Addiction & Recovery For Dummies

Paul Ritvo, PhD, is a professor at York University in Ontario, Canada. He’s also a Research Scientist at Cancer Care Ontario and a psychologist with over 25 years’ experience in the development and evaluation of evidence-based cognitive behavioral programming for healthy lifestyle behavior change.

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