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ORTC Articles

Slogans

What are some of the slogans of the Twelve Step program?

If you have been to Twelve Step meetings you probably have heard some or all of these slogans before. Take a few minutes now to really think about what each one means.

One day at a time

Recovery is a journey to be taken one step at a time. The goal is to avoid taking the first drink or first hit, and to stay sober one day at a time.

First things first

If you don’t stay sober, nothing else will matter. Your first commitment must be sobriety. This means being prepared to make whatever hard decisions are necessary in order to stay clean and sober at least for today.

Easy does it

Avoid taking on too much at once—especially during early recovery.

Live and let live

We must all live our own truth and, in the end, travel our own unique and sometimes painful path in life. As recovering people, we most focus our energies on living our lives to the fullest, not on controlling someone else’s path or judging their progress.

Let go and let God

Some things cannot be accomplished by human power alone. When you’ve done all that you can, ask your Higher Power to help do the rest.

Accept life on life’s terms

Acknowledge reality, and learn to embrace your life as it is. Life is the way life is. But you are changeable.

Progress, not perfection

The goal is to make progress, not to achieve perfection. Trying to reach perfection is trying to do the impossible. Remember, perfectionism stands in the way of maturity, emotional balance, and spiritual growth.

This too shall pass

Everything in life is temporary. Change is the only thing that’s permanent. Live in the moment and enjoy life to the fullest. Don’t let momentary setbacks, pain, or crises keep you from staying sober.

Turn it over

Turning over your will and your life to your Higher Power means asking for your Higher Power’s guidance. Give up control and turn it over to your Higher Power instead.

Go with the flow

When you go with the flow, you practice acceptance and bring your will in line with your Higher Power’s.

Keep it simple

This is a reminder not to complicate matters. It helps the alcoholic or addict to focus on staying sober and not become distracted by unimportant issues. It’s also a reminder that all problems don’t need to be solved at once.

Women in Recovery

What recovery barriers do women face?

While recovering men and women have many similarities in the issues that surface in their Step Four inventories, there are also a number of issues that are unique to women in recovery. Some women have extreme issues of guilt and shame. They may have been abused or have a child that suffers from fetal alco­hol syndrome. They may have problems with perfectionism or approval seeking. In addition, women have higher rates of mental health diagnoses, including anxiety, depression, and panic disorders, and they often have more severe medical problems than men to address in recovery. These various issues are discussed below in more depth:

Approval seeking

Women gain deep satisfaction from relationships. Because of this, they may deny their own talents and dreams in order to keep from threatening a relationship. Ultimately this leaves them feeling as if they have betrayed themselves. If you have a habit of seeking approval from others or trying to be someone you are not in order to please others, you may feel lonely, sad, and resentful. It helps to name these feelings and get support from your therapist, sponsor, or recovery support group to resolve these issues.

Abuse

For many women, alcohol and other drug use is intertwined with experiences of partner violence, rape, sexual abuse, and childhood physical abuse. Sometimes these issues need to be addressed in therapy outside of treatment. If these issues aren’t addressed, they can become barriers for women who struggle to maintain a successful recovery.

Mental health

Women have a higher rate of mental health/dual diagnosis issues to deal with when they leave treatment, such as depression, eating disorders, anxiety, and panic disorders. These issues typically require ongoing therapy after leaving treatment. If they are not addressed, they often contribute to relapse or an eventual return to use.

Perfectionism

Many women feel that they need to do everything perfectly. This tendency to pursue perfection often reaches into every area of their lives. They feel that they must look attractive at all times, never make mistakes, always be the good mother, wife, daughter, or sister. The truth is often that women may have trouble accepting themselves as they are. You may be afraid others will reject you or hurt you if you appear less than perfect. The ironic part is that while you are trying so hard to be perfect, you alienate the very people you want to impress and pull closer to.

Fetal alcohol syndrome

Fetal alcohol syndrome (FAS) is one of the leading and most preventable causes of mental retardation. Drinking during pregnancy causes FAS. Women who drink heavily (an average of five drinks per day) can have babies with withdrawal problems, abnormal reflexes, sleeping disorders, and other problems. Women often experience feelings of shame if their children suffer from FAS.

Guilt and shame

Guilt and shame can be especially difficult problems for women in recovery. They can be the result of one incident or the culmination of many things that have happened over time. If you have feelings of shame that have not been addressed, you are at risk for relapse.

You’ve worked hard in early recovery, but to maintain your ongoing recovery, you’ll need to keep working the Twelve Steps. Step Four and Step Five are particularly helpful when dealing with issues of guilt and shame. Recovery is the process by which you will be restored to a more fulfilling life with fewer emotional hardships and freedom from addictive behavior.

How can women avoid or overcome recovery barriers?

First and foremost, it is important for women to work their Twelve Step program and rely on the support of a Higher Power and the fellowship. No one can do recovery alone. Start working to understand your specific triggers, develop your communication skills, cultivate new ways of thinking, plan a regular time for meditation and spirituality, associate with sober friends, and make time for health and relaxation. All these things will help keep your life in balance.

Recovery Action Step

 

  1. Make a list of the potential barriers and high-risk situations most likely to set you up for relapse.
  2. Pair each problem with a solution, a coping strategy for that high-risk situation. When your list is finished, make plans to learn new skills, develop new ways of thinking, and take concrete steps to keep your life in balance.
  3. Discuss your barriers with your sponsor and recovery support group. They can help you come up with additional coping strategies.

Keeping your life in balance is possible by keeping needs and wants on an even keel. Prayer and meditation, relaxation routines, and exercise are good ways to stay centered.

How can you start practicing these new behaviors and ways of thinking? Give yourself positive feedback when you’ve worked hard on your recovery, and understand that if you slip and use alcohol or other drugs again, it doesn’t have to lead to a full­blown relapse. There’s still time for you to step right back into your recovery. Don’t minimize all the progress you’ve made; just go right back to the Twelve Steps and start again. It’s as simple as that. Don’t give up on yourself and your chance at a healthy, happy life just because you make mistakes. Simply learn from them and plan to avoid them in the future.

Remember to work the Steps, utilize your sponsor and sober friends for support, and go to meetings. These things will help you let go of guilt and shame, receive support, and develop and maintain a healthy, happy outlook where you can enjoy the freedom and peace of sobriety.

Each time you overcome a recovery barrier, you will gain confidence. You will understand that you can face high­risk situations, you can cope, and you can resist relapse. You can take back your life.

Web resources

There are many resources out there. The websites for the following organizations were chosen for their usefulness and user friendliness.

Substance Abuse and Mental Health Services Administration (SAMHSA): The SAMHSA site provides information and research on women and substance use disorders. The site also offers information on prevention and treatment.

National Institute on Alcohol Abuse and Alcoholism (NIAAA): The NIAAA site offers research on alcohol and women, information on prevention and treatment, and a list of workshops and meetings.

 

© 2014 by Hazelden Foundation. All rights reserved.

Big Book

What is the Big Book?

Established in 1935, Alcoholics Anonymous is a society of men and women who have joined together to help each other recover from alcoholism. Members come from many different racial and religious backgrounds, have a desire to overcome their alcohol abuse problems, attend local AA groups, and do not pay fees. Today, there are over two million people in Alcoholics Anonymous.

The Big Book—actually a nickname for the book titled Alcoholics Anonymous—is the core text of the AA organization. It contains personal stories from recovering alcoholics. The first edition, written at a time when the society’s membership totaled one hundred people, was released in 1939. Since then three other editions have been published, and the book has been translated into over forty languages.

Why is the Big Book important to recovery?

The Big Book offers personal stories of inspiration, experience, strength, and hope from other AA members who are recovering from alcoholism. It contains the Twelve Steps—an outline that guides alcoholics through the basic principles of the recovery process. The Big Book also addresses family members of alcoholics, giving them advice on how to deal with their loved one’s addiction.

The Twelve Steps of Alcoholics Anonymous

  1. We admitted we were powerless over alcohol—that our lives had become unmanageable.
  2. Came to believe that a Power greater than ourselves could restore us to sanity.
  3. Made a decision to turn our will and our lives over to the care of God as we understood Him.
  4. Made a searching and fearless moral inventory of ourselves.
  5. Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
  6. Were entirely ready to have God remove all these defects of character.
  7. Humbly asked Him to remove our shortcomings.
  8. Made a list of all persons we had harmed, and became willing to make amends to them all.
  9. Made direct amends to such people wherever possible, except when to do so would injure them or others.
  10. Continued to take personal inventory and when we were wrong promptly admitted it.
  11. Sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
  12. Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs.

How should you use the Big Book?

As addicts, we didn’t know how to live sober. We bounced through life going from one high to another, acting as if we were in control. The Twelve Steps offer us a new way of life and give us a basic guide on how to approach lifelong recovery. Use the Big Book to learn and work the Steps. Revisit your Big Book whenever you need inspiration. Remember, for over fifty years, these same Steps have guided millions of people to fight the disease of addiction with hope and spiritual guidance, rather than to live in quiet desperation.

Depending on where you are in working the Twelve Steps, you might want to look up Big Book topics on spirituality, forgiveness, or making amends. Whenever you need guidance or hope, make it a habit to call your sponsor and read your Big Book. Other recovering people are always available to help you on the journey of recovery.

Web resources

Alcoholics Anonymous

The official website of Alcoholics Anonymous provides information on where to find AA groups in your area, a survey to help you determine whether you have problems with alcohol, and general facts about the organization.

Responsibility

Responsibility

Most addicts and alcoholics have been running from responsibility for years. For many, this behavior was reinforced by family members and loved ones enabling them. With sobriety comes responsibility: for your feelings, your actions, and your own recovery.

How can taking responsibility affect your recovery?

Working Step Four will help you take responsibility for who you’ve been, who you are, and who you’d like to be in the future. In short, it asks you to take stock of your personality traits and examine them honestly and fearlessly so you can be rid of the shame, guilt, and remorse that have been blocking you from being your best self, personally and spiritually. Taking responsibility will also help you stop blaming others and start looking inward to take responsibility for your life.

Page 64 of the Big Book says,

Though our decision [Step Three] was a vital and crucial step, it could have little permanent effect unless at once followed by a strenuous effort to face, and to be rid of, the things in our- selves which had been blocking us. Our liquor was but a symp- tom. So we had to get down to causes and conditions.

Taking responsibility may cause you to relive some awkward, hurtful moments in your life. If you were the victim of physical, sexual, or emotional abuse, of course you can’t be held responsible for those acts. But you’ll still need to work hard to let go of the pain and resentment. Even a justifiable resentment can slowly kill you. Look at how you may have damaged yourself in response to that abuse. Talk to your sponsor, your counselor, or others in recovery about your feelings. Remember, working the Steps is not about others making amends or understanding, it’s about your recovery.

Don’t be afraid to seek help from others, such as your counselor, sponsor, or other recovering people. You don’t want to set yourself up for a return to chemical use. Stay connected with your support system. Talking to others can provide helpful feedback. You may have distorted images of yourself or fail to identify both positive and negative traits. Others who know you can often give accurate and much-needed insight while you are completing your inventory.

In addition to working Step Four, you can take responsibility in many other ways. Be responsible to attend Twelve Step meetings, spend time with your sponsor, and connect with your Higher Power. These are all needed to sustain an active recovery program. It’s not your sponsor’s responsibility to get you to meetings or to make you work your program. It’s yours.

You may also be struggling with the fact that people don’t yet trust the new you. Words won’t convince them that your recovery is for real, but your actions will. If you take responsibility and do what you say you’re going to do, people will begin to learn that they can trust you. Being responsible builds others’ confidence in you. People will take your recovery seriously when they see that you are serious about your commitments to them.

 

Withdrawal

What is acute withdrawal?

When you stop drinking or using, you may immediately experience the physical symptoms of withdrawal, which often last between three and ten days. These symptoms, including muddled thinking, forgetfulness, sensitivity to stress, elevated or numb emotions, sleep disturbances, lack of physical coordination, shakes, sweats, and other flu-like symptoms, are called acute withdrawal. Some recovering people get past the symptoms of acute withdrawal and feel their physical health return quickly. For these people, the worst of the physical symptoms of withdrawal are over. But for other recovering people, the transition back to physical health is slower. These people will move from acute withdrawal into post acute withdrawal.

What is post acute withdrawal syndrome (PAWS)?

Post acute withdrawal syndrome (PAWS) symptoms typically occur seven to fourteen days into abstinence and can last for another six to eighteen months. These longer-term symptoms of withdrawal from alcohol or drugs are the result of the toxic effects of these chemicals on the brain. It’s important to remember that this damage is usually reversible, meaning that with time the major symptoms will go away. With a healthy recovery program, this damage to the nervous system will repair itself over a six- to twenty-four-month period.

Why is PAWS worse for some people?

PAWS is more severe for some recovering people than it is for others. At times of low stress you may hardly notice PAWS symptoms, but when a stressful situation arises, the symptoms can return severely. In other words, you may feel fine one minute, but as soon as a stressor comes into your life, your brain seems to have “checked out.” Recovering people often refer to this feeling as a “toxic fog” or feeling “out to lunch.” During PAWS you may feel as if you are not able to think clearly, that you forget things, and that your emotions seem out of control.

If you aren’t aware of these symptoms and prepared for them, you may feel as if you are losing your mind or that you are not working your program properly. It’s important to remember that you are not alone; PAWS symptoms affect most recovering people. Each individual will experience the symptoms slightly differently in severity and duration.

As a person in recovery, you may have been exposed to certain conditions that resulted in disrupted brain function, which leads to more severe PAWS.

You are more likely to experience severe PAWS if you have a history of the following conditions:

 

  • combined use of alcohol and drugs or use of different types of drugs
  • regular use of alcohol or drugs before age fifteen or abusive use for a period of more than fifteen years
  • history of head trauma (from car accidents, fights, falling, etc.)
  • personal or family history of a metabolic disease such as diabetes or hypoglycemia
  • personal history of malnutrition, usually due to substance use disorders
  • physical illness or chronic pain

In addition, there are certain psychological and social conditions that worsen PAWS, including the following:

 

  • childhood or adult history of psychological trauma (e.g., participant in or victim of sexual or physical violence)
  • mental illness or severe personality disorder
  • high-stress lifestyle or personality
  • high-stress social environment

The four stages of withdrawal

Stage one: withdrawal (0–15 days)

During stage one you may find that you sleep more, act impulsively, or feel irritable, depressed, anxious, shameful, fearful, confused, or filled with self-doubt. Your cravings to use can still be very strong, and you may have trouble concentrating or dealing with stress.

Stage two: honeymoon (16–45 days)

During the honeymoon stage you may begin to feel better physically, with increased energy, optimism, and confidence about your life. You may begin to feel that your addiction is “under control” or “over.” Some recovering people relapse during this stage because they drop out of treatment early or stop recovery activities, such as attending Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or other Twelve Step meetings.

Stage three: the wall (46–120 days)

This stage of your recovery is often seen as a major hurdle in recovery. During this time you may become more vulnerable to relapse because you feel a loss of physical or sexual energy or because you feel depressed, anxious, irritable, or bored. You may have trouble concentrating and feel strong cravings or thoughts about using.

Stage four: adjustment (121–180 days)

When you get through the previous stages, you will probably feel a powerful sense of accomplishment. Your life begins to feel as if it’s getting back to normal as you adjust to your new lifestyle changes. Although your mood has improved, you may continue to feel bored, and you may even feel lonelier than you did in the previous stages. Your cravings to use will probably occur less frequently and intensely, and you may even begin to question whether you really have an addiction. This is dangerous thinking and can lead you to put yourself in high-risk situations that increase your risk of relapse.

What recovery tools can help you get through PAWS?

Working the Twelve Steps can help you get through PAWS, no matter the severity or duration of your individual symptoms. It’s important to remember that your withdrawal symptoms are temporary and will gradually disappear as you establish more “clean time” and work toward maintaining a healthy lifestyle.

Recovery from addiction is a long-term process that involves abstinence plus change. Recovery involves changing yourself (internal) and your lifestyle (external). You will need to develop new coping skills for change to occur and for your abstinence to continue over time. Recovery is not an easy or painless process. It takes hard work, commitment, discipline, and a willingness to examine the effects of addiction on your life. At first it isn’t unusual to feel impatient, angry, frustrated, or unsure that you want to change.

The specific changes you need to make will depend on how addiction has affected you and other people in your life, your motivation to change, and what you see as important to change to recover from your addiction. During your recovery, keep in daily contact with other sober people, go to Alcoholics Anonymous (AA), Narcotics Anonymous (NA), or other Twelve Step meetings, and make sure you visit with your sponsor. Proper nutrition, exercise, and stress management techniques will also help you manage and recover from PAWS symptoms. An open attitude and a willingness to learn will always remain essential parts of your recovery.

 

Withdrawal Journal Activity

Following are some questions to help you begin planning your recovery strategies:

1. list any physical and emotional withdrawal symptoms that you experienced when you reduced or stopped using alcohol or other drugs. For example: “When I quit booze, I had some tremors, felt sick to my stomach, lost my appetite, and couldn’t sleep very well.”

2. list several benefits of your recovery. For example, you might list the following:

 

  • improved physical and emotional health
  • more family time
  • better work performance

3. list two changes you need to make in your recovery from addiction. For example, you might say:

 

  • “I can’t hang out with people I got high with or people who will try to get me to use drugs or alcohol.”
  • “I need to control my anger and not use it as an excuse to use cocaine or drink alcohol.”

4. Choose one of the changes you listed above to begin working on now, and list two or more action steps to take to make this change happen. For example, your change may be “I can’t hang out with people I got high with or people who will try to get me to use drugs or alcohol.” Some possible action steps would be to

 

  • cut ties with users
  • socialize with NA/AA friends after meetings
  • start a hobby that doesn’t put you at risk to use

© 2014 by Hazelden Foundation. All rights reserved.

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Prescription Pain Relievers

Over 4 million Americans are currently using prescription pain relievers (Opiates) non-medically. The abuse of pain relievers has increased at a much more rapid rate when compared to other drugs of misuse. Opiate drugs are highly addictive and are used illicitly (Illegally) to achieve a state of euphoria or “high”.

Common prescription pain relievers (opiates): Darvon, Codeine, Demerol, Vicodin, Loracet, Morphine, Oxycontin, Percodan, Percocet, Fentanyl, Hydrocodone, Vicoprofen, Lortab

Some of the other potential short-term effects of prescription pain reliever abuse can include:
• Slurred speech
• Staggering or becoming clumsy
• Unusual sweating
• Nausea,Vomiting
• Dilated or constricted pupils
• Dizziness
• Confusion
• Constipation

Potential signs of prescription pain reliever overdose:
• Slow or difficult breathing, or not breathing at all
• Unconsciousness
• Coma
• Convulsions
• Cold, clammy skin
• Pinpoint pupils
• Death

Potential long-term effects of prescription pain reliever abuse:
• Tolerance for pain relievers, meaning a normal, safe dose no longer controls pain.
• A greater risk for abusing or becoming addicted to other drugs, especially in young people.
• Damage to a person’s brain and his or her ability to learn, especially if the person abusing pain relievers is young.
• Addiction to pain relievers.

Signs and symptoms of opiate withdrawal:
• Psychological pain
• Restlessness
• Muscle and bone pain
• Insomnia
• Anxiety
• Diarrhea
• Vomiting
• Cold flashes

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