The problems of getting and staying clean

The problems of getting and staying clean

This is a blog post from our guest author David H., Cutler Bay, FL.

If you are interested in the Narcotics Anonymous 12-step program, and how it can help people to quit taking drugs and find a new way of life, you will find useful information in this article. The NA steps have helped many people over the years. AA and NA meetings are great places to connect with new friends in recovery. To get started, look up an NA meetings list in your area, and get a copy of the Narcotics Anonymous Basic Text. To find active meetings in your area, you can also call your local Narcotics Anonymous Hotline. 

The Problem

My first sponsor and his friends started a group called Sunset Recovery, back in about 1984. The format request for any speaker at that meeting was: “Please start your story with the day you got clean. We really don’t want to hear the ʻwar storyʼ; we all know how to get high, but we don’t all know how to stay clean. So instead, tell us your experience in clean time, not the whole sordid mess you were in before.” But that was a difficult challenge for many speakers, who couldn’t resist dwelling on the dramatic, and playing the “Ain’t it awful” card.

One of our readings says, “We are not interested in what or how much you used, … what you have done in the past – but only in what you want to do about your problem, and how we can help.” Alas, too many meeting speakers have proceeded to ignore that suggestion – and have gone on, regardless, to talk about the past, and what and how much they used; and spent 95% of their share on the insanity, degradation and desperation of their using days. With only 5% of their time left, they at last remembered: “Oh, and then I got clean! And now everything’s great! The end.” Enduring such a share could be a frustrating experience, for someone who was hungry for recovery.

The Fellowship has matured a lot; speakers have gotten much better at carrying the message, instead of the mess. But still, we addicts (many of us at least) love the melodrama, the soap opera, of our addiction. We tend to accentuate the negative. We may even play “Can you top this?” games to outdo each other, saying: “You think that’s sick? Wait till you hear this!” It is said that you’ll never meet the sickest addict, because s/he is either still out there using, or locked up. The rest of us come in to the rooms or treatment in some semi-functional state: more or less an emotional wreck, more or less wretched, more or less spent – and fairly obviously sick. As newcomers in the rooms of recovery, we tend to still have the attitude of the streets: defensive, insolent, intolerant, wary, paranoid, faux-menacing, rebellious, angry, and resentful of anyone’s attempt to “tell us what to do.” (That’s why we call our formula of recovery “suggestions,” rather than “advice” or “prescriptions.” It takes one to know one; and we know just how resistant to others’ ideas we were when we were new.) We expect the newcomer to be crazy! That’s because we know that all of us were crazy, too, when we were newcomers! That’s why we suggest that newcomers just listen, because for most of them, it will be a while before they have more to contribute than their disease; after all, our meetings are supposed to be devoted to sharing our recovery, not glorifying or justifying our disease.

Years of chronic drug use tends to scramble the brains, a little or a lot. The faculty of good judgment has been seriously impaired. Newcomers try to put on a good show, so that everyone will think they’re “fine” – even though they may be dying inside. But everyone who’s been there knows that newcomers don’t know what’s good for themselves. They have been locked in sick thinking and bad habits for so long, that it will take a major decision – what we might refer to as a “surrender” – to start doing things somebody else’s way. We “suggest” to newcomers that they get a sponsor, and follow their suggestions; to get phone numbers of other members, and call them and talk with them; to attend 90 meetings in 90 days, so that the good habits of recovery can come to replace the bad habits of active addiction; to keep coming back, and not pick up drugs no matter what; and to work the Steps with their sponsors – because that is the program of recovery that has worked for us. We repeat these suggestions at every meeting, well aware that most newcomers tend to resist these good suggestions, want to do things their own way, and need to keep hearing it again, till the resistance wears down and the idea takes root.

But even with all these good examples and good suggestions, the newcomer has only a modest chance of staying clean, at least at first. While most of us can get it eventually if we just keep coming back, we know only too well that cycles of relapse and return are the lot of a great many addicts. That’s not because recovery doesn’t work; it’s because too often, we addicts just don’t work it. We’ll try everything else first! (As the old joke goes: When all else fails – follow the directions!) Many of us have the scars of numerous relapses – but we eventually “stop trying to re-invent the wheel,” allow others to guide us, take recovery seriously, stay put and stay clean. The problem is that addiction is so much bigger than mere drug dependency, and so recovery is so much more than mere abstinence from drugs. Recovery is a way of life, an education, a daily reprieve from addiction, an ongoing decision. Addiction is a disease; perhaps it is even better to call it a “syndrome,” because it’s a multi-level complex of diseases of the body, emotions, mind and spirit. You take the drugs out of a drug addict, and you still have an addict! The sick thinking, bad attitudes, irrational habits of mind and antisocial or even criminal behaviors and contexts can linger long into clean time. You can’t replace bad habits with nothing; you have to replace them with good habits, or the bad ones will just reassert themselves. The habits of a lifetime, or at least of 10 or 15 years of active addiction, do not die quickly, or merely fall of their own weight. They have to be superseded, and a new and more successful lifestyle has to be gradually developed to take its place. And while we say that we “don’t care what you have done in the past,” understanding the nature of the disease, and how we got here, is crucial to laying the groundwork for recovery.

So what are the dimensions of this “syndrome?”

I. Physical: Addiction is much more than the dependency upon and craving for habit-forming drugs. Chronic drug use actually changes the way the brain works. The endorphin system in the brain is designed to reward us for engaging in life-affirming activities: the normal brain receives little electro-chemical jolts of pleasure from such things as sex, love, sleep, eating, laughing, socializing, exercise, entertainment, creativity, learning, sharing, and a job well done. We are wired to do, and gain pleasure from, things that will be healthy and good for us! Endorphins also reduce pain naturally. But intoxicating drugs hijack this system, and provide us with pleasure rewards and kill pain, just by fitting into the same receptors as the endorphins would.
Since the endorphin receptors are now full of those intoxicating drugs, there isn’t room for our natural endorphins. So now the endorphin producers stop producing endorphins; it’s a closed-loop system. As the disease of addiction progresses, now there is no more pleasure to be had anymore from all those life-affirming activities; the only pleasure comes from the drug; and the only relief comes from trying to medicate the pain of everyday life. Nothing is funny; no joy derives from food, work or even sex; and life at an addict’s bottom is an endless sad, dull cycle of using and seeking more. Many of us have described it as a kind of living hell. There may be no joy in this cycle; there’s certainly no “high” left; but for a while anyway, there is at least some comfort, perhaps some numbness. But addiction is progressive; the drugs have stopped working; every hair seems to hurt; and eventually it may take teetering on the knife-edge of overdose, just to get a bit of numbness. Most of us had to hit some kind of bottom, or a series of bottoms, when even that comfort and numbness were gone, and we were left empty, helpless, in pain and in tears. Then the addict may at last, in sheer desperation, be willing to try recovery. The enjoyment of the normal pleasures of everyday life and the natural resistance to pain and discomfort may not reassert themselves immediately; but if we stay clean, they gradually will come back. We all will receive that gift of recovery, to our delight, if we are patient.

Newcomers are not only coping with intermittent cravings; they are also dealing with a profound sense of loss – it’s like losing their best friend or first love. As badly as drugs have kicked their behinds, they still feel a yearning for the comfort of getting high – even though the drugs may have stopped working effectively, or providing any real pleasure, for a long time. The feelings of craving and yearning will pass with time as we stay clean; but addicts are not used to practicing discipline and self-control, nor used to experiencing existential pain without the help of drugs; so a lot of newcomers go out again within their first few weeks. This is not due to a fault or failure in the program; rather, it is due to the persistence and perniciousness of the disease of addiction. It’ll take more than good intentions to overcome the pull, the gravity, of addiction.
Intoxication is, by definition, toxic. Virtually all the drugs we used for pleasure, to get high, and to reduce pain, have toxic effects and leave residues that derange brain function. Short-term intoxication produces short-term derangement; long-term intoxication produces long-term derangement. Most of the intoxicating drugs we used to prefer, also tend to impair or even shut down the higher brain functions of the frontal lobe – where adults experience things like conscience, caution, judgment, long-term planning, making connections and understanding consequences, etc. So the more and the longer we used, the more juvenile and even infantile our response to life became. Using addicts are all conducting experiments on their own brains: can they use enough to get high, and not quite enough to cause brain damage? Not everyone is lucky when the experiment is complete.
Bear in mind, the brain is not the only physical organ that is affected by drug addiction. Other body systems can also be seriously affected by drugs’ toxicity: heart, lungs, liver, kidneys, etc. – not to mention the many injuries and illnesses sustained while high. These can sometimes repair themselves, somewhat, in recovery – but only if we stay clean, nourish ourselves well, practice healthy habits, and let health professionals guide us in our physical recovery.

II. Emotional. It has been said that when addicts start using, they stop growing. Many addicts learn to use getting high as an escape – a substitute for dealing with the emotional frustrations and anxieties of everyday life. When they start doing that early, at say age 15 or 16, or even earlier, they tend to stunt or freeze their maturation at that age, because they never learned how to walk through their problems and find mature solutions to them. Thus many newcomers may look like adults, but inside they feel like adolescents, and often behave that way too. You can see them at the fellowship dances: newcomers in their thirties and even forties, standing at the back wall, dealing with teen-age insecurities: “What if I ask her to dance, and she says no?” they tremble.

A great deal of recovery is just sheer growing up; but that is easier said than done. Adulthood means coping with ambiguities, making peace with uncomfortable realities, adjusting our attitudes, taking responsibility for our actions, accepting our imperfections and embracing our feelings. While using, many of us had numbed our emotional response to life: some could not cry or grieve at the death of a loved one; some could not show any real caring or concern for the welfare of others; some acted like automatons or robots, going through the motions of “real life,” but feeling none of the normal feelings and emotions that serve to connect us to reality. Suddenly, upon getting clean, many addicts feel their emotions rushing back in – and this can be overwhelming; for some, even terrifying. Without good support from a loving sponsor and home group, the addict who is pretending that everything is “fine” can suddenly crack, and seek to silence those uncomfortable feelings in relapse on drugs.

It is said that addiction is a “Family Disease.” This is experienced on several levels: 1/ The susceptibility toward addiction seems to be genetic – addicts tend to run in families. 2/ When an addict gets sicker, usually the whole family gets sicker. 3/ Families often find themselves stuck with having to “Enable” an addict – i.e., letting or even helping them use, fending off consequences for them, buying into their denial, and making excuses for their absences or failings. 4/ Some family members can actually be codependent: an equal-but-opposite psychological malady in which they actually need the addict to stay sick, so they can be the “good one,” the responsible one, in the family. It is said that, in some cases, when the addict gets clean and starts getting better, the codependent actually gets worse! That’s because their illness’ self-justification is now threatened. Untreated, codependents can go from addict to addict, seeming to be a “long-suffering saint,” but actually deriving sick satisfaction from being an addict’s caretaker. Some can even sabotage an addict’s attempts at recovery, in order to keep them dependent. Worse, many addicts themselves have codependent tendencies; and when there are two or more addicts in a family, they may very easily enable each other. 5/ Since addiction affects the whole family, often in drastic and even tragic ways, it is not enough for an addict to get clean, as though that alone solves everything; the rest of the family often needs their own program, recovery, and counseling – even if just to deal with the rage and confusion of having to deal with an addict, and their baffling, unpredictable and dark disease.
Many newcomers, having been rejected by their biological family, seek to find a new spiritual family in the Fellowship. We are close, kind, affectionate and understanding; but we are not suckers. We tell the newcomer, “Let us love you until you can love yourself.” But we are not automatically trusting, just because we love. We know our own history: in our using days, we were conniving, deceitful, unreliable and sneaky. We made promises that we routinely broke; we abused the love and trust of those closest to us. And addicts who preceded and followed us in recovery, told the same story. Thus we have no reason to believe that the newcomer of today is any different than we were! I like to say, “I’ll gladly give newcomers my time and attention; but I won’t ask them to hold my wallet while I go swimming.” This is not because I don’t care or love; it’s because it’s putting too much pressure on their still-shaky willingness to be honest and responsible. It takes a while to really learn to consistently practice complete honesty, and live by spiritual principles. Old habits die hard; and like it or not, we have to prove to others – and ourselves – that we have really changed.

III. Mental/Intellectual. Addicts have said: “I’m not here for being stupid; I’m here for being crazy!” Actually, addicts are usually a little aboveaverage in intelligence; often they’re crafty, sly and clever. They have had to be. They may not be good students, but they are quick studies: sizing up a situation to gain an advantage. Their rebellious nature extends to schooling: not wanting to be told what to learn, but sharp-minded nevertheless. (I, for one, was always reading; I just wasn’t reading what had been assigned!)
Unfortunately, while addiction does lend itself to an unconventional and independent mind, it also twists one’s thinking into destructive and limiting forms. Addicts tend to develop paranoia, obsession, compulsion, fixed ideas and confused logic. They are extremists by nature, and often massively lacking in impulse control. They suffer from isolation, insecurity, immaturity, grandiosity crossed with low self-esteem, arrogance, false idealism, and escapism. They tend to rationalize and justify. (And here’s the distinction: rationalization is the attempt to make what is irrational, seem to be rational; and justification is the attempt to make what is unjust, seem to be just. Both are exercises in denial.) As addiction progresses, the cost of getting high grows, and the rewards diminish; but addicts rationalize those diminishing returns, claiming that the drugs “aren’t as good as they used to be”; and justify their chasing the high regardless of the ever-steeper cost, because they “deserve” a little “fun.” As isolation, paranoia and dysfunction set in, their “partying” becomes a “party of one” – because even other addicts aren’t willing to put up with their erratic and bizarre antics, and they aren’t willing to expose themselves to others’ scrutiny or craziness.

Some addicts have spent years self-medicating to cope with such psychological problems as depression and anxiety – or to cope with physical or emotional pain. Unfortunately, street drugs (unlike some medicines and nutrients that really can be effective) are not designed to treat those conditions! They tend to merely suppress problems, rather than ameliorate them, and the sick ideation and deranged thinking that accompany addiction only continue to come out in worse and worse ways. Drug use, even when medically necessary, distorts reality; worse, over time, the addict thinks the distortion is normal! Many newcomers have long-standing mental issues, aside from their addiction, that may need to be addressed by a mental health professional; just attending meetings or calling one’s sponsor may be inadequate to cope properly with these problems.
And while addicts in recovery accept the reality of “medical necessity” – the unfortunate requirement some endure for pain medicine after surgery, or during some chronic diseases – our common experience shows that the disease of addiction cannot tell the difference between using to get high, and using for a medical necessity. Recovering addicts have to be extremely vigilant, lest a surgery precipitate a relapse; and when taking medication crosses the line from relieving pain, and into “copping a buzz,” getting high, or escaping reality – it means they’ve relapsed. Many recovering addicts, knowing this, exhaust all other avenues for treating pain – nutrients, acupuncture, hypnosis, adjustment therapies, non-addicting non-psychoactive drugs, and others – before agreeing to mitigate pain with hard drugs. Even then, they may enlist the help of another person to hold the drugs for them, and mete them out appropriately, and as prescribed.

It is said that addiction is “a disease that tells us we don’t have a disease.” This comes from the component known as Denial, which includes: an ability to pretend or fool oneself; a capacity for minimizing a problem or issue; a shifting of blame or responsibility for a problem. Denial is a psychological defense mechanism, in which people are confronted by something too uncomfortable or threatening to accept, so they automatically disavow, refuse, or reject the information – even though the info is helpful, the problem is massive, and everyone else can see it – except for the addicts themselves. While many people deal with their problems in life by at first going into denial, it is especially problematic for addicts for two reasons: 1. Chronic drug use addles the mind and distorts reality; 2. the disease of addiction seems to develop a “mind of its own.” It seems at times to act independently and at cross-purposes to the rest of the mind, and to pressure one’s thinking toward using or relapse when it feels threatened by recovery, which would deprive it of its favorite “food.” More than just a defense mechanism, for addicts, denial can be a complex self-delusion that makes treatment and recovery more difficult. A paranoid addict may believe that “everyone’s out to get them,” when really, everyone wants to help them. Addicts also tend to deny the harmful impact of their using and behavior on others: “I’m only hurting myself,” they claim. This ignores the damaging effect their using has on their families, employers, community emergency facilities, and society, and falsely absolves the addict of guilt or shame.

It is said that penetrating the veil of denial requires three main principles: Honesty, Acceptance, and Surrender. One must become brutally frank with oneself, and overcome all the excuses, pretenses and fantasies the disease is adept at using; one must accept the sad fact that an addict cannot use successfully, and that real recovery will require complete abstinence from all intoxicants, and real work on oneself; and one must start surrendering to the Program, rather than to the Disease. While denial may continue to afflict addicts in many forms even in clean time, it is most pernicious and influential in the using addict, and it often takes a moment of crisis or clarity to pierce the denial and come to grips with the enormity of addiction.

IV. Spiritual. This is not a matter that depends on religious beliefs. It has to do with the essence of self, and what one is willing to actually doto awaken and realize the inner self. We are more than mere “mouths”; we need to find meaning and purpose in our lives – a reason for being. Using addicts possess very little meaning, and their sole purpose is just getting and using more drugs. But abstinence does not equal recovery; and the gap between stopping using and actually recovering can be perilous and awful. One addict used to say: “There is nobody in the world more miserable than an addict with no recovery and no dope.” Unrecovering addicts tend to feel horribly alone and bereft of human contact; and to feel a profound emptiness, a “hole in the gut.” And so when the drugs stop working, they try to stuff something else, some substitute addiction, into that hole to “fix” themselves. Many addicts become “excitement junkies” – looking for cheap thrills to exhilarate themselves for a time. The problem is that no job, money, relationship, ideology, pastime, toy or “rush” is big enough to fill that void. Only an awakened spirit, and perhaps the presence of a loving Higher Power, can do that.
Newcomers tend to still be spiritually sleepwalking: perhaps on the move, but not yet conscious; unwilling to go back to the downward spiral of using, but unready to entertain an expanding inner universe. It takes getting comfortable in recovery, and some time clean, to begin to address the central spiritual issue, the very nub, of addiction: Self-Centeredness. To an addict, everything is always all about ME: “I, I, I; me, me, me; my problems, my issues, my preferences, my story, my worries, my feelings, my desires – but enough about me; tell me what you think about me!” It behooves recovering addicts to find something akin to a “God of our own understanding.” This may have no basis in theology or cosmology; it is simply important not to try to be the god in our own little universe. The most successful recoveries tend to be those that manage to replace self-centeredness with God-centeredness. Addicts can recover without a Higher Power; however, it is just harder that way.

One of the spiritual traditions calls drug intoxication “Unearned Nirvana.” That is, bliss that one did not work for. They claim that such a “cheat” actually causes one to regress spiritually. And that is a fair conclusion: many of us, over time, became less wise, less self-aware, less human,the longer we used. The more we got high, the more we brought ourselves low.

“Clean” means more than just not using; it also means not dirty. If our lives, behavior and thinking stay mired in meanness and muck, it is impossible for the spirit to rise. Recovery includes a revolution of one’s moral sense: becoming good, loving, kind and fair, both to others and to ourselves. The process of working the Steps, especially the latter ones, makes clear what kind of people we want to be, and gives us tools to overcome our baser impulses, and to practice principles in all our affairs.

The primary purpose of working the Steps (besides staying clean, of course) is self-understanding. We learn that we must become more psychologically self-aware before we can become fully spiritually self-aware. The more conscious we are of our own inner nature, and the more alert we are to the deep rumblings of subconscious dissatisfaction, the less likely we are to fool ourselves, to go unconscious, and to begin again the downward spiral of self-destructive thinking that will lead back to active addiction. Just as there is a surrender in every Step, so too, there is a spiritual awakening in every Step. We learn that, paradoxically, surrendering our wills and lives to the care of a power greater than ourselves, actually empowers us. As we grow, we become more than we were; we understand ourselves, life and reality more profoundly and wisely. It becomes harder to “lull ourselves to sleep” with false beliefs and fool ourselves with crazy ideas, because now we know too much; and now we know ourselves too well. We stop trying to “fix” ourselves with outside busy-ness, failing relationships, and substitute addictions; and we start learning to accept ourselves as we are, and grow, as gradually enlightening beings. When problems arise, we “plug in” a principle and a rational plan, rather than plot yet another escape.

We do this because staying the way we were, as sick crazy addicts, bearing all the same problems we used to have aside from actual drug use, has become untenable. The longer we are clean, the less we can tolerate being our own worst enemies, and the more we are willing to go to any lengths to stay clean and recover. My third sponsor used to say, “You don’t have to work Steps – as long as you can stand it!” Other addicts have said, “Why would you want to attend a Twelve-Step Fellowship, and not work the Twelve Steps?” We surrender; we decide to do it someone else’s way; we cease being so self-centered, and if we’re lucky, we become more God-centered – and compassionate and loving enough to give back to others. If we do it right, we come to love recovery. We come to see it as a privilege, not a punishment.
The problem of addiction is vast, but not insoluble. Addicts tend to dwell on their problems; but recovery is about living in the solution. If we can admit who and what we are, develop persistence and hopefulness, and make the decision to follow through and embrace this new way of life, we have a very good chance of not just staying clean, but of living well, long and happily. But recovery is a program of actions, not of mere intentions. It won’t happen just because we want it; we actually have to work for it. When we do, we find that “first, it gets good; then it gets real good; then it gets real.
David H., South Miami FL

©2016 David L. Hecht