NewDay Counseling

Addiction can cause chaos, as if life has exploded into thousands of pieces that can’t be put back together. This type of chaos can cause anxiety, an unspecified fear that’s hard to pin down on any particular person, place or thing. Often, when someone comes into treatment, they report anxiety, and they might have even been diagnosed with anxiety disorder.

It’s difficult, in the beginning, to distinguish anxiety caused by addiction from anxiety that’s caused by an anxiety disorder. Many times when someone comes into treatment with an anxiety disorder diagnosis, the anxiety goes away after a few months of sobriety. It also happens, though, that anxiety remains has to be treated with medication. But time and recovery will usually reveal the truth.

We suggest to our clients they learn how to meditate, to stop the chaos and find a centered place within. This is actually healthy for anyone, whether they have a problem with addiction or not. Too many people get caught up in the mad rush of life and don’t take time to listen to what’s going on inside, or just relax the mind. If you throw the craziness of addiction in the mix, you have a life out of control — and, yes, this produces anxiety.

When someone in recovery begins to feel centered, they’re less likely to go back to drugs. They can make better decisions – it begins to make less and less sense to return to the craziness of addiction. If someone doesn’t learn how to slow down and find a calming center, if they just return to the hustle and bustle, and if they don’t deal with emotional problems, their life remains chaotic and anxiety-riddled — sobriety becomes painful rather than peaceful and mentally healthy — this is how people set themselves up for relapse. If recovery is chaotic and painful, it won’t be long before the person reverts to what they’ve taught themselves eases pain — drugs. In reality, returning to alcohol or their drug of choice, only provides short-term relief and long term pain, until there is no relief at all. Finding and maintaining a center in recovery is important.

Learning to deal with anger is vital in recovery from alcoholism. Actually, it’s vital in recovery from addiction to other drugs such as cocaine, opiates, etc. Here, though, I’ll address anger management in recovery from alcoholism. First, it’s important to establish anger as a normal emotion. Everyone gets angry. What’s important is how we deal with anger. Also, I don’t want to give the impression that unresolved emotions like anger cause alcoholic drinking. It’s the other way around — alcoholism usually prevents a person from dealing with emotions like anger. If, in recovery, anger is not managed, it’ll likely lead a person back to drinking. If unresolved resentments still churn in the person trying to stop drinking, it’s a trigger for relapse.

When alcoholism begins to progress, and when there are mounting consequences, the alcoholic finds himself/herself in a dilemma that’s usually right below the level of full consciousness. Internally, the alcoholic feels the need to continue drinking because, to the alcoholic, alcohol is what holds things together, and without alcohol things fall apart. This is part of the denial that characterizes alcoholism. The alcoholic denies alcohol is causing problems and blames alcohol related consequences on others, thus building up anger when confronted about drinking. This anger becomes a protective shield, rejecting everyone who tries to penetrate the denial. The spouse just doesn’t understand and wants to control – the supervisor at work is a jerk – the DUI was just a fluke and it could happen to anyone who’s had a few drinks and drives home. The alcoholic sees stress as coming from these outside sources, and sees alcohol as the comforter.

As alcoholism progresses, the physical, mental and emotional dependence on alcohol becomes stronger and stronger, and the denial becomes more psychotic, to the point the alcoholic can no longer tell fact from fiction. In treatment, once a person gets the alcohol out of his/her system and begins to clear up, we deal with anger issues, gradually breaking through denial. In group, people with addiction problems talk about the realization that their addiction is the problem not other people, places and things. The new person still in denial hears others who are like him/her honestly talking about their addictive drinking/drug use and this can cause a powerful awakening. We teach anger management skills that’ll help the person make it into long term recovery. Honesty is one of the first principles established in recovery. It’s hard to look at the truth when the truth is ugly and puts the person in what they perceive as a bad light. Showing empathy with the person suffering from alcoholism goes a long way toward building trust, because, after all, it’s not about beating up the person to make them feel shame — the point is to help the person overcome the delusional state of mind they’re in and to see the truth.

Many people hear the word sober and think of dull and boring. In addiction recovery, sobriety means something else entirely. Sobriety in addiction recovery means, among many other things, clarity. For someone who’s lived day in and day out in the mental fog of addiction, clarity of thought is a great gift. Over and over I hear people in recovery say they love being able to think clearly and to remember without spaces of confusion and jumbled memory. As addiction progresses, the mental fog becomes worse and the hangovers becomes longer and more painful, creating a sense of time and mental capacity slipping away.

We’re living in a time where clarity of thought is critical, such as work. The old factory jobs done by rote are now done by automation, and the new jobs require all the concentration and clarity you can muster. Plus, we’re living in a dangerous time with Covid and now it’s variants. Being under the influence on a regular basis with impaired judgement leads to risky behavior. In the 80s, it was risky behavior leading to AIDS, now it’s viruses and just the need to be sharp in a quickly changing world.

It becomes a matter of survival. Those with clarity of mind have an advantage. Also, as in any time, long-term relationships depend on clarity and focus. When addiction begins tearing relationships apart, it’s mainly due to lack of attention paid to significant others. It’s hard to give yourself fully to relationships when you’re torn inside and don’t even know yourself anymore. Relationships become so difficult when addiction is involved, they simply fall apart from exhaustion. Getting sober and allowing the mind to heal and for clarity to develop is a process, and it gets better over time, People don’t damage their minds overnight in addiction and in recovery they don’t heal their brains overnight. Clarity in sobriety is anything but dull and boring, it’s looking at life clearly after years of progressive darkness.

I post statistics on alcoholism here from time to time as an eye-opener. Most people see only commercials or ads depicting people drinking alcohol and having a good time, and for the majority of people that’s mostly true, but for the millions who become addicted to alcohol, drinking is anything but a good time — the horrors of alcoholism aren’t advertised. The statistics come from Alcohol.org.  

Alcohol use disorder (AUD) is a clinical diagnosis of alcoholism, or alcohol addiction.¹ The 2019 NSDUH estimated that 14.5 million people ages 12 and older had an AUD. According to the same data, an estimated 414,000 adolescents ages 12 to 17 had an AUD.¹

What’s really amazing is that only about 10 percent of those who need help receive treatment. That means 90% of people who suffer from alcoholism will never receive addiction treatment. The symptoms will be treated by medical professionals, like liver disease and pancreatitis, but there will be no addiction treatment to treat the fundamental problem of alcoholism. Untreated alcoholism has consequences other than medical consequences:

In the U.S., the economic cost of excessive alcohol use is estimated to be around $29 billion in 2010, with $179 billion in workplace productivity costs, $28 billion in medical costs, $25 billion in criminal justice costs, and $13 billion in motor vehicle collisions.²

The saddest consequence is premature death:

Alcohol is a significant cause of death in the U.S. According to the Centers for Disease Control and Prevention (CDC), more than 95,000 people die every year due to alcohol-related causes. That’s an average of 261 deaths per day.³ NIAAA reports that alcohol-related deaths are on the rise. The most recent statistics from NIAAA indicate that alcohol-related deaths increased from 35,914 in 1999 to 72,558 in 2017.⁴

In 2019, the CDC reports that the number of deaths due to alcoholic liver disease was 24,110, while the number of alcohol-induced deaths, not counting accidents and homicides, was 39,043.⁵

The truth is that alcoholism is treatable. Quality addiction treatment can help alcoholics remain abstinent from alcohol and prevent the many unnecessary consequences. We should make it easier for people to receive treatment when they have a problem with alcohol, instead of shaming them or ignoring the problem. Go to our resources page for more information.

I’m often asked what is the success rate in treatment. When I first started working in treatment decades ago, a counselor once answered that question by saying the success rate is 100%. He said he successfully gives a Recovery Management Plan to every client who’s completed treatment, and when they follow that plan they don’t return to alcohol, cocaine, meth, opiates or whatever drug was the person’s choice.

Some people follow the plan and others don’t. Time and again I’ve asked clients what happened, who return to treatment after relapsing, and the bottom line answer is they didn’t follow the Recovery Management Plan. Addiction is treatable, and anyone suffering from addiction can recover, unless they have some kind of cognitive disorder that prevents them from following a recovery plan.

Also, not everyone coming into treatment believes they have a condition that’s so serious they need to follow a long term Recovery Management plan. They think the drug use just got away from them and, now that they’ve cleared up and are feeling healthy, they’ll be more careful and will control their drinking or drug use. In treatment we give everyone information on addiction — we help each client look at the reality of their drug use and the consequences. Education is a big part of treatment, but, still, there are those who don’t think the information applies to them. Many addicts have died from what we used to call “terminal uniqueness”. 

The reality is that when a person’s predisposed to addiction, it doesn’t matter what that person or anyone else thinks or believes or wishes for, if the person continues to drink or use, the addiction will progress and consequences will follow — in most cases the person dies a premature death and suffers years before dying. So, when we give someone a Recovery Management Plan, it’s not just a suggestion for a little self improvement around the edges, it’s a plan to deal with a medical condition that’s insidious, destructive and deadly. You can look up the statistics online. This is the reality we deal with. The most amazing statistic of all is that only about 10% of those who need treatment receive treatment. 90% of all people suffering from addiction never receive treatment. Anyone who makes it to the point they receive a Recovery Plan should be grateful they have a way out.

Most people coming into addiction treatment are in some stage of denial. There are those who deny they have a problem at all, but when we get information from a spouse, an employer, a friend, medical information, DUI history, etc., we get a different picture. Many come into addiction treatment knowing there’s some level of substance abuse, but they deny they’re addicted — those in partial denial still think they can control the alcohol, cocaine, opiates, or whatever their drug of choice may be, yet their history’s filled with failed attempts at controlled use.

Then there are those who admit they have an addiction problem but deny it’s so serious they have to follow a detailed treatment plan and make major changes in their life. These people usually leave treatment confident they have it licked, in spite of warnings from their counselor they need to follow a recovery management plan. Normally, we’d say that positive thinking is a good thing, but when positive thinking fails to recognize the harsh realities of recovery from addiction, the pitfalls, the relapse triggers, the need for continued support and diligence, then positive thinking becomes just another form of denial.

Acceptance is the key to addiction recovery. Acceptance that there’s a problem, and acceptance that actions have to be taken long term in order to stay in recovery. Quitting is relatively easy, staying quit can be hard. Staying quit is made easier by following a recovery management plan. The recovering addict has to be on guard against the return of denial. It can sneak in under many disguises. If you’ve never had a problem with any drug, and don’t fully understand how someone can go through such a terrible experience as addiction, go to treatment and gain acceptance, then leave treatment and in two months go right back to drinking, smoking crack, taking opiates, smoking pot, whatever, then think about a diet you’ve been on, or any major change you’ve attempted that you eventually gave up on and went back to your former behavior. Change is hard, and changing from addiction to abstinence is very hard, because the drinking and using have become so much a component of lifestyle and daily behavior. When you do the same thing over and over for a long period of time, it’s hard to change to another way of living.

With addiction the stakes are high, so going back to addictive use can be deadly. It’s important for the recovering addict to know that acceptance is not just a one time experience — the recovering addict must promote and nurture full acceptance every day. Positive thinking can be helpful, after there’s full acceptance that a long term recovery management plan is necessary — then positive thinking is inspirational and uplifting.

Those of us who work in the addiction treatment field face resistance on a regular basis. Denial is prevalent in addiction. Many of us were taught to use will power in situations like this, to buckle up and overcome any adversity. Seeking help and accepting that a drug, and alcohol is a drug, has some kind of control over our minds, causing behavior that leads to severe consequences, just seems like a weakness, so most people coming into treatment are reluctant to admit they’re addicted, much less fully accept the fact and embrace recovery. Further into treatment, most will start realizing they aren’t alone, that others have the same problem, and it’s nothing to feel shame about.

When someone embraces recovery, it’s a big deal, an experience of happiness, a confirmation of what we do, and a feeling of joy for the person who’s chosen a new way. Recovery from addiction is nothing to hide and whisper about – it’s something to celebrate, even if the journey in recovery is long and taken day by day. In the moment, when a person has opened up and chosen a new path, it’s always amazing and uplifting.

Recently, Minna, a NewDay Counselor (who’s great by the way) received a letter from a patient who recently completed our Intensive Outpatient Program. The letter was such a source of positive energy, I had Minna ask if we could put the letter on this blog. He agreed and here it is below.

Addiction statistics are grim. It’s not a pleasant topic, but more people need to know these harsh facts. The statistics below come from the Addiction Center website – please click on the link and read the whole article. As the first statistic shows, the great majority of people with an addiction problem don’t receive treatment — in fact, only one out of ten receive treatment.

To understand the full scope of the problem, statistics which relate to deaths caused by addiction are skewed by how deaths are reported. If someone with an addiction problem has a car crash while under the influence, it’s probably reported that the person died due to injuries caused by the crash. In reality, it’s likely the person was under the influence and died because of her addiction problem. If a cocaine addict dies from a heart attack during a binge, there’s a good chance the death won’t be categorized as caused by cocaine addiction. If an opiate addict stumbles while under the influence, falls and hits their head hard enough to die, opiate addiction won’t likely be reported as the cause of death. You might see this as a stretch, but it’s just something to keep in mind. The number of reported addiction deaths are alarming enough without stretching, it’s just more alarming to think about all the lives, unreported in statistics, cut short by addiction, a treatable condition.

• Almost 21 million Americans have at least one addiction, yet only 10% of them receive treatment.
• Drug overdose deaths have more than tripled since 1990.
• From 1999 to 2017, more than 700,000 Americans died from overdosing on a drug.
• Alcohol and drug addiction cost the U.S. economy over $600 billion every year.
• In 2017, 34.2 million Americans committed DUI, 21.4 million under the influence of alcohol and 12.8 million under the influence of drugs.
• About 20% of Americans who have depression or an anxiety disorder also have a substance use disorder.
• More than 90% of people who have an addiction started to drink alcohol or use drugs before they were 18 years old.
• Americans between the ages of 18 and 25 are most likely to use addictive drugs.

• Every year, worldwide, alcohol is the cause of 5.3% of deaths (or 1 in every 20).
• About 300 million people throughout the world have an alcohol use disorder.
• On average, 30 Americans die every day in an alcohol-related car accident, and six Americans die every day from alcohol poisoning.
• About 88,000 people die as a result of alcohol every year in the United States.
• About 6% of American adults (about 15 million people) have an alcohol use disorder, but only about 7% of Americans who are addicted to alcohol ever receive treatment.
• Men between the ages of 18 and 25 are most likely to binge drink and become alcoholics.
• In 2017, approximately 2.3 million Americans between the ages of 12 and 17 and 2.4 million Americans between the ages of 18 and 25 started to drink alcohol.
• In 2018, a historically-low percentage of American high school students reported drinking alcohol. Only 18% of 10^th graders and 30% of 12^th graders admitted to drinking underage in 2018 compared to 25% of 10^th graders and 39% of 12^th graders in 2013.

In recent years opiate addiction has been in the news. The pandemic pushed stories like opiate addiction out of the news, but it’s still a huge problem. There have been a concerted effort across the nation to treat opiate addiction. Drugs like Suboxone have helped tremendously, although Suboxone is not very effective without addiction treatment and an understanding/acceptance of behavioral changes necessary to recover.

• About 130 Americans die every day from an opioid overdose.
• From 1999 to 2017, 399,230 Americans lost their lives to opioids.
• In 2017 alone, 47,600 fatal overdoses occurred in America which involved at least one opioid.
• In 2017, doctors issued 191,218,272 opioid prescriptions, a slight decline from the 200,000,000 opioid prescriptions which they issued every year from 2006 to 2016.
• Since 1999, the sale of opioid painkillers has skyrocketed by 300%.
• About 20% to 30% of people who take prescription opioids misuse them.
• 2 million Americans misused prescription opioids for the first time in 2017.
• About 10% of people who misuse prescription opioids become addicted to opioids.
• Approximately 2.1 million Americans have an opioid use disorder.
• About 5% of people with an opioid use disorder will try heroin.

Relapse Prevention

The basics of addiction treatment have a lot to do with relapse prevention. Especially in early recovery, it’s important to learn skills necessary to avoid relapse — however, avoiding relapse and thriving in recovery are not the same. A person can develop a plan to take certain actions to avoid relapse, but still be miserable. Even though relapse prevention is important, recovery is about more than relapse prevention. In the beginning of recovery, a lot of energy’s spent avoiding mood altering drugs. This energy spent on avoiding mood altering drugs can be mentally and emotionally exhausting, if there isn’t also something that generates positive recovery energy. A person who’s avoiding relapse because, say, there’s a legal concern, a relationship problem or pressure from an employer, etc., that motivates the person to stay straight will one day move beyond that pressure — the legal concern will go away, or the relationship problem will be temporarily resolved or work performance will improve. This can be a dangerous time for someone who’s not generating internal, positive energy to recover. A person staying straight for the judge, a spouse or an employer, but not generating internal motivation to recover and develop a good life without alcohol, cocaine, pot, etc., will likely return to their drug of choice once the external pressure is gone, even if their intentions are good and they tell themselves and others they’re serious about getting better. Usually, this person hasn’t really accepted the reality of addiction and how it takes more than just avoiding the alcohol, cocaine, opiate, etc., to really recover.

Internal Motivation

Something we don’t discuss enough is what people in long term addiction recovery do to change their lives and generate internal motivation in recovery. This is about much more than relapse prevention. This is about a deep internal change. First, there’s usually a full acceptance that if they start using a mood altering drug, their addiction is activated again and the same bad things, and worse, will happen. The person internally motivated will understand they’re doing this because they want to be straight, that they can enjoy life without some kind of chemical in their body. The person internally motivated will take responsibility for recovery, knowing if they take recovery for granted, they could lose it. The person internally motivated in recovery seeks and utilizes support from others, so that they remember what it was like and to keep their life in perspective. A smart person realizes they don’t have all the answers for everything, but they know how to utilize the experience of others to find answers. The person internally motivated is no longer exhausting their energy staying away from mood altering drugs, but, rather, they’re generating positive energy to move beyond drugs to a better, saner, healthier life. In a sense, they’re pulled forward to a better life.

Thriving in Recovery

The person thriving in recovery usually gives back by helping others who’re lost in addiction. They don’t necessarily devote their lives totally to helping others, but, when they get a chance and it’s appropriate, they willingly share their experience and what it took to recover. Sometimes, addiction treatment and recovery are perceived in ways that have nothing to do with what’s possible in recovery. I’ve witnesses many, many people who came to treatment with nothing, broken, angry, scared, confused, and then they found something, with the help of others, a switch came on, and they transformed their lives. They didn’t have to be forced to do the things that promote recovery. They willingly did these things and actively looked for other ways to enhance recovery: they developed new interests; they sought help with strained relationships; they re-evaluated their career goals; they joined a support group and started helping others; they got with a doctor and set a nutritional plan; they started exercising, improving their physical condition; they took time each day to stop the noise of life, to meditate and stay centered; they embraced life without mood altering drugs; they embraced life, period.

I’ve heard over a thousand alcoholic stories — it’s starts off fun and exciting, in most cases. The person can usually hold their drink better than others. Although building a tolerance to alcohol is perceived as a good thing by most people, it’s one of the first signs pointing to early stage alcoholism – however, just because you can drink a lot without getting drunk, that alone doesn’t make you’re an alcoholic — there are other signs and symptoms that must be present — I get into that in other posts. 

The alcoholic usually drinks without serious problems for months, years or even decades. Alcoholism is progressive and goes through stages. In the early stage it’s hard to detect alcoholism, but usually the person gradually drinks more and more until people begin to notice. Friends aren’t going to criticize other friends, usually, just because a person drinks on a regular basis, as long as serious problems don’t crop up. Friends usually comment indirectly how you are a party animal, maybe a spark plug at parties. They’re amazed at how much you drink without getting wasted.

It’s in the middle stage and late stage that drinking begins turning from endurance sport and fun into a serious condition that concerns friends and families. This doesn’t mean an alcoholic doesn’t have any problems until middle stage alcoholism — there are usually enough signs of a problem in early stage alcoholism to suggest a person seek consultation. It’s hard to convince someone, though, in early stage alcoholism they have a problem, because the alcohol is still working in their eyes. For the progressing alcoholic, however, alcohol stops working like it did before. The person is drinking just to feel normal — the high is short and elusive. It’s seems to the person like they’re going from bad hang-over and shaky hands to the first few drinks of the day, which makes the person feel somewhat normal, to drunkenness. The body is affected in many ways by alcoholism — one way is liver damage. When the liver is not functioning correctly, not detoxing the system, alcohol takes a more direct route to the blood system, and a person who once had a high tolerance is now getting wasted on a regular basis.

When a person drinks heavily on a regular basis, addictively, the body’s poisoned and the brain’s altered. This is the point the person begins to have very serious problems, including life threatening problems. It’s best to get treatment in the early and middle stages of alcoholism, before serious damage is done. The end of practically all the alcoholic stories I’ve heard has to do with alcohol no longer working. Alcoholics who get treatment struggle with the desire to return to drinking like it was in the beginning, but that’s gone. Some alcoholics accept that it’s over and they adjust to a new reality –others chase the old days in to some very dark places, including premature death. The same holds true for any other addictive drug, they work until they don’t. When you first think something is wrong, or when others first begin telling you something is wrong, reach out.