In the field of addiction and alcoholism there is a common definition for the word insanity: doing the same thing over and over again and expecting different results. This refers to a number of different aspects of addiction, but it especially points out the fact that addicts and alcoholics must make changes in their lives – usually dramatic changes – in order to beat the disease of addiction. These lifestyle changes may permanently affect the addict’s relationship with the people, places and things they once associated with. However, just as an addiction to drugs can be formed rapidly, becoming accustomed to lifestyle changes necessary for recovery can also happen quickly.
The first major lifestyle change for an addict or alcoholic is temporary but is the most dramatic. This is the active treatment phase, where a person will undergo treatment at a drug rehab center. They may partake in one of three types of programs:
*Residential Inpatient Treatment: Usually lasting 30, 60 or even 90 days, the client will live in the same facility where drug treatment is administered. Therapy is intensive and can be spread over 50 or more hours per week. For someone who was recently using heroin in the street this is a significant change, but likely a life-saving one.
*Day/Night Treatment: This program is considered a step down from inpatient treatment and consists of intensive therapies during the day and a supervised clean and sober living environment in the evenings.
*Outpatient Treatment: Outpatient programs are the easiest transition because therapies are only attended during the day. This type of treatment is excellent for those who have recently completed another type of treatment or for those who have recently relapsed.
The therapies employed at a drug rehab center are designed to prepare the recovering addict for the lifestyle changes that will be necessary in order to maintain sobriety once active treatment is completed. This includes individual therapy, group therapy and family therapy. The primary focus of these therapies is to identify negative thought patterns and develop skills and resources to change them. These and other therapies also focus on developing avoidance, refusal and stress management skills, which are critical to the success of any recovery program.
Ultimately the evidence based practices and reality therapies of most drug and alcohol rehab centers are designed to provide the necessary tools for addicts to make lifestyle changes related to substance abuse triggers. Substance abuse triggers are environments, people and things that can cause an addict to relapse.
The University of Pennsylvania Health System describes the neurological process of addiction:
“Child touches hot stove — painful sensation transmitted to brain — brain transmits message to muscles to pull away instantly — memory indelibly etched in brain to avoid doing that again. Negative reinforcement for a negative event — this is an appropriate message.
Untreated diabetic experiencing lethargy, blurred vision, constant hunger, thirst and frequent urination receives first shot of insulin — negative symptoms go away — feels great, feels “normal” — message transmitted that this would be a good activity to repeat — positive reinforcement for a positive event — this is an appropriate message.” (1)
These same neurological processes are responsible for addiction – the euphoric high a person feels is considered a positive event and therefore the brain will work to reinforce and recreate it. It does this by creating associations between drug use and a number of other factors – including the environment.
What this means is that certain environments could literally trigger a neurological response in a recovering addict and compel them to seek out drugs and use again. Driving by an old dealer’s house, walking in a park where a person used to take drugs, or going to a favorite restaurant/bar can all be triggers. In fact, some of these environmental triggers could be located in the recovering addict’s home. For this reason the solution is not as simple as avoiding all of these places. Instead, the addict or alcoholic must learn to develop coping skills to that will permit them to repress drug craving and compulsion until they develop associations to the environment that do not include drug use.
However, there are some environments that should be avoided as a rule, including anywhere that drug use is occurring, clubs or bars (for alcoholics), or anywhere where the risk of direct exposure to drugs or the glorification thereof is high.
The neurological nature of addiction extends to associations with people as well as environments, and probably more so because people can also put direct and deliberate pressure on an individual. For the recovering drug user or alcoholic, this means avoiding or limiting interactions with old friends, acquaintances or using partners who are currently abusing drugs or alcohol or those who have negative views about recovery. However, it’s important to note that the power of peer pressure is directly proportional to the level of commitment to an addict’s recovery program. In a report for Indiana University, Ruth C. Engs and Stuart W. Fors write:
“Peer pressure also represents a powerful force for both adults and children. How many adults can or want to say no when others at a restaurant order a drink? Furthermore, internal motivation for a behavior may be “yes,” and the idea of resisting peer pressure may not be important if the person really wants to do something.” (2)
For those who haven’t experienced addiction directly, it’s hard to imagine how a thing – an actual physical object – could trigger a compulsion to use drugs or drink. But the fact of the matter is that anything a person associates with their previous drug use could act as a trigger to relapse. In a blog on the subject, Dr. Adi Jaffe, an addiction researcher at UCLA writes:
“A trigger can be thought of as anything that brings back thoughts, feelings, and memories that have to do with addiction. . .” “I’m sure many of you can relate to the overwhelming memories and emotions that seem to come out of nowhere when you hear music you used to get high to. . .” (3)
This doesn’t mean that people in recovery should avoid music or movies or art or anything else that is associated with prior drug use, but instead that they should be prepared to cope with cravings if they occur, and to build new relationships and associations with the people, places and things around them.
Finally, a recovering addict or alcoholic must change their thought patterns in order to achieve meaningful and lasting sobriety. This is critical because “Many of the thought patterns in addiction are defensive and designed to protect the addiction.” (4) Therefore, people in recovery must make lifestyle changes that include changes to the way they think. This is achieved through ongoing therapy like one-on-one counseling, taking daily personal assessments and attending groups to support – and receive the support of – other people in recovery.
If you or someone you love is suffering from drug addiction or alcoholism and you need help, you’ve come to the right place. We are widely considered one of the most successful drug rehab centers in the country, and we have addiction specialists standing by to speak with you right now. Call the number at the top of your screen for a confidential consultation.
The first lifestyle change that an addict must make is to learn that it’s okay to reach out for help. . .
(1) University of Pennsylvania Health System Normal Brain Versus the Addicted Brain: The Difference
(2) Ruth C. Engs, Stuart W. Fors. Drug Abuse Hysteria: the challenge of keeping perspective. Journal of School Health. January 1988, Vol. 58, No. 1, 26-28.
(3) Jaffe, Adi Ph.D. Triggers and relapse, a craving connection for addicts March 17, 2010
(4) BBC Health Psychological Effects of Addiction