What to Do Once You Admit That You Have A Problem with Alcohol and Other Drugs
Dear 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.
G.B.U.
Steve
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