Heroin detox timelineBlog

Heroin Detox Timeline

Heroin is an extremely dangerous substance that is a big part of the opioid epidemic that is currently ravaging America. According to the Centers for Disease Control and Prevention (CDC), in the past decade, heroin abuse has more than doubled among young adults aged 18 to 25 years old.

The alarming growth rate of heroin use has brought with it even more troublesome side effects: more and more people are overdosing and dying. The CDC also reports that overdose deaths related to heroin have more than quadrupled since 2010. The death rate increased by 20.6 percent from 2014 to 2015 alone.

Hopefully, these stats show what a truly dangerous drug heroin is and will inspire those currently using to quit. However, the process of kicking a heroin addiction is complicated and takes some time. Heroin is NOT a substance that you can quit overnight, especially if you have been a long-time user.

Those who try to quit heroin cold turkey put themselves at a high risk for some serious health concerns, as well as an elevated potential to relapse, overdose, and die. In order to safely stop using heroin, you will need to enter a professional detox facility, and taper off of the drug under close supervision. Depending on your level of abuse and addiction, this can be a very uncomfortable and trying time that will require some professional help.

While everyone’s long-term recovery experience will be different, there is a general heroin detox timeline that you can expect to follow. No matter what, this process begins with a person developing an addiction to heroin, so let’s start with how that happens.

Heroin Addiction

A synthetic opioid that comes from morphine, heroin is usually found in white powder form, although it can sometimes be yellow, brown, or black, given its content, purity, and whether or not it is mixed with any other substances. The powder can be “cooked” and injected, or smoked and even snorted. Regardless of how it is taken, heroin produces a profound effect on the user’s brain and acts quickly, producing euphoric effects.

This intense, euphoric high is what makes heroin so popular. Unfortunately, it is also part of why the substance is so addictive. Heroin produces its effects by binding to opioid receptors in the user’s brain, releasing a neurotransmitter called dopamine. Dopamine regulates the body’s feelings of pleasure and reward, and when a person takes heroin, the drug gives them a rush of dopamine, causing intense versions of these feelings.

The initial sense of euphoria will wear off rather quickly, sometimes in a matter of minutes. This will then be replaced by grogginess, lethargy, and some other, less-enjoyable symptoms. Rather than deal with the almost flu-like side-effects of coming down from a heroin high, the user will often be tempted to use again to go back to the happy feelings the drug produced.

Then the behavior is repeated, and the cycle continues until they have a full-blown addiction. Heroin becomes the only thing that can activate their pleasure-reward sensors, and the drug abuse will begin to consume all aspects of the user’s life. Once they are fully dependent on heroin to maintain their status quo, family and work responsibilities will become unimportant, relationships will suffer, their personal health and hygiene won’t even matter anymore — all they will care about is their next high.

This worsens as the user builds a tolerance to the drug. It’s very easy for someone abusing an opioid like heroin to develop a tolerance to the substance, which is another major reason it is so dangerous and addictive. At a certain point in their addiction, their current dosage will no longer be enough to achieve their desired effects, as the body rebounds to combat the substance. This leads the person to take a higher dose, or using heroin more often.

These alarming addictive behaviors will put the user at higher risk for overdose. It should be noted that absolutely anyone can overdose from heroin, whether they are a long-time user or trying it for the first time, because there is no regulation over the drug, and therefore you have no idea how potent the substance will be, or what it may be mixed with.

While drug addiction is very difficult in itself, the user may eventually decide, or be pushed by friends and family, to quit using. This will hopefully lead the person to enter a detox facility, to help them safely get clean from heroin. The initial stages of attempting to stop abusing heroin are so hard, because this is when withdrawal sets in.

Heroin Withdrawal Timeline

Withdrawal is the part of getting clean from a heroin addiction that will be most difficult to deal with, and heavily influences the timeline of heroin detox.

Withdrawal itself is rarely fatal, but is so unpleasant that it can trigger the person to relapse at a time when they are most vulnerable to overdose. This is why a supervised detoxification is the safest path to take for recovery.

The withdrawal process will be different for everyone, and depend on a number of factors. This mainly includes how long they abused heroin, and how dependent their brain and body are to the substance. Typically, the longer and higher volume their abuse, the more severe and longer-lasting their withdrawal will be. Those with a history of mental illness or addiction may have a more challenging withdrawal period as well as those who used other substances at the same time they were abusing heroin.

Those who haven’t used heroin for long may only experience minor withdrawal symptoms, which typically won’t last for much time. Withdrawal can begin as soon as six to 12 hours after the user’s last dose of heroin, and the symptoms will range in severity from mild to moderate, and in some cases, severe.

Mild Withdrawal Symptoms

Most short-term withdrawal symptoms are physical in nature and will start to pop up shortly after the user’s last dose of heroin. The mild withdrawal symptoms of heroin may include:

  • Minor nausea
  • Abdominal cramps
  • Dehydration
  • Runny nose
  • Excessive sweating
  • Chills
  • Uncontrollable yawning
  • Muscle and bone aches
  • Muscle spasms
  • An excessive secretion of tears
  • Restlessness
  • Insomnia
  • Mood swings
  • An inability to concentrate

Moderate Withdrawal Symptoms

As the person’s withdrawal progresses and their body continues to rebound and adjust to the lack of heroin in the system, the withdrawal symptoms will begin to intensify. Moderate withdrawal symptoms can include:

  • Vomiting
  • Diarrhea
  • Agitation
  • Restlessness
  • Tremors
  • Trouble concentrating
  • Goosebumps
  • Fatigue

Severe Withdrawal Symptoms

Those who have not abused heroin for long may not reach this level of withdrawal, however, long-time users can expect some intense effects. These may include:

  • Anxiety
  • Insomnia
  • Depression
  • Hypertension
  • Rapid heart rate
  • Frequent, severe muscle spasms
  • Impaired respiration
  • Difficulty feeling pleasure
  • Intense drug cravings

Quitting Heroin Cold Turkey

Because of how intense heroin withdrawal symptoms can be, it is not advised to try and quit heroin on your own, or all at once, also known as “cold turkey.” Withdrawal will undoubtedly be a part of the recovery process, and it will be safer and easier to deal with in a rehab facility, where medical professionals know how to deal with your withdrawal symptoms.

Suddenly stopping the use of heroin can cause its own dangerous symptoms such as convulsions, hallucinations, and seizures. Most detox facilities will help a person taper off of their addiction, with the aid of medications. This helps to reduce the severity of their withdrawal symptoms and help the person get clean in a safe, controlled environment.

The Heroin Detox Timeline

The heroin addiction recovery timeline is closely related to the timeline of heroin withdrawal symptoms. However, the process of heroin detox will vary in time and intensity based on a number of factors, including the user’s age, body composition, health and addiction history, length of usage, and dosage amounts.

Heroin withdrawal can last anywhere from a day for those who did not use heroin for long, to a week or a matter of months for long-time users. The first symptoms of withdrawal usually pop up within six to 12 hours, depending on how long the person has been using. Those with a longer relationship with the drug will not see withdrawal symptoms pop up until later because of how much heroin is built up in their body.  

Withdrawal symptoms typically peak at around 72 hours after the user’s last dose, and will gradually become less intense over the next few days. Some withdrawal symptoms may persist for much longer, and linger long after the person has become “clean.” This is why recovery is thought of as a lifelong process.  

The Heroin Detox Timeline Phase 1: Days 1-3

Withdrawal symptoms will begin within the first 24 hours of the person’s last dose, and will be uncomfortable, at minimum. In some cases, it can be extremely painful. Relapse is most likely during this period, as the symptoms may be too much for a person to deal with, leading them to take more heroin.

Symptoms of the first phase of withdrawal may include:

  • Headaches
  • Irritation
  • Muscle aches
  • Sweating
  • Nausea
  • Diarrhea
  • Insomnia
  • Anxiety
  • Loss of appetite
  • Panic attacks
  • Aggression

Because the first few days are so intense, this is perhaps the most important period of the heroin detox timeline.

The Heroin Detox Timeline Phase 2: Days 3-5

Past day 3, the most intense symptoms should begin to subside, and the person will likely experience some further muscle aches, stomach cramps, shivering, and general fatigue. Eating a healthy diet and drinking lots of fluids during this time is crucial to help boost the immune system.

The Heroin Detox Timeline Phase 3: Days 5-7

During this period, the symptoms should lessen further, and subside completely after a week. However, for others, some symptoms may lessen. Regardless of whether or not withdrawal symptoms have completely disappeared, reaching the one-week mark does not mean that the person is cured and their recovery is over.

Most people should continue going to therapy for months, years, or even the rest of their life after their heroin addiction treatment concludes. This helps the person avoid relapse and deal with any symptoms that may persist. Because of heroin’s profound effect on the brain, some may even have lingering withdrawal symptoms for the rest of their life, known as post-acute withdrawal symptoms (PAWS).

Detoxing From Heroin In A Rehab Facility

As we’ve mentioned, detoxing from heroin is safest in a professional rehab facility. This is the best option for a heroin addict’s physical and mental health, allowing them to recover from their addiction in a controlled environment. Medical professionals at rehab facilities are trained to treat intense withdrawal symptoms to make the process as comfortable as possible.

They will also help the person taper off of the drug rather than quitting cold turkey. This will involve taking some medication, typically another opioid, and safely reducing the dosage until it is safe to stop completely. In this way, the user can avoid the most severe symptoms of withdrawal and will have less risk of relapse.

After the initial treatment is complete, patients can transition to outpatient treatment, therapy, meetings, and other options, but it will be a lifelong process. A healthy diet should also be continued.


A heroin addiction is among one of the most difficult to detox from because of its intense long-term effects on the brain and difficult withdrawal symptoms. The detox timeline from heroin will vary, but generally lasts at least a week, depending on the person’s relationship with the drug.

If you or someone you know needs help to quit a heroin addiction, Apex Recovery treatment center can help you start the road toward healing.

treatments for heroinBlog

Treatments for Heroin Addiction

The National Center for Health Statistics reported that in 2016 more than 15,000 deaths in the United States were caused by heroin, which is a number that continues to grow at an alarming rate of 19% per year.  It is this statistic, as well as the deaths related to prescription opioids that has led to what is currently labeled as the “Opioid Epidemic” or the “Heroin Crisis”. While these terms have been used to help influence policy change and impact change at a macro-level, they do little for the individual and the family suffering through a heroin addiction or trying to navigate various treatment options for heroin addiction.

 As scary as the alarming death rate from heroin overdose are the news articles describing corrupt “sober homes” and fraud stemming from illegal practices in unlicensed facilities that have tainted understanding of treatment.  The alarming rates of overdose and reports of unethical treatment practices have caused seeking treatment to be a very difficult, overwhelming and scary time. At APEX Recovery, we can help you navigate the process.

Signs of Heroin Abuse

Even before seeking treatment, it is important to understand the signs of heroin abuse, whether you are concerned about yourself, a friend or a family member.  Unlike alcohol, and in some states marijuana, which you can buy and enjoy legally and that many individuals use in moderation, heroin is a drug that is not only illegal but also extremely addictive.  Despite the negative reputation associated with heroin as well as the high addiction and overdose risk, many individuals continue to be drawn to the substance due to the reported feelings of ecstasy and euphoria.  

Heroin users report immediate feelings of pleasure that are often described as a “rush”, an overwhelming feeling of calm, or an increased feeling of confidence and overall well-being.  While these are the reported feelings of users, there are signs and symptoms of abuse that will be present and are often based on the amount and frequency of use as well as the length of time of heroin abuse.

Immediate Symptoms

It can be helpful to understand the signs of heroin intoxication if you are attempting to understand if your loved one is using.  Short-term effects of heroin include flushing of the skin, dry mouth and a reported “heavy” feeling of arms and legs. Immediate symptoms may also include nausea, severe itching, and vomiting.  Following the immediate intoxication, or high, an individual will be drowsy for multiple hours, have slowed breathing and a slowed heart rate and display what can be thought of as a foggy mental state.  It is also common that a user will alternate between awake and asleep.

Long-Term Symptoms

As a person develops a tolerance to heroin, which occurs after initial use, their use becomes more frequent with greater amounts to experience the same feelings.  Because heroin affects the levels of dopamine in the brain, which helps us to feel good, long-term users begin to rely on the drug to feel normal. Once this develops, which is known as dependence, it becomes increasingly difficult to manage normal stress, emotions and experience, and engaging in normal daily life becomes increasingly difficult.  Users that have developed both tolerance and dependence often report finding difficulty meeting basic daily needs as they become consumed with finding, buying and using heroin.

When to Seek Help

Heroin use is a slippery slope, with most individuals developing a tolerance and dependence immediately, which indicates the need for treatment.  Furthermore, it is important to address the problem before it negatively impacts family relationships, work and school obligations and physical health.

Common signs that heroin addiction has impacted psychosocial functioning include changes in behavior, which can commonly be observed as changes to eating and sleeping schedule, changes in friends and neglect of work obligations.  

Social effects could include loss of interest in family relationships and friendships, loss of job, financial stress and legal issues.  It is highly likely that if you are concerned that you have a problem with heroin use, or you are concerned about a friend or family member’s use, that is already time to seek treatment.

Stages of Treatment


One of the largest barriers to getting off heroin includes withdrawing from the physical effects of heroin use.  These symptoms can be both physically and psychologically challenging, with the user often seeking to return to use to endure the physical withdrawal symptoms.  The physical withdrawal symptoms have been portrayed in Hollywood films including Traffic, Requiem For A Dream and Trainspotting, that while appear sensationalized depict a very accurate experience of this process.

During the withdrawal process, as the substance begins to leave the body, the user will often experience nausea, vomiting and diarrhea, cold sweats and hot flashes, extreme muscle and body aches, agitation, anxiety and restlessness and strong cravings to use.  It is recommended that detoxification occurs in a medically managed facility where not only support for physical symptoms can be provided, but also emotional support to prevent relapse in the midst of detox.

Following completion of heroin detox, success increases exponentially when transitioning to residential treatment to address the emotional, social and psychological aspects underlying substance use.

Medication Assisted Treatment

Medication assisted treatment helps provide treatment for individuals with opiate dependency through combining behavioral therapy and counseling with the use of medical intervention as prescribed by a physician or psychiatrist.  The prescribed medication can help relieve withdrawal symptoms and reduce the experience of cravings. Medication Assisted Treatment in conjunction with therapy and counseling can be an effective treatment option for heroin addiction.

There are multiple types of medications that can be utilized in this option.  Medication Assisted Treatment is thought of as a tool to slowly wean an individual off opiates and heroin to prevent the extreme symptoms related to “cold turkey” detox.

Methadone Treatment

Methadone can help individuals function at a normal level while maintaining socialization, engagement in school and work and rebuilding relationships.  Methadone does not provide the incapacitating side-effects associated with heroin use. Methadone can be used both as a maintenance program as well as helping taper individuals off heroin.  While methadone is safer than heroin use, it remains highly addictive when not closely monitored and can lead to addiction or abuse.

It should be noted that methadone is not a cure for heroin addiction and should be used as a short-term option for heroin addiction and will require a taper program when stopping to prevent withdrawal.  Methadone treatment is provided in highly structured clinics and works most effectively when addressing underlying issues contributing to substance use.

Buprenorphine Treatment

Buprenorphine is also used as part of a comprehensive treatment that includes behavioral therapy and counseling and is used to treat heroin addiction.  Unlike methadone which is dispensed in highly structured clinics, buprenorphine can be prescribed for home use. Buprenorphine works by lowering the physical dependency side effects associated with heroin and can ease withdrawal symptoms and cravings with lower risks of overdose.  

Additionally, buprenorphine can block the effects of heroin and is commonly referred to under the brand name Subutex and is often prescribed with naloxone under the brand name Suboxone.  Suboxone is usually recommended as a longer treatment for addiction. Both methadone and buprenorphine are harm reduction treatment options as they relieve cravings and withdrawal symptoms, however, have continued addictive properties with potential for abuse, especially when not used in combination with counseling and therapy.


Naltrexone is an additional medication that can be used to help individuals maintain abstinence in recovery and is highly effective when used in outpatient treatment.  Naltrexone can be used in both an oral pill form as well as in a long-acting injection that is given once a month and known by the brand name Vivitrol. Naltrexone in both forms stops the euphoric experience of heroin and opiates, which means that while a person is on the medication, they do not experience the high from heroin if they relapse.  

Additionally, Naltrexone can help manage cravings, with positive results in preventing relapse through multiple studies.  It is noted that Naltrexone is not considered a “magic pill” to cure addiction, and as with other medication assisted treatment options, requires a combination of intensive psychotherapy, skills training, and family and social support.


Psychotherapy, or more commonly referred to as talk therapy, includes addressing underlying emotional and behavioral aspects to identify ways to overcome challenges and live a more fulfilling lifestyle.  Psychotherapy as part of treatment for heroin addiction is the foundation of residential treatment and can be addressed in both individual and group settings. When engaged in psychotherapy, therapists will build relationships with clients based on support and positive regard and will work closely with each individual to improve insight regarding their substance use, build motivation for long-term changes and develop a skill set that assists with managing distressing emotions.  

Multiple modalities have been supported by research and are evidenced-based in supporting an individual in recovery. While the goal of therapy is always to improve well-being, it can be difficult to discuss and address emotions and trauma, however, our trained therapists will provide emotional support as you gain the skills to manage addiction.

Family Therapy

Substance abuse affects the entire family, not just the individual, and family inclusion is important during the initial stages of treatment.  Family therapy can lead to an opportunity to mend relationships, help family members develop an understanding of the addiction, and assist the family towards developing a plan that promotes sobriety.  

Research has shown that actively involving family members in treatment not only benefits the individual but allows a family to make a positive impact on sobriety and that when family is included, individuals are more likely to maintain abstinence.  Family therapy includes opportunities to communicate while learning relationship skills as well as conflict resolution and problem-solving techniques to create a family system that will support all individuals towards living a more fulfilling life.

Outpatient Therapy

Outpatient therapy for heroin treatment is a necessary step in maintaining sobriety.  The initial process of heroin treatment includes the physical withdrawal symptoms, with the second stage addressing immediate emotional regulation skills, however it is not until a person has reacclimated to their daily life that the biggest hurdles are presented.  Clients completing treatment will often reference the day they left residential treatment as the true start date to their sobriety.

This is because while in residential treatment, an individual in recovery is provided with daily structure as well as elevated levels of support and monitor, however as they begin to reintegrate to their daily lives, they often find themselves triggered by the same stressors, people, places and things that originally helped develop the addiction.  Because of this, long-term outpatient treatment becomes important.

At APEX, our outpatient programs incorporate daily group therapy, individual psychotherapy, drug, and alcohol counseling, and psychiatry or addiction medicine services. We utilize CBT, DBT, Motivational Interviewing, Coping Skills training and a variety of other didactic and process therapies to help individuals who have already finished a formal inpatient or residential treatment program, are currently sober, and need a continuation of care.

 In the initial stages of treatment and sobriety, having someone for guidance in the common life problems and challenges has an enormous impact on the positive outcome of the recovery process.  During outpatient treatment, the goal is to help individuals move through the stages of change and move from early recovery, into living a more productive life, while adhering to personal goals and needs in the recovery process.

Part of outpatient therapy includes a heavy focus on relapse prevention.  Developing a comprehensive understanding of warning signs, triggers, and new coping skills is required to build a new life that is more satisfying and promotes sobriety.  Developing long-term goals and identifying a value system that reflects new ways of managing stress, daily challenges, and struggles is all integral parts of the relapse prevention aspect.  

In the development of a relapse prevention plan, it includes incorporating new healthy habits, developing a new support system, changing unhealthy relationships and understanding when to ask for help.  These tools help contribute to the long-term success of individuals that have effectively managed heroin addiction.

Am I Addicted to HeroinBlog

Am I Addicted to Heroin? Signs to Look Out For

The young man sat down on my couch. He was twenty and already showed the telltale signs of heroin use. His eyes were myopic, meaning pupils were as tiny as pins. The young man’s weight was diminished, looking more like a POW than a college kid. I knew as a psychotherapist, I had a casualty of the growing epidemic in my office. “I’m not addicted” the young proudly announced. “I use heroin, but I never slam that stuff.” Slamming refers to the use of IV or “shooting up.” Many young people think that if they simply smoke or sometimes snort heroin, they are not at risk for dependence. Of course, after years in the field and hundreds of heroin addicts treated, I know better.

Heroin addiction is insidious at first, but then grasps hold like a rebel force that is intent of leaving no survivors. “How long have you used” I asked. The young man responded for the last year he would use over a weekend, then stop. He readily admitted that his use had increased and that is was starting to be more painful to stop, a sign of withdrawal. He minimized this fact and stated “listen doc, I understand that people get hooked. In fact, I have lost a friend to overdose. Thing is, I am smarter” he exclaimed. “Why is that” I asked? He went on to rattle of his philosophy of how by not using every day, giving his body some rest, and not shooting up, would allow him to dance with the devil.

It was no more than 6 months later this young man that was in my office, was living out of his car, shooting up heroin several times a day, and facing jail time from stealing from his family and ex-boss. Indeed, heroin addiction is real, very real. Then how come people struggle to realize this until it’s often too late? 

History of Heroin Addiction

Heroin use has been around for some time. In reality, heroin use originated with the opium industry that was thousands of years old. In the late 1800’s heroin was first synthesized and then peddled as an elixir that suitable for many uses. Indeed, heroin is a substance with great anxiety relieving properties and pain blockers.

This was popular for many people and it wasn’t until the 1920’s that the addictive nature of the drug led to the prohibition on the substance. As with many things, once it became illegal, organized crime began their sale and manufacture of the substance and the rest as they say, is history. 

During the 1960’s heroin addiction began to soar. This was in part with the popularity of the hippie movement and drug pervasive side culture, but also due to the fact that several wars including Vietnam had left many traumatized men open to the numbing effects and warm embrace of heroin. Drug addiction rates rose and the reality that heroin addiction could quickly slip in and take hold of emotionally and physically vulnerable users, was clinically evident.

In 1971, then President Nixon, began to make policy against the use and spread of heroin. It was at this point that US society realized that heroin was no longer a closeted drug that only touched the fringes of population, but that an epidemic of a difficult addictive substance was no permeating many homes across the US.

One of the most difficult components of this new addiction for society to deal with was the unbelievable and often fatal consequences of addiction to heroin that was not readily seen in many other drugs. Heroin addiction occurred so much faster than other substances and the body seemed to latch on and crave the substance like none other.

Symptoms of withdrawal basically made users prisoners in their own bodies, making daily life impossible to live without “the fix” that brought users back to baseline. All the while heroin users would slip further and further into a hole that often-included joblessness, declining physical and mental health, and eventual heroin overdose and death. All hallmarks of addiction.

So why do people start using a substance that is now known to be so addictive and deadly, and how do people know if they are addicted to heroin? First, it is nearly impossible to use heroin and not become addicted. The drug focuses on the dopamine system in such a way, that the unnatural release of dopamine and other neurotransmitters supply the brain with a calming, warm rush that is often 400% greater than sex, buying a new car, winning the lottery, basically anything that can be naturally pleasurable.

The brain is so greatly hijacked with heroin, that it is nearly impossible for a brain to not be re-wired to a craving state. Additionally, because heroin is so easily metabolized and utilized in the human body, dependence -or addiction- occurs quickly and with severe withdrawal symptoms. 

Heroin Addiction and Withdrawal

Withdrawal is often the telltale sign of heroin addiction. Addiction Specialists often state that is you are using heroin, you are addicted. This might not be 100% accurate, but the fact is that heroin use will within weeks, or sometimes days of use, turn into an addictive downward spiral. Dependence is felt when the body and mind are so intertwined in use, that the body goes through horrific cravings and withdrawal without use.

These withdrawals include flu-like symptoms, vomiting, and severe diarrhea. The user also feels anxiety that is debilitating, sleeplessness and restlessness like the worst case of panic one can imagine. The body shakes and cramps from loss of heroin. People often can’t sleep, but also can’t get out of bed. The skin becomes clammy, dark circles are around the eyes, and weight is lost at a rapid rate. All these physical symptoms can last a week in acute state, and often for months in sub-acute withdrawal. 

Perhaps the most troubling part of heroin addiction is that of neuroplastic changes to the brain. If you are addicted to heroin, your brain is literally inoperable. Motivation is impossible. Anxiety is paramount, and depression and suicidal thoughts are almost always present. When one is addicted to heroin they feel like a slave to a master, literally incapable of separating reality from the life on the drug. These neuroplastic changes are often to the longest lasting aspect of heroin addiction, and it is not uncommon to see people that are still struggling with work and motivation two years after their last use.

While the brain is creative in its ability to rewire, heroin addiction almost always leaves previous addicts with a mind that feels less interested, less motivated, and less happy than a brain that had never touched the substance. This altered state is often very depressing and frustrating for previous addicts and can create relapse triggers on their own. Many heroin addicts feel that they have damaged themselves so badly, that overdosing, and suicide are viable options. If they can’t be happy without the drug, can’t motivate or participate meaningfully with life due to damage, what is the point of trying?

Fortunately, while heroin addiction is real and very problematic, there are good outcomes that can be found. Particularly with MAT, or medication assisted treatment, brain function issues can be greatly helped. Additionally, with long term heroin addiction treatment and support, many addicts return to a high quality of life. This is of course if they survive. Heroin is deadly, and it happens so frequently because a compromised brain on heroin often forgets about safety and reality.

When one questions if they are even addicted and plays Russian roulette with their life, the outcome can often be poor. When anyone starts using heroin and thinks they will be an outlier, surviving occasional use and avoiding drug addiction, they are certain to lose. When one begins to use in any way, multiple times, surrounding themselves with like-minded users, it is only a short time until dependence creeps in.

Physical deficits will be slight at first, but the mind will have already created the necessary feedback loop to keep the horse coming back to the watering hole. So, in short, if you are using heroin, you should consider yourself altered mentally and in process of becoming addicted. Heroin use is serious and not something that can be used recreationally. The consequences are usually most severe possible. So, in short, if you are considering if you are addicted to heroin, get help, support, treatment, and be honest with yourself. If you are not, it will be a short window of time before life altering consequences set in. 


How to Avoid Alcohol Withdrawl

You might scoff at something like alcohol withdrawal while the opioid epidemic continues to wreak havoc on our country, but withdrawal from alcohol is very real and nearly as prevalent. Withdrawal from other drugs like benzodiazepines (benzos) and opioids have certainly taken hold of the public consciousness, and rightfully so, but alcohol withdrawal is just as dangerous, even deadly.

In this post, we’re going to discuss what exactly alcohol withdrawal is, how alcohol affects family members, its symptoms, the withdrawal timeline, and also dish out some advice on how to avoid alcohol withdrawal.

What Is Withdrawal?

Withdrawal will be a difficult part of the recovery process no matter what substance a person has become dependent upon, but alcohol withdrawal is actually more severe than most other drugs. Alcohol is one of the few substances that can cause death, along with opioids. Fortunately, alcohol withdrawal fatalities can be prevented as long as a person tapers off their alcohol use safely.

The Alcohol Withdrawal Timeline

Alcohol withdrawal occurs in three levels and comes with a wide range of alcohol withdrawal symptoms:

Stage 1: Minor Withdrawal – The symptoms of minor withdrawal may start to appear just six to 12 hours after an alcoholic stops drinking. They will include sweating, shaky hands, mild anxiety, nausea, insomnia, panic, twitching, and headaches.

Stage 2: Mid-level Withdrawal – Mid-level withdrawal symptoms will set in around 12 to 48 hours after the last drink. These can manifest as more intense versions of the symptoms listed above, as well as some visual and auditory hallucinations. The person usually will be aware that the hallucinations aren’t real, but they will still be difficult for them to deal with. Other symptoms may include an irregular heartbeat, elevated pulse, and even possible seizures.

Stage 3: Major Withdrawal – Setting in 48 to 72 hours after a person stops drinking, significant withdrawal symptoms will peak in around five days. These can include further hallucinations, during which the person won’t be able to distinguish their hallucination from reality. They may also endure withdrawal seizures, an irregular heart rate or racing heartbeat, profusely sweating, fever, high spikes to their blood pressure, rapid breathing, become easily agitated, intense tremors, or even death.

As you can see, major withdrawal is the one where the real danger lies. Minor and mid-level withdrawal can be dangerous as well if the person already has high blood pressure or a bad heart. And the longer a person has abused alcohol, the more severe their alcohol withdrawal symptoms will be.

Another common symptom of minor and mid-level withdrawal is shakiness, which people will often refer to as “DTs,” or delirium tremens, however, this is a bit of a mislabel, because actually DT is more associated with major withdrawal and can be severe and life-threatening. Shakiness from minor and mid-level withdrawal is not dangerous and should pass within a few days.

What Actually Causes Alcohol Withdrawal?

On the surface, the cause of alcohol withdrawal seems rather obvious: a person who was abusing alcohol stops drinking, and then alcohol withdrawal symptoms set in. But what actually occurs in the body?

When a person drinks, the dopamine levels in their brain become elevated, which results in pleasant feelings. Thus, the consumption of alcohol can elevate a person’s mood, low their inhibitions, and increase self-confidence. When the person stops drinking, the alcohol leaves their bloodstream and the dopamine levels and feelings that come along with it will dissipate.

When this behavior is repeated by the constant consumption of alcohol, the repeated altering of dopamine levels in the brain will cause it to expect alcohol to be present, and will discontinue its normal production without the presence of alcohol. This is how a person builds a tolerance to alcohol.

The more they drink, the more tolerant to alcohol their body becomes, and the more dependent their brain will be on its interference. When this has reached the level of dependence, the person may suffer withdrawal symptoms as the effects of alcohol wear off, symptoms that can range from mild to quite severe.

To be more scientific, it turns out alcohol withdrawal is actually caused by a neurotransmitter rebound within the brain in the GABA system. When a person consumes high levels of alcohol over an extended period, their neurotransmitters will adapt and work harder to try and perform their function despite the effects of alcohol. When the person removes alcohol from their system, the neurotransmitters won’t switch right back with them, they will actually continue to produce excess levels.

With alcohol no longer coming into their body to suppress the hyperactive neurotransmitters, the person will begin to see the symptoms we listed above in stages. The symptoms of withdrawal are actually quite the opposite of the symptoms caused by consuming alcohol. When alcohol is in a person’s system, it causes relaxation, sleep, and calm, while removal and alcohol withdrawal cause panic, insomnia, anxiety and others. Benzo and opioid withdrawal affect the body much in the same way.

How To Avoid Alcohol Withdrawal

Obviously, the easiest way to avoid alcohol withdrawal is to never drink at all, but if you do plan to consume alcohol, is it always best enjoyed, and safest, in moderation. Alcohol withdrawal will occur when your brain has been affected by alcohol over a long period of time.

Have Less Than Four Drinks Per Day

Therefore one way to avoid withdrawal is to not exceed four drinks per day if you are going to drink every day. This should limit the level of affect alcohol has on your brain. However, while you can generally consume low amounts of alcohol daily and avoid withdrawal, drinking that much every day is not recommended for your overall health.

Mix In Abstinence Days

If you can avoid drinking every day, you should. Another way to avoid alcohol withdrawal is to mix in abstinence days each week, and it’s best if you can take several days off from drinking at a time. Even if you do choose to get intoxicated some days, as long as you mix in some detox days in between, you should be able to avoid any withdrawal symptoms.

If you can manage to have several abstinence days each week it will give your neurotransmitter systems the chance to return back to their normal levels. This is because it takes a few days off each week for the alcohol to get completely out of your system. Since the body metabolizes roughly one standard drink per hour, limiting yourself to four drinks per day will give your neurotransmitter systems the time they need to  As long as your neurotransmitters have enough time to return to their normal levels, alcohol withdrawal will not set in.

If you go on a weekend bender, say for a bachelor party or any other big event, you may encounter some minor symptoms at the end, especially if your alcohol consumption was especially high, however it should be rather minor, and pass within a day. Yes, this is also known as the infamous “hangover.”

Don’t Mix Alcohol With Benzos & Opioids

Benzos like Valium and Klonopin and alcohol have similar effects on the GABA neurotransmitter system. If you were to mix the two, it would first increase the chances that a person can overdose on benzos, but also compound the withdrawal symptoms from each, making the process much worse when the person stops using one or both.

Who Is Most Likely To Have Alcohol Withdrawal Symptoms?

Alcohol withdrawal is a largely individual process that will depend on a lot of factors, including a person’s body composition and genetics, their history with alcohol, length of alcohol abuse, amount of alcohol consumed, and more. However, in general, some common factors would position a person to be more likely to encounter significant alcohol withdrawal symptoms.

This group mainly includes those people who have consumed alcohol to the point of getting drunk over any duration of time. Someone who has stayed drunk for several days in a row can expect to feel some minor withdrawal symptoms once they stop drinking. Those who drink during the day for over a month, or get drunk every night for a month or more are highly likely to have severe withdrawal symptoms. Those with a history of alcohol abuse, or have dealt with alcohol withdrawal symptoms in the past, will be highly likely to re-encounter them, most likely in a more intense form.

Those who drink in moderation or just get drunk every once in a while are unlikely to see any alcohol withdrawal symptoms. But those who abuse alcohol for a month or more can expect to experience both physical and mental health issues if they stop drinking.

Alcohol Withdrawal Treatment

If you do encounter lighter forms of alcohol withdrawal, it’s not an emergency situation, and you most likely won’t need any help or support to get you through it. Simply keep yourself in a quiet place with soft lighting and try to have limited contact with people, as you’ll probably be quite easily agitated. The best thing you can do to support your own system is to drink a lot of water or drinks with electrolytes as well as eating healthy food. In a couple days, the symptoms should pass.

For more severe cases of withdrawal, as in those who have a long history of alcohol use disorder and are in stage 3 of withdrawal, you should seek help to deal with your symptoms. Since alcohol withdrawal can be quite difficult and dangerous, it is in your best interest to not attempt to recover on your own. Enter yourself into a alcohol treatment center so you can safely taper off of your alcohol dependence.

Tapering Off Of Alcohol Withdrawal

Because the symptoms can be so severe, it is not recommended to stop drinking “cold turkey ” or detox from home. Someone who has abused alcohol for any duration of time should actually taper off of their drinking, instead of trying to completely stop drinking all at once. This helps keeps withdrawal symptoms moderate and allows the person to safely cut back on their drinking.

Essentially, if you or someone you know have been drinking consistently for a long period of time, visibly shake, sweat profusely, have a rapid pulse or heartbeat, or high blood pressure, then it will be much safer to taper off from drinking rather than quit cold turkey. Tapering off of alcohol actually means that you will continue to drink, just in smaller amounts incrementally until your body and mind become less dependent on alcohol, and it is safe to stop. Doctors can now even prescribe prescription medication to take along with a tapering plan, and tapering off of alcohol should be done under supervision, most likely in a rehab facility.

When tapering off of alcohol, it’s best to use beer because of its low alcohol content. The person dealing with withdrawal symptoms should only drink as much as they need to keep their sweats and shakes at bay. Depending on the person’s level of alcohol abuse, the process may only take a day, while for others it can take up to a week or more. While tapering, the person must also remember to stay hydrated. If the person is tapering in a rehab facility, they may be given an IV and vitamin shots, but if you’re trying to taper at home, Gatorade is a great pick because of its balanced electrolytes.

If a person chooses to taper off of alcohol, they will be most successful if they set up a tapering schedule. The schedule will depend upon how much the person has been drinking and the withdrawal symptoms they are already encountering. But essentially, the more they have been abusing alcohol, the slower the taper schedule will be, meaning the process will last longer. The person will have to pinpoint their average consumption, put it in terms of how many beers that amounts to, and slowly start to cut a couple beers out of the schedule each day.

If the person tries to taper too fast, their blood pressure and pulse will rise, and the shakes and sweats will return. No matter what, it’s important to remember during the process that the beer is being consumed as medicine, and not for pleasure. Tapering too quickly can be fatal, which is why it is best to detox in a professional rehab facility, where the patients can be properly supervised.

At APEX Recovery, we help you identify motivating factors for long-term change, develop necessary skills to maintain recovery and include your loved ones in your recovery.  We treat individual patients and their unique needs through a model that we recognize is not a “one size fits all”. Our admissions coordinators are available 24 hours a day to give you the support you need to make positive changes.  Call APEX today.


How Alcoholism Affects Families

Many American families find themselves dealing with what seems like an unstoppable force for destruction. Addiction plagues many families and significant others on a daily basis. Many families lack the knowledge or understanding of how addiction impacts a family unit. Often, once chaos, financial burden, and hardship plagues a family, due to a family member suffering from addiction the family is left wondering how, why and what contributed to their loved ones’ situation. Often, many family members and marriages are torn apart by the devastating and long-lasting impact that addiction leaves on a family. Families wonder what they could have done better and what they could have changed. This article will discuss why addiction is more than a mere individual issue and will help educate families about why and how they can make lasting changes in their loved one’s life, and for themselves.

The family unit is a system. The famed clinician, Dr. Murray Bowen, researched family dynamics and pioneered the treatment and model of Family Systems Theory. This approach is useful when trying to glean an understanding of addiction. In fact, Dr. Bowen’s first research into family systems focused in large part on analyzing alcoholism. Alcoholism is often a trait that is passed down both through heredity, and also due to systemic dynamics observed and practiced within a family system.

Looking at a family through a lens of a system is like looking at a car with all its interworking pieces. Without a steering wheel or tires, a car could not operate. Similarly, when a family system is broken or dysfunctional, such as in the case of a parent with an addictive disorder, it leaves the entire system out of balance, and sometimes inoperable. Additionally, when one part of a system is dysfunctional, other parts of the system often over-function in order to keep up. This can be called homeostasis and often poor coping mechanisms, poor communication, and faulty defense mechanisms begin to be the norm. This leads to repeated patterns of behavior that sometimes lasts generations.

Enabling Factors

Many families dealing with a family member with addiction have heard the term “enabling.” Enabling by definition is giving permission to another to do something. In most addiction cases, family members often knowingly or unknowingly “give permission” to a substance user within their family. Often the family outwardly says they want their loved one to change or stop their addictive behavior, but because of ingrained patterns or faulty systems behavior, and overcompensating, many family members indirectly support continued addictive patterns, despite their words and best intentions. This is what enabling is all about, and it can be often found in dysfunctional family systems.

The term enabling grew out of the Al-Anon peer support group, a 12-step group created for family members dealing with an addicted loved one. It also is referred to in more clinical models such as Family Systems Theory. Enabling has many keys factors, but the primary concept from a family systems perspective is that due to emotional stress or dysfunction, some key people in a family system begin making excuses or attempt to overcompensate for another member. This is usually the addicted family member. Often, fear that the addicted family member will die, get in legal trouble, or further hurt the function or reputation of the family, leads members to make repeated attempts to gain control of the faulty behavior. These attempts usually fail and fail again. The system becomes strained, there is yelling, crying, bargaining between family members and the one using. This leads to emotional fusion and a decrease in “differentiation” or healthy interdependent behavior within a family. Often it looks like grown adults trying to parent grown adults, which is never a pretty picture.

Genetic Factors

In addition to generational transmission, a process of behavioral teaching and practicing that lends itself to generations of addiction and dysfunctional behavior, families often must realize the underlying genetic factors can play a role in addiction within a family. Modern research has opened the door for understanding family addictive process on a broader level. While there is no specific gene that codes for addiction, it has been researched and found that many aspects of behavior associated with addiction are passed on. So, what does this look like? If both parents are alcohol dependent, the offspring will be significantly more likely to develop the same malady. This has also been shown with biological twins. The good news is that there are many children of substance abusers that do not end up addicted. While this may be true sometimes, system theory looks at historical and genealogical patterns to illuminate potential problems. Genetics plays a role, in impulse control, reward circuitry of the brains, as well as with depression and anxiety, a large factor for self- medicating and ending up with an addiction problem.

Genetics also plays a role in personality and how well stress is tolerated. In general, the less someone tolerates stress, the more prone they can be to fall into addictive patterns. This process of poor stress tolerance is one that is directly hinged on genetic factors. In short, if parents do not tolerate stress well, the children will be at risk for the same. Much in that same way that addiction to substances can come from genetic factors, so can controlling and enabling behavior. Personality, while hinged on both environmental and genetic factors, it is widely agreed that genetics often plays the primary role. Couple this with learned behavior, and it is no wonder why generations of dysfunctional alcoholic families can be seen and studied. If one wants to understand addiction within the family, doing a good look over the family tree can provide a good starting place. Often clinicians will use a genogram, which is a clinically developed “mapping” technique that looks at various components of family trees, such as addiction.

After looking at both systemic issues and genetic components to addiction within a family, it is crucial to look at treatment for the entire family. Attempting to treat an individual without treating a family unit will often lead to relapse or failure. This is because any system that does not require function of all parts, will inevitably return to the previous dysfunctional pattern that occurred before. This is why family treatment is such a crucial part of treating any one person with addiction issues. Only with simultaneous treatment of the family and couple system, will allow for a marked change with that system, allowing both the addicted patient and family to change to a more optimal behavior pattern.

So, what does the family treatment of addiction look like? It is really quite simple, any treatment or detox program for any addictive individual, should also offer some sort of family therapy program. These programs often differ from program to program. Traditionally 12-step programs would recommend that spouses, family members and children of addicts should attend Al-Anon or Alateen. This model should not be confused with actual family therapy or treatment.

While the 12-Steps can provide family members with needed support and some spiritual philosophy, it fails to do offer two critical components. One, it does not provide actual therapy, or a process of clinically trained individuals working to assist in the counseling of the family process. This is necessary for learning communication skills, as well as to work through hurt from both sides of the family.  Two, it does not allow for integration with the addicted patient, who has been diagnosed with addictive use disorder. So often during the course of experience for a family dealing with addictive illness, many emotional wounds, lack or trust, and failure to communicate has been at play for sometimes decades. It is crucial that families attend therapy together to repair and restore needed attachment bonds in a new healthy way to improve a family’s and individual’s outcome.

Family Therapy

Family therapy and specifically family systems therapy, allows both an addicted patient and their family to work through much of the dysfunction that preceded treatment. Family therapy also allows people to share their needs, ideas, and what works for them, getting away from the lopsided and over-functioning behavior that often allows addictive problems to continue and grow. Finally, it allows a needed conversation about what life will look like for the family and individual after treatment is finished. Families must understand that every member must learn new ways to function healthier and more productively if the system is to grow and change for the better.

It is also crucial for an addicted patient to understand what boundaries and expectations family members have of them moving forward. Conversely, it is crucial that family members understand that a person that has worked through substance use disorder has a new way of thinking. Often this is a struggle for family members. Even though they always dreamed and hoped for recovery and abstinence, dealing with a family member that used to hide out, be passive, not communicate is often very different and challenging from a healthier adult person who sets boundaries and requires family members to have respect for their new ways of handling their situation and recovery.

In summary, addiction affects the entire family. This maladaptive pattern can lead to years of systemic dysfunction. Often, despite best intentions, advice, and attempting to control an addictive family member, a family becomes disengaged, angry and hostile. All members are left in a state of stress that leads to further dysfunction. Reasons for this family behavior and addictive illness within families are multigenerational processed and encompass both learned behavior and genetic factors. These deeply ingrained traits that are inherited as well as repeated within families, lead to cycles where it is impossible for both individuals with addiction, as well as their family members to function without professional help.

While there have been traditionally 12-step peer support groups, they fail at targeting more important factors that are required to get a system functioning healthy again. This is why it is crucial for families to be treated in conjunction with any one specific family member that struggles with addiction. Furthermore, it is important that any family or individual seeking substance abuse treatment does not do so without making sure the family as a whole seeks out family therapy.

Family Systems Therapy is one such model that was created out of evidence-based research by Dr. Bowen, who studied alcoholism within families. Working on differentiation with family members, as well as supporting direct communication, leads to improved outcomes for both the family and the newly sober patient. Only with this type of help, will a system be able to avoid a return to the pitfalls of homeostasis or repeated addictive behavior.

At APEX Recovery, we help you identify motivating factors for long-term change, develop necessary skills to maintain recovery and include your loved ones in your recovery.  We treat individual patients and their unique needs through a model that we recognize is not a “one size fits all”. Our admissions coordinators are available 24 hours a day to give you the support you need to make positive changes.  Call APEX today.


Why Detoxing From Alcohol at Home Isn’t Safe

If you or someone you know has been abusing alcohol, at some point you may decide that it’s time to stop. Alcoholism can have severe effects on your health and your life, and making the choice to quit is a significant first step to getting things back on track.

However quitting cold turkey, or trying to stop drinking on your own at home simply is not safe. The reason why is alcohol withdrawal.

Alcohol Withdrawal

When a person has abused alcohol for an extended period, they are likely to deal with some very uncomfortable alcohol withdrawal symptoms and avoiding them can be challenging. In fact, alcohol withdrawal symptoms are known to be much more severe than those associated with most other substances. Withdrawal from alcohol can even lead to death.

Alcohol withdrawal is actually caused by a rebound of neurotransmitters in the GABA system in a person’s brain. GABA receptors are responsible for producing a person’s feelings of calm, relaxation, and sleepiness. When alcohol is present in a person’s system, it enhances the function of their GABA receptors, giving them these feelings.

However, when they have abused alcohol for a long period of time, the receptors will struggle to return to normal function when alcohol is removed.

The GABA receptors will respond weakly to the presence of GABA in the absence of alcohol, and this will produce adverse feelings of anxiety, panic, and even insomnia, among others. The presence of alcohol also makes a person’s brain try to overcompensate and produce more neurotransmitters, which run rampant in the brain when alcohol is removed, elevating blood pressure, raising their pulse, and even causing hallucinations, fever, and DTs, or delirium tremens, which is the most serious form of alcohol withdrawal. DTs cause sudden confusion in the brain, can occur without warning, and can even be fatal.

While alcohol withdrawal symptoms will vary widely from person to person and are dependent on many factors, withdrawal generally occurs in three stages.

Stage 1: Minor Withdrawal

Minor withdrawal symptoms will include shakiness, sweating, some mild anxiety and/or panic, insomnia, twitching, headaches, and even some nausea. These alcohol withdrawal symptoms will appear within six to 12 hours after the last drink.

Stage 2: Mid-level Withdrawal

During mid-level withdrawal, a person will see the symptoms involved in stage 1 intensify, in addition to a rapid pulse, irregular or elevated heartbeat, and potential seizures. They may also encounter some minor visual and auditory hallucinations, but the person should be aware that they aren’t real. These alcohol withdrawal symptoms appear roughly 12 to 48 hours after the person’s last drink.

Stage 3: Major Withdrawal

Stage 3 withdrawal is when things get dangerous, as all symptoms will reach their highest levels. The person may have seizures, profuse sweating, intense tremors, rapid breathing and pulse, fever, significant spikes in their blood pressure, and will no longer be able to distinguish their hallucinations from reality. Stage 3 is also where death may occur. Major withdrawal arrives 48 to 72 hours after the person’s last drink and will peak around day 5.

While this information might make you think you should stop drinking right away, this isn’t the case. In fact, quitting cold turkey is quite dangerous and not at all recommended. Alcohol withdrawal can be fatal if you suddenly remove the depressant from suppressing the neurological activity in your brain.

So, how exactly can you quit drinking? The best way to stop an alcohol addiction is the tapering method.

How To Safely Quit Drinking Alcohol – The Taper Method

If a person has been drinking alcohol heavily over a long period of time, it won’t be safe for them to stop drinking suddenly. Worse, it can actually be fatal. Alcohol’s effect on the brain is so severe, that if it is suddenly removed from your system, the rebound of your neurotransmitters could cause severe rebound symptoms and even death. While someone who has abused alcohol for only a short time can probably safely quit “cold turkey” without dealing with anything more than mild withdrawal symptoms, those who have been long-time drinkers should taper off of their drinking.

Tapering means that the person will keep drinking, but safely cut back on their alcohol consumption over a period of time. This will help them manage their withdrawal symptoms and make sure nothing gets too intense for them. If symptoms start to set in a little too heavily, the person can simply drink a little more until they subside.

Beer is the drink of choice for the taper method due to its low alcohol content, and the amount of beer the person will drink and how long they will need to taper down their consumption will completely depend on the individual. If they were drinking a liter of hard alcohol per day, they may start out drinking quite a lot of beer, and slowly but surely cut back by a couple beers each day.

In the tapering system, beer is medicine, and the person will need to view it as such. They should only drink more if they absolutely need to because their symptoms have become too severe.

Since policing yourself, especially if you have an addiction, can be so challenging, it is best to detox from alcohol with some help, and you’re generally better off not attempting detoxing from alcohol at home. Here’s why.

The Danger In Detoxing From Alcohol At Home

Deciding to get sober is a big decision, but it isn’t a journey you should take on your own. It might be tempting to try and isolate yourself, and it’s entirely understandable that you wouldn’t want to put the burden on anyone else, but the fact is that trying to detox from alcohol at home is not safe.

Monitoring Your Detox Is A Lot To Ask Of Your Family & Friends

Even if you have a care system in place in the form of supportive family and/or friends, they may not be able to provide the proper care you need when withdrawal symptoms set in. After all, would your friends or family be prepared to deal with a life-threatening emergency if your withdrawal symptoms got that severe? It’s a big risk, and a lot to ask of someone you know and love.

You also aren’t going to be easy to deal with during this time, as beyond the physical withdrawal symptoms, you will also become easily irritated and agitated. This is normal, and part of the recovery process, but it is best to not let your frustrations affect your family.

Alcohol Withdrawal Can Be Life-Threatening

There is a common misconception that detoxing from alcohol isn’t dangerous, or at least isn’t as dangerous as detoxing from other drugs, but the fact is, that it’s one of the most dangerous substances to detox from, period. Alcohol withdrawal symptoms can be incredibly severe, and even life-threatening, so being monitored by a medical professional through an alcohol therapy program will put you in the safest position to quit safely.

Symptoms Are Worse If The Person Used Other Substances Or Has An Underlying Condition

The withdrawal symptoms are also compounded if a person used any other substances, such as benzos, heroin, opioids, cocaine, or methamphetamine, at the same time they were drinking. Any underlying medical issue that the person has, such as bipolar disorder, high blood pressure, asthma, anxiety, and more, can also complicate the alcohol detox process.

The withdrawal process, and alcohol abuse, in general, are often tied to depression, which can make it easy to slip back into drinking if you aren’t monitored. Medical professionals will make sure you taper off safely and don’t start to drink again for pleasure. They know the right amounts to give to keep symptoms at bay while also cutting back to the point of safely eliminating alcohol from your system entirely.

Detox Is Not A Quick Fix

As you read in the section about tapering off from alcohol, getting over alcohol withdrawal symptoms won’t be as simple as sleeping it off. The process is going to take some time, and you or someone you know was a very heavy drinker for a long time, it’s going to be very hard.

Staying Home Keeps You In A Bad Environment

If you try to detox at home, you are leaving yourself open to temptation to relapse and continue drinking. Withdrawal symptoms may be so bad that you may want to start drinking again, it’s easy to get right back into it. However, if you are able to remove yourself from your environment and bad habits by entering an inpatient alcohol treatment program, you’ll give yourself the best chance for a safe recovery.

Detoxing From Alcohol Symptoms

The symptoms of alcohol detox will closely mimic those of alcohol withdrawal because the two are tied at the hip. Those in alcohol detox can expect to sweat profusely, especially at night, will probably experience some headaches, feel overcome with shame, guilt and other emotions, and have a tough time with some other physical and mental issues. There’s no way to know what symptoms you will encounter until you make the choice to quit and begin the process. But again, if you taper off of alcohol, you’ll be able to quit safely.

The Detoxing From Alcohol Timeline

While there is not a specific timeline for alcohol detox, it will generally follow along with how severe a person’s withdrawal symptoms are. Withdrawal typically begins within 12 hours after the person’s last drink. These minor symptoms could get worse and move on to stage 2 or 3 within 24 to 72 hours. Sometimes, the intensity can pick up rather rapidly, while others, it may take a while for the true impact of withdrawal to hit.

Stage 3 withdrawal tends to peak around day 5 and should taper off thereafter. Some psychological effects may continue for a few weeks after the initial withdrawal period has ended but should be treatable.

We bring up the alcohol withdrawal timeline again here because withdrawal is actually the first step in alcohol detox. Detox is the process through which you will remove all of the harmful substances in your body. Alcohol detox, in particular, can take a few days or even a week or more, depending on the person’s level of abuse and health history.

During the detox process, you will work together with medical professionals to keep your withdrawal symptoms under control. By checking into a professional rehab center, you will be in a place where you can be constantly monitored by people who know how to handle the symptoms you may encounter and can react should a serious situation arise.

They will administer medications and make sure you are taking in the proper fluids and foods. Eating a healthy diet and staying hydrated will be extremely important during the detox process. However, once detox ends, things aren’t all fixed forever, detox is just the start of a long journey in recovery that will last the rest of your life.

The first goal during detox is to monitor you constantly and make sure your physical symptoms are kept stable. Some benzodiazepines may be prescribed during this time to help manage over-activity in your central nervous system as it attempts to rebound. Your blood pressure, heart rate, temperature, and breathing will all be closely monitored as well in a detox center.

Because tapering is often the safest method, staff will also monitor your alcohol usage during detox to make sure you stay on your tapering schedule and don’t start over-drinking again. They will help you taper down to wean the alcohol out of your system while making sure you are getting the proper nutrition you need. This controlled manner of detox is much safer than any program you can set up for yourself at home, and ensures you won’t harm any relationships with friends or family along the way.

Detox from alcohol is nothing to be embarrassed about, and asking for help is the first step toward a successful recovery. If you or someone you know is having problems with alcohol, seek a detox facility near you to help, and never attempt detoxing from alcohol at home without a real support system in place.

At APEX Recovery, we help you identify motivating factors for long-term change, develop necessary skills to maintain recovery and include your loved ones in your recovery.  We treat individual patients and their unique needs through a model that we recognize is not a “one size fits all”. Our admissions coordinators are available 24 hours a day to give you the support you need to make positive changes.  Call APEX today.


Is Alcoholism a Disease?

For decades, the accepted view on alcoholism and addiction was simple: addiction is a disease. This disease model of addiction shaped treatment, changed social outlook on addiction and became the acceptable excuse for all individuals suffering from addiction to alcohol. Even for those not struggling with alcoholism or addiction, it is difficult not to be aware of this flawed belief. Recently while watching television, I found myself looking at an actor posing to be a medical expert, wearing hospital scrubs and a stethoscope around his neck, telling me “Addiction is a disease!” But is there truth in this, and is alcoholism really a disease? To truly understand the most effective treatment for alcoholism, it is first important to understand why the disease model developed, and the negative impact of considering alcohol addiction an illness.

History of Disease Concept

The concept that alcoholism is a disease began with Dr. Benjamin Rush in the 1800’s to promote the prohibitionist political platform and was based on the idea that individuals that drank too much were diseased. This concept was continuously used through the early 1900s by those involved in the prohibitionist movement and the Temperance Movement, all based on a political agenda. This disease model belief of alcoholism as an illness gained additional popularity in the 1930’s with the rise of Alcoholics Anonymous and was supported by a study published by E.M. Jellinek. The evidence behind this study could be easily debated, however through understanding alcoholism as a disease, it helped change the common perception of the time that alcoholics were sinners, and instead removed the stigma. Shortly after Jellinek’s questionable findings, the American Medical Association identified alcoholism an illness, and then in 1955 officially identified alcoholism a disease.

To say that alcoholism is a disease only because of social and political reasons negates the evidence that does support the disease-like qualities of alcoholism. The National Center on Addiction and Substance Use states “addiction is a complex disease of the brain and body that involves compulsive use of one or more substances despite serious health and social consequences. Addiction disrupts regions of the brain that are responsible for reward, motivation, learning, judgment and memory. It damages various body systems as well as affects  families, relationships, schools, workplaces, and neighborhoods.” Alcohol over time and with chronic abuse changes brain chemistry, including pleasure centers, which causes functioning to change. Furthermore, an individual in the throes of long-term alcohol abuse, experiences physical alcohol withdrawal symptoms characterized by shaking, nausea, dizziness, sweating and risks of seizures when they stop heavy drinking without the care and support of medical personnel.  For these reasons alone, attempting to stop drinking suddenly and without support and attempting to detox from home can have long-standing medical implications. Just as not seeking treatment for a physical ailment can have potentially drastic health consequences.

The Global Concept of Disease

Further understanding the disease concept of alcoholism comes with understanding the global concept of disease. Disease by definition is an abnormal condition not caused by an external force that causes an identifiable group of signs or symptoms.  Using this definition, we can compare alcoholism to heart disease, lung cancer, diabetes and hypothyroidism, all which require treatment. It may be argued that heart disease or lung cancer may be a result of an individual’s choices, whether it includes an unhealthy and cholesterol ridden diet or smoking cigarettes daily, however, the diagnosis does not change. The ability of the heart to pump blood without restriction or the lungs to provide oxygen to the body shifts from the natural state, and is therefore considered a disease.

An individual born with Type I Diabetes or who develops hypothyroidism is not to blame for the physical disorder or the need for treatment and furthermore is not refused care because of choices that they made.  Similar to heart disease or lung cancer, the diabetic’s pancreas stops producing insulin and in the case of hypothyroidism, the thyroid slows down with less production of hormones. In the case of alcoholism, changes in the brain’s chemistry occur as well as damage to the heart, liver and pancreas. Additionally, without treatment, the only remedy for the physical withdrawal signs experienced by the alcoholic, is to consume more alcohol.

Just as some individuals are more prone to heart disease, diabetes or certain types of cancer, the disease model argues that some individuals are more prone to develop alcoholism. Years of research on alcoholism has explored this concept to help answer the question is alcoholism really a disease. It is fair to say that not every individual that drinks a beer, indulges in a cocktail or enjoys a glass of wine with dinner develops alcoholism. Studies have attempted to link genetic and biological markers to alcoholism to help explain the difference between the individual that is able to engage in moderate drinking behavior, and the individual that develops alcoholism. Despite these studies, there has not been evidence to support the presence of genetic predisposition, but rather significant support of the biological, social and environmental development model. In this development model, it is clear that when raised in a chaotic home, when exposed to alcohol and drug use at an early age, and when not taught the necessary emotional regulation skills, the likelihood of developing a substance abuse disorder increases.

Using this information and understanding the similarities between other physical illness and disease, it makes sense why alcoholism is a disease. The problem with considering alcoholism an illness comes from the concept associated with chronic disease, as chronic disease is considered a long-lasting condition that can be controlled but not cured.  But if alcoholism is not a disease, then what is it? Gene Heyman, a psychologist at Harvard University, takes a different approach in his book Addiction: A Disorder of Choice.  Heyman presents research that 80 percent of individuals with an addiction overcome the addiction by age 30 and can do so because of the demands of their adult life. If keeping a job, paying bills or being a parent can be a significant incentive for stopping use, then this directly contradicts the idea that addiction cannot be cured. With this, begins the argument that alcoholism is not a disease.


Before the disease model is entirely debunked, it is noted that labeling alcoholism as a disease has some benefits. It helps conceptualize alcoholism as a major problem requiring treatment and therapy and helps make treatment more accessible as it is thought of as a disease and not a deviant behavior. When conceptualizing alcoholism as a disease, it helps provide hope for treatment and implies that similarly to other diseases, relapse may occur and should not be a source of shame The problem is not in labeling alcoholism an illness, but rather in understanding the treatment for alcoholism, which begins with moving away from the disease model. And as we move away from the disease model, we also move away from the term “alcoholism” and “alcoholic” and move towards the terms “alcohol use-disorder” and “person”.

Traditional treatment for alcoholism and addiction based on the disease model was the 12-step model of Alcoholics Anonymous. AA and the subsequent 12-step groups are based on the concept of powerlessness, with step one stating “We admitted were powerless over alcohol” and subsequent steps referring to “defects of character” and personal “shortcomings”. Additionally, AA preaches that the alcoholic can only live “one day at a time”, that the alcoholic can never be cured and that if an alcoholic does not attend meetings, that they will certainly relapse. The problem with treatment for an issue when there is belief of lack of personal power and ability, is that a self-fulfilling prophecy occurs. With the belief in lack of power and choice, the individual absolutely does relapse and begins to act in which they do not have the ability to control themselves. It is in this that the alcohol use becomes chronic and “incurable”. This model simply does not work in helping people to move towards recovery and living a fuller and more stable life.

So if alcoholism is not a disease, and substance use disorders are in fact a choice, and the 12-steps do not support long-term recovery, the question of how to treat the disorder presents itself. In the late 1970s, a model commonly known as the Stages of Change Model was introduced, which then influenced the development of a technique called Motivational Interviewing. This model was based on the idea that every person has different and unique motivation for quitting a behavior and that they move through a series of stages that begins with not recognizing that a behavior is problematic and ending with sustaining positive behavior change.  

To understand this, think of a young adult female that smokes cigarettes. In the beginning stages of change, she does not believe it will negatively impact her health and does not seem to be swayed by rising levels of tobacco tax and the cost associated with smoking. Despite friends telling her the smoke makes her smell, she continues to puff away. This same woman marries and gets pregnant, in finding out that she is with child, she throws away her cigarettes and never smokes again. This same concept can be applied to alcohol use, with the idea that with the right motivation and sufficient reason for change, and individual can move from not recognizing the need to stop drinking, or denying that there is a problem, to wanting to treatment, making changes, and eventually achieving long-lasting sobriety.

In this non-traditional model of recovery, not only is recognizing the need for change and identifying reasons for wanting to change important, but the idea of self-efficacy is necessary. If I believe that I can make a change and be successful, I become more likely to be able to handle challenges and make continued choices that support that change. Self-efficacy is the exact opposite of AA’s notion of “powerlessness” and the need to rely solely on meeting attendance. If an individual adopts the belief that alcohol use disorder is a choice, and that they have the power to choose another option, they are able to use coping skills and will able to maintain their forward progress, despite challenges to their sobriety. Just as the disease model normalizes the concept of relapse, this model recognizes that challenges will arise, however with the belief in personal power and choice, a person is more likely to choose behaviors that support health and well-being.

Importance of Support System

The last and most important missing piece in the disease model of alcoholism, is the inclusion of family, friends and a support system in treatment. From a systemic approach of the treatment substance use, helping the individual to navigate relationship challenges and develop personal meaning in their lives is imperative. In his Ted Talk “Everything You Think You Know About Addiction Is Wrong”, Johann Hari addresses the concept of creating loving and supportive relationships. He highlights Portugal and their decriminalization of drugs that began in the year 2000, specifically with Portugal’s policy towards rehabilitation. In a country with one of the highest rates of addiction, Hari shares that through redistributing money spent on incarceration to rehabilitation, addiction rates drastically decreased. Most importantly, Portugal helped addicts find meaning in their daily lives, as addicts were assisted in identifying vocational goals and engaging in work in which they were able to find meaning.

Similarly, the founder of empirically-supported Emotionally Focused Therapy, Dr. Susan Johnson discusses the importance of attachment and connects the importance of finding meaning to connecting with people.  We as human beings have an innate need to securely attach to others, and she argues that the individual in the midst of addiction has turned to their drug of choice, rather than to others, to find the security that comes with connection. Dr. Johnson teaches that when individuals learn to turn safely to their loved ones, their relationships replace the need for addictive substances and become an antidote to addiction. Through this research, the need for treatment providers, friends and family, and even the substance user themselves to learn to implement compassion is clear. Threats of disengagement and detachment are not working, and instead replacing those threats with tools to assist with engagement and secure and positive attachment may be more effective.

With a fuller understanding of the disease model of alcoholism, similarities between alcoholism and physical diseases is clear, however this model is not the be all end all to understanding alcohol use disorder.  It is only through identifying alcoholism as a choice, that a new recovery model can be implemented and truly be effective. To impact long-lasting and positive change, a person abusing alcohol must first recognize their choice and power, develop the skills to combat challenges, and create relationships that support their recovery.  

At APEX Recovery, we help you identify motivating factors for long-term change, develop necessary skills to maintain recovery and include your loved ones in your recovery. We treat individual patients and their unique needs through a model that we recognize is not a “one size fits all”. Our admissions coordinators are available 24 hours a day to give you the support you need to make positive changes. Call APEX today.


Staying Sober in Legal Marijuana Cities

A number of states recently made the decision to legalize marijuana for recreational use. Today, it is legal to use and possess a small amount of the substance in California, Colorado, Vermont, Nevada, and other states. With legality comes a means for distributing cannabis. “Pot shops” have opened, making it easy for people to acquire marijuana and edible versions of THC in several cities.

While much time is spent on the recreational and medicinal benefits of marijuana, little time is invested in discussing the impact that legal marijuana has on those who may be recovering from addictions. Major metropolitan cities are home to people of all backgrounds, including those who are attempting to put problems with substance use behind them. The legal availability of marijuana in several cities and states can make life complicated for someone who wishes to stay as far away from drugs as possible, including those that are legal.

Remaining Clean in Cities Where Pot Is Legal

Anyone who has completed drug and alcohol rehabilitation knows that the path to recovery isn’t an easy one. Temptations exist at every place alcohol or even over-the-counter drugs are sold. Having easy and legal access to marijuana can make things even more complicated. Those struggling with sobriety need to follow wise advice on how to remain sober when so many sounds and images promote the use of marijuana.

The Dangers of a Relapse

Anyone who is struggling with addiction must keep one very important thing in mind: The use of any mind-altering substance—be it alcohol or any type of drug—creates the potential for a relapse. This includes both legal and illegal substances. Whether marijuana is legal or not in a particular jurisdiction isn’t the point. What does matter is avoiding the use of any drugs or alcohol in order to avoid a full-blown relapse and a return to using harder drugs.

Many people may need to enter rehab or a sober living facility more than once before becoming completely free of addiction. Frequent relapses bring with them many risks and health hazards. The unfortunate reality is that all the problems associated with addiction return during a relapse. Staying away from legal substances with addictive potential reduces the chances of falling into old habits. Unfortunately, when marijuana becomes legal, several related problems arise for those recovering from an addiction.

There is also something else to contend with: all the sources heralding the benefits of marijuana. These benefits won’t likely extend to someone in recovery.

The Hype Over Cannabis

Media hype over the legalization of marijuana does not help those wishing to remain sober. Unavoidably, though, news about the legalization of marijuana often comes with a great deal of media attention. Depending on the source of the reporting, the media coverage is often positive. The reports repeat sentiments by many in society who feel marijuana isn’t a dangerous drug.

Others celebrate the legality of marijuana as a win for civil liberties. Such reports make the use of marijuana not seem like a big deal. The decriminalization of cannabis certainly pushes forward the notion that it is harmless.

Messages of this nature won’t be a help to someone who wishes to be free of addiction. Positive messages about marijuana are no different than positive messages about beer and other types of alcohol. The affirmations can make it difficult for someone to remain clean because they hype everything but the possible harm and drawbacks of using the substance.

With these thoughts in mind, it becomes necessary to take concrete steps to avoid a relapse. While doing so may not be easy for someone in recovery, the steps do need to be taken.

A Clear Understanding

The key thing for those in recovery and persons close to them is not to fall into the trap of assuming legal marijuana somehow becomes safe to use. No drug rehabilitation counselor or other professional would suggest that using marijuana would be harmless for those recovering from a substance use disorder.

The presence of dispensaries in a neighborhood could dull the senses and accompanying attitudes necessary to assume the worst about the common gateway drug. The smell of marijuana smoke could create further problems for a person hoping to avoid drugs and alcohol. Walking past a bar can bring forth certain problems, but the smell of alcohol won’t exactly linger in the street. Marijuana smoke coming from a window, however, can hang thick in the air.

Inhaling secondhand marijuana smoke certainly doesn’t make it easy to curtail temptations. Unfortunately, the presence of places selling marijuana and the public use of the substance won’t keep down the urge to use, either. Therefore, a diligent and aggressive attitude becomes necessary to avoid falling into the trap of not taking the dangers of marijuana use seriously while in recovery.

No Small Amounts or Minor Usage

The use of marijuana has been referred to metaphorically as a “light switch.” That means that once the recovering addict starts to use marijuana, the “light switch” of addiction is turned on. Just as the flow of electricity travels to a lightbulb, impulses would be released in the person in recovery.

Marijuana may reopen gateways to addiction. Unlike a light switch, the power flow cannot simply be shut off. A full-blown relapse may occur. Even smoking marijuana just one time creates the potential for a relapse. As such, staying completely away from using marijuana under any circumstances is likely the best option.

Basic Points About Avoiding a Relapse

Common sense and simple advice may be quite helpful to someone who doesn’t want to fall into the drug dependency cycle once again. Such suggestions are not meant to oversimplify the complexities associated with remaining sober. However, the points do note that certain behavior patterns and lifestyle choices could reopen doors to addiction and all its troubles. Here are a few tips for staying sober in a city where pot is legal:

1. Stay Away From Places Where Marijuana Use Is Prevalent

Rules still exist even in states where legal marijuana laws have been passed. The use of marijuana in public places remains banned. Zoning laws in particular cities or counties may bar the sale of marijuana or ban dispensaries from operating. When choosing to live in a particular state, extra care must be taken to avoid those locations that have a high tendency for marijuana use and sale.

In some ways, this approach might come with more than a few inconveniences. Choosing to rent an apartment farther away from a place of employment may be required. Otherwise, the potential exists to be much closer to the dispensaries as opposed to staying a comfortable distance away from them.

Inconvenience won’t be as serious a problem as a relapse, however. Those in recovery know they must invest significant time and effort into staying sober. Therefore, accepting certain inconveniences may be required to achieve a worthwhile goal. Staying sober definitely falls under the heading of a worthwhile pursuit.

2. Do Not Associate With Marijuana Users

Visiting locations in which marijuana is sold definitely places someone near the specter of temptation. Unfortunately, there are ignorant people who do not realize the complexities those in recovery face. Because they do not see marijuana as a “real” drug or a substance that comes with dependency potential, they may be very inconsiderate to someone who is working to remain drug-free. This churlish behavior is more than rude. It could even be considered dangerous because it places another person at risk of relapsing.

Unfortunately, controlling the behavior of another person isn’t always possible. In fact, depending on the person, it may never be possible. However, someone could very well exude a certain level of control over himself or herself. The responsibility then falls on those wishing to avoid a relapse to cease associating with people who indulge in alcohol, marijuana, and other drugs.

3. Remain in Contact With Therapists

Continuing with therapy would be a wise move on the part of anyone concerned about how to remain free of the disease of addiction. As many point out, staying sober requires a lifelong commitment to the cause. Doing so on your own is not always easy.

In a state where marijuana is legal, the difficulty level increases even more. When cannabis is heavily promoted as a harmless substance, lax attitudes toward marijuana use persist, which complicates things for someone wishing to stay clean. So, why carry all the weight of staying clean on your own shoulders? Seeking help from an experienced drug and alcohol counselor may assist with remaining on the sober path.

4. Stay Close to Supportive Friends

Professionals are not the only ones who could prove enormously helpful to an individual in recovery. Leaning on the support of friends could prove beneficial when struggling with the temptations associated with prevalent marijuana use in a particular region.

The friends and acquaintances who understand the delicate situation in which you find yourself could be the most supportive. People who likewise struggle in a legal marijuana state know this is not an easy scenario to navigate. They also understand the great difficulties associated with battling the public’s somewhat lax sentiments toward marijuana, so they can often offer advice and guidance.

5. Make Wise Comparisons to Bars

Bars and other establishments that serve alcohol are found virtually everywhere in the United States. During rehabilitation treatment, recovery involves helping people make clear determinations to stay away from such places. One treatment method promoted by a rehab facility entailed taking a “field trip” to a restaurant where alcohol was served in order to help patients learn to avoid the temptations to drink while around alcohol.

Obviously, this approach doesn’t come into play until the patient is far along into the program. Visits to bars and other places serving alcohol cannot be done with a flippant attitude. The participants did not visit the bar on their own and without necessary and qualified supervision.

Still, the example of the trip may be considered a source of inspiration. In essence, the example proves it is possible to remain in the vicinity of legal substances and still overcome the urge to indulge. Granted, extensive therapy and treatment might be required to achieve such results. The fact that these results are achievable, however, should create a sense of hope.

6. Seriously Consider Relocating Elsewhere

On the surface, this might seem like an extreme response to dealing with the legality of marijuana in a particular state. After considering the harm that relapsing brings forth, however, a decision to make a move to a new state might not truly be deemed that extreme. Anything that supports sober living and remaining free from drugs or alcohol could prolong and preserve someone’s life.

Overcoming addiction involves major life decisions. Great difficulties may exist when planning out a relocation, but the ultimate goal of staying healthy should mitigate any concerns about moving. Living in a particular region isn’t worth dealing with certain struggles that can be avoided.

Professional Assistance Is Available

No easy answers exist for anyone who deals with an addiction. Our professional drug and alcohol counselors and medical experts are capable of helping people who are finding it difficult to address their substance use issues. Living in cities in which marijuana use is both legal and common further adds to the difficulties. Anyone who finds the struggles overwhelming may be best served by turning to Apex Recovery Rehab’s professional drug and alcohol rehabilitation service for assistance.


Relapse Prevention: Coping Skills & Warning Signs

Preparing to leave an inpatient treatment program can seem intimidating, especially if you have undergone intensive treatment for many months. It is normal to worry about relapse. No one wants to reach the point of deciding to get free from addiction only to begin having thoughts of failure once the immediate treatment team is left behind. Teaching relapse prevention coping skills are one of the essential parts of a complete treatment plan. Learning how to avoid relapse by recognizing warning signs and utilizing all available coping skills will help keep you on the road to a total clean and sober recovery.

What Is a Relapse?

One definition of relapse is “to fall or slip back into a former state, practice, etc.” Beyond dictionary definitions, relapse can send someone during recovery spiraling back into their substance abuse disorders if not handled quickly. The goal is to never fall into relapse, but that is not the reality when entering the recovery process.

As with any disease, there is an ever-present danger of relapse. Rather than facing this in fear, it should be used as a push to stay vigilant and watchful for early warning signs. It is possible to maneuver through this challenging landscape and avoid scenarios that lead you toward a slip if you’re armed with preventative measures and adequate coping skills with a solid relapse prevention plan. You can adjust and learn how to prevent relapse and stay on track toward complete recovery.

How to Avoid Relapse Using Prevention Techniques: The Essence of Recovery

Understanding how pervasive the disease of addiction is in the lives of addicts is critical before entering the recovery highway. Drugs or alcohol have been the driving force in the lives of addicted individuals for the duration of the illness. Every waking thought has been about using, obtaining, and having the funds to get the desired drugs or alcohol. Relapse can happen for more reasons than a robust physical craving. The entire lifestyle built around the addiction consumes the energy of the addicted person which creates self-defeating behavior.

A complete change in mental health occurs is when a full recovery takes hold and sticks. Even under optimal circumstances, the statistics show there is still a real risk of relapse. The Journal of the American Medical Association shows the numbers of relapse requiring additional medical assistance with several diseases. Asthma and high blood pressure show a 50 to 70 percent relapse rate, diabetes type 1 shows 30 to 50 percent, and drug addiction comes in at 40 to 60 percent.

Stages, Warning Signs, and Triggers of Relapse

Rarely do individuals travel the distance from normal recovery mode to drug and alcohol use overnight. It is a journey that can begin at any time after treatment and unfolds in stages. The more acute self-awareness is, the easier it is to spot potential problems. Below are three universally accepted stages that indicate levels of relapse.

Emotional Relapse

The stage of emotional relapse is not one of actively using or even considering use. In fact, denial is usually strong at this point, and it is a period of emotional setup.

Emotional relapse is marked by:

  • Isolation
  • Negative views of others
  • Sporadic meeting attendance or missing them altogether
  • Not staying involved while in meetings
  • Being emotionally reclusive
  • Reduced personal hygiene care and sleep difficulties

Mental Health

The mental health stage of the relapse process involves an increasing lack of resistance to full relapse. It can vary from basic cravings to the planning stages of drug or alcohol use. There are more times of people placing themselves in harm’s way, looking for an opportunity to use. Without recognizing these warnings, it is merely a matter of time before a complete relapse occurs. A few early warning signs of relapse include:

  • Increasing focus and strength of cravings for drugs or alcohol
  • Viewing past drug and alcohol use in any positive, glamorized light
  • Thinking about the ability to manage drug or alcohol use
  • Thinking of or making contact with those associated with past use
  • Placing yourself in dangerous positions and circumstances that can lead to use
  • Bargaining
  • Lying about activities and feelings
  • Complete planning of relapse or expressing inevitability


A complete physical relapse is when drug or alcohol use begins and becomes an uncontrolled activity after a period of recovery. A small lapse or one-time use can be turned around in some cases, but it is imperative to recognize the warning signs of mental relapse before it goes too far.

<2>Triggers of Relapse

The actual trigger for an addict to use again varies, but stress and opportunity are the prime culprits. The need to stop, slow down, and see what is going on is a vital part of remaining faithful to proper self-care. The use of coping skills is the best defense in relapse prevention.

Relapse Prevention Coping Skills

Observing and taking the warning signs seriously is the first step in how to avoid a relapse. You need to incorporate as many coping skills as possible that work for you and the stage of relapse you find yourself facing. Below are a few helpful coping skills that can reduce the danger level and keep you from falling into complete relapse.

Stress Control & Relapse Prevention Plan

Thoughts of self-medicating begin to take on a realistic value if stress levels are allowed to rise unchecked. Those who suffer anxiety issues will struggle with stress the most. Learn to recognize the overtaxing of your system in crisis situations, such as the death of a loved one or a job loss. Avoid self-defeating behavior and learn to deal with stress in a healthy way during the early warning signs of a possible relapse so you can experience clean and sober living.

You can help reduce stress naturally by:

  • Exercising or doing a physical activity that is enjoyable
  • Watching a positive movie
  • Getting involved in volunteer work
  • Contacting a loved one or sobriety peer member
  • Avoiding negative thinking

Avoiding high-risk contacts and behaviors is also crucial. It’s important to:

  • Avoid people from the past you used to get high or drunk with
  • Stay away from locations at which you used drugs or alcohol
  • Avoid parties and gatherings with drug and alcohol use
  • Never feel you are strong enough to abstain from drugs and alcohol
  • Keep in mind that using drugs or alcohol one time is not harmless and can cause complete relapse

You’ll also want to avoid isolation. To this end, you should:

  • Maintain steady interactions with people for relapse prevention
  • Stick with your therapy and support group meetings
  • Never try and manage a crisis alone
  • Reach out and ask for help if you feel overwhelmed

Maintaining open communication is also important. Make sure to:

  • Actively participate in meetings and therapy sessions
  • Always use open and honest communication
  • Let loved ones and professionals know when you are struggling
  • Maintain a positive journal that emphasizes your progress
  • Celebrate your victories with a special lunch, dinner, or personal item purchase

    Relapse Prevention Strategies

When managing cravings:

  • Know that they are a regular part of recovery and that they will pass
  • Find distractions such as reading a book or taking a walk
  • Maintain a healthy diet and exercise regularly
  • List the negatives of drug or alcohol addiction and why you will not go there again
  • Call trusted, nonjudgmental individuals you can discuss your cravings with

When Things Get Messy

If you or a loved one slips up and ends up using drugs or alcohol again, it is not the end of the universe. Relapse is actually a common occurrence in the recovery process. If it is your loved one who has relapsed, wait for them to be in a moment of sobriety before approaching them about entering treatment again. If you are the one experiencing relapse, know that it is a matter of undergoing more treatment and devising a more effective treatment plan.

Is Treatment Necessary for Every Relapse?

Not every case of lapse or relapse requires undergoing intensive treatment again. The real priority is honesty about the situation. Falling and taking one drink or using drugs one time does not necessarily mean a complete relapse will be the ultimate outcome. The duration and severity of the relapse are the determining factors.

Your counselor will need to look at:

  • What led up to the lapse or relapse
  • The effectiveness of your coping skills and relapse prevention strategies
  • Getting you an improved support system
  • The length of the relapse and your possible need for detox

Any incidences of lapse or relapse offer opportunities to change what does not work and increase the things that are working. It can seem disappointing, but recovery can still proceed at a steady pace. The more critical factor to consider is the safety of you or your loved one if the relapse has progressed to the point of dangerous levels of drugs or alcohol in the system.

The Perfect Treatment Plan

The perfect treatment plan is one that is malleable and changes to fit the needs of the addict. Treatment plans are never the same for two individuals. The types of drugs and alcohol used, amounts, length of time, stress management abilities, predisposition to addiction, duration of treatment, and plan continuity by client all play a massive role in treatment plan success.

A few of the necessary pieces of an ideal treatment plan are that it:

  • Is adjustable to fit the client needs at each stage of treatment and recovery
  • Addresses, identifies, and includes all support team members
  • Provides an assortment of planned coping skills
  • Identifies personal triggers that bring awareness for avoidance
  • Includes a fail-safe plan for possible lapse and relapse
  • Contains regular maintenance of the plan for changing needs

Critical Effectiveness of a Supportive Environment

Recovering from drug or alcohol addiction is one of the most challenging battles an individual will ever wage. It is one of the most important when it comes to health and well-being. The more supportive the environment, self-help groups and programs are, the better the results are for anyone attempting to break free from the grip of serious addiction. A few of the critical benefits of supportive teams, families, and sobriety peers are:

  • Increased and honest communication
  • A feeling of the client getting trustworthy advice
  • Supportive people who will warn when they see danger signs the recovering addict misses
  • Shared celebrations at all achievements
  • Support that lacks judgmental attitudes and social stigma
  • Ways to replenish strength when the recovering addict feels weak

Starting Over: You Can Still Win After a Complete Relapse

Although it may sound counterintuitive, relapse can often be a large part of the complete recovery process. Starting over after a serious relapse is done with gained knowledge about your weaknesses and strengths. It is a time to appreciate your humanity and realize that well-known celebrities have had to undergo additional treatment for relapse. No one is ever immune to moments of weakness.

We deal with substance abuse disorders by understanding underlying issues and co-occurring disorders so we can treat you with cognitive-behavioral therapy for a life of staying clean and sober. Seeing the relapse process battle through is done by living life to the fullest each day and enjoying the moments of sobriety. Falling can happen, but the real winners are the individuals who can stand back up and shake off the dust with a smile. Through relapse prevention therapy, you will learn how to live a healthy and sober life begins with deciding never to give up.


LAPD Addiction Prevention Unit

Rather than deal with a problem, it is best for the problem never to arise in the first place. Few would argue with this simple and often-repeated sentiment, and few would suggest all problems are easy to prevent. The epidemic of drug addiction, particularly opioid addiction, has been ravaging the United States for the better part of several years. No easy solutions exist to lead people to avoid using prescription or street drugs. However, steps can be made to prevent people from becoming involved with drugs. Educational programs and support groups may help with this noble cause.

The Los Angeles Police Department (LAPD) has devised a strategic plan intended to cut down on drug abuse in the City of Angels. It is to be hoped that the work done by the LAPD Addiction Prevention Unit can prove inspiring to other law enforcement agencies across the nation. Even a small amount of help toward assisting those dealing with drug or alcohol issues might save lives.

Who does this LAPD prevention program actually seek to benefit? The answer may prove surprising.


The common assumption is that the LAPD has set up a program to help the public with substance abuse prevention. Police do involve themselves in many community outreach programs. These outreach programs do frequently focus on drug education and prevention.

With this unique addition prevention program, things are a bit different. The LAPD Addiction Prevention Unit works at helping police officers avoid falling victim to alcohol and drug problems. Rather than seeking to terminate someone with substance dependence problems, the LAPD tries to help. Let’s hope the LAPD’s approach proves inspiring to other police departments as well.

The Unfortunate Stress of the Often-Thankless Job

Police work has long been referred to as a thankless job. In truth, millions of people thank the police for what they do. Others, sadly, do not realize just how difficult working as a police officer can be.

What many people fail to comprehend is the stress level associated with performing the work of a law enforcement officer. Many also do not understand just how consistently the exposure to stress truly is for a cop. Quiet nights become few and far between for many police officers. A police officer may even be required to respond to more than one major crisis per night. That takes a mental toll on the person exposed to such incidents, incidents that could end up being violent ones.

As career police officers and detectives note, the life experiences of law enforcement personnel involve seeing human misery to a level few others come into contact with. Crime and accident scenes can leave even a veteran of the police force shaken to the core. Certain images become difficult to dismiss and may lead to post-traumatic stress disorder, or PTSD.

Excess stress and the psychological anguish that comes with it might possibly lead to substance abuse problems. Since police personnel may be exposed to tremendously high levels of stress, they become at risk for substance abuse problems. While the public may not accept the possibility of law enforcement agents succumbing to addictions, the problem does manifest among an unfortunate number of police officers.

Police Officers Do Face Addiction Problems

A significant amount of study has gone into the impact of drug and alcohol use by law enforcement professionals. The reports associated with the studies have come back with shocking results. Per The American Journal on Addictions, 18% of male offices and 16% of female officers have suffered serious consequences from using alcohol. That comes out to a truly staggering number of police officers when you take into consideration just how many thousands work in the Los Angeles precincts alone.

Once again, stress and anxiety often lurk as the cause of these addictions.

Stress and Substance Abuse

The correlation between stress and substance abuse has long since been established by the addiction therapy profession. People under stress might reach for something seemingly capable of altering their less-than-desirable state of mind. As one of the members who runs the LAPD Addiction Prevention Unit noted, officers under a high level of stress may turn to alcohol and drugs as a form of self-medication. Those who suffer from high anxiety are often prescribed anti-anxiety medication in order to calm their nerves. While not everyone may be a believer in prescription psychiatric drug treatment, the medical profession has long established prescription therapy as a viable way to treat stress.

With legitimate prescription therapy, a proper diagnosis of a condition occurs and is followed by a written prescription for an appropriate drug in the appropriate daily amount. The patient is monitored and may also undergo special counseling to determine the root cause of the problem.

Choosing to self-medicate is hardly the same thing. Opting to drink alcohol in excess or turn to prescription painkillers illegally acquired would not fall under the category of legitimate therapy. Yet, this is what many do to address stress and PTSD. The mind-altering and mood-changing effects of alcohol and drugs become an unreliable means of addressing their current mental state.

Self-medicating becomes unreliable because there is no therapeutic benefit that comes from drug or alcohol abuse. The problem likely will get worse. The development of a full-blown addiction brings with it more psychological and physical problems. In short, as difficult as the problem of stress appears, the problem now runs the risk of becoming worse many times over. The stress and the root of stress now become compounded by the inclusion of a substance abuse issue.

A person who succumbs to the use of drugs and alcohol for self-medication rarely admits to a problem because he or she sees the rightness of the action. In other words, the person sees his or her behavior as the correct way to address stress. Alcohol calms nerves and helps a person forget about a stressful situation. Since it works, why let a judgmental person tell him or her what is wrong with the behavior?

Of course, substance abuse clouds judgment and behavior. Someone who chooses to self-medicate starts with a habit, and the habit expands into a full-blown addiction. This doesn’t occur overnight, but it will occur in time if the proper treatment isn’t undertaken.

Traumatic Events and the Use of Drugs and Alcohol

Substance abuse may occur as a means of dealing with traumatic events. The blanket of abuse covers up the memories and flashbacks associated with the trauma. Police officers see many horrible things over the course of their careers. Haunting images that stick with them might not go away quickly, if at all. So, alcohol and controlled substances become the means to hide the lingering sounds and images.

Unfortunately, a trigger effect may occur here. Anything that reminds the afflicted person of the traumatic event could trigger a desire to drink or use drugs. Since the underlying problem is never actually treated, the triggers always remain. Therefore, the problem with drugs and alcohol does not disappear.

Stress triggers refer to those incidents, events, and images that may lead to the onset of anxiety, depression, or other psychological and emotional responses. A person who undergoes a triggering event may not even be aware of the connection that exists between the trigger and the mental or sensory response. Consider this another issue associated with the lack of therapy and counseling required to deal with stress.

A police officer who suffers from trauma related to injuries inflicted upon children may, for example, suffer from triggers every time he or she passes by a schoolhouse. Since these triggers lead to a stress response, the way to deal with the feelings involves the choice of taking a drink. The triggers continue to fuel alcohol and other substance abuses. The cycle continues and won’t end without some sort of counseling. In the Los Angeles law enforcement world, steps have been taken to try and assist those in need.

Police Work and Painkillers

Stress isn’t the only cause of addictions among those involved with law enforcement. Police work can be quite physical. SWAT team members, in particular, may be required to perform physical duties that can affect the body in many ways. Of course, others who work on normal calls run the risk of suffering from physical injuries.

Sadly, problems with opioids and prescription painkiller abuse usually start when people suffer injuries and rely on the prescriptions to address chronic and daily pain. What might start with a legitimate prescription issued by a doctor may lead to increased habitual use and then to a major addiction. Prescriptions such as Oxycontin and Vicodin come with a significant potential for abuse. Those who commence use for legitimate reasons may never become free of the physical and mental hold the drugs eventually impose on them.

Such addictions affect people from all walks of life; this includes those who work in law enforcement as the LAPD has clearly acknowledged. The presence of the expanded peer groups shows the department does take the problem seriously. Most importantly, they are trying to help those who are suffering from addictions.

Dealing With the Issue in Los Angeles

The LAPD approach to helping fellow officers deal with alcohol and substance abuse problems commenced in the 1970s. Originally, the program started as a peer counseling group intended to assist those officers who were struggling with addiction. Over time, the peer counseling group would evolve into the official Addiction Prevention Unit of the Los Angeles Police Department. The members who run the program are not only sworn employees of the department; they also possess specialized training and education in addiction and recovery. An example of the training received is visible in a California Alcohol and Drug Counselor (CADC) certification held by one officer. This certainly contributes to their ability to help those fellow officers in need.

Of course, police officers dealing with an addiction may be leery about working with a peer group.

Concerns did and do exist about privacy matters related to counseling. Clearly, the addiction prevention sessions are not published or released as public information. Cops who venture into these sessions can feel confident that they won’t be stigmatized among other members of the police force. If this were the case, no one would continue the sessions, and the entire prevention program would shut down. If those participating were disappointed with the results of attending, the program’s reputation would suffer, leading to the end result being a major decrease in participation.

Seeking Help for Addiction Issues

While the assistance of the addiction prevention system surely would be appreciated by anyone dealing with substance abuse issues, nothing can supplant complete treatment at a drug rehabilitation facility. Whether the care is inpatient or outpatient, the person undergoing the care would be examined and treated by professionals with the experience and background necessary to safely help someone address addiction. Call us today to see how we can help you or your loved one overcome their addiction.