New Template for Recovery (eBook)

How to Launch an Awesome New Life with Sobriety

T. Christopher Portman Ph.D. (Autor)

eBook Download: EPUB

2024 | 1. Auflage
410 Seiten
Bookbaby (Verlag)
979-8-3509-3440-3 (ISBN)

Infos

The New Template for Recovery is for people who believe they have the ability to make important changes in their lives-- including quitting drinking. it is designed for those who want to succeed at sobriety but want something different than, or in addition to, what standard treatment programs and AA have to offer. If you want to pursue a forward going approach to recovery and become excited, rather than depressed, about life without alcohol, this book may be the place for you to find the motivation, the knowledge, and the pathway to succeed. If you are drawn to the idea of an independent recovery from an alcohol use problem, know that you are not alone, and rest assured that millions of people gain lasting sobriety on their own. Indeed, an irrepressible body of research finds that many, possibly most, people in successful recovery managed to quit drinking on their own. The New Template for Recovery provides a clear and practical, self-directed guide to sobriety and a better life by the use of a template for recovery that can be crafted and followed according to each person's needs. Learn: - the level of alcohol use problem that you have - how to safely manage alcohol withdrawal - why you are not to blame - the pros and cons of AA and standard treatment programs - the psychological and physical addiction process and its effectDiscover: - the forward going template model for recovery - how to focus on the life areas of recovery that are important to you - powerful relapse prevention strategies - the motivation to recreate your life your way

Textauszug

CHAPTER 1

Are You Safe to Quit Drinking

Problem:

Alcohol withdrawal can be physically and mentally unsafe.

How to win:

Evaluate your withdrawal risk and follow through on the appropriate help option.

Withdrawal Risks

While most people can quit drinking abruptly (cold turkey) without harm, it is not always safe. Depending on how much you have been drinking, for how long, how old you are, and other health factors, you need to be aware of the risk of harm from withdrawal and options for safely quitting. Most people realize that getting intoxicated is dangerous. Acute intoxication can lead to delirium, coma, convulsions, respiratory arrest, and death. And of course, long-term, there are myriad deleterious effects throughout the body—organs, muscle tissue, circulatory and nervous systems, brain and cognitive functions are all compromised and eventually damaged.

What most people do not know is that the withdrawal process also can be damaging. Once the brain is accustomed to being bathed in alcohol, it does not like having the alcohol removed. Heart attacks and strokes are possible as blood pressure can rise precipitously. Seizures and a phenomenon known as delirium tremens (the DTs) can occur. Cognitive damage also can result—in some cases permanently—and repeated withdrawals are especially challenging to the brain. A “kindling” phenomenon occurs as symptoms of withdrawal and its effects worsen with repeated detoxification.

Anyone who has a tolerance to alcohol will have some level of withdrawal upon quitting drinking, although only about 50 percent will notice symptoms. Research indicates that the incidence of noticeable withdrawal symptoms in the general U.S. population is low, whereas most people in treatment programs for alcohol use problems report withdrawal symptoms (Caetano, Clark & Greenfield, 1998; Saitz, 1998). Actually, each drinking episode is followed by withdrawal. Many people experience this as a hangover. If you are habituated to alcohol from regular use, however, and have increased tolerance, you may not notice significant hangover symptoms. It is important to know that the absence of symptoms does not mean the absence of damage. This may well be the case, but you just do not feel it. Because of this tolerance phenomenon, many alcohol dependent people do not realize the danger both from drinking and from withdrawal each time they quit. As one of my patients put it, “I thought I had developed an immunity to alcohol because I could drink so much, and without hangovers.” Big mistake!

Withdrawal Assessment

Whether or not you are safe to quit drinking may require a professional medical assessment. If you have any concerns at all, see your primary care physician, or an American Society of Addiction Medicine certified specialist, or go to a hospital emergency room or treatment center. This book can only begin to explain some of the symptoms and individual characteristics that suggest your risk of experiencing withdrawal problems.

Cutting to the chase—here are the alcohol withdrawal symptoms identified in the widely used Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) (Sullivan et al., 1989), along with my discussion of what some of these symptoms might mean for you. Remember—the items on the scale are designed to be asked and observed by a medical professional. I offer the scale here so you get some idea of what is or could be happening to you. Habituation and withdrawal are discussed further in Chapter 5, on the physical addiction process and effects.

Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)

[Many of the numbered response options are blank intentionally because they represent a subjective range of responses between extremes.]

NAUSEA AND VOMITING—Do you feel sick to your stomach? Have you vomited?

0 no nausea and no vomiting

1 mild nausea with no vomiting

2

3

4 intermittent nausea with dry heaves

5

6

7 constant nausea, frequent dry heaves and vomiting

TACTILE DISTURBANCES—Have you any itching, pins and needles sensations, any burning, any numbness, or do you feel bugs crawling on or under your skin?

0 none

1 very mild itching, pins and needles, burning or numbness

2 mild itching, pins and needles, burning or numbness

3 moderate itching, pins and needles, burning or numbness

4 moderately severe hallucinations

5 severe hallucinations

6 extremely severe hallucinations

7 continuous hallucinations

TREMOR—Arms extended and fingers spread apart

0 no tremor

1 not visible, but can be felt fingertip to fingertip

2

3

4 moderate, with patient’s arms extended

5

6

7 severe, even with arms not extended

AUDITORY DISTURBANCES—Are you more aware of sounds around you? Are they harsh? Do they frighten you? Are you hearing anything that is disturbing to you? Are you hearing things you know are not there?

0 not present

1 very mild harshness or ability to frighten

2 mild harshness or ability to frighten

3 moderate harshness or ability to frighten

4 moderately severe hallucinations

5 severe hallucinations

6 extremely severe hallucinations

7 continuous hallucinations

PAROXYSMAL SWEATS

0 no sweat visible

1 barely perceptible sweating, palms moist

2

3

4 beads of sweat obvious on forehead

5

6

7 drenching sweats

VISUAL DISTURBANCES—Does the light appear to be too bright? Is its color different? Does it hurt your eyes? Are you seeing anything that is disturbing to you? Are you seeing things you know are not there?

0 not present

1 very mild sensitivity

2 mild sensitivity

3 moderate sensitivity

4 moderately severe hallucinations

5 severe hallucinations

6 extremely severe hallucinations

7 continuous hallucinations

ANXIETY—Do you feel nervous? 0 no anxiety, at ease

1 mild anxious

2

3

4 moderately anxious, or guarded, so anxiety is inferred

5

6

7 equivalent to acute panic states as seen in severe delirium or acute schizophrenic reactions

HEADACHE, FULLNESS IN HEAD—Does your head feel different? Does it feel like there is a band around your head? Do not rate for dizziness or lightheadedness. Otherwise, rate severity.

0 not present

1 very mild

2 mild

3 moderate

4 moderately severe

5 severe

6 very severe

7 extremely severe

AGITATION

0 normal activity

1 somewhat more than normal activity

2

3

4 moderately fidgety and restless

5

6

7 paces back and forth during most of the interview, or constantly thrashes about

ORIENTATION AND CLOUDING OF SENSORIUM—What day is this? Where are you?

0 oriented and can do serial additions

1 cannot do serial additions or is uncertain about date

2 disoriented for date by no more than 2 calendar dates

3 disoriented for date by more than 2 calendar days

4 disoriented for place/or person

Total CIWA-Ar Score ____

Maximum Possibl Score 67

Patients scoring less than 10 do not usually need additional medication for withdrawal. The ratings are necessarily subjective. Nothing beats actual medical assessment by a doctor, and the scale’s recommendation that people with a score lower than ten usually do not need medical attention is really a moving target. What about scores only slightly higher than 10? Again, about half of those who are habituated to alcohol—that is, having a tolerance—do not experience any of these symptoms. If you have not noticed any withdrawal symptoms, this does not mean that you are safe. In general, the older you are, the more you have been drinking in quantity and frequency, the more times you have been through withdrawal, and the more health problems you have, the greater your risk for withdrawal-related problems.

Apart from feeling ill, anxious, and/or shaky, as mentioned above, more serious withdrawal problems include convulsions or seizures and/or delirium tremens (the DTs). Seizures are a definite sign that you need immediate medical attention. One or two seizures are unlikely to harm you seriously, but back-to-back seizures can cause death. The DTs can have a rather late onset, occurring up to a week after the person has stopped imbibing. The DTs are dangerous. Symptoms may include disorientation, losing touch with reality (psychosis), intense anxiety, severe agitation, accelerated...

Produkt-Details

• Erscheint lt. Verlag: 4.1.2024
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Naturheilkunde
• ISBN-13: 979-8-3509-3440-3 / 9798350934403