National reports estimate over 25 million Americans have a substance use disorder. This includes illicit drugs, prescription medications, and alcohol. In fact, when it comes to alcohol it is estimated that one in eight American adults have an alcohol problem.
Part of the attraction for alcohol lies in the fact that it is a readily available drug. Moreover, drinking is also openly encouraged by social media campaigns, memes and advertising. During the current pandemic, drinking has become a routine activity to cope with stress, fear and anxiety. Consequently, those who have an alcohol problem find it difficult to recognize or accept that they have a problem.
To illustrate, one recent alcohol advertising campaign showed two males drinking while watching sporting events at 8 am. Another advertisement showed a man drinking while in the shower. A problem drinker may look at these advertisements and think, “See, I’m not the only one who drinks in the morning. Heck, this guy even drinks in the shower – I don’t even do that!”
These societal messages can reinforce problem drinking and hinder or prevent the person from seeking help. But what happens when the problem drinker hits bottom? What does he do when he wants help? Where should she turn for assistance?
It is often said in recovery rooms that the first step is not Step One, but Step Zero. Step Zero is awareness. The person has finally conceived to their “innermost self” that they have a problem. From there the person is ready to…
1. Seek Help
Although seeking help and support is often the most difficult part of getting sober, it's also the most important step. The nature of addiction will determine the level of care the person will need to start on the path to sobriety. More severe addictions respond best to a medical detox and rehabilitation program. It is important to note that, attempting to detox alone can be dangerous and even fatal.
If the person needs support or therapy but a residential setting is not a viable option, outpatient facilities may be a suitable setting.
After inpatient therapy, or while participating in outpatient therapy it is crucial that the individual practice some sort of recovery program. Attending meetings or joining a support group is key to long-term recovery.
2. Stay Active
Staying healthy and sober might consume a person’s every waking thought, but it doesn't occupy much of their time. This is why keeping busy is a big part of a recovery program. Filling up the day with new activities, meetings, lectures, workshops and the like will give the person an opportunity to focus on the solution and focus less on the problem.
Many who are recovering from a substance use disorder suffer from a medical condition known as anhedonia. This condition hinders the person’s ability to feel pleasure. Some of the symptoms of this condition are: negative feelings toward one’s self and others, reduced emotional abilities, decreased verbal or nonverbal expressions, and difficulty adjusting to social situations.
Thus, the new person in recovery after a few attempts at socializing or engaging in sober activities may start to withdraw because it doesn’t “feel fun”. What’s important to know is this condition isn’t a permanent state. It can and will improve over time. The new person in recovery may have to open up to new experiences that feel awkward at first, but over time will start to feel normal and enjoyable. Getting outside, physical activities, diet and exercise can help improve one’s health and lift one’s mood too. Fresh air, sunshine and natural beauty are great antidotes for worry, stress, and depression.
Keeping busy is a great way to improve one’s physical health and boost mental health. However, throwing yourself into a million new things can take its toll too.
To counter this, the recoveree might want to set time aside to reflect. Keeping a physical or digital journal can be a useful tool. Charting growth, urges and the like is a great way to see progress over time. Many newly sober people take solace in meditation which can help quiet the mind and center the soul.
4. Recognize Queues Not Triggers
A trigger is something that once squeezed can never be taken back. A queue on the other hand, is a list of data items which are stored so as to be retrievable.
Triggers are inevitable. Once the trigger is squeezed the bullet is gone. A queue involves choice. If a queue is tripped, the recoveree has a choice as to whether or not to follow the data items associated with that queue.
Recognizing the queues is an important stage in recovery. The new recoveree may want to avoid the old faces and old places in early sobriety. Hence, avoiding bars and alcohol-based festivities may be useful. For many, nicotine and alcohol went hand in hand both literally and metaphorically. Thus, avoiding one cuts down on the urge for the other. Of course, external queues aren't the only queues of which to be wary. Internal queues like intense emotions can also create cravings and thoughts about using.
For some, dreams about using can be unsettling and disconcerting and can lead to waking thoughts about reusing. The new recoveree may think there is something wrong because they are having intense and life like dreams about drugs and alcohol.
Using dreams may be explained by the “extinction response” associated with a conditioned response. To eliminate a conditioned response, one simply withholds reinforcement. In other words, the dreams gradually disappear when the drugs and alcohol are eliminated and stay eliminated.
Another way to look at the “drunk dream” phenomenon is to look at it like “phantom pain”. Phantom pain is a phenomenon where one feels pain from a part of the body that's no longer there. This is sometimes a useful metaphor which helps the new recoveree to understand what’s going-on and lessons their anxiety that they are doing something wrong. Again, these night-cravings decrease in frequency and intensity with clean time.
5. Take Sobriety One Day at a Time
At the start of recovery, a lifetime of clean-time can seem daunting and overwhelming. Therefore, those new in recovery are encouraged to use the ODAAT philosophy – One Day At A Time. Sometimes, 24-Hours can seem too long. In this case the new recoveree is encouraged to take it one morning at a time, one evening at a time, even one hour at a time. It’s important for the new recoveree to remember that they don’t have to trip over something that is behind them.
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