In 2016, the federal government spent almost 30 billion dollars on drug control efforts.  Increasing demands are made on pharmacies to ensure that federally controlled prescription drugs are properly dispensed and properly managed.  Medical doctors, too, are under increasing pressure to limit the amount of prescription pain medication that they prescribe to the patients.  The Office of National Drug Control Policy is charged with monitoring and organizing our federal drug control policies.

Despite all of this, the number of people who die from prescription drug overdose continues to rise.  Prescriptions for pain medications increase yearly.  If anything, the government’s attempts to control prescription pain medications have only increased the illegal market for these drugs.  Further, people who do not have access to legal pain medication often turn to illegal substances in order to deal with their pain.  Cannabinoids are being tested as a less-addictive way to deal with pain and some states have legalized the use of marijuana for medical reasons.  ‘Medical marijuana’, as it is called, appears to offer a non-addictive solution to people in chronic pain, but the federal government has largely stood by and allowed this to continue.

Some place the blame on the fact that the government’s efforts too often treat drug abuse as an interdiction problem rather than as a public health problem.  That is, more money is spent on drug control when treatment may be what is needed.  As most people know, the Affordable Care Act (ACA), better known as Obamacare, encourages insurers to provide coverage for mental health treatment, including addiction treatment.  That is probably a step in the right direction, but it increasingly seems that the ACA is not working as many hoped it would.  Especially in rural areas, consumers have no access to ACA-approved coverage.

Federal efforts to control prescription pain medication have largely failed, as have efforts to prevent the importation of drugs that remain illegal in the United States, such as cocaine.  The ACA is, at best, struggling in its effort to give all citizens covered access to addiction treatment.  Some states have stepped up to allow citizens to use marijuana, but without any guidance from the federal government.  In the meantime, both those suffering from chronic pain and those seeking treatment for drug addiction are mostly left to do the best they can with what is available.

This is, without doubt, a serious public health problem and efforts so far to address have made insufficient progress.

The Washington Post investigated this issue.  Their reporting can be found at this link:  https://www.washingtonpost.com/news/wonk/wp/2015/12/09/the-federal-drug-war-is-failing-on-multiple-fronts-government-watchdog-says/?utm_term=.7ad263801fb0

Having already looked at the relationship between the recovery addict and their family and friends from the point of view of the addict, it’s time to speak to the family and friends of the addict.

For somebody who has never been a victim of substance abuse and addiction, it can be very difficult to understand the addict and their behavior.  It is not uncommon to hear such questions as: “Why don’t they just quit?” or “Don’t they care about anything aside from drugs?”  Questions such as these are reasonable for family and friends of the addict to ask.  Since they’ve never experienced addiction, they don’t have any way to truly grasp the power of addiction.

It can be helpful to provide information regarding how drugs impact the brain and change how it functions.  Understanding the way that the pleasure pathway of the brain and what addictive drugs do to it may give the loved ones of the recovering addict a dim sense of what the addict is going thru.  Information regarding the pain and discomfort that comes with terminating use of a drug may help to give them a hint of why the victim of addiction keeps going back to drug use.

It is vitally important that the family and friends of the addict not be judgmental about the victim of addiction.  It is one thing to recognize the destructive power of drugs of addiction, but it is something very different to condemn the addict.  The problem here is that we tend to judge others according to our own experiences.  It has been said, however, that we should not condemn another for falling in battle to an enemy we have never met.  In other words, we don’t know what we would have done in their shoes.  We don’t know what kind of suffering they were dealing with or what led them to use drugs in the first place.  There are all kinds of reasons why people choose to use addictive drugs.  For some, they were initially taken to help manage chronic pain and then became an addiction.  For others, mental or emotional pain was self-treated by the use of drugs.  Addictive drugs have also been used by people who suffer from social anxiety in order to help them manage social situations.  Again, you don’t truly know what you would have done if you were faced by the same problems.

As they enter into recovery, what the victim of addiction needs is support and encouragement, not condemnation.

 

Shame is one of the most painful parts of addiction.  In our best moments, we  look back and see how much harm we have caused to those we love.  We see the wreckage that our behavior has left in our wake.  We recall the lies we have told; the thefts we have committed; and the hearts we have broken.  For a person entering into recovery, this shame can be a terrible burden.  We worry about having to deal with those we have harmed in one way or another.  We are ashamed of how much others have suffered because they love us and care for us.  The more we remember the harm we have caused, the more we can feel ashamed of ourselves.

It is very important to realize that this shame will make recovery that much harder.  Remember that one of the benefits of getting high is that you don’t have to deal with painful stuff.  Indeed, many addicts began using because they were already suffering from mental or emotional pain.  As this new pain of shame begins to grow, our natural impulse will be what our response to pain has been in the past:  getting high.  We may know intellectually that getting high again will only create more problems, but drug use is the habitual way we have learned to handle life’s challenges.  “What worked before,” we think, “will work again.”  The more that shame finds a place in our lives, the more likely it is that we will not be able to sustain recovery.

The path to recovery does not lie in the past.  Pondering the sorrow of the past does not bring healing.  Wallowing in our failures will not solve our current problems.  It has been said that yesterday is past; tomorrow hasn’t arrived yet, so all we have is today.  It’s true.  We can’t change the past, but we can make decisions today that may help us have a better tomorrow.

This does not mean that we get to simply ignore the past.  We must be accountable for what we have done and seek to make amends.  We must recognize the harm we have caused.  It is the feeling of shame that is the problem.  In a way, shame is just another name for self-hatred.  Hating yourself won’t make you a better person.  Admit your failures, but don’t dwell on them or they may very well lead you back into drug abuse.

 

One of the problems faced by victims of addiction as they strive towards recovery is the response of family and friends.  In the case of friends or family members who also use addictive drugs, this may mean terminating or limiting your relationship with those persons.  It’s much harder to maintain a clean and sober lifestyle if you’re spending time with people who are still using.  Sometimes, it’s necessary to change your phone number or erase all of your contacts to make it more difficult to connect with other people that you previously used with or purchased drugs from.

Most victims of addiction have friends and family members who are not involved with drugs, and this is much harder to deal with than limiting or eliminating contact with other users.  Your family and friends who are living clean and sober lives and who do not have a history of drug use will often be unsure whether they can trust your commitment to recovery.  It may be that over the years you have lied again and again about your addictive behavior.  How many times have you sworn and promised that you’re not using when, in fact, you truly are?  It may be that you have borrowed money by claiming you need something only to use that money to buy drugs.  Perhaps you have stolen from friends or family members in order to get money to buy drugs.  Whatever the case, you have broken their trust a few times, or even many times.  Now, they’re perhaps unwilling to trust you at all.

This can be a very painful part of your recovery.  The very people to whom you are looking for support as you enter recovery have pulled away and do not want to trust you only to get used again.  You may begin to feel resentment about this, saying to yourself: “Just when I need them most, they won’t have anything to do with me.  Don’t they want me to recover?  Are they ever going to trust me again?”  It’s important to avoid this resentment.  If the people who love you are afraid to trust you, it’s nobody’s fault but your own.  You’ve broken their trust many times.  How do you expect them to suddenly start believing you again.  If you’ve lied to them many times, you may have to be honest and open with them twice as many times.  Your poor decisions have caused the problem.  You must begin to make good decisions to solve the problem.

 

OK, so you’ve entered into some kind of recovery program.  It could be a treatment center; a therapeutic relationship; or a self-help group.  You’re setting out on the road to recovery.  A previous post addressed the issue of shame and guilt, of being bound up in past mistakes and failures.  The question now is where you go from here.  How do you continue your progress towards a life free of addictive drugs?

First, it is necessary that you engage in concrete efforts to change how you manage your life.  Previously, drugs were probably a kind of crutch that you used to be able to handle — or avoid — the challenges of your life.  Saying, for example, that you intend to participate in a few self-help group meetings every week sounds good.  But, what’s a few?  Something more like one meeting every day or meetings on Monday, Wednesday and Friday is much more concrete.  It gives you a simple way to hold yourself accountable or have somebody else help you stay accountable.

Equally important is learning skills to help you manage life without using addictive drugs.  If you got drunk only or initially in order to handle social situations, for example, then you need to learn skills to handle social situations without drinking.

It may also be necessary for you to get treatment for mental or emotional issues that may have led you to abuse drugs.  If, for example, you suffered from depression and used drugs to feel better, then you’re going to need to get treatment for your depression.  If you were depressed before you began to use drugs, then that depression is going to show up again when you quit using drugs.

What is needed is working to prepare yourself to manage your life without the crutch of drugs.  Whatever it was that initially led you to the abuse of drugs must be addressed so that you are ready to move forward.  In other words, as important as it is to cease using drugs, it is even more important that you are ready to set out on a new path in your life.  Treatment for mental or emotional pain; skills for managing your life; and building a support network are all part of moving forward.  Your old ways of living and managing your life are over and done with.  Now it’s time to step forward into a new life.  Get ready for a whole new adventure.