Category Archives: Addiction

What about Us?

I realized today that I have been dealing with a family members addiction for over 10 years. During that time, they have been completely numb to the pain and misery that they have caused their family and their friends. They cause a crisis and come out of it because someone else bailed them out and the next day, they are numbing their misery and causing more while the rest of us are bright eyed and bushy tailed and feeling evey pain that the bitch (addiction) can inflict.

It is normal to feel violated in this awareness and say, “What about me?” , “Why is my every holiday ruined?”, ” Why do I have to come back early from vacations because of this miserable wretch?”.  What about us? Why me?

Well, let me answer that, because you still have a brain and a heart. You  have not become the selfish bastard that they have become. (Unless you are an addict also) You feel the pain because you can still feel at all. You have hope for the future or you wouldn’t be putting up with this nonsense. It says in the Bible somewhere that”Faith is the evidence of things hoped for and the substance of things not seen”. We hope because we still have faith in things that we cannot see at this time.

Let me encourage you to not take hope from the progress of the addict, not from circumstances, but from the higher power. If you depend on good news and progress for hope, you will always be disappointed. If you search for hope from the Father of hope, then he can give you hope in the down deep parts of your soul where you can draw strength.

What you do as a friend or family member is not useless but don’t get in the way of the progress. Don’t be the supporting wall that keeps them from crashing  and know that I don’t say that lightly. An addict doesn’t realize that it is very hard on us who love them to not answer the calls from the police, the constant appeal for money, and the consistent parade of lies that we have to tolerate for years. They don’t understand how hard it is for us to watch our loved ones get paraded off to jail. They don’t understand the pain if their children asking the grandparents, “Is my Daddy dead?” They don’t get it because they have been numb while we have had to cope in the land of the living.

Lower your expectations of the addict but increase your faith in the one that can bring them along. Get out of his way and let the process bring them to faith in something other than their addiction. When they start feeling the pain, remind them of the choices that got them there. Remind them constantly of the pain that the bitch has caused and that there can be a way out!

Kick her to the curb!

Never Again

Part of the slogan for NA is “Never again” and I really felt the meaning of that when I was talking to an inmate today who said that they had made the commitment to quit drinking (after 3 dwi charges) but he was still not ceratin that he would give up “weed” or “cigarettes” after his time in jail which has him completely clean at the moment.

The Bible says that “a double minded man is unstable in all of his ways” and to my thinking you cannat swap one addiction with the other. At some time in your life every addict has to say, I will never get high again. Tip toeing around one obvious problem and trying to self prescribe with another one makes no sense. I don’t care what your opinion of legalising marijuana or medical marijauna for pain, l can tell you from real experience of my own and of others that marijauna can break down your resistance to making good decisions about your addiction.

Face it, if you are currently an addict,what has drugs and alchohol done for you in the long haul anyway? You have to make the decision that it stops HERE and NOW! “Never again” not just for one or two of my vices that have gotten me here but ALL of them, Now!


Kick her to the curb!

Marijuana’s Long term effect on the brain

An article from

What are marijuana’s long-term effects on the brain?

Substantial evidence from animal research and a growing number of studies in humans indicate that marijuana exposure during development can cause long-term or possibly permanent adverse changes in the brain. Rats exposed to THC before birth, soon after birth, or during adolescence show notable problems with specific learning and memory tasks later in life.  Cognitive impairments in adult rats exposed to THC during adolescence are associated with structural and functional changes in the hippocampus.  Studies in rats also show that adolescent exposure to THC is associated with an altered reward system, increasing the likelihood that an animal will self-administer other drugs (e.g., heroin) when given an opportunity (see “Is marijuana a gateway drug?“). Imaging studies in human adolescents show that regular marijuana users display impaired neural connectivity in specific brain regions involved in a broad range of executive functions like memory, learning, and impulse control compared to non-users.

The latter findings may help explain the results of a large longitudinal study conducted in New Zealand, which found that frequent and persistent marijuana use starting in adolescence was associated with a loss of an average of 8 IQ points measured in mid-adulthood.  Significantly, in that study, those who used marijuana heavily as teenagers and quit using as adults did not recover the lost IQ points. Users who only began using marijuana heavily in adulthood did not lose IQ points. These results suggest that marijuana has its strongest long-term impact on young users whose brains are still busy building new connections and maturing in other ways. The endocannabinoid system is known to play an important role in the proper formation of synapses (the connections between neurons) during early brain development, and a similar role has been proposed for the refinement of neural connections during adolescence. If confirmed by future research, this may be one avenue by which marijuana use during adolescence produces its long-term effects.

The ability to draw definitive conclusions about marijuana’s long-term impact on the human brain from past studies is often limited by the fact that study participants use multiple substances, and there is often limited data about the participants’ health or mental functioning prior to the study. Over the next decade, the National Institutes of Health is planning to fund a major longitudinal study that will track a large sample of young Americans from late childhood (before first use of drugs) to early adulthood. The study will use neuroimaging and other advanced tools to clarify precisely how and to what extent marijuana and other substances, alone and in combination, affect adolescent brain development.

Marijuana, Memory, and the Hippocampus

This is an image of a rat brain with the different parts of the brain labeled.
Distribution of cannabinoid receptors in the rat brain. Brain image reveals high levels (shown in orange and yellow) of cannabinoid receptors in many areas, including the cortex, hippocampus, cerebellum, and nucleus accumbens (ventral striatum).

Memory impairment from marijuana use occurs because THC alters how information is processed in the hippocampus, a brain area responsible for memory formation.

Most of the evidence supporting this assertion comes from animal studies. For example, rats exposed to THC in utero, soon after birth, or during adolescence, show notable problems with specific learning/memory tasks later in life. Moreover, cognitive impairment in adult rats is associated with structural and functional changes in the hippocampus from THC exposure during adolescence.

As people age, they lose neurons in the hippocampus, which decreases their ability to learn new information. Chronic THC exposure may hasten age-related loss of hippocampal neurons. In one study, rats exposed to THC every day for 8 months (approximately 30 percent of their life-span) showed a level of nerve cell loss (at 11 to 12 months of age) that equaled that of unexposed animals twice their age.


Milestones of Sobriety

I found this on the web with no author attached.


Milestones of Sobriety: 30 and 90 Days — 1, 5 and 10 Years

Recovery from addiction is often described as a journey. People who make the decision to set down the bottle or walk away from drugs have made the first step on that journey, but they may spend years working before they really feel as though they’ve arrived at their destination.We decided to interview several people in recovery, to get a sense of how people deal with the challenges as they become more comfortable with sobriety. Here’s what they had to say. Please note that all of the names in this piece have been changed to protect the privacy of our sources.

30 Days: New to the Struggle

Wendy was just released from the rehab center when this interview took place, and it’s clear that she’s still working through some of the issues that helped her addiction to develop.

“To be honest, things are hard right now. I really want to go back to drugs sometimes, to just numb myself up. But I remember how much my parents did for me, and how hard I worked in rehab, and it helps me to stay on track. Right now, I’m trying to figure out just what all of my triggers are, so I can figure out how to handle them when they pop up. I don’t have that figured out quite yet.”

Even at the one-month mark, though, her life is much different than it was when she was an active user. She has some challenges to overcome, however.
“I’m living with my parents now, because I don’t really trust myself to live alone. That’s new, and it’s a little hard. I’m used to having some space and my own stuff, and I am just adjusting to sharing. But I’m so thankful they let me stay. I don’t know what would happen to me if I didn’t have help.”

Wendy is also dealing with some of the aftereffects of the many years she spent in active addiction, but she is finding some bright spots.

“In general, I’m just really emotional right now. I can really feel things, emotions I’ve been able to bury with drugs for years. I feel like I’m gonna laugh or cry all of the time. It’s strange, and I feel like I’m adjusting. But I am also just remembering how great life can be. Little things like chocolate or a soft pillow, they’re like the best things that have ever happened to me.”

90 Days: Emerging Confidence

Steve also deals with ongoing cravings for the heroin he was addicted to, but after talking with him, it seems as though the grip of his addiction is slipping just a little bit.

“At first, I had a hard time staying clean. It felt like I had to use all of my energy, all of the time, just to stay away from smack. I loved my drugs, and I missed them. I missed my buddies who used too. Now, though, I have really good habits that help me to stay sober. I go to bed early. I eat right. I have friends to call if I feel like I’m about to slip. There are all of these systems around me, you know? I think they help me to stay safe. I don’t feel like I have to focus on this all of the time,”he says.

But Steve seems aware of the fact that he could very well slide right back into addiction, if he isn’t careful. That’s why he makes sure to stay in contact with the recovery community.

“I’m still going to meetings. Two, sometimes three, times a week, I walk into that room and admit that I have a problem. It helps me to stay humble, and to keep from testing the boundaries and getting back in trouble,”he says.

It’s that work in meetings that reminds Steve of all of the work he has yet to do, he says.

“I see so many people who walk into those meetings just terrified, you know? Like they think we’re all going to laugh at them or punish them or something. They don’t know how to be vulnerable and just admit that they need help. I don’t feel like I can help them right now, as I think I still have so much to learn, but I see them and I feel their pain. It helps me to remember how bad things could get if I slip up.”

One Year: Seeing the Benefits

Annie quit using when she became pregnant. She says that her life is remarkably different now.

“I quit when I found out I was pregnant, but had been trying for a while before that. I had my daughter February 28th, and that was amazing. I got married to my daughter’s dad. I have a job. I have my own place again. I have an awesome relationship with my mom, and I get to see my nephews all the time now. Before, I never saw or talked to any of them. My husband had left for Montana; I was sleeping under a bridge. So things have changed a lot. In a great way,”she says. “I have a purpose and goals again. It’s hard but so worth it.”

Even though her life is so different, she often deals with deep-seated cravings for the substances she’s given up. She must work hard to steer clear of the substances she craves, and she’s developing a system to help her stay sober.

“I stay on track by communicating with my husband. If I feel a craving coming on, I tell him and we find something to do that distracts me. Our goal is to NOT DWELL on my addiction, not live in it,”she says.

Five Years: Growing and Changing

At the five-year mark, Gabriel has learned a lot about what it takes to stay sober. But in many ways, he feels as though he has much more to learn.

“I had a problem with alcohol, and when my addiction was in full swing, booze was my best friend and closest companion. I had no room in my life for anyone else at all, and all of my relationships were a complete mess as a result. My wife left me, my kids wouldn’t talk to me, and I had no friends I could talk to. Basically, I was shut out,”he says.

“Since I got sober, I’ve been working on repairing those relationships. I went to counseling with my wife and my kids, and I joined some networking groups at work so I could meet other people that I had something in common with. I also met a ton of really great people in my AA group. Now, I feel like I have a whole bunch of people I can call when I’m low. I don’t even feel like I need alcohol. My life is so full,”he says.

Even though Gabriel feels confident that his deep drinking days are behind him, he continues to work on his sobriety and he tries to build a strong foundation that will keep him away from future mistakes.

“I’m still going to meetings, obviously, and I’m also working as a mentor,” he says. “It’s challenging, as my mentee can be really demanding right now, due to his addiction and trying to win the battle. But it reminds me of just how low you can go when you let the demon win. So as much as I help him, he helps me.”

“I’m also still going to counseling,” Gabriel says. “The longer I go sober, the more new things that pop up for me to talk about. I don’t want to be overwhelmed by it, so I keep talking.”

10 Years: A New Way of Life

At 10 years sober, Becky seems like a success story. The changes she’s made in her life are certainly inspirational.

“When I was drinking, my life really revolved around the next drink I was planning to have. When I went to parties, I headed right for the bar. As soon as I got home from work, I dipped into the refrigerator. Everything else that might have been important just slipped away,”she says. “Since I’ve been sober, I’ve had more energy for real relationships. I think I listen better, and I really try to be there for the people I love and who love me. I’m also able to focus on my work, and I’ve done a lot of amazing things there. When I don’t have to worry about alcohol all of the time, where to get it and how to cover up how much I use it, I have more energy for things that are really important.”

Becky also has a robust system in place that helps her to preserve the gains she’s made.

“I start off every morning with a run. I can get into a meditative space as I run, just thinking about what happened the day before and what needs to happen today, and that helps me to stay peaceful throughout the day. Running also reminds me of what my body is capable of doing. It’s a wonderful machine, and I really shouldn’t pollute it with alcohol. Running gives me that reminder,”she says.

Becky also believes that giving back to her community, and reaching out to those who haven’t yet made the commitment to get sober, is a great way for her to preserve her own sobriety. She does have words of wisdom for people in this camp too.

“I used to think that getting sober meant leaving all fun and good times behind. I guess I thought it would be like a punishment, and when I got sober, I’d have to pay for all of the things I did when I was drinking,”she says. “In reality, I still have a whole lot of fun every day. I run around with my grandkids, playing dress-up and having tea parties, I get my toenails done with my girlfriends, I watch silly movies with my husband, and we laugh and laugh. Sure, I have moments when I’m sad and upset about things. That’s just part of life. But it’s absolutely not true that sobriety means sadness 100 percent of the time. I have so much happiness in my life now, and I’m sure that’s because I’m sober.”

Making It Happen

Clearly, overcoming an addiction to drugs or alcohol isn’t easy. Often, it takes years of hard work in order for people to make the real changes that lead to long-term success.


The Disease of Addiction

Someone sent this to me so I don’t know the source but I thought it was good information:

Disease of Addiction: An Expanded Overview

Since 1956, alcoholism has been considered a primary disease by the American Medical Association. It has only been recently, however, that research has discovered the etiology of the disease of alcoholism and other drug addiction. Through animal studies as well as imaging studies of humans, scientists have concluded that addiction is a disease of the brain. The part of the brain that malfunctions is the mesolimbic dopamine system, the seat of reward system that reacts to pain and pleasure. More specifically the neurotransmission system is hijacked permanently by alcohol and psychoactive drugs. At some point in the addict’s drinking/using life a metaphorical switch is thrown that causes the flooding or depletion of neurochemicals, foremost of which is dopamine. At this point the addict has lost all voluntary control of alcohol/drug consumption and drinks/uses drugs simply to feel “normal”. The biological need for drugs leads, inevitably, to damage the rest of the addict’s life.

Dr. James Milam, in his landmark book, Under the Influence, describes the predictable path of the disease of alcoholism. The same path is travelled in drug addiction. Following are excerpts from his work:

The Early, Adaptive Stage of Alcoholism

One of the first symptoms of alcoholism is, ironically and tragically, an ability to increase alcohol intake and still function “normally.” It is ironic because most diseases incur immediate and obvious penalties, not benefits, and result in reduced functioning rather than improvement in functioning. But in the early stages of alcoholism, the alcoholic is not sick, in pain, or visibly abnormal. In fact, the early, adaptive stage of alcoholism appears to be marked by the opposite of disease, for the alcoholic is “blessed” with a supernormal ability to tolerate alcohol and enjoy its euphoric and stimulating effects. This improvement in functioning is tragic because the alcoholic has little or no warning of the deterioration inevitably to follow.

In the early stage, the disease is subtle and difficult to recognize. It is characterized by adaptations in the liver and central nervous system, increased tolerance to alcohol, and improved performance when drinking.

The early stage of alcoholism is characterized by Adaptation, Tolerance, and Improved Performance:

Adaptation: A general biological rule holds that when any bodily system is under stress it either adapts of suffers damage. Adaptation is actually a tool of survival, helping the body endure stressful changes in internal or external environments. Adaptational responses occur rapidly, spontaneously, and in most cases, without the person’s conscious knowledge.

The adaptations which occur in the early stage of alcoholism are of two kinds: those affecting the metabolism of alcohol, and those taking place in the central nervous system and contributing to addiction. Both types of adaptation have direct effects on the alcoholic’s ability to drink large amounts of alcohol without becoming intoxicated (tolerance) and actually to function better when he is drinking than when he is not drinking (improved performance).

Tolerance: Every drinker has a specific tolerance to alcohol. Below his tolerance level, the drinker can function more or less normally; at levels above his tolerance threshold, he will act intoxicated. Tolerance is therefore a condition that can only be measured accurately in a laboratory where the drinker’s blood level and behavior can be carefully monitored.

Alcoholics typically experience a dramatic climb in tolerance in the first stage of alcoholism and can often drink huge amounts of alcohol without showing obvious impairment of their ability to walk, talk, think, and react. Anyone who observes the early- and middle-stage alcoholic’s drinking behavior is familiar with the fact that the typical alcoholic can drink as much as a liter of wine, a dozen beers, or even a bottle of whisky without acting drunk.

Improved Performance: In this early, hidden stage of alcoholism, the only visible difference between the alcoholic and the non-alcoholic is improved performance in the alcoholic when he drinks and a deterioration in performance when he stops drinking.

Alcoholics in the early, adaptive stage of their disease also show improvement of functioning as the blood alcohol level begins to rise. But unlike the non-alcoholic, this improvement continues with additional drinking. Even when blood alcohol remains at fairly high levels—levels which would overwhelm the non-alcoholic, causing him to stumble, stutter, and sway—the early alcoholic is often able to talk coherently, walk a straight line, or skillfully maneuver a car. Only when the alcoholic stops drinking and his blood alcohol level (BAL) descends, does his performance deteriorate—and it does so very rapidly.

Tragically, the alcoholic can only temporarily control his drinking behavior. Over a period of years, the cells’ dependence on alcohol becomes more firmly entrenched until, at some point, the alcoholic no longer has a choice. He needs alcohol to function, and he suffers terribly when he stops drinking. The benefits of adaptation are gradually overshadowed by the penalties of deterioration.

The Middle Stage of Alcoholism

The middle stage of alcoholism is characterized by Physical Dependence, Craving, and Loss of Control:

As physiological changes gradually occur, the penalties of drinking begin to outweigh the benefits. Pleasurable drinking for a “high,” a lift in feeling and performance from a relatively normal base, gives way to a more urgent “drinking for medicine” to “cure” the pain and misery caused by previous drinking. The basic cause of the increase in penalties is deterioration. Organs and systems that once welcomed the large doses of alcohol and tolerated its toxic aftereffects are being damaged. Now when the alcoholic stops drinking, his suffering is more severe and prolonged.

Physical Dependence: As [the alcoholic] drinks more, and more often, to get the desired effect, the cells of his body are soaked in alcohol for long periods of time. The cell membranes become increasingly resistant to alcohol’s effects, and the mitochondria within the cells increase in size and shift functions in order to accommodate the alcohol. With these changes, the adapted cells are able to live and thrive in an environment where alcohol is continually present in large amounts.

If the alcoholic over-drinks his tolerance, the cells will be overwhelmed, and he will get drunk. If he stops drinking, the addicted cells will suddenly be thrown into a state of acute distress. They have become unable to function normally without alcohol. The cells’ distress when alcohol is no longer present in the body, or when the BAL is falling, is evident in various symptoms known as “the withdrawal syndrome.” Withdrawal symptoms demonstrate that physical dependence exists; they are the visible signs of addiction.

Craving: Craving is the overwhelming need for a drink. Like everything else in alcoholism, craving is progressive. In the middle stages of the disease, craving becomes a need—the alcoholic needs to drink because his cells are physically dependent on alcohol. As tolerance increases and physical dependence sets in, the alcoholic gradually loses psychological control over his physiological need for alcohol. Finally, will power, self-restraint, and the ability to say “no” have no power over alcoholic craving. The physical need for alcohol overshadows everything else in the alcoholic’s life.

Loss of Control: As the alcoholic progressively loses control over his drinking, he is no longer able to restrict it to socially and culturally accepted times and places. He often drinks more than he intended, and the drinking continues despite extremely punishing consequences. He may drink in the morning, at lunch, in the middle of the night; he may drink in the car, the bathroom, the garage, or the closet as well as the tavern. His drinking behavior can no longer be disguised as normal or even heavy drinking. His inability to stop drinking—despite his firm resolution that he will stop after one or two—is striking confirmation that he is physically addicted to alcohol.

The alcoholic loses control over his drinking because his tolerance decreases and the withdrawal symptoms increase. The alcoholic’s tolerance, which was so high in the early stages of the disease, begins to decrease because his cells have been damaged and can no longer tolerate large amounts of alcohol. While tolerance in lessening, the withdrawal symptoms are increasing in severity. The alcoholic is now in the dangerous position of needing to drink because he suffers terribly when he stops drinking but being unable to handle the high levels of alcohol needed to relieve the symptoms. He has also lost the ability to judge accurately how much alcohol his body can handle. As a result, he often over-medicates himself with alcohol, drinking to the point where he either loses consciousness or becomes so violently ill that he is forced to stop drinking.

The Late, Deteriorative Stage of Alcoholism

The late, deteriorative stage of alcoholism is characterized by Malnutrition, Secondary Disease, and Death:

The late-stage alcoholic spends most of his time drinking, since otherwise his agony is excruciating. During the late stages of alcoholism, the alcoholic’s mental and physical health are seriously deteriorated. Damage to vital organs saps the alcoholic’s physical strength; resistance to disease and infection is lowered; mental stability is shaken and precarious. The late-stage alcoholic is so ravaged by his disease that he cannot even understand that alcohol is destroying him. He is only aware that alcohol offers quick and miraculous relief from the constant agony, mental confusion, and emotional turmoil. Alcohol, his deadly poison, is also his necessary medicine.

Malnutrition: All alcoholics suffer from malnutrition to some degree. A number of factors work together to make this condition almost synonymous with alcoholism. Large amounts of alcohol interfere with digestion and passage of nutrients from the intestines into the bloodstream. The alcoholic’s liver has a decreased ability to convert and release nutrients and make them available throughout the body. Without adequate nutrients, the cells, already weakened by long exposure to alcohol’s toxic effects, are not able to create bone, tissue, blood, or energy. The sick and injured cells thus do not have the resources to repair themselves, and damage continues unchecked.

Even the alcoholic’s earliest psychological and social problems stem from or are aggravated by nutritional deficiencies. For example, a thiamine deficiency (extremely common in alcoholics) can cause loss of mental alertness, easy fatigue, loss of appetite, irritability, and emotional instability. If the deficiency is allowed to continue, more severe mental confusion and loss of memory may develop.

In the later stages of alcoholism, the alcoholic is often so sick that he cannot eat, thus aggravating the already serious nutritional deficiencies. Massive vitamin or mineral deficiencies caused by long and heavy drinking may result in several unusual diseases of the central nervous system, including polyneuropathy (tingling sensations), Wernicke’s encephalopathy (headaches, tingling, double vision), Korsakoff’s psychosis (hallucinations), and amblyopia (blurred vision).

Secondary Diseases have been scientifically linked with late-stage alcoholism.

Heart: Heart Failure is characterized by symptoms of cardiomyopathy (disease of the heart muscle), cardiac arrhythmia (abnormal variations of heart beat), and hypertension (high blood pressure).

Liver: Fatty Liver is characterized by enlarged, inflamed fatty deposits. Symptoms include nausea, jaundice, and loss of appetite.

Hepatitis, or alcoholic hepatitis, is characterized by a liver which becomes inflamed, swollen, and extremely tender.
Cirrhosis is characterized by a liver which is virtually plugged with scar tissue, and which can no longer remove poisons and toxins from the body’s blood supply.

Gastrointestinal Disorders: Gastritis is an inflammation of the stomach lining severe enough to cause bleeding, bloating, indigestion, nausea, and headache.

Ulcers form in response to increased secretions of hydrochloric acid in late-stage alcoholics.

Respiratory Tract Diseases: In general, alcoholism causes damage to the lungs by interfering with the body’s normal defense mechanisms and thereby making the alcoholic susceptible to respiratory infection and injury. This interference with normal functioning can lead to:

  • Tuberculosis
  • Chronic Bronchitis
  • Emphysema
  • Lung Abscess
  • Pneumonia

In addition, alcoholics appear to have an increased risk of head and neck, esophageal, lung, and liver cancers. In each of these cancers, alcohol probably acts in a different way, sometimes directly affecting the cells, other times indirectly increasing the cells’ susceptibility to cancer. Late-stage alcoholics also exhibit a higher risk for pancreatitis, an inflamed gland condition characterized by severe pain in the upper abdomen, nausea, vomiting, and constipation.

If the alcoholic continues to drink, alcohol will kill him one way or another. Estimates vary, but according to one source, one-third of alcoholic deaths are from suicides or accidents such as drownings, fires from passing out with a lighted cigarette, head injuries from falling, accidental poisoning, or car crashes. Those who survive these hazards are destroyed by direct and massive damage to body organs and systems.

Causes of Death in a Group of Alcoholics include: cardiovascular disease (30%), cirrhosis (24%), upper gastrointestinal & lung cancer (15%), alcoholism (14%), pneumonia (7%), and other causes (14%).—from W. Schmidt and R.E. Popham, unpublished data, “Deaths in 1823 Male Alcoholics, Corrected for the Expected Mortality in Each Subgroup” (1978).

Stages of Recovery

Early Recovery
Recovery can take up to two years to become firmly established. Early recovery spans the first six months for most patients, and is the time when the risk of relapse is the highest. This is the time the patient is struggling with the major adjustments he must make. He begins to deal with the environmental and social cues to drink or use again, he develops new ways of dealing with stress at work and in personal relationships, he learns to deal with the mood swings and depression common in early recovery, he must begin the process of building a sober support system through attendance in AA or other support groups, and he starts developing sober social circles and activities.

Middle Stage Recovery
This occurs during the second six months of sobriety. During this time the patient must learn to deal with the physical, social, and psychological adjustments of sobriety. New relationships must be forged with loved ones because the behaviors of the past have changed so in recovery. The patient commonly goes through a grieving process, both over losses that occurred during drug use, and also over the loss of their “old life” and old friends. Reestablishing the ability to experience emotion is important, because addiction causes abnormal responses to loss. Part of recovery is learning to deal with past unresolved loss.

Late Stage Recovery
The third stage of recovery begins after one year. By this time the patient has gone through the adjustment process of early- and middle-stage recovery. He has gained confidence that the support systems and tools learned in treatment and recovery work. This is a time of stability and of becoming comfortable with recovery. However, abstinence alone does not necessarily mean a successful recovery is under way. There is a difference between being “Dry” (abstinent) and “Sober” (in successful recovery).

The “Dry” patient is not presently using alcohol or drugs, however he has not changed his past using lifestyle, nor come to comfortable terms with the need for permanent sobriety. He is ambivalent about life, where the “Sober” person looks forward to his new life of sobriety. The “Dry” patient feels abstinence as a constant sacrifice, and frequently thinks about using. The “Sober” patient sees abstinence as a gift to himself. The “Dry” patient continues the self-centered ways of his past, maintaining the old behaviors, friends, and activities. He doesn’t take care of himself physically or psychologically, and continues to suffer from guilt and shame because he has not come to terms with his past or present life. Patients who are merely “Dry” have a much higher risk of relapse than those “Sober” patients who have made major life changes necessary for successful long-term recovery.