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Inspiring Success on the Road to Recovery

Thursday, November 30, 2017

The Reality of Treating Pain with Opioids

By Mercy Care Plan/Mercy Maricopa Integrated Care staff

Most everyone has heard about the opioid epidemic — and the many lives lost to these highly addictive painkillers. The Arizona Department of Health Services released data on June 1, 2017 about opioid overdoses in the state. Those numbers showed that 790 Arizonans died from an opioid overdose; a 74 percent increase over the past four years. Statistics also show between June 15 and November 16, there were 564 suspected opioid-related deaths.

Easy access to opioids like Percocet, Vicodin, Morphine or Oxycodone contributes to this epidemic.
Think about a time you went to the doctor. Maybe you had a tooth pulled, twisted your ankle, hurt your back or had surgery. Were you prescribed a painkiller? You or someone in your family may have taken a prescription opioid without much thought as to what it was.

Did you know that prescription painkillers are cousins of heroin?
In fact, 80 percent of people who use heroin started with prescription pills. New information from the Centers for Disease Control and Prevention shows that it only takes four to five days to become hooked on pain medication.

Opioids act on the nervous system to relieve pain. And, treating pain with opioids is very common. So common that in 2013, there were enough opioid prescriptions written for every American adult to have their own bottle of pills . The highly addictive properties of opioids, coupled with physicians over prescribing their use, has led to an opioid epidemic. Across the U.S., more than 40 people die every day from overdoses involving prescription opioids.

But, an important question to ask is: Are opioids the best treatment for all pain?

“When we see a doctor for pain, we want relief. Does relief mean zero pain? No,” said Dr. Elisa Mashal, Medical Director for Mercy Care Plan and Mercy Maricopa Integrated Care. “Pain is our body’s way of telling us something is wrong. It’s important for your doctor to find out what the problem is and treat it so things don’t get worse. Not all pain is treated the same way. Just like you need different antibiotics for different kinds of infections, different medicines treat different kinds of pain.” It’s helpful to separate the myths from reality.

The myths vs the reality


  • MYTH: All pain is the same. Pain is pain.
  • REALITY: There are many different types of pain. Some of these are nerve pain, bone pain, muscle pain, pain after surgery, and pain after a dental procedure. Each type of pain is treated differently, and opioids are not proven to be the most effective treatment for any of them.
  • MYTH: If my doctor prescribes it, it must be okay. 
  • REALITY: Treating pain with opioids is much more common in the U.S. than anywhere else. Doctors were encouraged in the mid-90s to be more aggressive about treating pain, so prescriptions increased, and they haven’t stopped. People were given the impression opioids are the best way to treat anything other than the most minor pain. 
  • The U.S. accounts for only 5 percent of the world’s population, yet we use 99 percent of the hydrocodone (Vicodin) and 81 percent of the oxycodone (Percocet). Remember, 4 out of 5 people who use heroin started with prescription opioids and 35 percent of people on opioids for chronic pain develop a substance abuse disorder. 



  • MYTH: If I have anything more than minor pain, I need an opioid. 
  • REALITY: There is little or no evidence to show that opioids are the best treatment for pain (even after surgery). In comparisons, non-opioids work better than opioids for pain, even after surgery, yet hospitals rarely offer the choice. In fact, for chronic non-cancer pain, opioids are only a little bit better for pain, function and disability than sugar pills! 
  • “A combination of Ibuprofen (Motrin, Advil) and acetaminophen (Tylenol) has actually been proven to work much better for pain that just recently started,” Dr. Mashal said. “These over‑the‑counter pain relievers also work better than narcotic pain medicine for pain after minor surgery and kidney stones. For pain that has been going on a long time (chronic), your doctor can prescribe other medicines or treatments that work much better than opioids and will not cause addiction.”
  • When people use them after minor surgery, the risk of long-term opioid use goes up by 44 percent at one year after the surgery.



  • MYTH: If I’m in the hospital, I don’t have a choice about what pain medicine I get. I shouldn’t ask questions because the doctor knows what treatment would be best for me.
  • REALITY: It’s your body. Even in the hospital, ask your doctor about non-opioid options to treat your pain. Depending on the type of pain you’re having, you can ask for a non-narcotic anti-inflammatory medicine.
  • MYTH: If I still have pain, it means my medicine isn’t working. I should feel zero pain. 
  • REALITY: When someone is under anesthesia, they’re experiencing 100 percent pain relief. Otherwise, we should remember, instead of trying to cover up the pain, we should try to find the cause. When you’re getting treatment for your pain, your goal should be 30 to 55 percent pain relief and improvement in your function and quality of life. 

Debunking common misunderstandings is an important way to educate people about opioids. Understanding how they work is also important. 

How opioids work

Opioids bind to the same brain systems as heroin and morphine. They attach to the central and peripheral nervous system. These are called mu, delta and kappa receptors. These are receptors in the brain, stomach, intestines, spinal cord and other organs.
They suppress, or lower, your brain’s ability to sense when you aren’t breathing enough. That leads to heart rhythm problems. It can cause your heart to stop.
Opioids can also suppress your body’s natural “feel good” hormones, called endorphins. With repeated opioid use, you start to depend on the drugs for those “feel good” feelings.
It might not make sense, but opioids can even make you more sensitive to pain after you’ve used them for a while. What they don’t do is increase your ability to function in your daily life. They don’t help heal the cause of the pain. What are some other things you can do to help relieve your pain?

Exercise/physical therapy

There is great research to show exercise does help. It helps with everything from reducing pain to working as a treatment for depression. Exercise is especially helpful for low back pain, osteoarthritis and fibromyalgia. There’s also formal physical therapy. You can also try: Yoga, Pilates, Brisk walking, Swimming/water aerobics and Cycling

Weight loss/healthy eating

When someone is carrying a lot of extra weight on their bodies, that weight puts pressure on your spine and joints. That’s why it’s important to make weight loss a goal. There are many great books on healthy eating. You can work with a nutritionist at your local hospital. You can also join a weight loss group online, or in person for extra support. Always talk to your doctor about the best nutrition or exercise plan for you.

Cognitive Behavioral Therapy (CBT)

This is a fancy way of saying “talk therapy.” CBT helps you to change negative thoughts and behaviors. This, in turn, changes your awareness of pain and your ability to cope with it. There’s a lot of research to show this is one of the most effective treatments for chronic pain. It helps because so many people who suffer from pain also suffer from other trauma, like post-traumatic stress disorder (PTSD). You can do this in person with a therapist or get services online by teletherapy. Learn more at www.thepainproject.com.

Alternative medicine

Chinese medicine (e.g., herbs, nutrition, and exercise, like tai chi), acupuncture or osteopathic manipulation.
Acupuncture has become more widely known as an accepted alternative treatment for pain. The treatment involves stimulating specific point on the body with needles. It may help ease types of pain that are often chronic, for instance low-back pain, neck pain and osteoarthritis/knee pain.
If you decide to visit an acupuncturist, check his or her credentials. In Arizona, a license is required to practice acupuncture. You can see a list of licensed acupuncturists here: https://acupunctureboard.az.gov/.

Neurofeedback/biofeedback

This involves learning to regulate specific areas of your brain by feedback from your brain waves. This is done by psychologists, family therapists and counselors.

If you think you’re dependent or addicted to opioids
Opioid dependence is when your body starts to rely on the drug to feel normal. If you stop taking the drug too quickly or reduce your dose, you may have withdrawal symptoms. These can include:
Rapid heart rate • High blood pressure  • Runny nose and sneezing
Sweating  • Shaking • Confusion • Seizures
Seeing things that aren’t there (hallucinations)

“The good news is there are many places to go for help,” Dr. Mashal said. “It’s important to talk with your clinical team or provider about this.”

If you’re a member of Mercy Care Plan or Mercy Maricopa, you will find providers on our websites: www.mercycareplan.com or www.mercymaricopa.org. Click the “Find a Provider/Pharmacy” banner on the top right-hand corner of either website.  Call our Mercy Care Plan Member Services team from 7 a.m. to 6 p.m., Monday through Friday at 602-263-3000 or 1-800-624-3879 (TTY/TDD 711). Or, Mercy Maricopa Member Services team anytime, 24/7, at 602-586-1841 or 1-800-564-5465 (TTY/TDD 711). Check https://www.samhsa.gov/find-help and www.substanceabuse.az.gov/. If you think you may be dependent on opioids, talk to your doctor. Ask how to slowly reduce your dose safely to avoid withdrawal.

How you can help others

Dr. Mashal notes that it’s not uncommon for people to go through other people’s medicine cabinets looking for these types of medications.
“What if you do get opioids and have leftover medicine after your pain goes away?  Do you have teenagers in the house? Someone who comes to do home repairs?” she said. “It’s extremely important to dispose of any leftovers immediately.”

Visit www.acpa.net/arizona_drug_disposal_locations.aspx for a map of disposal sites all across Arizona. This will help ensure others won’t use your medications.


The Arizona Opioid Summit 2018

The Arizona Opioid Summit 2018

For more information and to register, visit www.arizonaopioidsummit.com. Visitors to the website can sign up for a complimentary e-newsletter on the opioid crisis in the region.


With the opioid crisis continuing to make headlines, those looking to make a difference will want to put the Arizona Opioid Summit on their calendars. The second annual conference will take place February 14-16, 2018 at the Tempe Mission Palms hotel near ASU.

On January 9 of this year more than 300 stakeholders met to discuss ways to engage treatment providers, law enforcement, and other groups to reduce overdoses and promote recovery. Advocates and professionals will reconvene in February to examine what progress has been made and explore what to do next.

“The second annual AZ Opioid Summit will be an ideal opportunity for stakeholders of all types to convene to share best and promising practices for tackling opioid abuse in our community,” said Doug Edwards, director of the Institute for the Advancement of Behavioral Healthcare, the conference organizer. “I hope people from many different disciplines and perspectives join us to explore ways in which we can make meaningful change and turn the tide of this public health emergency.”

The conference aims to bring together a wide range of attendees to offer a multi-disciplinary perspective. Those who should consider attending are private practice therapists, psychologists, clinicians, counselors, social workers, interventionists, pharmacists, advocates, families of people in recovery and those in recovery, public health and prevention officials, law enforcement, and federal, state, and local officials and lawmakers.

    The Arizona Opioid Summit 2018

With the opioid crisis continuing to make headlines, those looking to make a difference will want to put the Arizona Opioid Summit on their calendars. The second annual conference will take place February 14-16, 2018 at the Tempe Mission Palms hotel near ASU.
On January 9 of this year more than 300 stakeholders met to discuss ways to engage treatment providers, law enforcement, and other groups to reduce overdoses and promote recovery. Advocates and professionals will reconvene in February to examine what progress has been made and explore what to do next.
“The second annual AZ Opioid Summit will be an ideal opportunity for stakeholders of all types to convene to share best and promising practices for tackling opioid abuse in our community,” said Doug Edwards, director of the Institute for the Advancement of Behavioral Healthcare, the conference organizer. “I hope people from many different disciplines and perspectives join us to explore ways in which we can make meaningful change and turn the tide of this public health emergency.”
The conference aims to bring together a wide range of attendees to offer a multi-disciplinary perspective. Those who should consider attending are private practice therapists, psychologists, clinicians, counselors, social workers, interventionists, pharmacists, advocates, families of people in recovery and those in recovery, public health and prevention officials, law enforcement, and federal, state, and local officials and lawmakers.
Day one features presentations designed to educate and empower professionals and advocates to create meaningful change in their communities, which include:
Opioid Public Health Emergency – From Understanding to Action
Solving the Opioid Crisis Through Integration of Behavioral and Medical: The Trauma-Pain Connection
•Offering Choices for Treatment: An Examination of Medication Assisted Treatment Options and Personal Stories of Hope and Recovery
The Opioid Epidemic’s Impact on the Most Vulnerable 
Pharmacists, Prescribers, Hospitals, Healthcare Providers: New Advances in Working Together
How Kindness, Compassion, and One BIG Question Saved a Man’s Life
Turning up the HEAT – Heroin Enforcement Action Teams Make an Impact
Imposters on the Street – An Investigative Look at What’s Being Sold as Opioids and many more.

Speakers include Douglas W. Coleman of the U.S. Drug Enforcement Administration; Shana Malone of the Arizona Health Care Cost Containment System; and Haley Coles of Sonoran Prevention Works. Day one registration is limited to residents of Arizona for $45.
New in 2018, the conference is offering two additional days of educational sessions for clinical professionals for an additional fee. February 15 and 16 clinical experts will provide intermediate — to advanced-level training on treating opioid addiction and related disorders. An optional evening presentation will offer ethics training for clinical professionals.

Registration for the following days are open to everyone regardless of their state of residence, and continuing education credits are available.

Among the speakers will be internationally recognized author and trainer Claudia Black, PhD, who will explore Addiction and Trauma: How Clinicians Can Effectively Address Complex Cases Presenting in Young Adults. Mel Pohl, MD, DFASAM, will discuss Pain and Addiction: The Clinician’s Role in Treating Complex Co-Occurring Disorders. John Briere, PhD, will review Managing Countertransference: Key Strategies for Therapists During the Opioid Epidemic.

The conference is being organized by the Institute for the Advancement of Behavioral Healthcare, the largest media and events producer in the behavioral healthcare field. The Institute produces, among other events, the National Rx Drug Abuse & Heroin Summit.

The Institute’s educational advisors for the Arizona conference include the Arizona High Intensity Drug Trafficking Area (Arizona HIDTA), the U.S. Justice Department Drug Enforcement Administration, MATFORCE, Arizona Health Care Cost Containment System, Arizona Department of Health Services, Arizona Pharmacy Board, Community Medical Services, Sonoran Prevention Works, and U.S. Attorney's Office.

For more information and to register, visit www.arizonaopioidsummit.com. Visitors to the website can sign up for a complimentary e-newsletter on the opioid crisis in the region.

Don’t Quit Before the Miracle

All of us from Together AZ and the Art of Recovery Expo wish you a blessed and safe holiday season.

Being part of the ever growing community of addiction awareness, advocacy and prevention has given my life a very special purpose. When I made the commitment to see what this sobriety thing was all about, I had no idea how fulfilled my life would become. Through the years I have met hundreds and hundreds of people on the same journey, from the beginning through today — this family welcomes me with open hearts and arms.

While all our lives will have ups and downs, please stay on the path with us. Don’t give up, ask for help, and watch for the miracles. I’ve learned there is no other way to live. It took a lot of patience, fellowship, humility, and honesty to get to where I am at this very moment, sober and very very grateful.

To a Joyous Season and Beautiful New Year!

Scottsdale Recovery Center TRICARE Preferred Provider


Scottsdale Recovery Center is now a TRICARE Preferred Provider of substance use inpatient and outpatient services to active, inactive duty military members, veterans and their dependents of the TRICARE West, North and South Regions. As a TRICARE Provider, SRC is honored to provide behavioral health, substance abuse inpatient and outpatient services, with an emphasis on trauma, PTSD, and addictive disease disorders to active duty military members, retirees and dependents of the TRICARE West, North and South Regions.

Utilizing EMDR therapy as a primary treatment modality for trauma and PTSD, they employ the most experienced and accredited EMDR therapists the state has to offer. SRC is honored to help serve the health care and addiction needs of service members, veterans, and their families, and will help determine eligibility and benefits that can be utilized at Scottsdale Recovery Center. We are committed to helping military beneficiaries and partnering with all aspects of the TRICARE healthcare alliance.

Call us if your a TRICARE policy holder and need help getting sober, we are here for you America!  Call 1-888-NODRUGS and visit www.scottsdalerecovery.com

The Gifts of Pause

Tis the season to be jolly but the ho, ho, ho’s seems to be hiding. Today there is more holy cow than ho, ho, ho! To many of us, it feels as if we are waiting for the other shoe to drop and we are doing it while holding our breath. We haven’t had a lot of time to focus on what is good in our lives, what is sacred and fulfilling. So, what better time to pause and remember all the things that brings us joy.

The Holy Moments

For instance, those holy moments when something hits you just right with the perfect ah-ha and you get it, whatever it is. Or the holy moments when you are sitting with someone you love and the truth between you is electric. The holy moments when someone tells you how incredibly important to them and loved you are. Or those moments when you have wrestled with a problem, and suddenly step out of the box and have the answer.

How about that precious moment in the grocery store when some kid looks up at you when a grin the size of Milwaukee? What about the little successes when you didn’t forget your glasses or your pet insists on cuddling behind the bend in your knee, or rests her head there to watch TV with you?

Think about the times you have cracked up laughing with a friend or loved one in a movie or the food you ordered tastes as satisfying as the picture on the menu made it look. Or when you treated yourself to a dessert guilt free.

Think about when you wake up early and then remember you get to sleep in because it’s the weekend or when that outfit you love fits again.

What about the sheer joy of being a parent, grandparent or great grandparent! My munchkins start doing their dance the minute the music comes on and there is nothing sweeter than watching toddlers try to out dance each other.

If you are single how about having a singles holiday dinner with friends to celebrate your freedom and the fact that you all can keep shopping for the right partner and you’ve learned enough about yourself to have better boundaries and a well-trained “picker” this time.
I once wrote a poem.... “I sleep on my side of the bed as though there was still a your side. Will sleeping in the middle mean I am over you?”

Celebrate your singleness. Now, I love having the whole bed to myself.

Take a minute to be grateful for the people who get you. You know, the ones who never question your motives. The ones who understand the value of your character and spirit and celebrate that. And it could be time to celebrate your parents, even the ones who, were shall we say, screwed up. After all, they taught you everything you never want to do or be. That’s great gift.

There are also many gifts in aging. I understand more about life and the lessons we create for ourselves than ever. I am so glad to be past the challenges that brought me to my knees and so glad to be able to help my kids and grandkids create fewer of those for themselves. I am even glad to be near the last chapter of my life, because all these precious gifts and lessons are now the fabric of my soul. I embrace the sweet holy moments, the moments on my knees and the moments of enlightenment, kindness and new awareness’. We have so much for which to grateful. Take a moment this season to simply pause and be still — to reflect on the blessings in your life.

We who have the privilege of sharing our thoughts with you each month are incredibly grateful for you and Barbara for having this opportunity. You are the blessing in our lives, the people who help us fulfill our purpose and check our own integrity and level of vulnerability and honesty every month.
So, we all wish you every continued blessing. In the New Year, let’s all take a lesson from our canine friends. When they encounter poop in their lives, they simply kick some dirt over it and move on. Happy Holidays!

Dr. Evan specializes in relationships, personal and professional empowerment, compassion and consciousness. 602-997-1200, 602 571-8228, DrDinaEvan@cox.net and www.DrDinaEvan.com

Reacting to Triggers

By Renee Sieradski, EA 

Recently I was reacquainted with an old friend, Betty. We hadn’t spent time in a decade. I knew her during my before and during my first year in recovery, back then I was a different person. A woman without  boundaries or clear sense of my reality, codependent, and learning how to grow up. 

As we were catching up, I was reminded of how verbally abusive she had been though I hadn’t thought of her as a major player I would have to recover from. But here she was, someone who didn’t know the real me today. Still, I found myself interacting with her as if I was a victim who accepted verbal abuse, a little child again. I regressed and was almost immediately triggered.

Oftentimes, my first reaction or feeling when I feel this way is frantic, or reaching for ice cream to stop my feelings of helplessness. I wish that wasn’t true, but it was especially after Betty made several indirect references to how much weight I had gained. 

I attend a 12 step meetings, but can find myself wailing in my car, having the desire to never see this person again, to run and hide from the perpetrator I am facing. When triggered I discount my reality based on old negative messages from my father. 

I would not have felt disempowered had I stood up for myself in the moment with her. But my inclination is to freeze and disassociate when verbally abused, especially when caught off guard, under stress, or over-tired. Betty literally showed up unannounced at my office, without warning. I was triggered for 36 hours after she appeared at my office. During her visit, I agreed to do some pro-bono legal work for her, and she will likely not be pleased with my work. 

After the encounter, I had to increase my attendance at meetings and find it comforting to tell myself it’s okay to be triggered. My sponsor has taught me the idea of radical acceptance. No matter where I am now, it will pass. Because of my severe PTSD, I’m prone to relapses when I encounter new situations. My therapist calls it a shame fever. He says fevers eventually break, naturally, once the body fights off the illness. My body will naturally handle this,  but in the meantime, I need to be gentle and kind to myself. I don’t have to decide right now whether to confront or not to confront her again. I must realize I am reacting because Betty’s words hit on tender wounds in my soul, and it isn’t all her fault. Actually, she gave me an opportunity to feel a deep raw wound and remember how I once was a vulnerable child who was mistreated. In turn I can practice extra good self-care and become a stronger woman.

Just because you’ve received a tax notice, you may not owe 

Here are some common tax notices you might see after submitting your return:
  • We’ve adjusted your return
  • We’ve made changes to your return
  • We have found problems with your return
For years, I’ve responded to tax notices from the IRS or states and 20% of the time, they are a result of errors on the part of the taxing authority. This means 80% of the time a taxpayer has forgotten to include interest income from a brokerage account or forgotten to include their 1099 income from that “small” side job.
Two out of 10 times, the IRS or State has:
  • mislaid a tax check
  • cashed a check and didn’t apply it to taxpayer’s account
  • charged a penalty and when taxpayer paid it, send a letter of a credit on account (Yes, really)
  • not credited taxes withheld by pass-thru entities
  • posted your taxes paid to the wrong year

In these cases, all it takes is a phone call, fax or a letter to the IRS/State explaining what took place and requesting your account be reviewed. Ask your tax advisor to send this letter for you and sometimes this may alleviate your stress just because they are used to doing dozens of letters a year and they will know how to word the letter in such a way to get the desired result.Don’t assume because you received a letter regarding your taxes, you owe the money, do some research.

Healing with Creativity

By A. Padilla


The creative process at Blue J Creative Healing is based on Jungian Psychology and much of what Joseph Campbell said in the above quote. Students work in different mediums from encaustic wax, resin, paint, watercolors, clay, to music. It’s not just the traditional art materials — there is much more. Scientific data is available documenting how creativity helps with anxiety, depression, addiction and self-esteem. During the creative process all parts of our brain are activated at one point or another. This is why the process is so healing when in conjunction with a person qualified like Jenny Preece Schomaker Padilla.

Who Can Benefit?

Blue J Creative Healing helps kids, teens, and adults in conjunction with Cognitive Behavioral Therapy throughout the Valley. Randi Gray, LPC said, “Jenny provides clients with an alternative, creative way to process, learn, discover and grow. I’ve seen the beneficial effects her work has on clients. It has been a positive experience having Jenny in my practice, offering this additional resource to clients.”

Her gifts lie in guiding us to understanding our bodies, minds, and how all of these are important in creating wholeness and unblocking past issues. She also focuses on nutrition and how it impacts the brain and body. Her grandmother and mother nurtured the importance of nutrition. Jenny doesn’t believe in dieting however, more of a balance and understanding how different foods and portions work with our brain and bodies.

Jenny graduated from Pacifica Graduate Institute in Santa Barbara where she obtained her Masters of Art in Creative Life, Humanities, and Depth Psychology. After being a internationally published photographer for 15 years, she was diagnosed during with Spasmodic Dysphonia. This impacted her voice, which was part of her identity for sometime. She was a DJ at her college radio station. After college she pursued marketing and sales management positions in the travel and tourism industry, which required daily public speaking assignments. After trying yoga, meditation, traditional therapy, she still needed more to understand not only what she was going through but understand things in another perspective. She felt called to go back to school as a single mom of three in her 30’s, no small task.

Being able to put the puzzle pieces together with her graduate program and other educational experience she was able to come up with an individualized program. The “Creative Life” is a way of life for humans, just like water is to fish. She uses creativity on a personal basis. “Each person has it within them, we have just forgotten how to use and access it” says Jenny. In a world becoming more and more electronic there is a need for balance.

Jenny is a guide, teacher, and coach helping people get back in touch with the part of them that may have been suppressed or traumatized. Tapping into the “inner child” specifically and subconscious to find those things that help build the person. Julia Cameron has said, “When we open ourselves to our creativity, we open ourselves to the creator’s creativity within us and our lives.”

If you or a loved one struggles   with anxiety, depression, addiction or low self esteem please visit www.bluejcreativehealing.org for more details.

Make a commitment! Three behaviors for parents

By Dave Cooke, 100 Pedals

Dave Cooke is a dad on a mission, to help parents get control of their lives over the powerful, destructive influences of a child's addiction. As the father of a son in a ten year heroin battle, Dave knows all to well the challenges parents and families face. He also knows there is a way to find peace in the chaos. Contact Dave at dave@100Pedals.com.

In a recent parent coaching session, we examined ways to interrupt triggering exchanges between a parent and addicted child. Many parents began to recognize patterns in their exchanges and the toxic impact they were having on both.

We get caught in a trap of repeated responses to the frustrating, challenging and difficult choices our addicted children make, losing our own perspective on the adverse reactions our responses can have. Instead of helping or healing, we actually make things worse, even if that seems implausible.

Altering or interrupting our patterns or habits of responding, requires the willingness to adapt, change or adjust our responses to these confounding choices. Here are three behaviors to focus on to help interrupt unhealthy patterns in our exchanges and interactions with our addicted children:

Eliminate criticism, judgement and condemnation from your dialogue: This is essential for healthy dialogue and healing. Even in the most chaotic situations, our children need to experience our unconditional love more than anything else. Sometimes giving our best is difficult — if not impossible.

It doesn’t mean in our anger or frustration they need to experience our worst. Listening, accepting, encouraging, and supporting are powerful, loving behaviors. When they share the news of a bad decision, it’s best not to challenge, criticize or express frustration. Offer a word of appreciation, ‘thanks for letting me know’, a word of encouragement, ‘I’m confident you know what you are doing’, an offer to support, ‘if you need my help, let me know’.  You may read this example and think, What? 

This is interrupting old behaviors with new ones, changing dialogue, bringing healing and love to a broken, strained relationship.

Focus on what you have authority over and responsibility for. It took me a long time to recognize the extent I would try to manage and influence behaviors which were beyond my authority. Even when I thought I had extricated myself from my son’s addiction/recovery, I realized I shifted away from much of it, though not all.

Everything changed when... where he’s living, what he’s doing to manage his recovery, legal obligations, finances, job, relationships, or his other ongoing recovery or addiction habits were not my responsibility or under my authority.

Anything I did to help or assist in managing his life, is my attempt to control. Today I chose to exert a healthier influence on my health, habits, relationships, communications and interactions with him. Being in a healthier, more balanced lifestyle, better equips me to love him and encourage him when he needs or asks.  Anything else is meddling, another form of control.
I will not engage in behaviors or activities which hurt me. There are “favors” my addicted son has asked which I knew were not a good idea. Each time they went against my instincts, causing causing personal and internal distress when I did. In the end, my instincts proved to be correct, the supportive action was B.S. and I ended up hurt, frustrated, or disappointed in the process. Today, I pay very close attention to my safe meter: gut instinct, the wisdom of experience, and common sense. 

Unconditional love is not demonstrated by engaging in an activity which is instinctively off. Only in active addiction did my son ask of me things that didn’t seem right or were hurtful.  In active recovery, he has demonstrated his independence and his interactions are devoid of strange and uniquely abnormal requests. Making a commitment to honor our warning signs may not be popular with an addicted child; but, they go a long way in protecting you from additional pain while helping you maintain the healthy boundaries.

There are many other behavioral commitments I would love to encourage you to focus on. Through my experiences, these were the most critical and proved to be the most influential and beneficial.  I will share more about these three on my upcoming podcast.  








Navigating the Holidays when Your Child is in Early Recovery

By Dr. John Dyben, DHSC, MCAP, CMHP – Clinical Fellow

Families can experience many emotions while navigating the holidays, whether in still waters or rough seas. Friends and families come together and we place at the forefront of our thoughts all of the joy of our connections we may forget in the day-to-day. In these special times, our gratitude for life and joy in all we share is so sharply focused that many describe these as “magical” times, bursting with wonder and delight.

The flipside to this is emotional pain and difficulties may also be magnified during these times. We miss lost loved ones. We remember and wish for simpler times. We feel the weight of difficult circumstances a bit heavier.

In few ways is this phenomena more realized than with families who have a loved one in very early recovery.

Strong emotions combine with a multitude of questions to create a feeling of constant pressure and walking on eggshells. Families want to know how they should act around their loved ones new to recovery. Should there be alcohol at gatherings, who should be invited to functions, or should participate in celebrations at all. They wonder if they should give gifts or hold back. They agonize over how to have a “normal” holiday, often having had so many where their loved one was actively using substances – or absent altogether.

As someone who has been in this position, I can share there are three important guiding principles to help families navigate these times.

1. The Principle of the Sail

In sailing, the seasoned mariner knows that no matter how exact he is in his rigging and tacking and moving all of the parts of the boat, he cannot control the wind. Knowing what we can and cannot control, and then practicing the art of accepting that which I cannot, is paramount in keeping sane during these times. I remember the first time

I went to an Al-Anon meeting and was told that I could have peace in my life even if my loved one was still drinking and using substances. I thought it was the craziest thing I had ever heard in my life. And yet, it is true.

At the end of the day, no matter what you do, you cannot control your loved one’s recovery. That is the wind to you. You can let go of that outcome. You must let go of that if you are to find peace. This is incredibly difficult to do alone. No matter how smart or strong you are, getting support from others who understand what you are going through is critical. Participation in groups like Al-Anon, Families Anonymous and other support groups for people who have family members struggling with substance use should be as important as getting gifts ready for the season.


2. The Principle of Waxing Strength

When a person has an allergic reaction to a food that causes them to nearly die from anaphylaxis, they may end up in the hospital for days. They may feel weak and be particularly vulnerable to that allergen. It would make perfect sense that in preparation for that person to come home from the hospital, we would clear the house of the allergen and encourage others not to bring it into the home.

Eventually, in time, as the person gains strength and learns how proximity to the allergen affects him, he may be fine with it next to him.

In the same way, it is a good principle to keep alcohol, medications that can be misused and any other substances out of the recovery environment of a person in early recovery. In time, a fully recovered person may be able to be around alcohol with no problem at all. For this first holiday season, though, it is usually better if it is not around.

3. The Principle of Falling Walls

This principle will cover so much more than one might imagine if it is bravely pursued. Family members have many questions about how to act and what to do around a loved one in early recovery.

Also, they have questions about how much should be shared with others in the family and circle of friends. A simple, though sometimes counterintuitive way to handle this is to ask direct questions — and ask permission to ask, too.

What might happen if you approached a loved one in early recovery and said, “Hey, I am new to this and I have some questions. Would it be okay if I asked you about your perspective on the holiday?” In my experience, I was able to get so many answers that I could never have figured out on my own even though I had been agonizing over them for weeks.

Ultimately, there is no magic formula to make things perfect for this holiday season. And I’m pretty sure there is no such thing as a “perfect” holiday season, anyway. In fact, it is often the bumps, hiccups and awkward moments that make for the most laughter and joy when we are accepting of the reality and beauty of our imperfections.

If you have a loved one in early recovery this holiday season, know that you can have joy and peace in your life and your home no matter what happens. Know that the actions you can take are like the mariner’s work on the sails — but remember that the wind is out of your control. So talk as openly as you can and push yourself beyond your comfort zone to open up even more. Reach out for help and remember that everyone deserves the gift of support, including you.
May peace find you and your family and may you all celebrate life this holiday season.

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