Reducing the Social Cost of Recovery

photo_22580_20121013 One of the biggest struggles people have when it comes to recovery from addiction is the social sacrifices that are usually required in order to make recovery successful.   As someone gets deeper into their addiction, their social network gets defined by the addiction – most of the people they hang out with use.

There are obvious reasons for this – it’s more acceptable to use, increased access to substances, higher tolerance within the group for bad behavior and diminished healthy supports as a result of the bad behavior. While these relationships primarily revolve around use and manipulation there are also significant and meaningful shared experiences (losses involving mutual friends due to addiction as an example). Although difficult, ending these friendships are necessary but the lack of support one may experience need not be permanent – there are steps folks in recovery can take to overcome their losses.

1. 12 Step it

I try to make AA or NA a condition of treatment for folks in early recovery for many reasons; the first being that it measures up well to other forms of professional treatment;

Nevertheless, the results of one well-designed investigation called Project Match, published in 1997, suggest that AA can facilitate the transition to sobriety for many alcoholics. In this study, a group of prominent alcoholism researchers randomly assigned more than 900 problem drinkers to receive one of three treatments over 12 weeks. One was an AA-based treatment called 12-step facilitation therapy that includes contact with a professional who helps patients work the first few of the 12 steps and encourages them to attend AA meetings. The other treatments were cognitive-behavioral therapy, which teaches skills for coping better with situations that commonly trigger relapse, and motivational enhancement therapy, which is designed to boost motivation to cease problem drinking.

The AA-based approach seemed to work and compared favorably with the other therapies. In all three groups, participants were abstinent on roughly 20 percent of days, on average, before treatment began, and the fraction of alcohol-free days rose to about 80 percent a year after treatment ended. What is more, 19 percent of these subjects were teetotalers during the entire 12-month follow-up. Because the study lacked a group of people who received no treatment, however, it does not reveal whether any of the methods are superior to leaving people to try to stop drinking on their own.  link

The relationships formed in 12 step programs are far more sustainable than those developed in professionally led groups or in individual treatment.  In more intense acute settings, clients are generally discouraged from communicating with peers outside of group (for good reason) but AA encourages contact among members.  Folks in early recovery will find others who have been where they have been and are able to relate to at least some part of their experience. I can’t think of a more effective way for folks to rebuild their social networks than becoming active in AA or another 12 step program. Finding the right meeting is important so I encourage clients to go to as many different meetings as they can until they find one they are most comfortable with.

2. Explore hobbies that are “dry” and make sure some of them are social in nature

Another key to success in recovery are enjoyable activities – we need things to do as a way of avoiding boredom (usually a big trigger) and to help us cope in ways that are different. Folks in early recovery sometimes feel guilty about enjoying themselves- sometimes accountability is confused with punishment. It can be hard telling a friend or family member you depend on for support that you are going to spend time and money on leisure – but understand that depriving yourself of healthy leisure creates barriers to moving up the recovery ladder and robs you of tools you can use in managing abstinence. Deprivation pushes us to get needs met in impulsive and unhealthy ways.

It can also be hard to put yourself in social situations with people who may not be in recovery which is why a good first step may be to make this type of exposure activity based. Not all of our social relationship need to be deep and not everyone that we are friendly with needs to know our story – sometimes its good to have acquaintances that we spend time with in a specific context. Joining a gym is a great way to develop these types of relationships while engaging in a coping skill (exercise).

“Who can afford a gym?”

I’m sure you were blowing a lot more cash on your addiction and there are very affordable options. The YMCA offers classes and facilities for a little over $50/month (on average). Some YMCA’s provide scholarships for folks who are short on cash.

3. Volunteer

A systematic review and meta-analysis led by researchers at the University of Exeter Medical School in England found that volunteers reported lower levels of depression, increased life satisfaction and enhanced well-being.

Comparing data from several experimental trials and longitudinal cohort studies, the researchers also found evidence of an approximately 20 percent reduction in mortality among volunteers compared to non-volunteers. Researchers note the findings have yet to be confirmed in trials.  link

Volunteering kills time, can be enjoyable, gives you something to put on a résumé when you’re ready to get a job and provides you with purpose. Getting into a “work-like” environment may seem daunting but many organizations are flexible. If the whole “interacting with humans” thing feels overwhelming, consider volunteering at a no-kill animal shelter. The United Way is a great place to learn about volunteering and getting involved – much of the funding they provide to agencies and organizations is tied to the number of volunteers that are utilized.

4. If you believe in God then visit Him once in a while.

If you identify with a religion then get involved with services and go as often as you need to. Reconnecting with your faith not only gives you the ability to do something with others it can complement the work you’re doing in a 12 Step program. Church attendance and religiosity have also demonstrated positive effects on mood and physical health depending on one’s perception of God.

A study conducted in North Carolina found that frequent churchgoers had larger social networks, with more contact with, more affection for, and more kinds of social support from those people than their unchurched counterparts. And we know that social support is directly tied to better health. link

I’m not pushing religion, just saying that if you’re connected to it, then get your ass on a pew…or whatever they call it where you decide to go.

5. Get a pet

Yes I’m serious and it doesn’t have to involve a giraffe or a mountain lion (although that would be cool). Fish and hamsters will also work. Pets provide us with companionship and responsibility; they can even help us through triggers that may lead to relapse. There is a ton of research out there that demonstrates a connection between pet ownership and good mental health.

Until now, most research into the benefits of pets has been correlational, meaning it looked at the relationship between two variables but didn’t show that one caused the other. For example, prior research showed that elderly Medicare patients with pets had fewer doctor visits than similar patients without pets, or that HIV-positive men with pets were less depressed than those without.
In this study, 217 people (79 percent women, mean age 31, mean annual family income $77,000) answered surveys aimed at determining whether pet owners in the group differed from people who didn’t have pets in the areas of well-being, personality type and attachment style. Several differences between the groups emerged, and in all cases, pet owners were happier, healthier and better adjusted than were non-owners.

A second experiment, involving 56 dog owners (91 percent of whom were women, with a mean age of 42 and average annual family income of $65,000), examined whether pet owners benefit more when their pet is perceived to fulfill their social needs better. This study found greater well-being among owners whose dogs increased their feelings of belonging, self-esteem and meaningful existence.

The last study, comprising 97 undergraduates with an average age of 19, found that pets can make people feel better after experiencing rejection. Subjects were asked to write about a time when they felt excluded. Then they were asked to write about their favorite pet, or to write about their favorite friend, or to draw a map of their campus. The researchers found that writing about pets was just as effective as writing about a friend when it came to staving off feelings of rejection. link

Recovery from addiction does not mean being alone. Giving up old relationships that centered on use is necessary and although it may feel like betrayal you may want to consider the basis of the relationship and what you’re really walking away from. When you’re ready there are people, organizations, mountain lions and giraffes waiting to bring you in and help you along the way – all the way.

2 thoughts on “Reducing the Social Cost of Recovery

  1. I think it is a good article…. Is this paragraph correct?? I’m not familiar with “teetotal”. And also did u maybe mean “leading” instead of “leaving?

    teetotalers during the entire 12-month follow-up. Because the study lacked a group of people who received no treatment, however, it does not reveal whether any of the methods are superior to leaving people to try to stop dri

    Sent from my iPhone

    >

    1. thanks for your comment! teetotalar is an antiquated term that refers to an individual that never drinks. i think you are right that the author meant to use the term “leading” (this was a quote from another article)

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