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ORTC Articles

Medication Guide for People in Recovery

Using this guide

Many medications, both over-the-counter (OTC) and prescription (Rx), have mood-altering effects. Not only do these medications have addiction potential of their own, but they may also lead to relapse.

This guide lists some common medications to avoid, and others that are safer to use. However, it is not meant to replace the advice of a physician, pharmacist, or other health care professional. If you have any questions regarding medication use during your recovery, please contact your physician and/or pharmacist.

Moreover, this guide is not exhaustive. With so many medications on the market, it is impossible to list them all. Instead, you’ll simply find a few common examples in various medication categories. Again, if you have questions about a specific medication not listed in this guide, contact your physician and your recovery team.

Most medications are listed here by generic name—that is, by its active ingredient—with an example of its brand name in parentheses: for example, acetaminophen (Tylenol). Some medications are sold under many brand names. Check the label for the active ingredients: any brand-name medication package should also include its generic name.

Symbols used in this guide:

Rx = prescription only

OTC = over-the-counter

General guidelines

Be up-front with your physician and/or pharmacist about your addiction. If they are aware of it, they can prescribe or recommend more suitable medications.

Important: read all labels. Many OTC medications contain one or more ingredients that you should not be taking. Check both the active and inactive ingredients, as many contain alcohol as an inactive ingredient. If a medication that you should not be taking is deemed medically necessary by your health care professional, notify your sponsor as well as your recovery team. Make a plan for use as well as a plan to discontinue use.

Cold, allergy, and asthma medications

Avoid the ingredient pseudoephedrine, which has stimulant-like properties and is contained in most OTC cold and sinus preparations.

Avoid these and other pseudoephedrine-containing OTC medications:

  • Sudafed
  • Tylenol Cold & Sinus  DayQuil
  • Alavert D-12
  • Advil Cold & Sinus
  • Claritin-D
  • Theraflu

Other cold/allergy/asthma OTC medications to avoid:

  • diphenhydramine (Benadryl)
  • chlorpheniramine (Chlor-Trimeton)
  • clemastine (Tavist)
  • brompheniramine (Dimetapp Elixir)
  • ephedrine (Bronkaid, Primatene)
  • dextromethorphan (Robitussin DM, or any cough syrup with “DM”)
  • nighttime preparations, since most contain alcohol (for example, NyQuil)

Safe medications for cold, sinus, and allergy symptoms:

  • loratadine (Claritin, Alavert). Beware: Claritin-D and Alavert D-12 contain pseudoephedrine. Make sure you are using the pseudoephedrine-free medication.
  • saline nasal spray (Ocean)
  • Vicks VapoRub, Vicks steam
  • guaifenesin (Mucinex, Vicks 44E)
  • benzonatate (Tessalon Perles—Rx)
  • acetaminophen (Tylenol)
  • NasalCrom nasal spray
  • cough drops (such as Halls)
  • sore throat lozenges
  • salt-water gargle
  • Breathe Right nasal strips

Pain medications

The first thing you need to say at any visit to an emergency room or to a physician prescribing you pain medication is that you are recovering from an addiction. The physician and you will then create a plan to resolve your pain and maintain your sobriety.

Avoid all opioids:

Opioids are the most powerful known pain relievers. Naturally occurring opium derivatives include morphine and codeine. Partially synthetic derivatives of morphine include heroin, oxycodone, and oxymorphone. Synthetic opioid com- pounds include fentanyl, alfentanil, levorphanol, meperidine, methadone, and propoxyphene.

Avoid these and other opioid Rx pain medications:

  • fentanyl (Duragesic patch)
  • morphine
  • codeine (Tylenol #3)
  • oxycodone (Percodan, Percocet, OxyContin)
  • hydrocodone (Vicodin, Vicoprofen, Lortab)
  • hydromorphone (Dilaudid)
  • propoxyphene (Darvon, Darvocet)

For pain relief some physicians prescribe other medications, such as anti- depressants, that are also mood altering and addictive. Check this guide or talk to your doctor before adding them to your treatment plan. Avoid using all benzodiazepines (listed under “Psychiatric medications” below).

Be careful with dental procedures. Tell your dentist you’d like to avoid nitrous oxide or “laughing gas.” Injectable medications such as lidocaine or Novocaine are better because they provide the numbing pain relief without the mind-altering effect.

Safe pain medications:

Unless your doctor has told you to avoid these medications, they are generally safe (not addictive or mood-altering) to use for pain:

  • aspirin (Bayer)—OTC
  • ibuprofen (Motrin, Advil)—OTC
  • acetaminophen (Tylenol)—OTC
  • naproxen (Naprosyn, Aleve)—OTC  celecoxib (Celebrex)—Rx
  • ketorolac (Toradol)—Rx
  • methotrexate (Rheumatrex)—Rx
  •  infliximab (Remicade)—Rx
  • and many more

Psychiatric medications

Most medications that are used for anxiety, depression, and other neurological disorders are mood-altering. Some of these are safe and nonaddictive and some are not. If you are diagnosed with a neurological disorder, work with your doctor to pick the safest one that will handle your symptoms. If you are already on a medication, talk to your doctor before discontinuing its use. Some of these medications have severe withdrawal effects that require tapering down the dose.

Avoid all benzodiazepines:

  • diazepam (Valium)
  • oxazepam (Serax)
  • alprazolam (Xanax)
  • midazolam (Versed)
  • lorazepam (Ativan)
  • clonazepam (Klonopin)

Some acceptable prescription psychiatric medications:

  • fluoxetine (Prozac)—Rx
  • sertraline (Zoloft)—Rx
  • paroxetine (Paxil)—Rx
  • citalopram (Celexa)—Rx
  • escitalopram (Lexapro)—Rx
  • bupropion (Wellbutrin)
  • venlafaxine (Effexor)
  • amitriptyline (Elavil)
  • imipramine (Tofranil)
  • nortriptyline (Aventyl, Pamelor)
  • clomipramine (Anafranil)
  • buspirone (BuSpar)

Anticonvulsant and antipsychotic prescription medications to avoid:

Medications like the following should be avoided:

  • clozapine (Clozaril)
  • olanzapine (Zyprexa)
  • phenytoin (Dilantin)
  • risperidone (Risperdal)
  • phenobarbital (Luminal)

Most medications used for attention-deficit/hyperactivity disorder (ADHD/ADD) have a stimulant property. You should try to avoid:

  • methylphenidate (Ritalin)—Rx
  • dextroamphetamine (Adderal)—Rx

A safe medication for ADHD is:

  • atomoxetine (Strattera)—Rx

Common medications

Diet medications:

The majority of diet medications have stimulant properties; many contain actual amphetamines, which are extremely addictive. Therefore, it is highly recommended that you avoid all of these types of medications.

Some specific examples of diet pills that should be avoided are

  • sibutramine (Meridia)—Rx
  • phentermine (Adipex)—Rx
  • dextroamphetamine (Dexedrine)—Rx

Acceptable heartburn/upset stomach medications:

  • Prilosec
  • ranitidine (Zantac)
  • antacids such as Tums, Maalox, Mylanta, Rolaids; famotidine (Pepcid)

Acceptable diarrhea medications:

  • loperamide (Imodium A-D)
  • Kaopectate

Acceptable constipation medications:

These medications should all be avoided if you have an eating disorder. If you do not, the following medications can be taken:

  • docusate sodium (Colace)
  • Metamucil powder
  • senna (Senokot)

Mouthwash:

Many OTC mouthwashes contain from 9 to 21 percent alcohol. Avoid any alcohol- containing brands, such as

  • Listerine
  • Plax
  • Cepacol
  • Scope

Some mouthwash brands that are okay to use:

  • Colgate
  • Fluorigard
  • Act
  • Act Kids

Sleep agents:

It is best to avoid all sleep medications since they have depressant-like properties. The best treatment for insomnia is to find ways to relax: meditate, listen to music, or take a hot bath before bed. Try to find something that works for you. If you still have difficulty falling or staying asleep, discuss this with your physician and recovery team.

Sleep medications to avoid:

  • diphenhydramine (Unisom, Sominex)—OTC
  • zolpidem (Ambien)—Rx
  • zaleplon (Sonata)—Rx

Motion sickness agents:

Most of these cause mood-altering effects and should be avoided. A few examples of motion sickness medications to avoid:

  • meclizine (Bonine—OTC, Antivert—Rx)
  • dimenhydrinate (Dramamine)—OTC
  • scopolamine patch (Transderm Scop)—Rx

 

Alcoholics Anonymous (AA)

What’s the history of AA?

The story of Bill W. is entwined with the founding of Alcoholics Anonymous (AA). In 1935, a recently sobered-up Bill W. was on a business trip. The bar in the hotel lobby triggered his craving to drink. A series of calls led him to Dr. Bob, an alcoholic surgeon, who met Bill to talk. The fifteen-minute talk turned into a three-week visit during which both men gained their sobriety.

For the rest of their lives, Bill W. and Dr. Bob helped other alcoholics achieve sobriety. They decided to publish a book to describe the Twelve Step program of recovery they used to help themselves and other alcoholics. The book, Alcoholics Anonymous, was published and has been in print ever since. It has been translated into many languages and is used by recovering people worldwide.

Word spread about the AA program, and its ranks swelled. By 1950, AA held its first International Convention with 3,500 member groups in attendance. Today, more than 98,000 groups across the world are registered with AA’s General Service Office, representing nearly two million members.

What’s the promise of AA?

The promise of AA is that those who follow the program will have happiness and a new sense of freedom. AA is an informal program whose members share a common goal: help each other stay sober. At AA meetings, the principles behind the Twelve Steps and Twelve Traditions are explored. Members tell their stories, emphasizing how they failed and how they succeeded. They answer the questions of newcomers and help each other stay sober just for today. They listen, and they keep what they hear private.

AA groups are run by members; no one person or group of people is in charge. Membership costs nothing; the groups are self-supporting through member contributions. AA is not religious and isn’t affiliated with any faith denomination; members are encouraged to define their own version of a Higher Power.

How are AA and the Big Book connected?

Alcoholics Anonymous, also called the Big Book, was created when early AA members, including Bill W. and Dr. Bob, wanted to spread the word. They felt that the number of alcoholics suffering and dying in America was tragic. They also thought that many of these people could get better if they had access to what the early group members knew. This deeply felt motivation to spread the word led to publishing the Big Book in 1939. The Central Office of AA was founded at the same time.

The goal of the Big Book—then as now—is to provide a step-by- step way to recover from alcohol use. The book explains addiction to alcohol, offers a practical solution, and presents ways to put the ideas into practice in your own life. But from the beginning, the authors cautioned that the Big Book must be read carefully and completely.

The first section of the Big Book (through page 164) clearly describes the program, the process, and all of the key concepts. This section is a must-read. Following this are three sections of personal stories from the founders of AA, as well as more current stories. This diversity of storytellers and stories underscores that alcoholism can and does affect those in all walks of life, all ages, male and female, all ethnic backgrounds, and so on. The stories also provide a tremendous sense of identity with and belonging to a group of people who are just like you.

What are the Twelve Steps and Twelve Traditions?

Originally, Bill W. summarized six Steps from all the suggestions made by early AA members. The emphasis was on admitting powerlessness over alcohol, getting honest with self and others, making amends, and working with others. Bill W. soon expanded the Steps to twelve as a result of adding the concept of a Higher Power and trying to make the Steps airtight, with no room for “the reader to wiggle out anywhere.” When finished, the Twelve Steps were widely approved by clergy members and psychiatrists.

The Twelve Steps of AA are a set of principles that present a design for a way of living—the problem, the solution, and a plan of action. The Steps are practical tools. Their underlying principles are couched in early slogans like “One day at a time” and “Take what works and leave the rest.”

The Twelve Traditions grew out of a need to apply the program. The question arose of how the wisdom of the AA program could be shared without setting up a central place or person to be in charge. The Twelve Traditions outlined the fellowship, or community, of AA as a way to protect unity through collective rather than individual emphasis. Individuals must be vigilant to avoid letting grandiosity and big egos get out of hand. Bill W. wanted to ensure that the AA organization avoided the same problem. The Traditions were meant to assure that the organization remain humble and true to its original purpose.

What are the different types of meetings?

The two most common kinds of AA meetings are closed meetings and open meetings. Closed meetings are for alcoholics only. Open meetings are for alcoholics, their family members, and anyone else interested in solving a personal drinking problem or helping someone else solve such a problem. During the meeting, there is usually a period for local AA announcements, and a treasurer passes the hat to defray costs of the meeting hall, literature, and incidental expenses. The meeting adjourns, often followed by informal visiting over coffee or other light refreshments.

Guests at AA open meetings are reminded that any opinions or interpretations they may hear are solely those of the speaker involved. All members are free to interpret the recovery program in their own terms, but none can speak for the local group or for AA as a whole.

At speaker meetings, one or two members share their stories of what they were like before AA, what brought them to AA, and what their lives are like now. At discussion meetings, group members explore a pre-selected topic.

Other meetings are devoted to study of the Big Book,  the Traditions, or the Steps. A Twelve by Twelve meeting helps members explore aspects of both the Twelve Steps and the Twelve Traditions. Other meetings take place for beginners, for group inventory, and for business. Some meetings gather together people who share a common bond in addition to alcoholism: meetings for women, men, gay men, lesbians, younger adults, older adults, and so on. None of these meetings, however, exclude anyone. The only criterion for attending AA is the desire to stop drinking.

Why is AA participation so important?

AA meetings are the backbone of the fellowship of AA. People who join this fellowship share the experience, strength, and hope they have gained by practicing the Steps. AA works because the program doesn’t judge and members are willing to help newcomers learn. It also works because of the poignant way in which one alcoholic understands the experiences of another.

The fellowship of AA is a critical part of the strength many members get from attending meetings. Isolation and loneliness are often intense for active alcoholics. You, like many others, may have felt as though you “didn’t belong” in your pre-drinking days. Drinking enhanced that sense of alienation a thousandfold. What is the best antidote to alienation and isolation? Friendship. When you make a connection with another human being, intense feelings of loneliness decrease. Suddenly if you have a problem, question, or experience you don’t understand, you can turn to your fellow AA members for help.

Web resources

Alcoholics Anonymous The official AA website offers member guidelines, questions and answers, and a welcome message for newcomers.

Loners

What does it mean to be a loner?

A loner is one who avoids others or pursues a markedly independent course in thought or action.

How can participation in Twelve Step groups affect your recovery?

Some people in early recovery describe themselves as “loners” or “misfits.” For these people recovery can be more difficult. If you are a loner, participating in meetings by speaking or performing service work, even simple tasks such as setting up chairs or making coffee can develop your sense of belonging to the program and the group.

Being a loner may seem like a sign of strength to some, but in reality, it can be a sign that a person’s recovery is weak. If you look at the wording of the Twelve Steps, you will notice that the term “we,” not “I,” is used. Recovery is not something that can be done alone, at least not very successfully. The power of recovery is in the fellowship of alcoholics and other addicts helping each other.

Asking for help, talking about problems, and listening for advice are not signs of weakness but signs of wisdom. Others have traveled the pathway of recovery, and you can learn from their experience. And in turn, others can learn from you.

It is also true that your Higher Power will often use other people to speak to you and help you. All human beings are meant to be in community with others for this reason.

If you have been a loner, it may take a focused effort to break old habits of isolation. It may mean forcing yourself to do things and go places, even when you don’t feel like it, but it will be worth it. Try attending a Twelve Step recovery group. Most people find these meetings to be accepting, loving settings where you can just be yourself. Trust that others in the room have felt like misfits too, but have now found a place to belong.

Humility

What is humility?

“Humility” is a word that is often misunderstood, particularly by people in recovery from addiction. Humility involves a clear recognition and acceptance of one’s humanness. Learning humility means taking an honest look at your strengths and weaknesses in the spirit of attempting to become what you want to be.

Only when you work toward humility can you develop a realistic acceptance of yourself. Humility does not mean inadequacy. It means that you are no longer hiding anything. “The basic premise of humility is a desire to seek and do God’s will.”

Mother Teresa understood humility when she said:

“If you are humble nothing can touch you, neither praise nor disgrace, because you know who you are. If you are blamed you will not be discouraged. If they call you a saint you will not put yourself on a pedestal.”

How does humility affect recovery?

Learning humility will allow you to let go of feeling the need to be “right” or superior to others. This will also help you if you need to work to stop blaming others and start looking inward to take responsibility for your life. True humility also means that you have let go of your old character defects and are seeking spiritual values.

Working Steps Four, Five, and Six prepared you to understand who you are. Now you can turn to your Higher Power without pretense or shame, asking that your defects be removed.

While you are working the Steps, stay in contact with your sponsor, counselor, and others in your support group. Now that you’ve found your Higher Power, you may feel safe, secure, and motivated to work toward embracing humility and expanding your spirituality. That’s great: you should feel liberated and excited at this point. But use caution; don’t put yourself in using situations or around triggers. Don’t get overconfident. Your plans to stay away from people, situations, or places that could threaten your recovery are there to prevent the disease of addiction from overtaking you while you’re busy doing the hard spiritual work that will give you a daily reprieve.

You know you’ve achieved humility when you do your best and accept that the rest is up to your Higher Power.

 

Honesty, Openness, Willingness (HOW)

Why is HOW important to your recovery?

HOW (honesty, openness, and willingness) is a common phrase in Twelve Step programs. It represents three key ingredients that are needed to move forward in a successful program of recovery.

What is honesty?

Sobriety requires us to change the way we live, to adopt a lifestyle that requires rigorous honesty. While in active addition, most addicts and alcoholics are far from honest. They live in a world of deceit and denial. Recovery demands that they be honest with themselves first, but also with their families, their friends in recovery, and those they have harmed. The Big Book states, “Those who do not recover are people who cannot or will not completely give themselves to this simple program, usually men and women who are constitutionally incapable of being honest with themselves. . . . They are naturally incapable of grasping and developing a manner of living which demands rigorous honesty.”

Honesty means speaking the truth to yourself and others. Honesty at times, however, needs to be tempered with compassion. Never use honesty to purposely hurt someone. Practicing honesty makes it apparent that what is also needed is wisdom. When you are struggling with an issue of honesty, talk about it with your sponsor or recovery support group.

Learning how to be honest after living dishonestly takes focused effort and it requires the help of your Higher Power. Making small, daily choices to be honest will help you grow and develop spiritually.

What is openness?

Openness is difficult for most people in recovery. Much of the time, addicts and alcoholics feel that if people really knew who they were and how they felt, they would not like them. One way to start being open is with people you trust, those you feel would understand. A good place to begin might be in your Twelve Step group. Start little by little. Begin by sharing at a meeting and see what happens. Others will respond to your openness.

What does it mean to be willing?

Willingness comes from your commitment to do whatever it takes to recover. The Big Book states, “If you have decided you want what we have and are willing to go to any length to get it—then you are ready to take certain steps.” Follow the Twelve Steps of AA. You may also need to heed the advice of those that are already sober, even when it does not make sense to you at the time. Willingness is the commitment you bring to your recovery.

“Half measures availed us nothing. We stood at the turning point. We asked His protection and care with complete abandon.”

Honesty, openness, and willingness are the defining principles of AA. It is virtually impossible to drink and use drugs if you live your life in accordance with these simple truths.

 

© 2014 by Hazelden Foundation. All rights reserved.

Affirmations

What are affirmations?

Affirmations are an essential component of your ongoing recovery. To affirm means to declare something in a positive, firm, true way that is empowering. Affirmations are a way to change the messages of self-talk from negative to positive, from shameful and guilt-ridden to deserving and empowered. When many people first think of affirmations, they think of cute sayings that have little real power. But in truth, what you say is what you believe. Do you believe that you are worthy and deserve happiness, freedom, and empowerment? Can you affirm yourself with real conviction and meaning?

Affirmations are not a substitute for reality; they aren’t another way for you to exert denial, control, and reckless self-will over your life. Instead, they collaborate with surrender, spirituality, and your Higher Power.

Why are affirmations important to recovery?

You may have spent your entire life internally reciting restrictive messages about yourself and others. In recovery, you have faced your patterns of compulsion, denial, self-destruction, control, and inadequacy. But are you ready to assert that you deserve better? Are you ready to empower the good and the positive in yourself and in others?

The power to change is within you. But you have to believe it, say it, and live it.

How can you practice positive affirmations?

At first it feels awkward to practice positive affirmations. You may think, “I deserve to have a great job, a fantastic family, and freedom from pain.” But look in the mirror and say it out loud. It may seem awkward and even fake, but as time goes on, you will start to believe that you deserve these things, and the affirmations will become easier. You will start to notice that you are living the affirmations, creating a self-fulfilling prophecy that can only manifest itself by creating more positive energy in your life.

Recovery Action Step

Write down some loving, empowering affirmations for yourself. For example, “I am a beautiful person who is perfect just as I am today” or “I am a good person and I deserve to be happy.” Set a routine each day to read these. Look yourself in the mirror and believe them as you say them out loud.

Things you can do to affirm yourself and your recovery:

1. Work the Twelve Steps.

2. Read meditation/prayer books and focus on empowering thoughts every day.

3. Attend recovery groups or positive seminars or events.

4. Engage in positive self-talk, giving yourself new messages and new beliefs.

5. Write down affirmations of the positive life you imagine.

6. Surround yourself with people who support your recovery and believe in you.

7. Get a massage, go to a yoga class, or do something else positive for yourself because you deserve it.

8. Celebrate your successes with others.

9. Affirm others. Find out about the dreams and goals of others and support them.

10. Place affirmations in key places, such as on your desk at work or on the refrigerator at home. This way you will think about them on a daily basis.

Enemies

Why do you need to resolve issues with challenging people?

There will come a time when alcoholics and other drug users need to resolve issues they have with challenging people. These enemies can be people or feelings, and we will have identified many of them through our Fourth Step. Step Eight instructs us to be willing to make amends to them whenever possible. The Big Book describes it this way:

It is harder to go to an enemy than to a friend, but we find it much more beneficial to us. We go to him in a helpful and forgiving spirit, confessing our former ill feeling and expressing our regret. Under no condition do we criticize such a person or argue. Simply we tell him that we will never get over drink- ing until we have done our utmost to straighten out the past.

Making amends can set straight feuds and fights that have lasted many years. It can make friends out of people who have challenged us, and at the very least provide the opportunity to have a civil relationship.

This directive does not include those who have been perpetrators of abuse. Abuse is never the victim’s fault. Making amends to someone who has hurt you physically, sexually, or emotionally is not the focus of this passage. It may help you in your recovery, however, to get to the point where you can forgive an abuser so you can be free of anger and hurt.

Feelings as enemies

Substance abusers have other enemies that are not human. Perhaps our greatest enemies are resentments, jealousy, envy, and fear. Alcoholics need to constantly monitor their feelings and handle them in healthy ways. They do this so that resentments and other strong feelings do not shatter their serenity and rob them of their sobriety.

Prayer and Meditation

What’s the difference between prayer and meditation?

Prayer is talking to your Higher Power. Meditation is listening to your Higher Power.

For most people, life is frequently fast-paced and stressful. Everyone needs time to sit back and gain perspective on what they are here for and how they are conducting themselves in their daily lives. This reflection and introspection— looking inside oneself—can be done through prayer and meditation.

You may pray frequently, or you may never have prayed. If you don’t believe in prayer, try acting as if you do. Start praying and see what happens. Members of Alcoholics Anonymous call this “Fake it until you make it,” which means that as you begin to act in accordance with spiritual principles, you will begin to grow spiritually. Whether or not you fully believe in the power of prayer does not matter right now. The important thing is to begin prayer and meditation with an open mind. You have nothing to lose and everything to gain.

Your prayers do not have to be complex. The Serenity Prayer may be as much as you can do:

God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.

It’s helpful to think of prayer as a conversation—a conversation with your Higher Power. Keep it simple. Just talk about what’s on your mind, your concerns and worries. Nothing is too insignificant.

You may also want to explore other kinds of prayer.

What benefits will you get from prayer?

In the past you may have prayed, “God, get me out of this and I promise I’ll never drink or use other drugs again.” These prayers are self-serving. Instead pray for the courage to change and to confront the things that frighten you, threaten you, or make you angry. Pray for others, even those you don’t like. Use prayer to relieve the fears, grief, and anger that could cause you to relapse or return to alcohol or other drug use.

Prayers will bring you a sense of calm and well-being—a sense that you are part of a greater whole. It’s difficult to use alcohol or other drugs when you feel spiritually connected to your Higher Power and other people. But it’s easy to use substances when your heart is full of anger and fear.

On one level, prayer is about learning to accept external circumstances that you cannot change. But on a deeper level, prayer points to a fact about your inner life: you cannot directly control your feelings. However, you can influence your feelings through two other factors you can control: your thinking and your actions. Doing this moves you on to another quality described in the Serenity Prayer: courage. Courage allows you to seek spirituality and recovery one day at a time, while not letting fears or insecurities inhibit your spiritual progress.

What is meditation?

Meditation is all about listening to your Higher Power. The object of meditation is to clear your mind of racing thoughts, center yourself, and let go of fears, ambitions, jealousy, blame, and control. When you meditate, you will learn to listen to your inner self. Whenever your mind is racing with too many stressful thoughts of what you should be doing, what needs to be done, and what you should have done two weeks ago, focus on your breathing and make a conscious attempt to slow down and take full, long breaths. Soon, you’ll be able to use deep breathing to clear your mind for several minutes, and eventually even longer. When obsessive, stressful thoughts catch up with you, simply refocus your breathing. Keep practicing this, regardless of how many times it takes before you see concrete results.

How can you learn to meditate?

Like most worthwhile things, deep meditation is achieved through practice. With practice, you will learn to customize a method of meditation that’s right for you.

As a beginner, you may want to follow these steps to learn the basics of meditation:

1. Prepare the environment. Set aside a specific place and time. Consider shutting the door and unplugging the phone. Spiritual practice is about setting up a safe place that is free from distractions.

2. enter a state of relaxed alertness. Many spiritual traditions, such as yoga, emphasize posture. For example, sitting upright with a straightened spine promotes attention, alertness, and relaxation, all at the same time. Try different postures that feel comfortable to you and allow you to breathe deeply.

3. allow for uninterrupted silence. Listening begins as you quiet down. Freed from the compulsion to speak, criticize, or justify yourself, you can listen and gain direction for your life.

4. Listen and give acknowledgment. Step Eleven uses the term “conscious contact” to describe the state of being tuned in and listening with your deepest wisdom. When you receive guidance, let go of your own preconceptions about what should be and follow the inner guidance of your Higher Power.

Sleep

What are some of the sleep problems that people experience in recovery?

When you were using alcohol or other drugs, your sleep pattern may have been disrupted. Now that you are in recovery, post-acute withdrawal from alcohol and other drugs can leave you feeling sleepless and exhausted. Don’t worry. This process is normal, and it happens to most people in recovery. Eventually you will want to establish normal sleep patterns. The average person needs between seven to ten hours of sleep each night.

Sleep is important because it allows your body’s metabolism to slow down enough to repair daily wear and tear. Roughly one-fifth of all slumber time is spent in REM (rapid eye movement) sleep; this is where large amounts of psychological healing work are often accomplished.

What is sleeplessness?

Sleeplessness can take several forms:

  • difficulty falling asleep: one to three hours may pass before you can actually fall asleep
  • early morning awakenings: you wake early in the morning and are unable to get back to sleep
  • frequent nighttime awakenings: you fall asleep easily but wake up many times during the night

Many people worry about their sleep difficulties. This can create a vicious cycle: the more a person worries about being able to fall asleep, the more difficult it actually becomes. Once you get into bed, you may worry about things such as “Will I be able to sleep tonight?” or “Will I be too tired tomorrow to get my work done?” This type of worrying will only increase your level of physical arousal and impair your ability to sleep and relax.

Should you use medications to help you sleep?

Using medications to induce sleep can be unhealthy. Not only are many sleep inducing medications addictive, they can also make sleep problems worse.

Withdrawing from these types of drugs, such as benzodiazepines and barbiturates, actually cause a rebound effect where sleep difficulties temporarily worsen before improving on their own. This can be true even when the medication is not addictive. Many nonaddictive, sedating medications merely delay the process of correcting sleep problems.

Healthy options for improving sleep

There are many effective strategies for dealing with sleeplessness that do not involve using drugs:

  • Take a hot bath or shower before bed. Doing so will increase your body’s core temperature and help you relax.
  • Exercise four hours before bedtime, usually between 4:00 p.m. and 7:00 p.m. Mild to moderate exercise during these times will promote and induce sleep later in the evening. Exercising too intensely or too late in the evening may make falling asleep more difficult.
  • Avoid caffeine. If you insist on daily coffee or sodas, limit your caffeine intake to the early morning. Switch to decaffeinated beverages after 10:00 a.m.
  • Avoid using your bed for reading, writing, watching television, talking on the phone, or engaging in other activities that require mental alertness. Using your bed in this manner conditions your brain to react with increased alertness, which can keep you awake when you’re ready to sleep.
  • If you are tossing and turning in bed after twenty to thirty minutes, get out of your bed, go to another room, and engage in some type of relaxing activity, like reading, stretching gently, or meditating. Go back to bed only when you feel sleepy.
  • Use relaxation strategies. There are many different sleep tools available, including relaxation techniques and CDs or audio downloads. Try different tools until you find the one that works for you.
  • Avoid naps during the day. Although a nap feels good when you are tired after a night of sleeplessness, it only makes the problem worse the follow- ing evening.
  • Use “white noise.” A fan, relaxing music played very softly, or other background noise can allow the senses to relax rather than be alerted by sudden changes in noise level.
  • Eat small amounts of carbohydrates, such as popcorn, toast, or cereal, prior to bedtime. Some carbohydrates contain tryptophan, the amino acid that the body uses to make serotonin, the neurotransmitter that slows down nerve traffic. A high-carbohydrate meal also stimulates the release of insulin, which helps clear from the bloodstream the amino acids that compete with tryptophan, allowing more of this natural sleep-inducing amino acid to enter the brain.
  • Develop a relaxing ritual for the fifteen to twenty minutes prior to sleep, such as meditating, listening to relaxing music, and/or practicing relaxation techniques. This will help you relax your mind and body.
  • It is important that you practice these techniques on a regular basis because lack of rest can set you up for relapse and an eventual return to use. Change in sleep patterns may not happen “overnight.” But by developing good sleep habits, you will be taking good care of yourself and ad- dressing sleep problems in healthy ways. If your sleep problems persist for more than six months during your recovery, contact your physician for a referral to a sleep clinic for a full evaluation.

Remember, you may experience periods of exhaustion during recovery. This is normal. If your exhaustion exists for an extended period of time, contact your physician to see whether there are any other underlying physical or mental issues that should be addressed.

Recovery Action Step

What are some strategies you could use to handle sleeplessness or exhaustion? Journal about these and create your own plan of action.

What are some typical dreams people experience in recovery?

It is not uncommon for those in recovery, even people who have been in recovery awhile, to have dreams of drinking or using. Not everyone has this experience, but many do. It is a normal part of recovery, and it is harmless. What those dreams mean from a psychoanalytic standpoint is not as important as the fact that they do happen, and they shouldn’t surprise you.

For example, some recovering people dream that they are drunk, but they’re sure that they haven’t taken a drink. Others experience chills, shaking, or jitters when they wake up, as if they had been drinking. Of course this is all a bad dream, but it can be alarming. Being unsettled by these dreams is good because it indicates that you are far enough along in your recovery to realize that sobriety is what you want—that you don’t want to go back to living the nightmare of using.

Here are some general guidelines for what to expect from your dreams during your recovery:

Early recovery

Drug and alcohol use interferes with normal sleeping. When the using stops, many people experience frequent and intense dreams. The dreams seem very real and frightening. Remember, these are a normal part of the recovery process, and you are not responsible for using alcohol or other drugs in a dream. Exercise is a tool that may help you lessen this dream activity.

Middle recovery

Dreams about using typically become less frequent after six months of recovery. When they do occur, they can create powerful feelings that last well into the following day. It is important to be extra careful to avoid relapse on days following powerful dream activity. Often, dreams during this period are about deciding to use or not to use, and they can indicate how you feel about those choices.

Late recovery

During this time, dreaming about alcohol or other drug use can help warn you when you are more vulnerable than usual to relapse and an eventual return to use. When you have dreams about using, review your situation and correct any problems you discover. Listed below are some helpful actions you can take when dreams begin:

  • Exercise.
  • Go to Twelve Step meetings or to other outside support groups.
  • Call a counselor.
  • Talk to sober friends.
  • Take a break.
  • Stay away from alcohol and other drugs.

The great thing about sleep when you are sober is that you can wake up with no hangover and no concerns about what happened the night before. You can wake up feeling hopeful and content—another recovery gift you’ll receive one day at a time.

 

 

Paranoia

What is paranoia?

Paranoia is a mental health disorder accompanied by the irrational beliefs that someone or something is out to harm you. These delusions typically involve excessive or irrational suspicion and distrust of others. Intense paranoia can result in homicidal as well as suicidal thoughts.

Methamphetamine, cocaine, marijuana, alcohol, and ecstasy are examples of just a few drugs that can cause paranoia. Use of these chemicals causes physiological stress that can lead to paranoia, anxiety, or hallucinations.

Symptoms of paranoia should subside once you become sober and start working an active recovery program. If symptoms do not subside, you may have a mental health disorder along with substance addiction. Mental health disorders, such as depression or anxiety, that accompany addiction are called co-occurring disorders. If you think you have a co-occurring disorder, seek help from a counselor or psychiatrist.

In a much milder form, paranoia can be one more example of the “stinking thinking” that is so often part of the alcoholic’s or addict’s mind-set. As users, we tended to take a self-centered view of the world, perceiving events as directly related to us. We can become paranoid about others’ concern for us or paranoid because of the things we did while we were using. Working an active recovery program is a positive way to deal with this milder form of paranoia.

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