Addictions: Alcohol and Substance Abuse


Allan Schwartz, LCSW, Ph.D.

RecoveryWe talk a lot about alcohol and drug addiction. There are is a lengthy debate on this web site as well as others, about the pros and cons of Alcoholic's Anonymous and the value of 12 step programs. On television, there are now two cable channels that chronicle the real life stories people who are addicted and their struggles to recover. However, there is very little discussion about being in recovery and how that feels for former addicts. This has been brought home to me by several former drug and alcohol abusers who talk about the conflicts and challenges they face as they move further away from the days when they were addicted.

There appears to be a positive correlation between addiction and depression. However, a correlation does not mean a causative relationship. We do not know if depression leads to addiction or if or is the result of the abuse of alcohol and drugs.

What has become apparent is that, as time goes by, being abstinent is accompanied by many thoughts and feelings of regret for many former addicts. Several of these individuals, now working, earning a living and fulfilling their roles as father, mother, husband or wife become harshly self critical over opportunities lost, harm caused and poor choices made. More than the average person who can feel sad about dreams and hopes that are unfulfilled, the former drug abuser is an unrelenting and harsh self critic. Any time there are quiet moments and the opportunity to be introspective, negative thoughts and terrible memories come flooding in about the past. Often, the underlying thought is, "How could I have done those things? How could I have hurt my family and myself? How much better my life might be now, if I had not done those things?"

How to Cope:

There is no single solution for the former abuser and their loved ones who want to alleviate the pain. One of the complications for the former addict and loved ones is that there is the reality of the past and the things that happened. However, the past cannot be changed but the ability of people to heal build a better present and future is unlimited.

Here are some suggestions for smoothing the bumpy road of sobriety:

1. Psychotherapy is a vitally important tool for those who are entering sobriety as well as for those who are self critical and sad about the past. There is plenty of research that documents the need for psychotherapy for recovery and continued sobriety.

2. I am an advocate of mindfulness and meditation. Just read the excellent posts by our own Dr. Elisha Goldstein, Clinical Psychologist, to understand the value and need for a life of mindfulness and meditation.

3. In addition to reading Dr. Goldstein, I urge everyone, those who have and histories of addiction and those who do not, to read the beautifully books written by the Buddhist philosopher, Thick Nat Hanh. His books are sensible and poetic as he describes how to cope with all the challenges posed by life. In fact, his description will teach you how to appreciate the life you have. For the former abuser, and for the rest of us, the challenge is to value and live in the moment. The past is gone and the future is unpredictable but, if we should value the moment because we will never have it again.

4. In both my opinion and experience, attendance at either AA meetings or one of the other self help support groups, is very helpful in dealing with the challenges of sobriety. Cohesiveness, shared misfortunes and a lot of warmth and acceptance, are all encouraging people who have experienced these problems. AA is not the only support group available. There are such things as Smart Recovery and a whole host of other groups, a list of which can be found at this site, that are very useful.

5. For the families and loved ones of former addicts, it is important not to delude one's self by making reassuring and forgiving statements that will never be believed by the former user. Rather, it is important to provide a lot of empathy while refocusing on the present and the better life that everyone now has.

Your comments, questions, suggestions and advice are strongly encouraged.

Allan N. Schwartz, PhD



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