depression, anxiety, obsessive-compulsive disorder), and reduce dependence on alcohol and other drugs. 5
Retreat offers a continuum of care to help ensure that each patient s needs are completely met. Working Through Trauma It s not uncommon for people in treatment for addiction to have experienced past trauma and abuse. In fact, studies show a strong correlation between trauma/abuse and addiction. 3 While drugs and/or alcohol may temporarily relieve the symptoms of trauma by providing an intense pleasure response or by masking negative emotions, in the long run using drugs or alcohol is not an effective solution; on the contrary, it can be incredibly destructive. Individual counseling is a powerful tool for working through trauma and emotional hurts. Substance abuse counselors are specially trained to deal with issues surrounding addiction. This is why individual counseling is an integral and important part of a rehabilitation program. Family Education Another important tool in treatment is family education. Addiction is a family disease, and studies show that people have better chances of success in recovery when family and friends are involved. Family education covers topics and issues like: Codependency (what it is and how it affects families) The disease model of addiction Family dynamics Expectations, roles, and boundaries Communication skills What to expect in the early stages of recovery Family member support systems and fellowships Rehabilitation is just the beginning of a person s recovery journey. Maintaining sobriety while resuming normal activities, including school and work, is the next step in the process, which we ll cover in the next chapter. 6
Chapter 2 LIFE AFTER TREATMENT: MANAGING ADDICTION 7
The process of transitioning back into life after rehab should begin while the person is still in treatment. A reputable treatment center will thoroughly address the challenges of reentering the world as a sober person and provide ongoing support to boost a newly-sober person s chances of sustained sobriety. A person s home environment is unlikely to be as highly structured as the environment at a treatment center. This is why creating a stable, structured environment outside of treatment is critical, as stress and anxiety are leading causes of relapse. Let s take a closer look at stress and its effects on the body. Recognizing the Signs of Stress and Anxiety The effect of stress on our bodies is complex, affecting nearly every system. When we experience a tension-filled situation our bodies release fight or flight hormones, which causes a noticeable physiological response (rapid heartbeat, a surge of adrenaline, and increased respiration). This is a normal and temporary reaction temporary being the operative word. Chronic stress, meaning persistent low to moderate levels of stress, can take a significant toll on the body over time. Gone unchecked, poorly-managed stress can lead a person to resume selfmedicating behavior with drugs, alcohol, food, gambling, or other substances or activities. Many people use drugs or alcohol to relieve stress and cope with the pressures of everyday life, but the reality is that some level of stress in life is inevitable, and we must learn to deal with it productively. Recognizing the warning signs of stress and using healthy coping mechanisms can help prevent relapse. Watch out for these signs: Muscle tension, neck or back pain Upset stomach or nausea Anxiety Short temper Irritability Memory problems or forgetfulness Insomnia Fatigue Dry mouth Rapid heartbeat 8
Practical Tips for Managing Stress and Avoiding Relapse Below are some practical ways those in recovery can help defuse stress in order to improve their chances of staying sober. Manage your time: Time management is an important part of keeping stress under control. Pressure and stress from taking on too much too many hours at work, a huge class load at school can lead to relapse. Diving back into a full-time work or school schedule is not ideal, especially in the first 90 days of recovery when relapse is common. If possible, engage only in essential recovery activities, like 12- step meetings or counseling, and gradually add activities back into your schedule. Engage in stress-relieving activities: Many people find that engaging in stress-relieving holistic activities like yoga, mindfulness meditation, surfing, gardening, art therapy whichever activity they prefer can be tremendously helpful during treatment. The same is true in recovery, when managing stress is especially important. Seek out support: It s important to cultivate healthy relationships in recovery isolation is often a recipe for relapse. A 12-step program can help those in recovery connect with others who have faced similar struggles in a supportive, judgementfree environment. Those who aren t comfortable with 12-step can find support in other groups, such as SMART Recovery, Women for Sobriety, and others. Get enough sleep: A good night of slumber is not just a nicety, it s vital for health and well-being. Chronic sleep deprivation breaks the body down over time; the effects include everything from cognitive problems to weakened immune response to increased appetite/weight gain. Over time sleep deprivation can contribute to serious health issues like type 2 diabetes, heart disease, high blood pressure, and depression. For most people a good night s sleep means 7-8 hours, so get your Z s! Learn to identify stressors: It might be running late, missing deadlines, or having conflicts with family members, friends, or coworkers. Be proactive by anticipating stressors and making a plan; for example, you might set your alarm clock 20 minutes earlier than usual, pack your lunch and choose an outfit the night before work/school to avoid running late, reprioritize projects, or avoid getting involved in situations where conflicts with others are likely to be inevitable. Avoid triggers: This is especially important in the early days of recovery. Relapse triggers can include hanging out with old drinking/drugging buddies, stress and anxiety, complacency about sticking to a 12-step program, and overextending yourself at work/school/home. NIDA estimates the relapse rate for addiction at 40-60 percent, likening it to that of other chronic diseases such as asthma and type 1 diabetes. 4 Learn to identify triggers and avoid them. 9
Sober Living After Addiction Treatment A sober living house is a safe environment that provides those in recovery with the support they need to make the transition between addiction treatment and normal life. Sober living provides ongoing support while a person works toward greater independence. Sober living environments are completely free of drugs and alcohol, and the rules of the house are often fairly strict. Everyone must contribute by doing chores and participating in general. Some sober living houses have a therapist on call and hold regular 12-step meetings as well as skillbuilding workshops. The built-in social network of sober living is one of its greatest benefits. Being around others who have had similar experiences and who are going through the same struggles can be very comforting. How long a person stays in sober living will depend on their needs. While sober living shouldn t be used as a crutch to avoid living on your own, as long as it is still providing a benefit and is affordable, continuing is a good choice. Lengthier stays in sober living may be beneficial; studies show that the longer a person stays sober the less likely they are to relapse. 5 Many addiction treatment centers either have a sober living facility on-site or can recommend an outside one. 10
Chapter 3 FINDING MEANING AND PURPOSE 11
Humans have always sought to understand their existence. We are innately driven to find meaning and purpose in life. Having a sense of purpose is necessary for psychological well-being a claim that is backed by science. When considered from an evolutionary perspective, it becomes clear why: If our ancient ancestors didn t have a sense of purpose, they might not have fought so hard to escape that predator or tried so hard to win over a mate. In a very real sense, meaning and purpose are vital for survival and continuation of the species. We may live in a very different world today than our distant ancestors, but we re virtually the same psychologically. Meaning and purpose are still central to our lives. Some people find personal fulfillment through self-awareness or self-actualization, some by helping others, and some through religious pursuits or connection with nature. The Benefits of Holistic Therapies Having a sense of purpose is important for everyone, but it s especially for those in recovery. This is why many drug and alcohol rehab centers, including Retreat, offer holistic therapies as part of a comprehensive treatment program. Holistic therapies can include activities like: Yoga Equine-assisted therapy Art therapy Massage therapy Meditation Gardening Culinary arts Recreational therapy 12
Holistic therapies can help relieve stress and help people connect with their emotions and better understand their own behavior. These therapies are also known to help with co-occurring conditions like obsessive-compulsive disorder (OCD), avoidant personality disorder, depression, anxiety, and PTSD, and they often help patients address self-worth issues, emotional trauma, and abuse. Mindfulness meditation in particular can literally change brain activity and function. One study showed that mindfulness meditation decreases activity in the part of the brain known as the default mode network, or DMN, which is responsible for mind-wandering and self-referential thoughts; this is significant, as mind wandering is associated with lower levels of happiness. 6 Mindfulness meditation has also been shown to reduce symptoms of anxiety and depression and increase brain volume in the areas of the brain responsible for memory, learning, and emotion regulation. 7 The Advantages of Support Groups In addition to holistic therapies, support groups can be tremendously helpful for those in recovery. Participation in groups like Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) is an important and often lifelong part of recovery for many people. AA and NA offer many benefits meetings are held in a non-judgmental environment where attendees can simply listen and observe or actively share their stories and vent frustrations. Interestingly, one study found that women and men benefit in different ways from AA. 8 Men tend to experience increased confidence through building a supportive network of friends, helping them stay sober in high-risk situations (like parties), while women tend to benefit by finding ways of dealing with negative emotions that can trigger drinking. Participants in AA/NA can work the 12 steps at their own pace and find support from others who have gone through similar struggles. Seasoned AA/NA members may have the opportunity to help others by becoming a sponsor. In larger cities especially there is no shortage of meetings they happen every day of the week day and night. 13
Alternatives to AA Working a 12-step program is not the only option for those in recovery. Some people are put off by what they see as a faith-based approach to AA (five of the 12 steps mention God, for example). For these individuals there are alternative groups, including (but not limited to): SMART Recovery: Uses cognitive therapy approach to help members identify emotional and environmental factors that could lead to drug/alcohol use, and promotes responding to those factors in constructive ways. Secular Organizations for Sobriety (SOS): Advocates taking personal responsibility for problem drinking/drug use and promotes making sobriety a priority. Women for Sobriety (WFS): Focuses on personal empowerment and encourages members to learn how to better manage issues through group sharing. Emphasizes substituting negative, self-destructive thoughts with positive, selfaffirming ones. Teaches 13 statements of affirmation. There are many support group options for those in recovery today. Often it s a matter of trying out different groups until you find the one that you like best. The Importance of Support from Family and Friends Family and friends often play a critical role in urging a loved one to seek treatment in the first place, and they play an equally important role during and after treatment. If a person s drug/alcohol use affects friends and family members, it stands to reason that so does that person s recovery. Having the support of friends and family can provide further motivation for the person in recovery to live a healthy life and achieve long-term sobriety. It s important to note that supporting is not the same as enabling family members can and should set clear boundaries, but can do so while letting their loved one know they are there for them through their journey of recovery. Family Members Need Support, Too Al-Anon can be helpful for family member and friends whose lives have been affected by someone else s drinking or drug use. Al-Anon is a fellowship group similar to AA in which family members and friends can share their stories, vent their frustrations, and find ways of healing and tackling day-today upsets. Note that Al-Anon is not just for those who have a loved one with an active addiction people who grew up with an addicted parent, who have adult children in recovery, or another family member in recovery can also benefit. Managing a drug or alcohol addiction is possible with the right help and support. Contact the caring and compassionate staff at Retreat 24/7 at (855) 859-8808. Learn more about our treatment programs at retreataddictioncenters.com. 14
Sources http://www.nctsn.org/sites/default/files/assets/pdfs/satoolkit_1.pdf http://www.pnas.org/content/108/50/20254.short https://www.ncbi.nlm.nih.gov/pmc/articles/pmc3004979/ https://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/how-effective-drug-addiction-treatment https://www.drugabuse.gov/publications/media-guide/science-drug-abuse-addiction-basics https://www.drugabuse.gov/publications/drugs-brains-behavior-science-addiction/treatment-recovery https://www.psychologytoday.com/blog/craving/201402/how-often-dolong-term-sober-alcoholics-and-addicts-relapse http://healthland.time.com/2012/12/06/study-men-and-women-benefitin-different-ways-from-aa/ 15
Retreat was established in 2011 in Ephrata, Pennsylvania with the mission of providing a compassionate and spiritual environment where those suffering from the disease of addiction can begin the journey to recovery by providing enlightenment and education to the individual and their families. Since Retreat s founding, it has grown into a network of leading alcohol and drug treatment centers helping patients throughout the US. Each patient at Retreat works with a clinical team that includes a primary therapist, a team therapist, a treatment technician, a team nurse, and an outreach specialist. Retreat embraces a holistic approach to substance abuse treatment, taking into account each patient s physical, emotional, and spiritual needs. We offer inpatient drug and alcohol detox, rehabilitation, partial hospitalization, intensive outpatient, and family education programs. Retreat offers additional therapies to promote well-being, including recreational therapy, yoga, equine therapy, music therapy, gardening, art therapy, massage therapy, and others. Learn more about Retreat at retreataddictioncenters.com.