July issue by The Sober World,LLC

THE

A LETTER FROM THE PUBLISHER Dear Readers, I welcome you to The Sober World magazine. This magazine is being directly mailed each month to anyone that has been arrested due to drugs, alcohol and petty theft in Palm Beach County. It is also distributed locally as well as being mailed to rehab centers through out the county and country. Many petty thefts are also drug related, as their need for drugs causes addicts to take desperate measures in order to have the ability to buy their drugs. Drug addiction has reached epidemic proportions throughout the country and is steadily increasing. Florida is one of the leading States. People come from all over to obtain pharmaceutical drugs from the pain clinics that have opened virtually everywhere. The availability of prescription narcotics is overwhelming, and as parents our hands are tied because it is legal. Doctors continue writing prescriptions for drugs such as Oxycontin, and Oxycodone (which is an opiate drug and just as addictive as heroin) to young adults in their 20’s and 30’s right up to the elderly in their 70”s, thus, creating a generation of addicts. Addiction is a disease but it is the most taboo of all diseases. As family members affected by this disease, we are often too ashamed to speak to anyone about our loved ones addiction, feeling that we will be judged. We try to pass it off as a passing phase in their lives, and some people hide their head in the sand until it becomes very apparent such as through an arrest, or even worse an overdose that we realize the true extent of their addiction. I know that many of you who are reading this now are frantic that their loved one has been arrested. No parent ever wants to see his or her child arrested or put in jail, but this may be your opportunity to save your child or loved ones life. They are more apt to listen to you now then they were before, when whatever you said may have fallen on deaf ears. This is the point where you know your loved one needs help, but you don’t know where to begin. I have compiled this informative magazine to try to take that fear and anxiety away from you and let you know there are many options to choose from. There are Psychologists and Psychiatrists that specialize in treating people with addictions. There are Education Consultants that will work with you to figure out what your loved ones needs are and come up with the best plan for them. There are transport services that will scoop up your resistant loved one (under 18 yrs old) and bring them to the facility you have chosen. There are long term programs (sometimes a year and longer) as well as short term programs (30-90 days). There are Wilderness programs and there are sober living housing where they can work, go to meetings and be accountable for staying clean.

To Advertise, Call 561-910-1943

Many times a criminal attorney will try to work out a deal with the court to allow your child or loved one to seek treatment instead of jail. I know how overwhelming this period can be for you and I urge every parent or relative of an addict to get some help for yourself as well. There are many groups that can help you. There is Al-Anon, Alateen (for teenagers), Families Anonymous, Nar-Anon and more. This is a disease that affects the whole family, not just the parents. These groups allow you to share your thoughts and feelings. As anonymous groups, your anonymity is protected. Anything said within those walls are not shared with any one outside the room. You share only your first name, not your last name. This is a wonderful way for you to be able to openly convey what has been happening in your life as well as hearing other people share their stories. You will find that the faces are different but the stories are all too similar. You will also be quite surprised to see how many families are affected by drug and alcohol addiction. Addiction knows no race or religion; it affects the wealthy as well as the poor, the highly educated, old, young - IT MAKES NO DIFFERENCE. This magazine is dedicated to my son Steven who graduated with top honors from University of Central Florida. He graduated with a degree in Psychology, and was going for his Masters in Applied Behavioral Therapy. He was a highly intelligent, sensitive young man who helped many people get their lives on the right course. He could have accomplished whatever he set his mind out to do. Unfortunately, after graduating from college he tried a drug that was offered to him not realizing how addictive it was and the power it would have over him. My son was 7 months clean when he relapsed and died of a drug overdose. I hope this magazine helps you find the right treatment for your loved one. They have a disease and like all diseases, you try to find the proper care. They need help. Please don’t allow them to become a statistic. There is a website called the Brent Shapiro Foundation. Famed attorney Robert Shapiro started it in memory of his son. I urge each and every one of you to go to that website. They keep track on a daily basis of all the people that die due to drug overdoses. It will astound you. I hope you have found this magazine helpful. You may also visit us on the web at www.thesoberworld.com. Sincerely,

Patricia

Publisher Patricia@TheSoberWorld.com

IMPORTANT HELPLINE NUMBERS 211 PALM BEACH/TREASURE COAST 211 www.211palmbeach.org FOR THE TREASURE COAST www.211treasurecoast.org FOR TEENAGERS www.teen211pbtc.org AAHOTLINE-NORTH PALM BEACH 561-655-5700 www.aa-palmbeachcounty.org AA HOTLINE- SOUTH COUNTY 561-276-4581 www.aainpalmbeach.org FLORIDA ABUSE HOTLINE 1-800-962-2873 www.dcf.state.fl.us/programs/abuse/ AL-ANON- PALM BEACH COUNTY 561-278-3481 www.southfloridaalanon.org AL-ANON- NORTH PALM BEACH 561-882-0308 www.palmbeachafg.org FAMILIES ANONYMOUS 847-294-5877 Center for Group Counseling 561-483-5300 www.groupcounseling.org CO-DEPENDENTS ANONYMOUS 561-364-5205 www.pbcoda.com COCAINE ANONYMOUS 954-779-7272 www.fla-ca.org COUNCIL ON COMPULSIVE GAMBLING 800-426-7711 www.gamblinghelp.org CRIMESTOPPERS 800-458-TIPS (8477) www.crimestopperspbc.com CRIME LINE 800-423-TIPS (8477) www.crimeline.org DEPRESSION AND MANIC DEPRESSION 954-746-2055 www.mhabroward FLORIDA DOMESTIC VIOLENCE HOTLINE 800-500-1119 www.fcadv.org FLORIDA HIV/AIDS HOTLINE 800-FLA-AIDS (352-2437) FLORIDA INJURY HELPLINE 800-510-5553 GAMBLERS ANONYMOUS 800-891-1740 www.ga-sfl.org and www.ga-sfl.com HEPATITUS B HOTLINE 800-891-0707 JEWISH FAMILY AND CHILD SERVICES 561-684-1991 www.jfcsonline.com LAWYER ASSISTANCE 800-282-8981 MARIJUANA ANONYMOUS 800-766-6779 www.marijuana-anonymous.org NARC ANON FLORIDA REGION 888-947-8885 www.naranonfl.org NARCOTICS ANONYMOUS-PALM BEACH 561-848-6262 www.palmcoastna.org NATIONAL RUNAWAY SWITCHBOARD 800-RUNAWAY (786-2929) www.1800runaway.org NATIONAL SUICIDE HOTLINE 1-800-SUICIDE (784-2433) www.suicidology.org ONLINE MEETING FOR MARIJUANA www.ma-online.org Ruth Rales Jewish Family Services 561-852-3333 www.ruthralesjfs.org MEETING HALLS Billy Bob Club 561-459-7432 561-312-2611 central house 2170 W Atlantic Ave. SW Corner of Atlantic & Congress Club Oasis 561-694-1949 Crossroads 561-278-8004 www.thecrossroadsclub.com EasY Does It 561-433-9971 The Meeting Place 561-255-9866 The Triangle Club 561-832-1110 www.Thetriangleclubwpb.com

THE

Stressed, anxious, depressed, lonely? Are you concerned about your teenagers' behavior or perhaps you have conflict in your relationship with your spouse or other family members? Worried about your job, your health? We can help! We are a not-forprofit counseling center that provides individual, family and group counseling, and a variety of support groups for children, adults, and seniors. Our low cost services range from $5 to $45 per session. Call for an appointment. Mention Sober World and your comprehensive initial evaluation is only $25. Caring, confidential, professional support is just around the corner.

CENTER FOR GROUP COUNSELING 22455 Boca Rio Road, Boca Raton, FL 33433

561/483-5300 www.groupcounseling.org To Advertise, Call 561-910-1943

THE CONTINUUM OF CARE: By Myles B. Schlam, J.D., CAP / CCJAP

Years ago addicts and alcoholics were seen as morally deficient criminals and a nuisance to society. We have come a long way over the last couple decades in educating the public and the government to comprehend that addiction is a disease and those inflicted should be treated as such. We now have specialized Courts such as Drug Court and Mental Health Court to try to address the needs of these clients in a separate realm and focus more on treatment and less on punitive measures and retribution. We are blessed to have an abundance of excellent treatment facilities, both private and not-for-profits.

That being said, we are still losing many addicts that are falling through the cracks in the system. Of course there is the lack of funding issue, which is a travesty. Many addicts simply cannot afford access to treatment. This needs to be addressed with our legislators. However, I would like to focus this article on other factors that are often overlooked. I attribute the deficit in part to a lack of proper assessment and sufficient Case-Management of clients entering into treatment. You see, every client has unique and individual needs, thus we cannot treat all addicts the same. Any client entering treatment, (whether through the system or not), should be evaluated with a biopsycho-social assessment by an Addictions Professional to better understand the totality of their case. There are certain treatment facilities which specialize in specific modalities which address these factors. Clients with Co-occurring Disorders (a.k.a. Dual Diagnosis) for example need to be treated differently than those with purely an Axis I addiction. Chemical disorders need to be dealt with first and foremost. In many cases, these underlying disorders are at the root of the substance abuse, which is in essence self-medication. Not every treatment center is not going to be the appropriate place for every client. Certain treatment centers specialize in adolescent care, while others specialize in relapse prevention or holistic methods of treatment. Other treatment centers are equipped to deal with sexual abuse issues or eating disorders. Some treatment centers use the 12 step approach, while others implement behavioral modification or bible-based treatment. It is important to know which treatment center will meet the specific needs of the individual being assessed. It is also crucial to know the licensure status of a treatment center being considered. At ASI, we take precautions to ensure that every treatment facility we refer a client to is at least DCF licensed and preferably accredited (or at least be in the process of accreditation). We also insist on knowing the qualifications of the counselors, the program curriculum, and the client-counselor ratio. The continuum of care needs to start even before intake. A proper screening and assessment must be performed to determine the proper course of treatment for each individual client, including which facility is going to best meet his or her needs. If this is done correctly, I believe we can greatly reduce relapse and recidivism rates. I have seen many patients discharged from detox only to be referred by a case manager to a modality of treatment which is insufficient or unequipped to address their issues.

CONFUSED ABOUT WHICH TREATMENT CENTER IS RIGHT FOR YOU?

I have seen cases where a client is referred to out-patient treatment from detox, when they are seriously in need of residential treatment. Or even worse, they are referred to a ¾ way house, which is by no means a substitute for treatment. \We need to emphasize hands on Case-Management which continues even after the client is discharged. We need to emphasize follow-ups and aftercare. That is why I advocate for every client before, during and after treatment is concluded. A 30 or 60-day stay in a residential treatment center is by no means a cure, but hopefully it gives the client a good foundation from which to build. From the point of discharge, the client needs to be linked to the appropriate community resources including medical needs, counseling needs, housing needs, employment needs, public benefits, transportation, and of course support meetings. Contact should be maintained with the client by a Case-Manager on at least a weekly basis. For example, I usually make the rounds and meet with my clients on Fridays. I want to make sure they are getting the proper treatment as well as taking care of the myriad of issues which so often coexist with the addiction. These would include legal issues, driver’s license issues, living situations, employment, and health issues. Too often, the client leaves treatment only to return to the same dilemmas which contributed to them being in the state of incarceration or need for treatment in the first place. In sum, there needs to be more communication between staff in the various treatment facilities, the families of the clients, the Courts and the Criminal Justice System. We need accountability and not just a shuffling of clients from one facility to another without keeping adequate documentation and communication. Everyone needs to be on the same page- working together in the best interest of the client. Someone needs to coordinate everything and facilitate the process, making the transition as smooth as possible. We as Addiction Professionals need to be proactive and innovative. We must be vigilant and tenacious in our advocacy of clients. Consultation with an Addiction Professional from the onset can be very beneficial for not only the client, but for the Courts and Treatment Facilities as well. ASI is licensed by the Department of Children and Families for Case Management and General Intervention. Our specialty is treatment of Addiction for alcohol/drug offenders in the criminal justice system. We are available for a free consultation. Alternative Sentencing Evaluations can be conducted in-custody by appointment only. Any questions or comments regarding this article can be addressed to: Myles B. Schlam, J.D., CAP / CCJAP Advocare Solutions, Inc.- Executive Director (954) 804-6888 • WWW.DRUGCOURTPRO.COM

Miracles DO Happen HOPE. BELIEVE. RECOVER.

Choosing a treatment center is an important decision-one that you should not make alone! I can help you with: Placements • Consultation • Case Management Services • Client Advocacy • Court Liaison Services • Interventions • In-Custody Evaluations • Expert Testimony • Alternative Sentencing• Marchman Acts. Call me today for a free consultation.

A STRUCTURED, WOMEN--ONLY TRANSITIONAL HOUSING PROGRAM IN DELRAY BEACH, FLORIDA Millie Tennessee, Executive Director 561-302-9584

Certified Criminal Justice Addiction Professional Individualized Assessments

954-804-6888

Myles B. Schlam J.D., CCJAP CLINICAL TREATMENT COORDINATOR

voirdire34@yahoo.com www.treatmentguy.com

Lisa May, Director of Admissions 606-362-6989 lisa.miraclesdohappen@gmail.com

www.miracles-do-happen.net THE

To Advertise, Call 561-910-1943

The Cycle of Depression and Drug Abuse

A person who abuses drugs or alcohol often has their own personal reasons to do so. Usually, they are in pain physically or mentally. Their drug or alcohol abuse leads to shattered dreams and estrangement from family members. The new problems caused by the drug abuse lead to more drugs and alcohol, causing the user to dig themselves into a deeper and deeper hole in which they use more drugs to try and conceal those new problems from themselves.

of uppers were used, for example the specific two studied together were speed and cocaine, known as a “speed ball”.

The cycle of depression and drug abuse is usually as follows:

So, the vicious circle of depression causing drug use, which begets more depression, does not only affect the drug user, but the family of the drug user as well.

• A person is depressed. They take drugs to make themselves feel better. This really only masks the problem, so when the drug is no longer in their system, they become depressed again. To solve this feeling, the person once again takes the drug. This becomes a vicious cycle of abusing drugs to solve depression – when the reason for the depression is never handled in the first place. In fact, often times a drug addict’s job and family life go out the window once they become addicted to drugs. This estrangement from friends, family, and an honest living leads to further depression, which leads to further drug use. A classic example of the cycle of depression and drug abuse is Brian, a 33 year old Irish man who began using drugs and alcohol at 18, after his girlfriend had their first child. At the time, he didn’t know what to do about the situation he was in as a young father. He took heroin as an escape and got addicted. His drug use progressed to a point where he was addicted to heroin, depressed and in and out of methadone clinics. At 33 years old he has 3 children from whom he is estranged, and a bad relationship with the majority of his family. OR • A person decides to take drugs for a reason other than depression – maybe it’s for fun or because of peer pressure. Whatever the case, they take a drug. The drug gives them a certain “high”. When the drug begins to wear off, they get to a low point and become depressed. So, they take the drug again to avoid the depression that is caused by the drug losing effect. As time goes on, the low happens faster with the same amount of drugs, so they have to up the dosage. At this point, the person becomes consumed with chasing a high and avoiding the inevitable depression caused by the low of coming off the drug and facing reality. This is the other cycle of depression and drug abuse – taking a drug and then becoming depressed when the drug begins to wear off. So then the drug is taken again to avoid the low and so on. While depression is generally linked with all drug abuse, a recent study found that those who abuse “uppers” like cocaine, meth, speed, Ritalin, etc, were found to suffer from a deep depression while addicted to the drug. The depression tended to deepen when a combination

The drug and alcohol abusers themselves are not the only people who are affected by their addiction. Children of addicts have been found to suffer from depression and anxiety stemming from an unstable home environment. This, in turn, can create addicts out of the children.

At Suncoast Rehabilitation Center, we deal not only with the physical aspects of drug addiction, but with the mental aspects as well. Our drug free drug rehab program begins by helping the user get off the drugs quickly and without too much discomfort. A program is then tailored to them which helps replace the vitamins and minerals which have been robbed from their body by the drugs they were taking. Next, the former user goes through a communication course. Often, an addict becomes estranged thus withdrawing themselves and any constructive communication and interaction with others. This step gets the person comfortable with his environment again and able to communicate without being worried or introverted. The person then goes through a detoxification program. This program is tailored to remove drug residues from the body. The science behind this program is as follows: when a person takes a drug, not all of the drug exits the body. A small portion will become lodged in the fatty tissues. Later on, in a situation where this drug is released from the tissues (such as high stress or exercise), a craving for the drug can reappear. This is the main reason a person goes back to drugs after quitting – the drugs are not fully out of their system. Through a very exact program of exercises, a specific regimen of vitamins minerals and oils, and use of the dry sauna, the drugs and drug residuals are eliminated from the body. Finally, the person takes classes which are geared toward two points: to address the personal reason for addiction, and to enable him or her to live a drug-free life (these are detailed on our website www.suncoastrehabcenter.com). Then, a tailor-made a follow up program is done to ensure that things are progressing stably, and any help needed is given to use the tools they have learned during the course of the program to improve their life and stay off drugs. In this way, we break the horrible cycle of depression and drug abuse. Source List: BMC Public Health, Internal Medicine News, Drug & Alcohol Review, Nursing Standard, Drugs and Alcohol

THE

To Advertise, Call 561-910-1943

Is the Media to Blame for Eating Disorders? By Carolyn Ross, MD, MPH

Television, magazines, movies and books are a primary mode of entertainment for Americans of all ages. The media’s influence begins as early as toddlerhood. By age 5, children have received clear messages from the media about the physical characteristics our culture deems desirable to be thin. According to the National Eating Disorders Association, about 42 percent of first- to third-grade girls want to lose weight, and 81 percent of 10-year-olds are afraid of being fat. By adolescence, studies show that young people are receiving an estimated 5,260 “attractiveness messages” per year from network television commercials alone. The Sexualization of Young Girls The messages young people receive from the media can be troubling. A Dec. 2010 issue of French Vogue created a stir when it featured 6-year-old girls in heavy make-up, designer clothing and suggestive settings. Even more outrageous is a clothing manufacturer in Colorado called Kids N Teen that sells crotchless thong panties for children. The controversial show “Toddlers and Tiaras” has raised similar concerns. This TLC hit showcases the competitive world of child beauty pageants and features midriff-bearing young girls who are taught to prance, shake their bottoms and pose in a sexually provocative manner. Toddlers dressed as Dolly Parton, complete with padded bra, and Julia Roberts as the prostitute in “Pretty Woman,” learn that beauty is defined by fake tans, hair and teeth. Children of the 80s, many of whom are now parents themselves, need look no farther than their childhood icons to understand the impact of the media on youth. Cartoon favorites, including Rainbow Brite, the Care Bears, the Teenage Mutant Ninja Turtles and Strawberry Shortcake, have been made-over to appeal to a new generation of kids – and to match the hypersexualized images of females we see all over the media. Even Dora the Explorer and Angelina the Ballerina have been “modernized.” No longer so innocent and cherubic, these characters are taller, skinner and sexier and have interests that go beyond exploring the world and helping friends in need to include fashion and make-up. As the average child gets heavier, the icons they emulate get thinner. The Media Sends Dangerous Messages to Young Girls Wildly disturbing to parents of young girls, these trends are also raising serious concerns among eating disorder specialists. While the causes of eating disorders are complex and typically include both genetic and environmental factors, media messages surrounding our culture’s ideals of beauty also play an important role. The U.S. has the highest rates of obesity and eating disorders in the world. As a melting pot of people from all backgrounds, there is no genetic reason that explains this increased vulnerability to weight, body and food issues. Instead, we have to look at the messages our society sends about how we value our citizens. There is a fair amount of research showing that what happens in the media affects the rates of eating disorders, especially among girls and women. The fact that epidemiological studies have shown that eating disorders are more prevalent in industrialized countries suggests that cultural factors play a role. In a landmark 1998 study of girls in Fiji, Harvard researchers demonstrated how the introduction of television contributed to dramatic increases in eating disorders over a three-year period. In a culture that once valued a healthy, robust physique, girls began viewing themselves as fat, going on diets and feeling depressed about the way they looked, all in an effort to look more like the Western women they saw on shows like the original “Beverly Hills 90210.” After three years, 74 percent of Fijian teenage girls described themselves as too fat. Those who watched TV three or more nights a week were 30 percent more likely to go on a diet than their peers who watched less TV. Being called “skinny” went from a cultural insult to a worthy life goal. Minimize the Influence of Media on Your Child Being the parent of a young girl is a difficult job. As a result of media exposure, parents are no longer in exclusive control of their children’s perceptions of what is beautiful, but they do play an important role in mitigating the messages their children receive. Here are a few ways you can help your child make sense of the media: Take the Focus Off Appearance. Today, children are expected to look and act much more grown up than they really are. The message they receive from the media is that they have to be slim to be beautiful, and have to be beautiful to be valued. While sexualized images are prevalent, there are very few images depicting young girls winning math or science contests or excelling in sports.

Instead of focusing on the way your child looks, work to nurture their strengths and build positive self-esteem. Point out the other areas in which your child excels, such as kindness, humor, intelligence and being a good friend. Volunteering can help children focus on issues that are more important than weight and appearance. By getting involved in activities that make them feel good about themselves, encouraging them to pursue their interests, and nurturing their strengths, parents equip their children with the confidence to resist negative media messages. Discourage Dieting. Most parents want their children to be liked and accepted. Some try to help by teasing their child about their weight or encouraging dieting. A growing concern about childhood obesity has led some parents to focus heavily on appearance, unintentionally sending the message that their child is unloved or unaccepted because of the way they look. While the concern about childhood obesity is significant, the threat of low self-esteem, poor body image and eating disorders is just as real and just as damaging. There is a fine line between modeling healthy behaviors and promoting the message that appearance matters most. Rather than encouraging dieting and self-deprivation, a better message is health at every size. It is important to eat healthfully and stay active to reduce health risks, but not because falling short of the ideal weight and appearance portrayed in the media means an individual is flawed or less valuable. Address Your Own Self-Image. In order to accept their children as they are, parents often need to work through their own issues about weight and body image. By recognizing and addressing these issues, parents can avoid passing unhealthy attitudes on to their children. Find Positive Role Models. In addition to modeling healthy behaviors in their own lives, parents can help their children find positive role models in the media. There are a number of actresses and performers who have achieved success even though they fall outside society’s unrealistic ideals of beauty, as well as historical figures and political leaders that have accomplished more important goals than looking good. Limit Media Exposure. Children are surrounded by media messages everywhere they turn. While it’s unrealistic to think that parents can eliminate exposure to harmful media, you can set limits on how much time your child spends in front of the TV, reading magazines and engaging with other forms of media. Discuss Media Messages. No matter what a child looks like, they are bound to compare themselves to the images they see in the media and feel some degree of insecurity. Rather than hoping they are unaffected, talk to your children about the reality behind media images, including the way photographs in magazines are airbrushed and celebrities starve themselves to look ultra-thin. Know Your Child. Although parents don’t always realize it, children often have impressive insights into their own thoughts, feelings and needs. If you are concerned about a particular issue, ask for your child’s input. Children can’t fully direct their own lives, but listening to their voice will aid in solving problems. Encourage Strong Friendships. Among young girls, a “mean girl” attitude sometimes dominates. When girls don’t match our culture’s ideals of beauty, they may get bullied and teased, starting as early as elementary school. Project EAT (Eating Among Teens), a long-term study of the factors influencing teen eating habits sponsored by the University of Minnesota, found that weight-related bullying is directly correlated with an increase in extreme dieting measures. Help your daughter cultivate a sense of camaraderie among her peers and establish trusting, close-knit friendships with other females. These relationship skills will serve her now as well as into adulthood. If bullying is a problem at school, consider finding an alternative educational environment for your child that encourages diversity and acceptance. Although efforts are underway to change some of the most damaging aspects of the media, harmful messages will likely be part of our culture for a long time. We can’t hide our children from the culture we’ve created, but we can take steps to boost their self-esteem and protect them from the poor self-image and unrealistic expectations that often fuel eating disorders. Dr. Carolyn Ross is an internationally known physician, author and speaker on addictions, obesity and eating disorders. She serves as a consultant to The Ranch’s eating disorder treatment program in Tennessee, maintains a private practice in Denver, is the author of The Binge Eating and Compulsive Overeating Workbook: An Integrated Approach to Overcoming Disordered Eating as well as The Joy of Eating Well, and also hosts a weekly radio show, The Vital Life. www.recoveryranch.com • www.carolynrossmd.com THE

Creating Extraordinary Lives

For More Information: (800) 595-8779 www.promises.com

Promises Proudly Provides: • Safe and Nurturing Home-like environment • Confidential and Secure Setting • Client-Oriented- Individualized Treatment Plan • Multidisciplinary World Class Licensed Medical and Clinical Treatment Team • Integrative and 12-Step Therapeutic Approach • Uniquely Tailored Executive, Medical Professional, and Young Adult Programming • Individual; Group and Family Therapy • Unparalleled Leadership and Experience

Malibu, Executive Care; WLA; Professional Treatment Program; Intensive Out Patient

Together we can begin the journey to lasting life change and recovery

Ft. Lauderdale

Life Changing Treatment For The Real World

Alcohol & Drug Addiction Sex & Love Addiction Eating Disorders Trauma / PTSD Mood/Anxiety Disorders

Confidential and Home-like setting Compassionate and Highly Skilled Clinical and Medical Team Experiential Therapy: EMDR; Adventure Therapy; Equine Assisted Therapy Comprehensive Clinical Program Including Individual, Group and Family therapy Primary Treatment and Extended Care Detox

For information: 866.463.5496 www.therecoveryplace.net For more information: 800.849.5969 www.recoveryranch.com To Advertise, Call 561-910-1943

I’m Sober. Now what? By Dr. Lou Bevilacqua Mary started drinking and using pills when she was 15. She is now 28 and has a year of sobriety. She works in the field of finance and has her own apartment. Most of her time is spent at work and going to 3-4 AA meetings a week. She has thought about joining a gym but just hasn’t done it yet. Getting to sleep has been difficult. When she does get to sleep, she doesn’t want to get up. She feels tired all day and is losing interest in doing anything. One of the reasons Mary liked drinking was how it made her feel, more relaxed and able to talk with others. She especially liked how drinking kept the critical voice in her head quieter. Now that she is not drinking, the mental chatter in her head is back and loud as ever. When she is at work talking with co-workers, clients, and even when she is with family and friends, the critical tape plays over and over. It is telling her things like, “don’t bother, you know you’re not good enough for that position”; “Don’t bother talking with them, you know they don’t think you’re interesting”. There are a million other negative things Mary’s critical voice tells her throughout the day ranging from things she “can’t do”, “shouldn’t do”; and “shouldn’t have done”. These negative thoughts have fueled her sense of self-doubt, lack of confidence, and poor selfesteem. Such thoughts are what Mary used alcohol to drown out and forget and stop feeling so anxious and bad about herself. These constant negative thoughts are making it harder and harder for Mary to get through the day at work. When she gets home its even worse. At home, it’s just Mary and the critical voice in her head. She is becoming more withdrawn and starting to not want to go to work. Her anxiety and depression symptoms are getting stronger. After two rehab programs, three Intensive Outpatient Programs, countless AA meetings, two sponsors and working the 12 steps, Mary has finally learned how to stay sober. Now what? How can Mary get clean from depression and or anxiety? Often times underneath addiction lies the struggle to manage or overcome depression and anxiety symptoms. The symptoms of poor self-esteem, constant self-criticism, not feeling like you ever measure up and unwanted thoughts, to name a few, are often what the recovering addict used substances to numb out, forget, and try to stop feeling bad about. Once you get sober the struggle to manage and overcome such symptoms resurface leaving you vulnerable for relapse. So what can you do? One of the first things a person learns when they get sober is to avoid certain people, places and things that would prompt an urge to drink or use drugs. These are often referred to as relapse triggers to addiction. With regards to depression, they are often referred to as red

flags. The same strategy of identifying triggers to using can be applied to being depressed or anxious. Certain people, places and things can trigger or someone or be a red flag to feel depressed or anxious. Identifying a list can empower a person. I know for some people, being with certain family members leads to conflicts or put downs. Certain places trigger memories of abuse. Certain songs on the radio remind you of someone you are no longer with. One way to handle such triggers or red flags is by limiting your time and frequency of being with certain individuals. You can also avoid certain places and change the channel on the radio. Unstructured free time is often a trigger to relapse. This is also true for those struggling with depression and anxiety. A helpful strategy is developing a daily activity plan or schedule. Incorporate activities you like or used to like. Be sure the schedule includes activities with others once or twice a week. Getting out of the house often helps us get out of our head. Physical activity reduces the stress hormone cortisol and stimulates endorphins, which are the hormones that make us feel good. Sometimes we can’t get outside or do something. That’s when our thoughts can really play with our heads. Those negative thoughts seem stuck and it’s tough to interrupt them or stop them from playing. Try to write out those thoughts that are running through your head. Look at them on paper to create some distance from them. See them as words in a sentence rather than thoughts that you can’t turn off. Evaluate them and challenge them. • How else can you think about things? • Are the thoughts accurate? • Ask yourself, Is it true? • Is there another way to view it? Worry thoughts often revolve around things you “have to do”. In these cases, try writing out your plan with target dates as to when these things “have to” or need to get done. Making a plan often generates a sense of control and helps us feel more grounded. Changing and challenging unwanted thoughts takes practice. Try listing some unwanted thoughts on the left side of a page and replace them with alternative statements on the right side. For example, Unwanted Thoughts

Alternative Thoughts

“I can’t make it without using.” “Life is too much.” “I can’t get out of my head.”

“I’m stronger than I think. I’m going to call a support to help me.” “I can break things down into smaller chunks. I just need to focus on what I can do today.” “I can talk with others. I can write my thoughts out in a journal. I can distract myself with a crossword puzzle.”

Add some of your own unwanted thoughts and alternative thoughts. The more you practice, the better and easier it becomes. Sometimes you need support. It’s okay to ask for help. You don’t have to go it alone. The addiction community is famous for support. Attending AA, NA, or other 12-step meetings is a key building block to sobriety. The same is true for overcoming depression and anxiety. Find a support group of people who have had or who have depression or anxiety. If you are in therapy, ask your therapist for a list of such groups in the area. If there aren’t any, perhaps your therapist would be willing to start one. Being part of group helps decrease the isolation and also helps facilitate learning to share your thoughts and feelings with others. When people get sober they often lack or struggle with this ability. Talking with other sober people or others struggling with depression and anxiety can help you develop this skill. Another avenue for support is by getting on a distribution list for support or follow someone’s blog. I send out an email of support to hundreds of people every week. If you want to be added, just drop me a line at lbevilacqua@obhcares.com. In the subject be sure to put in, “email support”. For more ideas for overcoming depression you can also pick up a copy of my latest book, “When you can’t snap out of it: Finding your way through depression”. Throughout the book I use client accounts of what it is like to experience the primary symptoms of depression. Using cognitive therapy, I offer practical suggestions and strategies for each symptom. You can purchase a copy from www.amazon.com or www.barnesandnoble.com Any questions or comments regarding this article can be addressed to: Dr. Lou Bevilacqua Clinical Director, The Light Program 1440 Russell Rd. Paoli, PA 19301 lbevilacqua@obhcares.com

THE

Looking to have a good time in sobriety? 561-859-5167

Anonymous Events @eventsanonymous

To Advertise, Call 561-910-1943

When teens abuse drugs

-why it matters when kids experiment with drugs and alcohol Adolescent drug, tobacco and alcohol abuse is a pervasive problem around the world. Addiction and its medical consequences have been called the most costly health problem in America today. In the United States, nearly one in three teens and pre-teens have experimented with illegal drugs by the time they complete the 8th grade, and 40% have tried alcohol. 90 percent of adult addicts began in high school or earlier. The age of first drug use has moved downward: younger children are experimenting. Unfortunately, the danger for addiction increases greatly when children begin experimenting with drugs or alcohol before the age of 15. Clinicians in the field known that addiction is difficult to treat because it is a chronic and relapsing condition like diabetes. Like diabetes, addiction begins with predisposition and personal behaviors at first and develops into a disease of the brain and body later in life. It is becoming appreciated that while addiction does not often manifest until adulthood, addiction begins in the teen and the pre-teen years. Adolescence is a critical period of brain and emotional development psychologists have termed the “second individuation.” Brain development in adolescent is about as extensive as it is in infancy. These changes allow the adolescent to take on increasing control of his life. This second individuation ultimately prepares him for adulthood. Critical brain developments occur in the nucleus accumbens and the prefrontal cortex of the brain. The prefrontal cortex is critical in direct attention and in decision making. The nucleus accumbens has been called the motivation center of the brain. The nucleus accumbens is important to exploration, novelty-seeking, and risk-taking. The nucleus accumbens motivates us to seek out new experiences and repeat those things we have found enjoyable. It largely operates outside the conscious mind although it has a powerful influence on behavior. Adolescents are big risk takers. While they recognize the risks, they give the rewards in a situation more weight than adults do. This love of adventure is actually adaptive, as it leads to potentially useful life experiences. Succeeding in life requires risk taking. A related development in adolescence is the struggle for autonomy. Teens turn to peers for needs that were fulfilled by parents. Adolescents are social by nature and prefer to be around their peers. One reason for this is the sensitivity of the adolescent brain to a neural hormone

known as oxytocin that makes social connections rewarding. These adolescent developments are designed for increasing independence and eventual launching as an independent adult. All enjoyable stimuli, including food and sex, activate the nucleus accumbens. The difference between natural pleasures and drugs is that the latter produce a more rapid and forceful stimulation of the nucleus accumbens – by about 10 fold. As the adolescent continues to use drugs and alcohol their attraction is increasingly drawn to the chemical stimulation of their motivation center. Negative consequences from substance abuse gradually lose their ability to deter the adolescent from the substance. The nucleus accumbens’ responsiveness at this stage leaves the adolescent vulnerable to addiction. As drug use becomes regular, the addict develops increasingly negative mood because of the derangement of the nucleus accumbens and related brain structures. Taking more drugs becomes the surest way to feel “normal” again. A lifestyle focused on getting “high” develops. The changes in the brain gradually become entrenched and beyond “will power” to change. School, athletics, and hobbies become less important and eventually are given up. Personal growth during adolescence in frustration tolerance, emotional resiliency, the ability to relate to others, and self-control is postponed. Substance-abusing youth alienate themselves from non substance abusing peers leading them to socialize with delinquent peers. Alienation and rebelliousness lend themselves to substance abuse but also result from substance abuse. Drug abuse leads to many other consequences beside addiction alone. Drug abusing teens experience declining grades, have more absenteeism from school, and are at risk for dropping out of school. Marijuana, for example, interferes with short-term memory, learning, and psychomotor skills. Chronic alcohol is notorious for causing irreversible harm to the brain with chronic use. Some amphetamines and some designer drugs and MDMA (Ecstasy) have been linked to irreversible brain changes. Many drugs harm physical health. Alcohol damages the liver, cocaine can cause strokes and heart attacks, tobacco harms both the vascular system and the lungs. Adolescents are also at risk for injuries due to accidents (such as car accidents and overdoses). Young people are overrepresented in alcohol-related car crashes. One study showed that 4 to 14 percent of drivers who are injured or die in traffic accidents test positive for THC. Teens who use drugs are five times more likely to have sex than teens who don’t use drugs. Teens that use drugs are also more likely to have unprotected sex and have sex with a stranger. Teens put themselves at risk for sexual assault. There is a higher risk of STDs (including HIV) and teen pregnancy among drug abusing teens. Arrest and intervention by the juvenile justice system are eventual consequences for many adolescents abusing drugs and/or alcohol. Substance abuse is associated with both violent and income-generating crimes by youth. More than 39 percent of youth under age 18 were under the influence of drugs at the time of their offense. Drug and alcohol abuse jeopardizes family life, often resulting in a family crisis. Siblings are profoundly affected and negatively influenced by alcohol- and druginvolved teens. Substance abuse can drain a family’s financial and emotional resources. The social and economic costs related to youth substance abuse are tremendous when the costs of medical, juvenile justice and treatment services for these youth are taken into account. Many emotional and psychiatric conditions enable the development of drug addiction. Depression and bipolar disorder puts an adolescent at risk of developing a substance use disorder. Childhood trauma and abuse contribute to the development of substance abuse. Attention deficit/hyperactivity disorder (ADHD) predisposes to substance abuse. Aggression and antisocial behaviors is strongly linked to substance abuse, especially in boys. In some instances, an adolescent might be medicating feeling of depression or anxiety but often drugs and alcohol worsen the underlying emotional condition. For example, teens that use marijuana weekly double their risk of depression and anxiety. Teens abusing drugs place themselves at the risk of developing suicidal thoughts, and at risk of attempting suicide. In the absence of drugs and alcohol, adolescent development unfolds in a purposeful order. There is increasing autonomy and exploration because the adolescent brain is primed for openness to new and exciting experiences. In the end, an adult emerges who is both self-sufficient and responsible to those around him. If our adolescents can be kept from chemicals that hijack their developing brains our adolescents will be able to find themselves and reach their potential.

THE

To Advertise, Call 561-910-1943

SunsetHouse-Ads_Layout 1 2/17/12 3:31 PM Page 2

Back to Basics Basics--101

SUNSET HOUSE Helping Men Free Themselves from Addiction

An introduction to the Twelve Steps of Recovery

During this seventy-five minute DVD, Wally Paton, noted archivist, historian and author, takes you through all Twelve Steps the way they were taken during the early days of the Twelve-Step movement. Experience the miracle of recovery as Wally demonstrates the sheer simplicity and workability of the process that has saved millions of lives throughout the past seventy years.

Sunset House is a licensed, residential treatment program for men struggling with chemical dependency. We are committed to helping our men develop the skills necessary to lead sober and productive lives. Our goals are to safely and effectively transition our residents back into their communities with all of the tools necessary to maintain long-term, meaningful sobriety. Our clients are men looking for an affordable alternative to intensive inpatient treatment.

Wally has taken more than 500,000 through the Twelve Steps in his Back to the Basics of Recovery seminars. He has made this “Introduction to the Twelve Steps” presentation hundreds of times at treatment centers, correctional facilities, and recovery workshops and conferences around the world. This is a DVD for newcomers and old-timers alike. You can watch it in its entirety or divide it into three segments: Surrender (Steps 1, 2 and 3); Sharing and Amends (Steps 4, 5, 6, 7, 8 and 9); and Guidance (Steps 10, 11 and 12).

Our 2-acre campus is located in Palm Beach Gardens, just minutes from Palm Beach International Airport, numerous places of employment, 12-Step meetings, and public transportation. Amenities include an on-site laundry facility, gym, and Recovery Library with internet service.

The accompanying CD contains twenty-four pages of PDF presentation materials for facilitators and handouts for participants. Here is everything you need to take or take others through the Twelve Steps “quickly and often.”

Early recovery can be a difficult experience; our program is intended to aid residents in body, mind and spirit at every step of the way.

Wally has modified the “Big Book” passages so they are gender neutral and applicable to all addictions and compulsive disorders. In keeping with the Twelve-Step community’s tradition of anonymity, he does not identify himself, or anyone else in this DVD, as a member of any Twelve-Step program. This DVD was recorded at the Public Broadcasting Service television studio in Tucson, AZ using high definition cameras, flat screen graphics, and PowerPoint overlays. It is a state-ofthe-art production that is both instructive and enlightening. “It works—it really does.”

If you or someone you love is struggling with addiction, call Sunset House today at 561.627.9701 or email us at darthur@sunsetrecovery.com.

To order this DVD plus CD, please contact: Faith With Works Publishing Company P. O. Box 91648 ~ Tucson, AZ 85752 520-297-9348 ~ www.aabacktobasics.org DVD+CD Price: $79.95 + $11.05 (priority s/h) Total Price: $91.00

SunsetRecovery.com

Back to the Basics of Recovery - Step Two By Wally P. Came to believe that a Power greater than ourselves could restore us to sanity. In the first article of this series, I presented some of the guidelines that AA sponsors used in the 1940’s to take newcomers through the Twelve Steps in a couple of hours. I listed the “Big Book” passages they employed to take the first step in the surrender process, which is to admit we have a problem. In this article, we will examine the second part of the surrender, which is to acknowledge there is a solution to our problem. The Oxford Group, the organization from which A.A. evolved, used Four Spiritual Activities to take newcomers through the Steps. They were:

1. SURRENDER—A.A.’s First, Second and Third Steps. 2. SHARING—A.A.’s Fourth, Fifth, Sixth and Seventh Steps. 3. AMENDS—A.A.’s Eighth and Ninth Steps. 4. GUIDANCE—A.A.’s Tenth, Eleventh and Twelfth Steps.

In subsequent articles, I will explain how the “Big Book” authors converted these four steps to six in 1937 and then to twelve in 1938. In the early days, the sponsor took the newcomer through the Steps as quickly as possible in order to alleviate the pain and suffering of early sobriety, knowing that if he or she didn’t do so, the newcomer was at risk of relapse or worse. Once the newcomer had been through the work, the chances were very good he or she would continue the journey by sponsoring others through this simple and straightforward “program of action.” The second step is all about power–who’s got the power. In the first step we admit that before we take the steps we are powerless. When under the influence, alcoholics and addicts erroneously believe they have the power. They believe the lie that they are bulletproof and invincible. This is the illusion many pursue “into the gates of insanity or death.” In Step Two, we learn how and where to find the Power. The key “Big Book” passages for the second step are: Lack of power is our problem: pg. 45: 1 (1-4), 2 (1-3) Where do we find the Power? pg. 55: 2 (1-7), 3: (5-7) What if the newcomer doesn’t believe in the Power? pg. 46: 1 (3-8) In the first and second paragraphs on page 45, we look at the problem: “Lack of power, that was our dilemma. We had to find a power by which we could live, and it had to be a Power greater than ourselves. Obviously. But where and how were we to find this Power? “Well, that’s exactly what this book is about. Its main object is to enable you to find a Power

greater than yourself which will solve your problem.” The “Big Book” authors make it clear that the Power is the solution to our difficulties. In other words, our sponsor, psychologist, attorney, counselor, or anyone else for that matter cannot solve our problem. All they can do is help guide us to the solution. So, in order to recover, we have to find a “Power greater than ourselves.” But where are we going to find this Power? The authors answer this question in the second and third paragraphs on page 55: “Actually we were fooling ourselves, for deep down in every man, woman, and child, is the fundamental idea of God. It may be obscured by calamity, by pomp, by worship of other things, but in some form or other it is there. For faith in a Power greater than ourselves, and miraculous demonstrations of that power in human lives, are facts as old as (mankind itself). “ . . . We found the Great Reality deep down within us. In the last analysis it is only there that (this Power) may be found.” If the newcomer doesn’t believe in the Power, ask him or her to take the Second Step based on a willingness to believe that you believe in the Power. Tell enough of your story to demonstrate to the newcomer that you do believe. Then take him or her to the first paragraph on page 46: “. . . We found that as soon as we were able to lay aside prejudice and express even a willingness to believe in a Power greater than ourselves, we commenced to get results, even though it was impossible for any of us to fully define or comprehend that Power . . .” The second Step question is found on page 47, paragraph 2, lines 1-3. It reads: “Do (you) now believe, or (are you) even willing to believe, that there is a Power greater than (yourself)?” If you can answer in the affirmative to either the first or the second part of the question, you have taken Step Two. We are now ready to proceed to the Third Step. About the Author Wally P. is an archivist, historian and author who, for more than twenty-three years, has been studying the origins and growth of the Twelve-step movement. He is the caretaker for the personal archives of Dr. Bob and Anne Smith. Wally conducts history presentations and recovery workshops, including “Back to the Basics of Recovery” in which he takes attendees through all Twelve Steps in four, one-hour sessions. More than 500,000 have taken the Steps using this powerful, time-tested, and highly successful “original” program of action. THE

ADDICTION, SOBRIETY AND SPIRITUALITY By Tony Foster

The following article is the continuation of a two part article on the importance of Spirituality in long term recovery which was in our June issue. For those who want to read part one, go to www.thesoberworld.com Several other studies have suggested that 12-step attendance helps promote long-term abstinence for many people (Warfield & Goldstein, 1996; Bradley, 1988; and, Gorski & Miller, 1986). In 2003 Laudet, et al, found that attendance at meetings was successful in the short term (Laudet, Magura, Cleland, Vogel, & Knight, 2003). However, a deeper look at the study showed that it was very hard to get members to continue their attendance once they had established sobriety. While this study does not specifically discuss spirituality as a major factor, 12-Step programs are rooted in spiritual awakenings, as stated earlier. The finding suggest that while members establish their sobriety, their length of attendance has more to do with the severity of the problems or consequences they suffered at the hands of their drinking or drug use. Laudet’s study leads one to believe that a member’s level of desperation has a greater effect on long term attendance. However, the study fails to establish what happens to ones sobriety after attendance drops off. Laudet, et al, followed this study the following year by studying Double Trouble in Recovery, a fellowship adapted from 12-Step programs aimed at those who were dual-diagnosed, with substance abuse issues and a psychiatric illness (Laudet, Magura, Cleland, & Vogel, 2004). The study confirmed that attendance at 12-Step meetings is a strong factor associated with abstinence. Specifically, Laudet stated that not only is attendance a factor, but because alcoholism and drug addiction are chronic diseases attendance is most beneficial when it is ongoing. His research showed that drop off in attendance was often followed with relapse (Laudet, et al, 2004). However, once again, spirituality was not specifically mentioned as 12-Step programs were viewed in their entirety, as opposed to a discussion about what parts of 12-Step programs had the greatest effect. A 2005 study by Leigh, et al, found a significant relationship between spirituality and the use of both alcohol and tobacco (Leigh, Bowen, & Marlatt, 2005). Their research found that those with higher scores relative to spirituality were likely to engage in fewer harmful behaviors such as alcohol and substance abuse. This finding would support those in the recovery community who believe that addiction issues are rooted in a lack of spirituality, again suggesting future research to be necessary. Further, Leigh’s study found the connection of spirituality and recovery to be consistent with 12-Step philosophy that spirituality leads to recovery. The study also suggested that there may be a relationship between introversion and binge-drinking, perhaps causing future research to point in that direction also.

spirituality on alcoholism, adding spirituality as a component of treatment has been slow, even for some of its easiest aspects. He cites meditation as an easy component to add to treatment that would enhance spirituality with little or no cost or effort (Korinek, 2007). In a focus group conducted over a two year period Heinz, et al, produced a pilot study that attempted to look at twenty-five substance abuse out-patients and their attitudes and beliefs about spirituality, substance use, and recovery. Specifically, they aimed to find participants’ outlook on the relationship between spirituality and recovery and whether spiritual components could be integrated into a standard treatment setting without creating concerns about individual differences and beliefs. A focus-group methodology was used in hopes of gaining a unique perspective and insight into opportunities and concerns with spirituality’s inclusion (Heinz, Disnes, Epstein, Glezen, Clark, and Preston, 2010). Heinz also found, among other things, that addiction and spirituality have a hard time co-existing. When actively using, participants felt that their level of spirituality was lessened and their spiritual experiences hollowed. Further, they felt isolated from churches due to their selfperception of being an outsider. Conversely, when attempting to abstain participants felt that spirituality rose, giving them strength and peace. Further, they felt that during early sobriety spirituality provided something for them to reach for, and more importantly, hope. Many participants felt that hope was essential to recovery. Finally, they felt that spirituality and a faith in a higher power provided lessened the overwhelming personal burden of recovery (Heinz, et al, 2010). Finally, participants felt that spirituality as part of a treatment setting was a positive step forward. This was in contrast to their feeling that Narcotics Anonymous provided regarding spirituality. Participants felt that while in concept NA’s promotion of spirituality was positive, in practice there were problems such as hypocrisy, lack of acceptance by the group, and a general dislike of the format. These concerns would have to be addressed if spirituality were to become a part of a treatment center environment. The connection between spirituality and abstinence from addiction has been well documented in recent years through studies and journal articles (Heinz, et al, 2010; White, Montgomery, Wampler, and Fischer, 2009; and, Mason, Deane, Kelly, and Crowe, 2009). Interest in the connection has also spurred many dissertations and theses to be recently written on the subject. (Continued on page 18

Many other studies have also found a significant relationship between spirituality and recovery from substance abuse. In a rather large study entitled Substance Abuse; Religious Faith and Spirituality May Aid Recovery conducted in 2000, it was found that higher levels of religious faith and spirituality were associated with several positive mental health outcomes. Further, higher faith and spirituality was associated with increased ability to cope, greater resilience to stress, an optimistic approach to life, and lower levels of anxiety, all issues that a newly sober person must learn to deal with appropriately if they are to stay sober. It was suggested by the study that these attributes may lead to better results for substance abuse sufferers (Pardini & Plante, 2000). Other studies have suggested that spirituality as method of attaining sobriety has reached the point that its success has caused changes in the counseling field, regarding substance abuse (Steiker and Pape, 2008). The study cites a fascination with spirituality, retreats, college courses, discussion groups and a substantial increase in the sales of books and journals regarding spirituality as a phenomenon. Further, as suggested by Pardini and Plante above, Steiker and Pape found that those successful in recovery showed a higher level of prayer and meditation, which ultimately led them to increased health and a decrease in substance use. The authors claim spirituality as a “preventative antidote” to later relapse (Steiker & Pape, 2008). Pardini and Plante, among other researchers, contend that this is an area that should be further researched, hopefully leading to a more collaborative effort between members of religious organization and professionals in the medical and mental health fields (Korinek, 2007; Pardini & Plante, 2000; and, Morell, 1996). A 2007 study, entitled “Promoting Spirituality in Families with Alcoholism”, stated that spirituality provides a vital resource for healing and recovery from substance abuse. The article states that meditation is a spirituality-enhancing behavior that promotes an individual to be still and listen, inaction that is often not tolerated in today’s world (Korinek, 2007). Furthermore, he cites several researchers (Anderson, 1999; Walsh, 1999, and Martin & Booth, 1999) who illustrate that many of the original practices of Alcoholics Anonymous such as prayer and meditation, confessions and forgiveness, service to others, and other community-enhancing behaviors lead to a more communal mentality and an enhanced ability to cope and recover from substance abuse. Korinek goes on to quote the National Institute for Healthcare Research, which stated that there is strong evidence that spiritual involvement predicts less use of and fewer problems with alcohol, tobacco, and illicit drugs. Finally, the writer makes the argument that in the face of the positive effect of

To Advertise, Call 561-910-1943

(Continued from page 17)

ADDICTION, SOBRIETY AND SPIRITUALITY

In nearly every case the link has been made that a subject’s spirituality is a major factor in their “program” of sobriety if they are going to achieve long-term sobriety/recovery. A sample review of the more recent ones is provided below. The level of importance of spirituality, among other factors, was discussed in a 2007 dissertation entitled, “The Perceived Attributes of Abstinence by Addicts in Long-Term Recovery (Prince, 2007). Prince found that nine different themes existed in those who achieved long-term recovery/sobriety. The themes were spirituality, family support, social support, formal or informal treatment, significant life changing events, knowing one’s limits, volunteer/service work, recreational activities, and education. Many of the themes were also identified as being important in short-term recovery, implying that it is vitally important for those in recovery to maintain daily routines in how they stay sober. Prince’s study was conducted in a qualitative fashion in order to find commonalities among the different subject. Subsequently, eight subjects were used for the interviews. Of the nine themes that emerged only one, significant life-changing events, was identified by all eight subjects. Family and social support were identified by seven subjects. This was followed by spirituality, among others, that was identified by six subjects. Clearly, Prince found spirituality to be an important factor. An argument can be made even from the limited information provided that spirituality plays a role in many of the other themes also. For example, treatment center programs often have a spirituality aspect to their programs, in addition to social support, volunteer/service work, and significant life changing events having some subtle spiritual components. Additionally, it would appear that Prince’s study would follow the thoughts of 12-step recovery, although this was only touched on in this dissertation. A 2009 thesis, entitled “Religiosity, Spirituality, and Substance Abuse” explored the relationship between lifetime crack cocaine use, lifetime injection drug use, drinking problems, and illegal substance relative and the effects of religiosity and spirituality (Allen, 2009). Allen’s research found that the effect of spirituality on substance abuse was significantly higher as the seriousness of the kind of abuse increased. For example, he found that spirituality did not have as great an effect on drinking problems as it did crack cocaine or intravenous drug use. Interestingly, because alcohol use is legal and accepted, Allen finds problem drinking to be less dangerous than the drug use mentioned above. Statistics belie this finding. A 2004 study looking at deaths due to “indulgence” cited statistics provided by in the Journal of the American Medical Association showing that alcohol abuse kills five times as many people annually as all illicit drugs combined (Mokdad, et.al, 2004). Another interesting part of Allen’s research showed that religiosity and spirituality were seen as particularly helpful when combined with 12-step programs such as Alcoholics Anonymous and Narcotics Anonymous. Allen attributed this higher level of success to the social support aspect that 12-step programs foster, creating a sense of mutual encouragement and accountability in a spiritual environment (Allen, 2009). Furthermore, he states that 12-step programs may have some success due to their ability to suppress individualism, an example of this being the 3rd of the 12 steps which encourages participants to turn their will and their lives over to the care of God as they understand him (Alcoholics Anonymous, 1939).

feels that incorporating spirituality activities into ones program of recovery at different, specific times may foster improved potential outcomes. Streukens’ study is interesting and seems to agree with commonly shared beliefs and concerns in 12-step meeting rooms. That is, it has long been thought that someone in early recovery will have a much greater chance at sobriety if they have reached a level of despair that forces them to follow any suggestion, even one that may go against their core beliefs, such as a belief in a higher power (Streukens, 2009). As their life improves through their first year they often come to believe that spirituality and a higher power is the reason their life has changed for the better. In Streukens’ mid-term recovery stage the subject will raise his spirituality accordingly. However, as Streukens suggests, there often comes a time when the recovering person becomes complacent towards their spiritual needs. Streukens suggest this occurs at three years. Those in 12-step programs may differ with when it happens, but they definitely agree that it is a problem that has to be overcome, or it leads to relapse. 12-steppers believe this phenomenon occurs between five and ten years, somewhat later than Streukens. It has been often thought that one in recovery for as long as five years has allowed several factors to return to his life during this time. Most notably, it is felt that one’s ego, and all its negative characteristics, comes back. Additionally, the problems faced by a newly recovered person, such as legal, marital, employment, financial, and such have usually been overcome in the first several years of sobriety. This leads to another version of this phenomenon known in Alcoholics Anonymous as “letting the things that AA gave you take you away from AA”. An interesting follow-up to this study would be to look at why the complacency happens, a closer look at when it happens, how to recognize it is occurring, and what can be done about it. The review of literature and studies regarding the links between spirituality and recovery to addiction shows a consistently high priority put on spirituality as a major factor in one’s recovery. While it is clearly not the only factor in someone staying sober, it certainly is one of the factors that many journal articles and dissertations on methods of recovery address in some form. Additionally, 12-step programs and treatment centers have shown for many years that spirituality is one of the key ingredients in one staying sober (Steiker & Pape, 2008; Leigh, Bowen, & Marlatt, 2005; and, Pardini & Plante, 2000). The real question is how much spirituality is required? How “spiritual” are treatment centers willing to go with their curriculum? Will the person struggling with alcoholism and addiction submit themselves to large doses of spirituality? Further research is needed and adjustments in curricula need to be made. While wholesale changes are not realistic, treatment centers that are truly interested in recovery rates should take a long, hard look at what works for long-term sober people and make adjustments. Perhaps small at first, but over time the changes may need to be radical to have an significant effect on recovery rates.

Tony Foster is the Director of Therapy at the Beachcomber Outpatient Services treatment center located in Boynton Beach, Florida.

A 2010 dissertation entitled “Factors Contributing to Long-Term Sobriety Following Treatment for Drug and Alcohol Abuse” attempted to identify all the positive factors associated with someone achieving two years of abstinence following treatment (Jacobson, 2010) Jacobson’s qualitative study included fifteen participants, all of whom agreed that 12-step programs were their main strategy in staying clean and sober. As stated earlier, Alcoholics Anonymous and Narcotics Anonymous are spiritual programs in nature and promoted a spiritual awakening as the ultimate conclusion. Further, it was stated that being abstinent was not enough, one must attain a level of serenity and “work the 12 steps” to be truly sober. Finally, 60% stated that the ideal program would include medically supervised detox, in-depth therapy, and a spiritual component as the main aspects of treatment. One of the few quantitative study dissertations completed on the subject of alcohol and/or drug abuse relative to spirituality was entitled Alcoholism: Spirituality and Personal Dynamics (Streukens, 2009). Streukens’ dissertation attempted to explore and compare the relationship of spiritual and personality dynamics with three groups of recovery alcoholics. The groups were divided by length of sobriety; the first with less than one year, the second with one to three years, and the third with more than three years. Streukens’ study found that those in early recovery were also early in their spiritual journey, showing less spirituality than those in mid-term recovery. Streukens suggest that it is in mid-term recovery that one’s spirituality peaks. His findings suggest further that as one advances in their recovery years they become complacent in regards to their spiritual growth and health. Finally, Streukens

THE

Out-Patient • Intensive Out-patient • Day/Night Substance Abuse Treatment

Toll free (855) TRN-1212, phone (561) 822-3620 fax (561) 318-8136 www.totalrecoverynow.com

To Advertise, Call 561-910-1943

THE

P.O. Box 880175 Boca Raton, Florida 33488-0175 www.thesoberworld.com

The contents of this book may not be reproduced either in whole or in part without consent of publisher. Every effort has been made to include accurate data, however the publisher cannot be held liable for material content or errors. This publication offers Therapeutic Services, Drug & Alcohol Rehabilitative services, and other related support systems. You should not rely on the information as a substitute for, nor does it replace professional medical advice, diagnosis, or treatment. If you have any concerns or questions about your health, you should always consult with a physician or other health-care professional. Do not disregard, avoid or delay obtaining medical or health related advice from your health care professional because of something you may have read in this publication. The Sober World LLC and its publisher do not recommend nor endorse any advertisers in this magazine and accepts no responsibility for services advertised herein. Content published herein is submitted by advertisers with the sole purpose to aid and educate families that are faced with drug/alcohol and other addiction issues and to help families make informed decisions about preserving quality of life.