Question: In 1996 I entered an alcohol detox facility. Not a drink since, A week or so later I went back to the psych asking for something to help me relax, Rx no help. Asked again and he said what I really wanted was like booze in a pill (benzos). Went to new shrink and within 1 minute he dis RX for Ativan 1mg. Then 2ng. Now several psychs and many years later I'm on 40 mg valium and 10mg ambien. I need to quit but do not want to talk to current shrink. Not sure why. Am afraid he will be too aggressive or maybe I am not committed. Want to be school teacher and cannot nap as required. Have studied Ashton technique and want to try that. How does ambian fit in that? Obviously need help and should talk to shrink, but very skeptical. Went to one shrink who insisted on his schedule and he scared me off. Way to aggressive. Need help.

Dr. Mark Abrahams Says...:

Dear MikeL24:

Your predicament IS serious and it is one that requires medical intervention especially given the amount of Benzodiazepines that you have become habituated to. Withdrawal treatment of significant daily intake, plus its accumulation in the fatty organs over such a long period of time is NOT something that an individual should attempt without careful monitoring and the availability of a physician familiar with Benzo withdrawal. A competent and ethical physician would not advise you to proceed with the Ashton Technique on your own. 

By now you are probably aware of potentially life-threatening symptoms that can occur from Benzodiazepine withdrawal withdrawal. If you are not familiar with BenzoBuddies, this is an on-line community which can provide support and information to help you take the necessary steps to get free from Benzodiazepine addiction. This site is NOT a substitute for sound medical advice. http://www.benzobuddies.org . You may well require a stay at a detox facility where the attending psychiatrists are sympathetic to your situation and not contributing to it!

Once an individual has finally become detoxified from Benzodiazepines, there are a number of OTC supplements that can facilitate relaxation (e.g., certain isolated amino acids, herbals, and nootropics), but these cannot work as long as one's nervous system is monopolized by benzodiazepine drugs and the consequential neurotransmitter imbalances that characterize the condition.

Best regards,                                                                                                                                                   Dr. Mark Abrahams

Question: How do I handle my boyfriends relapse if/when that occurs? I am moving back in with him soon. He went to a 28 day in patient addiction program for alcoholism which he completed and was supposed to start outpatient treatment as soon as he got out. He did not. He has been out of treatment for almost 6 weeks now and has only went to one AA meeting. He lost his job due to his alcoholism just before going in to treatment. He lost his company truck several months before that. The truck he owns is not drivable and needs $2500 worth of fixing to run. He has a vehicle that he uses to get around occasionally but isn’t very safe to drive because the brakes aren’t good. I’ve given him a lot of money and I’m trying to free myself from codependency and enabling. He does not do anything during the day and hasn’t changed any habits that were there before. He sleeps a lot and is currently living with his parents, living off his VA benefit but the majority of that goes to his child support (he pays $1300/month for child support and gets $1500/month of a va benefit) I’ve asked him to sign us up for couples counseling several times, He acts as though it is my fault that we argue all the time but I’ve worked very hard on myself to create healthy boundaries in our relationship and he has denied every one of them. He forgot my birthday, he’s still very selfish, I’ve given so much of myself mentally,physically, financially, and emotionally and I am NOT READY TO GIVE UP BECAUSE OF THAT. Please help me!

Jim LaPierre Says...:

Hope,

My heart goes out to you

You feel that having invested so much in this relationship,

you can't just walk away and have so little return on your investment.

I'm sorry - whether he is drinking or not,

he is an insensitive and selfish man.

It's incredible that he got sober - I hope he stays that way,

but he is showing you loud and clear that he has no intention of making changes.

Please be completely honest with yourself - you've been trying for a long time now

not to know what you know.

It's time to move on and take care of you.

Question: Hi Jim. My name is Melissa and I have been almost 120 days sober from 12 years of high dose morphine use. But my mind is not normal and I am not feeling like I thought I would,,,i know its PAWS but I don't know how to make it stop. I literally feel insane... But I have done the whole thing by myself because I have no insurance, so I am dealing with this alone to and that is why I'm reaching out for answers. Thank you for your time

Jim LaPierre Says...:

Hi Melissa, Thank you for reaching out and connecting! First and foremost, congratulations! What you're doing is heroic and healthy. Post Acute Withddrawal (PAW) can last up to the first year of being clean and sober. Your body, mind and spirit continue to experience healing and a high degree of change. The key to managing PAW and the first year cliean in general is to have tons of support. When we go through things alone it's just not manageable.

Your body continues to detox. The first 30 days are the worst but the process continues. This is why nutrition, hydration, and exercise are so important. I remind folks that everything they tried to numb when they were using is going to resurface. Dealing with emotions is uaually the tougheest part. My briothers and sisters in the hals of Narcotics Anonymous are brilliant in their ability to teach ways of coping.

I highly recomend journaling - get everything that's on the hamster wheel in your head out in the open - things are more manageable and mre subject to change that way.

People often fear that they have done brain damage from their use. This is rarely the case. I would predict you'll be feeling better, but I urge you to keep investing in yourself. My bias is that the best investment we can make in recovery is to have fellowship and people who will hold us accountable for our goals.

It will get better. Keep going! If I can answer other questions, contact me anytime!

Best,

Jim

Question: I am on my way off taking Methadone and Oxycodone for good, and seriously it has been a long time coming and I am actually thrilled about it all ending! My question is that they want me to start taking Suboxone 8/2 mg twice a day! I already mentioned that I really didn't need/want that high of dose.. But there the Doctor's.. Also I mentioned wanting Zuzolv? Is there any major difference between the two that would affect me different than Suboxone? Also, I have noticed a lot of Psychiatrist's prescribe Adderall after the Taper off of Suboxone? Mostly because of the quick taper, and stop of taking the Suboxone, there is a big lack of normal energy, focus, concentration and still the ADHD type Jitter's. These people now say that it was the best thing for them, they are back to there old selves and definitely most important thing is that they don't want to take anything else ever again! Do you think this can be a good way to End all of the long Opiate Addiction? They are so happy with their lives now, good jobs, able to think right and have happy relationships and lives now!! Also im 33, when I took the ADD, ADHD test in school, it was suggested that I can get help with the ADD, ADHD, but at time it was not a big problem, like how they treat now.. So my parents thought for me to tough it out, more or less....

Joseph Novak Says...:

Let me start by letting you know that I am not a medical professional; my experience comes from being an interventionist and recovery coach.  I applaud you for taking the first steps to be free from substance abuse.  I am not an advocate for long term use of Suboxone.  I believe that many times people end up substituting one drug for another instead of having total abstinence.  I have not heard of Psychiatrists prescribing Adderal for "energy, focus, and concentration."  Again, now another medication is being introduced, but I question if it's really needed.  I advocate for some recovery program, 12-Step, Smart Recovery, Celebrate Recovery to help with long-term recovery.  Whatever program you choose to attend, work the program.  I hear the old saying "Meeting Makers Make It" but it's more than just attending the support group meetings.  If the program requires work (12 Step) then work the steps.  I have helped many clients live a healthy and happy life without using any mind altering substances.  

Question: SORRY FOR DELAY... I am on my way off taking Methadone and Oxycodone for good, and seriously it has been a long time coming and I am actually thrilled about it all ending! My question is that they want me to start taking Suboxone 8/2 mg twice a day! I already mentioned that I really didn't need/want that high of dose.. But there the Doctor's.. Also I mentioned wanting Zuzolv? Is there any major difference between the two that would affect me different than Suboxone? Also, I have noticed a lot of Psychiatrist's prescribe Adderall after the Taper off of Suboxone? Mostly because of the quick taper, and stop of taking the Suboxone, there is a big lack of normal energy, focus, concentration and still the ADHD type Jitter's. These people now say that it was the best thing for them, they are back to there old selves and definitely most important thing is that they don't want to take anything else ever again! Do you think this can be a good way to End all of the long Opiate Addiction? They are so happy with their lives now, good jobs, able to think right and have happy relationships and lives now!! Also im 33, when I took the ADD, ADHD test in school, it was suggested that I can get help with the ADD, ADHD, but at time it was not a big problem, like how they treat now.. So my parents thought for me to tough it out, more or less....

Joseph Novak Says...:

Let me start by letting you know that I am not a medical professional; my experience comes from being an interventionist and recovery coach.  I applaud you for taking the first steps to be free from substance abuse.  I am not an advocate for long term use of Suboxone.  I believe that many times people end up substituting one drug for another instead of having total abstinence.  I have not heard of Psychiatrists prescribing Adderal for "energy, focus, and concentration."  Again, now another medication is being introduced, but I question if it's really needed.  I advocate for some recovery program, 12-Step, Smart Recovery, Celebrate Recovery to help with long-term recovery.  Whatever program you choose to attend, work the program.  I hear the old saying "Meeting Makers Make It" but it's more than just attending the support group meetings.  If the program requires work (12 Step) then work the steps.  I have helped many clients live a healthy and happy life without using any mind altering substances.  

Question: Hi Jim, I wanted to ask you for your advice on how best to support my girlfriend who is in recovery. We met almost five years ago, she was 35 and I was 45. At that time she was living in an SLE, and I was divorced with my pre teen living with me. I didn't really understand the depth and history of her drinking problems the first year we knew each other. She was mostly sober and we developed a wonderful love for each other. Even through the years of ups and downs in our relationship, I do believe to this day, we both feel each other is a soulmate. Which brings me to today, and her recent release from a 30 day program she voluntarily entered with my help. When she was admitted only her mother and myself were authorized to call and check on her. We wrote letters to each other during the blackout. The first couple from her explained how her detox went, how she was feeling, how she was doing etcetera, and she let me know that I was no longer allowed to call only her mother could. The rationale was so that she could focus on her treatment, and I let her know I understood. The last letter I received she says that she felt it would be best for her to not be in a relationship anymore. You can imagine how difficult it is for me to reconcile that. I do understand that most recovery centers advise their clients do not enter into a relationship for one year. My problem is that we were already in a relationship. I am and have been her closest ally during her drinking episodes. And I want to be there for her during her recovery. I am diligently reading about the 12 step program, refuge recovery, meditation mindfulness and other modalities. We are meant to celebrate our 5th anniversary in a couple days. I want to do the right thing by her. I love her more and respect her courage, and I need some advice on how to approach her and support her. I don't want to drift apart, and lose all that we have worked so hard for together. - Adder

Jim LaPierre Says...:

Hi Adder, Thank you for connecting with me and for bringing such a painful situation to light. By doing so, you open door for countless others who struggle similarly. I hear the heartbreak in your words. More than that I see the powerlessness you're confronted with. As you expressed, "The last letter I received she says that she felt it would be best for her to not be in a relationship anymore."

I would encourage you ti state very simply what it is that you want and to express your earnest desire to support her in the way that she feels would work best for her. Sometimes people push us away just to see if we come back.

Ok, your hope spiked as you read that last line. What I urge you to do is to express your views and desires very simply and directly but to do so (this is the hard part) without expectation.

The suggestion we give folks is not only no new relationships but also no relational changes in the first year. Now, if she hs decided that her sobriety and/or her life are better without you, there is nothing for you to do except wait - it is possible that she will change her mind in the future.

I urge you to seek support for yourself. Powerlessness is painful sometimes and you deserve to focus on yourself and not simply on her. Turn your energies toward what you can do and away from what you cannot. The rest is waiting. If you choose to wait that's fine - but go invest in yourself during the interim. Everything else is a lousy option

Question: My daughters husband has just started a veterans court treatment program. So far things are looking up for him, but this is a 15 to 18 month program, and he just started a month ago. I feel that she still is being somewhat codependent on his needs which she somewhat agrees with me on. She also attends Al anon. She blames all of his problems (financial abuse of not paying any household bills - the biggest issue and a lot of selfishness) completely on the alcoholism. His father really took advantage of people and he was not an alcoholic. Could the alcoholism be completely to blame or do you think she just has blinders on?

Jim LaPierre Says...:

Hi there and thank you for your question. My first thought is, "Well, of course he is still codependent, it's only been a month." I am a huge fan of Veteran's courts, family drug courts, and other alternative sentencing and recovery programs. Given that he is a veteran, I am wondering if his experiences in the military are also impacting his behavior That seems likely to me. It sounds like your daughter is attending to her own needs and I urge you to simply support her and her family as this is indeed a long process and there are likely many changes yet to come. I generally see milestones/improvements in 3 month increments after a person attains sobriety and I urge utilizing AA and NA to meet the needs that have only just begun to surface. Good luck and blessed be!

Question: I don't know how to talk to my mom about going to rehab. We are not living in the same state and no one else in our family talks to her. She is homeless. Recently things have taken a turn for the worse, she has addiction and mental health issues. She is really paranoid when talking on the phone and she is very moody, I feel that if I mention rehab over the phone she will just get upset and most likely hang up on me. I want to fly out there and discuss it in person, but am not sure if that is the right way to handle it either. I'm so lost I dont know what to do I am so afraid of losing her, but if she doesnt get help I dont see her living much longer. Any advice will help. Thank you

James Cloughley Says...:

Thanks for reaching out to us--you have started off making a good decision. It is difficult to think straight and be real when you live in a vacuum. Without knowing a great deal more about what's happening for you it is difficult to be specific with any feedback. Having said that we can talk generally about options, approaches and next steps.

If you have decided to attend a rehab program that tells me that things have gotten pretty serious for you. Are you mandated to attend or is this a free will decision? I'll assume its a free will decision if that's OK. My suggestion would be to not tell your mom specifically what you are planning to do. And again not understanding how you communicate with her makes it a bit more difficult to develop any kind of plan to help her. Does she know you have challenges of your own around using? Again I'll assume she does. If she is as ill as you have stated she is--mental health issues, paranoia, mood swings and the addiction problem she most likely will not understand what you are telling her anyway regarding your decision to enter re-hab. Right now I would guess if she is relatively cognizant of her own being she is feeling isolated, alone, disconnected and the more she uses the more this is reinforced in her. It's likely that the drugs? or alcohol? or prescription meds? she is into are contributing to her paranoia and other related mental health issues and you are not going to be able to stop that from happening whether you see her or not. I'm not sure flying out to see her in person is right for either of you at this moment but that is a decision that is up to you-I'm not aware of the relationship you have with her. I believe establishing a 'contract' with her to speak by phone on a regular basis is the best way to go right now but that might depend on how delusional or paranoid she is. She may not be able to do this but it might be your best shot. The immediate goal is to try to establish a connection with her and help her understand that you care about her and tell her that you love her and that she is important to you. She needs to have this reinforced as often as you can--she needs to have some sense of value/worth to someone and it sounds as though you're the one she has chosen to be most important to her.

What you could say to her is something along this line: that you are looking at getting some help with your problem (don't mention re-hab) because you have decided that you would like to try another life style--that you have had enough of the one you are currently involved in and you would like to know what she thinks about that. You could ask her how she is doing but keep it general. I wouldn't mention her addiction issues at the moment---make this about you and not her. The hope is that by telling her this you may plant a seed for her as well. It sounds as though she will need some help with her mental health issues first before beginning to attempt to try and deal with the addiction and for that she will need to get some psych support of some kind. You need to understand that this is going to take some time to shake out but the sooner you begin the better are her chances. The more you help yourself and the more she hears that you are doing better the more hope she could generate for herself doing the same. Perhaps she dreams of having a relationship with you but doesn't know how to go about doing that--again not knowing much about the family history I can't suggest anything with certainty.

If you are in 'regular' contact with her can you say or tell when she is at her 'best'--what time of the day? Is she less messed up at night or more at night? If you can determine that then you agree to be in contact with her at the time of the day when she is likely to be at her 'best'. If she doesn't stick to the plan of when you'll next talk together just try to contact her when you can. She may forget about the plan to talk at a certain time or get it mixed up some how. This is going to be quite stressful on you so you need t find or organize some type of help for yourself. Perhaps an O/P counsellor through the referral agency or re-hab you are dealing with. If you are into any of the A's--A/A or N/A or C/A--any of these places could provide you with a relatively safe haven for a couple of hours when you need it or until you get into the treatment program you are considering. If you don't look after yourself you will not be much help to your mother.

I understand that you feel lost--who wouldn't feel that way with what you are dealing with. Also try to understand that there is only so much you can do to help her until she decides that she wants that help. In any event if you don't commit to a plan to get cleaned up you will be of little help to her regardless of what she decides. Not to put any pressure on you. You just need to be sure that this is what you want to do because once you start a process with your mom she is going to need you to be clean and sober to hold the 'light' for her.

I'd appreciate it if you could get back to me with any comments or thoughts you have about my response. If you feel that you can provide me with more info--great. If you got what you came for--great Just ask to connect with me again and if there is anything that I can do to help you I'd be happy to do that. All the best--Jim

Question: What is the difference between drug abuse and drug addiction?

Jim LaPierre Says...:

Hi there and thanks for your excellent question. Drug abuse is a strange term - people don't abuse drugs - drugs are inanimate objects. We abuse our bodies and minds with drugs. When we continue to abuse them we run the risk of developing dependence. We experience negative consequences as we continue to use and this is the hallmark of addiction - no matter the cost to our lives and to those we love, we continue to use. Most of us maintain the illusion that we can continue to abuse addictive substances without becoming addicted. Experimentation is possible but repeated use leads inevitably in this direction

Question: I have a daughter 25 who is 30 weeks pregnant and addicted to heroine, she is currently in jail for theft and missed her court appointments...Im working with an interventionalist who is also trying to find a place for her to go to rehab, nobody will take her because of how far along she is in her pregnancy, she has Medicaid for insurance..please help me

Jim LaPierre Says...:

Thank you for writing to me - my heart goes out to you. The road ahead will be very hard for all concerned. Not knowing the geographical location you're in my best guidance is to contact local hospitals and your interventionist should be more than capable of locating resources (I expect they are very few).

My prediction would be that change will occur when your daughter gives birth. As heart breaking as this is, the systems that have failed to help her to this point will become involved when she becomes a mom. My prayer for you and yours is that this life changing event results in treatment and change. Please take all th serenity you can in knowing that you are doing everything you can. Blessed be, Jim