Substance Dependence

 
Old 11-05-2002, 09:42 AM
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Substance Dependence

Smoke and MG, I received your message. I was unable to reply so I am going to start a new thread. Any questions that you have I will be glad to answer you to the best of my ability. MG, you indicated that you heard me say that Anon do not understand the addicts and I did say that for several reasons "denial" being the chief reason. The subtlties of the disease and how it impacts the addict is also affecting the Anons Check this out:

Substance Dependence:
The essential feature of substance Dependence is a cluster of cognitive, behavioral and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems. There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug taking behavior. A diagnosis of Substance Dependence can be applied to every class of substances except caffeine. The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogen Dependence). Although not specifically listed as a criterion item, "craving" (a strong subjective drive to use the substance) is likely to be exoerienced by most (if not all) individuals with Substance Dependence. Dependence is defined as a cluster of three or more of the symptoms listed below.

Criteria for Substance Dependence:
A maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12 month period

(1) tolerance, as defined by either of the following
(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect.
(b) markedly diminshed effect with continued use of the same amount of the substance

(2) withdrawal, as manifested by either of the following:
(a) the characteristic withdrawal syndrome for the substance
(b) the same (or closely related) substance is taken to relieve or avoid withdrawal symptoms.

(3) the substance is often taken in larger amounts or over a longer period than was intended.

(4) there is a persistent desire or unsuccessful efforts to cut down or control substance use.

(5) a great deal of time os spent in activities necessary to obtain the substance (e.g., visiting multiple doctors or driving long distances), use the substance (e.g. chain-smoking), or recover from its effects

(6) important social, occupational, or recreational activities are given up or reduced because of substance use.

(7) the substance use is continued despite knowledge of having a persistent or recurrent physical or psychol;ogical problem that is likely to have been caused or exacerbated by the substance (e.g. current cocaine use despite recognition of cocaine induced-depression, or continued drinking despite recognition that an ulcer was made worse by alcohol consumption.

worse case-scenario: continued use of cocaine despite recognition that DYFS is going to take your children away and put them in foster homes or possibly up for adoption.


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Old 11-05-2002, 10:59 AM
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Wow, Pernell. Your posts are golden.

As informed as I have become about addiction and how it affects the addict, you never fail to give me added insight to straight goods truth. I totally trust the information you post on these boards, even if it is not what I want to read. I want the truth, Pernell, and love you for telling it like it is.

As informed as I may be, and as seriously as I may have worked my recovery over many years, I still recognize myself when you use the word "denial". I have read everything I could get my hands on about crack cocaine and many other drugs, I have read about how addicted people are affected, physically, psychologically, and emotionally, and affects of long term use. I have read everything about codependency that I could find. And still, I ask the question "Why? too often.

Please continue to give us information - I am listening and I can hear you, and I am grateful from the bottom of my heart.
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Old 11-05-2002, 11:52 AM
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Ann, how about this; try this exercise:

A person who is negatively affected by another person use of substance to the point of dependence. The person affected is a concerned loved one who lives with or is in the company of the person using substances. This is the exercise, Take the word "denial" and all of the things I previously said about people who are substance dependent. It is the same for the people affected except it is "denial" not substances that is the drug. So go over the criteria for substance dependent and see if you can relate how denial is acting like a substance in the person who is negatively impacted by someone else's using substances.

Are you confused yet?


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Old 11-05-2002, 12:02 PM
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Well, I am still in denial!!
I am getting better though, everyday, baby steps......

Thanks for sharing
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Old 11-05-2002, 12:27 PM
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Pernell

Wow again. I never looked at it that way, but numbers 6 and 7 especially apply to me. I have neglected other important areas of my life, and I have been affected mentally and physically by my addiction to my son. Even working my recovery program, I have to be honest and say these things still apply to me. Maybe less than before, and I have diligently been working on it, but they still apply.

Here's a question - hope you don't mind. I understand about an addict giving up his drug and working on his recovery, but how does a codependent (like me) give up my son and work on my recovery. I have put up boundaries about him not living at home and not enabling, and I have let go of thinking I have any control over him or his addiction (and I don't want that control any more) but I am still affected. Will working my steps and my program just eventually get rid of the symptoms (6 and 7) or is there more I could be doing? Any suggestions are welcome, even if they hurt.

Thank you so much for helping me here.
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Old 11-05-2002, 04:29 PM
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Thankyou Pernell,

(a) a need for markedly increased amounts of the substance to achieve intoxication or desired effect.
Is the statement above the reason that alcoholics turn to drugs?

Also the one huge problem that I have is the fear of my son's death either from suicide or overdose. It is just too hard to sit back and let my son hit bottom if there is a risk that the bottom might be death. I will let him go to the breaking point, but when I see that he is near suicide or death I jump in.

Will I have to accept his death before he dies in order to take such a horrible risk?

I think this is really hard for a lot of us here.

Hugs,
MG
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Old 11-05-2002, 04:58 PM
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MG,

I have accepted that my son's death caused by his life style is a possiblity. I am not sure that that is the correct progression of my continuing recovery but that is as far as I have gotten.

Now I doubt that accepting his death as a concept would make his actual death less painful but my fear has been lessen and thereby my tendency to react.

Oh and thanks from me too Pernell!!!

Hugs,
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Old 11-05-2002, 08:24 PM
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JT,

That's great. It leads me to other thoughts and questions. If the real possiblity of his death brings on the reaction of jumping in to keep him alive then what other reaction is there? What would be a proactive choice instead of a reaction out of fear? The only thing I can think of is to leave him out there and pray with all I am and go through the hardest time I've ever gone through. And if he were to die it would be harder than the hardest time I've ever been through. So my reaction is to avoid all these horrible consequences.

Fear=Reaction=Avoidance

Hugs,
MG
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Old 11-05-2002, 08:51 PM
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First, I am going to make a statment that comes from the Basic Text of Narcotics Anonymous but before I do for those people who want to be proactive in another person's addiction no matter who that person may be "Acceptance". You must accept these truths as self-evident and prepare yourself as best you can. Here is the quote:

Chapter One
Who Is An Addict
Most of us do not have to think twice about this question. We Know!! Our whole life and thinking was centered in drugs in one form or another---the getting and using and finding ways and means to get more. We lived to use and used to live. Very simply, an addict is a man or woman whose life is controlled by drugs. We are people in the grip of a continuing and progressive illness whose ends are always the same: jails, institutions and death.

Can You Accept This?




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Old 11-05-2002, 09:04 PM
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Pernell,

I can accept jail and institution, but I can't accept death. How would one go about learning to accept such a horrible possibility. I think if it were a physical disease it would be horrible to accept, but at least I would be sure that it was completely out of my control. I think that the hard thing about accepting this kind of death possiblility would be always thinking that there was something I could have done to keep him alive. "If I had just let him live with me he would be alive today." I think this is where my denial comes in to play. I'm just not sure how though.

Hugs,
MG
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Old 11-06-2002, 04:37 AM
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MG,

I sounds as tho you need, then, to go back to accepting your powerlessness in regards to his disease. And accepting the fact that it IS a disease with symptoms, available treatment, and a prognosis (jail, insitution, death) if left untreated.

If you know you would feel blame if death became a reality, that is where you need to return.

When I finally truly accepted my absolute powerlessness over the progression of his disease death was a part of that.

Acceptance is the key!
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Old 11-06-2002, 08:12 AM
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JT,

I'm laughing because after I posted that I could hear you in my thoughts saying Acceptance is the key. I'll try to figure out how to accept this. I do still feel that I have the power to save him from death. I know I don't have the power to save him from his disease. I know I don't have the power over his recovery. I've learned powerlessness in a lot of areas.

Saving my son from death is making me a prisoner to his disease or should I say a prisoner to my disease.

Hugs,
MG
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Old 11-06-2002, 08:57 AM
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MG, there is a power greater than you that gave you life. And the same power with your help gave your son life. That power is the deciding factor in life and death. Believe this death is a part of life, it is inevitable. You cannot save your own life, think about it. You can enjoy your life and you can help someone else to learn how to enjoy their life. "Life Is" and that is as good a description of life as you will find. The other side of that is "Life Is Not" and there you have death as we know it.
Denial and the way, you allow it to play on your feelings, emotions and good sense is what makes for co-addictive behavior as explained above. It is not easy but it is necessary for you to be a healthy human being, accept the things you cannot change and have the courage to change the things you can.


In answer to your question above about a alcoholic turning to drugs. No, that is not the reason that one starts to do drugs. The reason is they were introduced to drugs and switched their drug of choice. The tolerance factor will still apply to the drug as it does to alcoholics.

Being thr bearer of this kind of news is not fun for me, I hope you know that. But you asked and I am trying to accomodate you as best I can without being morbid. Just the facts


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Old 11-06-2002, 09:22 AM
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Pernell,

I really appreciate your answers. I think fear is a key in all of this. My fear seems to be stronger than my faith. I'm allowing fear to control me. I think acceptance is a tool that takes the power out of fear.

Do you know of any other tools that will help with this?

Hugs,
MG
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Old 11-06-2002, 10:01 AM
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The truth and facts is what I need to hear. Those are some of the things that are helping me along the way!
You guys are great
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Old 11-06-2002, 11:55 AM
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MG,

Let me add that I have been in this program 10 years and it has been within the last 3 that I have accepted death as a possiblity. Before that I could feel myself tighten up at the very thought of it.

Pernell I am not sure if you agree, but it was my experience that it took time to accept the whole. My son has not lived at home for about 7 years and as his disease has progressed I was left unable to avoid that possibility any longer. And the anxiety disappeared. If I cannot control the disease I cannot control the outcome. I did not go looking for it...it found me over time.

I don't think this discussion is morbid at all. I still have hope...realistic hope.

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Old 11-06-2002, 12:47 PM
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That makes sense JT. The more I have to accept, the more I can accept. I think though there has to be some risk involved too. If I were to continue to care for his every need there wouldn't be as much acceptance needed. The more I let go, the more acceptance is needed. I guess prayer and faith takes over from there.

I'm not there yet so I'll just put myself back in today and work with it a day at a time.

Hugs to all,

MG
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Old 11-06-2002, 06:48 PM
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MG,

I find for me that that is backward. The more I was able to accept the more I was (am) able to let go. I am not having to force the letting go because as I accept "what is" the natural progression is to let go.

Everything revolves around acceptance. If you are feeling resentment it is because there is some person place or thing that you have been unable to accept.

If you are feeling anxiety it is because there is something you have not been able accept.

If you are feeling anger there is some person, place or thing that has not been accepted.

Acceptance is not a result of letting go....letting go is the result of acceptance.

Pernell?

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JT
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Old 11-06-2002, 07:04 PM
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Old 11-06-2002, 07:10 PM
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