Going the Distance

Goal

To be able overcome social pressures, stay motivated, and determine treatment options

Facing Social Pressures

Giving in to social pressures is the second most common cause of relapse. It is especially important to plan ahead on what to do when someone offers you drugs or tries to influence you to drink again. Be prepared for those situations!

1. Awareness and Avoidance. Be aware of direct and indirect social pressures. Stay away from situation that set you up to use. Going to the bar or parties with drugs are unnecessary risks. Avoid high-risk people, places, situations, and events, especially when you feel vulnerable to the influence of others or you are aware that your own desire to use is strong.

2. Acceptance. Keep in mind that a part of you may always be tempted to give in to pressures to use. Learn to accept and live with this part of yourself, because it is not likely to go away completely. Usually, the part of you that wants to use is strongest in the first few weeks and months after you stop using.

3. Visualization. Imagine yourself in situations in which others are offering you substances, and visualize yourself continuing to confidently say no. Visualize yourself in control of the situation and continuing to successfully resist internal and external pressures to use.

4. Assertiveness. Assertiveness refers to clearly and directly saying you will not use substances when offered them by others. Assertiveness involves being direct but not aggressive. You can aid your recovery by saying “no” in a direct and assertive manner before you are actually in situations in which others pressure you to use. Practice with a therapist, trusted friend or family member, or alone in front of the mirror.

5. Support group. Stick with your sober support group. You will learn how others have successfully resisted social pressures to use substances.

6. Keeping your goals in mind. Remind yourself privately of your sobriety goals and of the gains you’ve made so far. Regularly review your short-term goals (next few minutes to next few days) and how they fit in with your long-term goals.

7. Self-talk. Give yourself a pep talk about why you want to stay sober and how you are capable of resisting pressures to use. Talk yourself into the desired way of thinking. Don’t allow yourself to fall for the thought, “A few won’t hurt.” Remember your counterstatements for harmful thoughts like this. Tell yourself “I don’t need to use; I can resist.” Remember the problems your use has caused in your life and the benefits of continued sobriety.

8. Emergency planning. Some situations can’t be avoided, so know your options before a difficult situation occurs. If you feel it is important to attend a social or work event at which alcohol is being served or people are smoking cigarettes, plan to stay only a short time or take with you a supportive friend who knows you are trying to avoid drinking or tobacco use. If you feel the pressure to use growing in a particular situation, leave immediately. Avoid long discussions about why you don’t want to stay or why you aren’t drinking or smoking unless you think this will make it easier for you not to use.

Social Pressures Exercise

Instructions: List the social pressures you face and rate them from 0-5 using rating scale and tale below. Write down what coping strategies you want to use for each pressure, paying special attention to the ones with the highest difficulty.

Helpful Tips to Go the Distance

It can be difficult to stay motivated, to make the most out of treatment, and/or to determine whether you would benefit from using medication. If you are not in treatment, we strongly recommend it. Despite the stereotypes, this makes you no weaker as a person. If anything, it shows you have the strength to admit you can benefit from the help. Having some extra accountability will do nothing but good, and (also despite the stereotypes) most therapists really do care and are able to help significantly. Keep in mind that regardless of if you are taking medication or not, you have to learn coping skills to change your life and manage your disorder(s). While medications can be helpful, other strategies are also needed, which is why counseling or therapy can be helpful.

Here are some helpful tips from those who have “been there and done that”:

Staying Motivated

• Renew your commitment to recovery by reviewing your reasons for quitting alcohol or drug use.
• Remind yourself that low motivation is a temporary situation and things can change in the future.
• Review the benefits you have experienced in your recovery so far (write them down to remember).
• Identify additional benefits from continued participation in recovery.
• Remember the problems caused by your use of alcohol or other drugs.
• Think about your children or other important people in your life & what your recovery means to them.
• Ask for input from others in recovery to find out what they did during periods of low motivation.

Making the Most out of Treatment

• Share your story and history. This will help your counselor or other helpers to make better recommendations for your treatment and recovery plans.
• Develop a trusting relationship with a therapist or counselor. Let them know what bothers you, what goes well, what you like and dislike about your work together, and your problems. Tell the truth about close calls, cravings, motivational struggles, and relapses.
• Keep your appointments and stay in treatment long enough to reap the benefits. Do not create excuses and leave treatment against the advice of the people providing your care. Almost everyone who leaves against medical advice goes back to their problem.
• Get help with motivation when it is low.
• Accept that recovery is ongoing. There is no such thing as a quick fix.
• Acknowledge that recovery can be painful. It requires an open and honest look at life in relation to alcohol and drug use, and how this use has affected you and others. This self-examination may evoke guilt, shame, anger, and disappointment. As recovery progresses and changes are made, the pain decreases.
• Make abstinence your goal.
• Make changes in yourself. This is the real challenge of recovery. These changes may relate to thinking patterns, how emotions are handled, how problems are solved, relationships to others, how you spend free time, and self-image. These changes should be related to what you want to see different in your life.
• Address family issues. Since substance use disorders affect the family, discuss with your counselor the impact of your substance use on your family, how to improve family communication and relationships, and what treatment and self-help services can benefit your family. Involving your family in your recovery lets them support you and allows you to support them too. When families are involved in treatment, the outcome often improves.
• Consider medications.
• Improve your coping skills.
• Attend mutual support group meetings and expand your recovery network.
• Get help with any psychiatric problem.
• Prepare for lapse and relapse.
• Review your progress frequently, especially in early recovery.

Determining if You Need Medication

• You have been unable to stay off alcohol, tobacco, or other drugs for longer than a few months at a time.
• You have tried other forms of treatment and still gone back to using alcohol, tobacco, or other drugs.
• You feel it is very difficult not to drink or use tobacco or other drugs, although you know you should quit and want to quit.
• You often feel overwhelmed by cravings and strong desires to use.
• You have a lot to lose if you relapse, such as an important relationship, a job, or your professional status or license.
• Your physical health or mental stability has been greatly affected by your substance use and will continue to get worse if you use.
• You believe medications will help you benefit more from other forms of treatment such as professional therapy or participation in self-help groups.

Questions to Ask Your Doctor about Medications

• What is the purpose of this medication?
• When should I take this medicine? Should it be taken with food, or should I avoid eating before or after taking it?
• How long will it take for medications to have an effect on my symptoms? Which symptoms are most likely to be relieved?
• How will I know this medication isn’t working for me?
• What are the side effects? Will they go away? If they don’t go away, what can I do about them? Which side effects should I report immediately to my doctor?
• What are the risks of not taking this medication?
• How long will I need to take medication?
• What happens if I drink alcohol or use other drugs while I’m taking this medication?
• Are there other medicines, including over-the-counter drugs, that interact with this medication?
• What are the dangers of missing dosages of medications or taking more than prescribed?
• If I feel like quitting my medications, what should I do before stopping?

Tracking Progress

Although it often feels like an uphill battle, you may be amazed after a while to look back and see how far you have come. Few things are more encouraging. And yet it is all too easy to not take note of your progress???unless you are taking notes! One way to measure progress is to look at the effects of your substance use. If you are having fewer or less severe problems resulting from substance use, then you are also headed in the right direction. Consider this example:

Melanie has managed to reduce her substance use by about 80%. She recognizes that she still needs help and is working toward total abstinence. But because Melanie has significantly reduced her alcohol use and completely stopped her marijuana use, she’s had fewer disagreements with her husband, has not missed any work due to hangovers, and is not spending money that should go toward bills. Whereas she once felt like a hopeless alcoholic, Melanie now feels there is hope for her. Seeing her life improve has given her more incentive to continue working hard at achieving and maintaining total abstinence from alcohol and marijuana.

Keep in mind that if you are unable to achieve total abstinence but notice you are using smaller quantities and less often, this is a step in the right direction. You are making progress! Remember that this is a lifelong journey, but we think you will be amazed at what your decision to not turn back will accomplish.

Tracking Progress Exercise

Instructions: Keep a daily record using the table below to indicate if you remained abstinent or lapsed, how much you used if you lapsed, and how well you met the following goals:

1. Improvement in functioning and quality of life
2. Feeling more confident in your ability to cope with cravings and pressures to use
3. Increased awareness of high-risk situations
4. Willingness to discuss a close call, lapse, or relapse

You’ll need one table per week. Use this rating scale to evaluate how well you met the 4 goals:

Tip: If you are remaining abstinent but your ratings are not improving, discuss with your therapist and/or supporters what could be changed about your plan. “If it ain’t broke, don’t fix it,” but if it’s not working, change it.

Next Step

To learn more about treatment options, feel free to check out this website:
http://turntohelp.com/starting_treatment/?gclid=CK6XzLzMprwCFZN9OgoddA8AlA#what_are_my_treatment_options