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51g5nobfaul-_sx329_bo1204203200_The best book I know about how drugs of abuse work and their effects is Buzzed: The Straight Facts About the Most Used and Abused Drugs from Alcohol to Ecstasy, now in its fourth edition. No one is frying eggs and exaggerating or diminishing the effects of drugs of abuse in this book. You may be able to get this information in an internet search, but you wouldn’t be able to trust what you read. You can trust Buzzed, trust me.

Click here to go to the Amazon page.

Some Things You May Not Know About Substance Abuse, Part 11: Often Drugs Work Too Well

Often Drugs Work Too Well

You’ve told your doctor you are anxious or in pain. You got a prescription for Atavan, Klonopin, Valium, or Xanax, if it was anxiety; if it was pain, you might’ve gotten a script for a narcotic like Percoset, Vicodin, Oxicotin, or Morphine. These will certainly take away your anxiety or pain; fast. If you use them sparingly, or intensively for a limited period of time, they can be wonderful. If you use them too long, they can cause more problems than they solve.

There are drugs that work right away to make you feel better and others that take time to raise blood levels. The type that slowly raises blood levels never results in addiction. Anti depressants are like that, you get the side effects first and the desired effects don’t come for two to three weeks, if they come at all. That kind of drug may make you feel better, but not right away, and you can safely take them for an extended period of time.

The drugs that make you feel better right away by removing anxiety or pain can cause real problems if you rely on them too much and for too long. The first sign of trouble is increased tolerance, needing a larger dose of the drug to achieve the same effect. The body, in its wisdom, is building up defenses against the drug.

Why would your body do such a thing? Why won’t it just let you be free of anxiety and pain? Why does your body have to torture you like that?

It’s necessary to have some anxiety and pain for the body to function properly. They are signals that there is danger or something is wrong. Without anxiety, you wouldn’t look both ways when crossing the street. Without pain, you would walk on a broken ankle and injure it more. Anxiety and pain are too valuable to do without.

This is why the body will develop tolerance for the drugs that immediately take away anxiety and pain. If you fail to listen to the body and go on taking more anyway, then you begin to show the second sign of addiction, withdrawal. In withdrawal, as we have seen, (go here if you don’t remember seeing this) whatever anxiety and pain you took away with the drug, comes back, doubled, making up for lost time. This makes you use the drug even more, to avoid withdrawal.

The third way that these drugs get you is by working too well. They do such a good job of taking away anxiety and pain, short term, that you don’t develop ways to cope with them yourself. We can learn to cope with anxiety and pain without drugs; there are skills, if you learn to use them. If you don’t need to use them, you never learn.

If your doctor has prescribed drugs for anxiety or pain, it’s definitely OK to take them for a few weeks if needed, if you have no history of addiction. If you have a history of addiction, then you should tell your doctor so that the risks and benefits of taking them can be accurately considered.

How long is too long for these drugs? When you begin to show tolerance, when the initial dose is no longer enough, it’s already been too long. You should be making plans to stop them before bigger problems develop. Problems such as withdrawal, and not learning how to cope without the drug.

You, have a remarkable ability to learn to cope without drugs. If you tried it without drugs, you would know it.

Click here to see other posts I’ve written about addiction

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Some Things You May Not Know About Substance Abuse, Part 8: Positive reinforcement is not enough to motivate a person to stop using

Positive reinforcement is not enough to motivate a person to stop using drugs

You’re a good parent, a loving spouse, a decent boss, a fair judge, a caring therapist. You took psychology in college. You learned that positive reinforcement is more effective than negative reinforcement. Honey catches more flies than vinegar. But, you don’t know drugs, or, if you do, you haven’t thought it out.

Your praise, your rewards, your love, your kindness, your convincing rationale, your unconditional positive regard, is never, ever going to be enough. You’re competing with crack cocaine, with crystal meth, with heroin, with a good buzz. Do you know what you’re up against? Do you think gold stars are better than that?

The only thing that can challenge the reinforcement that drugs provide is pain.

Drug provide plenty of pain. First, there’s the withdrawal. Then, there’s the consequences of having poor judgment when they’re intoxicated. There’s money problems, work problems, legal problems, and health problems that all arise from substance use. Use long enough and there will be plenty of problems. There will be plenty of pain.

You can still praise and reward when there is something to praise and reward. You can be loving, kind, rational, and caring. You don’t have to provide the pain. The drugs and their consequences will provide plenty of pain. You just have to get out of the way. Stop covering for them. Stop taking the pain yourself.

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Some Things You May Not Know About Substance Abuse, Part 7: In the beginning of recovery, it doesn’t matter if you are self motivated. It just matters that you have motivation

In the beginning of recovery, it doesn’t matter if you are self motivated. It just matters that you have motivation

Most people believe that internal or self motivation is the best kind of motivation and that people who are motivated for recovery to please others, whether they be the court, a spouse, a boss, or a parent, are not as well motivated.

Facts and figures show otherwise. They show that people who are externally motivated are more likely to succeed in staying clean than those who are doing it just to please themselves.

The one who is only self motivated is free to change his mind, and most of them do.

It’s one thing to sit and say, I’m never going to use again. What alcoholic has not prayed to the porcelain god that very prayer? Most say they do not want to use again when they are suffering from the consequences, not the desires, of use. When the desire to use returns, there is nothing to stop them. The bars, drug houses, and tobacco shops are filled with people who want to stop using. The ones who do stop have a reason to do so and have the need to make sacrifices.

The person who is externally motivated has more to lose.

I will help anyone where they are at, whether they are internally or externally motivated. But, if I were to chose who I would work with in recovery, I would rather work with the ones who are both externally and internally motivated. They would be the most likely to succeed. But I would take a client who was externally motivated over someone who only had to please himself.

That is particularly the case if the addict has someone: a spouse, a parent, an employer, or a judge, who could externally motivate him, but chooses not to. That person is set up to fail because others have failed him.

The person who is externally motivated has people in her life that care enough to take a stand.

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Some Things You May Not Know About Substance Abuse, Part 5: Addiction Takes Hostages

Addiction Takes Hostages

The further people go into addiction, the more their lives center around it.

They discard all forms of recreation in favor of activities that include substance use.

All of their friends become using friends. Non-using friends drift away and the addict is drawn to those who don’t judge because they, themselves, are doing the same thing.

Sometimes particular careers are chosen for their proximity to the drug of choice. Alcoholics become bartenders; potheads, musicians; drug users, drug dealers.

In some cases, intimate relationships end as the loved one finds that he or she is a low priority compared to the drug. They are replaced by one of two kinds of relationships: either the type where the loved one picks up after the addict and helps the addict escape the consequences, or the type where the relationship is all about use.

Things go like this until the person enters recovery, then he or she finds that all the things they love are connected in some way to use.

He can’t see his friends because all his friends use and are unlikely to support his recovery because it would challenge their own use.

The alcoholic bartender can’t return to work without being tempted to drink; the marijuana smoking musician has to watch what she does on breaks; the addicted drug dealer has to learn to sell something else.

Otherwise innocent forms of recreation, hobbies, or art may put the recovering addict at risk. A writer who cannot write without a bottle of scotch at hand is in trouble; a painter who seeks inspiration in LSD has got to find a new muse.

Even intimate relationships can be a problem if they were associated with chemical use. The wife who lovingly keeps your refrigerator stocked with brewskis, even though she hates your drinking, is as much of a problem as the breswkis themselves. The boyfriend who was your connection to a dealer may have to go as well as the dealer.

The general principle is this: first the drug takes you hostage, then it takes everything you love hostage. Even if you get yourself free, the drug still has the other hostages in its clutches. You want to be near them, but to go near puts you at risk.

Every recovering addict wants to go in and free the hostages. They want to save their loved ones who are still addicted. They want to continue writing that novel that was started under the influence of scotch, finish that painting, inspired by a meaningful trip, work at their job, see their friends. But, consider this: you’ve seen enough hostage movies to know, it’s dangerous to free the hostages. Be sure you are safe and secure before you try it.

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Some Things You May Not Know About Substance Abuse, Part III

There are as many problems caused by withdrawal as caused by use

If we are familiar with a drug at all, we know, or, at least have been told, what the initial effect is like. Tobacco will make you calm, marijuana will make you mellow, heroin will give you a warm and cozy feeling all over, cocaine is a rush better than sex, and crystal meth a rush better than cocaine. These initial feelings are the reason most people use drugs, they are the reinforcers that get you hooked.

The initial effect is not the end of the story, though.

What actually happens is this. Drugs will begin a pendulum effect, so that your feelings swing from one extreme to another. The stronger the drug and the stronger the dosage, the more pronounced the extreme.

Let’s follow a typical course of events. A tobacco cigarette may very well get you calm. If you just had a fight with your wife and step outside and have a smoke, you will get calm. You might’ve gotten calm anyway even if all you did was step outside and stop fighting, but I’ll grant that a smoke might speed the process along. Here’s the thing, though. About three hours later, if you don’t have another cigarette, you will be anything but calm. By then, about half of the nicotine you introduced into your system will be gone and you will be jittery, irritable, and even more grouchy than you were when you and your wife were fighting.

This phenomenon is caused by that pendulum effect. It’s called withdrawal. It’s a backlash, your body attempting to find its equilibrium after it was thrown off balance. You’ll be wanting another cigarette, so that you can get calm. You might be sold on the idea that cigarettes make you calm. “I need to smoke,” you might say, “for my anxiety.”

The funny thing is, your anxiety was caused by cigarettes in the first place; caused by that pendulum the cigarette set into motion.

This phenomenon is not unusual. It arises when you use any drug that gives you an immediate effect and withdraws over the course of a few minutes or hours. About half the cocaine you use is gone from your body in an hour. That’s why the crash from a cocaine high is so severe. It can last days. Marijuana, on the other hand, takes a long time to leave the system, so that the withdrawal is not as pronounced.

We don’t see this pendulum effect so much when people first start using a drug. They usually start with lower dosages and stop an episode of use before consuming so much. A teenage boy, for instance, might get a fine buzz after a single can of beer and he may have little reason to drink any more. As he becomes a more experienced drinker and develops a tolerance for alcohol, he needs more and more beer, or will switch to stronger forms of alcohol, to achieve the same effect. That’s when he will begin to experience hangovers, the alcoholic’s version of withdrawal.

This is the way that we begin to believe the lie that a drug’s effect is confined to the initial high and doesn’t have anything to do with the subsequent withdrawal. It is the lie that drives addiction and convinces people that they can never stop.

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