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Dr. Steve Frisch, Psy.D. is a clinical psychologist in private practice in
Chicago, Illinois and Northfield, Illinois.

You can contact Dr. Frisch, Psy.D. at
(847) 498-5611.

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books.

What to Do Once You Admit That You Have A Problem with Alcohol and Other Drugs

ear Dr. Steve:

I need your help. I’ve never spoken to anybody about this before but I feel like I’ve reached the bottom of a very deep hole. I’m beginning to think that I was not made for alcohol, or drugs, for that matter. I have plenty of hard evidence—five years of painful, tiring, resentful, self-pitying, missed opportunities, failed loves, barroom fights, and self-hatred.

It’s like alcohol and drugs and me are complete enemies. I’ve lost so many fights trying to quit using that I can’t remember them all. Looking back, I think I always knew I had a problem with alcohol but you could have never convinced me that reefer and coke were not more than a passing fancy. But every time I tried to quit drinking, I would do more and more blow and reefer. Then I’d promise myself that I would stop using blow and reefer, and, boom, the drinking would get out of control in no time. I want to give it all up—alcohol, reefer, marijuana, the pills, all of it. Period. I cannot take it anymore. I surrender.

I’m tired of crying. I’m tired of promising myself things that won’t work. I’m tired of shedding tears, and losing new opportunities in the process. How can I stick to my resolve. I’ve tried quitting by myself before—more times than I care to remember. It never lasts long.  I give up. But where do I start? I tell myself I need to quit. I know that it’s in my interests. But then a week later I’m right back to drinking and drugging and brawling. I’m tired of lying to myself. I’m tired of this life. For the past five years its been weighing me down. I want to get on with my life. But after so many failed attempts at quitting, what reason is there for me to believe that it can be any different this time? Can you tell me where to start?

Alcoholism and drug addiction are a primary, chronic, progressive, and potentially fatal disease that is prone to relapse. The sooner you seek help, the greater your chances for a
long-term recovery.

Believe it or not, you’re already over the most difficult hurdle—admitting to yourself and others that you need help. Having so admitted to yourself that you have a problem with alcohol and other drugs, there’s a community of qualified healthcare providers who can assess the extent of your problems with alcohol and other drugs, evaluate your psychological and physical condition, medically supervise your early days of abstinence from alcohol and other drugs, teach you how to remain abstinent from all mood altering substances, support you in your efforts to create a sober lifestyle, and help you repair and rebuild the many burned bridges with the people in your life.

Make an appointment with a qualified healthcare provider. Up to this point you’ve been reluctant to talk to anybody else about your problem with alcohol and other drugs. This reluctance likely stems from feeling ashamed or embarrassed about needing help in general and more specifically, admitting to another person that you have a problem with alcohol and other drugs. Perhaps some of your judgments about alcoholism and alcoholics have prevented you from admitting to yourself and others the extent of your problem with alcohol. Consequently, you may believe that admitting that you have a problem with alcohol and other drugs is admitting to the fact that you have a shameful character defect or that you are morally flawed. However, the truth is that alcoholism and drug addiction are diseases that are no more a sign of character weakness or moral depravity than is asthma or diabetes.

A healthcare provider will be able to evaluate the extent of the problem you are having with alcohol and other drugs. Your healthcare provider will ask you a number of questions about your alcohol and other drug use. The purpose of these questions is to help you evaluate:
1.) Whether any occupational, interpersonal, familial, financial, legal, emotional, physical, and behavioral problems exist as a result of your drinking and other drug use
2.) Whether you’ve been able to stop your use of alcohol and other drugs when adverse consequences occur as a result of using alcohol and other drugs
3.) Whether you’re able to control your use of alcohol and other drugs
4.) Whether you’ve developed an increased tolerance to alcohol and other drugs
5.) Whether you develop withdrawal symptoms when you stop drinking and drugging for any length of time
6.) Whether you’ve developed any medical conditions as a result of your alcohol and other drug use
7.) Whether there are any co-existing medical conditions unrelated to your drinking and drugging that need to be treated as well. You need to answer these questions as fully and honestly as you can.

If your healthcare provider concludes that you may be dependent on alcohol and other drugs, they will likely encourage you to see a specialist in treating alcoholism and other drug addiction.

Based on your healthcare provider’s assessment of the severity of your problem, your treatment could involve several phases. If you’re diagnosed with the disease of alcoholism and/or drug addiction, treatment may start with medically supervised alcohol and other drug detoxification. This entails taking doctor-prescribed medications to ensure a safe withdrawal from alcohol and other drugs.

The goal of a medically supervised detoxification is to make it as medically safe as possible for you to stop taking alcohol and other drugs. Medical detoxification may involve gradually reducing the dose of alcohol and other drugs that you consume or temporarily substituting other substances that have less severe side effects. For some people, it may be safe to undergo medically supervised detoxification on an outpatient basis. Other people may require placement in a hospital or residential treatment center.

Because withdrawal from different categories of drugs produces different symptoms, different approaches are required to treating the presenting withdrawal symptoms. Withdrawing from central nervous depressants may cause symptoms such as restlessness, anxiety, sleep problems, rapid heartbeat, high blood pressure, low-grade fever, and sweating. More serious symptoms also could include hallucinations, whole-body tremors, seizures, profuse sweating, greatly increased pulse and blood pressure, and vomiting. The most serious stage of withdrawal may include delirium and is potentially life threatening.

Withdrawal from central nervous system stimulants may cause symptoms such as depression, excessive sleepiness, fatigue, headache, irritability, and inability to concentrate. In some cases, symptoms may include suicide attempts, paranoia, and impaired contact with reality (acute psychosis). Treatment during withdrawal may be limited to emotional support from family, friends, and doctor. In some cases, your doctor may recommend medications to treat paranoid psychosis or depression.

Withdrawal from opiates such as heroin, morphine, or codeine may cause side effects that can range from relatively minor to severe. The less severe symptoms may include anxiety and strong cravings for the drug. More severe symptoms may include sleeplessness, acute psychosis, rapid pulse, rapid breathing, high blood pressure, abdominal cramps, vomiting, diarrhea and weakness. Doctors often times substitute methadone to reduce the craving for heroin and to gently ease people away from heroin.

Once you’ve completed your medically supervised detoxification you may begin an integrated program of individual and/or group therapy along with attending 12-Step support groups such as Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These treatments are usually available in a hospital or residential treatment facility or on an outpatient basis.

Individual or family therapy with a psychologist, psychiatrist, or addiction counselor can help you begin to put the pieces of your life back together. Behavioral therapies can help you develop ways to cope with your alcohol and other drug cravings, strategies to avoid alcohol and other drugs, and prevent relapse. Therapy also can involve you talking about your job, legal problems and relationships with family and friends.

Long-term, once you’ve finished treatment, you will continue to attend 12-Step meetings, work with a sponsor, work the twelve steps, and perhaps continue working with a qualified psychotherapist.

You’ve taken a big first step in reaching out to me. Don’t stop here. Find a qualified healthcare provider in your community that can serve as your guide to answer your questions, support you through the difficult times, and help you maintain your abstinence from alcohol and other drugs. I wish you the best of good fortune.

Learn how to prevent and recover from chemical dependency as well as the aftereffects of chemical dependency on you and your family. Read Dr. Frisch’s, Psy.D. series of Recovery books—From Insanity to Serenity.

Pathfinder’s Checklist

1.) Make an appointment with a qualified healthcare provider.
2.) Make a plan for how to achieve and maintain abstinence from all mood-altering substances with a qualified healthcare provider.
3.) Undergo a medically supervised detoxification from your drug(s) of choice.
4.) Find out when and where Alcoholic Anonymous and/or Narcotics Anonymous meetings take place in your community.
5.) Learn as much as you can about alcoholism and the process of Recovery.



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