When your Doctor Srews Up

Bad things happen. many times they are outside our control. Often patients ask me, "Why did this happen to me?". Many times the answer is quite simple. Bad luck.

Unfortunately for many patients that bad luck continues when they step into their doctor's office. Many of us have long held to the notion that all doctors are created equal and that the profession is filled with many competent and intelligent people who are all equally qualified. Not true. Unfortunately many doctors do not all practice the same level of care. There are many very competent and thought leading physicians and there are many who are not. How do know which one you have. You don't. And you almost never will until it is too late. Checking their credentials will not help. Checking their academic background or board certification will not help. Checking to see if they have ever been sued will not help. Asking your neighbors will certainly not help. Nothing will help. It is really just luck.

When a doctor screws up, bad things happen. Just ask Stephanie. Her true story blog appeared earlier on these pages. Stephanie had all the classic signs and symptoms of Bipolar Disorder. But her doctor missed it. Missing bipolar disorder can be catastrophic and I am certain that in this situation it directly lead to Stephanie becoming an addict. If it had been recognized earlier I firmly believe that Stephanie's life would have been drastically different in a very powerful way.

Don't be afraid to challenge your doctor and ask questions. The smart and confident ones will welcome the questions and answer them thoroughly. the bad ones will be insulted and will blow off your questions.

A good doctor will save your life. A bad one may destroy it.

In Her Own Words

“Hello, my name is S. H. I come from a middle class background. I lived in Michigan then in Florida, while in Florida we moved to several places, because we moved we lacked social relations and we remained very close. I was always above average in school and sports but never the best. I began drinking in High School, this was a weekly habit until I got in trouble at sixteen. During summer break from school, I traveled with my family and went to sport summer camps with friends. While attending High School I met my husband, I remained sober for the rest of High School.

I left for college leaving my High School sweetheart behind, he soon proposed and we were engaged. After our fairy tale wedding we moved to Gainesville, Florida where I earned my bachelors degree as well as my masters degree. During my last semester of my undergraduate year I began to go out with the girls and my husband and his buddies. I began drinking heavily and experimenting with drugs at parties and clubs. First pot then cocaine, and a few other in between.

I managed to be able to achieve good grades, be involved in the college extra-curricular activities while still partying. I had two groups of friends, my class/volleyball friends and the people I partied with. I thrived of good and bad girl routine, and this challenge of balance. My goal for college was to get into doctoral school. I volunteered and held office positions in pre-professional clubs, and helped with research studies. I applied three times to only get on the waiting lists. Because I failed I went into a deep depression, this began a spiral of binges and daily usage of drugs. So much, my husband and I incurred a ridiculous amount of debt, finally I had enough it was either die or do something to change my life, I left it up to God. I asked what was his plan for me, career or family, I listened.

I got pregnant and stopped everything. Moved away, bought a house and began a career in Real Estate. I was very successful and made a great living with flexible time for my kids, while pregnant with my second child my family started to have moral dilemmas which questioned the values of which I was raised. I was confused and I felt it was all a lie, even though I had all this going on I still felt alone and confused. To add to this my baby had serious health problems at birth and was hospitalized for weeks. I tried to stay strong, I was drained trying to hold myself and my world which was now confused and chaotic. Together I developed post partum depression and began to self medicate with pills and coke. It was a two month binge of carelessness and stealing and lying to everyone I loved. I became trapped in my own house and isolated myself from everyone, my own thoughts became solitary confinement. I cried out for help and finally admitted I had a problem. No one understood they thought I had it all. They did not know about my addictive secret life and self loathing.

I came to Synergy Group Services, Inc, after a long phone call with the staff. I checked in after a painful goodbye to my kids and husband. I needed to figure out why I was so unhappy in my own skin so I could become a better mom, wife, daughter and person for myself. After a horrible detox from opiates I began therapy which allowed me to find out who I am, I also learned the tools I needed to deal with my addiction, I also started to take care of my body with the help of great nutrition and personal training in twenty eight days. This program was small and personalized. As a mom it was like a vacation, I caught up on sleep. My disease was finally diagnosed correctly I accepted my defects and put my life into God’s hand, I left feeling like myself for me, I surrendered my life and my plans became what God intended for me, my life became whole.”

Stephanie H.

Sunday; No Time to Rest

It's Sunday. A day of rest. Yeah right!

Addiction does not take a day off. It is relentless and tireless. It never keeps moving. It never gives you a break. It wears you down and it becomes increasingly more difficult to stop the momentum. Becoming an addict is never a conscious choice. The use of drugs is, but becoming an addict is not. There are those who do not believe this. They are typically the same ones who believe that homosexuality is a choice. It is not. Who would possibly choose such a devastating world as the world of addiction. Science tells us more and more that people who are addicts are often put on that course by their underlying disease state and it is that disease that we must address in order to change the course of their lives. What must, however, become a conscious choice is rehab.

It is a rare phenomenon that an addict can change their stars without help. Occasionally in the absence of underlying pathology an addict can turn their life around by themselves. That is the exception not the rule. The rule is that addicts must be treated like any one else with a chronic disease state. They need help. and they need help within the structure of a well constructed treatment program. One that deals with every aspect of their disease and every aspect of their family.

Addiction never takes a day off but you have the opportunity to change its course.

I Choose Happiness!

WE really do have a choice that we can make. I choose happiness. Unfortunately many do not. We are bombarded by pessimism everyday. Negative thinkers who often say that they have no control over the "basd luck" that dominates their lives. However i believe that bad luck is often the by-product of poor decision making and negative thinking that creates negative action and outcomes in our daily lives.

Positive thinkers are happier people and happier people live longer and healthier lives.

So I choose happiness. It is a conscious decision that all of us can make. No matter what the circumstances are there is still a choice. We live currently in the most challenging socio-economic era since the Great Depression. Financial uncertainty is the rule, not the exception for most Americans. And yet we still have a choice. You can still by the TV watching news shows and following the daily turmoil of the stock market or you can choose to worry only about the things that we can control and take everyday for what it has to offer us. To laugh with your children; to enjoy the wonders of nature as a new spring comes to full bloom; to hold your wife; to cherish your friends; to read a book; to do anything at all that brings us peace and serenity and happiness.

It all sounds so simplistic and I am not suggesting that it will pay the bills. But neither will worry. As I write this blog my 4 year old is running in the back yard with her friends. Her world is small and concentric. her needs are few. Perhaps we need to shrink our world. To think and laugh and play like a child.

It is possible. We can choose happiness. Think about those around you who do make that choice and those around you who don't. Who would you rather be with?

Addiction: Is it "god's" Fault or Yours?

So what is the answer? What does "God" have to do with it? Is it his fault that you became an addict? I think not. Then is it His responsibility to participate in your recovery? I think not. God did not have anything to do with picking up your first drink or ball of heroin. He did not hand you your first oxycodone or light your crack pipe. He did not misaligned the planets to create the set of circumstances which were so grave that you had no choice but to relapse. He cannot in any way be held accountable for your addiction. And so because of this you cannot ask "God" to hold your recovery in His hands. Like it or not, that is all on you!

Steps 2 and 3 of the the 12 Step Program bring "God" into recovery. First, in step 2, by saying that it is a higher power that will in essence set you free and then, in step 3, by saying that it is "God" specifically who will guide you on your path to recovery.

I am a Catholic. Raised in a traditional Catholic Italian small town family. I attended Catholic school from kindergarten through graduate school. I am not an addict, but I have "lived' in that world for the past 8 years and I can tell you one thing. "God" has nothing to do with your recovery.

Addicts often say that their recovery is in "God's" hands. That in the midst of their recovery they are "blessed". We are all blessed and the course of our lives is in our own hands. The higher power that will drive you to recovery lives in the power of your mind and spirit which creates the determination and drive that you need to change the course of your life. That to me is known as spirituality. It is not the spirit "above " us but rather the "spirit" within us. Every addict is responsible for their addiction and therefore they are responsible for their recovery. It is equally their responsibility to utilize the tools around them--therapists, doctors, family, programs, sponsors, and themselves--to assist in that recovery. But don't put it on "God's" shoulders. That just gives you someone else to blame if you relapse. Take control of your own life. Be the source of your own power.

"I'm an Alcoholic!"

“I am here to tell you my story of how I got here today.

It all started when I first experience my first drunken state at the young age of fifteen. That was all it took to lead me to rehab, merely three months proceeding my twenty first birthday, I could never say “NO” or get too drunk. I honestly thought I had everything under control, as I started my freshmen year in college at a proclaimed “Party School”, Georgia Southern University. Enumerable kegs, coolers of hunch punch, and bottles of liquor later, and I was put on academic probation, suspending me for a semester after only completing twelve hours out of thirty. I could get around this speed bump by simply transferring to another school, Valdosta State University. That solved nothing. The blackouts came every night, the promiscuity only got worse, my embarrassing GPA dropped even lower, it got to the point where I’d work only to have drinking money, yet I couldn’t pay my bills. I’d try to control my drinking by having only maybe three drinks, but I’d have five before we left the house. I wouldn’t eat anything all day just so the level of drunkenness would be that much more intense. You’d think I’d learned my lesson after a night in jail for a DUI, minor in possession, giving a fake name and birthday, suspended license, disorderly conduct and failure to stop at a stop sign, would teach me a lesson.

Nope, the very next night in a blackout drunk I got pulled over again but somehow got let off it. I suffered the same fate in this school, and only got one class credit out of eight. My parents had enough, no more spending their money to pay for me to party.

I packed my stuff and moved with my mom in Atlanta, Georgia. I was livid, no more partying! Little did I know my drinking could get worse. Shortly as in two day after moving in, my mom passed away. I went downhill fast, drinking to oblivion all the time. After such a traumatizing event my dad felt sorry and decided to pay for college once again, because I have high hopes of becoming a Dr., however I had to live ten hours away in Florida and ten hours away from my drinking friends.

In the midst of all this, my DUI case was settled with an amazing lawyer who got my DUI wiped from my record. I was on probation for a year, was ordered not to drink and got a breathalyzer apparatus in my car for six months. The drinking ensued and I simply didn’t drive my car when I visited my friends to party all day and night. I was dumb and tried to drive my car at eleven after drinking all night on New Years Eve. This registered in my breathalyzer and still on probation, my probation officer took me to court and I was ordered to go get an analysis to see if I had a drinking problem, of course I didn’t I thought that was stupid. I was shocked to hear that I desperately needed rehab. I thought everyone drank from noon to three A.M., blackout and repeated. I was forced to go to this facility disguised as rehab.

After coming to Synergy Group Services, Inc I finally accepted I had a drinking problem, after seeing other people and relating my live to them. I was an alcoholic!

The staff at Synergy Group Services, Inc. helped me realize that the source of my drinking was the pain I bottled up inside. I am now in touch with my feelings and I don’t have that nagging urge to drink. There is just simply no more inside to suppress. The people here have completely turned my life around and opened my eyes to other perspectives. I feel cared for because they genuinely want to help you. When you have that level of support, it makes you want to help yourself. They don’t make you feel embarrassed about being here, but proud that you are strong enough to help yourself because many can’t. I am not going to lie, I went in kicking and screaming but left thankful that I was given the opportunity to appreciate not only my life, but sobriety”

Addiction Recovery: Light Follows Darkness

Few things in life are certain. There is however one thing that we can all count on; that no matter what point we are at in our lives, it will certainly change. Life is never stagnant. Life is always changing. That is the good new for an addicts. It is in fact, a point of solace. Because while in the depths of your disease, in the darkest period of life, you can count on the fact that your addiction darkness will always be follow by light.

Recently I was taking a flight from Chicago. I had been working very late the night before and had tried my best to change my 5:30 AM departure time in a desperate hope of getting a couple hours of sleep before working late again at my arrival city. Without successfully changing my flight I boarded the aircraft exhausted, cold, and aggravated. I swore repeatedly that as important as my travel income was to the support of my family I simply needed to stop traveling. Shortly after take off I was staring out the window feeling badly for myself when this spectacular sunrise erupted in the distance. Amazing colors of brilliant intensity like I had never seen before painted the early morning sky. As the scene matured my mood completely changed. Gone within minutes was my frustration and even my fatigue. Suddenly I was so glad that I was on that flight.

Addiction recovery can look very similar to the scene I just described. Tired, frustrated, and often hopeless every addict is in a dark and dreary time in their life. But coming out of that darkness can be life changing and the addict can evolve into a new person that may have never been found if not for the darkness.

Never be satisfied with where you are and never be afraid of where you can go. Change is good. Darkness can be followed by light.

When Drug Use is OK

It seems so much easier. I never have any trouble try to get patients take antibiotics or medicine for their blood pressure or diabetes. Patients almost never turn down pain meds--especially addicts. Clearly addicts have the hardest time saying no when it comes to drugs that in any way resemble those chemicals which live in the same neighborhood as their substance of choice. But tell an addict that you are going to give them a drug to treat their anxiety or depression or bipolar disorder (unless of course it is a Benzo) and you have a whole new fight on your hands.

It is not just addicts that have an aversion to psychiatric or psychotropic medications. Everyday, not some days, everyday; I have a conversation with someone who is reluctant to take a medication to treat their psychiatric symptoms. People believe that they can control their own thoughts. That they have control over their emotions. That unlike their pancreas or kidney or liver they actually have control over their brains. That is simply not true.

As a patient imagine how many times you have woken up and said that this will be a day when you will not feel depressed or you will not have a panic attack. And yet it happens anyway. The centers of your brain responsible for emotion (depression, anxiety, fear, happiness, etc)lie in your limbic system; miles from from your prefrontal cortex. It is the prefrontal cortex that you do have control over. It is there that you can scratch your head or memorize a poem. It is a whole different world in the limbic system however, and you have no more control over that region of your brain than any other organ in your body. Medications allow us to change the dynamics of the limbic system in a way that we can't otherwise do consciously. And they can do it quickly. When combined with psychotherapy they can do it more thoroughly than any other treatment modality.

Perhaps most importantly, when you say no to medicine you may be guaranteeing that you will stay on a path or psychiatric illness with no hope of recovery. Recent studies show that when untreated, illnesses such as depression can cause irreversible anatomical, hormonal, endocrinological, and physiological changes to the brain and the adrenal gland. These changes not only attenuate recovery but also promote increased incidence of heart disease, diabetes, and stroke.

Today the United States leads the world in very few areas. One area where we are miles ahead of the rest of the world is psycho-social illness. The numerous reasons for this will be a topic for another day. One thing is clear. If we want to change this dubious distinction then we must stop saying "no" to the right drugs! Take your medicine!

Labels: Addiction science

It's just my Opinion

Everyone has an opinion. The problem is quite simply this; most are not qualified to share that opinion. Medicine, unlike virtually any other field, draws opinion like ants to a picnic. Many doctors don't even have the opportunity to stay as current as they should when it comes to the overwhelming body of medical information available. A mountainous swell of information is released on almost a daily basis. Yet, as difficult as it is to stay current at least doctors have 8 years or more of medical training to fall back on. So today when one patient told me that they disagreed with my diagnosis and another told me that they know more about what they needed than I did, well you will just have to forgive me if I disagree with them.

Nothing gets in the way of treatment more than the uneducated and unfounded opinions of patients. Why is it that a patient with absolutely no training or experience feels that they have all the answers while at the same time their board certified physician just simply does not know what they are talking about? I have no answer to that question.

Now I will admit that doctors are often inappropriately paternalistic. And there are clearly times in which the doctor/patient relationship should be a partnership. but more and more patients are trying to take control of their healthcare and they are suffering dearly for that decision.

do yourself a favor and defer to an expert if indeed you have faith in your doctor to be that expert. If you have no confidence in your doctor then get a new doctor. Just don't be that doctor.

Who are the Parents Anyway?

You see it all the time at the mall or the grocery store. It happens at home and in public. It happens on nights and weekends. It is a 24/7 phenomenon and it is all about Darwinism. The weak perish and the strong survive. The most significant problem is that I am talking about the parent child relationship and all the power being on the wrong side of the scale.

There is very little in life that is more disastrous than when a child has more power than a parent and the parents are unwilling or unable to change the dynamic. Parents must be parents and they cannot be their child's friend. Kids have friends their own age for that. Parents must be parents. Even when it is hard.

Children thrive when limits are set. As much as kids will naturally push limits they will also thrive with limit setting. When parents have an inability to set limits and live by those limits, it is under those circumstances that parents lose control of their kids. There are bad children out there who are bad independently of their parents but for the most part "bad" kids are created by bad parenting.

As kids get older and the dynamics between them become more rooted it becomes even harder for the parents to change the flow of power. Now fast forward to a teen or adolescent or young adult who has a drug and behavioral problem. Imagine how impossible it is for a parent to step in and have any impact on changing their child's behavior or getting them to even participate in a treatment program. More often than not if the child actually enters a program it is incredibly important that a large part of that program is spent on changing the parent/child relationship. Parents have to relearn how to be parents and kids have to relearn how to be kids.

No High Feels as Good as Sobriety

Today while seeing a patient for follow up of her drug addiction treatment she echoed the words of virtually every addict who has entered a program and put some clean time behind them. She simply said that she had forgotten how good she could feel while she was sober.

There is a saying amongst people who are dieting that "nothing tastes as good as skinny feels". For addicts it is about how good sobriety feels that should help them stay on the straight and narrow. "Chasing the dragon" is a real concept and no addict will ever achieve the perfection of the first high. Not just those doing heroin, but those doing cocaine and crack and oxy also. For addicts and alcoholics it is not just the "high" time that cannot measure up to sobriety, but perhaps even more importantly, it is the dry time which is the hardest. That is when you feel your worse and yet is the period in which you spend the most time.

Nothing feels as good as sobriety. It is giving sobriety a chance that is the challenge and being strong enough to not get on the train that takes you away for the real world. But rather to face the real world sober. The interesting thing is that when you do face it sober you actually find out that it really isn't that bad and that you will feel better than you have in years.

There are many other facets to the above statement and stated as it is above is clearly too simplistic. Sometimes simplicity is good and keeping things simple is always an advantage to complicated. so in keeping with that remember that I promise you that all things considered and accounted for--you will never feel as good as you do sober.

Everybody Hurts....Sometime.

It is not always easy--Recovery. In fact it is never easy. You have to want it bad. you have to be motivated, committed, and prepared to hurt. It is not for the weak of heart or those who are less than serious about the task which lies ahead.

Too often addicts do not have that level of commitment when entering rehab. Too often addicts will try to take shortcuts. Even worse is when an addict enters rehab without a true intention of putting in the work that is needed to get better. If you are not willing to hurt then you are not willing to become clean and stay clean.

I think where addicts fall short the majority of time is not during the actual rehab program, but instead it is upon re-entry to the "real" world. As hard as the beginning of a rehab program can be, it is nothing compared to the work that one has to do when you are back to all your stressors and triggers. So many people who have done beautifully during treatment watch all that work go up in flames when they relapse due to the pressures of everyday life.

There is nothing easy about rehab and sobriety. It hurts. There isno way around it. Don't try to minimize it. Own it. Work it. Win it.

"I"ll go to Rehab, But NO Drugs!!"

It is funny how addicts are able to compartmentalize and justify drug use. A woman entering rehab yesterday has been drinking 2 bottles of wine a day. She got off the plane drunk but ready for recovery! (how is it that a flight attendant can continue to serve passengers even when they have clearly exceeded their limit?) this is not her first program and she has never put together any substantial "dry" time. So now standing in front of me after an evaluation which clearly indicated that there was a very significant dual diagnosis, she firmly insisted that she would not take any "drugs" (medication).

A similar scenario occurred a couple days ago when an addict using methamphetamine, cocaine and alcohol insisted that he would enter rehab only if no one tried to treat him with "drugs". Clearly he considers his body a temple and doesn't want to pollute it with psychotropic medications!!

All addicts, particularly those with a significant dual diagnosis, will never be guilty of having insight and clarity of thought. This creates perhaps the biggest obstacle to effective treatment. We have often referenced within the pages of this blog that poor decision making skills are universal in the world of the addict and that does not just apply to their addicted world but also to their participation in rehab. Like many lay people who feel they know best when it comes to medical decision making, despite a complete lack of training or medical competency, addicts will not put themselves in the hands of their treatment staff and let go. It is particularly important for those addicts who have failed previous treatment and self imposed efforts to achieve sobriety to put their treatment program in the hands of those who are qualified. Simply put you have to let go to regain control.

The data continues to pile up that most effective treatment regimens must include the use of psychotropic medications and even the judicious use of benzodiazepams to allow addicts to overcome their dual diagnosis and by proxy their addiction. Addicts are not the only ones who are limited by their insight to accept this fact. Sadly their are many "old school" addiction programs who haven't gotten the memo either. They are practicing antiquated recovery techniques that simply don't work for the majority of addicts. You don't have to look any farther than treatment failure rates to know this to be true.

So when looking for a treatment program look for one well versed in dual diagnosis and one will to put a round peg in a round hole and a square peg in a square hole. Every addict is different and a good program individualizes treatment.

Addiction Stories: Sarah

My Name is Sarah I am 21 years old. I come from an upper middle class background of Jewish descent.

I went to a small private school in Boston for my freshman year of college where I was introduced to the party lifestyle. At first it was fun, then my grades started dropping and my life became unmanageable. This forced me to have to transfer schools and move back with my family in Texas.

While in Texas, I realized that partying too much was not my only problem, but that I could not stop drinking alcohol once I started. I basically used alcohol for my answer to everything. Alcohol became my escape for life. Two years and a lot of alcohol later, I finally gave in to my parents’ wishes and attended rehab. After some time, fast forward two treatment centers and several months clean from alcohol, I relapsed. When I relapsed I was not only drinking stronger alcohol and much more frequently but I was also introduced to using heroine which I liked a lot. Needless to say my heroine use and my drinking escalated extremely quickly. My life went down hill from there. I managed to attend four treatment centers wasting a lot of my parents’ money and having reservations to use the whole time there. My life became so unbearable that I just wanted to change, I didn’t care what I had to do, I needed to change my life or I knew I would end up dead or in prison.

Finally, I decided to choose life. I wanted to live life on life’s terms and I was determined to change no matter what I had to do. In 2008 my life started turning around and I completed another treatment center only this time I didn’t just go through the motions, I actually heard what needed to hear and addressed my character defects. I have also had the opportunity to implement what I heard and learned while attending Synergy Group Services. This last treatment center which I finally took seriously was the only one that worked. Until I came to Synergy I realized why I never was willing to hear what the other treatment centers were telling me simply that I had to change.

I have attended Synergy Group Services now for a month and I can honestly say this was the most crucial month of my life, this was the turning point where I either was going to be one of the success stories or just another statistic that relapsed. My mind was open and I was ready to hear what I needed to hear. Synergy has given me the confidence and the tools to believe in myself and exercise my potential to the fullest. I’ve realized that now I can not only be successful at completing what I started but have the courage to know I can lead a normal healthy lifestyle while remaining sober. The Synergy staff is extremely compassionate and dedicated which is exactly what I needed to be able to get over that last hump of believing in myself. My time at Synergy has been extremely beneficial towards my development into being independent and making right choices.

I Hate You; Can You Pick Me Up

The parent child relationship is the most unique of relationships. It is also the most difficult to figure out. It is parasitic. It is symbiotic. It is dynamic and therefore often changing. It is exhilarating. It is frustrating. And that is for both parties.

In the world of addiction the parent/child relationship is even more challenging for both parties. Children will be children no matter what age and often have a complete inability to "cut the cord" even if the relationship is an unhealthy one. Parent often are co-dependent and have an inability to "walk away" even if it is everyone's best interest.

Thank God for the addict that parents don't give up. They are resilient. They take every punch that an addict can give and keep moving forward. They continue to be willing to wrap their arms around their child and console them. No matter what.

The addict however is a different story. They want to believe that they are independent. They want to believe that they have grown up and can make their own decisions. They want to believe that it was their parents who screwed them up and that if it wasn't for their parents they would be just fine. Bulls_ _ t!! Addicts often direct their anger at their parents but it is all very displaced anger and is often inappropriate and unfounded. At the same time as soon as things go South and someone needs to be called that someone is always a parent. Parents will rescue. For better or worse, parents will rescue.

All of the above leads to a tremendous need for family therapy whenever an addict enters treatment. Never neglect or minimize the power of the parent/child relationship. Making it right will go a long way towards successful recovery.

Addiction Trauma and Recovery Drama

Trauma creates drama. It is unavoidable. In so many addicts when we peel back all the layers and finally get to the answer to the question "why" it is often related to trauma. The answer to the question "why" must always be found in order for recovery to occur but the answer is often a difficult one because that answer can cause so much pain. The trauma comes is all forms. Everything form family dynamics to sexual abuse to legal problems to psychiatric disorders. And so it is almost inevitable that unveiling that trauma will bring with it lots of drama.

Treatment success comes with keeping that drama to a minimum and not letting it interfere with the work that must really be done. In my time as a treating physician to those with a diagnosis of addiction I can absolutely tell you that the clients with the least amount of drama have the highest success rates. Two patients with the same circumstances surrounding their trauma may have completely levels of drama in their lives. I wish I could tell you what predisposes one patient to higher levels of drama than another but I cannot. It is occasionally a personality disorder. It is occasionally a psychiatric disorder. It is occasionally those "helicopter" parents--the ones who hover and coddle too much.

Today in the treatment center was a perfect example of how drama gets in the way of recovery. A patient who was doing so well for her first couple of weeks in the program let her drama disrupt not only her own program but the program of all those around her. The power of the mind is incredible and psychosomatic symptoms are over powering but it is really all just drama. Drama is more prevalent in the pessimistic personality--but how do you make a person optimistic?

I continue to look for the answers to the questions regarding the cure for drama. In the meantime keep the drama to a minimum and you will speed your recovery process.

Decision Making; Heart or Head

"Go with your heart" or "Think it trough, use your head". Which is it? Emotion or sensibility, which one leads to a better decision.

Too often in the world of an addict it is their decision making which leads disaster. the decision making process of the addict is often extremely flawed and because of this their life snowballs in the wrong direction. The inertia is often too hard to stop and one bad decision begets another one. Poor decision is without a doubt the biggest obstacle to sobriety.

So how do we change this paradigm? How can we improve the decision making skills of an addict. It is often hard enough to do it when the process is not complicated by neurochemistry clouded by drugs and psychopathology. The first step is to create some distance between the addict and his drug of choice. This alone often creates some clarity of thought. Most importantly, however, is to treat the underlying pathology.

the importance of dual diagnosis cannot be understated. Insight and honesty are tow characteristics for which bipolar patients are not well known and clearly good decision making cannot be made in the presence of untreated bipolar disorder. We cannot simply ask addicts to put their disease aside and "just make a reasonable decision" You cannot ask them to use tools that they just do not have. Poor life skills and pathology have prevented them from having the right tools and we must give them back to them while in treatment. Treatment is not just about sober time and 12 steps. It is about psychiatric treatment and skills development.

Take the emotion out of decision making and give an addict the right tools and there is a chance that they will choose sobriety.

Parenting an Addict; Hardly a Dream

As prospective parents we look forward with great joy and anticipation as we start our journey to parenthood. Even before the actual arrival of our child we are already thinking how we can be the best parents possible, provide all the essentials needed for a loving caring nurturing environment. As parents we don’t mind sacrificing so that our children can have all they need plus. We are gratified to see our children grow and develop and achieve their highest potentials so that life for them will be better for them that it has been for us. I guess you could say parents our very co-dependent on their children. When they are happy we are happy and when they are sad we are sad. We feel their joy and feel their pain.


Then a day comes in your life when joys and dreams of good things for your child come to a screeching halt. The day we find out that our child is “doing drugs.” It may be pot, cocaine, heroin, prescription drugs or alcohol or a combination of drugs, but regardless fear, anxiety takes over our bodies and minds. We try to find out all the circumstances surrounding what we have just found out. The extent of the abuse, what drugs, with who and whom are they getting these drugs from. The next step is to determine what kind of help we can offer our child. And as I went through this process anger and resentment and frustration entered into my life. As time progresses and the child we brought into this world so that they could enjoy success and happiness falls into a hole of drug use, deception and a life that most could not relate to or understand. Of course we send them to treatment, the best money can buy. But relapse after relapse fear and dismay heightens because as parents we do no see the light at the end of the tunnel. Then as a father the worst emotion of all surfaces, helplessness. After all I am a father and is it not my responsibility to make all right in the world for my family? With helplessness comes the next and final emotion as a father, failure. The acknowledgement that I cannot fix this problem for my child. That in the final analyses only the individual affected by this insidious disease can start and continue their own recovery. This acknowledgment took me many years to come to terms with. After much soul searching I came to the conclusion that I am only a parent. I can do only the best I can do. I also spent much time looking to blame someone for my child’s despair.

The disease of addiction affects the entire family tree, parents grandparents, other relatives and friends. Finally I came to the realization that addiction is truly a family disease for many reasons. As time marches on for many so does the disease of addiction gaining momentum in the most negative ways. Spiraling behaviors as a result of drug addiction bring other issues into the equation. Legal issues, family trust issues, resentment and family members dealing with their own psychological and physical fatigue of trying to keep up with all the negative behaviors of the addicted love one as their addiction spirals deeper and deeper.

I remember reading a book on the issue of kids and drugs many years ago when I discovered my child was involved in drugs. The title of the book is “Not My Kid.” I would suggest it be recommended reading for any family that first finds out that their child is abusing drugs. As parents we almost always retain hope that such a precious life we brought into this world will finally break away from the grasp of such a terrible disease. That the frown on the face of our child will turn to a smile and that they will achieve all the good things in life we planned for them before they ever entered this world.