Know you have a problem but not sure how serious it is or if you need treatment? Take this 1 minute addiction severity self test and learn how your level of addiction ranks.

How serious is your problem? How does your level of dependence (addiction) compare to other drug and alcohol users?

If you know you've got a problem but aren't yet sure what to do about it (AA/NA, outpatient treatment, drug rehab...) it may be helpful to take this quick addiction severity test that will provide you with a rating score which describes your level of dependence.

This test, called the Severity of Dependence Scale¹, is a reliable and valid test for a number of different types of substance addictions, such as opiates, marijuana, cocaine, benzodiazepam, amphetamines and alcohol.

So take a quick minute to answer the following 5 questions honestly and learn how your addiction ranks, and then use this information to make a smart decision about the best way forward:

The Severity of Dependence Scale

Over the previous 3 months:

1. Did you ever feel that your use of drugs or alcohol was out of control?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

2. Did the idea of not getting to drink or use drugs ever make you feel very anxious or nervous?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

3. Did you worry about your use of alcohol or drugs?

• Never or almost never - 0 points
• Sometimes - 1 point 
• Often - 2 points
• Always or nearly always - 3 points

4. Did you wish you could stop?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

5. How difficult would it be for you to go without using or drinking?

• Not difficult - 0 points
• Quite difficult - 1 point
• Very difficult - 2 points
• Impossible - 3 points

Scoring

• 0-3 = Negligible dependence
• 4-6 = Mild dependence
• 7-9 = Moderate dependence
• 10-12 = Substantial dependence
• 13-15 = Severe dependence

The higher your score, the more likely you'd benefit from addiction treatment. 

So What Level of Care Is Right for You?

Does your score on the Addiction Severity Test indicate a need for addiction treatment?

And more importantly, are you ready to make a real change?

Once you decide that you're ready to get addiction treatment you then have to decide what level of care best meets your needs and circumstances.

Ideally, you enlist a qualified medical or mental health professional experienced in substance abuse assessments to help you pick a level of care, but you have final say over what you get and where you get it and it's helpful for you to understand some of the factors that might indicate a need for more intensive residential treatment.

Residential or Outpatient?²

In general, it's a good idea to try less intensive and intrusive treatment options before committing to residential treatment, but in some cases, residential care is the best option even on a first attempt at treatment.

Residential treatment may be appropriate for you if you:

• have made previous attempts at sobriety with outpatient treatment without success
• have a co-occurring mental illness
• are physically dependent and require medical detoxification
• do not have a sober or stable home environment
• do not believe you can resist temptation while still in your home environment

Image Copyright: Beni Ishaque Luthor

Overcoming ambivalence: How does the ‘ideal you’ compare with the ‘current you’? Not sure? Well, take a few minutes to complete the following exercise and find out how far you’ve strayed from the life you’d love to have. If your lifestyle strays too far from your goals and values, you may want to consider serious action to get back on track.

Do I really need treatment? Do I need treatment right now? Maybe I can do this on my own. I like some parts of my life and I don’t want to give up all the fun…Things aren’t going very well for me though…Maybe I do need treatment!...Treatment is so expensive though, and it’s embarrassing…Maybe I can do it on my own…

Most people go through a lot of back and forth thinking before deciding to get (or forget about) addiction treatment.

And this makes a lot of sense - it’s a big, expensive, disrupting, life-changing decision, after all.

So you should take some time to think about it, to make sure it’s what you really want and that you’re ready to get it.

But what do you do after you’ve thought about it every which way from Sunday and you’re still no closer to a decision!??!!

That’s when you pull a few tricks out of the bag, like this values exercise, that help you structure your thoughts, organize your priorities – and ultimately make a decision that’s really in your best interest.

So if you’re on the fence and can’t make up your mind, take a few minutes to complete the following exercise and you might just find the answer you’ve been searching for.

Values Clarification Exercise (Living a Conscious Life)

We want to move toward our goals and live according to our values.      

Instead, we often just drift along, letting life circumstances and convenience dictate our actions.

And sometimes we even forget to think about what we really want out of life

You have a better chance of living the life you want if:

1. You identify specific goals and values
2. You make life decisions that match your values and move you toward your goals

This is an exercise that will help you to identify your ideal goals and values, so you can make better decisions and live a more conscious life. After you complete this exercise you may gain a better sense about whether or not getting addiction treatment makes sense right now.

Identifying Your Values and Goals

The idea is to figure out how the ‘ideal you’ would behave in different situations, compare the ideal you to the 'current you' – and then see if you need/want to take some action to move yourself closer to the person you’d love to be.

For this exercise:

1. Imagine that anything is possible. Do not let ‘reality’ intrude too much. For example, even if you think you have no chance of reconciling with your father, if that’s a goal you’d like to achieve (were anything possible) then write it down.
2. You don’t need to show this list to anyone, so make sure to write down what YOU WANT, not what someone else (or society) would consider appropriate. There are no right or wrong answers, there is only you and your inner drives and values.

The 9 Domains

Grab a piece of paper and write out value and goal statements for the following 9 domains of life.

1. Romantic Relationships

What type of romantic relationship would you like to have? In an ideal world, what is your relationship like? How does the ideal you behave in a relationship? List some specific examples of what you’d do in a relationship if you were always your best self.

2. Family Relationships

What kind of relationship would you like to have with loved ones (siblings, parents etc.) Imagining these relationships, what adjectives would you use to describe them (for example, supportive, loving etc.) Give specific examples of how the perfect you would treat other family members.

3. Friendships

How would the ideal you treat your friends? What are some things that you would do to create/sustain great friendships? What would a perfect friendship look like to you?

4. Career

In an ideal world, what type of work would you like to do? How would the ideal you treat co-workers and employers?

5. Education/Personal Development

If you could get any type of education or training, what would you get and why do you want it?

6. Free Time

How would the ideal you spend free time? What hobbies would you have and what activities would you take part in?

7. Spirituality

Is spirituality important to you? If it is, what does you ideal spiritual relationship look like? What adjectives would you use to describe the ideal spiritual relationship (spirituality does not have to mean organized religion. It can mean whatever you want it to).

8. Community Involvement

How would the ideal you make your community a better place? Is it important that you volunteer or serve others in some way? (Again, this is all about you and your values; do not feel compelled to write what you don’t feel – so for example, if service isn’t important to you, then leave this blank.)

9. Health

How would the ideal you take care of physical health? Write down specific habits that you believe are important to maintaining good health.

How Does the Ideal You Compare to the Current You?

After completing the exercise you should spot at least a few areas where your current habits diverge from what you’d consider ideal behaviors.

To improve your life, you may want to consider what you could do, specifically, to move closer to your ideal self.

The Funeral / Eulogy Exercise

This can be a bit distressing, but it’s an exercise that illustrates the benefits of living within your values and the consequences of living beyond them...

So unfortunately, you are going to die some day (as we all will). Hopefully you’ll have a long and healthy life, but for the purpose of this exercise, let’s imagine that you’re going to drop dead of a sudden heart attack in 15 years time.

Now imagine your funeral. Think about who would come, and what they’d say about you under the following 2 different scenarios:

1. Think about what people would say about you if you continued living exactly as you are now for the next 15 years, making no substantial changes to drive your behavior to better fit with your values. How many people would come? How many true friends would you have? What successes would you have achieved by then? When people listed the good you had done for others, what would they have to talk about?
2. Now imagine that same funeral, but this time imagine that you had (as if by magic) changed your lifestyle and behaviors so that everything you did matched your values perfectly. Would more people come? Would you have achieved more in life? Would you have done more good for others? Would you have more true friends and loved ones to mourn your passing?

You probably shouldn’t dwell on your mortality, but at the same time, when considering major decisions (like whether or not to get addiction treatment) you should take a moment to consider the big picture and to think about whether any given course of action takes you closer to or farther from a life that’s congruent with your values and desires.

Image Copyright: Boetter

A closer look at the 12 steps of AA, breaking things down and showing you how it can support you to live a clean and sober life.

If you are new to 12 Step programs or are coming back to the program, this two part series takes a closer look at the 12 steps of AA, breaking things down and showing you how, with a little work, it can support you to live a clean and sober life.

Before we get started on looking at the 12 Steps of AA, there are a few things I'd like to touch on, as they could be potential blocks to you doing the work needed, so let's get them out of the way early:

Moving The Road Blocks

1. It is NOT a religious program.

Yes it does mention GOD in 4 places in the steps description. However, GOD can be interpreted as an acronym for Good Orderly Direction. It can also be understood to mean anything we want it to mean within the context of the program.

We do not have to be religious or have any affiliation with a particular religion in order to succeed at working this program. If we do have an affiliation of some kind of faith, good for us, as it becomes a strength that we can use, but it is not necessary in order for us to be successful.

2. We are not broken with a need to be fixed.

We are not sick either. We are not so far gone that we can't help ourselves live more fulfilling lives. It will be and is our choice. Always has been. What we are, however, is human.

We are likely to be...

• hurt
• isolated
• angry
• guilt ridden
• full of shame and
  
• unskilled when it comes to managing our lives and our emotions.
  

We see others doing well and wonder why can't that be us. It can be if we are willing to do the work.

3. We don't get to re-write this program to suit ourselves.

We need to commit ourselves to the program as it is written. That's the only way this works. It was written in 1935 by two men (Dr. Bob Smith and Mr. Bill Wilson) who both had problems with alcohol but somehow understood the benefits of supporting each other when the other wanted to run or hide.

4. We need to understand that alcohol is a drug.

The 12 Steps were developed to help us deal with alcoholism primarily but works just as well for those who suffer from drug addiction. The program can be worked and lived by anyone.

In the end drug and or alcohol use will most likely take us to the same place(s) - those being jails, institutions or funeral homes unless we intervene in that destructive process.

5. This is a plan that becomes a way to live our lives each day.

Some days we will live it better and do a better job of living it than others. We need to understand that as long as we don't pick up a drink or a drug we'll be OK. This is not something you do once and then see yourself as 'cured'. It becomes a lifestyle that you adopt. Most who give this program a chance agree it is much better than the one they left behind.

Lets get started -- real life awaits:

When We Surrender We Win

Step 1

We admitted that we were powerless over alcohol -- that our lives had become unmanageable.

In my mind this first one is the toughest one to deal with. This one requires us to look at ourselves in the mirror and say 'hey man we fought the good fight but we can't beat it.' One of the main tenants of this program is: "when we surrender we win."

Drinking As Others Do

Our problem seems to be that we can't seem to figure out how to drink or use AND live a normal life like everybody else, all at the same time.

We tried:

• using every other day;
• just on the weekends;
  
• stopping at a particular number or
  
• amount or picking a time of the day that keeps us from becoming intoxicated while our kids are still awake.
  

We said that we could quit any time we wanted to. I use to say that I had quit hundreds of times. Proving what? Looking back I was saying that I couldn't stay 'quit' but I could stop for a short period of time. I was powerless beyond that.

Any one can quit -- for a while. The trick is staying quit and that's when we struggle. It cannot hurt you or any of your loved ones if you don't pick it up.

Restoring Sanity

Step 2

Came to believe that a Power greater than ourselves could restore us to sanity.

This means that we need to challenge the idea that we are the most important and intelligent people who have all the answers to all the issues on the planet. This step is about us restoring a sense of sanity to our lives. This isn't about what other people are doing or not doing to help us. This concerns us making poor decisions about how we choose to live our lives.

If we want to stop being overwhelmed with life's issues then we need to stop what we are doing that adds to the confusion. The common denominator in all of this mayhem is our substance use.

If we continue to do the things that drove us to the edge we will continue to experience the same outcomes -- chaos, hurt, disappointment and defeat. Where is the evidence that supports any other explanation? 

Seeing a Higher Power

Regarding the 'a Power greater than ourselves' statement consider these questions:

• When could we stop the sun from shining or the wind from blowing? These are powers greater than we. We can't always see them but we can feel their presence all around us.
• The consciousness of our AA group says that those in attendance are collectively smarter than we are. How can they all be wrong and we be the only one in the room that has it right?

If we look around there are many examples of things that are greater and more powerful than we are. That 26 oz bottle of rye or that case of beer could make us do just about anything no matter how hard we wanted to stop. It also means that we can now recognize there is strength in numbers.

The primary issue here is realizing that, with the help of others, we can regain a sense of control over the choices we make. We do not and often cannot do it all alone.

Making a Committed Decision

Step 3

Made a decision to turn our will and our lives over to the care of God as we understood him.

This step is about being willing to make a decision first and foremost. Just the decision to become willing to look at or consider another approach to changing our lifestyle is immense. Without it, making any kind of move or change in our lives is extremely difficult at best if not impossible.

This could easily mark the first time in a very long time that we made a decision that was in our best interest and we were not under the influence of a drug at the time. This willingness shows a move to allow others to help us re-take some essence of control of our lives from the drugs and alcohol that nearly killed us. We are not sure what a 'power greater than ourselves' looks like but we are beginning to see that there are some things that are bigger than we are - more influential - more powerful. The 2nd and 3rd step allows for the possibility that there are forces in our lives beyond our influence. 

Exploring Our True Selves

Step 4

Made a searching and fearless inventory of ourselves

Now the work becomes more personal. This step is considered by many as the 'turning point' in most recoveries. The first three steps are vital to the success of the rest of the program. If we can understand and feel that there is some hope for a better life out there and if we are willing to take the risk of seeking it out then we become ready to tackle Step 4.

This is where we get to look at ourselves under a microscope of sorts. We begin to see that our approach to managing our lives has flaws in it. We need to take a 'fearless' look at how we have gone about trying to get what we want and ask ourselves how successful we have been to date. The willingness that we have begun to accept in our lives in step three will help us look at what we are doing that isn't working well for us and will help us consider some different approaches.

A Trusted Someone

This is a step that is best done with the help and support of someone we trust in the program -- a sponsor but not a family member.

We have to be willing to hear an 'outsiders' opinion about what we are doing, how we are doing it and the apparent outcomes from our efforts. The idea here is for us to check our behavior and change those behaviors that are not working out with regards to getting us or keeping us more connected to the world we want to be a part of. It is a building step and not a step that is meant to be critical, guilt ridden or demeaning in any way. My sponsor told me to 'keep the good stuff and get rid of the stuff that isn't so good'.

Ownership Of Our Wrongs

Step 5

Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.

Up to now most of the work we have done or needed to do was within ourselves. It was between me and me. Now it's time for us to begin to trust in others and their desire to help us get better. I recognize how difficult this can be for many of us. In the past trust has meant pain, heartache, betrayal, abandonment and isolation.

Now the work that needs to begin is about including those, so called, trusted ones and allow them into our circle of influence. We need to share with these few folks some of those secrets we have been carrying for a long time. But we become concerned that if others really knew certain things about us they may not like us any more or want to share their lives with us.

This step takes a great deal of courage and risk. Always, when sharing who we are with others, we need to weigh the value of complete disclosure with how much they need to know -- to what depth. There is a fine line between honesty and full disclosure. One of the future steps (Step 9) we will cover says that 'we disclose certain things but not if it hurts ourselves or others.'

When we do this step we might want to share our information and our insights of who and what we are with someone connected to the clergy. You may or may not believe in 'God' but we know that ministers are sworn to confidentiality and there can be a great deal of comfort and safety attached to a relationship of this type. In any event we need to feel sure and be sure of the confidants we encourage to be a part of our process with doing Step 5.

Removing Our Character Defects

Step 6

Were entirely ready to have God remove all these defects of character.

It may have taken us a long time to get here -- to arrive at this place where we are feeling as though we may just be able to do this. We need to be reminded that working through the steps is not about how fast we can do it. It is not a race or a sprint but rather a marathon. It doesn't take a specified number of weeks or months or years to work through the program. There is no right or wrong way to do this work. It does however take perseverance, dedication and a willingness to spend the time to achieve times of peace, prosperity and happiness. The important part is that you never give up trying to find a way that makes sense to you. I've worked with clients in the past who spent months just dealing with Step 1. I admit that I struggled here for a bit. 

Change Your Thinking

How could someone or something 'take or remove' these defects of character from me? I still was questioning what my 'Higher Power' was. I didn't understand how to involve my Higher Power in my life. What role was he to play? I had finally identified what behaviors and attitudes I had to change and so I depended on the strength and support of my home group to help me with this step. Actually this part was quite easy once I got by the arrogance of thinking that I was just fine and that it was the rest of the world that had a problem. I had to change my way of thinking about my defects of character and once I had done that they were no longer an issue -- they were gone. Many folks in A/A struggle here so I can only suggest that by giving up something or changing it -- a belief or a mind set for instance -- you take away its power and influence. 

Building a New Future

The remainder of the steps are about the transition from where you are to where you want to be and I will describe and discuss their significance in Part 2 of this article (published on ChooseHelp.com, next week). It is important you get the basics of the first part so that the second part is more easily understood and therefore can have a much greater impact on your life choices. Obviously you are free to do whichever steps you want when you want but it is more meaningful to do them as you come to understand them and to incorporate them into your lifestyle on a daily basis.

I had mentioned previously that this is a 'way of living' program. These are the basics most folks who enjoy their lives try to live by each day. It is what they are conscious of daily and what they eventually come to do each day in order to manage themselves effectively.

For those who are ready to jump into the next phase of their recoveries,
continue with Part 2 (Steps 7-12) of this series.

If you are new to 12 Step programs or are coming back to the program, this two part series takes a closer look at the 12 steps of AA.

If you are new to 12 Step programs or are coming back to the program, this two part series takes a closer look at the 12 steps of AA, breaking things down and showing you how, with a little work, it can support you to live a clean and sober life.

"Ours is a spiritual, not a religious program"
--well known statement in the AA and NA program

Removal of Our Shortcomings

Step 7

We humbly asked Him to remove our shortcomings.

For those folks who are not considering working their program from a faith based perspective I suggest you can do the following to work on and through this step. The important issue here is that you have reached a point in your recovery where you have identified many of the 'short comings' -- those character flaws that really mess up your life.

Some examples might be placing your own self-importance ahead of all others, distorting the truth to serve your own best interest or need, saying one thing and doing another, gossiping (especially to promote personal gain) and practicing deceitful behavior just because you could.

Burning Up the Negatives

With clients that I work with who are not faith based I suggest you take all your 4th step work - go to the beach or a safe wooded area-someplace where you are alone and bring along a steel pail or coffee container (anything that won't burn).

Put all of your 4th step notes in the container and set it on fire. Allow the wind (we have established that the wind is stronger and a greater force than we are) to carry off the smoke that has been created. Then dig a shallow hole and bury the ashes. Mother Earth devours the ashes and the wind carries away the negative energy.

Sound hoaky?' I suppose but the symbolic energy that you have created and participated in is very powerful indeed. You have identified the negatives in your life.

You agreed to rid yourself of them and then carried out that behavior. It works. It is the inner conversation that you have with yourself that is strengthened and important.

You can even write something to read at you ceremony that signifies a change in attitude or names which perspective you want to adopt -- "I will be more honest".

You are now ready to carry on with steps 8-12. You have connected your inner world, and we all have one, with your outer world.

Identifying Our Affected Others

Step 8

We made a list of all persons we harmed, and became willing to make amends to them all.

It sounds so simple but it takes humility, courage and honesty to face the facts around how you treated other people when you were using. The purpose is to clear the wreckage of the past with those who are important to you and those who deserved better than what you gave them.

It also allows for the reconciliation of some of the important relationships that you would like to have back but you may not be sure about how to go about repairing our relationships. This step simply encourages us to make a list of those people and that is all for now. Take your time and make sure that the list is as complete as you can make it.

This is not about feeling guilty about how you treated some folks but rather preparing to set a new stage so that, when the time comes, we may walk among those we care for with our heads up and a clear conscience.

Mending Broken Relationships

Step 9

We made direct amends to such people wherever possible, except when to do so would injure themselves or others.

This is where you accept the responsibility for how things have gone in the past because of your substance abuse and seize the opportunity to set things right with all those folks that you have listed.

It is also vitally important that you do not attempt to be overly honest to the point where any of your declarations, that may include other people's behavior, becomes public knowledge.

For example: You, your good friend and his girlfriend go to a party and drink far too much. Later in the evening you and the girlfriend begin to be a bit more friendly than is acceptable and lines are crossed. You both realize that that was not appropriate and manage to stop before any further harm is done.

Admitting to your good friend now that that happened back then would be an example of making amends that would hurt, not only your friend but his girlfriend and might jeopardize their relationship not to mention your relationship with your friend. Apologize to the girlfriend if you like but including your friend in your efforts to clean off your slate would not be suggested here. This is one of those things that you might just have to learn to live with.

Making a Personal Inventory

Step 10

We continued to take personal inventory and when we were wrong promptly admitted it.

Because we are human we will continue to make mistakes and we will continue to engage in ways of living that are not always healthy for us. It's important for us to take a bit of time on a regular basis to do 'a mini 4th step'. If we see some things that we question then we correct them. If we see or hear that we are stubborn, for instance, then we need to look at that and determine what that is about. Are we sliding back into old habits or ways? If we are -- correct that.

The biggest mistake that folks in recovery make at this point is defending something that they have done that is not OK. We are better to admit that we screwed up - correct the issue and move on. Make your amends to anyone who deserves an apology. That way it doesn't become something that smoulders under the surface. Put enough of those little smouldering issues together and you could easily have a relapse in the making.

Stepping Back and Reviewing Our Progress

Step 11

We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will and the power to carry that out.

This is a very important piece of the program because it encourages us to revisit how far we have come in the program and to give thanks for what we have gained. If you are a faith based person then this can happen through prayer and meditation. If you are not then it can happen through self talk and meditation. Keep a journal summing up what you have learned in the past week or month or year.

Write yourself a letter outlining all the things that have come about because you have decided to remain clean and sober. Give thanks for all the knowledge you have gained and all the healing that has begun, the relationships that are more healthy now and the possibilities that have been presented to you because you choose, each day to remain clean and sober. This step provides us with an opportunity to be grateful and thankful to whatever force or power helped us get as far as we have.

It is the inside work that we have done, the skills that we have developed and the open mindedness that we have allowed that has helped us get this far. It is a power or force greater than ourselves that we may, albeit reluctantly, acknowledge, even with some lingering doubts, that has helped us to vastly improve the quality of our lives.

Growing Ourselves by Supporting Others

Step 12

Having had a spiritual awakening as a result of these steps, we tried to carry the message to addicts, and to practice these principles in all our affairs.

Once we get to the point when we 'finish' the 12th step there is a concern that always presents itself. There is the possibility that we can get 'cocky' - that we can think to ourselves that we finished the program, that we have learned all there is to learn and that 'I've got it done now.' Some even think that they can go back out again and have a drink or a toke every once in a while because they know how to stop now. Many a program has tanked because of that error in judgement.

Each time you go down it becomes more difficult to get back up again. When you are finished the program you go back to number 1 and start again. It will not be quite the same program because of the things you know now that you didn't or couldn't know back when you first started out on this journey.

The way you continue to grow is to help others who struggle. Remember that 'we keep what we have by giving it away.' Help those who don't believe they can do it or are intent on doing it 'their way'.

You have to be careful that you don't get caught up in their stuff and you have to be careful that you don't take on their recovery program and try to get them to do theirs the same way you do yours. Sometimes you just have to let them go and hope that they make it back. Everyone has to travel their own journey of recovery at their own speed. But many keep coming back. Our job is to be sure that there is a warm, caring, non-judgmental place for them to come back to and a warm hand shake or hug that says:

"We're here for you -- come on in!"

Learn this simple distraction and breathing exercise that works well to get you through periods of intense cravings.

You can (and should) try to avoid cues and triggers but there’s no way to dodge them all; if you’re in recovery – and you want to stay in recovery – you need to learn to cope with cravings.

Cravings come in waves. They feel like they’ll last forever but if you can endure for 20 minutes or so, they always dissipate into nothingness.

And fortunately, the more often you resist those cravings, the weaker they get and the less frequently they bother you.

If you can hold on for just a few minutes, you can almost always overcome your cravings. To help you with this, here’s an easy-to-remember coping strategy (The Four Ds) to get you safely past the 20 minute danger zone.

The Four Ds

This is a classic relapse prevention technique. The Ds stand for:

1. Delay – Since cravings rise and fall like waves, if you can delay a relapse decision for 20 minutes you’ll generally find the cravings dissipate on their own.
2. Distract – Craving time passes more quickly when engaged in a distracting activity for a few minutes.
3. Deep breathing (De-Stress) – Deep breathing exercises help you maintain calm and purpose when cravings hit, keeping you from making rash decisions.
4. De-Catasrophize - In the midst of a craving it's easy to get caught up in panicky 'end of the world' type thinking, like "I can't take it any longer." Or, "I'm never going to succeed so I might as well get high now." Don't let inaccurate catastrophic thoughts guide your actions. Challenge your thoughts and when necessary, reframe them into more accurate notions, like, "This is really uncomfortable, but at least my withdrawal symptoms will go away within a few days."
   

Also try - Drink a glass of water – Drinking a glass of water relaxes you and sets your purpose. Imagine your cravings as like a runaway train gathering momentum to a disaster. Simple activities like taking a moment to drink a glass of water are like brakes that slow that train!

So the next time you feel a craving, remember The Four Ds and avoid a permanent mistake caused by a temporary urge.

Here are 20 solid distraction ideas that will keep you occupied just long enough. Try any or all that make sense to you, or better yet, come up with a list of your own.

You may want to write down a few go-to distraction tasks and keep them on your person (see the example chart at the end of this article). This way you won’t be left scrambling for distraction ideas when already struggling with cravings – you’ll have your ideas planned out and ready to go.

20 Distraction Ideas for Cravings

1. Take a shower, even if you don’t need one. Scrub hard and turn the water as hot (or cold) as you can stand it. Let it soak into you for a few minutes and by the time you towel dry 20 minutes later you’ll probably feel a lot less tempted to fold.
2. Wash and wax the car
3. Call a friend and talk about their problems (not yours)
4. Clean the fridge, the bathroom or the garage – cleaning anything provides just the right amount of physical exertion and mental distraction – and as an added bonus you feel better after getting it done.¹
   
5. Walk the dog (or just take a walk around the block)
6. Go jogging
7. Do a quick home work-out
8. Meditate or do yoga
9. Play a musical instrument
10. Do a progressive muscle relaxation exercise or write in a journal
11. Catch up on work for a few minutes
12. Prepare an interesting snack, and then enjoy it
13. Do a crossword or Sudoku puzzle
14. If you’re tempted to drink or use at home, then get out of the house and go for a drive. This can be a risky. Don’t get in the car if you’ll steer by autopilot to the nearest bar or drug dealer
15. Play a challenging video game
16. Do bicycle maintenance
17. Cut the grass
18. Walk out and get a coffee
19. Fix that thing that needs fixing – replace burnt-out light bulbs or dead batteries, etc.
20. Water all the plants or groom your pet
    

The next time you feel a craving coming on, take a moment to feel it in your body, and then tell yourself that it’s going to pass if you can just wait it out – and then use one of the 20 methods listed above (or any others you can think of) to distract yourself while you wait for that urge to disappear.

And since the more tools you have at your disposal the better your odds of success, learn how to urge surf as well – it’s a fantastic mindfulness technique that lets you glide with attention right over the peak of a craving.

Make a Relapse Prevention Card to Take with You

OK, you’ve read this far, and if you think the 4 Ds make sense, take 5 minutes to write a relapse prevention card to carry around with you. Do it right now (before you get distracted :) and you maximize your odds of having it ready when you need it.

Instructions

Fold a paper into four squares:

1. On on the first square, write out The Four Ds
   
2. On the second square, write out 5 or 10 personally relevant distraction ideas
3. On the third square, write out 3 or 4 of your most significant reasons for wanting to stay clean and sober
4. On the fourth square, write out some negative expectations - accurate predictions for what will happen if you slip and use or drink.

Negative Expectations – When you’re about to relapse you tend to focus on positive expectations and gloss-over negative expectations.

Some examples of positive expectations are:

•  “I’d have such a good time if I did a few lines and went out dancing.” Or “I am so stressed right now – a few drinks would really relax me…”

Some examples of negative expectations are:

• “If I drink tonight I will feel hung-over and ashamed tomorrow.” Or “If I start doing cocaine I won’t stop until all of my money is gone.”

By writing down accurate negative expectation statements you provide a counter-balance for the positive expectation statements your addicted mind manufactures all on its own.

An Example Relapse Prevention Card

Image Copyright: Naftels

Learn to relax with imagery in 7 easy steps; it’s a great skill that protects you from relapse.

No matter who you are or what your situation, improving stress management skills can improve your quality of life.

But if you’re in recovery and fighting to avoid relapse, knowing a few effective de-stressing techniques can make the difference between continuing sobriety and an emotion-driven return to drinking or drugs. Not to get melodramatic here – but for those in recovery, relaxation exercises can be literal lifesavers.

Because they’re so important and because stress levels tend to go up in early recovery, you should learn and practice a few techniques that work for you. Some examples of common stress-busting exercises include deep breathing for relapse prevention, meditation, progressive muscle relaxation, and the topic of this article – imagery exercises.

So take a few minutes now to read through the steps and experiment with imagery for yourself. It doesn’t take long to learn but you will get better with practice – in fact with enough practice, some people can escape to serene relaxation just by thinking of a certain word or image.

A Step-by-Step Guide to Relaxing with Imagery¹

1. Start off by finding a place where you feel relaxed, safe and comfortable – someplace where no one will come in and disturb you for a few minutes.
2. Sit comfortably in a chair and close your eyes. Concentrate on taking slow and deep breaths.
3. When you feel ready, scan your body from your feet to the top of your head looking for any kind of tension. When you feel tension, try to relax it completely, imagining that you expel the tension with each slow exhalation.
4. Now, imagine a place where you feel great – safe, comfortable and at ease. It can be a place that you know well or a place from your imagination. Examples could be a secluded tropical beach, a place from your childhood or even a place you’ve only seen on TV or in a book.
5. Picture yourself in this environment. If you imagine a tropical beach, imagine yourself laying on the sand or in the lapping surf. Try to bring all of your senses into the experience. What does the sand feel like? Imagine the warmth on your skin. What does the air smell like? Try to smell the tropical plants and the smell of the sea. What do you hear? Try to imagine the sound of the waves and birds. What are the colors like? Try to picture the blue of the sky and the turquoise of the water.
6. Enjoy some time in this peaceful place. What do you call it? By giving it a name, you’ll find it easier to return to this relaxation simply by recalling the name and the images you associate with this name.
7. Stay within the scene you’ve created until you feel calm. When ready to leave, take a moment to transition slowly back to the ‘real world’ – keeping your eyes closed for another moment and continuing to breathe slowly and deeply.

Though imagery exercises don’t always come naturally, with a little practice and persistence, you’ll find they offer a pretty immediate antidote to the stresses of early recovery – and of life in general.

For anyone struggling with heroin addiction, the treatment options can sometimes seem overwhelming. Learn what treatments are available and which one may be right for you.

An addiction to heroin devastates the physical, emotional and spiritual health of anyone caught in the cycle of dependency and abuse.

Some people, with extraordinary willpower and social support, can detox and stay sober without professional assistance, but these people are rare and the vast majority of heroin addicts will need professional heroin treatment. For the purposes of this article, only professional treatment options are discussed. There are many self-help groups and programs available for heroin addiction as well.

The Five Methods of Heroin Treatment

There are five professional methods of heroin addiction treatment. Heroin addicts may elect to undergo:

1. Medically Supervised Detoxification
2. Rapid Detoxification
   
3. Residential Rehab Program
   
4. Medically Assisted Treatment
5. Naltrexone

Each of these methods for heroin treatment has pros and cons. Some treatments may work better for some than others and some of the treatments can be used in combination. For example, an addict may have a medically supervised detoxification followed by a residential rehab program.

Treatment for every addiction should be individualized to meet the needs of the addicted person.

• Some addicts have been able to hold on to jobs and keep their addiction secret. A person in this situation may not want to go to a residential rehab program because people might question where they are and their addiction would come to light.
• Others may have been using heroin for twenty years or more and need more intensive treatment to learn how to live a life without substances.

The next section describes each treatment method in detail so you can decide which treatment would be best for your situation.

~ Method 1 ~

Medically Supervised Detoxification 

Detoxification is simply the process by which the opiates leave your body and the body begins to return to normal working order without opiates.

Detoxification generally takes from three days to a week depending on how much opiates the addict was using. Opiate withdrawal can be extremely painful and could possibly be dangerous if the addicted person has other health problems such as diabetes or heart problems. 

Medical Supervision

Because of the dangers of opiate withdrawal, it is necessary for opiate withdrawal to be medically supervised. This means that any facility that will detox an addicted person from opiates must have medical staff on duty. Generally, a nursing staff will observe the addicted person and report to a doctor who is on call and checks on the patient daily.

Medications

Medications can be prescribed by the doctor to make the addicted person more comfortable while undergoing detoxification. Many facilities prescribe medications for nausea, diarrhea, sleep and other symptoms of heroin withdrawal. Whether or not to prescribe medications and what medications are prescribed are at the discretion of the doctor so this will vary from facility to facility.

Staff at some facilities use Suboxone to ease withdrawal symptoms and then they wean the addict off Suboxone over a few days to a week. If you are considering detoxification, you can contact the facility you have chosen and ask them how they usually handle detoxification. They may not be able to give you clear-cut answers because treatment is individualized and you would have to be seen by the doctor but they might tell you if they use Suboxone or not.

While detoxification rids the body of opiates, it does not treat the underlying causes or the psychological aspect of addiction. For this reason, detoxification can be a first step before entering a residential rehab program.

~ Method 2 ~

Rapid Detoxification

Rapid detoxification is a process where the addict is placed under anesthesia while they are given medications to rid their body of opiates. Medications given may be naltrexone, which is an opiate blocker, or clonidine, which is a blood pressure medication. The process takes about one to two hours.

• The idea is that the body is completely rid of opiates while the addict is comfortably asleep throughout the process. This form of treatment can be more dangerous than a slower detoxification process.
  
• There is some controversy over the effectiveness of this treatment. While it does rid the body of opiates, this treatment on its own does not address the psychological aspects of addiction.

~ Method 3 ~

A Residential Rehab Program

Residential rehab treatment is inpatient treatment which generally lasts from 30 to 90 days; the addicted person stays at the treatment facility 24 hours a day.

Inpatient treatment facilities vary according to treatment philosophy and psychological techniques used to treat addiction.

Some inpatient facilities are based on the 12 Step model:

• These facilities encourage addicts to attend 12 Step meetings and develop support systems to maintain sobriety. They may have people from Alcoholics Anonymous (AA) or Narcotics Anonymous (NA) come to the facility to talk to you about the program. And many facilities with this philosophy will take you to AA or NA meetings outside of the facility.

Other facilities take a mind, body and spirit approach with treatment techniques that address each of these areas.

• This means the facility would include treatments that address psychological, physical and spiritual needs. Psychological treatments may involve learning about triggers and cravings and developing ways to cope with these as well as building coping skills for life.
  
• Exercise could be a part of treating the physical part of addiction as well as medications for dual diagnosis addicts. Dual diagnosis means that the addict has mental health issues in addition to addiction.
  
• Spiritual treatments may involve encouragement to return to the church or religion the addict believes in, discovering spiritual beliefs or exploring how addiction changed their values and spiritual beliefs.

Some inpatient facilities specialize in treating dual diagnosis addicts and alcoholics:

• If you have a mental health diagnosis in addition to addiction, it is important to find a facility that will address both conditions. People who have co-occurring mental health problems cannot ignore the need for mental health treatment since mental health symptoms tend to affect the addiction.
• For example, someone with depression may relapse when they feel depressed or someone with an anxiety disorder may be more prone to using drugs when their anxiety is worse. To not treat the depression or anxiety would be like treating half of the problem. 

Regardless of philosophy:

• Most inpatient facilities offer both individual and group therapy
• Psycho-educational groups are also common at inpatient facilities. Psycho-educational groups are groups focused on a particular topic which the group facilitator will educate the group about and then allow the group time to discuss the topic. Some facilities even have classes to teach the addicted person about the disease concept, how drugs affect the brain and other educational topics.
• Some facilities offer free time to engage in recreational activities, read recovery literature or write in a journal.
• Other facilities offer classes in arts and crafts.  Some even have pets that the addicted person can interact with because pets can offer great stress relief.
• You may be expected to do chores like cleaning your room and common areas.
• There may be areas and equipment available to engage in sports like volleyball or basketball.
  
• Some facilities take clients to recreational activities outside the facility. As you can see there are a variety of activities that could be a part of your treatment.

Each facility is different and each will have different activities. You can contact different treatment programs to find out what their program has to offer. Many facilities even have websites and Facebook pages so you can learn about the facility before you go.

~ Method 4 ~

Medication Assisted Treatment

Medication Assisted Treatment (MAT) is a form of heroin treatment which provides the addict with opioids to replace the heroin or other opiates the addict may be taking. Opioids are synthetic or man-made medications. Opioids keep the addict from having withdrawal symptoms. There is some controversy over the use of MAT as some people believe it is just substituting one drug for another. However, MAT medications have significant advantages over heroin use for the addict.

1. One advantage is that MAT medications are longer lasting. MAT medications have a half-life of 24 to 36 hours which means that only half of the medication leaves the body in 24 to 36 hours. The advantage of this is that the addict no longer needs to take drugs every 2 to 4 hours but can take a medication once a day. This helps the addict remove themselves from the lifestyle of addiction.
   
2. Another advantage is that MAT is taken orally and is created so that an addict cannot abuse it intravenously. This keeps the addict from getting the euphoria associated with street drugs and also helps reduce incidents of disease such as HIV and hepatitis.

There are two types of MAT – Methadone and Suboxone

Methadone

Methadone is an opioid used to treat heroin addiction. Methadone is a partial blocker which means that it partially blocks the effects of other opiates. This is to keep the addict from using other opiates in addition to methadone.  Methadone can be prescribed by a doctor for pain but it is generally prescribed and dispensed in methadone clinics. Addicts must go to the clinic daily until they earn the privilege to have take-home bottles. The methadone wafer is dissolved in water and juice is usually added or it can be dispensed in liquid form. Methadone is dispensed by a nurse and must be swallowed in front of the nurse to be sure it is not diverted to sell on the street.

When an addict begins treatment with methadone, the doctor prescribes a low dose based on information gathered during the intake process. The dose is gradually increased until the addict is stabilized. Stabilization means the addict is on a dose that keeps them from having withdrawal but does not intoxicate the addict.

By itself, methadone only keeps the addict from having withdrawal symptoms. However, methadone clinics are required to provide counseling to the addict to treat the psychological aspects of addiction. While in treatment, the addict can learn about the disease of addiction, relapse prevention techniques and develop new social connections with people who don’t use drugs. They can also deal with many of the consequences of their addiction. For example, addicts can begin to face legal problems, health issues, repair family relationships and even go back to school.

Once the addict has stabilized on a dose, learned about addiction and repaired many of the problems in their life, they can gradually decrease their methadone dose until they are drug free. Some addicts choose to remain on methadone and can be on it for the rest of their lives if they choose to do so.

Suboxone/Subutex

Suboxone is an opioid with a full blocker. Suboxone contains Naloxone which is added to keep addicts from abusing it intravenously. It also keeps addicts from being able to get the euphoric effects of opiates while on Suboxone. As long as the addict takes their medication daily, they cannot get “high” by using opiates. This helps deter the addict from abusing their medication.

Subutex is the same as Suboxone but it does not contain Naloxone. It is meant for pregnant women and others who cannot take Naloxone for health reasons.

Heroin addicts who choose Suboxone treatment are generally given a dose between 8 mg and 16 mg. Much like methadone, the doctor prescribing the Suboxone will prescribe a dose sufficient to keep the addicted person from having withdrawal symptoms. Many Suboxone clinics provide counseling to treat the psychological aspects of addiction. Suboxone can also be prescribed by individual doctors who are certified to prescribe it.

To find a doctor or clinic that prescribes Suboxone or methadone, the Substance Abuse and Mental Health Services Administration (SAMHSA) has a treatment locator on their website. SAMHSA is a government program that provides information on substance abuse and mental health issues. 

~ Method 5 ~

Naltrexone

Naltrexone is a drug marketed under the name Revia, Depade and in extended release, Vivitrol. Naltrexone is an opiate antagonist used to treat heroin addiction. The addicted person must be free of all opiates and not in withdrawal before this medication is given. It works by blocking the euphoric effects of opiates. The addicted person cannot get "high" while taking this medication. It can be given orally but the addicted person has to take the medication daily for it to be effective. If the addicted person stops taking the medication, they can use opiates after the drug is out of their system. This mean that if they have cravings, they can simply stop taking the medication and go back to heroin use. It can also be given in the form of a monthly injection which means the addicted person cannot get "high" for at least a month after getting the injection. It is commonly prescribed after an addicted person has completed another treatment like Suboxone or a residential rehab program.

Any of these types of treatment can work if you can recognize that heroin brought more pain and horrible consequences to your life than fleeting moments of pleasure. However, the best treatment with the highest chance of success is the treatment that you put the most work into. Heroin addiction is never easy to overcome but it can be done when you work hard at your recovery.

Image Copyright: Alex Holzknecht

With the DSM-5 the American Psychiatric Association has a new diagnostic manual. Substance abuse and dependence are now gone - replaced by mild, moderate and severe substance use disorders. Will the changes affect you? Check out the new diagnostic criteria to find out if you have a substance use disorder.

THE BOOK! Imagine a tome so powerful that you couldn't get treatment unless it said you should...It sounds like science fiction - it's actually real.

The DSM-5 is the 5th edition of the American Psychiatric Association’s (APA's) diagnostic guide book, called the Diagnostic and Statistical Manual, or DSM for short.

Often called psychology’s bible, the DSM provides lists of behavioral symptoms which clinicians use to diagnose different mental health conditions.

But why should you care?...

Well, for clinicians, the DSM is important because it provides a common language and diagnosis framework - and for everyone else, the DSM is important because you won’t get insurance coverage for a mental health condition unless you meet the DSM diagnostic guidelines.

What’s Different in the New Edition?

When considering substance use disorders, the new edition has a few substantial changes.

• In the fourth edition, substance use disorders were divided into 2 separate conditions: abuse and dependence. In the new edition, these disorders have been combined into one, called substance use disorder.
• A person can now get diagnosed with a mild, moderate or severe substance use disorder. In the last edition, you either had a disorder or you did not, and there were no shades of gray or considerations about severity. 
• The APA has strengthened the diagnosis. Under DSM-IV guidelines, a person only needed to show a single symptom for a diagnosis of substance abuse. Under the new guidelines, a person must show at least 2 symptoms to get diagnosed with a substance use disorder.

Diagnosing Substance Use Disorders

Here are the 11 criteria (paraphrased) used in the DSM-5 to diagnose a substance use disorder.

Count how many of the following symptoms match your experience over the past 12 months. Don’t count a symptom unless it caused or causes significant impairment or distress.

1. Recurring substance use has led to your failing to fulfill major responsibilities at school, work or home.
2. You repeatedly use drugs or alcohol in risky situations, such as when operating machinery or driving a car.
3. You experience alcohol or drug cravings.
4. You continue to use alcohol or drugs despite the fact that you realize that your use of alcohol or drugs causes or worsens reoccurring social or relationship problems (it keeps getting you into fights with your wife, for example).
5. You have developed a drug or alcohol tolerance. You need more than you used to to experience the same effects.
6. You experience withdrawal symptoms when you stop using or significantly cut down your use, or - you use other similar substances to stave off withdrawal symptoms (for example, using Valium when not drinking).
7. You often take/drink more drugs or alcohol than you had planned on - and/or you use/drink for longer than you had planned on (for example, you often stop for a drink after work with friends and intend to have just one or two - and then you don’t leave until closing time.)
8. You have a persistent desire to cut down or stop your use of drugs or alcohol, or - you have tried and failed to cut down or stop your use of drugs or alcohol.
9. You tend to spend a lot of your time using drugs or alcohol, recovering from your use of drugs or alcohol or doing what’s needed to get drugs or alcohol.
10. You have given up or reduced your participation in social, occupational or recreational activities that used to be important to you, and replaced these activities with drug or alcohol use.
11. You continue to use drugs or alcohol despite knowing that drugs or alcohol cause or worsen a persistent physical or mental health problem.¹

Scoring

• If you identify with 0 or only 1 of the criteria you do not meet the minimum threshold for a substance use disorder diagnosis
• If you identify with 2 or 3 criteria, you have a mild substance use disorder
• If you identify with 4 or 5 criteria you have a moderate substance use disorder
• If you identify with 6 or more criteria, you have a severe substance use disorder²

Why Did the APA Change the Diagnosis?

The APA explained the reasoning behind the changes as:

1. Eliminating the Artificial Distinction between Abuse and Dependence

It could be quite difficult to differentiate between mild dependence and severe substance abuse. In reality the line between abuse and dependence was mostly artificial, to allow for easier categorization.

Though the retest validity and reliability of the DSM-IV dependence diagnosis was quite good, the test retest validity and reliability of the abuse diagnosis was much worse.³

2. Ditching 'Dependence'

The dependence/addiction terminology was confusing.

While dependence is used medically to describe normal bodily adaption to a consumed substance (as you might become dependent on blood pressure medication) it was also used in the previous edition to describe addiction, and this led to a lot of unnecessary head scratching.

In the new edition, the word dependence is rightfully gone, replaced by addiction.

3. Strengthening the Diagnosis

In the previous edition, showing a single symptom, such as a distress-causing legal problem stemming from use, earned you a diagnosis of substance abuse. In practice, this meant that approximately 70% of people diagnosed with substance abuse met only a single criteria after being charged with a DUI.

While nobody would minimize the problems associated with impaired driving, many people arrested for a DUI do not really have substance use disorders requiring treatment (The DSM-V has also dropped the legal problems symptom from the diagnostic criteria).⁴

Criticisms

Considering its influence, it’s not surprising that the DSM attracts controversy and dissent.

NIMH - It Lacks Validity

Here’s a big one - The National Institute of Mental Health (NIMH), announced it will no longer use DSM categories as a basis for future research, citing a lack of validity.

While the NIMH still supports the DSM-V as the best current standards manual for the diagnosis and treatment of mental disorders, they say it’s not really good enough, given what we know now about the workings of the brain.

They’re calling for research that will support a move to diagnoses made more on changes to the structure and function of the brain, rather than based on clusters of symptoms - essentially a move away from diagnosing diseases like addiction from the way they make people act, and toward diagnosing these brain diseases based on how they change the workings of the brain.⁵

It May Rob Treatment Resources from Those with the Most Serious Problems

By classifying those who just meet the minimum criteria for a mild substance use disorder with the same condition as those with the most serious problems, some critics wonder if this could increase the number of people who qualify for treatment and overwhelm an already overwhelmed treatment system.

As the numbers who qualify go up - especially on the milder end of the spectrum - the percentage of those with more serious problems able to access treatment resources may go correspondingly down.⁶

It Muddies the Waters

And on at the consumer level, there are those that suggest that rather than clarify things, the new DSM simply leads to weakened diagnoses, especially when relying mainly on the truth-telling of people likely predisposed to denial.

According to addiction counselor Jim LaPierre LCSW, CCS, Executive Director of Higher Ground Services in Maine, “Addicts and alcoholics are already looking to minimize the significance of their use. If we say that someone is ‘mildly’ addicted we help them to rationalize. Accurate diagnoses of severity of substance abuse and addiction is highly contingent upon accurate self reporting. Given that alcoholics and addicts tend to downplay the frequency and amounts they use, this simply muddies the waters further.”

How Will The DSM-5 Change Things for Patients?

While only time will reveal the new edition’s actual impact, at the consumer level, it may not change things all that much.

Here’s why:

While it’s true that clinicians often have to use DSM-5 diagnostic criteria for insurance purposes when referring patients to treatment, these professionals are still left with some pretty considerable wiggle-room that lets them apply the diagnosis that’s going to bring the most beneficial outcome.

For each diagnostic criteria, the clinician has to decide if it has caused significant impairment - and that’s a pretty subjective decision to make - so If your doctor thinks you need treatment, and she knows you need to meet at least 4 criteria to qualify for treatment, then she is very likely going to use her subjective judgment to find the 4 criteria that get you the treatment you need.⁷

Image Copyright: Colton Witt

Don’t quit Ambien before you know what you’re up against and have a plan for success. Learn about 2 tapering methods and one method of rapid detoxification (with flumazenil) as well as about the brain changes associated with zolpidem addiction and the treatments you need to counteract these changes.

When you have insomnia, you're never really asleep, and you're never really awake (from the movie Fight Club).⁹

For those that can't sleep, Ambien, used intermittently and at therapeutic doses, isn’t too dangerous.

At higher doses though, things change. It starts to light-up a wider array of benzodiazepine receptors and it starts to feel a lot more like a typical benzodiazepine, like Valium or Xanax.

Basically, at higher doses, it gets you high.

So when you take higher doses for a while, it’s easy to grow both physically dependent and addicted, and once dependent and addicted you’ll need to:

1. Taper down slowly to minimize withdrawal symptoms
2. Get some form of addiction treatment, to learn to manage cravings and avoid relapse

Read on to learn about the withdrawal symptoms you can expect and about how to minimize withdrawal symptoms through one of three tapering and detox methods.

Ambien Addiction = Benzo Addiction

According to the Council for Information on Tranquilizers, Antidepressants and Painkillers (CITAP) – Ambien (zolpidem) and other drugs of the Z class are simply benzodiazepines by another name.¹

Though they look different chemically, at high doses they act similarly in the brain - and the withdrawal management, tapering and treatment recommendations for Ambien addiction and benzodiazepine addiction are essentially the same.

Ambien Withdrawal Symptoms

If you’ve been using this medication daily for longer than 2 weeks, you should not stop using suddenly. Stopping suddenly is hard on the body and generally results in very unpleasant withdrawal symptoms.

Typical Ambien withdrawal symptoms include:

• Shakiness and tremor
• Moodiness
• Bouts of depression and crying
• Anxiety, nervousness and panic attacks
• Lightheadedness and flushing
• Sweating
• Nausea and vomiting and other digestive complaints, like stomach cramping
• Muscle cramps
• Insomnia (having a hard time falling or staying asleep)
• Tiredness
• Seizures (more rare)²

Tapering Down

Due to the very real risk of seizures, once dependent, you should never stop using Ambien very suddenly, nor should you reduce your daily dosage too quickly.³

Once dependent, to quit Ambien, you must choose one of the following three primary options:

1. Taper down slowly off Ambien
2. Switch over to a longer acting benzodiazepine like diazepam (at an equivalent dose) and then taper down from that
3. Detox off Ambien in an inpatient facility while receiving a continuous flumazenil infusion

In most cases, doctors will advise that you slowly taper down your dose, or switch to an equivalent dosage of a longer acting benzodiazepine, like diazepam, and then taper down from that.⁴

Straight Ambien Taper

The simplest method is the straight Ambien taper.

You should consult with your doctor when making a tapering plan, but don't get pressured into a rapid reduction - after all, what's the hurry? Consider taking your time and know that spaced gradual reductions cause fewer withdrawal symptoms and less rebound insomnia.

As a conservative starting point, you might consider a 10% reduction every 2 weeks. Or, you can try a slightly more aggressive tapering plan, such as reducing by 10% per week, knowing that you can always slow things down if it becomes unmanageable.

Tip for Success – Stay in control of the process and the pace. It’s your body and you know what’s manageable and what’s not. Don’t let an outside ‘expert’ impose a schedule that doesn’t work for you. It’s OK to pause reductions during times of great stress or when withdrawal symptoms get too severe - but try to avoid retreating to a higher dosage after a reduction. For the best chances of success, you can slow down, but never go backward.

Switching to and Tapering from Longer Acting Benzodiazepines

Ambien is a fast acting sedative, with a half life of roughly 2 hours (a little less for children and a little more for elderly users). After taking Ambien your blood plasma levels will peak at approximately 2 hours post ingestion.⁵

Although fast acting sedatives work great to get you sleeping quickly and alert by morning, they result in highly variable plasma concentrations - and this isn’t ideal for a tapering situation.

As an alternative, you can switch from Ambien to an equivalent daily dosage of a long-acting benzodiazepine, like diazepam, without feeling any withdrawal symptoms. Once stabilized on this longer-acting medication, you can start tapering off just as you would for a straight Ambien taper.

Tapering from a medication with a longer half life results in more stable blood plasma concentrations. This is a good thing because:

1. Stable plasma concentrations eliminate the intoxicating highs and the worst of the lows (withdrawal symptoms). You need to learn to live without the highs and you won’t mind minimizing the lows.
2. You taper slowly to give your brain a chance to heal and adapt. Stable blood plasma concentrations facilitate this healing.

To maximize your odds of tapering success, consider:

1. Waiting until a period of low work/life stress to start your tapering regimen - Since withdrawal symptoms can include low mood/anxiety, insomnia, fatigue, etc. you probably don’t want to tackle the first days of tapering during an especially busy or chaotic time of year.
2. Consider taking some time off work for the first few days or week or so, to get used to the tapering experience while minimizing demands on your time and energy.
3. Tell a few close friends and family about your tapering regimen. You’d be wise to make use of their support and they may appreciate an explanation for what might otherwise seem like unusual behaviors.
4. Consider joining an in-person or online support group or community of others also tapering from Ambien or benzos.¹⁰

Before you start read our complete guide to tapering off benzodiazepines

Using Flumazenil

In extreme cases, such as when a person can’t or won’t taper, there is always the option of hospitalization and rapid detoxification with a continuous flumazenil infusion.

Flumazenil works as a benzodiazepine agonist (among people with benzodiazepine tolerance). When administered continuously, it allows for the abrupt discontinuation of Ambien and a rapid detoxification.⁶

Controlling Withdrawal Symptoms with Medications

In some cases, your doctor may prescribe medications during tapering to help alleviate symptoms of withdrawal, such as to:

• Help minimize the risk of seizures
• Help with rebound insomnia
• Reduce palpitations
• Reduce the severity of psychiatric withdrawal symptoms, like anxiety or depression⁷
  

Psychosocial Addiction Treatment

People addicted to Ambien have 2 problems.

1. They are physically dependent on the medication
2. They are addicted to the feelings it provides (the high)

A successful tapering regimen gets you past your physical dependency, but it doesn’t do anything to treat your addiction to getting high – for this you require addiction treatment.

Brain Changes = Cravings

By getting dependent and addicted to Ambien you change your brain in 2 fundamental ways:

1. Your dependency alters the functioning of your benzodiazepine/GABA systems. You remedy this by slowly tapering down and allowing your brain the time it needs to heal and revert back to a ‘normal’ state of functioning.
2. Your addiction alters the structure and functioning of a number of neural systems, such as executive functioning (thinking, planning, impulse control etc.) memory and reward systems.

Though a slow taper reverts your GABA/Benzodiazepine systems back to normal, it does not heal the many brain systems altered by addiction – these changes are long-lasting or irreversible.⁸

And one consequence of these lasting brain changes is the experience of persistent cravings.

Because of the way addiction hijacks the functioning of the brain’s reward, thinking and memory systems, a wide array of situations and stimuli can trigger intense cravings, for long after you quit, without you even realizing what triggered your sudden urge to use.

Examples of situations and states that can trigger cravings include:

• Anger or stress
• Environmental cues that remind you of drug use
• Certain moods, such as feeling celebratory or bored
• Social cues (for example, running into a friend you once used with)

So, for long after you quit, you keep experiencing cravings, and if you fail to resist your cravings just once, you can easily fall right back into active use and addiction.

It’s not an easy thing to overcome, and that’s why addiction treatment can help a great deal.

Addiction treatment teaches the skills you need to minimize your exposure to situations that trigger cravings, how to deal with the cravings that do arise, how to develop a support network, how to handle life stresses and even how to handle yourself should you ever slip-up and fall back into use.

You can get addiction treatment:

• From a therapist or substance abuse counselor
• Through an intensive outpatient program
• By going to rehab or enrolling in a day treatment program
• By joining a therapy group

And you can further increase your odds of success by participating in a community self-help support group, like NA.

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Though it might seem odd to take new drugs as a way to quit old ones, addiction treatment medications, when combined with behavioral therapies, can help a great deal to keep you on the path of recovery. Learn more about what’s available and why they’re used.

Do you really need new drugs to stop taking the old drugs? There’s something sort of counter-intuitive about taking new drugs to quit using other substances, but research tells us that in most cases, combing an appropriate med with education and addiction treatment produces the best odds of lasting recovery success.

Why consider medications?

1. Addiction is a brain disease. It changes the brain’s structure and function. Much of this change is reversible, but some is not. Some of these brain changes cause symptoms - like memory problems or poor impulse control - that make relapse very likely. Some medications help you to feel better and function more normally during this initial recovery period and this reduces your relapse risk and increases the odds of a successful long term recovery.

2. Addiction treatment works… but only if you stick with it. A lot of people drop out of treatment early because they feel so sick or discouraged or because they can’t handle the cravings. Medications that reduce some of the negative symptoms can help you to stick with treatment for long enough to start seeing some of the lasting benefits. ¹

How Can Medications Help?

1. They Can Help with Withdrawal Symptoms

Medications like benzodiazepines for alcohol or the short term use of methadone or Suboxone for opiates can help to reduce the severity of withdrawal symptoms during the initial abstinence phase. During detox, medications can increase comfort and decrease health risks.

2. They Can Help You Avoid Relapse

Some medications, like Antabuse, are designed to discourage relapse by making you very ill if combined with alcohol. Other medications, like naltrexone (taken as a daily pill or a once a month injection) discourage relapse by taking away many of the rewarding effects of alcohol or drugs use.

3. They Can Help with Cravings

Medications like Suboxone, methadone and naltrexone can partly or completely eliminate drug or alcohol cravings.

4. They Can Help You Manage Co-Occurring Psychiatric Disorders

It’s difficult to make recovery progress when symptoms of active mental illness sabotage your best efforts. Research tells us that mental illness and addiction are best treated concurrently, and in many cases this means using psychiatric medications while participating in an addiction treatment program.²

Addiction Treatment Medications

The following medications are FDA approved for use as addiction treatment medications. In some cases your doctor may also suggest the off label use of medications not included in the list below.

• Alcohol – Acamprosate, Disulfiram (Antabuse) and Naltrexone
• Opiates – Methadone, Buprenorphine (Suboxone) and Naltrexone
• Tobacco – Bupropion, Varenicline, nicotine replacement therapies

Do Most Addiction Treatment Programs Make Use of Addiction Treatment Medications?

Although addiction treatment researchers at NIDA and SAMHSA endorse a combination of appropriate addiction treatment medications and behavioral therapies as the most effective form of treatment, many treatment programs do not make use of these medications.

1. Some programs do not have a physician or psychiatrist on staff capable of prescribing medications
2. Some programs choose not to use medications for philosophical reasons

A research study released in March 2011 revealed that even among private treatment programs with access to a prescribing physician, less than 50% of these programs made any use of available addiction treatment medications and only 24% used any kind of addiction treatment medication to treat alcoholism.³

If you are searching for a treatment program, you should...

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Learn more about this evidence based 16 week intensive outpatient treatment program, specifically: class frequency and program length, therapies used, degree of family involvement, evidence supporting its effectiveness and typical benefits.

Are you or is someone you love addicted to cocaine or methamphetamines and in need of intensive outpatient treatment?

Well if so, once you start researching different types of intensive outpatient programs you’ll likely see that many run treatment from something called the Matrix Model.

And if you’re like most people…you’ll have no idea what that means!

So…What’s the Matrix Model?

The Matrix Model is a medium length intensive outpatient treatment program for people addicted to cocaine and other stimulants that combines a number of different forms of therapies with education and urine testing. It’s been around since the 80s and there’s a fair amount of evidence that proves its effectiveness.

A few facts:

• The Matrix Model is a 3-times a week, 16 week intensive outpatient program that was developed over a 20 year period and which is targeted primarily at stimulant users (cocaine, methamphetamines etc). The 16 weeks of intensive outpatient treatment are typically followed by 36 additional weeks of less intensive continuing care.
• The Substance Abuse and Mental Health Administration (SAMHSA) considers the Matrix Model an evidence based program. This means that a substantial amount of quality research proves that it works to reduce drug and alcohol use, increase psychosocial functioning and reduce risky behaviors.
• The Matrix Model makes use of a number of different therapeutic modalities, such as cognitive behavioral therapy, motivational enhancement, couples and family therapy, individual therapy, group therapy and 12 step facilitation.
• It is designed to be informative in nature. Be the end of the program, graduates will have learned cognitive behavioral skills, relapse prevention techniques and early recovery skills
• A trained therapist will guide each session and offer advice and support. The therapist within the Matrix Model acts like a teacher or coach and does engage in confrontation tactics. The therapist-client relationship is designed to enhance feelings of self worth and self esteem.
• Loved ones typically have an opportunity to get involved in the recovery process during family education group sessions.
• Clients in the program will have their urine tested for drug use on a regular basis.
• Clients in the program will get an introduction to 12 steps programs.¹

What Are Some of the Benefits of the Matrix Model?

The Matrix Model:

• Helps people in recovery create a structure for life and gives each person a set of expectations to live-up to
• Provides accurate information about drugs and recovery and teaches core cognitive behavioral concepts and skills
• Gets the whole family involved and educated
• Provides positive reinforcement for good efforts and change and helps people learn from setbacks and negative behaviors
• Helps people get started with the 12 steps
• Uses urine and blood alcohol testing to encourage honesty and legitimate work towards recovery²

What Evidence Supports the Matrix Model?

A number of clinical research studies have compared the effectiveness of The Matrix Model to treatment as usual.

• In one study, people getting treatment within Matrix Model programs were 38% more likely to stay in treatment than people getting treatment as usual and 27% more likely to finish treatment.
• In another study, people getting treatment within Matrix Model programs produced 25% more drug-free urine samples than people getting treatment as usual.³

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Selective memories of drug or alcohol use - where you remember the fun and forget the pain - are common in recovery, and unless you’re careful…they can END your recovery. Learn what triggers selective memories, how to spot them and how to squash them.

Quitting drugs or alcohol is relatively easy - anyone can hold on for a day or a few days or even a week or two. But staying quit for a month or a year or a decade is another thing entirely.

It’s easy at first to remember why you’ve stopped - but after a while you’ll start to fantasize about the good times you had on drugs or alcohol, and through some complicated memory gymnastics, you’ll start to sort of gloss over memories of negative consequences as you fixate on remembrances of pleasures and fun.

This is called selective memory and it’s something that happens to most people in the initial recovery period.

No one needs addiction treatment to quit using or drinking for a short period of time, but a lot of people do need the tools learned in treatment to overcome temptations and tricks of the mind – like selective memory – that doom so many well-intentioned recovery attempts to early failure.

Dealing with Selective Memory

• You have probably had intensely pleasurable experiences using drugs or alcohol.
• The reasons you have chosen to stop using drugs or alcohol probably have little to do with how good drugs or alcohol can make you feel. Your motivation to quit is likely driven by a wish to avoid experiencing all of the adverse consequences that accompany your use of drugs or alcohol.
• Since ‘good-time’ daydreams can lead to relapse, it’s important to be aware of the dangers of these selective memory fantasies, be able to spot situations that cause you to fantasize and have strategies at the ready to counter selective memories when they arise.

Situations That Trigger Selective Memories

You can experience selective memory at any time, but some situations are more likely to trigger these dangerous fantasies, such as:

1. When you find yourself telling stories about when you were using or drinking. Especially stories of crazy times or exploits
2. When you find yourself listening to other people tell similar stories, especially stories that showcase wild fun and good times (these stories rarely feature the negative consequences and bad times also that occurred as a result of those good times).
3. When you feel overwhelmed, exhausted or down you are more likely to fantasize about how good drugs or alcohol used to feel and about how good they could make you feel right now.

Overcoming Selective Memory

Selective memories paint a vivid but unbalanced mental picture of what life was like before you quit drugs or alcohol.

To diminish their power, you need to find a way to balance things out with more accurate recollections of things really were back in the ‘good old days’

Some good ways to do this include:

• Make a list of what your drug or alcohol use cost you (family, custody of kids, job etc.) and keep this list in your wallet. Consult your list whenever selective memories start to emerge - or preferably - even in situations likely to prompt selective memories.
• Take a visual reminder of the consequences of your drug or alcohol use - an eviction notice, medical report, divorce paper etc. – and put it in a picture frame. Put this frame on display where you can see it whenever you start experiencing the warning signs of selective memories
• Make a list of people you harmed while using or drinking and how specifically you did them harm. Keep this list in your wallet and at the first sign of selective memories take a moment to give one of these people a call. *

Learning to See the Truth – The Value of Addiction Treatment

The truth is, not many of us would wind up addicted to drugs or alcohol if they weren’t fun and if they didn’t provide pleasure.

But those easy pleasures come with a high price tag and once you’re at the point where you’re ready to quit for good, you’ve decided that the fun of drugs and drink just isn’t worth all the pain and problems they cause.

Addiction is tricky though and relapse has a way of sneaking up on you...like through selective remembrances, poor coping skills, cravings etc - unless you’re careful and unless you’re prepared.

By learning to anticipate the risks to your recovery you can take pre-emptive steps to avoid them.

This is how addiction treatment helps, and learning great ways to deal with selective memories is just one of the skills you need to learn to give yourself the best shot you can at lasting recovery.

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Get research-proven behavioral couples therapy and learn how to create the kind of relationship that supports recovery instead of enabling abuse.

Is addiction a problem for you or your romantic partner?

Well, if you’re willing to work together as a team and get recovery focused couples therapy you can create a relationship which provides a strong foundation for sobriety.

And though it makes intuitive sense that the people closest to us could help the most, in this case research backs up intuition with findings that show that not only does behavioral couples therapy reduce substance abuse, it can also improve relationship satisfaction, reduce aggression and violence and improve the mental health of affected children.

Behavioral Couples Therapy (BCT) for Alcoholism and Drug Abuse

Spouses, boyfriends and girlfriends can have a powerful positive or negative influence over substance abuse.

• Oftentimes, protective instincts lead to enabling behaviors that only make it easier for the drinking or drug use to continue. Good intentions alone don’t really help very much.
• However, when romantic partners get involved in the therapeutic process and learn to provide the kind of relationship support that strengthens recovery, then the positive influence can be dramatic.

If you or someone you love need(s) substance abuse treatment you may want to consider behavioral couples therapy (BCT) for alcoholism and drug abuse as one good option to try.

The therapy works from the premises that:

1. Our intimate partners in life exert a strong influence over our behaviors. If trained to support and reward abstinence and good decision-making then they can assist in the recovery process.
2. Relationship conflict and discord destabilizes the recovery process and increases the chances of relapse.  Therapy which helps to eliminate relationship problems therefore also helps to reduce the odds of early relapse.

What’s Involved in BCT?

During BCT you work, with the help of a therapist, to transition your relationship from an entity that supports drinking or drug use to one that offers a solid foundation for recovery and abstinence.

A round of BCT typically requires 15 to 20 hour long therapy sessions over a 5 to 6 month period.

Typical components of BCT therapy include:

• The signing of a recovery contract between the therapist and the relationship partners
• The therapist introduces activities and homework assignments that are intended to increase communication within the relationship, increase positive feelings within the relationship, increase positive shared activities and to prevent relapse.
• At the start of each session, the couple and therapist discuss any substance use or other breaches of the recovery contract that have occurred since the previous session.
• The couple present and discuss their relationship homework from the previous session
• The therapist and the couple talk about emerging relationship problems and how to solve them

Outcomes: How Well Does Behavioral Couples Therapy for Substance Abuse Work?

Based on the outcomes of a number of quality research studies The Substance Abuse and Mental Health Administration (SAMHSA) endorses behavioral couples therapy for alcoholism and drug abuse as an effective evidence-based intervention.¹

Research tells us that BCT helps to:

• Reduce substance abuse – Across a variety of studies, compared to people who received alternate care, such as individual therapy, people who received BCT reported less drinking and drug use for up to a year after the completion of therapy (the last follow-up).
• Improve the quality of romantic relationships – Compared to alternate modes of therapy, people who received BCT reported greater relationship satisfaction in the months following the completion of therapy.
• Increase participation in other forms of substance abuse therapy – In one study, men who received BCT attended more scheduled treatment sessions and took more naltrexone than men who had not received the therapy.
• Decrease violence within the relationship – Alcoholic men who received BCT initiated less verbal and physical aggression for at least 2 years after the completion of the therapy.
• Improve the mental health of children within substance abuse affected families – In one study, 32% of children of couples getting BCT showed psychosocial impairment at the start of the therapeutic process. By a year after the completion of BCT, that percentage had been reduced to 5%

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Is it Vicodin addiction or just Vicodin dependence? Not sure? A self test here can help. Next, learn about effective treatment options.

Are you addicted to Vicodin or just Vicodin-dependent?

If you don’t know, then read on to learn the differences between the two conditions, and if you want to stop Vicodin, learn about the different methods you can use to achieve your goal.

Vicodin Dependence vs. Vicodin Addiction

Vicodin Dependence

If you take Vicodin every day for a period of weeks, you’ll become physically dependent on the medication, you’ll need to take gradually increasing doses to feel the same analgesia and you’ll experience uncomfortable withdrawal symptoms when you try to stop or wait too long between doses.

• If you never abuse Vicodin, you’re probably not addicted (though you may be dependent). If you are only Vicodin-dependent, you do not need addiction treatment. If you decide to stop you can likely minimize discomfort by tapering gradually, rather than stopping too suddenly.

Vicodin Addiction

If you sometimes use Vicodin just to feel good (not only to control pain), if you take more than your doctor prescribes or if you combine Vicodin with other substances to get high, then you abuse this medication and you are at serious risk of addiction.

With chronic use, and especially with chronic abuse, some people become both opioid dependent and opioid addicted. Addiction is considered a brain disorder – it’s like addiction hijacks control over the brain!. With repeated use of a very pleasurable substance, like Vicodin, you may cause dysfunction in brain circuits that regulate impulse control, memory, attention and others. You’re not aware of these changes as they occur, but once they do, it becomes very difficult to control your use behaviors. Some of the behavioral consequences of addiction brain changes include:¹

• Being unable to control how much you use (taking more than you had intended on using.)
• Continuing to take Vicodin despite realizing that it does you harm.
• Becoming fixated on getting and using the drug.
• Craving Vicodin.
• Neglecting your familial or work responsibilities
• Engaging in uncharacteristic behaviors to get Vicodin (such as lying, doctor shopping or illegal acts.)

Test Yourself for Addiction

If you think you’re addicted, here’s a quick test that can help you identify the severity of your situation.²

Over the previous 3 months:

1. Did you ever feel that your use of Vicodin was out of control?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

2. Did the idea of not getting Vicodin ever make you feel very anxious or nervous?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

3. Did you worry about your use of Vicodin?

• Never or almost never - 0 points
• Sometimes - 1 point 
• Often - 2 points
• Always or nearly always - 3 points

4. Did you wish you could stop?

• Never or almost never - 0 points
• Sometimes - 1 point
• Often - 2 points
• Always or nearly always - 3 points

5. How difficult would it be for you to go without using?

• Not difficult - 0 points
• Quite difficult - 1 point
• Very difficult - 2 points
• Impossible - 3 points

Scoring

• 0-3 = No addiction
• 4-6 = mild addiction
• 7-9 = Moderate addiction
• 10-12 = Substantial addiction
• 13-15 = Severe addiction

Vicodin Addiction Treatment Options

People who are addicted to Vicodin and Vicodin-dependent will experience withdrawal symptoms and very strong drug cravings when trying to quit. Most people who become addicted need some form of opioid addiction treatment – often combined with medication – to stay in recovery for any significant length of time.

Your main Vicodin addiction treatment options are:

1. Opioid replacement therapy – methadone or Suboxone, ideally combined with ongoing addiction treatment.
2. Opioid detox followed by residential or outpatient addiction treatment.
   

• Not recommended: Detox or ultra rapid detox only – with no follow up addiction treatment.

Most people feel like if only they could get past the physical withdrawal symptoms, they’d be able to stay drug free for good. Unfortunately, without addiction treatment, this is rarely the case. Detox and stabilization is an essential phase that prepares you for treatment, but alone, if offers you little protection against relapse.  

Opioid Replacement Programs: Methadone or Suboxone

Research shows that people who combine effective medications with ongoing addiction treatment generally have the best chances for long term recovery³  and that people who stick with an opioid replacement program for at least a year are far more likely than those who try an un-medicated recovery to maintain abstinence from opioids.⁴

Methadone and Suboxone are medications that work as substitutes for Vicodin in your brain. When you take methadone or Suboxone instead of taking Vicodin each day, you will:

• Not feel opioid withdrawal symptoms.
• Not feel drug cravings.
• Not get high.
• Be able to function normally once again.

Residential or Outpatient Addiction Treatment

If Suboxone and methadone aren’t for you, you can try a detox program followed by a residential or outpatient addiction treatment program.

A Vicodin detox will last up to a week and can be a pretty unpleasant experience. You can detox on your own, but getting withdrawal assistance, on an outpatient or residential basis, can improve your comfort during this first phase.

After detox, addiction treatment teaches you how to avoid and overcome drug cravings and how to change your life to reduce the odds of relapse. Your addiction treatment program should last at least 3 months in total duration and you should stay involved with some form of continuing care program for at least the first year of recovery.

Your main options are:

1. Opiate replacement therapy – Methadone or Suboxone, ideally combined with ongoing addiction treatment
2. Opiate detox followed by participation in a residential or outpatient addiction treatment program

Not recommended: Most people feel like if only they could break free from these pills for a few days and get past the physical withdrawal symptoms, they’d be able to stay drug free for good. Unfortunately, without addiction treatment, this is rarely the case. Medical detox only (or ultra rapid detox only protocols) may get you drug free in a few days, but without further and continuing participation in an addiction treatment program, you are very likely to succumb to drug cravings and relapse back to use. Medical detox programs or ultra rapid detox are not truly forms of addiction but rather programs that get you ready to participate in addiction treatment – alone, they teach you nothing about avoiding relapse.

Opiate Replacement Programs: Methadone or Suboxone

Research shows that people who combine effective medications with ongoing addiction treatment generally have the best chances for long term recovery* and that people who stick with an opiate replacement program for at least a year are far more likely than those who try an un-medicated recovery to maintain abstinence from opiates.

Methadone and Suboxone are medications that work as substitutes for Vicodin in your brain. When you take methadone or Suboxone instead of taking Vicodin each day, you will:

• Not feel withdrawal symptoms
• Not feel drug cravings
• Not get high
• Be able to function normally once again

Taking a pill once or twice a day or taking a daily dose of methadone get you free from the cravings and withdrawal symptoms that derail so many unmedicated opiate recovery attempts. On methadone or Suboxone, you can function normally once again and can get your life back on track before you make an ultimate attempt to taper down off either of these medications.

Research shows that people who do best in opiate replacement programs take their medication for at least a year and also participate in addiction treatment programs, like group therapy, cognitive behavioral therapy or relapse prevention programs.

There are a lot of myths and untruths that circulate about methadone and Suboxone treatment, but since these medications may represent your very best shot at a lasting recovery you get educated about the pros and cons of opiate replacement therapy before making any treatment decision.

Vicodin Detox Followed by Residential or Outpatient Addiction Treatment

If Suboxone and methadone don’t feel right to you, you can also break-free from Vicodin addiction by participating in a supervised detox program followed by a participation in a residential or outpatient addiction treatment program.

A Vicodin detox will last up to a week and can be a pretty unpleasant experience. Entering into a supervised detox program for this first week of abstinence is a good way to reduce the discomfort of the period as you also increase your odds of sticking the week out.

Although opiate withdrawal symptoms aren’t generally dangerous, nursing care and symptoms relieving medications can improve your comfort during this initial stage..

Detox alone is not considered addiction treatment and those that leave the process after detox only are likely destined to relapse back to Vicodin abuse and addiction. After a stay in detox you are ready, however, to begin the real work of recovery by participating in an outpatient or residential addiction treatment program.

Find out if you need residential or outpatient addiction treatment.

Addiction treatment teaches you how to avoid and overcome drug cravings and how to change your life to reduce the odds of relapse.

Your addiction treatment program should last at least 3 months in total duration and you should stay involved with some form of continuing care program for at least the first year of recovery.

You Can Beat Vicodin Addiction

Recovery from opiate addiction is tough – but people do it everyday and so can you.

Grant yourself the time and energy that’s needed for the best odds at long term success. There are no quick fixes, but with effort and perseverance and by using the best medications and/or addiction treatment methods, you give yourself a strong foundation for a better life in the future!

Having trouble finding or paying for quality addiction or mental health treatment? Well, if you’re lucky there’s a clinical trial recruiting subjects near you and if you’re eligible you may be up for free treatment from some of the nation’s top addiction specialists. Read on to learn about more of the benefits, and the legitimate risks, of clinical trials participation.

Would participating as a subject in an experimental study on some aspect of addiction treatment be right for you?

At the time of publication The National Institute of Health was advertising more than 119 000 clinical trials across American and in many countries of the world.

There are some attractive elements of clinical trials participation (not least of which being that your treatment might well be free of charge) but it’s not something to go into lightly or before you’ve got all the facts.

Read on to learn more on the benefits and drawbacks of clinical trials participation and consider whether getting into an experimental study on addiction treatment is a good decision for you.

What Is a Clinical Trial?

A clinical trial is a health related research study done on humans. Many are done to evaluate the effectiveness of a new or modified type of therapy or medication. Clinical trials are also used to evaluate the safety and side effects of a novel therapy or medication.

Participants in most clinical trials will be assigned to receive a certain intervention (therapy or medication) and the outcome or effectiveness of this intervention will be carefully recorded. In most cases, other participants in the same study will receive a different type of intervention, so that the effectiveness of the novel intervention can be compared against the effectiveness of an existing intervention.

In many studies, some participants are assigned to a control group. Subjects assigned to a control group may receive a placebo therapy or medication. In most cases, neither the subjects nor the investigators will know which participants are receiving the active intervention and which are receiving the placebo intervention.

Having a control group helps researchers to better understand what their intervention is doing, but if you are considering a clinical trial which uses a control group you have to accept that you may be randomly assigned to the group which receives a placebo. This is not something you will have any control over.

Informed Consent

All reputable clinical trials begin with a process of informed consent, during which potential study subjects are educated about the intentions of the research, the possible risks and benefits of participation, the duration of the study, what will be required of each participant and any other salient details.

After each participant understands the purpose, risks and benefits of the study they will be asked to sign an informed consent document. This document only affirms that the study participant understands the risks and objectives of the study; it is not a contract and signing it does not commit you to any course of action. In all clinical trials, you are free to withdraw from the study at any time and for any reason.

The Pros and Cons of Clinical Trials

Some of the Benefits of Clinical Trials Participation Include:

• Your treatment may be free or greatly subsidized. In some case, you may even be paid to participate
• You may gain access to therapies or medications that are not yet available elsewhere
• You may receive treatment from top experts in their field
• You may avoid lengthy waiting lists for treatment
• You will be assisting in the important process of health research
• You can withdraw from a study at any time, so you may  have little to lose in trying one out

Some of the Drawbacks of Clinical Trials Participation Include:

• The experimental intervention may produce unknown dangerous or unpleasant side effects
• You may be assigned to a placebo group and receive no active medication or therapy
• You may be required to travel to a hospital or clinic more frequently and spend more time receiving care then you otherwise might
• The experimental treatment may not work well

Where to Learn About Clinical Trials in Your Area

The National Institute of Health runs a clinical trials website. At this website you can search by location and by keyword for illness/type of treatment to find clinical trials recruiting volunteers in an area near you.¹

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