Recovery...as this drunk sees it #4

   We are now going to assume that the individual presented to treatment or assigned to a self help group has successfully detoxified and it appears that they are not crazy.

At this stage of treatment detoxification still has two important influences on treatment.

Younger, more resilient bodies clean up in a hurry,

look great, feel great, what is the problem??,

I’m O.K. and I think I can go home now.

The patient has just awakened from a relatively long drug and alcohol induced stupor

and the guilt and shame

that is felt once they realize where they are is

too much to handle, time to leave.

   Most treatment facilities enforce a blackout of five to seven days after the patient has been committed to prevent the patient from trying to arrange transportation to “Get me out of Here.”  The excuses to leave are as varied and as creative as there are clients in every rehab center.  Most alcoholics have been rightly accused of lying once or twice in their lives and trying to flee rehab is a suitable challenge to any alcoholics creative story telling.

   The second thing that must be understood is that the entire cleansing of the body and mind usually takes a whole year and many times up to two years. Many recovered alcoholics will describe the experience of total detoxification as an event where at a given moment, a year or two after drinking has stopped, there is a feeling that a fog has lifted from their brain.

Now begins the most critical process of recovery treatment.

   Through the use of personal interviews and introduction into small group therapy sessions the counselor and the client must agree to be honest, trusting and to agree to thoroughly examine why the client is in treatment.

Self realization is the key to recovery.

There is very little emphasis on how much or what kind of alcohol was consumed, when the alcohol was consumed or where the alcohol was consumed. The emphasis is on the consequences of the drinking.

Most alcoholics agree that they rarely had trouble every time they drank, but when there was trouble it was usually because of drinking. The emphasis of the self education is to have the client understand, in their own words, what control the alcohol had over their actions.

As an example: I had only two drinks three nights ago, because I said I was only going to have two. I had only two drinks two nights ago, because I said I was only going to have two. Last night I said I was only going to have two, but I lost count.

Group therapy is one of the strongest forms of assisting the client to begin self realization. In the normal 28 day, 4 week treatment program, there are two clients who have three weeks exposure, two who have two weeks, two who have one week and two who are just out of detox, recently admitted. By sharing experiences and learning to identify with someone who has the same apparent problems, the client is guided to self realization. A peer group admonishment is not as damaging to the fragile ego as a direct condemnation from family or other authority figures. A good therapist asks questions and allows the group to provide an answer or explanation. Are you being honest?

Many of the best, one on one, client therapist discussions end with the therapist recommending the client take the issue to their group session. Most clients who do not like their groups are incapable of being honest and are having trouble facing reality.

The group does not like them either.

Admitting that there is a problem with alcohol is the springboard to the next step of the treatment program.

If the alcoholic is trying to sober up using the twelve steps of Alcoholics Anonymous, they have just completed step 1.

“We admitted we were powerless over alcohol, that our lives had become unmanageable”.

Happiness is helping someone help themselves.

Michael_e

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Recovery...as this drunk sees it #3

Alcohol is a poison.

Detoxification of the alcoholic can be fatal.

When any alcohol abuser goes to treatment,
the first goal is to "Dry the person out."

It is not advisable to have a serious
problem drinker attempt to "dry out"
without the supervision of a Doctor
or trained clinician.

The mornings after sweaty shakes
are the first signs of withdrawal.

The alcoholic does not have his morning eye opener because he likes to drink; he has his first drink to make the pain and discomfort of the withdrawal symptoms go away. The dancing Pink Elephants are a scary hallucination for the alcoholic. If you are old enough to remember the classic Disney animated short of the Dancing Pink elephants, you can almost believe that the writers of that cartoon knew something about withdrawal from alcohol.
The following is an excerpt from an article published in the NIAAA (National Institute on Alcohol Abuse and Alcoholism) Journal in 1998.
 "Initial symptoms may include headache, tremor, sweating, agitation, anxiety and irritability, nausea and vomiting, heightened sensitivity to light and sound, disorientation, difficulty concentrating, and, in more serious cases, transient hallucinations. These initial symptoms of "Alcoholic Withdrawal" intensify and then diminish over 24 to 48 hours. Delirium Tremens (DT's), the most intense and serious syndrome associated with Alcoholic Withdrawal is characterized by severe agitation; tremor; disorientation; persistent hallucinations; and large increases in heart rate, breathing rate, pulse, and blood pressure. Delirium Tremens occur in approximately 5 percent of patients undergoing withdrawal and usually appear 2 to 4 days after the patient's last use of alcohol."

HUGH MYRICK, M.D., is an assistant professor of psychiatry and RAYMOND F.ANTON, M.D., is a professor of psychiatry at the Medical University of South Carolina, Department of Psychiatry, Center for Drug and Alcohol Programs, Charleston, S.C.

According to the statistics quoted in this article,75% of treated alcoholics have acute symptoms of alcoholic withdrawal when attempting to quit drinking.
A common error is to assume that an abuser, who has detoxed himself several times before without problems, can do it again. The disease of Alcoholism is progressive and personal histories as well as studies show that every detox is worse than the one before. The main reasons to have an alcohol abuser treated at a hospital or inpatient treatment Rehab center include constant and vigilant care as well as the patients’ removal from their normal environment and routine.
Another reason to seek treatment at a hospital/clinic is the availability of medications to reduce the fatal affects of withdrawal. According to the above article there are more than 150 medicines that have been used to lessen the physical affects of alcohol withdrawal. Unfortunately there has not been enough testing to recommend one drug over another, or even the proper dosage to use. Additional benefits to inpatient treatment include diet and exercise. A drunk usually ignores eating real food and when they show up for treatment, vitamin deficiencies and other health problems that have to do with a poor diet, only contribute to the affects of a bad or possibly fatal withdrawal. The next benefit of inpatient treatment is the clinical evaluation that is made in the first couple of hours or days of treatment. Is the alcoholic drunk or is he crazy? Until the withdrawal process is completed and the drunk has sobered up, it is difficult to proceed with the appropriate treatment until the mental evaluation is made. In the Rehab environment the addict/abuser also finds some solace with being among others who are having the same experience.
The aim of treatment in a rehabilitation center is to break the cycle of intoxication and withdrawal. This cycle varies among drinkers. In the early stages of alcohol dependency the cycle may be as far apart as once or twice a year. As the disease progresses the cycle may become once a month. Those who are in this cycle are usually referred to as binge drinkers. In the worst cases, the cycle becomes a daily routine. Many drinkers do not get drunk every time they drink. There are those who drink a certain amount every day to prevent withdrawal symptoms, and then binge once or twice a year, once a month, on weekends only, and eventually the binges take on a life of their own and the drinker has no control over when the drunks will happen.
Extended abstinence is required to restore the abusive drinker's health and well being.

http://pubs.niaaa.nih.gov/publications/arh22-1/38-43.pdf

Happiness is helping someone help themselves.       

Michael_e