Alcoholism and Holidays

Alcoholism and holidaysI could have titled this recovery and holidays rather that alcoholism and holidays, but I believe we all need to come to terms with the word “alcoholism”and “alcoholic”. Alcoholism is perceived as a harsh word that some prefer to soften with terms like Alcohol Use Disorder (AUD). Regardless what we call it, the reality’s the same. I’m okay really with using a different term as long as it doesn’t change the way people perceive the seriousness of the disease. Yes, alcoholism, or AUD, is a serious, debilitating. progressive and deadly brain disease. Recovering alcoholics have to make adjustments, and one adjustment in early recovery is how to deal with holidays and all the attendant festivities.

It seems like a downer when a newly recovering alcoholic comes up on a holiday like Christmas and invitations to parties arrive. What to do? Go and drink a soda that looks like a mixed drink? Tell the host that you aren’t drinking? Don’t go? Make a pledge to yourself or your spouse, partner or friend who might be going with you to leave if you get uncomfortable? Each individual has to make their own choices, of course, but it’s much better to get advice from someone in long term recovery who’s dealt with alcoholism and holidays a few times, or many times.

If the recovering alcoholic is going to AA, they suggest that newcomers get a sponsor, someone who’s been in recovery for awhile and knows the pitfalls. No one has to recover alone. There are many people who can and will support you in recovery — the recovering alcoholic has to seek them out and ask for advice and support. It’s difficult for most people to admit they have such a serious problem they have to ask for help, but there’s no shame in asking for help. If you don’t know anything about real estate, you find someone who does. If you want to learn a new language, you seek out people and methods to teach that language.

Alcoholism and holidays are tricky. There’s unnecessary stress during the holiday season — it doesn’t have to be that way. If a person in early recovery chooses to avoid parties with heavy drinking, then that’s probably a good choice. There will be other holidays, and when that person is strong in recovery and the desire to drink has gone away, a recovered alcoholic can do anything others can do, except drink alcohol without consequences.

Gratitude in Addiction Recovery

An Gratitude of AttitudeIn the recovery communities you’ll hear a term — an attitude of gratitude. Gratitude in addiction recovery is significant because it helps rewire the brain. The reason it’s an attitude of gratitude is because constancy is necessary to change years of negative thinking caused by addiction. I used to be a skeptic. I didn’t believe in the power of positive thinking, and I still don’t believe in the gimmicky “positive thinking” that changes a person in a short period just from reading a book or going to a seminar.

But positive thinking as a constant attitude toward life makes powerful and lasting changes. Below is an excerpt from Psychology Today:


If you want to be happy the rest of your life, make sure you keep your brain happy. Why? Because being happy matters more to your brain than you might think. In fact, feeling pleasure can be so stimulating for your brain that it is primed to respond to pleasure in a way that reinforces pleasure. Your brain offers rewards to steer you on a pathway to happiness, and you can offer your brain rewards that will encourage it to become even more finely tuned-and to grow well into your old age. Other reasons to want a happy brain: Negative mood variance disturbs your interaction with your environment, affecting your ability to perceive, remember, and reinforce existing or create new neural connections, while being happy improves your ability to be more cognitively alert and productive. Other than being much more fun to be around, being happy:

  • stimulates the growth of nerve connections.
  • improves cognition by increasing mental productivity.
  • improves your ability to analyze and think.
  • affects your view of surroundings
  • increases attentiveness.
  • leads to more happy thoughts.

Happy people are more creative, solve problems faster, and tend to be more mentally alert.

Thanksgiving is coming up and it’s a prime example of recognizing the power of gratitude. The only problem with Thanksgiving is that many people quickly go back to their negative thinking after the day is gone, the games are over, the turkey is cold and family has left. Positive thinking, like gratitude in addiction recovery, is a practice, an orientation toward positive, happy living. Although positive thinking is not magic and doesn’t automatically change a painful reality, it empowers the brain to find solutions and healing — it can generate inner strength and courage to endure hard times.

Treating Opiate Addiction

opiate addiction treatmentTreating opiate addiction is difficult. Detox alone is insufficient for most opiate addicts. After getting opiates out of the body, you’re left with the 90% of the problem. After detox, there’s what’s called Post-Acute Withdrawals. This is an excerpt from Addictions and

There are two stages of withdrawal. The first stage is the acute stage, which usually lasts at most a few weeks. During this stage, you may experience physical withdrawal symptoms. But every drug is different, and every person is different.

The second stage of withdrawal is called the Post Acute Withdrawal Syndrome (PAWS). During this stage you’ll have fewer physical symptoms, but more emotional and psychological withdrawal symptoms.

Post-acute withdrawal occurs because your brain chemistry is gradually returning to normal. As your brain improves the levels of your brain chemicals fluctuate as they approach the new equilibrium causing post-acute withdrawal symptoms.

Most people experience some post-acute withdrawal symptoms. Whereas in the acute stage of withdrawal every person is different, in post-acute withdrawal most people have the same symptoms.

The Symptoms of Post-Acute Withdrawal

The most common post-acute withdrawal symptoms are:

  • Mood swings
  • Anxiety
  • Irritability
  • Tiredness
  • Variable energy
  • Low enthusiasm
  • Variable concentration
  • Disturbed sleep

Post-acute withdrawal feels like a rollercoaster of symptoms. In the beginning, your symptoms will change minute to minute and hour to hour. Later as you recover further they will disappear for a few weeks or months only to return again. As you continue to recover the good stretches will get longer and longer. But the bad periods of post-acute withdrawal can be just as intense and last just as long.

Each post-acute withdrawal episode usually last for a few days. Once you’ve been in recovery for a while, you will find that each post-acute withdrawal episode usually lasts for a few days. There is no obvious trigger for most episodes. You will wake up one day feeling irritable and have low energy. If you hang on for just a few days, it will lift just as quickly as it started. After a while you’ll develop confidence that you can get through post-acute withdrawal, because you’ll know that each episode is time limited.

Post-acute withdrawal usually lasts for 2 years. This is one of the most important things you need to remember. If you’re up for the challenge you can get though this. But if you think that post-acute withdrawal will only last for a few months, then you’ll get caught off guard, and when you’re disappointed you’re more likely to relapse. (Reference:

The reason most people think treatment doesn’t work is because they consider detox and short-term counseling to be treating opiate addiction — it’s not. For treatment to work it should be comprehensive and long term. In reality, a recovering addict is always “treating” the condition, because a recovering addict can go back to the drug at any time after any length of time. Just like the diabetic never becomes un-diabetic, the recovering addict never becomes un-addict.

Addiction Prevention

Addiction preventionDo addiction prevention programs work? They do if they’re comprehensive. Comprehensive means consistent, repetitive, thorough, pertinent, etc. Below are 16 Prevention Principles from the National Institute on Drug Abuse






Prevention Principles

These principles are intended to help parents, educators, and community leaders think about, plan for, and deliver research-based drug abuse prevention programs at the community level. The references following each principle are representative of current research.

Risk Factors and Protective Factors

PRINCIPLE 1 – Prevention programs should enhance protective factors and reverse or reduce risk factors.14

  • The risk of becoming a drug abuser involves the relationship among the number and type of risk factors (e.g., deviant attitudes and behaviors) and protective factors (e.g., parental support).32
  • The potential impact of specific risk and protective factors changes with age. For example, risk factors within the family have greater impact on a younger child, while association with drug-abusing peers may be a more significant risk factor for an adolescent.11, 9
  • Early intervention with risk factors (e.g., aggressive behavior and poor self-control) often has a greater impact than later intervention by changing a child’s life path (trajectory) away from problems and toward positive behaviors.15
  • While risk and protective factors can affect people of all groups, these factors can have a different effect depending on a person’s age, gender, ethnicity, culture, and environment.5, 20

PRINCIPLE 2 – Prevention programs should address all forms of drug abuse, alone or in combination, including the underage use of legal drugs (e.g., tobacco or alcohol); the use of illegal drugs (e.g., marijuana or heroin); and the inappropriate use of legally obtained substances (e.g., inhalants), prescription medications, or over-the-counter drugs.16

PRINCIPLE 3 – Prevention programs should address the type of drug abuse problem in the local community, target modifiable risk factors, and strengthen identified protective factors.14

PRINCIPLE 4 – Prevention programs should be tailored to address risks specific to population or audience characteristics, such as age, gender, and ethnicity, to improve program effectiveness.21

Prevention Planning

Family Programs

PRINCIPLE 5 – Family-based prevention programs should enhance family bonding and relationships and include parenting skills; practice in developing, discussing, and enforcing family policies on substance abuse; and training in drug education and information.2

Family bonding is the bedrock of the relationship between parents and children. Bonding can be strengthened through skills training on parent supportiveness of children, parent-child communication, and parental involvement.17


  • Parental monitoring and supervision are critical for drug abuse prevention. These skills can be enhanced with training on rule-setting; techniques for monitoring activities; praise for appropriate behavior; and moderate, consistent discipline that enforces defined family rules.18
  • Drug education and information for parents or caregivers reinforces what children are learning about the harmful effects of drugs and opens opportunities for family discussions about the abuse of legal and illegal substances.4
  • Brief, family-focused interventions for the general population can positively change specific parenting behavior that can reduce later risks of drug abuse.27


School Programs

PRINCIPLE 6 – Prevention programs can be designed to intervene as early as preschool to address risk factors for drug abuse, such as aggressive behavior, poor social skills, and academic difficulties.30, 31

PRINCIPLE 7 – Prevention programs for elementary school children should target improving academic and social-emotional learning to address risk factors for drug abuse, such as early aggression, academic failure, and school dropout. Education should focus on the following skills:8, 15

  • self-control;
  • emotional awareness;
  • communication;
  • social problem-solving; and
  • academic support, especially in reading.;

PRINCIPLE 8 – Prevention programs for middle or junior high and high school students should increase academic and social competence with the following skills:6, 25

  • study habits and academic support;
  • communication;
  • peer relationships;
  • self-efficacy and assertiveness;
  • drug resistance skills;
  • reinforcement of anti-drug attitudes; and
  • strengthening of personal commitments against drug abuse.

Community Programs

PRINCIPLE 9 – Prevention programs aimed at general populations at key transition points, such as the transition to middle school, can produce beneficial effects even among high-risk families and children. Such interventions do not single out risk populations and, therefore, reduce labeling and promote bonding to school and community.6, 10

PRINCIPLE 10 – Community prevention programs that combine two or more effective programs, such as family-based and school-based programs, can be more effective than a single program alone.3

PRINCIPLE 11 – Community prevention programs reaching populations in multiple settings—for example, schools, clubs, faith-based organizations, and the media—are most effective when they present consistent, community-wide messages in each setting.7

Prevention Program Delivery

PRINCIPLE 12 – When communities adapt programs to match their needs, community norms, or differing cultural requirements, they should retain core elements of the original research-based intervention27 which include:

  • Structure (how the program is organized and constructed);
  • Content (the information, skills, and strategies of the program); and
  • Delivery (how the program is adapted, implemented, and evaluated).

PRINCIPLE 13 – Prevention programs should be long-term with repeated interventions (i.e., booster programs) to reinforce the original prevention goals. Research shows that the benefits from middle school prevention programs diminish without follow-up programs in high school.25

PRINCIPLE 14 – Prevention programs should include teacher training on good classroom management practices, such as rewarding appropriate student behavior. Such techniques help to foster students’ positive behavior, achievement, academic motivation, and school bonding.15

PRINCIPLE 15 – Prevention programs are most effective when they employ interactive techniques, such as peer discussion groups and parent role-playing, that allow for active involvement in learning about drug abuse and reinforcing skills.6

PRINCIPLE 16 – Research-based prevention programs can be cost-effective. Similar to earlier research, recent research shows that for each dollar invested in prevention, a savings of up to $10 in treatment for alcohol or other substance abuse can be seen.

Addiction and drug abuse are major problems, so, addiction prevention efforts have to be major.

Spiritual Solutions to Addiction

Spiritual solutions to addictionAs addiction science has advanced through the years, spirituality in addiction treatment is regarded as voodoo by many healthcare professionals, but most of us who’ve worked in the field for decades believe there are spiritual solutions to addiction. When you witness the amazing process of recovery over and over, you begin to see something change that’s beyond the physical. Call it what you like, but spiritual is good word to describe it. Bill Wilson, co-founder of Alcoholics Anonymous, called it a psychic change in part of his writings, but also talked about the spiritual aspect of recovery.

Bill Wilson’s ideas on recovery were influenced by the famous psychiatrist, Carl Jung. Below is from a NYT’s article:

It came about in 1932 when an American alcoholic named Rowland Hazard was sent to Zurich, Switzerland, to Dr. Jung’s clinic. After about a year, Jung told Rowland that since they had been unable to bring about a psychic change in him, he would be discharged.

No doubt startled, Rowland asked, “Is there no hope, then?”

Dr. Jung’s answer, an astonishing one for a man of science, was, “No, there is none — except that some people with your problem have recovered if they have had a transforming experience of the spirit.”

I’ve witnessed this “transforming experience of the spirit” many, many times over the years. This doesn’t mean that what science has discovered about addiction treatment is useless, far from it — it takes all of it. There are medical solutions, intellectual solutions and there are spiritual solutions to addiction. When all three are present, recovery is almost guaranteed.

First, the medical aspect of addiction is addressed to clear the body of the drug and to address physical/mental damage, then the person is informed/taught that addiction is a powerful brain disease which overpowers will and reason, and then the person is urged, in different ways with different descriptive language, to search for spiritual solutions to addiction. It needs to be said that spiritual here does not necessarily mean religious. It takes a deep and lasting change of mind for recovery to become real and powerful. Call it what you may, but, whatever it is, it’s life-changing, and life-saving.



Congressman Buddy Carter visits Newday Counseling

Congressman Buddy Carter visited NewDay Counseling along with Field representative Hunter Hall. Congressman Carter and Mr. Hall asked a lot of questions, especially related to the national opioid crisis. We discussed how NewDay is doing its part to help treat opioid addiction. We also discussed the need for prevention programs in our schools.

It was a very positive meeting. Our Clinical Director, John Capachione, and our Medical director, Dr Michael Hall, were in attendance – they described our treatment program and suggested ways in which government can help deal with the problem.

I appreciate Congressman Carter’s interest in addiction treatment and his knowledge of the medical/pharmacological aspects.

The Art of Addiction Recovery

The Art of RecoveryWhy not the art of addiction recovery? There’s The Art of Motorcycle Maintenance, The Art of Zen, The Art of Love, The Art of War, on and on. I admit, The Art of Addiction Recovery is not as catchy, but, hey, it might catch on (I’m not the first to coin the phrase, I’m sure, but Google doesn’t reveal a book by that title). In a sense, as in the other endeavors mentioned, there’s art to recovery. When addiction recovery becomes important, and when the recovering person begins to give serious thought to recovery, they learn it’s more than not taking the first drink, the first shot, snort or smoke. Solid, comprehensive addiction recovery entails nutrition, exercise, emotional health, mental stimulation/learning, practice and, yes, imagination and innovation.

I’ve witnessed the recovery process thousands of times, and each recovery is unique. One of the ironies of addiction is most addicts think their drug makes them unique and interesting (in their heads, at least), but the cruel truth is most addicts take a predictable route with common consequences. As the addiction progresses, the person becomes less interesting and more limited by the demands and restrictions of addiction — they usually aren’t growing as a person, aren’t paying attention to relationships, and becoming predictably erratic and nonsensical when under the influence. When we look for signs and symptoms of addiction, it becomes obvious how addicts take common paths to their bottoms. In recovery, the art of recovery, if you will, the recovering person discovers what they buried, the good and the bad, and they’re then free to become a unique individual — they become open to positive, imaginative, innovative change.

The art of addiction recovery might sound strange, and it might sound like hyperbole to say recovery is enhanced (manifested?) by imagination and innovation, but when a person starts seeing possibilities, imagining different ways to make recovery interesting and stimulating and growth oriented, then it becomes personal. Recovery becomes a quest, a challenge, a series of actions that’re well-thought out, made stronger by support from those who’ve recovered, and made real by diligent, wide-awake effort. The Art of Addiction Recovery sounds okay to me — if I had the time or the ability, I might write  book (now that’s imagination!)

Healthcare and Addiction

Addiction and healthcareHealthcare and addiction, in reality, are closely connected – in obvious ways and not so obvious ways. I want to address the hidden costs of chemical dependence/addiction. Our healthcare system treats mostly symptoms of addiction. One of the problems is often with addiction the effects are so far removed from the cause in time it’s hard to follow the path from cause to effect. If early healthcare costs could be immediately associated with addiction, then maybe the fundamental problem could be treated, thus, in the future, saving billions upon billions, not to mention quality and length of life in general.

The healthcare system, like many systems in business, especially when it comes to addiction, is driven primarily by short term financial concerns. This systemic drive to cut costs rejects proposals to treat fundamental problems so costs are significantly lowered in the future. If there’s not a short-term financial benefit, then most healthcare concerns will not properly treat addiction today to save money in the future. Most healthcare concerns don’t even identify addiction as a significant cause of current healthcare costs when it’s obviously a fundamental problem. Emergency rooms are filled with addicts who get bandaged, stitched and temporarily fixed up then sent back out to return over and over. Who’s following the dots from early addiction to death and recording the consequences in between? I’ve worked in the addiction field long enough, since 1983, to see clearly causes and effects related to healthcare and addiction. 

Research shows that long-term quality treatment is effective for many addicts. Some addicts can recover through shorter term treatments, and some alcoholics can go straight into Alcoholics Anonymous and do well. But, most addicts require treatment, and long-term treatment is the most effective means to establish long-term recovery. The problem is in the present healthcare system there isn’t a desire to fund long-term treatment. The main reason long-term treatment is not funded is because it costs too much money — this is what you’ll hear over and over. Insurance companies will officially say it’s not medically necessary, but the reason they say this is to cut costs short-term (am I too cynical?). Never mind the insurance company will pay for the addiction in other ways — accidents, liver disease, gastritis, gun shot wounds, heart disease, stress related illnesses, etc.

Also, when we talk about the effectiveness of addiction treatment, we’re talking about addiction treatment that’s never received the funding or resources equivalent to other major healthcare concerns. There are many professionals in the healthcare system who don’t believe addiction is a chronic brain disease requiring treatment, although this has been established in medicine and science for many decades. There has never been a concerted nationwide attempt to consistently treat addiction as a serious medical condition that requires major resources and expertise. You don’t hear young people going to college saying they are going to start a career in the field of addiction treatment. Healthcare and addiction have been loosely associated, although in reality they are closely connected, and addiction treatment has been haphazard. Once addiction is accepted as the major health concern it is then, perhaps, insurance companies and others involved in the healthcare system will follow the dots from early addiction to all the consequences that follow.

Addiction – Reaching Out for Help

reaching out for helpMost drug addicts, including alcoholics, don’t receive treatment — in fact, only about 10% receive treatment. This is astounding. Reaching out for help is difficult, but that’s not the only problem. Once an addict decides to get help, it’s hard to access treatment. Even though new insurance regulations say that insurance companies must provide coverage for addiction just the same as any other medical condition, deductibles and co-pays are so high many addicts can’t afford to enter treatment.

There are state funded programs for those who don’t have insurance or the ability to pay, but if everyone who needs treatment suddenly sought out treatment, there wouldn’t ne nearly enough specialty treatment facilities to deal with the problem. Our society has done a poor job of dealing with addiction — this is from the above linked NYT’s article:

It estimated that the annual economic toll related to alcohol is $249 billion and that the toll related to drugs is $193 billion.

The majority of people who misuse substances do not develop a use disorder, the report said. But roughly one in seven Americans — 14.6 percent of the population — are expected to develop such a disorder at some point.

Only about 10 percent of people with a substance use disorder receive any type of specialty treatment, the report said. And while more than 40 percent of people with such a disorder also have a mental health condition, fewer than half receive treatment for either.

At one time employers were using EAP services to help employees reaching out for help access treatment, but managed care has weakened most EAP programs to the point of being ineffective. There’s still widespread resistance to treating addiction as a medical concern. Many still consider addiction a personal choice and a matter of will-power — they don’t think treatment is necessary and they don’t believe it works. Few resources have gone into quality addiction treatment in the past few decades. The 90s saw the closure of treatment centers across the nation. It’s true that some facilities began to overcharge and treat patients at the highest level of care whether they needed that level of care or not, but the reaction to this problem was far too drastic.

Now that addiction treatment has improved levels of care, it’s time to create more quality, accessible specialty treatment for addiction. When addicts are reaching out for help, there should be good treatment available. I have worked in the field long enough to know that treatment works, but only if there are quality, dedicated, well-paid, educated professionals working in the field using best practices. Quality treatment that uses the practices and preaches Recovery Management principles is effective — it will be more effective if more people learned the facts about addiction.


Individual Counseling and Addiction Treatment

addiction treatmentWhen it comes to individual counseling and addiction treatment for chemical dependence, I recommend addiction treatment, intensive outpatient or inpatient or a combination of the two. I would never minimize the importance of individual counseling for issues such as anger management, anxiety, relationship problems, depression, grief, etc. — counseling is life-saving in many incidences. There are many people who’re confused and lost and need help getting on track and figuring out the complexities of life. Just understanding what can go wrong with the brain is at times terrifying. It’s nothing to be ashamed of and almost everyone goes through a period in which they could benefit from counseling. It’s been my experience, though,  listening to the stories of addicts, too many to count, that individual counseling for addiction isn’t that effective. If a counselor/therapist has specific training in addiction disorders, then individual counseling is likely to be much more effective, but, still, most addicts need specialized addiction treatment that includes group therapy.

One of the main stories I hear from addicts is that they were ashamed of the addiction label, so they convinced themselves it must be emotional problems causing the insane drug use. To the addict it was more respectable to see a therapist for depression or stress than to check into an addiction treatment center. The addict would minimize their alcohol or other drug intake and talk to the therapist about their stressful job or dysfunctional marriage. This type of counseling almost always makes an individual feel better and gain insight into the particular problems they address, but in the case of addiction, the problems dealt with are symptomatic problems. The fundamental problem of addiction wasn’t addressed.

So the addict would go on drinking or using some other drug, and the problems became worse and worse. Until the fundamental problem of addiction is addressed, it’s like taking cough syrup but not dealing with the cause of the cough. The difference between individual counseling and addiction treatment is a matter of focus and understanding the fundamental problem that must be addressed first. For addiction, I recommend addiction treatment that includes group therapy — this way the person has to face and deal with the addiction. After dealing with the addiction and gaining stabilization there’s always ongoing counseling issues that individual counseling can help, but as long as the addict is drinking alcohol or using some other drug, individual counseling will be sabotaged by the addict.

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