Is abstinence the only answer? Quality of life in addiction recovery.

Contributing author: Chelsea Crow

Abstinence should not be the only standard by which we measure success in addiction recovery.

There’s no doubt that for some addicts, full abstinence is necessary for recovery. Still, it would be hard to deny that even if they can’t stay completely clean, addicts who reduce their use substantially can see great improvement in their quality of life. I think that improvement shouldn’t be ignored.

I’ve been advocating for the use of other measures for success in addiction treatment for a while now, and a recent article gets us a step or so closer to having others consider it.

The study was conducted in New York City. All participants had a history of heavy illicit substance use for at least a year, and all self-reported abstinence for at least one month. The researchers then followed them for a period of two years, using a baseline interview at the beginning, after one year, and at the end. The interviews consisted of participants’ self-reported abstinence, Quality of Life , change in life satisfaction, as well as their commitment and motivation to abstinence.

Not surprisingly, the study found that those who reported greater life satisfaction at the baseline interview were likely to stay abstinent for longer. However, they also found that overall life satisfaction for participants remained high for most. What they didn’t look at was whether or not participants’ life satisfaction decreased with all levels of use or whether a severe relapse was necessary to cause such a reduction.

I think this should be one of our next explorations. I have a feeling that with reduced use comes greater life satisfaction and quality – even if the abstinence is not complete. I think that by beginning to explore that connection, we’ll be able to make much more refined discoveries about methods of treatment that can save lives. There’s no question that even reductions in use can allow the body, and brain, at least a partial recovery from the effects of heavy drug use.

I’ll keep you updated.

Citation:

Laudet, Alexandre B., Becker, Jeffrey B. & White, William L. (2009). Don’t Wanna Go Through That Madness No More: Quality of Life Satisfaction as Predictor of Sustained Remission from Illicit Drug Misuse. Substance Use & Misuse, 44 (2), 227-252.

Always stay mindful – My different experience with recovery, addiction, and crystal meth

One of the main features of addiction is, unfortunately, how insidious it is.
Given everything I’ve been learning in the past 12 years about drugs, their abuse, and the people involved, I feel right in saying that most people don’t realize how far gone they are until it’s too late.

I consider myself fortunate in finding my way out of my crystal meth addiction, and I’ve met many others who’ve found their way as well. Still, I realize constantly that you can’t be too vigilant or too aware in watching out for inroads back to disaster.

My Experiment

methAs I’d said before, I began drinking again after 3 years of staying completely sober. My decision to leave typical recovery was made after talking with my parents and loved ones and making sure that they understood what this meant. I made sure that if I began reverting back to my old way of being lazy, aloof, and disrespectful, they would step in and send me right back to rehab.

This was my way of running the famous AA experiment and for me, it’s been working for the past 5 years or so.

But, I am always aware of how intoxicated I am and it is rare nowadays that I let myself get to the point of the loss of control. I have this constant voice in my head now that monitors how drunk I feel. I DO leave unfinished glasses of wine at dinners at times, and I do my best to make wise choices before going out so that I don’t make dumb ones later (like driving under the influence).

How I stay grounded

Still, most of my awareness about my addiction and what it means comes from my constant work in the area. Working with people who are in the throws of their disease keeps me in touch with how far I’ve gone and how much I don’t want to go back. I now know much more about the risks and about what I’d be doing to myself were I to take them. I don’t want to kill additional neurons, and I sure as hell don’t want to go through 2 more years of hell trying to put my life in order. I’ve never tried speed again since the day I quit in 2002 because I can’t say that I’m sure of what would happen next, and I don’t want to find out in case it’s bad…

This is why I believe that education is one of our best weapons in the battle against addiction.

My most valuable help

Lastly, I feel like one of the most important ingredients in all of this is having people you can trust and confide in. I don’t have many of those, but there are a few, and my family is always there, and I share everything with them.

For me, it was the moment I chose to be forthcoming with my family and hide nothing from them that has healed years of tension, mistrust and fighting, and I never want to go back .

This however means that they too have to be open. We now laugh when I say things like “I wish I could do some speed now to get me through all this work I have,” but I assure you, no one was laughing 5 years ago…

A word of caution

DefeatedMy sponsor in AA “went out” (meaning he started using again) a few months ago after being prescribed pain medication for surgery. Many in AA would point to the fact that he should have never been prescribed those pills in the first place. Everything I’ve learned about the brain indicates that automatic relapse is only likely when using one’s “drug of choice“. I say it was the dissolution of his marriage and his trust that having been sober for 12 years he could do no wrong that got him in trouble.

The moral:

Be open, accepting, and loving. Let those around you say things that make you uncomfortable without too much judgment so that they feel safe in coming back to you, and if they ask for help, know how to give it to them. No matter how happy people are to finally quit drugs (or another addiction), the feeling of defeat when they realize they now have to learn to live without their crutch can be enormous. This is where the help is most important.

Question of the day:
Do you have a story about the support you found necessary for your own recovery or the recovery of someone close to you?

Addiction brain effects : Opiate addiction – Heroin, oxycontin and more

Okay, we’ve talked about crystal meth and cocaine and how they affect the brain during drug use. As I mentioned, both cocaine and meth interfere with the way the brain stores and cleans up important neurotransmitters, including, most importantly, Dopamine and Norepinephrine.

opiates-morphine & heroinThe class of drugs known as opiates, which includes morphine, heroin, codeine, and all their derivatives (including oxycontin), acts on the brain in a completely different manner. Since our goal at All About Addiction is to explain drug use and abuse as comprehensively as possible, let’s turn our attention to this opiate addiction next.

Heroin, morphine, oxycontin, vicodin and other opiates

While cocaine and crystal meth work by disrupting the normal functioning of molecules responsible for cleaning up released neurotransmitters, opiates work by activating actual receptors that naturally occuring neurotransmitters activate. Substance like this are known as agonists; they perform the same action (identically as, to a lesser, or greater extent) as a substance the body already manufactures.

In the case of morphine, heroin, and most other opiates, the most important receptors activated are knownOpiate Receptors as µ-opioid receptors. Activation of the µ-opioid receptors is associated with analgesia (suppression of pain), sedation, and euphoria, which makes sense given the relaxing, pleasure inducing effects of opiates.

Natural opioids (also called endogenous opioids), which include endorphins, are used by the body to relieve pain and increase relaxation, especially during periods of extreme stress. These are the chemicals that make sure we can function during accidents, like after breaking our leg…

Opioids and dopamine

Opioids also increase the amount of dopamine in the brain indirectly. As I mentioned in the earlier posts, dopamine is thought to be the reward indicator in the brain. Unlike crystal meth and cocaine, heroin and its relatives increase the activity of dopamine neurons by releasing the hold that other neurons (that use GABA) have on them. Think of this as the release of pressure on a hose spraying water on a lawn. When the pipe is pinched, only so much water can get through, but once the clasp is released, water can flow in greater quantity; this is essentially what opiates do.

Heroin addiction and long term opiate use

Like I said before, this doesn’t sound so bad, does it? All we’re talking about here is the increasing of the functioning of system that already exists in the brain. The problem isn’t so much in the process, the problem starts when this system gets activated for long periods of time.

HeroinHeroin addicts, and other frequent users of opiates complain about the extreme discomfort they feel when they stop using the drugs. This discomfort has been described as the worse case of the flu you could imagine. Doesn’t sound too appealing, does it? In fact, withdrawal symptoms associated with stopping opiate use are at least one of the main reasons many users return to the drug after trying to clean up. This in addition to all the other effects of the drug on the brain to make wanting to stop so much harder.

The reason for the pains and aches? Given the overactivation of its pain suppression system, the body not only reduces its own supply of opioids, but it also turns up the sensitivity on its pain receptors. Heroin users notice this as an increase in tolerance, but they compensate for it by simply using more. However, when they stop, they’re left with a body unable to suppress its own, hyper sensitive pain system. The results are more than uncomfortable, they’re simply excruciating…

Another common complaint of addicts is diarrhea. This, again, is simply the reversal of the constipation caused earlier by heroin’s actions on opioid receptors that are present in the peripheral system (outside the central nervous system).

I’ve heard addicts speak online about the slow recovery from opiate addiction and I want to dispell a myth here:

Opiates DO NOT stay in your system for weeks or months – The drug itself is gone from the body within days. The reason for the continued suffering is the slow adjustment of your brain and body back to the way things were before the drugs. Think of how long the tolerance took to develop… Now play the tape back in reverse. That’s what happening to you. You can help relieve the pain, but know that if you use anything in the opiate family, you’re making the process last much longer…

So, in summary: As usual, the actions of opiates on the body and brain are not all the severe, extreme, or inappropriate. Opiates are still used in medicine for pain suppression, not only because they work, but because the potential for abuse when used in this way are minimal to non-existent. However, as with all drugs, continued, chronic, abusive use of opiates will change the way your body functions in ways that will produce the exact opposite effects of those users like so much. This leaves people not only with possible addiction problems, but also with a terrifyingly uncomfortable return back to normal functioning.

Addiction help

If you need help finding treatment for your own, or a loved one’s addiction, make sure to give our Rehab-Finder a try: It’s the only evidence-based, scientifically created, tool for finding rehab anywhere in the United States!

Links of the week

Guess what? It’s that time again. Here are some posts by other writers that offer good help for addicts. I know I’ve been slacking on these, but I’ve simply had too many of my own cents to add. It happens often.

Trudging the gentle path: Being an atheist in recovery

Spiritual River: A new recovery eBook

Stop eating disorders: How to stop a binge

About.com: Signs of a relpase (I don’t necessarily agree with all of these, but it’s a good article)

Addiction Recovery Basics: Sign of addiction

That’s it for now, enjoy!

And don’t forget to click the title of the post for related articles on allaboutaddiction.com that offer addiction help!

Latest drug addiction research from CPDD: Drug use patterns among adults

I’m currently attending the annual meeting of the College on Problems of Drug Dependence (CPDD) in Reno, NV.

Since there’s so much drug addiction research being presented here, I figured I would post a daily update with some of the things I found most interesting. There’s absolutely no way for me to see all the presentations I’m interested in, so what I get to see is what you get to hear about.

One of the interesting presentations today had to do with a broad study of drug use patterns among adults who are not drug addicts. The study, conducted by researchers at the University of Alabama (who ran the CARDIA study), looked at the drug use patterns of adults enrolled in a Coronary Artery Risk study over many years. It’s important to note that drug use in this case does not include smoking, drinking alcohol, or marijuana use. The researchers also didn’t distinguish between use of different drugs for the purpose of this study.

The researchers found 4 common drug use patterns:

  1. No current use – Over 80% of the participants reported no use within a month of any of the follow-up dates. More than half of those people said they’d used at least one drug at some point in their life, but their use was not common enough to ever fall within a month of their check-ups.
  2. Early use, low frequency – About 12% of people used drugs with some frequency at an early age but then reduced their use throughout the follow-up period.
  3. Persistent use, low – These users continued to use drugs throughout the study period, but their use did not escalate.
  4. Early, persistent, use – These users started early, used a lot, and though their use tapered off, it remained higher than any other group throughout the study.

I personally think that these findings are encouraging. They show that at least within this population, only a small proportion of individuals engage in what we would consider chronic, dangerous, drug use.

I reported similar findings regarding relapse in alcoholics in another post a while back (see here), and I’m glad that statistical techniques are being used to uncover larger patterns of drug use and abuse in a more general population.

More addiction research to come. There’s almost too much to report!