Wednesday, August 15, 2018

Local media addresses the growing meth crisis

While much of the country has been focused on putting a stop to the opioid crisis, many people with addiction problems have turned to methamphetamine. Cottonwood’s clinical director Kathleen Parrish recently spoke with News4 about the dangers of the meth and the long-term damage it has on users. 

To learn more about the addiction treatment programs at Cottonwood, click here or call us at 888-727-0441.

Monday, August 13, 2018

Returning to Work After Rehab

Returning to work after treatment
There are many "firsts" to look forward to when you complete an inpatient or extensive outpatient rehabilitation program. For a lot of people, the opportunity to return to work is a big accomplishment.

As you approach this sobriety milestone, it may be necessary to create a detailed plan of action regarding a number of factors, including:

  • Knowing your employment rights and employer expectations
  • Establishing clear boundaries
  • Recognizing and handling work-related triggers
  • Pacing your workload to minimize stress
  • Creating a network of support both in the workplace and outside of it
Regardless of the type of position you once held, you'll now be approaching it from a completely different perspective. Use what you've learned in treatment to make the process easier.

Know Your Rights

The U.S. Department of Labor (DOL) is quite clear about employer obligations for employees completing substance abuse treatment and returning to your job. For example, the Americans with Disabilities Act (ADA) considers drug abuse and alcoholism disabilities. This means you're protected from discrimination by law due to treatment and past use—but not current use.

Your employer must allow you time off for necessary functions required by your healthcare provider or treatment facility continuing care plan. These may include doctor's visits, therapy, support meetings, and other vital components of your recovery.

Federal and state laws also outline that you're under no obligation to tell anyone in the workplace—including your direct management—why you were gone. Your company's human resources (HR) representative is your liaison to effectively going back to work.

This is all what your employer should do for you. In return, you're required to uphold employment standards. Make sure to talk with the HR representative so you have a clear understanding of the following expectations.

  • Your employer has the right to administer random and/or scheduled drug tests; prohibit alcohol or drugs in the workplace or at work functions; and require the same conduct and job performance of someone in recovery as all other employees.
  • In addition, the DOL indicates your employer can “discipline, discharge, or deny employment to an individual with alcoholism whose use of the substance adversely affects job performance or conduct to the extent he or she is not qualified.”

Finally, the DOL advises companies and returning employees to develop a right-to-work agreement. This is beneficial for all parties involved, as it once again provides clear expectations. In order to return to work, you must be cleared by a healthcare professional. Then, he or she may partner with you and your company's HR representative to establish guidelines for your return, workplace and job duty requirements, and other factors.

This helpful article from Workforce describes the process in more detail, and here's a sample of a right-to-work agreement.

Establish Clear Boundaries

As stated previously, you don't have to explain your stay in rehab to anyone in the workplace—unless you want to. It's a professional environment, and your private life doesn't need to be a part of it.

In order to establish clear boundaries regarding your recovery, you may find it necessary to determine what's most important:

The choice is yours. Work with your recovery team to determine the best course of action.

Deal with Triggers

Work can trigger a number of negative reactions in people, regardless of whether they have substance abuse disorder. But for individuals in recovery, staying mindful of what prompts compulsivity is crucial to continued good health.

Ask yourself:

  • Does this work support my sobriety?
  • Are there people or situations that contribute to my anxiety, depression, or negative feelings of self-worth?
  • Do the behaviors of individuals in the workplace present too many challenges to my recovery?

Remember: while you may need employment, you need to also be secure in your journey to long-lasting wellness. Make a point to frequently touch base with your support network and continuing care counselor if you feel threatened in any way.

Use Stress-Relieving Techniques

When you first return to the workplace, it may be helpful to ease into the full routine gradually. Maybe start part time initially, plan for a four-day workweek, or participate in a job-share program. These alternative schedule options can be part of your right-to-work negotiations.

As you become more accustomed to the daily rigors of the job, you'll need to rely on stress-relieving techniques that bolster your energy, health, and outlook just like everyone else. This is a valid concern, as the American Psychological Association reports that chronic work stress affects approximately 65 percent of people in the United States.

For some people in recovery, triggers and stressors may be the same. But more often than not, work stress likely develops because of:

  • Heavy workloads
  • Lack of opportunity for promotion or growth
  • Low pay
  • Boredom
  • No control over direction or purpose of tasks
  • Inadequate recognition or acknowledgment of effort
  • Conflicts in the workplace

Just as you learned to identify key substance abuse triggers, recognize what may add to your stress level and manage your response with a healthy balance of:

  • Proper diet and exercise
  • Time to relax and recharge
  • Firm work boundaries, such as not being available 24/7
  • Clear communication regarding goals, objectives, and expectations

Use Your Support Network

Returning to work is an important first step to shaping your new life. You don't have to do it alone. Whether it's regular therapy, a sobriety support group, or a strong collective of friends, family, and coworkers, anchor yourself in reassurance, guidance, and reassurance.

Cottonwood Tucson also helps all patients develop a relapse prevention plan that provides a stabilizing force. Here's what may help you.

By Tracey L. Kelley

Wednesday, August 8, 2018

Keeping a Meditation Journal

Meditation journaling
A meditation practice can help you manage a number of aspects in life. Whether you need a moment of calm in an otherwise busy day or have a deeper intention for cultivating stillness, meditating provides a safe space.

When someone "practices" meditation, he or she is continually learning. It's a never-ending journey, with many pivotal points along the way. This is why keeping a meditation journal can be a powerful tool for understanding what each session reveals and how you feel before and after practice.

How Meditation Helps People in Recovery

When people are in recovery from substance use disorder (SUD), they may try a variety of wellness techniques. Because addiction is classified as a brain disease, it's important to regain brain health after addiction by improving neural connections and recalibrating the natural response of dopamine, endorphins, and serotonin.

You can do this any number of ways:

  • Get mental exercise. Play games, read, do puzzles, and engage in hobbies.
  • Stay physically active. Your body is designed to be in motion. Any form of regular movement oxygenates your brain and increases blood flow.
  • Eat whole foods. It's crucial to stay away from junk food and white sugar—also an addictive substance—and focus on fruits, vegetables, lean protein options, and other foods rich in antioxidants, vitamins, and minerals.
  • Create a support network. People who understand your journey and help you maintain wellness contribute greatly to brain health.
  • Reduce stress. Meditation, quality sleep, breathing and relaxation exercises, and even a hot bath do wonders for reducing stress and cravings.

For people in recovery, medical studies indicate that meditation provides benefits such as:

  • Improved mindfulness. One common characteristic of addictive behavior is the inability to stay in the present moment. By using meditation to enhance mindfulness, you're able to accept and tolerate a single moment in time. This helps you develop better self-control.
  • Better health management. Meditation calms the nervous system, so it helps you effectively deal with symptoms of chronic co-occurring conditions such as depression and anxiety. It can also reduce problems with compulsiveness and insomnia.
  • Greater self-confidence. Too often, SUD develops from a traumatized emotional or mental state. In an article for Psychology Today, Dr. Ronald Alexander refers this as the "wanting mind." Since meditation improves the activity of the amygdala—a region of the brain that regulates emotional response—Alexander believes a person in recovery can develop a more realistic perspective. This makes you feel better about yourself and what you've overcome. As a result, you develop a healing path for the future.

How a Meditation Journal Helps You

Using a meditation journal before and after a session offers a clearer picture as to who you are in the present moment. This is especially beneficial for anyone trying to accept the past and embrace a future of new possibilities. It's also helpful to understand how you really feel and to allow reflection on that existence without judgement.

The act of writing to express thoughts and emotions is helpful, too. It's a private exploration of self—no correction, no tests. Just a channel to a better state of being.

Your journal may be a few lines you type in a computer file or handwritten in a bound notebook with a special pen. Either way, keep your intention manageable. A brief note will do if you don't want to write a lengthy entry.

Over time, as you review your experiences, you may opt to change what you witness and record. Each entry should have the date, time, and your conditions—at work, at home, on the train, and so on.

Here are some examples to help you begin:
Observations after practice:

  • Guided meditation: Tried a new version of about 20 minutes. Didn't like the man's voice, but managed to go off somewhere for a while. When it was over, I noticed my leg fell asleep, but otherwise felt okay.
  • Breathing with visualization. Was grumpy when I started, but calmed down quickly. It was only 10 minutes long, so I was surprised I felt better after just a short while. I'll do a longer version next time.
  • Mantra meditation. This was about 15 minutes, and it worked well. I think the mantra helped me not focus so much on what I was thinking about before the session.

Observations before and after:

  • Before: I feel forced to do this because my counselor suggested it. I'm not certain what to expect. After: I liked this particular meditation because it was short, and I almost fell asleep! Not sure that's the point, but it was relaxing.
  • Before: I feel really agitated because someone at work made some comments I didn't like. But I'm looking forward to not thinking about all of that for a while. After: I still feel somewhat annoyed, but I know there's no reason to worry about any of what was said. It has nothing to do with me.
  • Before: In yesterday's meditation, I couldn't believe how calm I was afterward! I wonder if I'll feel the same way today. After: My thoughts were racing a little more than usual. I tried to follow the visualization, but seemed to lose track of things quickly.

Remember, this is a private journal. It doesn't matter what you observe except how it relates to your progress. Also, try not to let the act of journaling interfere with the art of meditation—in other words, don’t think about what you're going to write while in the experience!

At the end of each week, create a summary of experiences. This helps you spot trends, potential triggers, and other characteristics that may be important to your new discoveries in wellness.

Holistic Healing Techniques at Cottonwood Tucson

The professionals at Cottonwood Tucson believe you can take back your life and heal SUD through deliberate physical, emotional, mental, and spiritual practices. Our therapeutic approach combines the necessary medical applications with holistic techniques, including meditation, yoga, EMDR, and mind-body therapy.

By Tracey L. Kelley

Tuesday, July 24, 2018

How Yoga Helps Recovery

The most progressive treatment for drug and alcohol addiction addresses the whole person, not just the disease. Most effective continuance of care plans include holistic modalities that help the goal to improve an individual's mind, body, and spirit.

A regular yoga practice is one of the most popular ways to foster this internal connection. Statistics from 2016 indicate approximately 37 million people do yoga in the United States.

The medical community continues to acknowledge the many benefits associated with yoga. The American Osteopathic Association highlights the following: 
  • Improved sleep
  • Relief from chronic stress
  • Enhanced mood through natural dopamine release
  • Heightened concentration
  • Ease of anxiety
  • Relaxed mind
  • Enhanced connection with breath
  • Less pain and fatigue
  • Increased range of motion and flexibility
  • Reduced inflammation
For someone in recovery, therapeutic movement such as yoga also calms the nervous system, reducing the "flight or fight" response. Not only does this induce a better state of calm, it also helps curb impulsive behavior—a critical component for preventing relapses.

Through a yogic practice of controlled breath and deliberate movement, an individual can also develop better awareness of the present moment. This awareness encourages a release of the past and reduces anticipation of the future. In the present, it's easier to accept how things are, who you are, and why both matter.

Yoga Assists Natural Brain Chemistry

Research supports the theory that people who struggle with drug or alcohol abuse suffer from a brain disease. Neurotransmitters are "tricked" into a false state by the artificial substances.

For example, when you're affected by mental, emotional, or physical stress, your brain activates corticotropin-releasing factor (CRF). CRF controls the sympathetic nervous system—"flight or fight"—and behavioral responses. CRF is a great natural relief in short bursts, but it may be forced by the chemical effects of drugs or alcohol into a heightened level, intensifying cravings.

Yoga prompts the parasympathetic nervous system—"rest and digest"—to respond more readily. This balancing measure encourages the brain to efficiently regulate CRF.

Another vital neurotransmitter is gaba-aminobutyric acid, or GABA. Connected to your brain's reward center, GABA encourages brighter moods and decreased anxiety. An individual suffering from substance abuse, particularly alcoholism, receives a false chemical effect similar to GABA, triggering the brain's reward mechanism. This compounds the need for substances, no matter what consequences occur as a result of overuse.  

Clinical trials involving alternative techniques for addiction recovery indicate a focus on controlled movement and breath is one method to further counteract unnatural stimulation of the brain. In this instance, results from these trials suggest yoga resets GABA levels to a more organic response to relieve anxiety and improve mood. Furthermore, a variety of studies show that exercises such as yoga, running, biking, and swimming improve serotonin production and encourage a more natural release of it.

In addition, recent theories in addiction treatment suggest a combination of therapy and exercise may help prevent relapses and promote lifetime wellness.

How Yoga Helps You "Urge Surf"

There's a concept in recovery programs that teaches people to "urge surf." This when you feel a craving coming on and acknowledge it, perhaps even ride that wave, but not act on it.  

Another important factor of yoga is how it helps you create a more mindful life. This doesn't mean you have to isolate yourself from the world and sit on a mountaintop. Mindfulness as a practice for people in recovery allows for space in the present moment to see the fine line between action and reaction, gain control over impulsiveness, and recognize triggers and deal with them.

Whether or not you use the urge surf method, you can apply the following techniques associated with yoga to be more mindful of why your recovery and wellbeing has value.
  • Stay open hearted. Many people consider the space on their yoga mats to be a safe haven—a place where they can treat themselves with compassion, release expectations, and recognize their full potential. 
  • Breathe. Too often, we forget the power of deliberate inhalation and exhalation. But remember: there's a reason why you're encouraged to take 10 deep breaths when you're upset. Focused breathing calms your nervous system.
  • Move without judgment. Through yoga practice, you experience joys and challenges, just like life. Some poses may be easy for you—others require you to progress more gradually. You can open up to each experience in the present moment with curiosity, not doubt or criticism.

Choosing a Yoga Practice

As you venture into a new life without addiction, your treatment plan may involve a variety of modalities and activities designed to help you accomplish meaningful goals.

The style of yoga you experience during treatment may be a great start, but when you return to daily life outside of your treatment facility, seek a qualified yoga instructor to continue your practice. There are many approaches and disciplines, each offering specific benefits.
  • If you feel a 12-step approach may help you manage a new path in life more effectively, consider Yoga of 12-Step Recovery, created by Nikki Myers after her troubles with addiction.
  • For someone healing from trauma or PTSD, a specialized approach called Trauma Sensitive Yoga may allow you regain "a sense of empowerment, especially for people who may have felt choiceless and powerless."
  • The Viniyoga, developed by Gary Kraftsow, adapts yoga practice to the "condition, needs, and interests of each individual" with specific focus on personal ritual, meditation, breath, function, and repetition.
  • The practice of yin yoga creates an atmosphere of passive release, which may be the remedy for someone dealing with severe body aches and the proverbial "monkey mind."

To learn more about what discipline may appeal to you, review this short list provided by Yoga Journal, and don't be afraid to be a "yoga tourist" for a while in your community. You'll meet people focused on positive wellness and learn what styles resonate with you the most.

By Tracey L. Kelley

Wednesday, June 27, 2018

Choosing to Share Your Addiction Story

Sharing between friends
One of the hardest aspects of pursuing life without addiction is determining how much to share with others. There are many situations when it's evident you're following a different path.

It's important to remember that ownership over your recovery story gives you agency to understand what the truth means to you, what questions you'll answer if disclosure is the best option, and why you might share your sobriety journey. 

Accept Your Past

Too often, there are myriad negative thoughts and emotions involving addiction. Sometimes, with good reason. If addictive behavior resulted in legal issues, family difficulties, or serious health concerns, those and other complications require careful analyzation, evaluation, and acceptance.

The techniques you learn through group, individual, and experiential therapy while in an inpatient rehabilitation facility help you deal with emotions such as shame, blame, and guilt. This process allows you to acknowledge and accept the circumstances leading to and involving your addiction. 

Once you identify the root cause contributing to addictive behavior, your healing begins. This becomes a powerful platform to share your story with understanding, compassion, and confidence.

Assess the Reasons for Disclosure

Feeling comfortable in your skin allows you to face the various situations that require you to discuss your history of addiction. Consequently, prioritizing disclosure may be necessary in the following situations:
  • Many people have to reveal their condition if they took time from work to enter treatment and are returning to that job.
  • If someone is choosing to date again and wants to be honest with a new partner, a frank conversation may be necessary to establish healthy boundaries.
  • Certain health conditions require full disclosure about past drug and alcohol use if there's the possibility of complications, or if a particular course of treatment requires medication.
Sober living allows you to make better choices. While you have nothing to hide, you also have the right to privacy. So, other circumstances might be on more of a need-to-know basis. For example:
  • If you've struggled with impulsive spending and some friends ask you to join a shopping spree, this might be a trigger for you. If you're not ready to share the reason, it might be easier to say no to the invitation.
  • Certain food-centric events might make you uncomfortable while you're healing from an eating disorder. A private conversation with the party host regarding your situation may put you at ease and allow you to follow a meal plan but still enjoy the social occasion.
  • Going out with the gang from work for happy hour could be a lot of fun, even if you're not drinking. Extending an offer to be the designated driver while sipping a tonic and lime doesn't put you on the spot to explain more than you want.
Often the level of intimacy you share with someone determines who should hear your story. Perhaps some of your family members and close friends already know. Maybe you have people in a support network who simply "get it" and don't require any explanation. Take each situation as it comes and allow space to evaluate the purpose of disclosure.

The Freedom of Authenticity

Many people are concerned about the questions they'll get if they open up about addiction. This is when you can trust the treatment foundation you've received to present your best self: not an image of perfection, nor a perception of who you think others want you to be.

The National Council on Alcoholism and Drug Dependence highlights people in recovery. The messages convey the importance of human beings recognizing challenges and moving beyond them. Here are just a few:

  • "I'm a nurse. I lost everything to my addiction and spent four months in jail because I stole drugs from work. In the last 11 years I've worked my 12-step program as if my life depends on it, because it does. I regained my family's respect, my nursing license, my hope, and am grateful for every day." —Kristin, Wisconsin
  • "The darkest days of my mental illness and addiction were spent in a bathroom throwing up and stuffing my mouth with food. My struggle with anorexia, bulimia, and compulsive and destructive behaviors began at too young of an age. I now make choices every day to stay positive. I own a business, am a therapist, and have high ambitions for my future that don't involve limiting beliefs or behaviors. I'm free, I'm a survivor!" —Sarai, Arizona
  • "While in the Army I was shot by a sniper, and stayed in the hospital for three months on a constant morphine drip. When I got out, I was prescribed morphine for my injuries but started to abuse my pills. What made me stop is the death of one of my best friends. We were all taking pills along with alcohol, and he died of heart failure. At the funeral, his mother asked me, 'How did my son die?' The pain in her eyes was a pain I didn't want my mother to experience." —David, Georgia
  • "Addiction is not a choice, moral failing, or sign of weakness. And recovery can look like you and me. Today, I am using my voice to call attention to the health, happiness, and healing possible in recovery. My life is proof. It’s time to end shame and open up about recovery." —Fay, California
There's personal power in sharing your story, in a time that matters, controlled by you. This power allows you to connect with people struggling to overcome trials, or to educate individuals who only know the stigmas and myths of addiction.

When someone asks questions, simply be truthful. Answer to provide clarity and information. No shame, no regrets. Just a human being in a constant cycle of becoming.

At Cottonwood Tucson, we extend a treatment approach that offers people the opportunity to become creators of their reality through health and wellness. If you or someone you love needs this kind of attention, please reach out.   

By Tracey L. Kelley
CARF - Commission on Accreditation of Rehabilitation FacilitiesNATSAP | National Association of Therapeutic Schools and ProgramsNBCCNAADAC