First of all you probably should make a decision about the size of the social circle you require. This is a factor of your personality as well as your needs and stage of your drug addiction treatment. The more outgoing you are the larger the group, but even if you are not gregarious, the size of the group must support the amount of assistance you might require. When just coming out of a drug rehab facility, you might be using your social support quite heavily and thus want to insure you have enough people in your circle so as not to exhaust them, or overuse and overburden them.

Also key in the process is to insure that those involved in your social circle benefit from a mutually satisfying process. You must share the good as well as the bad, and support their needs as well. For this to truly help it must be a two way street. Above all be thankful and acknowledge your gratitude to those around you who care.

If you have just left a drug rehab, go slow in restoring friendships and relationships. This is especially true of ones that might have been damaged by your addiction. Give them some time to see the changes you have worked on in your addicition treatment. Also there is no need to discuss every detail of the issues you covered in rehab. Over time what is appropriate to discuss will be evident. Sometimes in the excitment of demonstating the changes in your life, you may reveal things that later you you wish you had left unsaid.

Have a plan for a crisis situation no matter what. Include a back-up plan, in case that person is not available. Again this would best be done before you left the drug rehab or treatment facility. Once your emergency plan is in place, take the time to contact others gradually and keep the first contacts brief pleasant and upbeat. Get permission from someone before you call them at 3 a.m. Respect that others have lives and commitments as well. While your addiction treatment is a large priority in your life, make sure that in your conversations and contacts you have balance. Find common interests that have nothing to do with substance abuse or recovery.

As you re-establish your contacts, gradually discuss the type of support you require. There will be appropriate moments to point out the strengths of your friends, such as their honesty, and how that might help you. Again remember to give the type of support you wish to receive. Above all, don’t use your support system and a dumping ground to constantly unload all your frustrations. In How to Win Friends and Influence People, Dale Carnegie said don’t criticize, condemn, or complain. Even when discussing your problems, you can stay focused on the solutions. Nobody ever want to listen to someone go on and on about how difficult addiction is. Look for the gifts, and insights your drug addiction has given you and talk about the great changes you wish to make and how you will make them. Ask them about things in their life they wish to change and how you might support them. Following some of these suggestions will help your build a solid caring support system, and some really great friends as well,

Yesterday I discussed the value of social support in the treatment of drug and alcohol addiction. Today we will go through the types of social support and how to start to work it into you life to prevent relapse.

Emotional support: People who are emotionally supportive tell us they are concerned about us, trust us and think well of us. The value of this type of support is very large. Emotional triggers are probably the single largest cause of relapse, as well as one of the driving forces of the cause of the substance abuse in the first place. Without quality emotional support, the addiciton will return or continue.

Sharing information: Family, friends or counsilors give us factual and insightful information about a particular important decision, idea or stressful event. Addiction and drug abuse are conditions of isolation. As such they lend themselves to distortions in thinking as someone doesn’t get much input from others to get balance in the information used to make decisions. Quality, factual information is vital to disrupt addictive cycles, and one of the main functions of a good drug rehab is to help provide and discern this type of input.

Practical help: People who care about us assist us with practical day to day help such as gifts of money or food, assistance with cooking or help with a car repair. Life bumps can often escalate into the emotional conditions of frustration, anger and overwhelm. All of these again are often precurssors to drug and alcohol abuse. Controling and limiting them are again vital.
Sharing points of view: People offer their opinion about how they view a particular situation or how they would choose to handle it. All too often it is easier to see the solution to someone else’s problem, long before you can see the solution to your own. Addiction leads to thinking patterns that often result in poor decisions. Getting outside input is of great assistance in broadening our problem solving tool kit. Again in a quality drug rehab this process should be started, but once you leave rehab, it is you social support group that will continue and expand on this.

The next step in the process in to think about how many people are required for an adequate support system. Tomorrow will deal with how to find and build the size that is right for you.

In drug addiction treatment or when leaving drug rehab, one of the core requirements to maintain sobriety is a strong social support system. Social support is not the same as a support group. Social support is a network of family, friends, colleagues and other acquaintances you can turn to, whether in times of crisis or simply for fun and entertainment. Support groups are generally more structured meetings or self-help groups led by health professionals or â??peersâ??.

Why Develop Social Support?

Your positive friends and social contacts can encourage you to stay free of drugs and alcohol and support you to manage daily emotions such as sadness or depression.

Talking with a friend over coffee, visiting a relative or attending a drop in meditation session, can help you through difficult times that come periodically with alcohol and drug addiction treatment.

Sometimes just knowing they are there for you is enough to reduce stress and let you get on with living your life. Stress is one of the most prevalent precursors or triggers of relapse. Many individuals say they started using illict drugs in the first place to help to cope with stress.

Social support can increase your sense of community, purpose and self-esteem, adding to positive mental health. Again isolation and low self worth are common triggers for drug use. When someone feels like they don’t belong, or don’t have a worthy purpose, they are far more likely to return to their addiction.

They can also be there to celebrate your successes. Many people, even ones without drug addiction, tend to minimize their victories, but maximize their setbacks. Those of us who have lived through addiction or have been to drug rehab know this is especially prevalent and must be dealt with.

“There are many sorrows in todayâ??s world! These sorrows are due to hunger, to dislodging, to all kinds of illness. I am convinced that the greatest of all sorrows is to feel alone, to feel unwanted, deprived of all affection. It consists in not having anyone.”

Mother Teresa

The value of social conncetion in drug and alcohol treatment cannot be underestimated. Tomorrow I’ll discuss the types of social support.

Yesterday, I discussed one of the great priciples from The Fifth Discipline(1). Today I’d like to mention the other. It involves a term he calls “Shifting the Burden”. It simply means when we treat the symptoms of a problem, rather than deal with the fundamental problem. It also is what is happening in many addictive cylces

Take for instance social situations. If someone feels shy or arkward they may tend not to get involved in them. However maybe after a couple of drinks they feel more at ease and relaxed, and then get involved with other people. Later the next day, the person has doubts weather the people they met actually liked them. They decide if they knew the “real” person, they wouldn’t have been successful. This sets up more stress. This gradually leads to situations of a few more drinks, or drugs to relax. This again leads to more insecurity. An negative addictive cycle has been established.

By dealing with the symptomatic solution in using alcohol to “loosen up”, the cause of the original problem never goes away. In fact is the insecurity and isolation actually increases. A fundamental solution would be dealing with the shyness in the first place. Taking a public speaking course would deal with the root cause, the lack of confidence to speak up in social situations. This type of action, sets up a positive addictive cycle. You try someting new, gain some confidence, and try something a little harder the next time.

I sure this sounds a little simplistic. However when you look at most situations involving drug and alocohol abuse, the drugs become a cure for a symptom in someone’s life. The drugs help someone cope with stress. Alcohol is used to unwind after work. Or I need the drugs to relax. All of these situations would be much better served by dealing with the root fundamental cause of the stress or tension.

1. The Fifth Discipline, Senge Peter M.,1990 p. 105

We are always on the lookout for things that will help everyone in dealing with substance abuse and addiction. A great book is The Fifth Discipline, by Peter M. Senge (1). It is about deveopling learning organizations. While not directly dealing with drug addiction, it has a great deal of techniques and insight on how to view and deal with complex problems. What I found particularily useful is the concept presented by Mr. Senge, was a management principle of don’t push growth, remove the factors that limit growth.

This applies to the drug addiction and rehab field almost perfectly. When someone is trying to change a long standing habit such as addiction, so many times all the energy is focused on the change. However, one of the reasons that change is easier and more successful in a drug rehab is that it helps remove most of the factors that have been limiting this change before. A key limiting factor in drug addiction is one’s peer group. Most times to make a major shift in your life you have to change your group of friends. In rehab you are surrounded with a group of people wanting to change, not a group of people wanting to use drugs. It makes a huge difference in outcome.

Other factors that may fall into the same category would include old perceptions, where someone lives, and the type of employment one has. Changing these to ones that support a new healthier lifestyle will have far more effect on the success of drug treatment than just focusing on the change itself. The book is loaded with lot’s of other great ideas, that would help anyone overcome addiction.

1. The Fifth Discipline, Senge Peter M.,1990, p 95-98

While looking at another blog I saw an example of how we can change the way something is veiwed. A blog on depression, (common in drug addiction) is trying to change the way we view and treat depression. If a lot more people started blogs on drug addiction and drug rehab, maybe we could do the same thing. Have a peek at :http://www.depressionblog.com/

Looking over the past twenty years, it seems more people are stuggling with substance abuse then ever before. We constantly hear that our children are getting addicted at earlier and earlier ages. In the drug rehabilitaion field we hear of clients going to the sixth or even seventh drug rehab. There are examples of people in the late thirties and even early forties, with little druge abuse history, developing rather quickly a full blown drug addiction with all it’s harsh life disrupting effects.

Two questions come to mind immediately when considering the above statments. One is, are these statements really true? Is the drug addiction problem getting worse? Are our kids getting in trouble with alcohol and drugs at a ever lower age than before? The answer seems to be to both questions a resounding yes. Despite massive efforts through police and drug enforcement, and monumental drug abuse education plans, it doesn’t seem like the tide has yet turned on the “drug war”. The statistics again seem say we are putting people in jail for drug related crimes faster than ever and our incarceration levels are at all time highs.

If it is true, and our drug and alcohol problems are increasing, the second obvious question is, WHY? What has changed or is still changing, that allows the problem of drug abuse to grow and grow. Many people point to a breakdown of the family, and a decreasing of the moral values of our country. While this is an easy target to blame, it is also a difficult one to study and quantify as there are so many variables in play at once. When our politicians tackle the drug addiction problem, this is an area they love to focus on. It gives them the “high” moral ground. Mom, apple pie, and God, who can be against those?

I wish to pose the idea, that it might not be tied to the “breakdown” of society. More people than ever before are graduating from universties and colleges. More people than ever are concentrating on personal growth, and learning. Spirituality in a myriad of forms grows in the hearts of many, many people. As was witnessed in the post 9/11 surge in enrolment in the military and the unbelieveable effort of the men and women in Iraq, patriotistism, and the belief in democracy and the values of what this country stand for are alive and well. Could there be a simpler basis of the drug addiction we face today?

The two most difficult areas of the drug and alcohol today are the issues of availability and potency. Twenty-five years ago, before the advent of cell phones and pagers, you had to drive into the “rough” part of town and find somebody to supply you. Difficult, and not a process that could be repeated over and over again easily. It was not something that young children could do. Twenty-five years ago, alcohol was not available in countless retail outlets that were open essentially 24 hours, seven days a week. Now most illicit and presciption drugs as well as alcohol are delivered to your door, simply by placing a phone call to your dealer, pharmacy, or alcohol outlet.

The quality and strength of illicit drugs is far, far greater than 25 years ago. Many of todays drugs of choice didn’t even exist in the 1970’s and 80’s. Cannibis is up to twenty times more potent now than before. With the current crop of drugs out there being so much more “effective”, the time it takes to become truly addicted is quite short. Then when you try to stop, they are constantly available so that at any moment of weakness, you have the potential to slip.

The constant availability also decreases our fear or concern towards the issue. The sad fact is that we were far more “afraid” of drugs individually in the 70’s when the drugs were weaker and less effective. The substances that are abused today, are far more addictive, cheap, and dangerous, and yet are so commonplace the “fear” is gone. However as the drugs grew more potent and pure, our abillities to deal with addicted people did not grow at the same rate. A tipping point has occured in the situation. Attacking drugs by trying to stop the supply does not seem to be working. Other options might have to take considered. Society as a whole has made smoking no longer “socially” acceptable. Smokers have been driven out of all public buildings, most restaurants and now even bars. Many smokers complain that soon they won’t be able to smoke in their own homes. Maybe this is the direction we need to go with the drug addiction problem.

Risky sex and injection practices

There also appears to be an interaction between adopting risky sexual behaviours and engaging in risky injection behaviours. More often than not, once an IDU couple has adopted unsafe sexual practices the partners are more likely to share injection equipment because this behaviour is perceived to be of a similar magnitude of risk or because it is already too late
Sharing injection equipment is far riskier than engaging in unsafe sex in terms of contracting hepatitis C virus

You May Have Problems Managing Sex, Drugs and Alcohol If You Haveâ?¦

Had regrets about sex â??the morning afterâ?? because you drank or used drugs â??the night beforeâ??
Suspected you might be pregnant â?? or actually became pregnant because drugs or alcohol made you careless about contraception
Become sexually involved with people you would not choose as partners if you had not been drinking or using drugs
Been unable to remember what happened â??the night beforeâ??
Been unable to perform sexually or to enjoy sex after drinking or using drugs

People Can Leave Behind a High Risk Life Style

Continue with alcohol and drug treatment and build your relapse prevention plan
Ensure you and your sexual partner get a full screen for STDs
Get knowledgeable about STD transmission
Get knowledgeable about the forms of protection and their limitations

Stopping Using and Sex

Stopping using can be a confusing time for sexual relationships
Sexual desires can return very strongly
You can mistake return of sexual feelings and desire for love or relationship intimacy
You can suddenly think â??this is the person for youâ??
The new partner or yourself can have sexually transmitted diseases that are not showing symptoms
Or the reverse, you may realize you have to address your feelings and sex history before being able to engage in sexual relations now that your feelings and emotions are no longer numbed by drugs or alcohol

Guidelines For Safer Sex

Use of either alcohol or drugs can impair your decision-making ability and make you very vulnerable to acquiring a sexually transmitted infection
Some people only feel comfortable in social situations if they are using alcohol or drugs
Others cloud their judgment by drinking or using drugs and end up doing things they would not have done if they were not intoxicated

You must decide when itâ??s right for you to have sex and not allow yourself to be pressured by a partner or peers or media
Abstinence is recommended when one or both partners are being treated for sexually transmitted infection

Testing for sexually transmitted infections will allow both you and your partner to know if either one of you is infected with STDs and to deal with it before you become intimate

Illicit Drugs and Sex

Narcotics and tranquilizers are downers and they affect the sexual interest of people who use them in the same way i.e. less interest
Amphetamines and cocaine stimulate sexual desire but impair orgasm, making sex very frustrating. With regular use, desire for sex is reduced

Heroin and morphine are often responsible for sexual dysfunction
Nearly 50% of male addicts report impotency and many female addicts are inorgasmic
All report low levels of sexual interest
Similar dysfunction is reported for crack or free basing cocaine users

Marijuana and Sex

Result is unpredictable
Some say it enhances lovemaking as it increase blood levels of phenylethylamine, a neurotransmitter associated with love and lust
Yet marijuana makes some people withdraw socially or become anxious or irritable which does not enhance sex

Sex, Injection Drugs and Power

Issues of power imbalance appear to first emerge with injection initiation.
Males gain control of the initiation by directly injecting females after first injecting themselves. Frequently, females fail to learn how to inject themselves and become injection dependent on other injection drug users (IDUs), often requiring help to inject throughout their injection use.
This may lead females to feel that they do not possess the power to insist that injection equipment not be shared or that equipment be cleaned between users.

Drugs and Safe Sex

Similarly, problems of gender-based power imbalance are observed in sexual relationships with respect to the adoption of risky sexual behaviours.
Often, if the male decides not to use a condom the female accedes, possibly because she feels she does not have the power to object or because she wants to confirm and/or create trust and intimacy in the relationship.

Sexuality is Complex

Sexuality is intricately tied in with our emotions, our mind and even our spirituality
Our expression of sexuality is related to our:

history
belief system
body image
deepest secrets
basic sexual nature
emotions of fear, anger and pain
need for and fear of emotional intimacy

Self Esteem and Sex

When self esteem is low we tend to get involved with sexual partners and sexual practices that reflect and reinforce our poor image of ourselves, leaving us with less self esteem than we had before. Promiscuity, prostitution, sadomasochism and sexual addiction are all manifestations of low self esteem. These behaviors perpetuate low self esteem by causing those involved to feel isolated and full of shame and humiliation.

Alcohol Abuse and Using Drugs Before Sexual Encounters Can:

Inhibit clear thinking and decision making skills
Make talking and listening more difficult
Make it harder to assess potentially dangerous situations
Increase aggression
Decrease motor function so that it may be difficult to use a condom or another barrier method correctly

Alcohol and Sex

Too much alcohol:
Numbs the nerve endings in both male and female genitalia
Decreases female lubrication and can lead to painful sex
Affects the rational processes of the brain
Can increase oneâ??s expectations for sexual experience, yet decrease desire, arousal and satisfaction
When people of average weight drink more than two beers, cocktails or glasses of wine in an hour, alcohol interferes with erection in men and impairs sexual responsiveness in women
Drink too much and all youâ??ll do in the prone position is pass out
In large amounts may compromise the effectiveness of low-dose oral contraceptives

Prolonged Drinking and Sex

Prolonged drinking of alcohol alters male sexual behavior. The liver is stimulated to produce a substance that steps up its destruction of the male sex hormone
Excessive prolonged alcohol intake results in withering or atrophy of the testicles, enlargement of breasts in the male, loss of male distribution of hair, and impotence
Many unwanted pregnancies occur when partners are too inebriated to use contraceptives responsibly