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

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

Yet the measure of any and all of such material wealth pales in comparison to our ability to function optimally physically, emotionally, mentally, socially and spiritually.  Especially in an age of great economic uncertainty such as the present, our most important assets are those that we carry with us: our health, our connections to others, and our ability to “bob and weave” through the everyday trials, as well as blessings, we encounter.

By “growing” your recovery capitol, you gain strengths and coping mechanisms which enhance your ability to maintain a clean and sober lifestyle.  Thankfully, such growth is not subjected to the whims of the economic markets, nor is it taxed. 

Once a stable, uninterrupted state of recovery is achieved, building recovery capitol in the form of solid relationships, optimal health and wellbeing, engaging work and recreational activities will boost the value of the most marketable assets in your portfolio: YOU!

Paula

Yet, where exactly are we all rushing to?  This question is especially important to those in recovery who may be tempted to skip a meeting or a call to a sponsor, or a service commitment here and there. 

Given the stressors of seemingly endless engagements, often with the folks who tend to push our buttons the most, the holidays are the time for more recovery-related participation, not less.

Recovery can never afford to take a holiday.  No personal or vacation time is granted from activities which support recovery.  The more active one participates, the better the outcome, especially at the holidays, regardless of any time pressures.

Paula

Living in a suburb of New York City at the time, I had had no exposure to the smell of evergreen since the Christmas before.  Prior to that shopping excursion, I had no experience that clearly profiled the potent power of smell or any unequivocal demonstration that exemplified the instantaneous physiological response that smell could evoke solely based on stored memories.

While strolling down the aisle of lighting decorations, I unexplainably found myself with a torrent of tears streaming down both cheeks.  Not the type to display such emotional responses in public, I was mortified by the situation and began to question my self-control and sanity. 

Then, all of a sudden, I realized that I had been ambushed by the wafting scent of evergreen coming from the doorway leading directly to the live-tree stand outside.  Just as suddenly, I recalled that the very last time I had smelled such an aroma was at my father’s wake December 25^th of 1988.  Since florists only stock live arrangements of poinsettias, evergreens and similar greenery on Christmas Eve, my nose had delivered me right back to all those hours I had spent in front of floral arrangements surrounding my father’s coffin the year before. 

The memory associated with the smell triggered a litany of emotions I had felt back then, in spite of the fact that I had been in a joyous holiday mood only milleseconds before.  My brain had instantly, and automatically, transmitted the last highly significant meaning that had become associated with evergreen in my memory bank the year before.  Basically, my brain transported me back to the state of mind I was in at that time.

Although relieved to discover that I was not having an unexplained public breakdown, but an easily explained public meltdown, the fact is that smells which are associated with an event or situation can maintain sufficient potency to affect us, even years later.  While no one can predict with certainty what any exposure to subtle holiday aromas may have, I do know that if the scent of evergreen can provoke an unwanted eruption from my tear ducts, that other smells which have been unconsciously associated with alcohol or other drugs can prompt a knee-jerk response in anyone in recovery.

That is why the early members of Alcoholics Anonymous stressed constant contact with other members of their support group and a Higher Power.  Please exercise extra vigilance not only during this joyful season, but every day.  Although smells can be powerful cues, staying close to peers in recovery and consistently practicing recovery behaviors can help one deal successfully with whatever comes along.

Paula

Undeniably, the founders of Alcoholics Anonymous put much significance in gratitude.  In fact, the phrase, “Attitude plus gratitude equal recovery,” is found in the book, “As Bill Sees It.” 

Listening to any person express gratitude for receiving life-saving surgery, or hearing an individual recount being rescued by a passer-by who intervened in the face of imminent peril, we hear the unmistakable quality of gratitude and an attitude of Thanksgiving.  Such experiences of salvation mirror what is communicated by an individual in solid recovery from addiction.

Celebrating recovery is at the very heart, celebrating Thanksgiving, and celebrating Thanksgiving is the very essence of the joy of recovery.  That both recovery and Thanksgiving merit hearty celebration, every day of the year, is in my estimation a given.

 Be well!

 Paula

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

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

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