Addiction & Recovery For Dummies

Introduction 1 About This Book 2 Foolish Assumptions 3 Icons Used in This Book 3 Beyond the Book 4 Where to Go from Here 4 Part 1: the Hole in the Heart: Detecting Addiction 5 Chapter 1: Addiction: What Is It? 7 Defining Substance Use, Abuse, and Addiction 8 Understanding what addiction is 8 The difference between abuse and dependence 9 Your personal definition of addiction 11 The Role of Experimentation 13 Assessing Your Addiction Risk 13 Warning signs of addiction 14 A comment for families and friends of the addicted person 14 Exploring Methods and Models of Treatment 15 Treatment centers and professional help 15 Things to consider when deciding on your treatment 16 The twelve-step program and other self-help approaches 16 The Ins and Outs of Recovery 17 Overcoming fears and obstacles to recovery 17 What to do if you slip 17 How to relate to family, friends, and colleagues 18 What family and friends can do 18 Chapter 2: Substance Use, Substance Abuse, and Addiction 19 The Basics of How Substances of Abuse Work 19 The Drug Lineup 20 Marijuana (THC) 21 Sedatives and tranquilizers 22 Stimulants 23 Psychedelics 24 Opiates and narcotics 26 Dissociative anesthetics 27 Anti-anxiety and antidepressant drugs 27 Volatile hydrocarbons (inhalants) 28 Steroids 30 Chapter 3: Behavioral Addictions: Addictions Without Substances 31 Some General Advice 32 Compulsive Gambling 32 Three phases of compulsive gambling 33 The impact of compulsive gambling 34 Sex and Pornography 36 Pornography addiction 37 Sex addiction 37 Love addiction 38 Computer Games and the Internet 39 Food Addiction 41 Eating too much 41 Eating too little 41 Work Addiction 42 Do I have a problem? 42 How work addiction starts 43 Kicking the habit when everyone is asking for more 44 Chapter 4: Dancing with the Tiger: The Risks of Experimenting 47 Going with the Flow: Peer Pressure and Other Influences 48 Partying and club drugs 49 Hooking up 49 “I didn’t know what I was doing” 50 Rebellion and experimentation 50 The Risks of Experimentation and Addiction 51 Drinking, drugging, and driving 51 Unsafe sexual behavior 51 The sex trade 52 Crime 52 Anger and aggression 53 Child abuse and neglect 54 Health risks 55 The Costs of Addiction to Families 56 The blame game 56 The consequences to you and your family 57 Part 2: Taking Those First Steps 59 Chapter 5: Recognizing Addiction in Yourself and Others 61 Am I at Risk? 62 Genetics: Addiction Across Generations 63 Determining who’s susceptible 64 Applying your family history 64 How a Body Gets Addicted 65 From the mind out 65 From the body in 66 What drugs are the most addictive? 67 Waking Up to Your Own Addiction 68 Starting with self-observation 69 Taking a quick self-assessment 69 Breaking down the types of addictions 71 Perceiving Addiction in a Loved One 76 Case study: Jack and his daughter 76 Recognizing the warning signs 77 Chapter 6: Assessing Your Readiness: Do You Need Help Now? 81 Understanding Your Role as the Client 82 Assessing the Options 82 Avoiding hopelessness 83 Choosing what’s right for you 84 Matching Your Characteristics to Treatment Options 84 Client characteristics 84 Treatment characteristics 89 Making a treatment choice 90 Deciding When to Start 91 Cost-benefit analysis of seeking help 91 Self-assessing your readiness for change now 92 Chapter 7: Quitting: Easy to Say, Hard to Do 95 Successful Quitting 95 Becoming Aware of Your Triggers 96 External triggers 97 Internal triggers 97 Combination triggers 97 Time as a trigger 98 Your identity as a trigger 98 The ease of availability as a trigger 99 Magical thinking 99 Increasing Your Motivation to Change 100 Factors That Affect Your Ability to Find Addiction Freedom 101 Geographical change 101 A change of job 102 New relationships 102 Codependency with a partner 103 A recovering partner 104 Part 3: Examining Treatment Approaches 105 Chapter 8: Treatment Choices 107 Different Viewpoints on Addiction 107 The moral dimension 108 The disease perspective 108 The pharmacological perspective 109 Thinking your way free: The cognitive-behavioral perspective 110 Addictions as a bad habit: The learning models 110 The psychodynamic perspective 111 The biopsychosocial perspective 112 Combination Treatments 113 The twelve-step treatments and other variants of the AA model 114 Treatments based on cognitive behavioral, psychodynamic, and learning methods 115 Chapter 9: Reviewing Inpatient and Outpatient Treatment Options 119 Interventions: Breaking Through Denial and Fear 120 How an intervention works 122 Intervention principles 124 Choosing an interventionist 125 Residential Versus Outpatient Care: Deciding What’s Best for You 125 Outpatient Treatment 126 Psychotherapy 126 Controlled drinking 127 Risk reduction 128 Tips on seeking outpatient professional help 129 Residential or Inpatient Treatment 130 The stages of inpatient treatment 130 It’s voluntary 131 The rules of rehab 131 How long is long enough? 132 Aftercare 132 The Minnesota Model 133 Relapse Prevention 134 Therapeutic Communities and Sober Living 135 How therapeutic communities work 135 A focus on rehabilitation 136 How effective are therapeutic communities? 136 Who obtains treatment from a therapeutic community? 136 How long should you stay in treatment in a therapeutic community? 137 Andrew’s Choice: A True Story of Getting into Treatment and Achieving Success 138 How things began 138 One day in rehab 139 Chapter 10: Treating Physical Dependence 141 Understanding Your Body’s Reactions to Drugs 142 Detoxification: What Is It, and How Does It Work? 143 The goals of detox 144 The process: In the body 146 The process: In the mind 146 Knowing What to Expect with Detoxification Treatments 147 Detox from alcohol and other sedatives/hypnotics 148 Detox from stimulants such as cocaine and amphetamines 150 Detox from opiates 150 Detox from marijuana 151 Detox from inhalants/solvents 151 Medications That May Help 151 Medications for alcohol problems 151 Medications for treating benzodiazepine withdrawal 152 Medications for treating opiate addiction 153 Medications for stimulant abuse 153 Maintenance medications and craving reducers 153 Methadone Treatment 155 What is methadone? 155 Methadone myths 156 Who should choose methadone treatment? 157 Does it work? 157 Chapter 11: Twelve-Step Programs 159 Types of Twelve-Step Programs 160 The Actual Twelve Steps 161 Working Your Program 162 Hitting bottom and working toward recovery — one day at a time 163 Discovering spirituality 164 Using affirmations 164 Deciding Whether a Twelve-Step Program Is Right for You 165 Problems with Twelve-Step Programs 166 What the critics say 166 Is a twelve-step program enough? 167 Chapter 12: Joining Self-Help and Support Groups 169 Secular Organizations for Sobriety and Save Our Selves (SOS) 170 The SOS approach 170 Joining an SOS group 171 Self-Management and Recovery Training: SMART 171 The SMART approach 171 Joining SMART 172 Women for Sobriety (WFS) 173 The WFS approach 173 Joining WFS 173 Religious Organizations 175 Chapter 13: Psychedelic Therapies and Other Alternative Treatments 177 Psychedelics 178 Acupuncture 181 Correlational research 182 Clinical trials 182 Ibogaine 183 How ibogaine may work 183 Ibogaine research 184 Ketamine 185 Nutritional Therapy 186 Addictions and poor nutrition 186 What is good nutrition? 187 Macrobiotic diets 187 Meditation 189 Harm-Reduction Approaches 191 Chapter 14: Teen Treatment 193 Why Alcohol and Drugs Are More Destructive When You’re Young 194 It’s easier to damage a growing brain 194 Teens have a tougher time these days 194 What to Do When You Suspect Substance Abuse in a Loved One 195 Advice for parents 196 Advice for good friends 197 A word about denial 197 Be prepared for a long haul to a healthy recovery 199 Making the investment in teen treatment 199 Getting Treatment as a Teen 200 Asking for help: Any time is a good time 200 Finding a counselor 201 Relating to your counselor 202 Counseling in group programs 204 Residential treatment: Group and individual treatments 205 Harm reduction programs for youth 206 Remembering That Slips Aren’t Freefalls 207 Part 4: Life in Recovery 209 Chapter 15: Overcoming Barriers to Recovery 211 Be Prepared: The First Step 212 Building Your Skills for Recovery 212 Pacing: Taking Things One Step at a Time 214 If you’re going too fast, slow down 214 If you’re bogged down, pick up the pace 215 Pacing with time 215 Pacing with activities 215 Building Resilience 216 Maintain personal hygiene 216 Explore your senses 216 Exercise 217 Handling Your Everyday Fears 218 The work of worry 218 Death and dying 219 Abandonment 220 Handling Your Fears about Recovery 220 Short-term fears: Withdrawal problems 220 Long-term fears 221 Avoiding Self-Anger: A Slippery Slope to Relapse 222 Putting judgments on hold 223 Recognizing negative moods 223 Recognizing stressful situations 224 Taking Action: Storming the Barricades 225 Taking action to commit to change 225 Taking action against triggers that increase cravings 226 Taking action to build self-confidence 226 Taking action against negative moods 227 Chapter 16: Handling Slips and Relapse 229 Slips Versus Relapse: What’s the Difference? 229 Why Relapse Happens 230 You can almost count on it 230 Triggers for relapse and what to do about them 231 High-risk situations and their remedies 232 The good news: Relapse is preventable 233 Learning from Relapse 233 Examining your relapse 233 Doing things differently next time 234 Getting Your Balance Back 235 Medications may help 236 Getting back on track 236 Deciding whether you need some extra help 236 Chapter 17: Handling Work and Family During Recovery 237 Dealing with Relationships During Recovery 238 Dealing with positive changes 238 Dealing with negative changes 239 Dealing with Family Problems 240 Do the right thing: Be a good role model 240 How families are affected by addiction 241 Making positive changes in family relationships 242 Solving family problems by changing norms 242 Making long-term plans for positive change 243 Dealing with Work Problems 244 Scenario one: You were hardworking to begin with 244 Scenario two: You lose your job due to your addiction 245 Dealing with Financial Problems 246 Relapses, Restarts, and How They Affect Your Family 247 Coming to terms with a relapse 248 Restarting with the help of your family 249 Chapter 18: For Families and Friends: Ways to Make a Difference 251 Breaking Through Denial and Codependency 252 Overcoming denial 254 Dealing with resistance 254 Preparing for Change 256 Helping Your Loved One Follow Through 257 Recognizing negative emotions 258 Empathizing: “I feel your pain” 258 Supporting Change over the Long-Term 259 The six weeks of helping 259 Expecting and getting through relapse 260 The Ups and Downs of Change 261 Dropping expectations and falsely positive images 261 Turning downs into ups 262 Sustaining Optimism and Support in Your Family 263 Leaving fantasy-land to find realistic optimism 264 Being deserving of victory and success 264 Part 5: the Part of Tens 265 Chapter 19: Ten Ways to Help a Friend or Loved One 267 Talk Things Over Truthfully While You Listen Attentively 267 Recognize the Telltale Signs of Addiction 268 Confront Denial 268 Help Get Treatment 269 Let Go of Your Need to Control the Situation 270 Hold Criticism at Bay 270 Offer Balanced Support 271 Understand What You’re Fighting 271 Remain Optimistic 272 Know What to Do When Treatment Efforts Fail 272 Chapter 20: More Than Ten Self-Help Resources 273 Self-Help Books for Problems Related to Addictions 273 Self-Help Websites for Managing Addictions 275 Websites for Treatment Models 275 Websites for Families and Teens 277 Websites for Problems Related to Addictions 278 Online Lectures on Addiction-Related Topics 278 Treatment Centers 279 Index 281