Nothing Changes if Nothing Changes

One of the most commonly repeated AA mantras is “Nothing changes if nothing changes.”

If your substance use is becoming “a problem” to you or someone you love, you may need to change. This is a problem you can fix. Taking the first step can be hard. The first step could mean just saying it out loud. Drinking can be hard to talk about so if you are in a relationship with a problem drinker a good approach to start the conversation might be to say, “let’s get healthy together”. Bloodwork and doctor check-ins can also help the conversation along to find out what the cumulative effect of substances has done to the body. Test results can be a motivation to change, just as after a cleaning at the dentist you’re more motivated to floss. Drinking more than recommended means drinking more than your liver can handle. Excessive use of drugs or alcohol can damage our bodies, our relationships, and our mental health. Action is required to repair the damage.

The key to success may mean treating alcohol as neither a right nor an enemy. Treat it as something to have around to the extent - and only the extent - that it makes your lives better. Adults are allowed to drink for fun. It’s when drinking stops being fun that we have to pay attention. Look for other things in life - besides alcohol - to take the edge off a hard day. Adopting healthy lifestyle behaviors can bring about huge rewards, one step at a time, one day at a time!

Nobody ever sets out to be addicted. When you first start taking a substance, you may think you can control how much you use. We call this the experimentation stage. The initial high may be so good to you that you chase that high with subsequent use to try to get that same feeling. Over time you may need more of that substance to get the same feeling. The substance may take precedence over other activities, and it becomes more habitual. You may develop relationships with other people who like the same sensation. Cravings or strong urges can become uncontrollable.

Substance use is very different from substance abuse, which is very different from substance addiction. Substance addiction becomes a disease and a progressive disease at that. The disease can be managed just like any other disease, but it does require treatment. There can be a fine line between each category but once someone crosses over the line into addiction, the ability to be a controlled user or a social user becomes different and may even be impossible. To recover from the disease of addiction, abstinence from mood-altering substances is required in order to manage the symptoms.

You can get sober in many different ways. You can go to outpatient treatment, intensive outpatient treatment, or inpatient treatment, all of which will use some form of cognitive behavioral therapeutic approach. You can go through a medical detox, you can take medication-assisted therapies, or you can go to support groups. You can work with a 12-step program (like AA) and align with a sponsor or accountability partner. Prayer and giving the problem to God is a personal favorite of mine. Sometimes, people use the old “cold turkey” approach and just stop using it after they make up their mind to stop. A combination of all of the above may be necessary depending on the depth of the problem. You may need to throw everything you can at the problem and see what sticks.

I believe talk therapy is critical to lasting recovery. Learning to communicate what the problem is can lead to self-awareness and a sense of self-control. Talk therapy can be instrumental in learning problem-solving skills, learning how to effectively make better decisions, learning how to assert oneself, and learning many different coping skills. Sometimes, there may be co-occurring disorders (more than one), which means that once the substance has been removed from one’s life, the underlying reason one started abusing substances in the first place is revealed and must be dealt with. For instance, one might have social anxiety, so he drinks whenever he goes into public in an attempt to manage his anxiety. Without the alcohol, the social anxiety returns. He may need to learn how to socialize without the use of alcohol.

For someone with a substance use issue, change may be tweaking the amount consumed in a setting or limiting yourself to special occasions and this might look like taking a turn in the road to veer right or left to avoid a bump in the road. For someone with a substance abuse issue, change will require making a U-turn in the road since you can see the pothole up ahead that you’ll need to avoid. For someone with a substance addiction issue, change will require taking a different road altogether to avoid falling into the same pothole. The AA slogan of “change your playgrounds, playmates, and playthings” for the person with the addiction will save a life.