From Addiction to Recovery Cheat Sheet (DRAFT) by Wendie Ent

The American Society of Addiction Medicine (ASAM) defines addiction: Addiction is a primary, chronic disease of brain reward, motiva­tion, memory and related circuitry. Dysfun­ction in these circuits leads to charac­ter­istic biolog­ical, psycho­log­ical, social and spiritual manife­sta­tions. This is reflected in an individual pathol­ogi­cally pursuing reward and/or relief by substance use and other behaviors. Addiction is charac­terized by inability to consis­tently abstain, impairment in behavioral control, craving, diminished recogn­ition of signif­icant problems with one’s behaviors and interp­ersonal relati­ons­hips, and a dysfun­ctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activi­ties, addiction is progre­ssive and can result in disability or premature death.

I hate meetings! I hate higher power! I hate anyone who has a program! To all who come in contact with me, I wish you death, I wish you suffering! Allow me to introduce myself! I am the disease of alcoholism and drug addiction— Cunning, baffling, and powerful, that’s me. I have killed millions and I’m pleased. I love to catch you with the element of surprise. I love pretending I am your friend and lover. I have given you comfort, have I not? Wasn’t I there when you were lonely? When you wanted to die, didn’t you call me? I was there! I love to make you hurt! I love to make you cry! Better yet, I love it when I make you so numb you can neither hurt nor cry. You can’t feel anything at all. This is my true Glory! I will give you instant gratif­ication and all I ask of you is long term suffering. I’ve been there for you always, when things were going right in your life, you invited me in. You said you didn’t deserve these good things, and I was the only one who would agree with you. Together we were able to destroy all good things in your life! People don’t take me seriously! They take heart attacks, strokes, and even diabetes seriously, fools that they are, they don’t know that without my help these things would not be made possible. I am such a hated disease--- And yet, I do not come uninvited. You choose to have me. So many have chosen me over reality and peace. More than you hate me; I hate all of you who have a 12-step program. Your programs, your meetings, your support, your Higher Power all weaken me and I can’t function in the manner I am accustomed to. Now I must lie here quietly. You don’t see me, But I am growing bigger than ever. When you only exist, I may live. When you live, I only exist. But I am here and until we meet again, If we meet again, I wish you suffering and death! Signed, Your Disease ---Author Unknown

According to the Substance Abuse Mental Health Services Admini­str­ation (SAMHSA) The coexis­tence of both a mental health and a substance use disorder is referred to as co-occ­urring disorders.

People with mental health disorders are more likely than people without mental health disorders to experience an alcohol or substance use disorder. Co-occ­urring disorders can be difficult to diagnose due to the complexity of symptoms, as both may vary in severity. In many cases, people receive treatment for one disorder while the other disorder remains untreated. This may occur because both mental and substance use disorders can have biolog­ical, psycho­log­ical, and social compon­ents. Other reasons may be inadequate provider training or screening, an overlap of symptoms, or that other health issues need to be addressed first. In any case, the conseq­uences of undiag­nosed, untreated, or undert­reated co-occ­urring disorders can lead to a higher likelihood of experi­encing homele­ssness, incarc­era­tion, medical illnesses, suicide, or even early death. People with co-occ­urring disorders are best served through integrated treatment. With integrated treatment, practi­tioners can address mental and substance use disorders at the same time, often lowering costs and creating better outcomes. Increasing awareness and building capacity in service systems are important in helping identify and treat co-occ­urring disorders. Early detection and treatment can improve treatment outcomes and the quality of life for those who need these services.

Individual paths to recovery differ, and packages of treatments and supportive services for mental and substance use disorders should be tailored to fit individual needs. For many people with behavioral health problems the most effective approach often involves a combin­ation of counseling and medica­tion. Supportive services, such as case or care manage­ment, can also play an important role in promoting health and recovery.

In an introd­uctory paragraph, explain how you were introduced to your substa­nce(s) of abuse and what you perceived the pay offs (benefits) of continued use to be. This may have changed through the years. Write this letter as if the substa­nce(s) was a close friend or lover.

In the 2nd paragraph, identify the negative conseq­uences of alcohol and other drug (AOD) use. Give sufficient detail to evoke emotio­ns/­fee­lings.

This exercise can be conducted as a group exercise. You might consider using the poem "I am Your Diseas­e" to warm your clients up for the activity. Allow for silence (pregnant pauses) during proces­sing. Allow partic­ipant to cry - use tissue only for a dripping nose.

Using art and music therapy (instr­ume­ntal), spend at least one-hour having clients draw their addiction and process it with the group. Immedi­ately follow this group with Exercise #1 B.

I will add this later

Relapse is often a part of the recovery process, but it does not have to be.

Don't allow guilt and/or shame over a slip create a full-blown relapse.

Begin again with more inform­ation.

Plot where you think you are on The Jellnick Curve. If your friends or family members are present, compare your plotted location to where they place you! If you have ever been accused of using AOD when you have not been, ask your friend­s/f­amily about the early warning signs that they observed in your behaviors.

In a 3rd paragraph, identify the potential positive conseq­uences of quitting AOD. This may also be conducted as a group exercise. Be certain to leave sufficient time for processing and silence. Give enough detail to allow you to envision this with as many senses as possible. You may chose to augment this activity with a collage or vision board depicting hope for the future.

Uplifting music selections should accompany the compos­ition period.

Write a Post Script (PS).

Indicate your awareness of your vulner­ability issues and steps you will take to avoid these issues, protect yourself and/or heal these areas.

An explan­ation of why you want to change.

List ten negative conseq­uences of your AOD use:

List ten specific distra­ction, self-s­oot­hing, grounding, etc techniques that can stop you from using:

List ways that you can enhance your social well-b­eing:

List ways that you can enhance your physical well-b­eing:

List ways that you can enhance your intell­ectual well-b­eing:

List ways that you can enhance your enviro­nmental well-b­eing:

List ways that you can combat PAWS

Include a 1 month planning calendar - including scheduled mutual support meetings that you intend on attending.

CBT Diary

PTSD Coach

VetChange

SMART Recovery on line

Plan your week with a week-a­t-a­-glance calendar.

Augment your mood chart with a daily journal!

Speicifc

Attain­abl­e/A­che­iveable

Time Sensitive