The Addiction Recovery Blog

Most individuals who have recovered from alcohol or other drug addictions understand all too well the meaning of the word tolerance.  It is that phenomenon whereby individuals require more of a substance to get the same physical or emotional response that the chemical gave them when they first started drinking or using.

Yet many laypeople and professionals do not appreciate the role that hyperalgesia may play in the use, abuse or misuse of prescription pain relievers that are classified as opiates, such as oxycodone.  Hyperalgesia is defined as an abnormally increased perception of pain and recent research has demonstrated that even after only one dose of an opiate painkiller that an individual can experience the occurrence of hyperalgesia. 

That’s right.  The medication that was taken for the specific purpose of decreasing pain might create in some individuals an increased sensation of pain.  This is why many individuals in recovery who have legitimate pain syndromes have reported to me over the years that a non-steroidal anti-inflammatory such as Motrin or another over-the-counter preparation like Tylenol actually relieves their pain better than the potently addictive drugs categorized as opioid medications did.

This phenomenon of hyperalgesia gives me reason to pause and reflect upon all the times as a nurse working in the addiction treatment setting that a patient may have been very well-educated regarding the tolerance aspect of their disease, although some of what they actually experienced may actually have been an increase in symptoms specifically caused by the prescription pharmaceuticals producing hyperalgesia.  Either way, the possibility of encountering this phenomenon is another reason those in recovery from any addictive disease may want to avoid taking an opioid medication for pain.

Surely more research into the brain disease of addiction and substance use disorders as well as pain management will reveal more in the coming years, yet it is certainly crucial to  note that the proliferation of opioid prescriptions to reduce pain may have not only put people in harm’s way leading them into acquiring a substance use disorder but may have made some feel pain more acutely than if they had just self-prescribed themselves to a liberal dose of “benign neglect.”

More to come on benign neglect in the future.

Paula

Capitalizing on the brain’s ability to be distracted can help maintain and extend recovery. This benefit can be found in the art and continued practice of deferring, if only for a few precious, yet vital minutes, the action of reaching out for that bottle, joint or pill.
As human beings, we get distracted constantly. In fact, the brain’s perception of distractions or changes in our surrounding area is what saved the species in primitive times from predators. Whatever the brain was focused on prior to identifying a threat in the environment was relegated to the back burner the instant that a hazard was recognized. In this modern era, our Number One Enemy has become addictive substances and behaviors.
The distinction that the individual in recovery, or seeking recovery, must make is that the habit of inserting a meaningful distraction into consciousness the moment a risk to continued sobriety is detected is an absolute must. Thus, the practice of frequent, regular calls to sponsors and other members of a recovery support network have become time honored responses which thousands in recovery have used successfully over time. The willingness to form this healthy, recovery-preserving habit is a testimony to ones intent to become, and remain, abstinent from mood-altering substances and behaviors. Such conversations can secure a healthy footing that leads to lifelong recovery and can serve as an antidote for relapse.
Some people have developed specific lists they carry in their wallet which specifically outline a plan of actions to take if temptations surface. As individuals explore triggers with sponsors, therapists and other members of their support group, they can begin to discern the earliest circumstances and behaviors that have led them to drink or use in the past. As the saying goes, “He who forgets the past is destined to repeat it.”
While some will find that reaching for the earplugs and listening to a soothing tape is advantageous, others will prefer opting for strenuous activity, such as jogging or weight training to tame the beast of intrusive thoughts of using. Finding healthy distractions which work for you in a variety of situations and forming the regular practice of inserting those practices into your everyday life is something that can be developed to secure an uninterrupted recovery journey.
Paula

Although most of us avoid distractions as much as possible, they can, at times, be a wonderful gift.  Seeing such natural occurrences as a wandering mind in a positive light can not only be helpful in fostering a growing acceptance of “life on life’s terms” but, if utilized properly, distractions can help reduce the power of cravings.

Have you ever noticed how a phone call to, or from, a sponsor or peer in recovery can interrupt thoughts of drinking or using?  Certainly the co-founders of Alcoholics Anonymous recognized the blessing in tactics such as phone calls and meetings, even though such fellowship activities are much more significant than a mere diversion of one’s attention.

As much as we believe that the human brain is capable of multi-tasking, the fact remains that we can only pay close scrutiny to one thing at a time.  What we think about grows in direct proportion to how much and how long we focus on such thoughts.  It is part of the legacy of wisdom that has been passed down from one generation of AA to the next in oral qualifications at meetings as well as the literature which explains quite logically how important it is to banish thoughts of drinking or using as soon as they are recognized for what they are: temptation.

The next blog will discuss in greater detail how to effectively use distractions to support rather than hinder your recovery!

Paula

Looking more closely at interventions which are performed by loved ones to alleviate problems with alcohol and other drugs, there are some finer points which warrant careful consideration. Aspects such as the timing, the type and amount of preparation to be done prior to actually intervening, how to actually orchestrate the details of an intervention, and identifying who should be present at such an event, are key areas that can influence whether an intervention will be successful. Likewise, having solid treatment options lined up ahead of time which are ready and willing to accept the identified individual is also a facet that must be carefully orchestrated.

As the devil is often said to be in the details, and successful outcomes with interventions are often tied to the very smallest of details, the assistance of a substance abuse professional who has specialized training and expertise with such interventions is a natural place to begin. Proficiency and skill in conducting interventions is vital to coordinating all stakeholders in a way which solidifies their actions in a manner that brings the individual to not only recognize that they have a significant problem with substances, but to actually motivate that person to accept necessary treatment.

Consulting with the Association of Intervention Specialists (AIS), which is a network of trained specialists who can guide families and friends, business executives, and others through the intervention process, is a great place to find out more information. The AIS can also assist in locating an interventionist in your area who has met, or exceeded, the specific educational and performance standards established by the Board Registered Interventionists (BRI). For more helpful information, as well as board certified interventionists in your geographic area, visit http://www.associationofinterventionspecialists.org/index.php

Recalling the tragedy of the man whose email prompted last week’s blog, titled, “Why Can’t This Just Be A Dream?” puts into clear perspective the fact that substance use disorders are progressive, potentially lethal, medical conditions if left untreated. With timely, optimal intervention and treatment, as well as ongoing vigilance, extremely successful long-term outcomes are possible. While taking action to get help for a loved is an extremly difficult decision to face, take it from those left behind in the aftermath of a fatal overdose that TAKING ACTION is highly preferable to experiencing the tragic suffering of losing a loved one.

Paula

Recently I received one of the most compelling emails I have ever received.  The subject line was, “Why Can’t This Just Be A Dream?”  Moved beyond words by the writer’s genuine expression of emotion, candor and clarity, it was written by a man whose fiancée, a nurse, had died of an overdose shortly before her 36^th birthday.  The man described how his betrothed was a very responsible, kind, loving and caring woman who was the antithesis of reckless or wild.  Shy and withdrawn, she lived a quiet life which ended abruptly with an overdose in the staff bathroom of the intensive care unit where she worked.

Not at all savvy to the signs of possible addiction, this man was unaware of his fiancée’s drug use.  He wrote of the subtlety of what was visible to him; of his naiveté and inability to put together a clear, concise picture of what was actually happening.

What he brings to the fore for all of us is the immense shock, sadness, and utter disbelief that no one in the ICU where his fiancée worked recognized a problem and that the supply of potent narcotics was not more secure. The questions he asks, which have been echoed by others before him, are somewhat rhetorical, yet nonetheless legitimate:  “How many have to die?  How many have to suffer?  When will the industry wake up and address the problem?”  He concluded with the words, “Her death cannot be in vain.” 

While this may at first blush appear to be off-topic for an addiction recovery blog, I believe it is quite germane and actually on-point.  The piece portrays that some people regrettably pay dearly, with their very lives, at the hands of addiction.  By profiling the perspective of the loved ones left behind, it underscores the significance of effective interventions that can save lives.

Countless times the true story of former First-Lady, Betty Ford’s recovery has been told.  Indeed, her phenomenally successful overcoming of addiction began after a professionally led intervention, which included several key people in her life, led her to accept extensive treatment for addiction.  Yet it is equally important to understand that, prior to the successful intervention achieved the desired result, there was a similar, single-handed attempt made by her daughter; a one-on-one confrontation which resulted in the daughter being summarily thrown out of the White House.

To facilitate the noble intent of the man who courageously wrote, “Why Can’t This Just Be A Dream,” which was to prevent tragedies similar to the one he experienced, there will be further discussion next week on the subject of effective substance use disorder interventions.

Paula

Little installments of solid commitments to recovery add up over time.  In fact, repeatedly engaging in even small increments of time exclusively devoted to recovery serve to propel you forward in a positive direction.

Make a commitment to devote at least two minutes, a mere one hundred twenty seconds upon arising to reflect upon the coming twenty-four hours.  Review the day to come and create sandwiches of support for yourself around difficult tasks.  For example, if you have an important interview at ten o’clock sharp, plan to make a phone call to your sponsor or another supportive person both before and after the interview.  Utter a simple prayer to your Higher Power or the universe that you handle whatever transpires with acceptance, grace and dignity.  Realize that no matter what happens, the most important thing is that you stay on the path of recovery. 

Remember that “luck” is the intersection of preparation and opportunity, and that neither adequate preparation nor an abundance of worthwhile opportunities are possible for you if you enter into the throes of active addiction.  Uninterrupted recovery does coax “luck” and other good things, like healthy relationships, to move in your direction.

Paula