ORTC Articles

How does addiction affect money management?

Recovering alcoholics and drug addicts often find themselves with large amounts of debt that accumulated from spending money on alcohol and other drugs, gambling, compulsive spending, unemployment, or frequent absences from work. Addiction can cause people to disregard other aspects of their life— such as finances—while they focus on alcohol and other drug use. Many people use drugs to temporarily escape problems such as loneliness or anxiety, but their addiction inevitably creates long-term financial problems.

Former alcoholics and drug users may have poor credit ratings combined with feelings of failure (due to dissolved marriages, loss of employment, and other difficulties resulting from their addiction), which can cause them to think that they cannot overcome their money problems.

What is compulsive spending?

Compulsive spenders buy things that they really do not need and won’t use. They often acquire large amounts of credit card debt. Shopping gives them a temporary “high” and takes their mind away from problems or feelings of sadness or loneliness. Later, however, this high is replaced with guilt and anxiety, and they may face additional financial difficulties such as bankruptcy and mounting bills.

What are some strategies you can use to gain control over money?

Planning can help you gain control over money. You can create a budget by listing your expenses; these may include house, car, and insurance payments. You should also list things such as gasoline, groceries, and health care items. One way to get a good estimate of your monthly expenses is to keep a daily log of your spending. You can then figure out how much money you need to put aside for food, clothes, and other items each month. You should compare your expenses to your income and see where you need to cut costs. A financial counselor can also give you advice on money management and may be able to direct you to organizations that offer assistance. For example, some organizations provide temporary housing until you get on your feet again.

How can you get out of debt?

Make a list of people or companies that you owe money to and work on paying them back in small, consistent increments. In some cases, you may be able to prioritize your bills if a lender is willing to give you additional time to pay back your debt.

When you pay back debt or purchase items, refrain from using credit cards or get rid of your credit cards altogether. This will help you avoid having to pay interest. Paying with cash (rather than relying on credit) will also make you less tempted to buy nonessential items.

You may need to cut corners by spending less money on nonessentials such as entertainment; however, do not deprive yourself of too much or you may revert to your old spending habits. If money is still too tight, you may want to get an extra job or look into consolidating your bills.

Support for getting out of debt is also available from Debtors Anonymous or other such organizations. Fellow group members can provide you with valuable resources and encouragement to help you get your finances in order. Of course, consult with your sponsor.

Web resources

Debtors Anonymous (DA) The Debtors Anonymous website lists addresses and websites of DA groups and provides questions and signs to help you determine if you have an issue with compulsive debt.

What are eating disorders?

According to the National Eating Disorders Association, nearly ten million females and one million males suffer from anorexia or bulimia in America. Another twenty-five million suffer from binge eating disorder. While eating disorders may begin with preoccupations with food and weight, they are most often about much more than food. Long-term physical health implications of eating disorders include heart failure, hair loss, kidney damage, serious tooth decay, and osteoporosis.

The link between eating disorders and addiction

Did you know that some 30 to 50 percent of bulimics also abuse alcohol or drugs? While it is possible to abstain from alcohol and other drugs, it’s not possible to abstain from food. You may have been diagnosed for concerns related to an eating disorder while you were in treatment. Or maybe you are more concerned about your eating habits now that you’ve been through treatment. Be aware that once you are in recovery, there is a risk of trading one addiction for another.

What causes eating disorders?

Although no one variable has been found to “cause” an eating disorder, research has shown that certain personality characteristics, genetic disposition, environ- ment, cultural pressures, and biochemistry all play significant roles in the devel- opment of these disorders.

What is anorexia nervosa?

Anorexia nervosa, typically called anorexia, is the most severe type of eating disorder. A person with this disorder has an intense fear of gaining weight and restricts food intake.

What are the symptoms of anorexia nervosa?

People suffering from anorexia are in a cycle of self-starvation. The body is denied essential nutrients that it needs to function normally. This disease can cause serious, irreparable damage to vital organs, such as the heart and the brain, and can lead to death. Physical symptoms of anorexia nervosa include:

• weight loss of at least 15 percent of original body weight
• tendency for the body to feed upon itself
• poor muscle tone
• chemical or fluid imbalance that can lead to cardiac arrest and death
• electrolyte/hormonal imbalances
• excessive loss of hair (or increased growth of fine hair)
• edema (swelling) and intolerance to cold
• pale conjunctiva and mucous membranes
• in women—absence of at least three consecutive menstrual periods

Psychological symptoms of anorexia nervosa include:

• shame-based existence
• need to control
• hidden feelings
• mental and emotional deterioration—the person no longer perceives reality in a normal way
• belief that a thin body is both desirable and powerful
• intense fear of weight gain
• constant feeling of not being good enough
• obsession with physical attractiveness
• depression and irritability

What are the consequences of anorexia nervosa?

Consequences of anorexia nervosa include:

• abnormally slow heart rate and low blood pressure, which increase risk of heart failure
• reduction of bone density (osteoporosis), which results in dry, brittle bones
• muscle loss and weakness
• severe dehydration, which can result in kidney failure
• fainting, fatigue, and overall weakness
• dry hair and skin; hair loss
• growth of a downy layer of hair all over the body, including the face, in an effort to keep the body warm

Where can you get help for anorexia nervosa?

The first step toward recovery from anorexia nervosa is to ask for help. Eating disorders are most successfully treated when diagnosed early. The longer abnormal eating behaviors persist, the more difficult it is to overcome the disorder and its effects on the body. First, contact your medical doctor and therapist for specific treatment options.

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

ANAD can help you find a support group and offers an online chat room, educational materials on treatment, and information on how to find the right therapist.

What is bulimia nervosa?

People suffering from bulimia eat large amounts of food and then try to get rid of the excess calories by fasting; purging (inducing vomiting); abusing laxatives, diuretics, or enemas; or exercising obsessively. This unhealthy behavior is known as bingeing and purging and is often done in secret. A person with bulimia often feels ashamed and tries to hide the behavior.

What are the symptoms of bulimia nervosa?

Physical symptoms of bulimia nervosa include:

• in women—irregular menstruation
• dehydration, dry skin, brittle nails and hair
• fainting
• constant thirst
• dizziness
• electrolyte imbalance
• muscle weakness
• muscle cramping
• dental enamel erosion
• enlargement of the salivary glands below and in front of the ears

Psychological symptoms of bulimia nervosa include:

• repressed feelings, especially anger
• hypersensitivity to criticism
• strong feelings of powerlessness and depression
• impulsiveness
• self-isolation, difficulty with intimate relationships
• secretiveness
• shame-based existence
• low self-esteem
• obsession with food, weight, physical appearance, control
• strong need for others’ approval
• preoccupation with body size

What are the consequences of bulimia nervosa?

Those with bulimia can damage their esophagus and stomach with excessive vomiting. Stomach acids brought up through vomiting can also wear away the protective coating on teeth. According to the National Eating Disorders Association, bulimia can lead to:

• electrolyte imbalances that can result in irregular heartbeats and possibly heart failure and death. Purging can cause these imbalances as the body dehydrates and loses potassium, sodium, and chloride.
• gastric rupture during periods of bingeing
• inflammation and possible rupture of the esophagus from frequent vomiting
• tooth decay and staining from stomach acids released during frequent vomiting
• chronic irregular bowel movements and constipation as a result of laxative abuse
• peptic ulcers and pancreatitis

Where can you get help for bulimia nervosa?

The first step toward recovery from bulimia nervosa is to ask for help. Eating disorders are most successfully treated when diagnosed early. The longer abnormal eating behaviors persist, the more difficult it is to overcome the disorder and its effects on the body. Contact your medical doctor and therapist for specific treatment options.

National Eating Disorders Association (NEDA)

NEDA offers a toll-free live help line and a nationwide list of treatment facilities and support groups searchable by state.

What is binge eating?

Binge eating is similar to bulimia in that it involves consuming excessive amounts of food. But binge eaters do not purge to compensate for the additional food. As a result, many are overweight or obese.

What are the symptoms of binge eating?

Binge eaters tend to be overweight and are at risk for high cholesterol, high blood pressure, and diabetes. Physical symptoms of binge eating include:

• gallstones
• arthritis
• circulatory problems
• hormone imbalances
• sleep apnea
• upper respiratory problems
• diabetes
• hypertension
• cardiovascular disease
• breast cancer
• lower life expectancy
• obesity
• stroke
• in women—menstrual irregularity

Psychological symptoms of binge eating include:

• lack of awareness of feelings
• passivity
• strong need for others’ approval
• low self-esteem
• sense of powerlessness
• depression
• superficial relationships
• difficulty expressing anger or disagreement
• strong need to take care of others at their own expense
• shame-based existence
• self-disgust, depression, or guilt after overeating

What are the consequences of binge eating?

Binge eating disorder often results in many of the same health risks associated with clinical obesity, such as:

• high blood pressure
• high cholesterol levels
• heart disease as a result of elevated triglyceride levels
• type 2 diabetes
• gallbladder disease

Where can you get help for binge eating?

The first step toward recovery from binge eating is to ask for help. Eating disorders are most successfully treated when diagnosed early. The longer abnormal eating behaviors persist, the more difficult it is to overcome the disorder and its effects on the body. First, contact your medical doctor and therapist for specific treatment options.

Overeaters Anonymous (OA)

OA is a Twelve Step program of recovery from compulsive overeating. It is not just about weight loss, obesity, or diets. Instead, it addresses physical, emotional, and spiritual well-being. Their website provides lists of meetings indexed by state, along with lists of online or phone meetings. OA also features a member- written monthly magazine and an online store.

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)

SAMHSA is part of the U.S. Department of Health and Human Services. Its mission is to reduce the impact of substance abuse and mental illness on America’s communities. Its website offers access to many publications about eating disorders.

National Association of Anorexia Nervosa and Associated Disorders (ANAD)

ANAD can help you find a support group and offers an online chat room, educa- tional materials on treatment, and information on how to find the right therapist.

National Institute of Mental Health (NIMH)

NIMH is a U.S. government organization, an agency of the Department of Health and Human Services, dedicated to research and education in the field of mental health. Its website is a great source of information about specific mental health disorders and eating disorders.

National Eating Disorders Association (NEDA)

NEDA offers a toll-free live helpline and a nationwide list of treatment facilities and support groups searchable by state.

Overeaters Anonymous (OA)

OA is a Twelve Step program of recovery from compulsive overeating. It is not just about weight loss, obesity, or diets. Instead, it addresses physical, emotional, and spiritual well-being. The OA website provides lists of meetings indexed by state, along with lists of online or phone meetings. OA also features a member- written monthly magazine and an online store.

Odorless, tasteless, and colorless, some club drugs can be slipped into drinks and are known as “date rape” drugs.

What are club drugs?

Club drugs describe a number of extremely dangerous stimulants, sedatives, and hallucinogens. They are odorless, tasteless, and colorless, and are often used by young people at dance clubs, bars, and all-night dance parties. Here are a few of the most common:

• GHB (gamma-hydroxybutyrate) is a sedative, also known as liquid ecstasy, G, and Georgia homeboy. At lower doses it can relax. Higher doses can be potentially fatal.
• Ketamine is a fast-acting anesthetic and painkiller that was designed for veterinary use. Known as Special K or K, it is most often used in liquid form but can also be a white pill or powder.
• Rohypnol is the brand name for flunitrazepam. A very small dose can lead to profound temporary amnesia, which explains its link to sexual assault and being called the “date rape drug.” Slang names include roofie and roach.
• MDMA, also known as ecstasy, X, or Adam, has both stimulant and psychedelic effects. Chronic abuse appears to damage the brain’s ability to think and to regulate emotion, memory, sleep, and pain. This is only a partial list. New designer drugs, or new formulations of old drugs, make their way into the market regularly.

Can club drugs be abused?

The category of club drugs covers a wide variety of substances. Some are illegal to use in any setting, and therefore any use is considered abuse. Others are commonly prescribed for legitimate uses. The National Institute on Drug Abuse (NIDA) states that the abuse of prescription drugs occurs when “they are taken without a prescription, in a way other than as prescribed, or for the experience or feelings the drugs give.” In other words, taking a prescription medication that you were not prescribed, in a way that it wasn’t prescribed (such as overuse, taking it with alcohol, or crushing and snorting pills), or strictly in order to get high is considered abuse. Certain club drugs can also lead to addiction.

The American Psychiatric Association (APA) uses the term “substance use disorder” to define a pattern of use that leads to significant physical, inter- personal, medical, or work problems. Substance use disorder is further broken down into drug-specific use disorders, such as “stimulant use disorder” or “sedative, hypnotic, or anxiolytic use disorder,” depending on the specific drug and its qualities. Substance use disorder is rated as mild, moderate, or severe based on how many criteria are met. A person diagnosed with a substance use disorder can also be classified as in remission, or what is commonly referred to as “in recovery.” Those with substance use disorder should receive treatment, and those who identify themselves as addicts often find the skills and support to stay sober through peer support groups like Narcotics Anonymous.

Addiction is considered a brain-based disease characterized by abnormal drug- seeking behavior that leads to impaired control over one’s drug use. Addiction means a person will continue using alcohol or other drugs despite the harm it does to their health, family, work or school, and relationships. An addict may experience withdrawal symptoms (physical pain, fatigue, depression, trouble sleeping, irritability) if he or she stops using, and may need to keep using just to feel normal. “Curing” addiction is not a matter of willpower or moral strength any more than is curing diabetes or cancer. Like diabetes and cancer, addic- tion is considered a chronic disease which is beyond one’s control and fatal if left untreated.

How do club drugs affect a co-occurring mental health disorder?

Co-occurring disorders, or dual disorders, occur when a mental health disorder, like depression or schizophrenia, is present along with addiction, alcoholism, or other substance use disorders. Screening for co-occurring disorders should be part of any good assessment or treatment plan.

Symptoms of drug addiction can mask and mimic signs of mental illness. It can be even more problematic to diagnose a mental illness with a co-occurring addiction to club drugs. This is due to uncertainties about the sources, chemicals, and possible contaminants used to manufacture club drugs.

How do club drugs affect the brain?

The role of brain chemistry in substance use disorders is a relatively new finding in the treatment field, but a rapidly growing body of evidence supports it. Club drugs as a category includes many different types of drugs, and each drug affects the brain in a different way.

GHB acts on at least two sites in the brain which create sedative effects. At high doses, GHB’s sedative effects may result in sleep, coma, or death.

Rohypnol can produce anterograde amnesia, or a blackout state, in which individuals may not remember events they experienced while under the influence of the drug.

Ketamine is a dissociative anesthetic, so called because it distorts perceptions of sight and sound and produces feelings of detachment from the environment and self.

Is addiction to club drugs treatable?

Yes. Because club drugs cover a wide spectrum of drugs—amphetamines, opioids, and hallucinogens—treatment approaches for each drug are different but all are available. Patients who are open and candid with their counselor about their drug use will give the counselor optimum tools for isolating, and treating, co- occurring symptoms. Withdrawal from some of these drugs can be painful and medically dangerous, so it is recommended that users who want to quit consult a medical professional.

Web resources

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

National Institute on Drug Abuse (NIDA)

This government organization is dedicated to addiction research and education. Through its website you can access up-to-date publications about many different drugs of abuse as well as emerging trends.

Substance Abuse and Mental Health Services Administration (SAMHSA)

SAMHSA is part of the U.S. Department of Health and Human Services. Its mis- sion is to reduce the impact of substance abuse and mental illness on America’s communities. Its website offers information and resources about preventing and treating addiction and mental illness.

How does patience affect recovery?

Recovery takes patience. It may take years for you to really be aware of how recovery has changed your life, but that doesn’t mean you are not making progress by abstaining, changing behaviors and attitudes, and growing spiritually. These things all happen slowly, in subtle ways.

Addicts are often impatient people. As addicts we sought chemicals that would give us the biggest high in the quickest amount of time. We didn’t have time to wait twenty-four to forty-eight hours for the chemical rush—we wanted immediate relief. Now that you’re in recovery, it will be a challenge for you to be more patient and let go of seeking instant gratification. Remember the slogan “Time takes time.”

Inhalants from aerosol cans or marking pens are sought after for a brief high, but users risk organ damage and sudden death.

What Are Inhalants?

Inhalants and solvents are chemicals found in household products such as glue, dry cleaning fluids, or gasoline. The fumes or vapors are intentionally inhaled for mood- altering effects. Because inhalants are found in products that are designed to remove stains, kill weeds, or waterproof surfaces, they can cause substantial damage to the body and organs.

There are four general categories of inhalants:

• Volatile solvents: paint thinners and removers, dry-cleaning fluids, gasoline, glues, correction fluids, and felt-tip marker fluids.
• Aerosols: spray paints, deodorant and hair sprays, vegetable oil sprays for cooking, and fabric protector sprays.
• Gases: Medical anesthetic gases include ether, chloroform, and nitrous oxide, commonly called “laughing gas.” Household or commercial products containing gases include butane lighters, propane tanks, whipped cream dispensers, and refrigerants.
• Nitrites: often are considered a special class of inhalants and are commonly known as poppers or snappers.

Source: Drug Enforcement Administration

How Does Inhalant Use Affect a Co-occurring Psychiatric Disorder?

Many people with a mental health problem turn to substances to feel better. For example, a person who is depressed may turn to inhalants to feel better. Because the euphoria is brief, the person will probably repeat the usage, increasing the risk for addiction, overdose, and even death. What’s more, the symptoms of inhalant use can mask and mimic mental health symptoms. Inhalant-induced hallucinations, for example, might be mistaken for signs of schizophrenia—resulting in ineffective treatment.

How Does Inhalant Use Affect the Brain?

The effects of inhalants are similar to those of alcohol, including slurred speech, lack of coordination, euphoria, and dizziness. Inhalant abusers may also experience lightheadedness, hallucinations, and delusions. Inhalants deprive the body of oxygen, a condition known as hypoxia. Hypoxia can damage cells throughout the body, but the cells of the brain are especially sensitive to it. Someone who repeatedly uses inhalants may lose the ability to learn new things or may have a hard time carrying on simple conversations. Other effects from inhalants can be lethal or irreversible.

Is Addiction to Inhalants Widespread?

Although not very common, addiction to inhalants can occur with repeated abuse. In a 2006 study, less than 0.1 percent of individuals admitted to substance abuse treatment reported addiction to inhalants as their primary substance of abuse. However, of those individuals who reported inhalants as their primary substance, nearly half were adolescents aged twelve to seventeen.

Where Can I Learn More?

• drugabuse.gov A National Institute on Drug Abuse Web site.
• familydoctor.org A consumer Web site of general health information, including addiction and mental illness.
• healthyplace.com This easy-to-search consumer Web site contains extensive information about severe mental illness and specific drug use.
• inhalants.org An informational site created by the National Inhalant Prevention Coalition.
• justice.gov/dea/concern/inhalants.html Information provided by the U.S. Drug Enforcement Administration.
• samhsa.gov and csat.samhsa.gov These U.S. government Web sites are dedicated to mental health and substance abuse treatment, respectively.

Source: NIDA InfoFacts: Inhalants

What is insecurity?

Insecurity is a fearful, anxious feeling also marked by a general lack of confidence and stability.

How can insecurity affect your recovery?

While we were drinking and using, alcohol and other drugs offered a reprieve from feeling inadequate and insecure. Using substances at parties suddenly made us feel okay: people liked us, we were popular and funny, and everything made sense. We could dance, talk, and enjoy being in our own skins.

But the substance-induced confidence was temporary. Addicts, like most people, are complex. We project wholeness when inside we are empty. We feel jealous and act arrogant when we feel insecure. We work hard to get other people to like us when we don’t like ourselves.

You started to combat insecurity when you worked Step One. You looked
at yourself honestly and accepted yourself and your disease. Continue working Step Four and Step Five, which will lead you to deeper discovery and acceptance of yourself. Once you learn to be honest with yourself, you’ll more easily accept yourself and others in day-to-day life. As you gain experience in recovery, work- ing Step Ten as a daily spot-check of your inventory will help you identify and snuff out insecurity before it inhibits your spiritual progress.

As you grow in your relationship with your Higher Power, you will learn to depend less on yourself. You may find a growing sense of security because you have the strength, wisdom, and support of a Power greater than yourself. Don’t focus on insecurity. Instead, focus on growing this relationship with your Higher Power and working the Steps: your insecurities will lessen and may fall away altogether.

How can you talk with children about your addiction?

Children who have lived with addiction have the right to understand why and how it happens. Now that you’re out of treatment, you may not know exactly what to say to your children or how to interact with them. This can be a confusing time for children, and they may deal with hurt emotions by acting as if everything is fine or by being aloof and angry. Like most parents, you really love your children and want only the best for them.

Because you are a recovering addict, you might feel hypocritical talking to your kids about the dangers of alcohol and drugs or about things like trust. Put those thoughts aside; your job as a parent is to inform and protect your kids. If you send them honest, consistent messages, they will listen. One of the first things you can do to repair your relationship with your children is to help them understand what addiction and treatment are all about.

Examine your motives

Be honest about why you want to talk to your children. Do you want to keep your children away from alcohol and other drugs? Do you want to create a more honest relationship? Are you trying to relieve your own guilt? Identify some pos- itive things you would like to accomplish, such as establishing trust or commu- nicating love, and keep the conversation focused on that goal.

Check your expectations

Don’t expect to heal your relationship in one talk. Make sure your expectations are realistic. Your children may respond with anger or by being aloof. Or they may try to take care of you or protect you. It takes time for children to take in the in- formation, digest it, and make sense of it. You don’t have to convince them of anything; start out with the simple expectation that you will share and be heard.

Move forward

Let go of fear, guilt, and shame. The discussion should come from a place of honesty and acceptance of the disease and of yourself. What your children want to know most is that you love them, that you’re sorry, that you take responsibility, and that you will abstain from alcohol and other drugs.

How can you establish trust with your children?

You may have damaged your relationship with your children. They may have pulled away from you as your addiction became worse. If you are like many who suffer from the disease of addiction, you may have been through treatment several times. Even though your children may not say it, the first things they will want to know are “Are you sober?” and “How long will you stay sober?”

How can you develop trust again with your children? Remember, in early recovery your first job is to stay clean and sober. If you’re not clean and sober, you can’t be the trustworthy, dependable parent your kids need.

It may take time for your kids to trust you again. Your recovery may stir up lots of different emotions for your children. They may react with anything from hope and happiness to resentment and anger. Be patient; allow your kids to feel, express, and process these emotions.

Your children may have learned to take on a lot of responsibility, parenting themselves while you were drinking and/or using. They may feel “Who are you to come back and start telling me what to do?” If your children have showed a lot of maturity and self-care during that challenging time, respect that maturity. Let them know that you trust them and their capabilities by giving them tasks that match their maturity level, like creating their own weekly homework and entertainment schedule.

Another way to build trust is to spend quality time with your kids. While you were drinking and/or using, your kids probably had to step up and be responsible for themselves, which left little time for play. Create fun ways to connect with your kids and their friends. Learn more about their lives by doing things with them, like engaging with them in athletic events, going to movies, listening to music, or helping them excel in other healthy activities they are interested in.

Rebuilding trust and repairing relationships with your children can create
a lot of stress for you, and it could be hard on your recovery. Make sure you get some support to keep your emotional life in balance. Join an AA group and connect with members who have gone through the same family struggles that you are facing. In early recovery, it’s important that your goals be realistic. You won’t be able to fix everything with your kids right away. Give it time. Your most important goal should be to stay clean and sober. Make sure your environment is free of triggers and using situations. Go to meetings and stay in contact with your sponsor. Get enough rest, food, and exercise. As you slowly rebuild trust in yourself, you kids will notice, and they’ll start to trust you more as well.

How can you break the cycle of addiction in your family?

Studies show that children of addicts are more likely to develop substance use disorders than children of non-addicts. This doesn’t mean that if your children drink they will become alcoholics. It means that their brain chemistry may make them much more vulnerable to addiction. Your children are not alone; one in four children lives in a family with alcohol abuse or alcoholism.

Some parents new to recovery feel awkward about talking with their kids about alcohol and other drugs. They feel like they’re saying, “Do as I say, not as I have done.” This awkward time is really an opportunity for parents to talk about the addiction experiences that have relevance to their children’s lives.

Use your experiences to stress that drinking and driving should never be mixed, to empathize with kids, and to understand the attraction they have
to alcohol and other drugs. This encourages young people to discuss their own feelings, experiences, and problems. It isn’t enough to say, “Just say no to alco- hol and other drugs.” Saying no only works with very young children; older kids need the whole message. You’ll need to acknowledge how tempting alcohol is to young people, how it loosens them up and makes them feel more confident at first. But balance this with the second part of the message: alcohol and drugs are dangerous, drinking and driving can kill you, and so can drug use.

How can you teach your children about the dangers of alcohol and other drugs?

As a parent or caregiver, you play a vital role in influencing your child. You serve as a role model on the use of alcohol, control the availability of alcohol in your home, and help set your children’s expectations concerning drinking behaviors. A recent study shows that children whose parents are involved in their lives—hold regular conversations, attend after-school events, and listen to their problems—are less likely to drink or smoke.

Clarify your own standards

Until you have really given it some thought and are clear about your own standards on alcohol use or nonuse, it’s difficult to communicate with any credibility.

Set clear, firm standards for your children that reflect spiritual beliefs, personal values, and family health issues. If you are inconsistent with your messages, you open up the possibility for kids to create their own standards.

Rules and expectations need to be clearly spelled out with young people before drinking opportunities present themselves. Young people need to be pre- pared to say no to alcohol in advance of drinking opportunities. Parents need to help them choose parties where there will be no alcohol. Parents need to deliver a clear message: alcohol or substance use of any kind is not acceptable.

Research indicates that little or no use of alcohol is strongly associated with young people who perceive that their parents would be upset if the young people use alcohol. What’s more, parents can teach responsible decision making through the most powerful means available: the parents’ own example.

Explain the risks

It’s essential to provide young people with two key facts that are powerful argu- ments for abstinence:

1. Alcohol is a drug that’s potentially addicting.

2. Underage drinking is illegal.

Present the basic consequences of drinking and using

• addiction
• fatal automobile accidents
• physiological damage (brain, liver, and cellular damage)
• teen pregnancy
• greater risk of STDs
• crime
• poor academic performance

What really sinks in for young kids is how alcohol will hurt them today. So tell your kids that alcohol impairs coordination and judgment, which may lead to serious injury, and will make them sick the next day. Tell them that drinking will impede athletic performance. Tell them the human brain is in peak development at their young age and that heavy drinking can hinder intellectual development.

Why do children drink and use?

When asked about why kids drink, parents often name external forces: lax supervision at school, families who let children take unreasonable risks with alcohol, peer pressure. But kids themselves often name internal factors: the desire to experiment with something new, to take risks, and to “see how I’d feel.”

Help your kids practice refusing alcohol. Instead of offering vague advice to “just say no,” do some role playing. Parents can pretend they’re someone offering their kids a drink, and then they can ask the kids how they would respond. Help your kids decide exactly what to do and say. Parents who help their kids prepare for sticky situations give them powerful tools for staying clean and sober.

Many adolescents find the need to fit in so strong that they will do virtually anything to be accepted. Some students, such as those who are not in sports or other school activities, may feel especially isolated and vulnerable to peer pressure. For many kids, the easiest group to belong to is the group that uses. They accept pretty much anybody. As long as you drink or use, you’re in.

The desire to fit in, combined with young people’s easy access to illegal chemicals and parental indifference about alcohol use, means that kids need to learn specific skills in order to successfully resist peer pressure to drink or use.

As adolescents grow and mature, they will experience different social situa- tions in which peer pressure will come up.

How can you help your children battle peer pressure?

Teach kids this five-step model to resist peer pressure:

1. Ask questions. Size up the situation before “going along.” For example, a classmate might say, “Hey, let’s go hang out at the mall,” when he or she has shoplifting in mind. To be responsible, ask, “What are we going to do? How long will we be there?” These questions will help you make informed decisions before getting into a problem situation.
2. Name the trouble. After you identify the situation, state the possible problem: “Drinking and then driving to a movie sounds like a bad idea to me.”
3. State the consequences. Use the threat of punishment as an excuse not to drink. Say something such as “My parents would ground me for months” or “I could get kicked off the soccer team.”
4. Offer an alternative. If a friend invites you to drink or use, suggest an alternative, such as “Let’s go get pizza.” If the friend pressures you more, walk away but leave the door open. You could say, “Hey, that’s fine. We will be eating pizza if you change your mind.”
5. Get out of trouble. If you find yourself in a problem situation, get out immediately and call a responsible adult for help.

What can you do if your child is using alcohol or other drugs?

Often when recovering parents find that their child has a problem with alcohol or other drugs, they’re tempted to rush to get their child into treatment without assessing the seriousness of the use.

Children, especially teenagers, may not be fully honest about their use patterns. To find out whether they’re a frequent user, dependent, or addicted, it’s helpful to meet with an addiction specialist for an evaluation and suggestions for resolving the situation.

If you find that, despite your efforts to intervene, your kid is “going down the tubes” because of alcohol or other drug use, then you will need to get him or her into a substance abuse treatment center. This will be a hard and emotional time for you as a recovering person, and you’ll need to make sure you get the support you need from other AA members, your sponsor, Al-Anon, or Families Anonymous (FA) to handle the emotional stress of dealing with an addicted child.

Take faith and inspiration from the fact that you have been through treatment. You can help your child understand the disease of addiction and start living his or her own recovery plan one day at a time.

Web resources

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

National Institute on Drug Abuse (NIDA) for Teens

NIDA’s teen website offers facts on drugs, answers to common questions, and real-life stories of teens who have recovered from using alcohol and other drugs.

Talking With Kids About Tough Issues

Talking With Kids About Tough Issues is a national campaign by Children Now and the Kaiser Family Foundation. The website offers tips on discussing topics such as alcohol and other drugs, sex, violence, and HIV/AIDS with children.

What problems do African Americans face in recovery?

All people being treated for addiction to alcohol and other drugs have to face their own issues of self-identify. By working Step Four, you are asked to look at your true identify and face the things that have blocked you from spirituality. For the African American in recovery, the question “Who am I?” raises the issue of racial identity.

Embracing identity

In early recovery, you may still feel guilty and ashamed of the things you have done to yourself and others while you were addicted to alcohol and/or drugs. But as an African American, you may also have to deal with both seeing yourself through the lens of society and trying to measure up to its standards. Many generations of African Americans have had to endure the hardships of racism, educational discrimination, and economic exploitation. Other African Americans feel physically unattractive. This negative self-image often comes from living in a country that is dominated by European ideas of beauty.

Whatever your personal situation, as an African American you’ll need to take time to examine the choices you have made in response to any societal problems in your life. To succeed with your ongoing recovery, you must develop a healthy concept of who you are and how you relate to your Higher Power and to other people.

Sharing emotions

As you grew up, you may have been taught to “push down” your emotions and pain; you may not have been allowed to express them freely. In response to this, you may have built up a wall of defense to block out emotional pain. This may make it more difficult to understand Twelve Step concepts such as “powerlessness” and “trust.” You may even view dysfunctional behavior as being somewhat normal. Now that you’re working on your ongoing recovery, it’s important that you identify and discuss your feelings with your sponsor and others in your support system.

You may go to AA meetings where many members are white. If you feel that your voice is not being heard, or you fear that your special issues are not being understood, don’t push these feelings down. These emotions are very personal and important.

Many of the people you encounter in meetings, support groups, and your daily routine may seem very different from you. But remember that all people have common values of family, friends, health, and education. All addicts are in the same situation: they hurt the people who love them, they allowed their lives to become unmanageable, and they need help from their Higher Power to recover.

Developing spirituality

Spirituality plays an important role in many African American families and provides comfort for social and economic struggles. Participation in spiritual activities allows opportunities for self-expression, leadership, and community involvement. Building bridges between these activities and the Twelve Steps is crucial for recovery.

Recovery Action Step

Think about some spiritual activities that you can engage in. Think about getting involved with a church or community center. Consider joining a meditation or prayer group. Check with local colleges or community centers for classes on spirituality or meditation.

List some ways you plan to participate in spiritual activities during the next few months. Share this list with your sponsor or recovery group.

Facing community challenges

Many people in the African American community have experienced significant problems with housing, health, education, crime, and employment. But these problems can’t be resolved in the midst of alcohol and other drug addiction. Using alcohol and other drugs may seem like an easy way to lessen life’s frustrations, but it only makes the situation far worse.

African American communities often have a high degree of commitment to family. Family unity is expressed through community involvement and service. to others. The best thing you can do for yourself, your family, and your community is to work hard on your recovery, learning to practice the life skills that will enable you grow spiritually with increased pride in your identity.

What do you have to gain?

Working the Twelve Steps will help you learn how you fit into the universe, how to relate to your Higher Power, and how to relate to others. You will be able to choose your own path in the future, which will give you the power to be truly free and happy. You’ll learn to understand and accept different values, share common experiences, accept others simply as human beings, and respect yourself enough to expect the same in return.

Personal Recovery Story

“When I was young, my self-image was terrible. I wanted to go to college, to travel the world, but people in my family didn’t even graduate from high school, much less college. We had little money, and back then there weren’t many good jobs for girls with no education. I got pregnant at sixteen, got married, and was a divorced single mom by eighteen.

“By that time, I was drinking almost every day to mask the pain of facing the life I was stuck with. I wanted college, trips to Paris, opportunities. But I couldn’t find a job, and my husband abused me physically to control me.

“My life had started to spin out of control. I didn’t eat, only drank. I barely left the house anymore. My mom finally checked me in to a treatment center. “I’ve been in recovery for just over ten years. As African Americans, we have dealt with racism and sexism from whites and others. We have witnessed the struggles of amazing people from our own mothers to people like Martin Luther King Jr. We can rise above addictions, violence, self-hatred, and brutal poverty to make new lives for ourselves.”—Based on one African American woman’s view on recovery

How can you maintain your ongoing recovery?

Try to find a sponsor and a recovery support system of people whom you feel safe with and whom you can relate to. Remember, your self-worth is not based on how others perceive you; it’s based on your perception of yourself.

To maintain your ongoing recovery, you’ll need to keep working the Twelve Steps. You’ve worked hard in early recovery; now it’s time to protect and plan for your ongoing recovery. Remember to work the Steps, utilize your sponsor and sober friends for support, and go to meetings. These things will help you develop and maintain a healthy, happy outlook and enjoy the freedom and peace of sobriety.

What are the barriers to addiction treatment for older adults?

Myths and attitudes

Getting older adults the addiction treatment they need and deserve often means overcoming myths and attitudes we have about older people and the myths that older adults have about themselves.

When talking about an older adult who abuses or misuses alcohol or other drugs, we’re likely to hear comments such as these:

• “My mom lost her husband and her house, and now she’s headed to a home for older people. She’s lonely, and drinking is the one joy she has in life. Why take it away from her?”
• “My dad is sixty-nine years old. Sure, he drinks too much; he always has. He’ll never change.”

Such attitudes from family members or loved ones pose stiff barriers to getting help for this population. The adult son who thinks drinking is his mother’s one and only joy is fooling himself. Chances are the drinking doesn’t make his mom happy at all. Instead, it’s probably causing her misery, depression, and shame and robbing her of the good health she could enjoy for many years to come. In addition, older adults who suffer from addiction may view alcohol or other substance use disorders as a moral weakness rather than a treatable disease. This will keep them isolated and impedes their chances of getting help.

Personal and physical loss

Personal losses can multiply quickly for older people: the death of a spouse or close friends, the loss of a job because of retirement, the loss of a home, the loss of self-worth, or the loss of children who move out of state.

If you are an older adult who has always been active, you may look forward to retiring but then find that it’s not as fulfilling as you expected. Suddenly you may lack a sense of purpose or feel that you’re not needed.

The physical effects of aging also make older adults more susceptible to chemical addiction. One example is the change in body mass and lowered efficiency in processing alcohol or prescription drugs. The result: older adults may drink or use other drugs less and feel a greater effect. Drugs can build to a toxic level more easily in bodies that function more slowly.

What issues should older adults consider in recovery?

Many older adults develop addiction later in life, after suffering losses or health problems. This is called late onset of addiction. Consequently, family members may have a more difficult time identifying addiction. Begin by watching for signs of substance use. Take note, for example, if your loved one undergoes a personality change after drinking, is frequently intoxicated, drinks alone, loses interest in hobbies and activities, neglects his or her personal appearance, or drinks while taking prescription medication in spite of warnings.

If you notice these signs, consider talking to an addiction counselor, psychologist, physician, or clergy member to decide whether further action is necessary. If it is, then you need to express your concern to the person directly. How can you confront this person without offending them? Be gentle and caring. Do not appear condescending, and avoid judgmental labels such as “alcoholic” or “addict.” You might simply state, “I’m concerned about your health and would like you to be assessed and evaluated by a professional.”

When approached in this way, many older adults may admit a need for help. But even if the person reacts negatively, don’t give up. You’ve planted a seed of recovery that can still grow.

Older adults can succeed in recovery; in fact, older adults in general have higher abstinence rates after treatment than their younger peers. Despite the myths, older adults continue to show that they can change and enjoy the benefits of sobriety.

Why are social skills important to your recovery?

Social skills help you connect to others. Living the life of addiction is often equivalent to living in isolation. The deeper you slide into addiction, the less you see and communicate with others. You may lose touch with yourself. Shame and guilt can drive you away from normal day-to-day relationships.

Social skills include communication and etiquette—what you say and what you do in relation to others. Are you able to share pleasantries and make small talk? These are valuable skills for making people immediately comfortable. Are you at ease in gatherings where you don’t know anyone? The ability to connect quickly with strangers can transform situations that could trigger relapse into fun, rewarding experiences. Do you go out of your way to meet the needs of others? Helping others feel comfortable and welcome goes a long way toward enriching and solidifying friendships. Caring about the needs of others also conveys respect for them, a sure way to connect in a meaningful way.

Even passing associations with people can yield meaning for you. For example, when you enter a new Twelve Step meeting, you are surrounded by unfamiliar people. Yet if you listen closely to others, you will find some answers to your problems. You may also find comfort in learning that others have lived through similar experiences. Developing social skills can reduce or eliminate certain triggers for relapse.

What’s your communication style?

Recovering people sometimes struggle with being either too passive or too aggressive. These tendencies can have long-lasting effects on your life and your sobriety. For this reason, assertiveness training is often recommended for people in recovery.

Passive behavior can cause you to

• deny yourself or your rights
• avoid expressing feelings
• remain hurt and anxious
• give up your right to choose
• fail to reach your goals

Aggressive behavior may cause you to

• reach your goals and also create resentment in others
• express your feelings in a hurtful way
• minimize others and put them down
• deny others their rights

Assertive behavior allows you to

• express feelings honestly
• attain your goals
• respect others
• improve your self-image

Once you understand your communication style, you can make some changes to work out trouble spots. For example, if you don’t listen well, practice silence. Make sure you don’t interrupt others. Are you too loud or too soft spoken? Moderate your volume. Do you put your needs first? Or last? Practice ways to ensure that everyone’s needs are recognized and respected.

How can you improve your social skills?

First, remember that most people aren’t born with great social skills. Most of us have to develop those skills by watching others and modeling what we see. You can do the same thing. Pick out a person you resonate with from your circle of family, friends, or Twelve Step group members. Analyze what that person does that makes you feel welcomed. Why do you trust that person?

Chances are you’ll find that the person you chose to observe has some specific social skills that you can model. Does he or she reach out a hand to greet you? Smile? Remember your name immediately and ask about what you discussed the last time you met?

The basic skills of putting others at ease are really quite simple.

• Make eye contact—but remember that eye contact is a culturally specific behavior. Native Americans and Asian Americans, for example, might use eye contact differently than European Americans do. For example, Native Americans may sit in an AA meeting and look at the floor instead of the person talking. This is their culturally accepted behavior.
• Care enough to remember names and personal details, and ask about them.
• Offer your hand to shake.
• Imagine what that person might need and ask to provide it, whether it’s a place to sit or a beverage.

These basic kindnesses show respect and care for someone—it may be someone you just met or someone you see every day. Acquaintances, friends, co-workers, and family members all deserve the same respect and care.

Another aspect of recovery involves learning when to say no. Refusal skills are a must, because you need to feel comfortable doing it. What are some ways to say “no thanks” without offending others? The trick is to respect both your own needs and your host’s. If you are offered an alcoholic drink at a party, a simple “No thanks, I prefer soda,” will do. What are some other likely situations you should prepare for? Plan for those situations and think about how you’ll respond. You can always role-play refusal skills with a friend or another AA member.