Relationships in Recovery

RELATIONSHIPS IN RECOVERY Maintaining Connections Through Addiction, Recovery and Beyond BY THE STAFF OF SOVEREIGN HEALTH TABLE OF CONTENTS [Click on chapters to navigate to page]

How to Recognize an Overdose 1 PAGE 4 How to Choose an Addiction Treatment Center PAGE 8 2 How to Manage and Defeat Cravings 3 PAGE 13 What to Do After a Relapse PAGE 17 4 How to Reconcile Damaged Relationships in Recovery 5 PAGE 21 How to Move Past Legal and Financial Problems PAGE 29 6 A Guide To Sovereign Health’s Facilities PAGE 34 A Directory of Behavioral 7 Health & Recovery Resources PAGE 39 8

2 INTRODUCTION CHEMICAL DEPENDENCY INVARIABLY LEADS TO LOSS. Material losses can usually be replaced in sustained recovery. Relationship loss or damage is a little trickier. An important part of the healing process requires honest self-examination and a look at our relationships. Chances are certain things will need to change so that old patterns of behavior don’t lead back to substance abuse. Perhaps amends need to be made. Maybe a toxic relationship needs to end. In any case, this process requires courage, acceptance and action. Relationships cannot heal by simply abstaining from alcohol or drugs. Whether you’re in recovery, or you are a parent, child, brother, sister, spouse, significant other, co-worker, boss, friend or neighbor of someone who is— reconciling relationships requires intentional effort. That’s where this book comes in. We explain why it is important to face the wreckage of the past and offer some practical tips to help. We also provide suggestions for protecting sobriety during the process and a handy directory of resources for everyone involved in the recovery process. Fortunately, the sober community — from the first responders, social workers, counselors, clinicians, to secular and faith-based sponsors and volunteers — is always available to provide generous support and guidance simply for the asking. Friends and families of someone in early recovery require healing as well. Professional counseling can be a lifeline, particularly during times of crisis. Over the long term, establishing a peer support network in the local community is essential. Strength, safety and wisdom lie in the relationships we build. The recovery journey is truly miraculous. Misery, pain and despair are replaced with joy, freedom and hope. We at Sovereign Health hope you find this little book useful along the way.

3 CHAPTER ONE

How to Recognize an Overdose By Kristen Fuller, M.D.

[Click to return to contents] HAVING A LOVED ONE WHO IS HOOKED ON DRUGS OR ALCOHOL CAN BE DEVASTATING TO BOTH YOU AND THE ADDICTED PERSON.

Fearing that one day your loved one will overdose, you tremble at the thought of receiving that dreaded phone call. In 2014 alone, more than 47,000 people died from a drug overdose, according to the Centers for Disease Control and Prevention. Recognizing signs and symptoms of a drug overdose may give you the time you need to seek immediate medical care by calling 911 before it is too late. Each class of substances has its own set of symptoms that occur when an individual is under the influence. Although it is best to prevent an overdose, recognizing the signs and symptoms can potentially save your loved one’s life.

HOW TO RECOGNIZE AN OVERDOSE 5 • Chest pain SYMPTOMS OF OPIOID INTOXICATION & • Dilated pupils OVERDOSE • Tremors • Pressured speech Opioids, also known as narcotics, • High energy levels are the No. 1 cause of substance • Irritability/restlessness overdose worldwide. They come in legal prescription drug forms SYMPTOMS OF ALCOHOL / such as morphine, oxycodone, hydrocodone and others, and BENZODIAZEPINE in illegal forms such as heroin. INTOXICATION & Symptoms of intoxication and OVERDOSE overdose include: Alcohol and benzodiazepines act • Pinpoint pupils on the same receptor in the brain • Confusion and have very similar effects. • Extreme fatigue / Death from an overdose of ben- loss of consciousness zodiazepines or alcohol alone is • Slurred speech very uncommon, but using together can potentiate an over- • Constipation dose. Symptoms of intoxication • Dry mouth/eyes and overdose include: • Shallow breathing / • Slurred speech respiratory depression • Confusion • Impaired balance / ataxia SYMPTOMS OF COCAINE INTOXICATION & • Impaired motor function OVERDOSE • Somnolence • Respiratory depression • Nervousness • Double vision • Sweating • Racing heart beat

6 HOW TO RECOGNIZE AN OVERDOSE • Severe abdominal pain SYMPTOMS OF PHENCYCLIDINE (PCP) • Nausea/vomiting INTOXICATION & • Sweating OVERDOSE • Dark urine • Yellowing of the skin/eyes • Combativeness / (jaundice) extreme aggression It is important to be aware that • Extreme agitation many of these signs and symp- • Superpower strength toms overlap. If a loved one is • Hallucinations acting strange or demonstrating • Horizontal nystagmus any of the above symptoms and (side-to-side eye movements) you have a high suspicion of overdose, take immediate action: SYMPTOMS OF 1 If your loved one is unre- METHAMPHETAMINE sponsive, place him or her INTOXICATION & in a recovery position (on his or OVERDOSE her side) and immediately call 911. By placing the person on his • Restlessness or her side, it prevents aspiration • Vision spots in case of vomiting. Stay in the room with your • Sweating 2 loved one and continue to • Aggressive behavior talk to him or her. • High fevers Don’t give your loved one 3 • Severe abdominal pain anything to eat or drink. • Sweating 4 Don’t induce vomiting. SYMPTOMS OF 5 Follow instructions from ACETAMINOPHEN AND the 911 first responder. OVER-THE-COUNTER PAIN RELIEVERS OVERDOSE

HOW TO RECOGNIZE AN OVERDOSE 7 CHAPTER TWO

How to Choose an Addiction Treatment Center By Kristen Fuller, M.D.

[Click to return to contents] BREAKING THE CYCLE OF ADDICTION IS A LIFELONG PROCESS. It takes commitment, hard work, honesty, trial and error, and a strong supportive network. It is very common to relapse multiple times, but once an individual is in a program and has a supportive network, over- coming a relapse and achieving long- term recovery is much easier. Finding treatment for your loved one can be challenging. There are many types of inpatient rehabilitation centers and outpatient programs, and each treatment facility offers different therapeutic approaches.

FINDING THE RIGHT INPATIENT TREATMENT CENTER

The most important criterion for finding the best rehabilitation program is making sure your loved one feels safe and comfortable with the treatment center. It is important that the treatment fits the individual’s needs and that there is enough HOW TO CHOOSE AN ADDICTION TREATMENT CENTER 9 supportive and ancillary staff ment. You should not feel pres- available to provide the best sured or like you’ve been given a care. The road to recovery starts sales pitch. with an evidence-based treat- • Ask to see the treatment fa- ment program, whether it is an cilities where the person will inpatient facility or an outpa- be staying. Make sure they are tient program. clean. • Ask around. Go to recovery • Ask about medication regi- meetings such as Alcoholics mens, meal services, extracur- Anonymous and obtain informa- ricular activities, counseling tion about the inpatient treat- sessions, and 24-hour care ver- ment centers in your area. Just sus part-time care. like any other type of service, • Make sure your insurance is having a primary referral from accepted and ask about all the someone you know can help nar- financial aspects of treatment. row down the treatment center Treatment is expensive and will options. require careful financial plan- • Make sure you and your ning and budgeting. loved one feel comfortable • Inquire about continuing during the tour and the admis- care after patients leave a pro- sions process at the treatment gram and ask about relapsing. center. • Do your research. Read online OUTPATIENT TREATMENT reviews and ask for the creden- tials of the clinical staff. Make Not every individual will need sure the facility is accredited and or choose to enter into an inpa- up to all standards. tient treatment center. Some • Make sure all of your ques- individuals will pursue outpa- tions are answered appropri- tient support groups. Alcoholics ately. Anonymous (AA) and Narcotics • Don’t allow a treatment cen- Anonymous (NA) are two very ter to pressure you into enroll- well-known outpatient support

10 HOW TO CHOOSE AN ADDICTION TREATMENT CENTER groups that follow the 12-step The pillars of the 12-step pro- programs. Other types of out- gram center on the belief of a patient programs, such as harm higher power and accepting that reduction, SMART Recovery and the addict is powerless. Without Moderation Management, are this higher power, sobriety can- great alternatives. Obtaining the not be obtained. AA and other best treatment and care depends 12-step programs have an all-or- on what your loved one needs. nothing approach: The person is The 12-step program is a spiri- either completely sober or an ad- tually based guidance program dict; there is no middle ground. used by addicts who are trying to One of the great benefits of AA, recover from alcohol use, drug and other 12-step programs alike, use and compulsive behaviors. is that they require a partnership

HOW TO CHOOSE AN ADDICTION TREATMENT CENTER 11 between two recovering alcohol- platform. This allows users to re- ics, more commonly known as a main anonymous. sponsor/sponsee relationship. Moderation Management of- This sponsor is someone who has fers education, behavioral successfully worked the program change techniques and peer sup- and achieved port for prob- recovery and lem drink- who can give THE ROAD TO ers seeking advice and RECOVERY STARTS to decrease lend a help- WITH AN their drinking hand to his ing — whether or her spons- EVIDENCE-BASED to moderate ee throughout TREATMENT PROGRAM. drinking levels the recovery or to abstain process. completely SMART Recovery, founded in from alcohol. Moderation Man- 1994, is an alternative to AA pro- agement believes in helping early grams. SMART Recovery focus- problem drinkers before they be- es on cognitive and scientifically come full-fledged alcoholics and based methods that utilize psy- hit rock bottom. This program chological treatments. SMART aims to help these people rec- Recovery stands for Self-Manage- ognize their drinking problems ment and Recovery Training and early and take the steps to learn is a self-help, abstinence-based about moderation and harm re- program for people who are try- duction instead of absolute ab- ing to overcome an addiction. stinence. Using the principles of psychol- Many types of recovery pro- ogy, individuals help themselves grams are available and it is im- to quit a problem habit, address portant that you take the time habit-related personal problems to research each avenue so your and prevent relapses. In-person loved one receives the best care meetings are available, but many and achieves lasting sobriety. addicts participate in the online

12 HOW TO CHOOSE AN ADDICTION TREATMENT CENTER CHAPTER THREE

How to Manage and Defeat Cravings By Courtney Lopresti, M.S.

[Click to return to contents] CRAVINGS ARE TERRIBLE. Managing cravings — particularly at the start of recovery — can feel difficult, if not impossible. This list is meant to serve as a brief primer for facing cravings in your daily life. If you are actively dealing with cravings right now, don’t worry — you will be all right. Cravings are normal, temporary and can be defeated. Take several deep breaths before reading this list. Just wait. The beautiful thing about cravings is that they will always — ALWAYS — disappear. It may SEEM like the only way to make them go away is to give in, but that feeling is just your brain trying to trick you. Often, simply waiting for the cravings to go away will be enough for the feeling to dissipate. When the cravings disappear (as they always will), you’ll recognize the power you have: the power to defeat the voice in your head and stay sober. It won’t always be easy to ignore these urges and cravings — especially early on in your recovery

14 HOW TO MANAGE AND DEFEAT CRAVINGS — but the confidence boost you’ll on an episode of your favorite get from successfully defeating television show. them will make the next time It may help to come up with a easier. list of distracting activities and/ If your cravings don’t disappear or excuses in advance to rapidly on their own within 10 to 15 min- leave a triggering situation. utes, you may need to take some 2 DISARM the thoughts. other action. DISARM is a mental exercise For instance … recommended by SMART recov- 1 Go somewhere else. ery, a self-management and re- When cravings stick around covery training group. for longer than 10 to 15 minutes, DISARM stands for Defeat the this can mean Addiction that some- OFTEN, SIMPLY Salesman in thing in your Your Head. environment WAITING FOR THE With this ex- is triggering CRAVINGS TO GO ercise, you’re them. May- encouraged be you’re in AWAY WILL BE to view your a restaurant ENOUGH FOR THE cravings not with a partic- FEELING TO DISSIPATE. as an all-pow- ularly visible erful force, bar, or maybe but rather as you’re chatting with a friend who an annoying salesman that can played a role in your less-than- be defeated if you talk back to sober past. him (or her). The salesman will Leave. Get away. Just escaping do whatever it takes to get you the situation might be enough to to use again and is an expert at distract your mind from the crav- using your weakness against you. ings. If they’re still around after Attack the salesman through you’ve left, try to do something powerful counter statements, distracting. Start a puzzle, or put reminding him or her that —

HOW TO MANAGE AND DEFEAT CRAVINGS 15 even though it’s EASY to give in ly perfect person in your support to the cravings — you don’t need group? He or she has cravings. to. After attacking the salesman, Your sponsors and role models? distract yourself and instead fo- They are intimately familiar with cus on activities and images that cravings, even though they’ve remind you of the benefits of be- been sober for decades. ing sober. Cravings will not kill you. (Crav- Understand that cravings ings, it should be noted, are very 3 are normal. different from acute symptoms of You are not hopeless or doomed alcohol withdrawal, which can be to failure. You are not a bad per- deadly.) They are not a sign that son. You are not the exception to your attempt at sobriety will fail. the rule. Keep this in mind, and resisting Everyone who has EVER engaged those cravings will become much in an addictive behavior has expe- easier. rienced cravings. That seeming-

16 HOW TO MANAGE AND DEFEAT CRAVINGS CHAPTER FOUR

What to Do After a Relapse By Dana Connolly, Ph.D.

[Click to return to contents] SLIPS HAPPEN. RELAPSES OCCUR.

Drinking after getting sober and using drugs after kicking the habit can be discouraging, but take heart. The relapse itself is not important; it is what happens next that matters. Relapse can be a learning experience or a death sentence. Honesty and taking action can make the differ- ence between life and death.

IS THE SLIP REALLY A RELAPSE?

Many people wonder how a “slip” dif- fers from a “relapse.” This issue was addressed in the classic 1947 article by William Duncan Silkworth, M.D., entitled “Slips and Human Nature.” In his article, Dr. Silkworth states that the slip is, in fact, a relapse. He describes relapse as a complacency with recovery behaviors that occurs when things are generally going well in sobriety. This complacency leads to errors in thinking and judgment, which result in relapse. Other factors can interfere with recovery behaviors besides complacency when things are going well. 18 WHAT TO DO AFTER A RELAPSE Stress, trauma, loss, adversity the sooner you can enjoy recovery and major life changes can also again. Here are some tips to help: affect daily routine and threaten 1 Stop drinking and/or tak- sobriety. Even travel can be dis- ing drugs right away. Dis- ruptive enough to put people at pose of remaining alcohol and risk. But as Dr. Silkworth points drugs, and do not buy any more. out, the relapse begins with erro- If someone else is providing the neous thinking before the actual alcohol or drugs, leave the envi- drink (or drug) is taken. ronment immediately. Relapse can be prevented, even Tell someone who is com- 2 during times of extreme stress mitted to your recovery. and difficulty, if healthy lifestyle 3 Eat. habits and recovery behaviors are maintained on a daily basis. But 4 Sleep. when relapse does occur, no mat- 5 Attend recovery meetings. ter the cause, it is always wise to Resume other healthy hab- 6 have a contingency plan. its, such as exercise. 7 Resume other recovery be- FOR THE PERSON haviors, such as reading WHO RELAPSES recovery literature, watching recovery videos, journaling, Rigorous honesty is paramount in praying, meditating and laugh- all aspects of recovery. Admitting ing with safe friends. to yourself and another human With the help of your spon- 8 being (preferably someone in re- sor or counselor, examine covery) that relapse has occurred the causes and circumstances can be life-saving. The help, sup- that led to the relapse to elu- port and accountability gained by cidate what part of the recov- sharing what happened can help ery program wasn’t working, prevent further isolation and so that you can take a different desperation. The sooner you ac- approach. knowledge the relapse, the easier 9 Remember what it took the withdrawal period will be and WHAT TO DO AFTER A RELAPSE 19 to get sober, as it will proba- gry, betrayed, disheartened, frus- bly take the same things again. trated and even hopeless. Learn- Think through what the conse- ing to be patient enough may quences will be on the current seem impossible, and so might path of drinking and/or using the whole situation. But just as drugs and consider what else the person battling the addiction there is to lose. can learn from a relapse and de- Get help as soon as possi- velop a more foolproof recovery 10 ble, even if it means check- plan, loved ones can also learn ing into a re- life lessons and habilitation SETBACKS AND emerge stron- center. Inpatient STRUGGLES ARE PART ger as a result. or residential de- Whenever pos- toxification can OF THE PROCESS OF sible, your loved provide medi- LEARNING. one should go cation to make back into treat- withdrawal safe and comfort- ment following a relapse. Don’t able. allow your own healthy lifestyle habits to become interrupted. FOR FRIENDS AND Attend support group meetings, FAMILY MEMBERS such as Al-Anon, which offer a means to cope and a social sup- Relapse is not unusual when re- port network. Social support is covering from alcohol or drug ad- critical for friends and families diction, especially during the first of those who are battling addic- year or so. Setbacks and struggles tions. are part of the process of learning Just remember, recovery is a jour- what works and what does not. ney of self-discovery that brings Think self-discovery, not failure. some of life’s greatest gifts. This Never give up. journey provides the strength When a loved one relapses, friends needed to stay sober and to help and family members may feel an- others achieve lasting sobriety.

20 WHAT TO DO AFTER A RELAPSE CHAPTER FIVE

How to Reconcile Damaged Relationships in Recovery By Dana Connolly, Ph.D.

[Click to return to contents]

21 RELATIONSHIPS DAMAGED BY ADDICTION ARE COMPLICATED. Social stigma promotes “scapegoat- ing,” in which the person with the addiction gets blamed for all of the problems in the relationship, even in sobriety. Not only is this attitude unfair, it also makes honest problem-solving impossible. For this rea- son, it is crucial to remember three key points when reconciling damaged relationships in recovery: • Let go of the past and do not worry about the future. Only focus on the present. • Do not criticize or blame. Each person is only responsible for his or her own behavior. • Admit your own faults. Tell the truth even when it is not what the other person wants to hear. Honesty is the only policy. Not all damaged relationships can or should be repaired in recovery, but all must somehow be reconciled. Doing so paves the way to make amends so that you can enjoy life again. Rec-

22 HOW TO RECONCILE DAMAGED RELATIONSHIPS IN RECOVERY onciliation also prevents ongo- moments we share. ing fear, anger, resentments and The underlying principle of 12- guilt, all of which can threaten step programs is that addiction is sobriety and sanity. a symptom of a spiritual illness. Reconciliation is complete when Repairing relationships with oth- two or more people reach a mutu- ers re-establishes a connection al agreement, whether spoken or with the higher power and cures unspoken, on how a relationship the spiritual illness. Practicing is to proceed. Some relationships the 12 steps provides the strength will heal, although it may take required to live free of addiction. time. Other relationships will For those who have a loved one end and new ones will begin. Get- with an addiction, the 12 steps of- ting through it all is possible by fer a way of coping. remaining sober, staying socially While it would be nice if the 12 connected and practicing good steps are completed with ease, lifestyle habits. Many people also the addiction goes away and ev- find that their faith and trust in erybody lives happily ever after, a higher power gives them the that is rarely the case. All kinds strength and courage they need of emotions ensure that the pro- to handle difficult transitions in cess will be interesting at the sobriety. very least. Working with a sponsor and attending meetings offer SPIRITUAL the social support needed to get CONSIDERATIONS through it relatively unscathed.

While talking about God might RESOLVING not seem politically correct these RESENTMENTS days, discussions about relationships are difficult outside the Some emotions are more dan- context of a higher power, which gerous than others. Resentment, is love. We experience this as love jealousy, frustration and fear are works through us and other be- particularly toxic for those in re- ings (human or animal) and the 23 HOW TO RECONCILE DAMAGED RELATIONSHIPS23 IN RECOVERY covery, according to Alcoholics Write down what harm 2 Anonymous (Page 145). The AA was done and describe all book also states that resentment of the feelings it caused. is the root of all spiritual illness Consider which of the sev- 3 and the leading cause of relapse. en parts of the self were In other words, resentments can affected: self-esteem, pride, fi- be fatal for those in recovery. The nances, relationships, ambitions, good news is that resentments emotional well-being and sexual- can be resolved, and in doing so, ity/intimacy. damaged relationships get rec- Consider your own role in onciled. 4 the issue by acknowledg- The word resentment literally ing selfish, fearful or inconsid- means to feel again. Resentments erate behavior. are negative feelings that keep Describe what feelings repeating until they are resolved. 5 might have been aroused Defined as “bitter indignation at in the other person, such as jeal- having been treated unfairly,” re- ousy, suspicion or resentment. sentments will remain until they Consider how you could are reconciled or the resentful 6 person dies. have handled it more ef- fectively. Repeat the moral invento- DEALING WITH THE 7 WRECKAGE OF THE PAST ry for all those who were harmed by the addiction and Based on the 12 steps, resent- related behavior. ments and relationships can be After the written part is com- reconciled by starting with a writ- plete, consider contacting the ing assignment: person with whom you have resentment, unless doing so would 1 Make a moral inventory. Identify the person, institu- harm someone in some way. The tion or principle that caused the purpose is to resolve your own resentment. part in the issue, not to demand Continued on page 26 24 HOW TO RECONCILE DAMAGED RELATIONSHIPS IN RECOVERY AMENDS & FORGIVENESS Amends and forgiveness are two of the most beautiful parts of recovery. But getting there requires some work, some of which can be difficult or painful. Below is a guide to walk you through the necessary groundwork for reconciling relationships and resentments. WRITE IT DOWN Make a list of those you have harmed and those with whom you harbor resentments. For each one, ask yourself: 1 2 3 4 5 What parts of What was my What caused How did I make How could I my sense of self role in what me to behave the other have handled it were harmed or happened? the way I did? person feel? better? threatened? TAKE ACTION Next, go through each name one by one with the following process: Is the person still alive?

YES YES NO

Will bringing up the Forgiveness / Forgiveness / issue harm anyone? living amends living amends

NO NO

Is it possible to Letter / phone / video meet in person? 1 2 3 4 5 6 YES Set up Get Tell your Ask what Work out Follow Take the meeting. support. side. you can do a mutually through. next steps to make agreeable it OK. deal. Continued from page 24 Receiving forgiveness feels good, an apology or start a fight. Be but it is not as important as doing sure to be prepared and have a the forgiving. Forgiving others for supportive other involved. If pos- the harms they have caused is a sible, admit to the other person path to freedom. Whether or not your own role in the issue and ask the offender is sorry is irrelevant. the other person how the situa- Some reasons why forgiveness is tion could be amended. In person essential: is the best approach, but video • Anger and resentment serve calls, telephone calls or written no purpose. letters also work. • Anger and bitterness can in- If direct amends are not possi- fect relationships with others ble, take indirect action toward who weren’t involved in the ini- amending the situation. An ex- tial conflict. ample of indirect amends would • Unforgiving victims become be if you owed money to a de- further victimized by their own ceased ex-friend but never paid negative emotions. because of a dispute, you can set up installment payments for the • Forgiveness therapy reduc- person’s heirs. es depression, hostility, anger, stress and distress. Based on the 12-step process, the chart on the previous page • Forgiveness promotes health. summarizes some of the actions “It is in pardoning that we are to take when repairing relation- pardoned” — from the Prayer of ships. The algorithm is not meant Saint Francis of Assisi to replace the recommended • Forgiveness is both a choice 12-step process, which includes and a process, and every per- reading the associated literature, son has his or her own way to attending group meetings and achieve it. working with a sponsor. Some things to consider once you make the decision to forgive: FORGIVENESS • The other person’s

26 HOW TO RECONCILE DAMAGED RELATIONSHIPS IN RECOVERY perspective feelings prevents growth and can • Occasions of hurting others make people feel stuck. Like for- in the past and being forgiven giveness, getting unstuck by let- • Spiritual beliefs such as di- ting go involves a choice and a vine justice or karma process. • The posi- In her book “The Language tive effects RECONCILIATION IS of journaling, of Letting Go,” prayer and/or COMPLETE WHEN TWO best-selling meditation OR MORE author Mel- ody Beattie, • Alternative PEOPLE REACH A reflects on is- thoughts and MUTUAL AGREEMENT, sues related to behaviors codependency to use when WHETHER SPOKEN OR and how dai- negative UNSPOKEN, ON HOW A ly meditations thought pat- RELATIONSHIP IS can help main- terns return tain a healthy LETTING TO PROCEED. perspective. GO She eloquently articulates the An important aspect of forgive- choice and process of letting go, ness involves letting go. This may “Today, I will understand that I mean letting go of the past, let- hold the key to my freedom. I will ting go of how things were “sup- stop participating in my oppres- posed” to be, letting go of the sion and victimization. I will take blame, anger, resentment and responsibility for myself, and let grief. And when relationships others do as they may.” cannot be repaired or when they cannot even be reconciled, learn- RESOLVING GUILT ing to let go can be very healthy. Holding on to unhealthy rela- Often, letting go involves sur- tionships, ideas, thoughts and rendering the need for control to 27 HOW TO RECONCILE DAMAGED RELATIONSHIPS27 IN RECOVERY triumph over adversity. In doing under the circumstances, guilt so, many are able to realize that feelings usually subside. If not, they belong to something much perhaps more amends need to be bigger and better. Only then are made. they able to appreciate all of the Debilitating pathological guilt good in the world and be mental- usually signals an underlying ly present for others. mental illness, such as obsessive-compulsive disorder or LINGERING GUILT childhood trauma. When guilt Guilt tends to persist until you feelings interfere with daily func- make either direct or indirect tioning or lead to alcohol or drug amends. Once you truly feel that use, seek evaluation by a mental you have done everything in your health professional. power to amend the situation

28 HOW TO RECONCILE DAMAGED RELATIONSHIPS IN RECOVERY CHAPTER SIX

How to Move Past the Legal and Financial Problems Caused by Drugs By Dana Connolly, Ph.D.

[Click to return to contents] WHEN “DOPE SICKNESS” OR WITHDRAWAL SETS IN, PEOPLE WHO ARE CHEMICALLY DEPENDENT ARE FORCED BY THEIR OWN BODIES AND HIJACKED BRAINS TO DO WHATEVER THEY MUST TO DRINK OR TAKE DRUGS. Sometimes they feel they have no choice but to break the law. As a result, legal problems are not a matter of if, but when.

LEGAL IMPLICATIONS OF SUBSTANCE ABUSE

Laws vary from state to state, but for the most part, the legal implications of ongoing addiction are very predictable. The usual charges relate to drug possession, public intoxi-

30 HOW TO MOVE PAST THE LEGAL AND FINANCIAL PROBLEMS CAUSED BY DRUGS cation, driving under the influ- tremely painful for the addicted ence, domestic violence, fighting, person. prescription The legal and fi- fraud, prosti- RECONCILING THE PAST nancial conse- tution, shop- AND PLANNING FOR quences of ad- lifting, rob- diction are as bery and other THE FUTURE CAN ALL vast as the men- forms of theft. BE DONE BY tal and physical Jail, prison, UNDERSTANDING THE consequences. criminal re- For those en- cords, penal- ISSUES AND STAYING trapped by sub- ties and fees, IN THE PRESENT. stance use, hope job loss and may seem like a other conse- fading memory, quences destroy people with ad- but recovery is possible. Reconcil- dictions and usually their fami- ing the past and planning for the lies as well. future can all be done by under- Criminal offenders have sub- standing the issues and staying in stance use and chemical depen- the present. dency rates that are more than four times those of the general FINANCIAL PROBLEMS population. In addition, research RESULTING FROM demonstrates that treatment, SUBSTANCE ABUSE even when involuntary, results in far less criminal behavior and Recovery from addiction inevita- recidivism. Yet fewer than 20 per- bly involves some level of finan- cent of incarcerated individuals cial recovery. Restoration of fi- who need substance use treat- nancial stability and relief from ment receive it. Even those who debt can seem overwhelming and are chemically dependent on cause stress that could lead back drugs or alcohol are forced to to substance use. It’s important abruptly detoxify without treat- to put aside any regret from the ment, which is dangerous and ex- past and any worry about the fu- HOW TO MOVE PAST THE LEGAL AND FINANCIAL PROBLEMS CAUSED BY DRUGS 31 ture, and focus instead on taking Once all resentments are recon- appropriate action. ciled, take these steps: Because the nature of substance 1 Rebuild your credit. use disorders predisposes those Credit is an indirect measure who suffer from them to vic- of credibility and trustworthi- timization, especially financial ness. Rebuilding credit truly lies victimization, resentments usu- in keeping one’s word. By being ally develop. It timely, making is important to IT’S IMPORTANT TO payments and resolve any re- PUT ASIDE ANY REGRET keeping com- sentment before mitments every attempting to FROM THE PAST AND day, credibility restore financial ANY WORRY ABOUT and credit will stability so that return simply it can be done in THE FUTURE, AND by being con- a completely ob- FOCUS INSTEAD ON sistent. Going jective state of TAKING APPROPRIATE to work, school mind. Some un- and social gath- derlying resent- ACTION. erings all help ments might be to rebuild trust- toward those who take advan- worthiness within society. Social tage of addicted individuals for gatherings help build meaningful their own financial gains. relationships, which are powerful assets. Meetup groups, recovery GOING FORWARD meetings, church groups or other community organizations all af- You can protect yourself from ford an opportunity to regularly such manipulations by staying see the same people and build re- sober, helping others recover and lationships. Other benefits of be- preventing future generations longing to a social group include from falling into the addiction gaining priceless information trap. Part of staying sober is re- about finding housing, buying a solving resentments. car, getting a job, obtaining legal 32 HOW TO MOVE PAST THE LEGAL AND FINANCIAL PROBLEMS CAUSED BY DRUGS assistance and more. ical expense when it meets the 2 Get out of debt. Internal Revenue Service require- Debt can weigh heavily on ments. Medications, transporta- the conscience and thus threaten tion and travel related to treat- sobriety. Getting out of debt will ment should also be deductible. also happen little by little. Start Those who have had no income in with a list of every debt and then the past year do not necessarily create a monthly budget. Revise need to file a return and associat- the budget monthly. Some find ed paperwork. Consider consult- paying off small debts first is a ing with a professional income good way to begin the process. tax service. Keep in touch with creditors so 4 Invest in the future. that they feel comfortable offer- Sobriety today is a wonder- ing more flexible payments and ful investment for tomorrow. Re- perhaps even lowering your in- covery is when things stop falling terest rates. It never hurts to ask. apart and start falling into place. As finances improve, take a small 3 Consult with a tax professional. part of the money that used to Drug and alcohol addiction treat- be spent on drugs or alcohol and ment is tax-deductible as a med- save it for an especially bright, new future.

HOW TO MOVE PAST THE LEGAL AND FINANCIAL PROBLEMS CAUSED BY DRUGS 33 CHAPTER SEVEN Photo: Fafe Knapp / Sovereign Media

A Guide to Sovereign Health’s Facilities Compiled by Amanda Habermann, M.S.

[Click to return to contents] SOVEREIGN HEALTH IS A PREMIER PROVIDER OF MENTAL HEALTH AND ADDICTION TREATMENT SERVICES. With locations conveniently located across the U.S., we’re prepared to help you – or a loved one – through treatment. Here is a guide to each of our facilities:

ARIZONA

Sovereign Health of Chandler Chandler, Arizona 1-866-598-5661 A residential rehabilitation facility for women only, specializing in survivors of trauma and abuse, in addition to the treatment of mental health and substance use disorders. Visit our website: www.sovarizona.com Photo: Fafe Knapp / Sovereign Media

A GUIDE TO SOVEREIGN HEALTH’S FACILITIES 35 SOVEREIGN’S LOCATIONS

CALIFORNIA Sovereign Health of Sovereign Health of San Clemente’s Eating San Clemente Disorder Program San Clemente, California 1-866-629-0442 1-866-629-0442 Treatment program specifically Residential treatment facility designed for women with eat- that offers detox and individu- ing disorders. Sovereign Health’s alized, comprehensive behavior- eating disorder program empow- al health treatment services to ers clients to develop and main- patients with mental disorders, tain a healthy relationship with substance use disorders and their body and mind. co-occurring disorders. See more about the Eating Visit our websites: Disorder Program: www.sovhealth.com www.sovhealth.com www.sovcal.com www.sovcal.com

36 A GUIDE TO SOVEREIGN HEALTH’S FACILITIES Sovereign Health of www.sovcal.com Los Angeles Culver City, California Sovereign Health of 1-866-629-0442 Rancho San Diego Treatment facility that provides El Cajon, California holistic and comprehensive 1-866-615-7266 behavioral health treatment Adolescent residential facili- services to patients with men- ty that provides youth ages 12 tal disorders, substance use to 17 years with comprehensive disorders and co-occurring dis- behavioral health treatment orders. This facility also has a services for mental illness, sub- specialized track for those who stance use disorders and co-oc- have a history of trauma and/or curring disorders. post-traumatic stress disorder. Visit our websites: Visit our websites: www.sovteens.com www.sovhealth.com www.sovcal.com www.sovcal.com

Sovereign Health of Rancho Sovereign Health of San Diego’s Eating Palm Desert Disorder Program Palm Desert, California 1-866-615-7266 1-866-629-0442 Provides education and treat- Provides detox and residential ment for eating disorders to fe- treatment for patients with male youth ages 12 to 17 years. mental health conditions, sub- The eating disorders program stance use disorders and co-oc- specializes in providing inpatient curring disorders. Also home to and outpatient services as well Sovereign’s PRIME program for as a number of evidence-based men aged 40 and over. treatments, including CBT and Visit our websites: DBT. www.sovhealth.com Visit our websites:

A GUIDE TO SOVEREIGN HEALTH’S FACILITIES 37 www.sovteens.com Provides detox and individual- www.sovcal.com ized, holistic behavioral health treatment services to patients FLORIDA with substance use disorders and co-occurring disorders. This fa- Sovereign Health of Fort Myers cility is equipped to provide services to both English- and Span- Fort Myers, Florida ish-speaking patients. 1-866-217-5527 Visit our website: Provides detox and comprehen- www.sovtexas.com sive behavioral health treatment services to patients with mental UTAH disorders, substance use disorders and co-occurring disorders. White River Academy Visit our website: Delta, Utah www.sovfl.com 1-866-300-0616 Adolescent residential treat- Sovereign Health of ment facility that provides males Pompano Beach between the ages of 12 to 17 Pompano Beach, Florida years with behavioral problems 1-866-217-5527 with experiential activities, com- Provides treatment for patients munity services, an academic with substance use disorders and curriculum and therapeutic pro- co-occurring disorders. gramming from a Positive Peer Culture treatment modality Visit our website: and dialectical behavior therapy www.sovfl.com to foster personal growth, responsibility and healthy lifestyle TEXAS choices. Visit our website: Sovereign Health of El Paso www.whiteriveracademy.com El Paso, Texas 1-866-399-5740 38 A GUIDE TO SOVEREIGN HEALTH’S FACILITIES CHAPTER EIGHT

A Directory of Behavioral Health and Recovery Resources Compiled by Amanda Habermann, M.S.

[Click to return to contents] THE RESOURCES LISTED BELOW ARE FOR INDIVIDUALS WITH SUBSTANCE USE DISORDERS. They’re also for friends, family members and other loved ones affected by the substance use disorder to contact in an emergency situation.

EMERGENCY RESOURCES

If you are in immediate danger or are in need of immediate assistance, call 9-1-1. Poison Control Center 1-800-222-1222

DISASTER RESOURCES

American Red Cross Contact your local Red Cross: redcross.org/find-your-local- chapter Mental health volunteers travel to disaster sites to provide emotional support, and help people to cope

40 RESOURCES after a disaster. samhsa.gov/find-help/disaster- See more at the Red Cross web- distress-helpline site: www.redcross.org/get-help DisasterAssistance.gov FEMA Helpline SUICIDE AND 1-800-621-FEMA CRISIS INTERVENTION 1-800-621-3362 Boys Town Crisis and Suicide TTY: 1-800-462-7585 Hotline 711 or VRS: 1-800-621-3362 1-800-448-3000 Website: TDD: 1-800-448-1833 disasterassistance.gov Provides 24/7 immediate phone assistance and short-term crisis National Center for Missing & intervention and counseling for Exploited Children (NCMEC) parent-child conflicts, marital Safety tips for disaster prepared- and family issues, physical and ness for families. See more at sexual abuse, suicide, pregnancy the website: and runaways, and provides local missingkids.com/Disasters referrals throughout the U.S. Visit the website: SAMHSA Disaster Distress boystown.org/hotline Helpline 1-800-985-5990 Covenant House TTY: 1-800-846-8517 1-800-RUNAWAY (786-2929) Text “TalkWithUs” to 66746 Covenant House provides care Trained crisis counselors provide and vital services to youths be- free, 24/7 assistance and support tween the ages of 17 to 21 years to people who are coping with who are homeless and living on the after-effects of a disaster. the streets. Crisis care is provided to at-risk and homeless kids Visit the website: who are unsafe, abandoned,

RESOURCES 41 abused, trafficked, exploited or of crisis. living in a house that is not safe. Visit the website at: For youth in need of immediate crisiscallcenter.org assistance, visit the following website to find a crisis care shel- National Alliance on Mental ter near you: Illness (NAMI) HelpLine covenanthouse.org/home- 1-800-950-NAMI (6264) less-youth-programs/NINELINE [email protected] HelpLine staff and volunteers Crisis Call Center answer questions about mental 1-775-784-8090 health issues and transfer crisis 1-800-273-8255 or suicidal situations to a nation- A 24/7 suicide prevention and al crisis line. Visit the website: crisis hotline that provides sup- nami.org port for individuals in any type

42 RESOURCES National Runaway Safeline 150 crisis centers. 1-800-RUNAWAY (786-2929) Visit the website: Text: 66008 suicidepreventionlifeline.org Provides victim and family support services including immedi- DOMESTIC VIOLENCE ate crisis intervention for families who need help with missing, AND SEXUAL ASSAULT exploited or recovered children. National Domestic See more at the website: Violence Hotline 1800RUNAWAY.org 1-800-799-SAFE (7233) 1-855-812-1001 (Deaf callers) National Suicide Hotline TTY: 1-800-787-3224 1-800-SUICIDE (784-2433) Operators are available 24/7 to [email protected] provide crisis intervention ser- Free, confidential crisis hotline vices and referrals to local ser- for friends, family members and vices and shelters for victims of individuals who are depressed domestic violence (partner or and have thoughts of suicide. spousal abuse). Operators can Visit the website: hopeline.com also help connect people with emergency help in their own National Suicide Prevention communities, including shelters Lifeline and emergency services. 1-800-273-TALK (8255) Visit the website at: thehotline.org/help TTY: 1-800-799-4889 24-hour, toll-free, confidential suicide prevention services to Rape, Abuse & Incest National anyone in suicidal crisis or emo- Network (RAINN) Crisis tional distress. Call is routed to Hotline the nearest crisis center in the 1-800-656-HOPE (4673) national network of more than Chat online at:

RESOURCES 43 online.rainn.org or visit the SafeQuest Crisis Line website at: rainn.org 24/7 Crisis Hotline: 1-866-487-7233 (4UR-SAFE) SafeHorizon SafeQuest’s National Domestic 1-212-577-7700 Violence Hotline: Email: [email protected] 1-800-799-7233 Nonprofit victim services agen- Main office: 1-707-422-7345 cy in New York City, with 57 (Monday through Friday program locations that provide 9:00 a.m. to 5:00 p.m.) compassion and support, are A 24-hour crisis intervention line provided to people experiencing for people affected by domestic domestic and intimate partner violence and sexual assault, in- violence, child physical and sex- cluding emergency shelter, sup- ual abuse, human trafficking, port groups, art therapy for chil- stalking, youth homelessness dren, prevention education and and crime. Here are some of resources. SafeHorizon’s services: Visit the website at: Domestic Violence Hotline: safequest.org 1-800-621-HOPE (4673) Crime Victims Hotline: Sexual Assault Support 1-866-689-HELP (4357) Services (SASS) Hotline Rape and Sexual 1-775-784-8090 Assault Hotline: Provides immediate crisis inter- 1-212-227-3000 vention services for survivors 1-866-689-HELP (4357) of sexual assault, their family TDD for All Hotlines members and friends. 1-866-604-5350 Visit the website: crisiscallcenter.org Visit the website: safehorizon.org

44 RESOURCES Team Hope at the NCMEC Helps rescue those who are held 1-866-305-HOPE (4673) captive against their will due to 1-800-THE-LOST (843-5678) sex trafficking and sexual -ex ploitation. Provides peer and emotional Visit the website: support to families in crisis who run2rescue.com/index.php have missing, recovered and exploited children. See more at the website: CHILD ABUSE missingkids.com/TeamHOPE AND NEGLECT Call 9-1-1 or contact your local HUMAN TRAFFICKING police department. VICTIMS Childhelp National Child Abuse Hotline National Human Trafficking 1-800-4-A-CHILD (422-4453) Resource Center (NHTRC) 24/7 hotline that offers crisis in- Hotline: 1-888-373-7888 tervention, resources and refer- *Support provided in more than rals to emergency, social service 200 languages and support resources. 24-hour, toll-free hotline that Visit the website at: provides support and help to childhelp.org/hotline human trafficking victims and individuals who are being forced to have sex, work or perform National Abandoned Infants services against their will, or are Assistance Resource Center under age 18 and engaging in 1-510-643-8390 commercial sex. Provides training, information, Website: support and resources to service traffickingresourcecenter.org providers who assist children who are abandoned or at-risk of abandonment due to drug use Run 2 Rescue and/or HIV/AIDs in the family. 1-888-224-6062 RESOURCES 45 See more at the website: Thursday’s Child National aia.berkeley.edu/about-aia/ Youth Advocacy Hotline 1-800-USA-KIDS YOUTH (1-800-872-5437) The National Youth Call Center Loveisrespect.org’s National for At-Risk Youth provides free Teen Dating Helpline assistance to assist both parents 1-866-331-9474 and children with substance use TTY: 1-866-331-8453 disorders and other issues. Text: “LOVEIS” to 22522 Visit Thursday’s Child website: A 24/7 helpline available to teens thursdayschild.org who have been involved in an abusive relationship. PARENTS & FAMILIES Visit the website at: www.loveisrespect.org The Addict’s Mom (TAM)

46 RESOURCES addictsmomprofessionals.com missingkids.com/MissingChild Website that provides mothers with support and valu- Partnership for Drug-Free able low-cost resources to help Kids Helpline their children with substance use 1-855-DRUGFREE (378-4373) disorders and provide mothers with a place to share their own Monday through Friday experiences. 9:00 a.m. to 5:00 p.m. Eastern See a directory containing a list time of professionals and resources A toll-free, confidential national for mental health and substance helpline provides support to par- use disorders. ents whose children are abusing drugs or alcohol and helps them take effective action to support Circle of Parents their loved one. Contact Julie Rivnak-McAdam at: Visit the website at: 1-804-308-0841 drugfree.org/get-help/helpline/ Provides a friendly, supportive environment led by parents and VETERANS other caregivers for anyone in a parenting role where they can Department of Veterans Affairs discuss the successes and challenges of raising children. Assists veterans with substance use disorder and mental health See more at the website: services; finds the closest VA circleofparents.disscada.com/ and the services it provides. Vet Centers provide readjustment National Center for Missing & counseling and outreach services Exploited Children to all veterans who served in any 1-800-THE-LOST combat zone. (1-800-843-5678) Use the VA locator tool at www.va.gov/directory to find Visit the website for more information: your nearest VA. Visit the web- RESOURCES 47 site online at: va.gov and referrals to mental health pro- vetcenter.va.gov fessionals across the country. Visit the website: Deployment Health militaryonesource.com Clinical Center 1-301-295-7692 RAINN’s Safe Helpline Provides resources for service 1-877-995-5247 members and their families and Provides 24/7 confidential, one- a link to alcohol and mental on-one crisis intervention ser- health screening assessments. vices and emotional and sexual Visit the website: assault support for veterans, www.pdhealth.mil/ and information for family and friends of victims. Also provides tailored crisis support and inter- Homeless Veterans Chat vention services to sexual assault 1-877-4AID VET survivors and their loved ones. (1-877-424-3838) Visit the website at: Online chat safehelpline.org Provides assistance to homeless veterans and their families. For Veterans Crisis Line prevention, housing, employ- 1-800-273-8255 and Press 1 ment assistance or other resources for homeless veterans, Send a text message to “838255” visit: va.gov/homeless or chat online Trained professionals provide 24/7, toll-free, confidential ser- Military OneSource vices to any veteran or service 1-800-342-9647 member in crisis, family mem- (toll free; available 24/7) bers of veterans or any person TTY/TDD: Dial 711 and give the concerned about a veteran. toll-free number 1-800-342-9647 Visit the website: Provides brief assessments and VeteransCrisisLine.net 48 RESOURCES Cocaine Anonymous (CA) SELF-HELP RESOURCES FOR SUBSTANC ABUSE 1-310-559-5833 AND DEPENDENCE [email protected] 12-step meetings for those who Alcoholics Anonymous (AA) want to stop using cocaine and 1-212-870-3400 all other mind-altering Monday through Friday substances. Visit the website at: 8:30 a.m. to 4:45 p.m. ca.org Based on the 12 steps, these meetings are available to anyone Crystal Meth Anonymous who has a drinking problem and 1-855-METH-FREE has the desire to achieve 1-855-638-4373 sobriety. (24-hour helpline) Visit the website at: aa.org A 12-step fellowship of men and women whose primary purpose

RESOURCES 49 is to stop using drugs and carry SELF-HELP FOR FRIENDS the message to those addicted to AND FAMILY MEMBERS crystal meth. Visit the website at: AddictionSurvivors.org crystalmeth.org Online: addictionsurvivors.org Narcotics Anonymous (NA) A not-for-profit organization 1-800-TODAYNA (863-2962) that providers peer support to individuals with substance use 1-888-NAAHORA (622-4672) disorders and their families and (Regional English and Spanish friends. helpline numbers) NA is a fellowship of men and Adult Children of Alcoholics women who have a problem with drugs and wish to live a life free 1-310-534-1815 of their addiction. Groups are A recovery program for adults based on the 12 steps. raised in an alcoholic or other Visit the website at: dysfunctional family based on the 12 steps. Members meet in a na.org (international) mutually respectful and safe en- todayna.org (regional) vironment. Visit the website at: Teen-Anon adultchildren.org/meetings 1-510-316-7100 For a current listing of ACA Addiction recovery for teens meetings, visit: whose lives have become un- adultchildren.org/find-a- manageable due to their drinking meeting or drug use. Groups are based on the 12 steps. Al-Anon Family Groups Visit the website for more infor- 1-866-425-2666 mation: teen-anon.com Email: [email protected]

50 RESOURCES Self-help groups available for women who are spouses, par- family members — including chil- ents, relatives or close friends of dren, spouses and parents — and an individual who is dependent friends, co-workers and employ- on cocaine. ers of alcoholics. Visit the website for more infor- Visit the website at: mation at: co-anon.org al-anon.org Co-Dependents Anonymous Alateen International 1-757-563-1600 1-602-277-7991 Provides support for friends and 1-888-444-2359 (toll free) families of problem drinkers. 1-888-444-2379 (Spanish toll Website: free) al-anon.alateen.org A fellowship of men and women with the common purpose of Because I Love You (BILY) developing healthy, loving rela- 1-818-884-8242 tionships. A support group for parents Website: coda.org whose children (of all ages) have behavioral problems, including Families Anonymous (FA) problems with alcohol and drug 1-800-736-9805 use. Groups focus on providing famanon@familiesanonymous. structure, consequences and org consistency. BILY Too is the Youth Group for peer support. 12-step, self-help recovery program for family members, rel- Visit the website at: bily.org atives and friends of those who have drug, alcohol or behavioral Co-Anon Family Groups problems. 1-480-442-3869 Visit the website at: A 12-step fellowship of men and familiesanonymous.org

RESOURCES 51 Gam-Anon Family Groups 1-718-352-1671 [email protected] 12-step fellowship for men and women who are spouses, family members or close friends of compulsive gamblers, who have been affected by a loved one’s gambling problem. Website: gam-anon.org/

Grief Recovery After a Sub- stance Passing (GRASP) 1-714-865-7879 Founded by parents who lost their child to addiction, GRASP is a model support group for those who have lost their loved ones. family members of addicts based The groups provide support to on the 12 steps. relatives who have lost someone Visit the website at: to alcohol and/or drugs. nar-anon.org Visit the website at: grasphelp.org Parents of Addicted Loved Ones (PAL) Nar-Anon Family Groups 1-480-300-4712 1-800-477-6291 (toll free) or Email: [email protected] 1-310-534-8188 Provides hope and support Self-help groups available for through addiction education 52 RESOURCES for parents dealing with a loved SAMHSA’s Buprenorphine one addicted to alcohol and/or Treatment Program Directory drugs. 1-866-BUP-CSAT (287-2728) Visit the website at: [email protected] palgroup.org To find physicians authorized to treat opioid dependency in a SMART Recovery - Help for particular state, utilize the Bu- Family & Friends prenorphine Treatment Physician 1-866-951-5357 (toll free) Locator. 1-440-951-5357 Provides resources. Also holds SAMHSA’s National Helpline local meetings for family and 1-800-662-HELP (4357) friends. TTY: 1-800-487-4889 Visit the website at: Also known as the Treatment Re- smartrecovery.org/resources/ ferral Routing Service. SAMHSA’s family.htm National Helpline provides free 24-hour, confidential treatment SUBSTANCE USE referrals, 365 days a year, and DISORDER TREATMENT information about mental health RESOURCES and/or substance use disorders, Partnership for Drug-Free Kids’ prevention and recovery in En- AlcoholScreening.org glish and Spanish. To take an alcohol screening as- Visit the website: samhsa.gov/ sessment or for help finding a find-help/national-helpline treatment program: alcoholscreening.org/Get-Help. SAMHSA’s Opioid Treatment aspx Program Directory Visit the website: Contact SAMHSA’s Division of alcoholscreening.org Pharmacologic Therapies: 1-240-276-2700

RESOURCES 53 [email protected]. 1-301-656-3920 gov Resources: asam.org/public- The Opioid Treatment Program resources/resource-links Directory is an online directory that assists in finding opioid Centers for Disease Control treatment programs by state. and Prevention (CDC) ADDITIONAL RESOURCES 1-800-CDC-INFO (1-800-232-4636) 2-1-1 TTY: 1-888-232-6348 211us.org Visit the website: cdc.gov Referral Search for help with food, housing, employment, Collaborative for REMS Educa- health care, counseling and more tion (CO*RE) at: 211search.org/ [email protected] Visit the website: core-rems.org Addictions and Recovery.org 1-416-920-2982 Community Anti-Drug Coali- Visit the website: tions of America (CADCA) addictionsandrecovery.org/ 1-800-54-CADCA Visit the website: American Psychological cadca.org Association 1-800-374-2721 (toll free) National Alcoholism and 1-202-336-2721 Substance Abuse Information Center (NASAIC) Visit the website: apa.org 1-800-784-6776 (toll free) Visit the website at: American Society of Addiction addictioncareoptions.com Medicine (ASAM)

54 RESOURCES The National Center on Visit the website: Addiction and Substance thenationalcouncil.org Abuse 1-212-841-5200 National Council on (Monday through Friday Alcoholism and Drug 9:00 am. to 5:30 p.m. Eastern Dependence (NCADD) time) 1-212-269-7797 Website: Hope Line: 1-800-622-2255 centeronaddiction.org Visit the website: ncadd.org National Council for Behavioral Health National Institute of Mental 1-202-684-7457 Health (NIMH) Email: communications@ 1-866-615-6464 (toll-free) TheNationalCouncil.org TTY: 1-301-443-8431

RESOURCES 55 1-866-415-8051 (TTY, toll-free) Advises the president on drug Provides English- and Span- related issues, coordinates ish-speaking assistance drug-control activities and related funding, and produces the Monday through Friday annual National Drug Control 8:30 a.m. to 5:00 p.m. Eastern Strategy, which outlines the ad- time. ministration’s efforts to reduce Visit the website at: illicit drug use and consequences nimh.nih.gov/ of drug dependence. See more at the website: National Institute on Alcohol whitehouse.gov/ondcp Abuse & Alcoholism (NIAAA) Visit the website: Office on Women’s Health niaaa.nih.gov 1-800-994-9662 Visit the website: womenshealth. National Institute on Drug gov/mental-health/hotlines/ Abuse (NIDA) 1-301-443-1124 Partnership for Drug-Free Kids Website: drugabuse.gov 1-212-922-1560 drugfree.org National Library of Medicine 1-888-FIND-NLM Public Health’s Resources (1-888-346-3656) for Addiction Local and international calls: 1-281-846-3085 contact@ 1-301-594-5983 publichealth.org Website: Website: publichealth.org/ nlm.nih.gov/nlmhome.html resources/addiction/

Office of National Drug Control Substance Abuse and Mental Policy (ONDCP) Health Services Administration

56 RESOURCES (SAMHSA) in this compelling revised and 1-877-SAMHSA-7 (toll-free) updated book. In Addict in the (1-877-4727) Family, the gripping stories of fa- thers, mothers, sons, and daugh- 1-800-487-4889 (TDD) ters of addicts offer important Website: samhsa.gov lessons on loving, detachment, intervention, and self-care.” READ MORE The Addict’s Loop: A New The 5 Love Languages: Understanding And Workbook The Secret to Love That Lasts For Codependent By Gary Chapman Relationships And Addiction “In the #1 New York Times best- By Rene Eram seller The 5 Love Languages, “What is codependence, really? you’ll discover the secret that What creates addiction? Why am has transformed millions of re- I attracted to the same codepen- lationships worldwide. Whether dent relationships over and over your relationship is flourishing again? Why can’t I stay sober? or failing, Dr. Gary Chapman’s Why do I keep hurting or getting proven approach to showing and hurt by the people I love? How receiving love will help you ex- do my relationships affect my perience deeper and richer levels addiction? These questions and of intimacy with your partner — many more are answered in The starting today. … ” Addict’s Loop. The Addict’s Loop uncovers and describes a new Addict In The Family: Stories of model for understanding code- Loss, Hope, and Recovery pendent relationships and how By Beverly Conyers they can create and fuel addiction. It is also a workbook with 9 “Witnessing the addiction of steps toward recovery.” a family member or loved one is a heart-rending experience. But hope can prevail, as shown Boundaries: When to Say Yes, RESOURCES 57 How to Say No to Take Control parents find peace of Your Life By Cathy Taughinbaugh By Henry Cloud and John “I’m Cathy Taughinbaugh. I coach Townsend moms and occasionally dads on “Having clear boundaries is es- how they can help themselves sential to a healthy, balanced and their children when they are lifestyle. A boundary is a person- struggling with drugs or alcohol.” al property line that marks those things for which we are respon- Chancers: Addiction, Prison, sible. In other words, boundaries Recovery, Love: One define who we are and who we Couple’s Memoir are not . … ” By Susan Stellin and Graham MacIndoe Cathy Taughinbaugh: Helping

58 RESOURCES “In this powerful memoir of ad- light on how alcoholism has af- diction, prison, and recovery, a fected many different types of reporter and a photographer tell relationships in many different their gripping story of falling in ways. It also shares why various love, the heroin habit that drove Al-Anon tools have been helpful them apart, and the unlikely way in improving our relationships or a criminal conviction brought our attitudes about them.” them back together.” How Al-Anon Works for Codependents’ Guide to the Families & Friends of Twelve Steps Alcoholics By Melody Beattie By Al-Anon Family Groups “The New York Times bestselling “Al-Anon’s basic book discusses self-help book that offers advice the mutual-help program of re- on how to find and choose the covery, including personal sto- recovery program for you, as well ries. A beginning approach to as a directory of the wide range the Twelve Concepts of Service is of Twelve Step programs, includ- included.” ing AA, Codependents Anon- ymous, Codependents of Sex The Language of Letting Go: Addicts, Adult Children of Alco- Daily Meditations for holics, and more … ” Codependents By Melody Beattie Discovering Choices: Our “Melody Beattie integrates her Recovery in Relationships own life experiences and fun- By Al-Anon Family Groups damental recovery reflections “This book explores the many in this unique daily meditation facets of our recovery in rela- book written especially for those tionships. Drawing on the ex- of us who struggle with the issue perience, strength, and hope of of codependency. hundreds of members, it sheds “Problems are made to be

RESOURCES 59 solved, Melody reminds us, and to move from active addiction the best thing we can do is take to sobriety. Gorski’s pioneering responsibility for our own pain work describes six stages of re- and self-care. In this daily inspi- covery from chemical dependen- rational book, Melody provides cy and offers sound advice for us with a thought to guide us working through the challenges through the day and she encour- of each stage — challenges that ages us to remember that each can create frustration and lead day is an opportunity for growth to relapse. and renewal.” “Use this book as a compass in your recovery to help you stay on A Man’s Way Through course.” Relationships: Learning to Love and Be Loved The Relationship Cure By Dan Griffin By John M. Gottman, Ph.D., and “This book contains general in- Joan DeClaire formation about relationships, “A revolutionary five-step pro- recovery, and men’s socialization gram for repairing troubled re- and development.” lationships — with spouses and lovers, family members, friends, Passages Through Recovery: An and even your colleagues.” Action Plan for Preventing Relapse Twelve Steps and Twelve By Terence T. Gorski Traditions “Based on the experiences of By Alcoholics Anonymous thousands of recovering men “Originally published in 1952, and women, Passages through Twelve Steps and Twelve Tradi- Recovery presents an action plan tions is the classic book used by for preventing relapse, one that AA members and groups around can help us understand how re- the world. It lays out the prin- covery works and what is needed ciples by which AA members

60 RESOURCES recover and by which the fellow- to real life. Written by a certi- ship functions. The basic text fied alcoholism and drug abuse clarifies the Steps which consti- counselor with more than twen- tute the AA way of life and the ty years of experience, it offers a Traditions, by which AA main- wealth of wisdom, knowledge, tains its unity.” and genuine support for anyone in recovery.” Understanding the Twelve Steps: An Interpretation and When a Family is in Trouble: Guide for Recovering Children Can Cope with Grief By Terence T. Gorski from Drug and Alcohol Addiction “This practical, no-nonsense guide takes the mystery out of By Marge Heegaard the Twelve Steps, presenting a “Provides basic information straightforward explanation of about drug and alcohol addic- what each step means, as well tions and encourages healthy as examples of how it translates coping skills.”

RESOURCES 61 Sovereign Health is a leading nationwide network of behavioral health treatment facilities that are accredited by the Joint Commission and licensed to treat mental health, substance use and co-occurring disorders, and eating disorders.

We offer residential treatment, partial hospitalization, intensive outpatient programs and gender specific programs for men and women, adolescents and seniors. Our individualized care also includes cognitive remediation as well as a recovery management program following discharge.

Sovereign Health aims to lead a paradigm shift in behavioral health by providing a new standard of excellence for patients with behavioral symptoms.

62 NOTES

63 NOTES

64 REFERENCES

CHAPTER ONE Number and age-adjusted rates of drug-poisoning deaths involving opioid analgesics and heroin: United States, 2000–2014. National Vital Statis- tics System, Mortality File. National Center for Health Statistics. Centers for Disease Control and Prevention; Atlanta. CHAPTER TWO Alcoholics Anonymous; New York City.

Harm Reduction Coalition; New York City; Oakland, California.

12Step.org; Asheville, North Carolina.

SMART Recovery; Mentor, Ohio.

Moderation Management; St. Louis. CHAPTER THREE

SMART Recovery; Mentor, Ohio. CHAPTER FOUR

Silkworth WD. Slips and Human Nature. Silkworkth.net.

Al-Anon Family Groups; Virginia Beach, Virginia. CHAPTER FIVE

The 12 Steps in a Generic Form. 12Steps.org; Asheville, North Carolina.

The Big Book, Fourth Edition. Chapter 10, To Employers. New York City: Alcoholics Anonymous World Services; 2013:145.

Oxford Dictionaries. Oxford: Oxford University Press.

The Big Book. Fourth Edition. New York City: Alcoholics Anonymous World 65 Services; 2013.

Twelve Steps and Twelve Traditions. New York City: Alcoholics Anonymous World Services; 2012.

Akhtar S, Barlow J. Forgiveness Therapy for the Promotion of Mental Well-Being: A Systematic Review and Meta-Analysis. Trauma Violence Abuse. 2016 Mar 23.

Toussaint L, Shields GS, Dom G, Slavich GM. Effects of lifetime stress expo- sure on mental and physical health in young adulthood: How stress de- grades and forgiveness protects health. J Health Psychol. 2016;21(6):1004- 14.

Beattie M. The Language of Letting Go. Center City, Minnesota: Hazelden Publishing; 1990:106.

Co-Dependents Anonymous; Phoenix.

Shapiro LJ, Stewart ES. Pathological guilt: a persistent yet overlooked treatment factor in obsessive-compulsive disorder. Ann Clin Psychiatry. 2011;23(1):63-70.

CHAPTER SIX Research Portfolio Online Reporting Tools. National Institutes of Health. U.S. Department of Health & Human Services; Bethesda, Maryland.

66 CREDITS

THE AUTHORS Dana Connolly, Ph.D., is a senior staff writer for Sovereign Health, where she translates current research into practical information. She earned her Ph.D. in research and theory development from New York University and has decades of experience in clinical care, medical research and health education. Sovereign Health is a health information resource, and Dr. Connolly helps to ensure excellence in our model.

Kristen Fuller, M.D., is a senior staff writer at Sovereign Health and enjoys writing about evidence-based topics in the cutting-edge world of medicine. She is a physician and author who also teaches, practices medicine in the ur- gent care setting and contributes to medicine board education. She is also an outdoor and dog enthusiast.

Amanda Habermann, M.S., is a staff writer for Sovereign Health. A graduate of California Lutheran University, she received her M.S. in clinical psychology with an emphasis in psychiatric rehabilitation. Her master’s thesis was written on “The effect of parental codependency on elementary school children’s social and emotional development,” and her research has been accepted for poster presentations at the Western Psychological Association. She brings to the team her extensive clinical background and skills in psychological testing and assessment, clinical diagnosis, research and treatment, and recovery techniques for patients with mental illness. She is a passionate researcher and enjoys staying up to date on the newest topics in the field.

Courtney Lopresti, M.S., is a senior staff writer for Sovereign Health, where she uses her scientific background to write online blogs and articles for a general audience. At the University of Pittsburgh, where she earned her master’s in neuroscience, she used functional neuroimaging to study how the human cerebellum contributes to language processing. In her spare time, she writes fiction, reads Oliver Sacks and spends time with her two cats and bird. Court- ney is currently located in Minneapolis.

67 THE EDITORS Susan Logan-McCracken, M.P.W. (Master’s of Professional Writing), is a writer and editor for Sovereign Health. An award-winning author, Logan-Mc- Cracken has 25 years experience as a journalist, most recently as the editor of Cat Fancy magazine. She received her master’s in professional writing from the University of Southern California, where she became obsessed with accuracy, fair reporting and correct English usage. When she is not writing or editing, she enjoys singing, and hanging out with family and furry friends.

Rachael Mattice is the managing editor for Sovereign Health, leading a team of diversified writers and editors in the digital newsroom. Also a freelance music journalist, she pulls from her versatile background in journalism, digital marketing and visual content creation to boost innovative ideas and high-quality assets for the Sovereign brand. CLINICAL EXPERTS

Anthony J. Mele, Psy.D., is the chief clinical officer with Sovereign Health. He earned his doctorate of psychology at Widener University in Pennsylvania. More recently, Dr. Mele established the Catholic Clinical Consultants for Cath- olic Health Care Services in Pennsylvania. As the founding executive director, he established the clinical and operational infrastructure of the company. He also maintained several corporate and clinical responsibilities such as meeting financial goals and providing patient care. Before that, Dr. Mele was the senior vice president at A&M Philadelphia in Pennsylvania, a behavioral health care consulting and marketing company that provided health care and service industry clients with operational consultation based on the principles of organi- zational and clinical psychology.

Monica Powers, Psy.D., earned her doctorate in applied clinical psychology at the Chicago School of Professional Psychology. She holds a master’s degree in marriage and family therapy from the University of Phoenix. Her internship was completed at the Los Angeles County Department of Mental Health, where she ran the Healthy Way LA program, which provides mental health services to underserved populations in Los Angeles County. Dr. Powers continued her post-doctoral work at Sovereign Health’s Los Angeles facility. Under Dr. Pow- ers’ guidance, the Sovereign Health Los Angeles facility has grown to meet the

68 challenges of a vast metropolitan area. THE DESIGNER

Brian Moore is a staff writer and graphic designer for Sovereign Health. A 20- year veteran of the newspaper industry, he writes articles and creates graphics across Sovereign’s portfolio of marketing and content products. Brian enjoys music, bicycling and playing the tuba, which’s he’s done with varying degrees of success for over 25 years. CONTACT US

For more information and other inquiries about this media, contact the author and designer at [email protected].