For the person who has fought back against drug addiction and has been walking the road of recovery, stress can pose a dangerous threat. For many, the stress of struggling to find work, rebuild relationships, or a sudden loss through death can be enough to trigger a return to using drugs. Stress is a powerful force for people without an addiction history, but when there has been a pattern of soothing stress with substances, the temptation to do so again when the stress temperature rises is great. A recent National Institutes of Health-funded study may have discovered the key to preventing stress from triggering that kind of relapse.

The grant-funded study was actually a partnership between researchers from the University of Pennsylvania and Brown University. The investigation provides a clear outline for the sequence of events within the brain leading up to a stress-induced drug relapse. The study debunked prior hypotheses about the relapse pathway and uncovered evidence that the part of the brain connected to meeting basic needs (the VTA) was pivotally involved.

The study employed rats with a history of cocaine addiction but who were not presently addicted.  Some of the rats were treated with a chemical (nor-BNI) that inhibits certain VTA receptors (known as kappa opioid receptors), while the other group of rats did not receive the treatment.  Next, all of the rats were made to undergo five minutes of stress-inducing exercise. Observation showed that the treated rats did not revert to cocaine use even after being stressed. The non-treated rats did go back to cocaine.

When we meet our body’s essential needs such as eating and drinking, the brain releases dopamine, a chemical that rewards our behavior with a sense of pleasure. At the same time, healthy brains also release GABA, which modulates dopamine release. Drugs keep GABA from doing their job of controlling the dopamine flow and hence drug use produces an oversized rush of good feelings.

Relapse Prevention with Stress Prevention

In this study, researchers first demonstrated that stressors prevent GABA from slowing down dopamine release. This explains how stress can be a preamble to drug relapse. In the presence of stress, the proper amounts of reward chemicals are disordered. Pleasurable activities become inordinately pleasurable. However, the study team showed that by introducing nor-BNI into the VTA area of the brain, the dopamine controls remained in place even during periods of stress.

By honing-in on the neural underpinnings of a stress-caused relapse, these scientists may have found a way to interrupt the chain reactions that trigger a return to drug use. The study could prove to be a major leap forward toward creating a targeted medication that could remove a domino from the stack and prevent the inevitable result.

Finding a rehab that has not only a great rehabilitation program but a great aftercare program is another way to help prevent relapse.  Read Choosing the Right Drug Rehab for Your Loved One to learn more.

When practicing addicts hear the word “sober” they immediately think of an eternity of boredom, drudgery, suffering, loneliness, anxiety, or just plain blah. As we stand at the edge of the diving board, trying to decide if we really want to dive into this program, we can’t help thinking of all of the fun nights we won’t be having, the awkward explanations for why we aren’t drinking, the new un-fun persona we imagine we’ll have to assume, and all the friends who will eventually stop calling. This is the reward for giving up booze?

For a while there is no way around it—we’re going to feel a little like fish out of water. Whether we like to admit it or not, we have built our lives around our behaviors and substances of choice. The prospect of a day or night without our fix made us uneasy, apprehensive, and anxious—provoking a feeling of dread. Unwilling to walk through the space of time without our drug of choice, we abandoned our plan to make a go of it sober and headed back to the welcoming arms of our old friend and nemesis.

But there came a day when there was no choice. We couldn’t keep up the drinking game any longer. If we were going to actually live and avoid certain alcoholic death, we were going to have to muster the courage to try sobriety.

But then something interesting happens. What we thought would be drudgery turns out to be delight. This has been true for many people and it can be true for you too.

In sobriety, life becomes something to live—an event for which to be present—not a doom from which we need to escape. Suddenly we find that we enjoy our days without alcohol and that we are seeing and experiencing the world in a new way. It is not boring—it is exhilarating.

New pleasures are discovered. When we drank we only thought of the euphoric rush of getting our fix and escaping even the smallest of irritations and anxieties. But in sobriety we learn how to meet life and how to embrace it—even in the challenges. We notice beauty, we learn new skills, we give our time to new activities, we feel ourselves growing stronger and developing as people. Life is full and rich and soon we don’t even miss alcohol.

Loneliness slips away in favor of real relationships. Though we often drank in the presence of others, our real date was with the booze. It was with alcohol that we felt we could be ourselves—whomever that was. We struggled to form real relationships of mutual trust and love with other people. We feared vulnerability. But in recovery we are learning how to give and take, how to be a friend, how to serve, and how to love. Our life is filling up with people who care about us and we are seeing the joys of authentic relationships—joys which alcohol could never provide.

Sobriety comes first. We never thought we’d say that sobriety and the program were our number one priorities, but we are learning that the new life we are becoming accustomed to, and even beginning to cherish, is utterly dependent upon it. We don’t handle these blessings carelessly. We know we are always just one sip away from where we were, and now we can’t bear the thought of going back.

“I realized that I had to separate my sobriety from everything else that was going on in my life. No matter what happened or didn’t happen, I couldn’t drink. In fact, none of these things that I was going through had anything to do with my sobriety; the tides of life flow endlessly for better or worse, both good and bad, and I cannot allow my sobriety to become dependent on these ups and downs of living. Sobriety must have a life of its own.” (Alcoholics Anonymous, He Only Lived To Drink, 451)

Want to get your Sober Life with the 12 Step Program? Think it’s just for Christians? Read: Recovery Myth-Buster: A.A. Is A Christian Organization

As much as we are all dying for freedom and spontaneity, what we have to acknowledge is that ‘freedom’ isn’t really freedom at all. We want the option to be able to say ‘yes’ to our substance of choice whenever we want to—but what happens when we can’t say ‘no’? The ability to say ‘no’ is, too, a freedom and one that we lose when we pursue the false freedom of being able to engage in our addictive behaviors whenever we want to. There is, in fact, a trade-off. We cannot have our cake and eat it too. If you don’t have a problem with drinking, then you don’t need to worry about putting boundaries around your behavior. But if you are reading this, you are likely concerned that there may be a problem. By boundary what we actually mean is abstinence. It’s not the news you wanted to hear. You were hoping there was a way to drink and enjoy drinking like a normal person and then stop drinking when some internal trigger alerts you that you have enough. But isn’t this what you have been trying to do for months, years, or even decades?

The 12-Step Program doesn’t set out to teach you how to live normally with alcohol, it teaches you how to live normally without it. This is the hard reality that we have to accept: we have tried to moderate our drinking and we have failed. We thought that having ‘control’ over when and how much we drank was what we wanted until we saw that we were no longer controlling alcohol—it was controlling us. It is time to give up the fight and accept that the only way to regain control of our lives is to get rid of alcohol entirely—to put a firm and unmovable fence between ourselves and drink.

At first it seems controlling or overzealous. Are we just making too much of this whole thing? Plenty of people drink, we tell ourselves. Why do we need to be so serious about it?

So how does a boundary bring freedom? Because when you embrace sobriety, you receive your mind back. You have the power to say no. Alcohol is no longer your steamroller. And this is a freedom unlike the so-called freedom we think we had when we could drink ‘whenever we wanted.’ But there was a problem with that kind of freedom. We didn’t have the choice to not drink whenever we wanted. Alcohol was the boss. In sobriety we take our lives and our decision-making capacity out of alcohol’s hands and we reclaim it as our own.

We become free to make plans and keep them, to give our word and stick to it. We stop living in the shadows of broken promises and failed attempts and futility. When we get honest with alcohol, we get honest with ourselves and the rest of our lives and we become free.

Most of the principles of recovery contain a paradox and this concept is no different. But where has conventional wisdom or common sense ever gotten us? We have to reject the advice and the methods and the approaches that are not working for us and not serving our goal.

You have the right to be free. You have the right to be sober. You cannot imagine what that life will look like and certainly it is a little scary to think of. But what if, emotionally, you could be brought to a place of never actually needing a drink? What if life became manageable? What if you felt as good sober as you did the moment you took the first drink? Would you try it?

Watching for signs of relapse in loved ones. Read: Relapse Prevention: Signs of Relapse in Recovering Addicts

When someone is struggling with addiction, having a loving support group of individuals who are highly committed to his or her recovery and sobriety is important. Friends and family can help make rehab treatment successful and can also act as watchmen on the road to recovery. Surveys have shown that many of those seeking recovery from alcohol misuse experience at least one episode of relapse along the way.  Drug abuse is similar. However, it is possible for watchmen to see road signs that warn a potential relapse is imminent.

Some signs are physical, some mental and others emotional, but they are all fairly accurate in predicting the direction the addict’s behavior will head. Alert loved ones will learn to read these cues and do what they can to steer the recovering loved one onto a better road.

If the person shows signs that just being around alcohol affects them, if he or she becomes anxious or irritable at gatherings where alcohol is served, a relapse may be in the offing.  The recovering addict’s heart even may race if others nearby are consuming alcohol.

People who have been misusing alcohol or drugs have become accustomed to feeling numb or living in an emotional monotone. Living with the daily fluctuation of emotions can sometimes prove extremely trying. If the person expresses feelings of isolation, loneliness, or depression, these could trigger a relapse. Irritability and anger are also red flags that the person is finding it hard to manage mood shifts.

Relapse Prevention

Any small stress can be enough because the person is unpracticed in the art of problem-solving and evaluation or regulation of emotions. Testiness could be a red flag that self-soothing with alcohol or drugs is lurking.

While it is impossible to see into another person’s mind, listen for signs that the person is fantasizing or fondly remembering prior instances of substance use. Once the person embraces a positive mental image about using drugs or alcohol, he or she will often look for a way to re-connect with former companions or seek to drink or use drugs without others knowing.

Indulging in positive imagery feeds the cravings, yet the person feels conflicted and guilty about breaking sobriety promises. This self-inflicted stress means that relapse is likely. If you see your loved one reaching out to prior friends or becoming secretive, be aware that this could be a sign of relapse.

Loving friends and family can be on the watch for signs of relapse and they can even warn the person when they see signs of danger, but no one can control another person or prevent them from relapsing. Having an alert support network can make the chances of relapse diminish, but only one’s personal commitment to sobriety can safeguard him or her from the many ways that recovery can be temporarily derailed.

Find help with relapse prevention: Making Your Way in an Addiction Recovery Support Group

Peer groups for addiction and alcoholism are an integral part of the healing and recovery process. These assemblies of the hopeful can be extraordinarily effective at facilitating constructive interactions between people who are attempting to make a successful transition from sickness to health. Recovery from addiction is hard and challenging work, and the advice and support that substance abusers receive from their peers in support groups can be valuable beyond measure.

Or at least, this is how it should be. Unfortunately, peer groups are no different than any other type of self-organized entity in that they can be highly effective or completely dysfunctional depending on the quality of the input of the participants. Ultimately, those who attend peer support groups must put in a real effort to make sure these self-organized healing-centered associations deliver on their promise to assist, and without this type of care and concern a peer group may come nowhere close to living up to its potential as a force for good.

A lot of the responsibility for the quality of the peer group experience obviously falls on the shoulders of the group leader, who must use his education and experience to help steer discussions in a positive direction. But while a good leader has great influence, if the members of a peer group don’t hold up their end of the bargain, even the best leader will not be able to organize an assemblage that rises above the mediocre. The voluntary relationships that the members establish among themselves are the lifeblood of all peer support groups, and it is vital that recovering addicts and alcoholics who attend group meetings work hard to make these gatherings productive and enlightening for all.

To some extent this burden may seem a little unfair; after all, addicts in the early stages of recovery already have a lot on their plates, and asking them to take on the added responsibility of helping to ensure that peer support groups are run effectively may seem like a bit much. But passivity is not synonymous with recovery from chemical dependency, and anyone who is serious about overcoming a drug or alcohol problem should be ready to take an active role in his or her project of redemption at each step along the path. If a peer group is only as good as its members – and this truism is as rock-solid as they come – then each of those members must be prepared to expend effort and energy to facilitate the recovery process, for their own good as well as the good of their fellow addicts.

So what characteristics make a good peer support group member? There are many possible answers to this question, but the analysis of peer group dynamics that follows should provide some useful guidance for those seeking insight.

Recognizing and Respecting Boundaries and Communication Styles

Addicts and alcoholics in peer support groups share a common problem, but nevertheless each is a profoundly unique human being whose differences must be recognized and acknowledged. Human individuality is the main reason listening skills are just as important in communication as speaking skills, and peer group members should concentrate very closely on what their fellow group members are saying so that they can respond appropriately and constructively to what they are hearing—presume nothing but hear everything, this should be the credo of all peer support group members when dealing with their fellow recovering addicts.

But to gain real insight, it is also important to hear what people are not saying—while some people are comfortable speaking about their lives and their problems in public others are far more reserved and reticent, and everyone’s preferences and styles should be understood and respected. In ways that are sometimes subtle and sometimes obvious, each and every person in a peer support group will let the others know when they are ready to talk, how much information they are willing to disclose, and how much honest feedback they are comfortable receiving. Good peer group members realize this, they pay attention to the signs, and they adjust their interactions with their fellow recovering addicts and alcoholics accordingly.

The Power of the Practical

Recovering substance abusers attend group meetings hoping to find support and understanding, but they are also looking for practical advice to help them cope with the pitfalls and temptations they will inevitably face as they travel the path to sobriety. Whether their useful knowledge has been gained through wise analysis or trial-and-error, most recovering addicts have discovered strategies and techniques that have helped them make it through the rough times, and their “stories of the road” can be immensely helpful to others who will likely face, or are already facing, the same obstacles on their journey to good health. For the newly sober the possibility of relapse looms at every moment, and any ideas about how to handle cravings, overcome the depression that often accompanies withdrawal, or resist the triggers that can sabotage recovery in an instant can be extremely helpful.

In general, a positive attitude in the peer support group setting is highly recommended. But vague, pie-in-the-sky platitudes sound insincere and can actually interfere with the establishment of good relations between support group members. Hard-earned practical advice, on the other hand, will always be accepted with gratitude and appreciation.

The Grace of Acceptance

Giving good advice is wonderful, but accepting the suggestions and insights of others with good grace also helps to make the atmosphere in peer group sessions feel warm and inviting for all who come. When people feel free to share their thoughts about the situations others are experiencing, and when they know their efforts to help will be applauded, it enables them to connect more deeply with other recovering substance abusers and helps them open their hearts and minds to the guidance they will be offered by others in return. Regardless of whether the advice a particular person gives actually has the potential to help anyone else is irrelevant; just the fact that he or she feels comfortable speaking up and contributing is what matters the most.

Peer group members really do need each other, for validation as much as for anything else, and for this reason everyone who attends group meetings should give equal attention to all. Recovering addicts and alcoholics are searching desperately for a renewed sense of purpose, and having the chance to help others who are in a similar situation can help fill in the emotional and psychological gaps that will come to the forefront once drugs and alcohol are no longer around to provide their dubious compensations.

Following the Leader, and Letting the Leader Follow

As previously mentioned, group leaders play a vital role in managing and developing peer groups that actually work the way they are supposed to. But even though they are officially the ones in charge, group leaders still need all the help and support they can get. For example, peer group members who listen closely to what their leader says and ask questions or offer critiques can boost his or her efforts substantially, offering positive reinforcement to a message that may be of vital importance to everyone.

In peer groups, leaders are only as good as their followers. When recovering addicts and alcoholics are willing to support their leaders’ hard work by participating eagerly and attentively in the discussions they initiate, it sets a good precedent and encourages others to get more deeply involved as well.

Getting into rehab for your addiction was a huge and important step. Making it through the process was an uphill battle. Now, you are out of rehab and back in the real world. The first thing you want to do is drink, right? No matter what anyone tells you before you go into recovery, resisting the urge to relapse once you are sober may just be the hardest part of all.

Once you are out of your support network and 24-hour care of a rehabilitation facility, you are largely on your own. You may have helpful and supportive family and friends, but you are the only one who can stop you from drinking again. You must find a way to cope with your feelings and the underlying reasons that you became an addict in the first place. Something has to replace the drinking and now is the time to find your healthy alternatives. Here are some ideas to get you inspired:

• Exercise. Now is a great time to get fit. Find a fun way to be more active, such as taking classes at a gym or learning how to dance. If you enjoy socializing with others, consider joining a league for soccer, baseball, basketball, or any other team sport. The more active you are, the less time you will have to think about drinking. Additionally, exercise and physical movement release natural feel-good chemicals in your brain, so you can literally get a natural high from working out. If you get bored easily, or if working out begins to feel like a chore, change it up and try different things.
• Get creative. Exercise and physical fitness are great for keeping your body fit and for keeping your mind clear, but mental fitness is also important. Stoke your creative fires and tame your urges to relapse. Engaging in something creative is a great way to express yourself and to release the tension that you feel when you have an urge to drink. Try painting, drawing, or even writing. Expressing your thoughts on paper, even if you are the only one who will ever read it, can be very therapeutic. If art has never been your strong suit, consider taking a class at your local community college or community center.
• Learn something new. In addition to the creative arts, your mind can benefit from learning something more academic. This could be practical. For instance, you might want to enroll in a local community college and work toward a degree. You can also learn something new just for fun. Maybe you have always wanted to go to Paris. Start learning French so you can go one day and speak with the locals.
• Focus on work. If you enjoy your job, dive in head first and take on new and more challenging projects. If you are not so satisfied at work, this could be a great time to work toward something new and better. Maybe a promotion at your current location is possible. If so, talk to your boss about what you need to do to earn that raise and new position and then put all your energies into doing it. You might also consider searching for and getting your dream job. This is a great way to focus your urges on something positive.
• Pick up a hobby. Maybe you used to work on model trains or you gardened, but your drinking got in the way. Now is the perfect time to get back into your old hobbies. They made you feel good in the past, so use them now as a way to resist the urge to drink. If things from the past hold too many negative memories, start up a new hobby.
• Spend time with family and friends. This may be the most important tool you have in your kit for releasing pressure and avoiding a relapse. When you feel bad, turn to a trusted confidant and vent. Take him out for a cup of coffee and have a good, long, healing talk. Surround yourself with friends and members of your family who are positive influences. A strong social life is key to staying sober and healthy.

Whatever you do to relieve tension and pressure, make sure it is not a return to the bottle. Having come this far, you know you have the strength to stay clean. Use these ideas to help you vent your frustrations and to find an outlet for your excess energy.

Whether you recently lost your spouse of 25 years or have been diagnosed with a major illness, the deep pain you feel can easily threaten the recovery you worked so hard to achieve and maintain. You may find yourself toying with the thought that getting drunk or high-and staying there-is the only conceivable way to ease the gut-wrenching emotions weighing on you. Despite everything you learned in your drug rehab treatment, grieving can be a risky process for any recovering addict. But, as painful as it is, it’s a necessary process.

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I lift up my eyes to the mountains- where does my help come from? My help comes from the Lord, the Maker of heaven and earth. Psalm 121:1-2

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