After finishing a drug or alcohol rehab program it is not only your family that you may have to deal with the stigma of addiction. Your friends may also present a problem.

Why Your Friends May Discriminate Against You

They may be involved with drugs or alcohol.
They may have lent you money, clothes or other supports and feel taken advantage of.
They have experienced abandonment when your addiction took priority over their needs and feelings.
They have experienced previous times when you said you were clean and are unsure if they can believe you this time.
They have experienced dishonest communication in your relationship.

Managing Discrimination From Friends

End relationships with friends involved in activities that threaten your recovery.
Set the stage and check for motivators for yourself and them.
Use the competence, control and connection checklist to plan for interactions with friends.
Listen.
Confirm what you have heard.
Demonstrate the behavior you agree upon and use patience with yourself and them e.g. If you owe them money agree with them on how and when to pay the money back.
Ensure your body language, verbal communication and written communication reflect a willingness to listen and to rebuild friendship.
Ensure your physical appearance reflects the person you want to project when you are with them.

Just as with your family the best way to deal with this is through dialogue. By taking the time to adequately reflect on the situation and deciding how to handle it in advance, you will greatly increase the chances on dealing with this positively and insuring less stress in your life and those around you. Simply then a greater chance of sobriety and a positive drug rehab experience.

So after drug or alcohol rehab, if you have experienced some discrimination and completed the steps we last discussed, you are ready for the next step:

Managing Discrimination in Your Family

Step 2: Meeting your family
When the time is right, ask your family about the problems they have had with your addiction.
Remember, you are doing this to understand their concerns not defend yourself.
Work to create a connection with your family by listening attentively to what they have to say. This may include their anger or sadness or other strong emotions.
Show respect for their feelings by listening attentively.
Your task is to understand them first before you can be understood.

Step 3: Acceptance
Affirm what your family is saying by acknowledging their right to their feelings.
Acceptance does not mean you agree with what they tell you, it means you accept they have a right to their feelings.
Acceptance is shown through a genuine demonstration that you understand that they have been disappointed, angry or sad.
If they have helped you, tell them how important this has been to your recovery.
Doing this will help to re-establish for them their importance in your life.

Step 4: Sharing Knowledge
Tell your family about your experience at the drug or alcohol rehab you went to
Tell them what you learned about addiction, communication, relapse prevention etc.
Show them other materials that demonstrate the depth of your education. Some of these will be personal so use your judgment about what to let them see.
Tell them about your plans for a new life including your plans for managing emotions, work, school, exercise etc.
Tell them your plan for managing any slips and returning quickly to a lifestyle of abstinence.
Show them you did your homework while you were in drug rehab, and your commitment statements you did while in rehab.

Remember, your family may need time to adjust to the new you. They may have doubts about your commitment to change. Show kindness and patience and give them time. It took you time to change in rehab and after rehab. Give them the same time.

After you leave drug rehab you will probably meet up with some discrimination.

Who May Discriminate Against You

Your Family
Your Partner
Your Employer
Your Teachers
The Police
Your Friends

What Will You Experience?

Avoidance
Exclusion
Blaming
Low tolerance for differences
Greater focus on flaws or errors
Pity
Over solicitousness
Aggression

Why Your Family May Discriminate Against You

They love you and yet feel disappointed
They want the best for you and yet feel disappointed
You may have stolen from them and they are still worried about trust
You may have been violent and they are afraid
They have little understanding of addiction and feel confused by your past behavior
They are frightened and donâ??t want you around anymore
Their expectations were too high and you couldnâ??t meet them
They pity you because they donâ??t believe you have the strength to change
Other reasons you will be aware of

Managing Discrimination in Your Family

Step 1: Set the stage
Take the time to think quietly and rationally about your family
Who are the members of your family?
What are their individual and collective values?
What do they think about you? How have they shown their beliefs?
Who in your family has had the most difficulty with your addiction?
Who do you trust the least, the most?
What do you want to tell them about you?

Write all of this down

Before attempting to deal with this issue, be sure that you are clear about the answers to the above questions. Again this can be something that you can work on while still in a rehab. Perhaps one of the counsilors at the rehab can go over your list with you and give you input. Drug addiction and it’s treatment involve your life and the lives of those around you. This is part on the homework to insure you get the very most you can out of any drug or alcohol rehab. I’ll discuss how to approach your family after you leave rehab with this information tomorrow.

You have gone through a drug and alcohol rehab program, worked very hard at staying sober. You have integrated many of the things you learned in rehab, and actually have made real strides at changing your life. Even with all these positive things since rehab you still may suffer with other peoples ideas about addiction and the labels they put on you. Even though you are no longer an addict, many still see you in this light. It’s like they expect you to fail and end back in rehab.

Prejudices About Addiction

Anyone who has experienced addiction is:

Untrustworthy A person without family or friends
Lazy Unpredictable
Unemployable Sexually promiscuous
Violent Undependable
Addicted for life A criminal
Emotionally unstable Beyond redemption

These are some of the prejudices people who have experienced addiction may need to overcome.

Where Does the Stigma about Addiction Come From?

Opinions based on incorrect knowledge.
Hold the view that there is little hope of recovery from addiction because neighbor still drinks.
Use inaccurate media coverage about crimes where the person was using drugs or alcohol.
Use cultural or family beliefs that may not be accurate.

Poor Understanding of Addiction because of :
Over simplified public messages like the â??Just Say Noâ?? campaign.
Biased treatment provider information such as the â??addict is powerlessâ?? or â??everybody relapsesâ??.
Limited quality research that is circulated to a narrow audience.

These are some of the erroneous beliefs that lead to discrimination. After you have been to rehab you may experience some or all of the above. The subject of the next few days will be how to deal with the above. Predudice can lead to increased stress in your life. Increased and uncontrolled stress become a negative cycle that may lead to relapse , and another trip to rehab which simply reinforces the streotype. More on this tomorrow.

Relapse Prevention Requires The Development of Physical Health and Stamina

The benefits of regular physical health activities cannot be over stated in relapse prevention.
The positive impact on attitude, mental health and physical health is extensive.
Relapse prevention requires the development of a flexible, challenging and habitual exercise component to your every day life. Most drug or alcohol rehab programs have a component of physical fitness to them. You must continue with this when you leave rehab.

The Impact of Physical Activity on Heath

Improves emotional health by:
Aiding in stress management
Improving self confidence and self esteem
Increasing social activity when exercising with others
Increases intake of oxygen and blood movement increasing efficiency
Muscles get toned and fat is burned
Endorphins are produced creating a strong feeling of wellbeing
Result: You look and feel better

Reduces feelings of depression and anxiety
Helps control weight.
Promotes psychological well-being.

The last three points are critical to any relapse prevention plan. These are large stressors in anybody’s life. Decreasing them is key to prevent slips and multiple visits to rehabs. It would be ideal if during rehab one got on a great fitness plan and left the drug rehab fit, toned and in shape.

Yesterday I discussed that before leaving a drug or alcohol rehab on should have in place a plan about physical boundaries to prevent relapse. This is not the only area to set boundaries.

Emotional Boundaries Set A Border Or Limit

Emotional boundaries establish your feelings as separate and distinct from those of others.
I am in charge of my own feelings, moods, and problems, not my family members or friends.
I will be friends with others without taking on their values and making them my own.
I will only share feelings about my past addiction when it will advance my personal growth.

What emotional boundary could you maintain to keep you safe when you leave rehab?

Intellectual boundaries set a border or limit

Intellectual boundaries allow you to have your own thoughts, ideas, beliefs, and values.
I will speak for myself and express my opinions.
I have my own ideas and do not have to always depend on others for solutions.
I can defend with clear information my right to choose not to drink or use drugs.
What intellectual boundary could you maintain to keep you safe when you leave drug rehab?

Spiritual boundaries set a border or limit

Spiritual boundaries set limits based on your spiritual beliefs and values
I believe exercise is my form of meditation, and I will not miss getting in touch with myself each day.
I believe that my body is my most important asset and will not allow someone else to dictate the time or type of sex I have.
I believe that honesty is my basic value and refuse to allow someone else to talk me into dishonest behavior for whatever reason.
What spiritual boundary could you maintain to keep you safe when you leave alcohol rehab?

Relapse Prevention Requires a Support Network

A support network of relationships that assist you in meeting your goals and provide meaning and friendship in your life is essential to relapse prevention.
You will need to have defined your support network before leaving any alcohol or drug rehab center. A support network is essential to help keep all of the boundaries you have set out intact. They are an important step in the jump from a rehab back to real life.

Five Areas To Work On

A relapse prevention plan requires concrete life goals in five areas with tasks and timelines identified
Relationships
Work and school
Home and community
Physical health, mental health and spiritual health
Communication
You have or will before you leave a drug or alcohol rehab developed your goals in each of the above areas. If you haven’t completed this before you leave rehab you certainly have to do it first thing out.

Setting Boundaries
The skill of setting and maintaining boundaries is essential to relapse prevention
You will have completed your boundary setting inventory and plan before you leave any drug or alcohol rehab treatment center. It is impossible to have a healthy relationship with someone who has no boundaries, with someone who cannot communicate directly and honestly. Learning how to set boundaries is a necessary step in learning to be a friend to yourself. It is your responsibility to take care of yourself - to protect yourself when it is necessary. It is impossible to learn to take care of yourself without owning yourself, and owning your rights and responsibilities as creator of your life.

Physical Boundaries Set A Border Or Limit

Physical boundaries control when and how others approach you, behave in your home
I will not allow a hug from someone I do not like
I will not allow drugs or alcohol in my home
I will lock the door on my bedroom when I need to be alone
I will not allow smoking in my home or in the presence of my children
I will not allow drinking in my car
What physical boundary could you set to keep you safe when you go home? It is by setting clear physical boundries before you leave rehab so you won’t have to decide in advance what places are safe for you. If you haven’t decided this in advance it is far more likely to find yourself in a situation that will lead you in the wrong direction. Also by deciding in advance you can role play responses to people that try to “convince” you to do something you are not sure of. Again it would be wise if you practiced this before you left drug rehab. If not, do it immediately as soon as you leave rehab otherwise the chances of relapse are far greater.

Improving the outcome for yourself following treatment in any drug or alcohol rehab is assured by improving your skills in managing the issues that research shows lead to relapse:

Response to stress and to feelings of anxiety, fear, anger, frustration or depression

Interpersonal conflicts

Relapse Prevention

Relapse prevention is a process of using and developing skills, attitude, beliefs and values that support you to achieve your life goals.
Relapse prevention is first and foremost about taking the time and thought to make a clear commitment to how you truly want your life to be.
For some reading this column, the first step has not yet been taken toward relapse prevention.

The first step is deciding that continuing use is not your goal
Step one is committing to a life that is self care centered.
Turn to someone you know and trust and say the following out loud:
I am committed to caring for myself because I care deeply about myself and achieving excellent physical and emotional health is my first goal.Using my physical and mental health to the best advantage for myself and those I care about is my second goal.
How did that feel?

State Your Commitment

Take five minutes and write down your own commitment in your own words and why you want this above anything else in the world. Save your commitment statement and work on it occasionally over the next week. This statement will be the foundation of your relapse prevention plan. Why not make a commitment that the last relapse you had before you entered rehab will be you last relapse ever. Everyone who quits using alcohol or stops drug abuse has a final relapse. Why not make you last one the VERY last one? There are lots of techniques to keep yourself safe. This commitment statement is the “why” or reason for doing these techniques. As part of any exit treatment plan on leaving a rehab, it would be wise to do this commitment statement. Make the steps neccessary to make your last relapse your very last one and you last rehab, your very last visit to drug rehab.

There is no such thing as a relapse caused by things external to you.
There is only the choice to use again, which is influenced by how we manage or do not manage our lives.
Choosing to use again, is a conscious choice on your part, it is not subconscious.
No one but you can choose to pick up that glass of alcohol, swallow that pill, snort or inject that drug.

Relapse is an act

Relapse is the act of returning to a previous condition, a return to a former mood, state, or way of life, especially a bad or undesirable one, after coming out of it for a while.
No one says, â??I had a relapse and started exercising again, I donâ??t know how that happenedâ??.
No one says, â??I had a relapse and started going to school again, I donâ??t know how I got enrolledâ??.

An act is something that somebody does or the action of carrying something out
A reason is an explanation of justification for something, usually behavior or non behavior i.e. why an action was taken or not taken.

Unless you are psychotic or have suffered serious brain damage, you are aware of your reasons, motives or causes for acting or thinking in a particular way. Relapse is then a decision a person makes. It is not some unplanned event or bad luck. It can begin innocently enough by not taking care of all the details neccessary to stay sober. The things discussed in a drug or alcohol rehab program are not just exercises to be done once or twice. You must learn to incorporate these practices in your life once you leave a rehab or it is very likely that you will return to another rehab treatment program down the road. I will go through some relapse prevention strategies over the next few days. The point I wish to make today, is that just like the decision to go to a rehab is a choice, so is to set up the cirsumstances of a relapse. To undo the quality safe decisions learned in rehab is also a choice, a bad and dangerous choice.

Contrary to what your partner, friend or family member may believeâ?¦absolute honesty is not always the best policy for developing communication skills.
It is not in your best interest, nor is it in the best interest of relationships, to discuss the detailed behaviours in your past lifestyle when doing so may result in the possible destruction of the relationship or your self-esteem.
Your mother does not need to know the details of every time you stole money out of her purse in the past.
Your partner does not need to know the details of every sexual encounter you ever had; they need to know you are going to get tests for sexually transmitted diseases because your addiction caused you to exhibit poor judgment.

As in all things in life, communication about the past requires a balanced approach, enough but not too much.

Lying or avoidance is not the goal either.
It is possible to be honest, and share only what you feel comfortable sharing while maintaining your pride and dignity.
It involves requesting respect for your privacy and the support to pursue your sincere desire to change your life.
Those who truly care about you and your recovery will respect your emotional boundaries when it comes to your past addiction lifestyle. (http://www.understandingsexualaddiction.org/pridelessons/pride_00o.asp)

So the same rules pretty much apply to your family. Go slow and be cautious in revealing everything in your past and in what you discovered in drug rehab. Stress the future and what you are trying to do. If you are doing the work to make fundamental changes in your life after coming out of rehab, everyone will see it. You don’t have the discuss rehab, the results will speak for themselves. Leaving drugs and alcohol behind permanently will do most of the talking for you.