ORTC Articles

What are hallucinations?

Hallucinations are distorted perceptions of reality. A person having a hallucination may see images or hear noises that are not actually present. In some cases, visual hallucinations will cause a person to see light and color differently, while other times the distortion may be more dramatic. For example, a person who is hallucinating may experience paranoia or even “see” someone trying to harm them.

Hallucinations can also involve the senses of taste, touch, and smell, although this is less common. Drugs that cause hallucinations can also dull the user’s sense of pain and cause vivid—and sometimes scary—hallucinations, which can result in a fearful reaction of wild, violent behavior.

What causes hallucinations?

Hallucinations can be caused by a number of factors, including drug use. They can result from taking high doses of drugs such as LSD, mescaline, or PCP that affect the neurotransmitter serotonin. An overdose of stimulant drugs, including cocaine and methamphetamine, can cause sensory hallucinations; some users even report feeling bugs crawling on their skin.

In addition, hallucinations may occur when alcoholics abstain from drinking. Alcoholics often experience hallucinations thirty-six to seventy-two hours after withdrawal from alcohol.

People with Alzheimer’s disease, bipolar disorder, or schizophrenia may also experience hallucinations as a part of mental illness.

Web resource

SAMHSA: Tips for Teens

The SAMHSA site provides clear information on the signs and dangers of hallucinogen drug use. It provides links to other sites on drug use prevention.

What are hallucinogens?

Hallucinogenic drugs alter a person’s thinking, sense of time, and emotions. Hallucinogens can cause people to see images, hear sounds, and feel sensations that seem real but do not exist (these are hallucinations). Some hallucinogens can produce rapid, intense emotional swings. Hallucinogenic compounds occur naturally in trees, seeds, fungi, and leaves and have been used during religious rituals for centuries. The compounds can also be made in laboratories.

The four most common types of hallucinogens are LSD, peyote, mushrooms, and PCP.

• LSD (d-lysergic acid diethylamide) is one of the most potent mood-changing chemicals. Discovered in 1938, it is manufactured from lysergic acid, found in a fungus that grows on rye and other grains.
• Peyote is a small, spineless cactus in which the principal active ingredient is mescaline. Mescaline is also found in other varieties of cactus as well. This plant has been traditionally used by natives in northern Mexico and the southwestern United States as a part of religious ceremonies. Mescaline can also be produced through chemical synthesis.
• Psilocybin is obtained from certain types of mushrooms that grow in tropical and subtropical regions of South America, Mexico, and the United States. These mushrooms (or “shrooms”) typically contain less than 0.5 percent psilocybin plus trace amounts of psilocin, another hallucinogenic substance.
• PCP (phencyclidine) is a dissociative drug developed in the 1950s as an intravenous anesthetic. Dissociative drugs cause users to lose connection with reality, experience memory loss, or enter a trance-like state, as well as hallucinate. Its use as an anesthetic has been discontinued due to serious adverse effects. It is a white crystalline powder soluble in water or alcohol. It is sold on the illicit drug market in tablet, capsule, and colored powder forms that are normally snorted, smoked, or orally ingested. It is a very dangerous drug. Depending upon how much and by what route. PCP is taken, its effects can last approximately four to six hours.

How do hallucinogens affect the brain?

Hallucinogens distort a person’s perception of reality. They disrupt the interaction of nerve cells and the neurotransmitter serotonin. Distributed throughout the brain and spinal cord, the serotonin system is involved in the control of behavioral, perceptual, and regulatory systems, including mood, hunger, body temperature, sexual behavior, muscle control, and sensory perception. In the brain, PCP also alters the actions of dopamine, a neurotransmitter responsible for the euphoria and “rush” associated with many abused drugs.

The American Psychiatric Association (APA) uses the term “phencyclidine use disorder” or “other hallucinogen use disorder” (depending on the substance) to define a pattern of hallucinogen use that leads to significant physical, interpersonal, medical, or work problems. It is rated as mild, moderate, or severe based on how many criteria are met. A person can also be classified as in remission, or what is commonly referred to as “in recovery.” Those with hallucinogen-related 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 drugs or alcohol 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, addiction is considered a chronic disease which is beyond one’s control and fatal if left untreated.

How do hallucinogens affect a co-occurring mental health disorder?

Co-occurring disorders, or dual disorders, is 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.

People with co-occurring disorders, including serious mental health disorders such as schizophrenia, can seriously endanger themselves by becoming suicidal or violent when taking psychedelics or dissociative drugs. Because hallucinogens can distort one’s sense of reality, they are particularly dangerous for people struggling with mental health disorders.

Is addiction to hallucinogens treatable?

Yes. Most users of hallucinogens voluntarily decrease or stop its use over time or get help because of their experiences of “bad trips.” LSD is not considered an addictive drug since it does not produce compulsive drug-seeking behavior. However, LSD does produce tolerance, so some users who take the drug repeatedly must take progressively higher doses to achieve the state of intoxication that they had previously achieved. Hallucinogen users often find treatment later for addictions to alcohol or other drugs. Treatments for PCP users may take place as a result of legal or medical interventions for a life-threatening overdose.

Addiction won’t go away, like a cold or the flu. It is a chronic disease, meaning you have it all your life. However, by staying sober and getting ongoing support, recovering people can live normal, healthy, productive lives.

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 mission 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 jealousy affect recovery?

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. We are a mixture of contradictions.

Now that you are working on your recovery, watch out for jealousy because it can arouse emotions of fear, self-pity, anger, resentment, and frustration that will inhibit your spiritual development. If you take time to analyze your feelings of jealousy you will find in them a combination of all your imperfections. They may appear in mild or passive form, yet they are all there: self-pity, resentment, intolerance, dishonesty, criticism, suspicion, and anger.

To combat jealousy, start with a thorough Step Four and Step Five, which will allow you to discover and accept yourself with total honesty. 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, working Step Ten as a daily spot- check of your inventory will help you identify and snuff out jealous emotions before they inhibit your spiritual progress.

Your loved ones may also struggle with jealousy now that you are in recovery. They may be jealous of the close relationships you are developing with others in your Twelve Step program, especially if their own relationships with you continue to be strained. They may be jealous of the fact that your Higher Power is changing you in ways they could not. Recognize and validate your loved ones’ feelings while assuring them through your words and actions that you need and value your relationship with them.

What are the signs of compulsive gambling?

One warning sign of compulsive gambling is that the gambler begins to think constantly about gambling. His or her everyday life becomes centered on winning to the point where even lunch breaks and vacations are planned with gambling in mind. Family, work, and other aspects of life are ignored in order to spend time gambling.

Compulsive gamblers often try to hide their addiction to gambling and will not admit the extent of their gambling losses. They might borrow money from co-workers, sell possessions, or take out loans without stating the real reason they need the money. They often justify their actions by thinking that the next time they gamble they will win enough to pay back their debts.

As the need to repay their losses increases, compulsive gamblers often bet larger amounts of money. Continued losses can lead them into greater debt and depression, which can include suicidal thoughts. Moodiness and irritability are also signs of compulsive gambling.

What are the dangers of compulsive gambling?

Excessive gambling can lead to large amounts of debt. If you have been a compulsive gambler, you may have taken out loans and stacked up credit card bills to support your gambling habits. You may have borrowed money from friends, relatives, and co-workers, which leaves you feeling uneasy around these people when you can’t pay the money back.

Gambling can also lead to family and marital problems. Your spouse or partner may become angry when he or she realizes the extent of the financial problems that you both face. Family members may become irritated that you spend more and more time away from home, ignoring the needs of the family. This secretiveness can make the spouse or partner feel betrayed, causing the relationship to further erode.

Your job performance may suffer because your concentration is on winning, not on work. You may misuse your time at work by making “secret” phone calls (which are usually debt related), calling in sick in order to spend time gambling, and taking extended lunch periods to gamble. When compulsive gamblers are unable to find funds to support their addiction, some may even embezzle money from their company.

Compulsive gamblers often suffer from health-related problems as well, because they neglect their health while focused on gambling.

How can you recover from compulsive gambling?

Try to find a sponsor and a recovery support system that makes you feel comfortable and safe. Gamblers Anonymous (GA) can offer support based on the Twelve Steps, while Gam-Anon can help family members who have been affected by a loved one’s gambling addiction.

To maintain your ongoing recovery from gambling and other addictions, 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 friends for support, and go to meetings. These things will help you develop and maintain a healthy, happy outlook on life.

Web resources

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

Gamblers Anonymous (GA)

This website provides information about compulsive gambling, the history of Gamblers Anonymous, and the Twelve Steps. It offers a directory to help you find GA meetings in your state and a questionnaire to help you determine whether you have a problem with gambling.

Gam-Anon

Gam-Anon is a self-help organization for the spouse, partner, family member, or close friend of a compulsive gambler. It offers a directory of meetings indexed by state.

What problems do Jewish alcoholics face in recovery?

Alcoholism is universal, yet some in the Jewish community hold that substance use disorders are not a problem among Jews. This myth is now fading, but still, some Jewish families may hesitate to expose their troubles, to appear to fall short of a high community standard. Shame and guilt may compound the denial problem. These factors can cause some to feel isolated and to neglect seeking help and support—despite the fact that Judaism has such a strong ethic of service and solidarity.

Moreover, some Jewish people believe that the Twelve Steps are not com- patible with Judaism, when, in fact, many aspects of the Steps are very similar to Jewish teachings. Another stumbling block: Alcoholics Anonymous meetings are often held in churches, which may initially be a problem for those of non- Christian faiths. However, AA meetings today can also be found in synagogues as well as in secular settings.

How can you maintain your ongoing recovery?

Alcoholism is not a failure of moral character or willpower. It is a disease. It is not something to be ashamed of, but a disease to be taken care of, much like you would take care of diabetes. Addiction happens to people from all backgrounds and walks of life. Although people in your Twelve Step program may not share your faith and ethnicity, they do share the common story of struggling with addiction. Look for the common ground you have with others rather than seeing the differences.

Try to find a sponsor and a recovery support system of people that you feel safe with, that you can relate to. You may want to join an organization such as Jewish Alcoholics, Chemically Dependent Persons, and Significant Others (JACS). This organization provides a comfortable environment for Jewish alcoholics to seek recovery, and it supplements programs such as the Twelve Steps with Jewish teachings and traditions.

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.

Web resources

Jewish Alcoholics, Chemically Dependent Persons, and Significant Others (JACS) JACS is a part of the Jewish Board of Family and Children’s Services. The JACS website provides articles on alcoholism written by rabbis, links to other sites about alcohol use disorders, and meeting locations.

What if you don’t believe in God?

Agnostics, atheists, or anyone who doesn’t agree with a religious-based idea of God can substitute the concept of a Higher Power. Your idea of a Higher Power that you can trust will be uniquely your own. Some people may call their Higher Power God. For others it is the inherent greatness of nature and the universe. Some people put their faith in the collective energy of their Twelve Step group—for them the group is their Higher Power. A belief in God or religion is not necessary. What is necessary is grasping the truth that our own human power (self-will) has proven ineffective against this disease. Step One acknowledges our dire need to tap into a Higher Power to recover.

Agnostics typically believe that we should all think out our own standards of conduct for ourselves. If you are an agnostic in recovery, you can work Step Two by understanding that you need strengths beyond your own awareness and resources to restore you to sanity. You can work Step Three by making a decision to entrust your will and your life to the care of the collective wisdom and resources of those who have searched before you and found recovery.

If you’re like many people in early recovery, you haven’t defined your Higher Power yet. That’s okay; you don’t have to know who or what your Higher Power is right now—you just need to know that you aren’t it.

Why do you need a Higher Power?

The Twelve Steps teach us that the way to lifelong recovery is to give up self-reliance and willpower, instead relying on God or a Higher Power. Step Two, “We came to believe that a Power greater than ourselves could restore us to sanity,” encourages us to find our own idea of God as a Higher Power to guide us. This allows us to remove ourselves from an ego-centered position in the world.

Step Two teaches us that addiction is the by-product of a spiritual problem that requires a spiritual solution. This means you need the help of others; you don’t have all the answers. For a lifetime of recovery, you will need to find a Higher Power, a loving, guiding power you can really trust.

Why do you need to let go of self-will and self-reliance?

Some people say that Twelve Step programs are more difficult for intelligent, inquiring people because these people are used to being completely self-directed, self-actualizing, and self-reliant. But remember, it was our best thinking that got us into our destructive addiction to drugs and/or alcohol. Living in recovery requires us to follow the suggestions of those with recovery experience. The Twelve Steps don’t ask you to quit thinking critically. To the contrary, the Twelve Steps demand rigorous thinking, honest self-knowledge, and a deep commitment to looking beyond our own self-destructive will. The journey of recovery asks our willingness to take responsibility and accept reality. It demands that we avoid reliance on the superficial, magical beliefs (“stinking thinking”) that kept us in our addiction.

How can your expectations affect your recovery?

Achieving a state of acceptance and letting go of expectations can be recovery’s most difficult and painful challenge, one that many of us face time and again at various points in our lives. Acceptance means letting go of our judgments and expectations, which often prevent us from accepting ourselves and others willingly. Rather than continuing to wish that our circumstances were different, or thinking that we know better than those around us, we come to acceptance when we come to terms with ourselves and others.

When Beth first started going through treatment, she couldn’t talk about her experience of being sexually abused as a child. For years, she had kept her feelings and thoughts clenched in her heart like a fist. Then she started writing. At first, the words poured out in great waves onto the pages of her journal. Over time, she began to notice how each sentence and each page brought greater release and distance from the pain she had borne in silence for so many years. Her painful childhood began to lose its power and stranglehold on her and her life.

Journaling, in conjunction with therapy or other help, can help you bridge your inner and outer worlds and connect with a path of action and reflection. Writing is sorting. Writing gives you a way to respect your mind, choose and harness your thoughts, interact with and change who you think you are. That is what a spiritual journey is—it’s a major change, over time, of your self-identity. This is followed by a corresponding change in what you believe you are capable of achieving.

While keeping a journal or recording your feelings is not a substitute for therapy or treatment, writing can measurably improve your health. Researchers theorize that journaling is effective because it lets people synthesize and make sense of their experiences.

In early Twelve Step recovery, you were encouraged to tell your story as a way to openly and honestly acknowledge your powerlessness over addiction. As you worked the Steps, your story unfolded further as you took stock of yourself and your behavior. Because it accepts your truths and stories without judgment, a journal can be a valuable tool during this introspective process.

Recording your truths and feelings in a journal will better prepare you to interact honestly with others in mutual self-help groups, in your family, and in all other aspects of your life.

How do you start to keep a journal?

There is no right or wrong way to keep a journal. It may be helpful for you to simply sit down with pen and paper, or at the computer, and make a contract with yourself to write for at least five or ten minutes. If you need to, set a timer to verify that you’ve accomplished your daily writing goal.

Don’t worry about spelling, punctuation, or whether or not your writing makes sense. Just write. Sometimes it helps to use a repetitive phrase such as “I used to _____________, but now I ___________.” List whatever comes to mind.

You don’t have to stay with the original sentence or subject. Follow your thoughts and write about wherever they lead you. A journal isn’t just a negative dumping ground. It is a place to record positive thoughts as well. You may want to consider recording blessings from each day. Each night before you go to bed, list the gifts you were given that day: the quality of light on a cloudy day, the friendly clerk at the grocery store, the laughter of a child, or anything else that made your heart lighter, even for a moment. This is a great way to fall asleep with what recovering people call “an attitude of gratitude.”

Keeping a journal makes good sense for those who participate in Twelve Step recovery programs. Letting go and turning over what you cannot change, changing what you can, acknowledging your weaknesses, and celebrating your joys are all integral aspects of Twelve Step recovery. A journal is a safe place where you can record those changes, let go of your fears, and express confusion, anger, doubt, remorse, and joy. A journal is a constant friend that accepts your negative and positive feelings unconditionally. It is also a place where you can chart your growth, step by step.

What is perfectionism?

Perfectionism is not the healthy pursuit of excellence; it’s the consistent expectation that we meet unrealistically high standards. It’s impossible to always do our best, and holding ourselves to a constant standard of perfection will only lead to frustration and low self-esteem. Perfectionism is a common problem. If you can’t stand mistakes and consistently hold unrealistic standards for yourself and others, you probably have perfectionist tendencies. If issues of perfectionism aren’t addressed, they can inhibit your recovery.

Who are perfectionists?

In general, perfectionists settle for no less than the very highest standards
of performance both from themselves and others. In this way they differ from people who strive for excellence in healthy ways by taking pleasure in pursuing their goals.

Bill W., cofounder of AA, once described alcoholics as “all or nothing” people. We know from decades of recovery studies that the addict’s central problem is “self-will run riot.” Bill W. saw that alcoholics often try to overcome their personal limitations by playing God. This behavior results in more problems because people can’t “will” themselves perfect. Constant perfection is an unattainable goal.

What does perfectionism have to do with your recovery?

If you believe you should be perfect, you’ll have a very strong desire to try to control your addiction with sheer willpower—and decades of experience tell us this won’t work. Your will is not enough; you must look outside yourself for the help you need to preserve your ongoing recovery.

Step Three requires us to surrender our will and control to our Higher Power. We must be willing to accept the fact that we have limitations and that we need help to succeed in our recovery.

Judging ourselves

If your character includes a perfectionistic streak, you may also be more vulnerable and sensitive to the opinions and criticism of others. If you learned early in life that others valued you because of how much you achieved, or how smart, successful, or popular you were, you may have learned to judge yourself critically, based on external standards. You may even see yourself as worthless if you don’t achieve your goals.

If you think that you must be perfect to be acceptable to yourself and others, then you’ll add loads of unnecessary stress and anxiety to your life. Most people don’t judge us as harshly as we judge ourselves. We can reduce our stress by choosing to think, “I don’t need approval from everyone all the time. It’s okay for me to make mistakes, though I prefer not to. Mistakes are an opportunity to learn and improve.”

Think about success in a different way. If you are handling yourself with integrity and honesty, and are putting all your positive energy into something, then take pride in the journey. Don’t let anxiety and worry about the “what-if ’s” stress you out. You might want to join a new AA group or a book or movie club, but you have fears that you might stutter or look foolish, and then people won’t like you. You might procrastinate about showing up for a meeting for fear of failure: will you be smart enough and meet others’ expectations? Realize that it’s all right if you make a few mistakes. You don’t have to be better than everyone else all the time. We are all works in progress, and we’re all in different stages of our lives.

Judging others

Perfectionists don’t just demand perfection from themselves, they also have high demands from the world and all the people in it. As perfectionists, we will try to control people and events, and then become frustrated when things occur that are beyond our command. We may even feel a compulsion to control others and improve them to meet our standards of excellence or achievement. This is a self-defeating behavior that limits our relationships with others. If our expectations are always unrealistically high, we become intolerant of others’ mistakes. This leaves us stressed and disappointed and makes others feel unaccepted and judged.

Will the twelve steps help you with perfectionism?

The Twelve Steps teach us to accept our limitations as imperfect human beings. Accepting ourselves and others is critical to our recovery. To truly recover we need to see ourselves for who we are, let go of our ego and pride, and reach out to others for help. None of this can happen when we are pursuing our own will instead of listening to our Higher Power.

What can you do about perfectionism?

If you cling to perfectionism in your recovery it could set you up for relapse. For example, you may think that your abstinence should be perfect, and anything less means that you, as a person, are a total failure.

To begin, you’ll need to challenge the self-defeating thoughts and behaviors that fuel perfectionism. These strategies may help:

1. set realistic and reachable goals based on your own wants and needs. Make sure the goals are reasonable by measuring them against your past achievements and performance when you were at your best. As you reach one goal, then you can set the next goal at a higher level. Setting realistic goals will lead to a greater sense of achievement and self-esteem.
2. rethink your idea of success. Think about any goal you would love to achieve. Instead of being dissatisfied with anything less than your ultimate idea of success, think about how significant it is to achieve even 50 percent of your goal. Give yourself some credit for the smaller successes—as long as you are achieving steps along the way to your goal, you’re succeeding.
3. enjoy the journey. Think about success not only as achieving grand goals, but respect the energy, integrity, and time that you dedicate to your journey along the way.
4. recognize the power of mistakes. Mistakes are a great opportunity to learn. Think of a recent mistake you have made and list what you learned from it.
5. confront your fears. Many of us who are perfectionists are afraid that we don’t stack up against expectations—our own or others’. Give yourself a reality check by asking, “Have I set up impossible expectations for myself?” “What am I afraid of? What is the worst thing that could happen?”

Can celebrations and holidays threaten your recovery?

Celebrations and holidays are often a hard time for people in recovery because they can expose you to these triggers and situations:

• alcohol or other drugs, which may be present
• increased stress
• heightened emotions
• free time without structure
• lack of access or limited access to your sponsor or recovery support group
• stress about money or finances

How can you protect your recovery during celebrations?

Talk to your sponsor and lay out a plan for coping with celebration triggers. Some of us try to take shortcuts or don’t make our recovery the priority. It’s easy to become busy or overconfident. We forget that without abstinence from alcohol or other drugs we will lose all the things that are valuable in our lives.

Recovery Action Step

Take another recovering person with you for support during the celebration. Having someone there who understands your fears and urges is important. It keeps you accountable.

Recovery Action Step

Talk to your sponsor or recovery support group. Make a relapse prevention plan to handle the triggers that you might encounter during celebrations and holidays.

Let your sponsor know if you may be in a tough situation during an upcoming work party or at a Christmas dinner. Make sure you have a way to leave the party or celebration if you feel your recovery is threatened.

Personal Recovery Story

“My friend Brian and I were both planning to go to a Halloween party thrown by our mutual friends. I’m in early recovery, so before the event I told Brian that I wasn’t sure how I would react to being around an open bar where beer and wine were served. We discussed the situation and decided that we would drive separately so that I could leave if I needed to.

“I wanted some extra support, so I brought another recovering person with me to the party. And I brought the phone number of my sponsor—just in case I needed someone else to help me and keep me accountable.”

—Sarah, in recovery from alcohol addiction, sober for seven months