periodic short term relapse

[Steve-T]

  Ive been into recovery for about 25 yrs. I have never been comfortable in either AA or NA. I donot have an ability to enjoy over use of alcohol, but can enjoy small quantities, as a normal drinker does.I have a history of depression and anxiety, am being treated for these conditions with non euphoric type medications. I have a long history of idiotic relapses, short binges with pain pills or other narcotics. I almost feel fated to do this about every 3 yrs. of so. Are there any others out there who relate with this behavior? If so please post. Also are there any good support programs that do not require adherence to complete abstinance from alcohol as part of their recovery from narcotics addiction?

[HVM, M.Ed.,C.A.S., CN]

    You have asked an important question about whether it is possible to recover from addiction to one substance without giving up all others, even if those other drugs(including alcohol) have not presented as a problem.  Many of my colleagues in the addiction field will insist that complete and total abstinence from all mind altering substances is required.  My own view is not so dogmatic.  There are SOME people who can use other substances while abstaining from the one that caused a problem. I suspect that this is a very SMALL number of people, although I do not have research to back up this claim.  Most addiction specialists do agree that complete abstinence (in your case, even from alcohol) would give you the best possible shot at successful recovery.  
   Many theories have been advanced to explain how use of a non-problemmatic substance can lead to relapse.  Some providers call this cross-addiction, meaning that the addiction can be manifested in several different behaviors, all of which can be understood to be attempts to change the way you feel.  One explanation is that the experience of getting high reminds your body of a pleasurable state, and awakens cravings for your drug of choice.  Another explanantion is that your nervous system (including your neuro-chemistry) has been changed so that you will always be vulnerable to addiction and relapse.  Specialists in the field sometimes refer to this as neuro-adaptation.  Other theories have to do with the behavioral cues associated with ingesting substances that trigger other, related behaviors.  For example, it has been shown that the ritual of lighting a cigarette, and the smell of sulfur from the match are associated for many people with drinking alcohol, which can lead to relapse.  For this reason, many addiction specialists now advise that people strongly consider quitting tobacco as part of their substance abuse recovery.
    Regardless of the explanation for this link between seemingly benign use and relapse, you still have some work to do in your recovery.  I generally recommend that individuals who insist upon their right to use other substances carefully examine their motives for doing so.  Is it an attempt to be a rebel?  Would your life be seriously diminished if they were to give up alcohol?  Could there possibly be a link between occasional alcohol use and relapse with narcotics that you have been unable or unwilling to see?  You may want to consult with people who know you well, including a substance abuse treatment professional, to answer these questions.
    I am troubled by your suggestion that you are "fated to do this every three years or so."  This can be a self-fulfilling prophecy, and you can challenge this belief.  In particular, it is essential for most people in recovery to find support from others.  You did not say what your discomfort with AA and NA is.  Could it be that fellow recovering people have advised that you not drink?  This seems a bad reason to avoid AA.  If you just cannot bring yourself to attend a 12 step meeting, even in the spirit of exploration and investigation, rather than critiquing what you see and hear, you have chosen a much more difficult road.  
    Minimally, I recommend that you find a competent addictions treatment specialist, who will be willing to both understand your choices AND to challenge them on occasion.  You can carefully observe your behaviors to learn what has preceded the episodes of using drugs, so that you can recognize earlier the chain of events which culminate in a relapse.  Many people will say that the relapse "came out of the blue", until they begin to see patterns and learn to take steps to interupt the cycle.
    I am not aware of support groups for narcotic users that do not recommend complete abstinence.  However, Moderation Management is an approach which helps problem drinkers learn to drink in safety, by recognizing bodily cues, risky environments, etc.  I am not sure this approach would be helpful in your case.
    For more information about Addiction and Recovery, check out the Ask DrSteve website, hyperlinked below.

    This information is provided for general medical education purposes only.  Please consult your physician for diagnostoc and treatment options pertaining to tour specific medical condition.
Keywords: narcotics; relapse; abstinence; self help groups