Editor’s note: To protect their privacy, the clients’ names in this article are pseudonyms; all other details of their stories are accurate.
Until last July, Mary Johnson’s daily habit was to come home from work, open a bottle of wine, drink while cooking dinner, have wine with dinner and then drink all night until she passed out in the wee hours of the morning. She had been drinking heavily for more than 10 years, and she knew she had a problem. But when she experienced two blackouts within three days, Johnson decided that enough was enough.
“After that I was scared,” says Johnson, 46, of Rockingham County. “I had driven during a blackout. I didn’t hurt anyone, but I had allowed myself to get to that point.”
Johnson knew she needed help, so she did some research. That led her to call Robin Breeden, LCSW, Life Recovery coordinator at Sentara RMH Behavioral Health Services.
“She made me feel comfortable about calling,” Johnson says. “She was sympathetic, but she didn’t coddle me. It made me feel good about what I was doing.”
After meeting with Breeden and discussing her options, Johnson decided to register for the Life Recovery Program. She hasn’t had a drink since.
The Life Recovery Program helps clients deal with life’s ups and downs, which in turn helps them deal with their substance abuse addictions. Based on the model under which alcohol and drug dependency is regarded as a disease, the program requires clients to attend 16 group support and education meetings—twice a week for eight weeks.
As part of the program, clients learn about the physical underpinnings of their addictions.
When someone misuses alcohol or drugs, the brain’s neurological pathways become altered, training the brain to expect the reward that the substance delivers. The substance then becomes an unhealthy coping mechanism to deal with life’s challenges. The more a person uses the substance, the stronger the ‘rewired’ neurological pathway grows, and the more ingrained the habit becomes.
“There’s use, abuse and addiction,” Breeden explains. “When a person is addicted, physical cravings cause changes to occur, and the brain becomes hijacked by the addiction.”
When a client chooses sobriety over addiction, he or she is also choosing to create a new neurological pathway. At first such a challenge may seem daunting, but it’s far from impossible. Although addiction is a chronic and progressive disease, it’s also highly treatable, according to Breeden.
“Addictions can happen to anyone,” she continues. “No single factor can predict whether a person will become addicted to drugs or alcohol—the risk is influenced by a person’s biology and environment, as well as psychosocial factors. Addiction can be the result of any of those causes.”
At Life Recovery meetings, clients support one another, learn from each other and—best of all—find out they’re not alone.
In addition to teaching clients about the science of addiction, she helps them understand the role substance use has played in their lives. Clients learn about the situations and emotions—such as depression, anxiety and trauma—that trigger them to crave alcohol or drugs.
“It’s like an onion,” Breeden says. “Once you start peeling the outer layers of the addiction, you can find the stress-inducing event that triggers each individual’s substance use. Then we can identify better and quicker ways to manage the patient’s stress and emotions, helping them to make a stronger recovery.”
Knowledge is Power
Breeden, who has substantial experience working the journey of recovery with many clients, has coordinated the Sentara RMH Life Recovery Program for two years. She often incorporates client experiences and her knowledge of addiction and recovery into the curriculum, which includes teaching clients about the disease model of addiction and accepting the fact of their addiction.
“Genetics, environment and how we handle stress all play a role in addiction,” Breeden says.
Addiction may develop as a response to painful or traumatic experiences as a way to dull or forget such pain. Drugs and alcohol are quite effective at numbing pain by overwhelming the brain’s neuroreceptors with artificially elevated levels of dopamine. The brain learns to crave whatever causes the dopamine surge and even begins to prioritize it over other survival needs such as food, shelter and sex.
Addiction also may obscure other mental health disorders such as depression, anxiety and bipolar disorder. These issues may begin to surface only after the client starts to address his or her substance abuse, however. Then the client can begin to work on the root cause of the addiction.
Another cause of substance abuse that is becoming more prevalent in recent years involves medications prescribed by physicians to help patients manage pain caused, for example, by injury. For some such clients, extended use of opioids may actually increase their sensitivity to pain, so they often abuse the drug by increasing the dosage or prolonging its use after their prescription has run out.
The Life Recovery Program offers support and education to those working to change their neurological pathways, but it’s hard work. As one program client says: “There is no magic pill.”
The Underlying Issue
Johnson was surprised to discover that alcohol wasn’t actually the source of her problem, but was rather a coping mechanism. At the root of her alcohol addiction was anxiety, and alcohol was her way of coping with those feelings.
“At my first meeting, I heard people talking about their triggers and, now that they’re sober, how they deal with things,” Johnson says. “You can’t really heal until you know what your sickness is. Alcohol may not be at the root. It may be anxiety or some other factor. Everyone has underlying issues.”
Johnson frequently had used alcohol to ease her anxiety when in large groups of people, so she was hesitant about joining a group therapy program. Breeden assured her, however, that the group was supportive and nonjudgmental, and that the meetings were intended to be a “safe place” in which participants could share their experiences. That was the beginning of Johnson’s recovery.
One of the coping skills Johnson learned in the Life Recovery group was mindfulness, the practice of bringing oneself back into the present moment in order to regain control of one’s emotional state. She now practices mindfulness daily to help her be more aware of her emotions and how they can trigger her desire to drink.
“When you realize you’re going down a path that will lead you to use, you can stop,” Johnson says. “Mindfulness is a huge help!”
To further explain mindfulness, Breeden suggests imagining life as a car.
“I am driving my car, but if I let my anxiety or anger drive that car, I’m going to wreck,” Breeden says. “Mindfulness puts us back in the driver’s seat.”
Breeden teaches clients these steps to help them manage their emotions:
• Breathe. Use a breathing exercise and practice every day.
• Change thoughts from negativity to strength-based thinking: “I’ve got this.”
• Be mindful. Find a distraction. Go outdoors, look at the blue sky and use your five senses.
“Breathing tends to speed up when we’re anxious, so with mindfulness we focus on slowing down and thinking about breathing,” continues Breeden. “And we reopen our five senses. Repeated substance use can numb our senses, so we need to learn to see, hear, smell, feel and taste again.”
Breeden says that taking these simple steps “brings you back into the present moment.”
A Young User Turns His Life Around
Nick Brown, now in his mid-20s, began abusing substances when he was a young teenager. At the time, his main focus in life was getting high.
Brown realized he was addicted when, at age 15, he looked in the mirror and saw how sick he was.
“I looked as if something had sucked my soul out of my body, and it took all the happiness with it,” he recalls. “I was choosing synthetic happiness over genuine happiness.”
Like many substance abuse addicts, Brown had to hit “rock bottom” before he decided to stop using. In jail for the second time and facing a possible 20-year sentence, he realized something needed to change after, in a life-changing stroke of good fortune, he was released on a technicality.
“I fell to my knees and cried,” he says. “I swore to God that I would change.”
Brown’s path to recovery has been similar to that of many other users. While circumstances vary from person to person, the recovery path often follows these general steps:
• Suffer the accumulation of negative consequences as use becomes abuse.
• Desire to stop substance use.
• Stop using.
• Maintain sobriety by learning about triggers and managing them with new coping skills.
• Stay vigilant through 12-step programs and/or community support groups.
• Plan for relapse. If/when relapse occurs, talk to your therapist to learn what triggered the setback and how to prevent a recurrence in the future.
“I didn’t know it was going to be so hard,” Brown notes. “I thought that when I hit rock bottom and admitted my use, I’d be able to change. But it’s not that easy.”
Recovery is never easy, points out Breeden. “Clients may stumble on their path and relapse,” she says. “It takes determination, honesty and courage to get back up and continue the journey.
According to Brown, his biggest challenge has been “coming to terms with all the destruction” caused by his behavior.
“Most people with substance addictions deal with guilt, shame and other consequences of their use,” Breeden adds. “The families of addicts, likewise, are often forced to deal with issues related to the disease.”
Dealing with consequences has certainly been part of the recovery process for Brown.
“I threw away everything I had: a trust fund for college, my relationship with my father,” Brown says. “The worst thing is knowing that it wasn’t only my life I threw away—it was the lives of others, too. I had to realize how much I had thrown away, and then I had to accept it.”
The group therapy aspect of Life Recovery has been significant in Brown’s recovery, and he now continues to participate in sessions in part to help others in the program who are recovering from addiction.
“Supporting people is something that helps me,” Brown says. “It really means a lot when someone tells me that I have inspired them.”
Helping Family Members of Users
Life Recovery also offers help to family members who have been affected by the substance abuse of their loved ones. Through the program’s services, relatives can learn how to support a recovering addict and improve their relationship in the process.
After the eight weeks of Life Recovery, clients have the option of attending a monthly group session. Another option is to attend Alcoholics Anonymous meetings, which shares numerous principles with Life Recovery.
“This isn’t just about recovery; it’s about your life,” Brown says. “I guess that’s why the program is called Life Recovery—it goes beyond just dealing with addiction.”
With a year of sobriety now behind her, Johnson is feeling stronger than ever. These days if she gets invited to a gathering where others may be drinking, she decides ahead of time, based on her state of mind at the time, whether attending would be a wise idea.
“Alcohol wasn’t my only trigger, though,” she says. “Everyday stressors and life events also caused me to turn to alcohol. Now, thanks to Life Recovery, I have an effective way to deal with them.”
Robin Breeden, LCSW, Substance Abuse Coordinator, Sentara RMH Outpatient Behavioral Health
Robin Breeden, LCSW, has been an active, licensed professional therapist in this community for more than 20 years. She earned a master’s degree in social work from Virginia Commonwealth University in 1998 and received her Virginia Board Licensed Clinical Social Worker license in 2004. She is the substance abuse coordinator for Sentara RMH Outpatient Behavioral Health and is a member of the Sentara RMH Emergency Department’s Psychiatric Evaluation Team.
Breeden has extensive experiencing working with adolescents, families and individuals dealing with mental health concerns and substance abuse issues. She has had a private practice for seven years; and also has worked for Broadway High School and J. Frank Hillyard Middle School for three years as a prevention/intervention crisis counselor.
If you or someone you know needs help dealing with alcohol or drug abuse, call Sentara RMH Behavioral Health Services at 540-564-5100 and ask to schedule an appointment to determine whether Life Recovery would be an appropriate program for you.