The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt.1

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The Last Addictions Memoir (Hopefully): An Evidence-Based Recovery Story Pt.1

By Anne Giles 03/24/17

A personal recovery story in the context of the latest data on what addiction is and what effectively treats it.

Image: 
A vase of daffodils.
Photo credit: Anne Giles

Author's Introduction: I had a fully developed brain and a fully developed professional, social and personal life when I developed an addiction to alcohol near the age of 50. I had some of the known precursors for addiction, but not in a combination or magnitude to make anyone who knows me, or even health care professionals reviewing my case say, "Oh, yeah, she's gonna get it!" With one exception.

I am a resident of Blacksburg, Virginia. According to research on the relationship between community violence, trauma and addiction, I am one among a likely cohort of 300 in Blacksburg who developed addiction after the Virginia Tech shootings in 2007.

My wish is that readers with substance use disorders will insist on evidence-based treatment for addiction, that the addictions treatment field will jettison belief-based practices, addictions policymakers will align laws with what Maia Szalavitz tweeted truly fights addiction - "Love, evidence & respect" - and "addictions memoirs," like this one, will become ho-hum, then passé because there's no story in people getting effective treatment and then getting on with living their singular, precious lives.

The Last Addictions Memoir (Hopefully) begins with its end, "3 Handouts I Wish I Had Been Given My First 3 Days in Recovery from Addiction." Handout 1 is below. Handout 2 and Handout 3 will appear on subsequent Fridays. 

Addiction almost felled me once, the secrecy a second time. I am so grateful to The Fix for freeing me on 5/26/16 from the silence.

**************

3 Handouts I Wish I Had Been Given on My First 3 Days of Recovery from Addiction - Handout 1

"Love, evidence & respect." - Maia Szalavitz’s answer via Twitter to the question, “What fights addiction?”

1.  Who you are does not cause addiction.

2. Nothing bad you have done, nor good you failed to do, caused addiction.

3. You do not deserve addiction, nor do you deserve not to have addiction. It's just an unfortunate condition having no moral value one way or the other.

4. You are not the problem. Addiction is the problem. Let's see what we can do to solve or improve this for your unique, individual situation. And we'll do this with compassion. As Maia Szalavitz writes, "To return our brains to normal then, we need more love, not more pain."

5. Get medical care for the medical condition of addiction. Forced abstinence can result in dangerous withdrawal symptoms, decreased tolerance and increased craving, an intolerable emotional and mental state, and risk of a dangerous, potentially deadly, return to use.

6. Symptoms of addiction can appear as thoughts, words, and actions perceived as irrational, anti-social, and immoral. Addiction is not, in and of itself, a thought problem, a moral problem, a spiritual problem, a mental illness, or a behavior problem. Addiction is not a personality type. It's a brain condition, contentiously defined, uncertainly located, and uncertainly targeted for treatment, but detectable in the brain at the minutest level.

7. Unfortunately, at this time, we know of nothing you can specifically do on your own to immediately and directly treat, cure, or reverse malfunctions in brain structures associated with addiction. Until we can identify exactly which brain structures and circuits to treat with medications, stimulation or probes, and what beneficially modifies them, for now, other than directly through the medications we know of, we'll have to use indirect means.

8. However, what can directly administer care to brain structures is protecting them from problematic substances. That's why obtaining medical care and professional help to assist with abstinence or harm reduction is critical. Over time, helpful changes may occur in the brain in the absence of overwhelming or damaging substances.

9. Focus maximum effort on becoming aware, very specifically, of what helps you stay abstinent and what does not. If you're practicing harm reduction, discover what helps you use less, less often, or use less problematic substances. Acute awareness takes painstaking attention, but the logic is simple. If you can become aware of inner and outer conditions that precede use, you may be able to do something about them. If you don't know, you can't.

10. Needing or wanting to abstain, and firmly deciding and being resolved to quit, unfortunately - as you know from former heroically determined efforts to quit followed by heartbreaking returns to use, all explained by the brain science of addiction - aren't sufficient to achieve abstinence.

11. You must learn what each substance did for you or meant to you, how you related to it, how it worked for you, and how it eased or enhanced your experience or your life. Discovering this, and finding alternate ways to get your needs met, is difficult but worthy, essential work. Again, the logic is simple. If you can learn what substances did for you, and find alternate ways to get most of that done - regrettably, possibly never again to the extent substances did - you're more likely to be able to do without them.

12. Repeat: Go to a doctor. Although medical treatments for directly treating the brain for most substance use disorders are currently unknown (however, methadone and buprenorphine directly affect brain areas involved in opioid use disorder), several medications can be helpful with creating the stability necessary for intensive self-learning. In addition to being assessed for medication-assisted treatment (MAT), ask to be screened for mental illnesses and physical illnesses that might be causing conscious and unconscious stress and distress, the primary precursors to a return to use. (If you don't have health insurance and can't afford to self-pay, try to find local organizations that will help you get health insurance or help you with costs for medical care.)

13. Abstain from self-judgment. Become aware of a learned pattern of self-harshness, now nearly automatic. It feeds shame, a primary source of inner distress. Self-discernment is a compassionate process of discovering one's strengths. In contrast, self-judgment cruelly weakens, reduces and demoralizes. As Maia Szalavitz urges, treat yourself for addiction by loving yourself, getting evidence-based care, and respecting the gravity of this illness and the heroic effort required to overcome it.

The opinions expressed here are mine alone and do not necessarily reflect the positions of my employers, co-workers, family members or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Anne Giles, M.A., M.S., is a counselor, writer and business owner. She writes about addictions treatment, recovery and policy at annegiles.com. As of this writing, she has been abstinent from alcohol since December 28, 2012, and is in remission from alcohol use disorder.

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