There is a way out of this situation. But – and there’s always a disclaimer, isn’t there? – it won’t be easy and it will take time. Of course, there’s no guarantee the urges and cravings won’t come back, but when and if they do, you’ll be in a much better position to cope with them.

Cravings and Urges – What Are They?

You certainly know what you feel, but what are cravings and urges, really? What is the physical and/or psychological basis for them? Do they happen to every addict? How can they appear months and years after you’re clean and sober? Will they ever go away for good? These are excellent questions that frequently come up during treatment for addiction.

Cravings and urges are best described as strong memories that are linked to the effect of drugs (alcohol, cocaine, marijuana, methamphetamine, prescription drugs used for nonmedical purposes, etc.) or addictive behavior (such as compulsive gambling, spending, or sexual behavior) on the neurochemistry of the brain.

Using brain imagery techniques, researchers have been able to pinpoint intense brain activity when addicts are shown pictures of crack pipes, alcoholic drinks or other visual images of addictive substances or behavior. Research shows that these images or cues can be as brief as 33 milliseconds before they activate the brain’s “go” circuit – even before the person is even aware of it happening.

What actually happens is this: The brain remembers the intense relief or pleasure of the previous drug experience or addictive behavior. It is a kind of programmed response to past association with drug use that activates the cortical areas of the brain by just the sight, sound, smell or thought of the drug itself. You don’t have to be using the drug to experience the craving or urge. Simply seeing or hearing or smelling a trigger – a beer commercial, the sound of ice tinkling in a glass, the sweet aroma of marijuana – makes you relive the experience and produces a strong emotional reaction. This is the craving or urge that you feel.
Tied to memories of such intense pleasure and relief, cravings and urges are both very powerful and tough to ignore. As to whether all addicts have them, the consensus is that they do, although how they react to them is very much individualized.
Some addicts can have the urge and not act on it. Maybe their addiction wasn’t as deep-seated, or they didn’t have any genetic predisposition to addiction (family history of alcoholism, for example). Their addiction may have been more of an environmental and social nature than a hard-core, chronic manifestation of the disease.

Even so, there are many hard-core addicts who successfully overcome their addiction – and are able to combat cravings and
urges effectively. That is not to say that the ability to cope with cravings comes easy or that it doesn’t require conscious effort – especially in early recovery when the memories are the most vivid and insistent.

What Happens in a Craving?

You know you’re experiencing a craving when you start to feel a tingle of anticipation. You hear, see, or smell the trigger and your thoughts center on the memories of using. You can’t get it out of your head.

Cravings aren’t something that you can schedule around, since you never know when they are going to occur. You can get a craving just by watching television or going to the beach, while you are trying to work or go to sleep. All you know is that your body is telling you how much better you’d feel if only you took that drink, smoked that joint, used that drug, went to the casino – you get the picture. Actually, that’s the point: You do get the picture and now you need to know what to do about it.

Source: Drug Addiction Treatment

Photos by Leslie Ellen Ray

The Internet Yogi (theinternetyogi.com)
This web site was developed by David Shannahoff-Khalsa, a research scientist at the University of California, San Diego who specializes in treating psychiatric disorders with Kundalini Yoga. He has developed a protocol using Kundalini Yoga meditation to treat obsessive compulsive disorders and addiction. These techniques can also help improve mental concentration and mental stability, reduce anxiety and depression, and promote a deep sense of inner peace. The protocol uses unique intense active meditative breathing, chanting, and movement techniques (all while sitting in a chair), and is available for purchase on videotape on his web site.

In addition, Dr. Shannahoff-Khalsa has written an article describing a specific Kundalini Yoga meditation technique for treating addictive disorders that is available full text online.

Shannahoff-Khalsa DS. “An introduction to Kundalini yoga meditation techniques that are specific for the treatment of psychiatric disorders.” The Journal of Alternative and Complementary Medicine. Volume 10, Number 1, 2004, pp. 91-101.

For more information on addiction, recovery and treatment for substance abuse visit sunrisedetox.com .

Walking Away Isn’t Quitting

When you walk away from your family, it should never be as a result of the desire to quit. Whether you are the recovering addict or the spouse of the newly-sober individual, your reasons for leaving must be based on the best interests of all concerned. The decision should come after all other options have been thoroughly explored, and/or you’ve come to the realization that by staying, you’re doing more harm than good – harm to you, your spouse and your family.

Let’s take an example. Jennifer, mid-30s, is the live-in partner of Woody, 40. They have no children but prior to Woody’s stay in rehab for cocaine and alcohol addiction, they’d talked about getting married and starting a family. Jennifer is an artist who works from home, an only child whose parents are deceased. Woody’s mother is an alcoholic and his father a compulsive gambler. His two younger brothers, Alex and Tim, early 30s, are heavily into street drugs. Money has always been an issue in Woody’s family and he witnessed many explosive arguments at home growing up. Jennifer worships Woody, but doesn’t know how to relate to him now that he’s home from addiction treatment. He’s often silent, not the talkative person she so enjoyed, and he doesn’t want to socialize anymore. Her own work is suffering, since she feels compelled to watch over Woody all the time, afraid that he might slip. They haven’t had sex since before he went into rehab and Woody says he no longer wants children. In fact, Woody’s so different now that Jennifer feels trapped in a relationship she doesn’t want.

Clearly these two individuals are experiencing a great deal of difficulty adjusting to Woody’s new sobriety. The couple isn’t married, so there would not be any legal issues to untangle should they decide to split. Woody and Jennifer may benefit from continued counseling, if they’d go. It appears, however, that their finances are constrained, so professional couple’s therapy probably isn’t in the cards. Woody needs to resume attendance at his 12-step meetings (Alcoholics Anonymous and Cocaine Anonymous) – even though he says he doesn’t like the people there and it’s not helping him. Jennifer could find help through Al-Anon or Nar-Anon, but she seems unlikely to go.

Perhaps in this instance, Jennifer and Woody should part ways – at least until Woody is more firmly rooted in his sobriety and has a solid game-plan for his future. Staying together now could mean the relationship continues to disintegrate to the point of irreconcilable differences. For his part, Woody should attempt to see things from Jennifer’s perspective. If she truly means anything to him, he will put aside his own concerns and resolve to set her free. He needs to heal himself before he can open up to Jennifer or any other woman. Jennifer, on the other hand, needs to let go of her guilt and have the courage to stand up to Woody. She needs to be free of Woody’s needfulness.

Display Respect and Love

It’s not as easy as that, however. Walking away involves striving to achieve a delicate balance of resolve and independence, and needs to be accomplished with a display of respect and love.

In other words, you don’t need to have a shouting match to get your point across. Two people should be able to sit down together, or with a counselor present, and discuss their wants and needs in a civil manner. No matter how rough things have been, or how many hopes and dreams have been shattered, the decision to split can be amicable. Sometimes, however, the hurt has been so profound that one partner is unable to see anything good in the other. In such instances, the split should occur as quickly and with as much dignity as possible.

Let’s take another example. Bradley, 58, is married to Lynnette, 43. The couple have three young children, two girls, ages 11 and 15, and one boy, 17. Bradley has been doing his best to take care of the children while his wife was in treatment for compulsive sexual behavior, alcoholism and prescription drug addiction. This was Lynnette’s third time at rehab. Bradley has a good job, is a loving father, but has been repeatedly hurt by Lynnette’s affairs and blatant refusal to be a mother. In fact, she’s often been verbally and physically abusive to the children while she’s drunk and high – most often when she returns from one of her sexual liaisons. Bradley’s at the end of his patience. Lynnette refuses to change, and has stated on more than one occasion that she wants out.

Bradley’s most important consideration is the welfare of his children. While he believes in marriage for life, in this case, he has come to realize that Lynnette is not the partner for him. He and Lynnette should work out the details for her departure, making sure that the children are not negatively affected by the discussions and arrangements. Bradley’s best bet is to remain as respectful of Lynnette as possible, and show her cordiality, if not love, as she leaves the family.

Source: Drug Addiction Treatment

Managing the pain

There are many techniques for pain management that are very effective, both while we are in treatment and afterwards, if we just give them the chance to do so. Listed below are just some of the many useful and effective tools. A qualified physician should approve all techniques before you attempt them:

1. Physical Therapy: This is the most effective treatment of all. Most of us have been through many forms of physical therapy before, but chances are good we were abusing chemicals at the same time, nullifying or weakening the therapy. The form of treatment can also strengthen other parts of our bodies that can be used to physically support the pain area, such as back, leg and stomach muscles. Posture exercises are essential in chronic pain therapy.
2. Heat or Ice Therapy: I have two reusable ice packs in the freezer at all times. Ice is fast acting and very effective. Heat is very soothing to sore muscles. Always follow the suggestions of a physician, to be sure this type of therapy will help you and is safe.
3. Relaxation Techniques: Stress causes pain and pain causes stress. Relaxation helps reduce stress while helping reduce muscle spasms. There are various methods of relaxation, and some are more effective than others, depending upon the source of the pain. Deep breathing exercises can work wonders, since deep breathing is the body’s natural way to relax.
4. Biofeedback: This is a specialized form of relaxation that can help you relax the area that is the source of pain. This is taught by pain management programs or professionals in private practice.
5. Massage Therapy: This works well when used alone or combined with other pain management techniques. The majority of us suffer from muscle pain even though our injury sites may be elsewhere. It is usually the responding muscles that hurt the most.
6. Alternative Medicine: Many of us receive relief from alternative sources such as chiropractic adjustments, acupuncture, reflexology and other forms of alternative medicine. This type of treatment is usually done when in-patient treatment is complete, however your particular program may make exceptions.
7. Proper Diet: Depending upon the person, a nutritionist can be consulted for healthy eating habits. If we are overweight, chances are we are making the pain worse by putting extra strain on the body.
8. Psychological and Psychiatric Support: Any program specializing in addiction and chronic pain will have appropriate counselors and psychiatrists to aid in pain management. Counselors and psychologists give emotional and spiritual guidance. They can also provide healthy support in therapeutic activities such as group therapy. Psychiatrists can prescribe antidepressants that can relieve depression and contribute to pain relief.
9. Medications: All treatment programs of this nature have staff physicians than can provide pain relief by prescribing appropriate non-mood-altering medications that are just as good as, if not better than narcotics and benzodiazepines. It may take some trial and error before the best overall medication is found for each individual. Just remember, mood-altering medications are not effective once tolerance builds, and chances are the medications you abused stopped providing physical relief.
10. Occupational Therapy and Vocational Guidance: Many of us are distressed because we can no longer function at work. Some of us must make occupational changes because of our chronic pain. Pain management treatment should include services that can help you return to work, or guide you toward new trades. Occupational therapy may be required if you intend to eventually return to your line of work. This involves training your muscles so they can cope with the stress of a particular job. Vocational counseling can help you change careers. These counselors specialize in this form of therapy, which includes a variety of testing and guidance.
11. Setting Goals: Once we have arrived at a level of acceptance of our pain, it is imperative that we begin setting specific goals that, once we reach, gives us hope and raises our self-esteem. Setting specific goals is a major function of treatment planning. Your counselor will provide guidance and help you set these goals.
12. Family Therapy: This is an essential part of treatment because the family plays such an important role in addiction and chronic pain. This form of therapy will help the family work through fears, and help them understand how they enable destructive behaviors in both areas.

One dose of buprenorphine remains active in the human body for as long as 48 hours, which provides a longer duration than morphine. This is one of the qualities that make this drug ideal for helping opioid addicts to break free of their addiction. Since the drug remains in the body for 48 hours, it also ensures that the withdrawal symptoms that people experience are significantly decreased.

Buprenorphine requires sublingual (under the tongue) administration on a frequent basis. Drug administration should always be supervised by a substance abuse treatment professional, and doses must be strictly monitored. Federal regulations require this in order for treatment centers and medical facilities to be able to administer the drug at all.

There are some side effects that can occur along with the use of buprenorphine. They range from moderate to severe, and it should be pointed out that this drug can, in some cases, produce fatal side effects. The most commonly occurring side effects include the following:

• Headache

• Drowsiness

• Dizziness

• Vomiting

• Decreased libido

• Constipation

• Respiratory depression

Respiratory depression is the side effect that presents the most serious problems with the use of buprenorphine, as it can be fatal in some people. Unfortunately, there is no way to correct or treat this problem should it develop.

While undergoing buprenorphine treatment, all patients are regularly monitored to see how their livers are functioning, as some adverse effects can be caused by using this drug.

Even though buprenorphine is used to treat people with opioid addictions, the possibility does exist for an addiction to the buprenorphine itself to develop. The types of dependencies that can develop include both physical and psychological. People who are considering undergoing treatment with this drug should be aware, however, that instances of people becoming addicted to buprenorphine are quite rare.

Often times, one of the primary questions that people have is whether they should choose buprenorphine or methadone as a treatment option. Both of these drugs are routinely used for short-term and long-term treatment of opioid addiction. Dosing requirements may be a bit better with buprenorphine simply because of the drug’s ability to remain in the body for 48 hours, thereby offering longer-term effects. With buprenorphine, patients typically only have to receive a dose every other day, while methadone requires daily dosing.

Buprenorphine also has an advantage regarding the total amount of treatment time that is required to successfully complete a detoxification program. With buprenorphine, treatments generally last for a few months, while with methadone indefinite or sometimes lifelong treatment is necessary.

It is very important that buprenorphine be administered in an inpatient treatment facility, particularly one that specializes in substance abuse treatment. Inpatient treatment programs not only offer patients detox programs, they also offer treatment or rehabilitation programs that are designed to help people learn healthier ways of living. Some of these treatment programs include counseling, diet and exercise, massage, acupuncture, and group therapy.

The purpose in these additional treatments is to give patients a better chance of maintaining success by giving them the tools they need to lead lives that are free of substance abuse. If patients learn how to be healthy and happy (physically and emotionally) then they will be far less likely to have a relapse.

Source: Drug Addiction Treatment

This is NA Fellowship-approved literature.

Copyright © 1983, 1988 by

Narcotics Anonymous World Services, Inc.

Only you can answer this question.

This may not be an easy thing to do. All through our usage, we told ourselves, “I can handle

it.” Even if this was true in the beginning, it is not so now. The drugs handled us. We lived to

use and used to live. Very simply, an addict is a person whose life is controlled by drugs.

Perhaps you admit you have a problem with drugs, but you don’t consider yourself an addict.

All of us have preconceived ideas about what an addict is. There is nothing shameful about being

an addict once you begin to take positive action. If you can identify with our problems, you may

be able to identify with our solution. The following questions were written by recovering addicts

in Narcotics Anonymous. If you have doubts about whether or not you’re an addict, take a few

moments to read the questions below and answer them as honestly as you can.

1. Do you ever use alone? Yes ? No ?

2. Have you ever substituted one drug for another, thinking that

one particular drug was the problem? Yes ? No ?

3. Have you ever manipulated or lied to a doctor

to obtain prescription drugs? Yes ? No ?

4. Have you ever stolen drugs or stolen to obtain drugs? Yes ? No ?

5. Do you regularly use a drug when you wake up or when you go to bed? Yes ? No ?

6. Have you ever taken one drug to overcome the effects of another? Yes ? No ?

7. Do you avoid people or places that do not approve of you using drugs? Yes ? No ?

8. Have you ever used a drug without knowing what it was?

or what it would do to you? Yes ? No ?

9. Has your job or school performance ever suffered

from the effects of your drug use? Yes ? No ?

10. Have you ever been arrested as a result of using drugs? Yes ? No ?

11. Have you ever lied about what or how much you use? Yes ? No ?

12. Do you put the purchase of drugs ahead of

your financial responsibilities? Yes ? No ?

13. Have you ever tried to stop or control your using? Yes ? No ?

14. Have you ever been in a jail, hospital,

or drug rehabilitation center because of your using? Yes ? No ?

15. Does using interfere with your sleeping or eating? Yes ? No ?

16. Does the thought of running out of drugs terrify you? Yes ? No ?

17. Do you feel it is impossible for you to live without drugs? Yes ? No ?

18. Do you ever question your own sanity? Yes ? No ?

19. Is your drug use making life at home unhappy? Yes ? No ?

20. Have you ever thought you couldn’t fit in or have a good time

without drugs? Yes ? No ?

21. Have you ever felt defensive, guilty, or ashamed about your using? Yes ? No ?

22. Do you think a lot about drugs? Yes ? No ?

23. Have you had irrational or indefinable fears? Yes ? No ?

24. Has using affected your sexual relationships? Yes ? No ?

25. Have you ever taken drugs you didn’t prefer? Yes ? No ?

26. Have you ever used drugs because of emotional pain or stress? Yes ? No?

27. Have you ever overdosed on any drugs? Yes ? No ?

28. Do you continue to use despite negative consequences? Yes ? No ?

29. Do you think you might have a drug problem? Yes ? No ?

“Am I an addict?” This is a question only you can answer. We found that we all answered

different numbers of these questions “Yes.” The actual number of “Yes” responses wasn’t as

important as how we felt inside and how addiction had affected our lives.

Some of these questions don’t even mention drugs. This is because addiction is an insidious

disease that affects all areas of our lives—even those areas which seem at first to have little to do

with drugs. The different drugs we used were not as important as why we used them and what

they did to us.

When we first read these questions, it was frightening for us to think we might be addicts.

Some of us tried to dismiss these thoughts by saying:

“Oh, those questions don’t make sense;”

Or,

“I’m different. I know I take drugs, but I’m not an addict. I have real emotional/family/job

problems;”

Or,

“I’m just having a tough time getting it together right now;”

Or,

“I’ll be able to stop when I find the right person/get the right job, etc.”

If you are an addict, you must first admit that you have a problem with drugs before any

progress can be made toward recovery. These questions, when honestly approached, may help

to show you how using drugs has made your life unmanageable. Addiction is a disease which,

without recovery, ends in jails, institutions, and death. Many of us came to Narcotics

Anonymous because drugs had stopped doing what we needed them to do. Addiction takes

our pride, self-esteem, family, loved ones, and even our desire to live. If you have not reached

this point in your addiction, you don’t have to. We have found that our own private hell was

within us. If you want help, you can find it in the Fellowship of Narcotics Anonymous.

“We were searching for an answer when we reached out and found Narcotics Anonymous.

We came to our first NA meeting in defeat and didn’t know what to expect. After sitting in a

meeting, or several meetings, we began to feel that people cared and were willing to help.

Although our minds told us that we would never make it, the people in the fellowship gave us

hope by insisting that we could recover. […] Surrounded by fellow addicts, we realized that we

were not alone anymore. Recovery is what happens in our meetings. Our lives are at stake. We

found that by putting recovery first, the program works. We faced three disturbing realizations:

1. We are powerless over addiction and our lives are unmanageable;

2. Although we are not responsible for our disease, we are responsible for our recovery;

3. We can no longer blame people, places, and things for our addiction. We must face our

problems and our feelings.

The ultimate weapon for recovery is the recovering addict.” 1

1 Basic

Detox at an addiction center can take days or even weeks, depending on what the person was abusing, how much they were using and for how long. However, just because a person has completed medical detox doesn’t mean that they are through with their rehab program. In fact, detox is just one small step in the larger process of freedom from drug and alcohol dependency.

When a person becomes addicted to drugs or alcohol, they aren’t just addicted to the substance they are abusing – they become addicted to the flood of pleasurable stimuli that the substance provides to them. No drug rehab program can be successful without changing the mindset of a person and helping them to understand how their addiction has changed them and what they need to do to move forward.

In addition to the lessons about moving forward that are taught at a rehab center, addicts also must address the root causes of their addiction. The majority of addicts start abusing drugs or alcohol because of other factors such as genetics, unhappy childhoods or unstable current lives. Without addressing these underlying factors, most people will eventually fall right back into their patterns of addiction and dependence.

For all of these reasons, it’s important to do more than just “get dry” when trying to quit drinking. Long-term abstinence requires a total rehab program that addresses every aspect of the drug or alcohol addiction.

By Sarah Michaels

When the time came that I began to go through the twelve steps I had been clean and sober for over three months and still felt disconnected from God.  The first step was to admit that I was powerless over drugs and alcohol and that my life had become unmanageable, which was easy for me.  However the second step was no easy feat, “We came to believe that a power greater than ourselves could restore us to sanity.”  I went over and over the words in my head and tried to think what it meant to me and how I could relate to this concept of a power greater than myself.  My sponsor told me that she had a similar experience when she was a newcomer and that all that I needed at that time was to believe that there was something in the universe that was more powerful than me.  I had heard of people using the fellowship of Alcoholics Anonymous as their Higher Power because they felt that the group was more powerful than they were alone.  That idea made sense to me and for the time being it would suffice.  I was hopeful that in time my relationship to God would blossom and develop as was the experience of others in AA.

The first step in recovery is asking for help and physically getting off whatever substance you were abusing.  Detox is only the beginning of your transition into a new life of sobriety.  Once your body is clean of drugs and alcohol and you have completed your detox program my suggestion is to attend a drug rehab center.  Some will tell you that this is not necessary and for the few people out there that have an extremely strong sense of discipline and are absolutely sure that they want to live a drug free life then they may be able to stay clean and sober without attending a rehab. However the statistics prove that your chances go up 10 fold if you attend and complete a drug treatment program. 

 

There is a variety of drug programs available ranging from the traditional 28 day inpatient rehab to some less intensive outpatient programs.  Through my own personal experience I have found that the best way to stay off drugs and alcohol is to attend an inpatient rehab program with a minimum length of 28 days.  There are also some residential drug treatment centers that offer longer programs (3-9 months) but many find that they are unable to put this amount of time aside.  If you are able to invest 6 months into drug rehab because you feel that you need to then that is a great testament to your commitment to your recovery.

 

When choosing which rehab to enter be wise and select one that fits your individual needs.  If you also suffer from depression or anxiety make sure that they have a psychiatrist on staff that will be able to meet with you and assess your situation.  If you feel more comfortable in a single sex environment then choose a treatment center that has separate units for men and women.  Most important before you check yourself into any drug treatment facility, do a little research on their history and their success rates; it doesn’t hurt to do some investigating.  If you are in need of some advice of where to go and are in the South Florida area, New York, New Jersey or Pennsylvania email me and I will share my experiences with you.

The best detox center in my experience has been The Sunrise Detox located in Lake Worth, Florida.  They have a gentle and loving approach towards drug detoxification patients and treat all of their clients with dignity and respect. The staff at Sunrise Detox is the most caring and genuine that I have ever encountered. They actually care and want to see you recover and that is why there is such a comfortable and safe feeling there.

According to the Sunrise Detox website: “We believe that recovery from alcohol and drug addiction should be dignified. We’ve gone to great lengths to create a feeling of home at Sunrise Detox. There are no locked doors, and Sunrise Detox is not an antiseptic hospital environment. Our clients reside in comfortable, modern, elegantly furnished rooms, with plenty of space for personal belongings, and they are not required to wear uncomfortable hospital gowns during detoxification. Individuals can dress in the clothing of their choice, and have easy access to in-house laundry facilities. We also operate our own full-service, on-site gourmet kitchen which serves a diverse menu of nutritionally balanced meals and snacks.”  It makes a huge difference to be able to wear your own clothing and not be forced into a medical gown while going through withdrawal.  Each and every creature comfort that is afforded at Sunrise Detox makes the process of coming off drugs easier to bear.

The most praiseworthy aspect of Sunrise Detox is that they understand what a comfortable detox means and they don’t see detox as a time to make the patient suffer.  Through a comfortable, medically monitored detoxification process they aid their clients in their first steps towards recovery.