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... During the week she holds down a very good job, works out regularly, cooks healthy meals for herself, and even spends time volunteering. She appears enviably happy.
As soon as the weekend hits, however, it is like a different person emerges. She often combines prescription medications with alcohol causing her to black out. She often drinks the next day to ease her hangover. I have picked her up from strangers' houses, bars, and even random street corners only to have her wake up on my couch the next morning with scant memories of the night before. She has very few friends that will go out with her because it inevitably turns into babysitting a belligerent, foul mouthed, 30 year old. I've tried several times to approach her with my concerns, only to be shot down and reminded of her weekday successes. She believes that because she\'s sober 5 nights out of the week that she doesn't have a problem, but her binging is out of control. Lauren
Let's start with the weekend and work backwards. A blackout is caused by drinking a large amount of alcohol in a short period of time. Your friend may abstain during the week, but she is exhibiting dangerous behavior on the weekends. Binging and mixing alcohol and prescription medications, blacking out and drinking to lessen a hangover are all symptoms of the disease of alcoholism. If your friend continues on this narrowing path, she will eventually lose her ability to control herself during the week.
I am going to say something you may not want to hear... When you pick her up from compromising situations, allow her to crash on your couch and rationalize her behavior, you are allowing the negative behavior to continue. I know how difficult it is to approach someone you care about, to talk about their drinking problem. But the issue is not how often your friend drinks (although weekend binges are problematic). It's the fact that her drinking is causing problems in her personal life that she is unwilling to address. Even if they only occur on the weekends.
The components of life are varied - work, interpersonal relationships, physical health...Your friend's most visible activities are managed, but her personal life, safety and health are being impacted. In addiction, social, occupational and recreational activities are neglected or abandoned. It is almost certain that, even though she says her life is not impacted by alcohol during the week, her weekend behavior is spilling over into her weekdays. How do you think she feels on Monday mornings? How productive do you think she is on Friday afternoons?
The best thing you can do, is to sit her down and tell her that you care about her and want to remain her friend, but not while she's drinking. Rae
Dear Rob: I would say this is a lapse, not a relapse. It’s like you sprained your ankle, instead of completely breaking your leg. But, a "relapse" and a "lapse" are as much about functioning and thinking, as they are about using alcohol. Taking a sip of alcohol is not the lapse. That’s the end result of addictive thinking. A relapse begins psychologically. The sipping of the alcohol is just the visual of other things that have been going on. These "struggles" are important to address from this day forward.
Don’t focus on the relapse, it’s just a word. You can tell that to your friend Albert... Your concern and priority should be getting back on track immediately.
An important thing to note, is that you knew you had been "struggling". Make sure you’re actively practicing your recovery. When you become complacent, addictive thinking can start to creep in. Think about what stressors and triggers led you to that drink and be mindful of those in the future. Know that there are signs like, mood swings that you and others can watch for in order to prevent a lapse.
Use this as a learning experience. Put what you learned into your recovery tool kit to make you stronger and smarter. Your next step is to address how you are going to move forward. Be aware. If you begin to struggle again, talk to a sober friend, step up your 12-step meeting schedule or get out and get some exercise. If the difficulties continue, seek professional help.
The holidays are meant to be a time for joy and merriment. But, for a lot of people holidays bring stress, whether it’s from being around family members to traveling. The holiday season is especially challenging and stressful for people in recovery. There are cocktail parties (even the name is triggering) and heavy drinking gatherings that can bring about strong urges. BUT, you don’t need old substances to have a festive time. There are some proactive steps you can take to reduce your stress and keep moving forward in your recovery.
You can bump up your support system. During the holidays, reach out to your sponsor, therapist, and support group more frequently. Spend time with others in recovery. Your support system can help you recognize your personal limits. You can talk with them before you go to that holiday party and then plan to meet with them afterwards.
If you are going to a party where there will be alcohol or other substances, evaluate the situation and have a plan in advance. Bring a sober friend with you. Drive yourself, so you have a way to leave the party and go someplace safe if needs be. In addition, you can make sure to arrive early and leave early to avoid prolonged exposure. Or, you can set a time frame beforehand and clearly state it when you arrive. Then stick to it.
Prepare responses and rehearse them. If you’re not ready to share about your recovery with family and friends, have a strategy for turning down drinks or other substances, as this is when vulnerability is at its peak.
Know your triggers and how to manage them. Take care of your mental and physical health. Be sure to take some quiet time each day. Fit relaxation and meditation into your day, if just for a few minutes, no matter how busy you are. Get enough sleep every night too. Eat nutritious meals or a snack every few hours to keep your blood sugar up. Low blood sugar can make you feel anxious or irritable making you feel impulsive or tempted. If you’re early in recovery, stay in low risk situations and avoid ones that are high risk. If further along in recovery, know your plan for when you’ll be in a medium or high risk.
Celebrate the season in a new way. Create new rituals or symbols that help redefine joy for you in your recovery during the holidays. You can host your own holiday party for recovery friends or your support group.
Dear KB: I'm glad you asked this question. It is critical the entire family be educated about the disease of addiction. Education and family therapy will support your treatment and recovery. Members of the family system often refuse to acknowledge their role. We want to make family members allies and partners in the recovery process. With therapy and education, we are able to deal with the potential for blame - for your past behavior or your continuing behavior.
We want to manage your family's expectations. It is unrealistic to assume you are "fixed" when you leave treatment. But it is natural for your family to think you will feel better immediately. Without education, family members are unaware of Post-Acute Withdrawal (PAWs) symptoms. PAWs can make someone new to recovery tired, edgy, sleep deprived and out of sorts. The symptoms of PAWs can last up to three years. When we involve the family in the recovery process, they begin to understand the path of the disease, the root cause of addiction and their role and responsibilities in the recovery plan.
Dear Stymied: As with many other progressive, chronic illnesses, relapse is unfortunately part of the recovery process. It reminds me of going off a diet to eat a cookie and then thinking “the damage is done, might as well eat the whole box.” In treatment we teach that the tools to address the relapse are just as important as the tools to prevent it. So not only do you learn how to prevent yourself from giving into that craving, you learn how to address the situation when you’ve given in and are two boxes of thin mints deep. The way to move forward is to work through the shame and guilt. Reach out for help. Rely on your support systems (that are hopefully already put in place). For more insight about relapse check out the blog post 10 Triggers to Relapse/10 Practical Sober Solutions and 7 Ways to Stop Fearing Relapse.
Dear MM: Sanford House is a women’s addiction treatment center. We are well aware that many of the women who come to us are moms. The fact is, when you’re deep in your addiction, you’re not present as a caretaker. So time spent in treatment, is necessary to begin the healing process. In the long run, being away from your kids during treatment can be valuable to your recovery. At Sanford House, we support communications between our women residents and their families. Daily phone calls and skype or facetime chats are allowed and family therapy sessions are provided and encouraged. Addiction is a family disease and we know your relationship with your children is vital to your good health and successful recovery.
Dear B: The purpose of detox is to rid the body of alcohol or drugs in a physically safe way. But detox is not addiction treatment or rehab. In the simplest sense, detox deals with the physical aspects of addiction. Treatment deals with the emotional aspects, like the emotional pain of substance abuse. So, the answer to your question is, “Yes.” If you’d like more information, I’ve written an article called "What is Drug and Alcohol Detox"