Question: I don’t have a drinking problem but I have had meth and cocaine issues in the past. These days whenever I have even a half a beer I get the cocaine itch and 2 or 3 times out of ten if I have a few beers it will end up in a cocaine binge. I don’t want to quit drinking in fact I am a restauranteur so with wine and spirits on my menu it is almost impossible for me to not drink at all. I am just getting too old to be doing this to my body. I don’t even like cocaine that much anymore that is the sad thing – I just need it. I won’t drink with people I use cocaine with. I think that helps a bit. Is there anything else I can do to separate?

Jennifer Hamilton Says...:

Even though alcohol is not the substance your brain prefers, it does activate the brain reward pathway. This pathway by passes the prefontal cortex, or "judgement" center of your brain. In other words, your brain goes on a sort of auto-pilot, not bothering to consult you about what it wants to do. Another much easier way of saying it is that alcohol is a "trigger" for you. Like any "trigger", we can deny permission to the brain to have what it wants, but it gets harder and harder as the alcohol also affects your judgement. You may know something is a bad idea, have few drinks, and it seems like a great idea. For some people this trigger happens with as few as one drink. If you are not willing to abstain from alcohol, you could experiment with how many you can have without being triggered. You also need an "emergency plan" for when you do want to use cocaine, perhaps a friend you call, like a sponsor of sorts. It is your life and you can live it the way you choose, just be willing to deal with the consequences of your choices on your body. One more thing, if your line of work makes it more likely that you want to drink because you are around it, perhaps that is a sign alcohol holds a greater importance to you than you realize, even if it is "just" psychological dependence. Thanks for the interesting question.

Question: Hi Jennifer, I'm not sure if this message came through, but I wanted to let you know that "Daddy's Disease" is available on ebook and "Mommy's Disease" will be published by the end of the month. Both are available on amazon.com. My webisite is www.alcoholismhurtskids.com. Thank you so much for getting back to me and for your support in getting this information out! best, carolyn hannan bell, lpc

Jennifer Hamilton Says...:

I posted the link to your book on Amazon on my Facebook account. I have a large network of therapists on there so that will help spread the word. I will also recommend it to the therapists that I supervise through email as they are all children's therapists. In addition, I will let my co-workers know. I hope this helps to spread the word. Have you considered contacting men's recovery centers and making them a deal to buy mass quantities for their children when they return home? Is it meant only for the therapist to use or can parent's use it too? It would be therapeutic for the men as well to see what little Tommy is going through. It could be used as part of their therapy and then purchased as a part of their program to use at home or take the child to a therapist and use when they go home. Just a thought. Prison substance abuse program's could really benefit and there may be funds for purchase. Just another thought. Thank you for writing it. I will buy a copy for my kindle and perhaps a hard copy as well.

Question: Which is more effective, being court ordered to substance abuse treatment or voluntary?

Jennifer Hamilton Says...:

I am assuming you are asking for my opinion here rather than a review of the literature on the subject. I have seen both work. Many people enter "voluntarily" for reasons that are not all that "voluntary". For example, a spouse says "stop using, get help or we are finished", an employer tests for drugs and refers the person for an evaluation and help or the person gets a charge and before they go to court, they go to treatment because their attorney tells them "it will look good to the judge".

Motivation to change is a complex issue. Some people will change when they hit what some term a "high-bottom", in other words, they have not lost everything or maybe not anything yet, but for them, something happens that opens their eyes. Others can lose literally everything and still not have the motivation to change.

Once a person enters treatment, the most important factor isn't whether or not they were admitted voluntarily, but rather, the relationship that develops between the treatment provider and the person in treatment. The ability to be non-judgmental, empathetic, warm and use reflective listening is shown to help a person change and remain changed more so than confrontation or coercion within the treatment setting (vs. getting someone there). I hope this helps!

Question: I am addicted to cocaine but I am ready to quit for real this time but I also know that I cannot quit on my own without help. Does drug rehab work better than getting myself into an outpatient program? I am worried that if I stay at home I won’t be able to resist the temptations from all the people around me who still like to party.

Jennifer Hamilton Says...:

I strongly suspect you would meet the criteria for inpatient treatment.  There is great help in getting away from easy access to your drug of abuse, everything that is a cue and triggers a craving in you and the people you use with for as long as possible.  It gives the brain time to get used to not having it all the time.  If you don't do inpatient (many of my clients have detoxed in jail) it is very hard to resist the urge to use early on in recovery.  The longer it has been and the more you learn to shape new behaviors, the easier it is. It may be worse for you to feel you "tried and failed" at outpatient.  If you are trying to use commercial insurance to get inpatient treatment, many times you have to "fail" at outpatient treatment (go for a while and continue to use) in order to qualify for inpatient.  There are plenty of places to get help that do not require this, however, if you meet their criteria for admission.  Hope this helps.