Sunday, April 06, 2008

On the Tragedy of Chronic Relapse:
By Peter S. Lopez ~aka Peta

Sunday, April 06, 2008

Main Entry: chron•ic
Pronunciation: \ˈkrä-nik\
Function: adjective
Etymology: French chronique, from Greek chronikos of time, from chronos
Date: 1601
1 a: marked by long duration or frequent recurrence : not acute [chronic indigestion] [chronic experiments] b: suffering from a chronic disease [the special needs of chronic patients]
2 a: always present or encountered; especially : constantly vexing, weakening, or troubling [chronic petty warfare] b: being such habitually [a chronic grumbler]
synonyms see inveterate
— chronic noun
— chron•i•cal•ly \-ni-k(ə-)lē\ adverb
— chro•nic•i•ty \krä-ˈni-sə-tē, krō-\ noun

~ Introduction ~

For the recovery community, one of the saddest events for us is when one of our own gets caught up and lost in the tragedy of chronic relapse. When we come and meet together at our recovery meetings we often refer to ourselves as family. Sadly, the chronic relapser is one of our most troubled family members.

~ Brief Explanation of Chronic Relapse ~

Together as a group of wounded people we share common struggles and successes on a daily basis against a common deadly disease called drug addiction. It pains us when one of our own falls down into the old harmful ways of the demented drug addict. However, we do not shoot our wounded but help them get back on track. All who have fallen down into relapse are always welcomed back into our herd once they have sincerely made a decision to get with our simple 12-Steps program and stay safe in the middle of the herd.

In the chronic relapse process, one sobers up, gets involved in the protracted process of building up a strong recovery program, attends meetings, gets a sponsor, tries to work all the Steps, then, gradually or suddenly, goes back out into one’s poison of choice, hits bottom again, then, sobers up again for a time, gets back involved in recovery, claims a new sobriety date, then, goes back out again into the ‘dope fiend’ world over and over again. One becomes more and more damaged and discouraged each time with low or no self-esteem. In general terms, true self-esteem involves self-love, self-respect and self-confidence and is essential for the recovering addict to ever be a healthy humane being.

Relapse from recovery can happen to a recovering addict who sat right next to us at many 12-Step Group Meetings, who was part of our own personal recovery, who was involved and participated in group discussions, someone we were close to and with whom we had meaningful conversations, then they go out. On the surface the potential relapser seemed to be working a good honest program. It could be a brother or sister with whom we shared our stories, someone we cried and laughed together with and who has now gone out on his own and left the safety of the herd. Then, that person goes out back into his poison of choice and re-enters the wild ‘dope fiend’ subculture of fear, deceit and paranoia and ends up lost in despair, darkness and depression.

The guilt, shame and misery suffered by the chronic relapser become so deep, painful and overwhelming that the chronic relapser can lose all hope for genuine recovery. He can give up on ever getting a handle on or control over his addiction. One goes out the same, but never comes back the same if he comes back at all. Some never come back.

Relapse is a sign of our continued sickness, not a mandatory part of recovery. One does not need the drama trauma of a relapse to get well. Sometimes a relapse can be a real learning experience, part of one’s educational experience, a new beginning, and a fresh start. After a severe relapse, one can decide to come back and get involved in working a solid strong program. We can come back wiser, stronger and more determined than ever before to stay sane and sober and continue working on our recovery. It takes complete honesty, hard work and substantial clean time to work a strong progressive recovery program one day at a time.

If we pay attention, stay aware and know about specific signs and symptoms we can see a severe relapse coming around the corner and avoid its negative effects by using our recovery tools, practicing relapse prevention strategies and staying in conscious contact with the Creator for spiritual guidance.

~ Primary Causes of Chronic Relapse ~

The three primary causes of chronic relapse are:
1. A weak recovery program
2. A toxic environment and
3. The craving brain

Drug addiction or chemical dependency is the most complex and complete disease known to science as it attacks the trinity of the three existential dimensions of the entire human being: the mind, body and the soul. Addiction is the quintessential biological, behavioral and spiritual disorder. In fact, the activated addict exhibits an obvious form of obsessive-compulsive- disorder (OCD) with chronic relapse often a part of the disease.

~ Cause: A Weak Recovery Program ~

For the recovering addict, the primary cause of chronic relapse is a phony weak recovery program. Relapse can only happen to someone who has first been involved in the whole healing process of recovery, who has been working on building up a strong recovery program and recovery support network. One who has shown a period of real genuine improvement and begins to really understand the underlying problems and basic roots of drug addiction. Recovery itself becomes a key part of our personal daily life-style of living sane and sober. However, one can only relapse away from and out of a recovery program. If one is not seriously working a real program one cannot suffer an actual relapse. With no strong recovery program already in place and online there can be no relapse. What would we relapse from? No program, no relapse and no hope for true recovery.

One can easily go out and return to the same old evil ways of drug addiction and do what drunks or ‘dope fiends’ do: engage in alcohol binge drinking or taking drugs in order to escape from the connected realities, stressors and responsibilities of life, but that is not a real relapse in the clinical sense. It is only another insane exhibition of the disease of drug addiction that is a modern plague worldwide.

After a relapse one needs to completely re-examine one’s whole recovery program in order to check for basic flaws, blind spots and fine tune our program for success. What happened on the road to recovery that resulted in the backsliding of relapse? What were the common signs and symptoms that could have been helped with relapse prevention skills?

To be fair, a temporary brief lapse or slip in one’s program of a day’s duration is NOT an all-out relapse. This is a grey area for some, especially for those who are fanatical about recovery. One loses one’s sobriety day but has not completely abandoned one’s recovery program. One can be sober from a primary drug of choice, such as alcohol, yet still be addicted to other substances in cross-addiction or be addicted pharmaceutical drugs.

We do not want to encourage dreary dry drunks in a shaky sobriety or cranky drug addicts only practicing temporary sobriety. We want to actually treat and cure the root causes of drug addiction and that requires working the 12-Steps and doing a complete and searching personal inventory. The ultimate goal is complete liberty and freedom from all forms of addiction. We can recover of our own free will in harmony with the power of Creator God.

After we have arrested our indulgence in our addiction, just for today, we still need to work on our recovery in terms of getting rid of our major character defects, shortcomings and inner demons in order to grow, mature and develop as honest humane beings.

The essential elements of a strong progressive recovery program are:

1. A true Christian spiritual conversion and sincere spiritual awakening when we completely surrender to the Creator’s will for us and freely admit we are powerless over our addiction in order to win our liberty from all the evil ways of addiction. Surrender to win.

2. Regular attendance and participation at home group meetings, working the basic 12-Steps program on a daily basis and helping other addicts who want to get into living sober, real recovery and spiritual growth; along with the help and support of a trusted guide or sponsor and a strong recovery support network. Be clear, stable and consistent.

3. Work on developing a wholistic system of healing that involves daily prayer and meditation; studying educational literature; daily journaling about our progress; working out with a physical fitness program; a healthy lifestyle with proper diet and nutrition and other forms of medical treatment, spiritual healing and self-improvement. Whatever works, works. Whatever helps, helps.

4. Getting involved in progressive community action, doing volunteer service and staying active out in the real world. We need to work on exploring new interests, developing our talents, sharpening our skills and getting involved in life in ways that help us get out of our individual self-centeredness in order to promote social integration and combat isolation.

The typical drug addict is selfish, self-centered and running on self-will scared and alone. The recovering drug addict should be working on self-esteem issues and at the same time be involved in helping others as an honest humane being who has real care, concern and humane compassion for all others. We should stay involved in connected reality.

~ Cause: A Toxic Environment ~

The toxic environment of the recovering drug addict can be scattered with hidden traps, quick triggers and planted landmines that easily engulf one back into the dementia of drug addiction. The recovering addict must always be armed with recovery tools and stay aware of people, places and things in his immediate surroundings that can be throwbacks into old sick behavior. As much as possible, we should stay far away from old familiar haunts and slippery places in all our pathways. Choose your traveling routes with caution and avoid toxic areas where drug traffic is a common part of the turf.

Stay safe with the recovery herd and escape out of all toxic relationships. Make new friends who are serious about their recovery and stick with the winners, not the losers. Do not try to save anyone else and be an enabling co-dependent to anyone, then end up going back out into your old ways of addiction yourself. You cannot save anyone if you cannot first save yourself! First things first!

Clean house, including your address book. Get rid of all objects, items and symbols in your home environment that remind you of old addictive ways. Health is the greatest wealth. Stay healthy in all your ways, which includes healthy choices in all your relationships. Sometimes you need to get away from the herd and go meditate in a quiet secluded spot with a notepad and pen just enjoying nature at a safe park or nearby river.

Know who and what you are, stay focused. Do not get dull and distracted by idle trifle thoughts and empty meaningless activities. In your day to day life, never be afraid of reaching out to another recovering addict for help. Let your original motivations be honest and pure, not selfish and manipulative. Overall, we need to transform our whole mentality, our behavior and our spirituality in order to get well because it is in our personal self-interest to do so and in the interests of others we love to do so, not for selfish individual ends alone.

Learn to understand and apply the 3Ds: direction, discipline and determination. At first, you only have to work the program one day at a time. Tomorrow we’ll see, Just make it through today sane and sober. Let tomorrow take care of itself.

~ Cause: The Craving Brain ~

The human brain is located in the skull at the top part of the central nervous system. It controls, directs and guides the mental processes, physical actions and inner spiritual strivings of a functional human being. It helps to maintain equilibrium, homeostasis or harmony by various forms of self-regulation essential to achieve a bio-balance in the brain and instructs the body to correct any imbalances that come up.

~ Illustration of the Human Brain and Key Regions ~


Deep in the center of the human brain lies the limbic system which directs the three primal survival behaviors –eating, avoiding being eaten and reproducing. This ancient reptile brain region gathers the sensory data input mandatory for survival. Bundles of nerve cell fibers work their way from there to a cluster of nerve cell bodies of spiny neurons known as the nucleus accumbens which is the seat of motivation to action.

“The nucleus accumbens definitely plays a central role in the reward circuit. Its operation is based chiefly on two essential neurotransmitters: dopamine, which promotes desire, and serotonin, whose effects include satiety and inhibition. Many animal studies have shown that all drugs increase the production of dopamine in the nucleus accumbens, while reducing that of serotonin.

But the nucleus accumbens does not work in isolation. It maintains close relations with other centres involved in the mechanisms of pleasure, and in particular, with the ventral tegmental area (VTA).”

“Neurons carry information through the nervous system in the form of brief electrical impulses called action potentials. When an impulse reaches the end of an axon, neurotransmitters are released at junctions called synapses. The neurotransmitters are chemicals that bind to receptors on the receiving neurons, triggering the continuation of the impulse.”

In the craving brain of the drug addict the normal neurotransmitters of dopamine and serotonin are out-of-balance in the chemical chain reaction of a vicious circle with no end. High dopamine is activated in the ‘got-to-have-it’ search for the drug that does not stop until it ‘get-its’ and high serotonin is achieved for a temporary state of bio-balance in the duped drugged brain. However, in time the effects of the drug always wears off, serotonin drops low and the craving brain is once again activated with high dopamine in pursuit of more of the desired drug to ease the pain of the craving brain. It is actually a form of chemical warfare that is self-inflicted because we are addicted or devoted to our primary drug of choice because of the craving brain, especially in a toxic environment. One does not become addicted by accident, but by bad unhealthy choices.

“Our approach does not center solely on abstaining, for often an addict will abstain many times before the irresistible urge wins over again. We concentrate on one important goal: making every effort to correct the craving brain. Responsibility for our actions requires a response ability, an ability to say no. The craving response removes the ability to rationally decide our actions. The “gotta have it” is driven by the same overpowering biochemical forces used when survival is at stake. Correcting the craving brain provides choice. With choice comes responsibility for one’s actions. While the individual bears primary responsibility, family, friends and community need to be involved.”
Source: The Craving Brain. By Ronald A. Ruden, M.D., Ph.D., pg. 140

The human brain encases our mind as the throne of thought and the center of human consciousness. It is capable of grasping the concept of the vast cosmos yet can notice the tiniest detail. It can be our greatest ally or our own worst enemy. It is the highest most complex form of matter and key to understanding connected reality. Therefore, we must command the mind in order to discipline the body and guide the spirit.

~ Conclusion ~

The recovering addict must stay alive, be good at learning and have a mind open to new ideas as he carefully collects a whole set of recovery tools ~ weapons of war ~ to fight and win the drug war against addicts as he practices relapse prevention strategies.

Once the chronic relapser overcomes the demon of denial he must accept the clinical fact that he is a very sick ill person who has been captured and held hostage in a drug war that he does not even know he is in. To be sure, drug addiction is a brain disease that masks an even deeper disease of the soul that cannot be treated and cured in sterile isolation. He must go far back in search of memory, examine all his life experiences, review his present situation and seek serious professional help with a trained therapist, guidance counselor and/or spiritual healer. He really needs a long-term wholistic treatment program and in some cases temporary hospitalization.

For our spiritual healing we need to go far beyond only attending regular 12-Step Recovery Group Meetings. Think outside any book. Creative human imagination is more important that human intelligence. Ultimately our progressive recovery is a deep personal struggle within our innermost being in conscious contact with the Creator in order to outwardly manifest our potential in connected reality and be the best version of all we can be in life. Each new day in recovery should be a fresh start as we go about creating our day as survivors of a deadly disease, not as passive victims. We cannot change our past, but we can change our perception and understanding of the past in order to work HERE AND NOW in the present on developing a bright, creative and productive future for us. Above all, we must change, change and change as we practice relapse prevention therapy.

“Relapse Prevention Therapy ~ RPT intervention strategies can be grouped into three categories: coping skills training, cognitive therapy, and lifestyle modification. Coping skills training strategies include both behavioral and cognitive techniques. Cognitive therapy procedures are designed to provide clients with ways to reframe the habit change process as learning experience with errors and setbacks expected as mastery develops. Finally, lifestyle modification strategies such as meditation, exercise, and spiritual practices are designed to strengthen a client's overall coping capacity.

In clinical practice, coping skills training forms the cornerstone of RPT, teaching clients strategies to:
(a) understand relapse as a process,
(b) identify and cope effectively with high-risk situations,
(c) cope with urges and craving,
(d) implement damage control procedures during a lapse to minimize its negative consequences,
(e) stay engaged in treatment even after a relapse, and
(f) learn how to create a more balanced lifestyle.”
Source: Relapse Prevention Therapy: A Cognitive-Behavioral Approach
By George A. Parks, Ph.D. and G. Alan Marlatt, Ph.D.

Indeed, the chronic relapser is a key part of our recovery, there is usually at least one in every group. We are actually blessed when they come back home to the herd alive. None of us are all well until we are all well. In today’s world, the sick social conditions of poverty, misery and suffering spawn more and more drug addicts seeking a fruitless false escape from the social stressors of life that push and pull one down into getting involved in drugs and other forms of vain escapism leaving an empty void of love in our lives. These unjust realities must be addressed, changed and transformed in ways that promote life, liberty and the pursuit of happiness.

We should be actively involved in helping people get into recovery from all negative forms of addiction and unhealthy life-styles. In the process, we are helping to create a new humane being who enjoys high self-esteem, is equipped to face the challenges of life, is able to find solutions to problems and who is capable of helping to create a just, fair and humane world for all of us. We help ourselves by helping others as we are all ultimately one with the infinite cosmos.

Wake up, come together and create a new life. Continue to grow up, mature and get rid of old ways that never did serve us well. We need new creative ways of coping with our social environment in order to transform the tragedy of chronic relapse into the triumph of a new humane being who is ready, willing and able to face life as it comes on life’s terms, with all its ups and down, ins and outs, good times and bad times. We must move forward one day at a time with a new vision of a bright future where people live, love and work together because they know the beauty and power of being harmony in with the Creator.


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