SMOKING - Blog

Patricia used to approach the holidays with an overwhelming sense of dread, because she never knew what her alcoholic brother might do to ruin them. As Thanksgiving floral arrangements gave way to sparkling Christmas ornaments and the drone of holiday music, her stomach would clench more each day and her mood would grow darker.

“Some years were just awful,” she recalls. “So often my brother would show up drunk and make a scene at family gatherings. He’d scare his kids, embarrass his wife, and break my mother’s heart over and over again. One year he got arrested a week before Christmas for driving under the influence and for disorderly conduct. I remember that we called the judge to ask if they could keep him in jail until after the holidays. We all breathed a collective sigh of relief when they did just that. We could finally relax and enjoy ourselves, knowing he was safe but unable to spoil things for everyone.”

Thankfully, those painful memories are distant ones now, because Patricia’s brother—after 25 years as a practicing alcoholic—stopped drinking 20 years ago. “But it took me several years after he went into treatment to trust him and his recovery,” she says. “For a long time, I still prepared myself for the worst, half expecting another midnight phone call saying he had been an accident.”

The holiday scene Patricia describes today, however, is right out of a Norman Rockwell painting. “My brother is a grandfather now, and he is like an excited little boy, eagerly watching his grandkids open the gifts he laboriously and lovingly picked out for each of them. I’m so grateful that my parents got to experience his sobriety and witness the profound changes he made in his life before they died.”

Patricia says her own involvement in the Twelve Step program of Al-Anon has helped her understand that addiction is truly a disease that affects the entire family. She says recovery has allowed her to unearth the meaning of the holiday season and reclaim them as the joyous and contemplative occasions they were meant to be.

In autumn, the early settlers of our country gathered and evaluated their harvest, preparing themselves for the challenging winter months ahead as they gave thanks for the bounty their hard work brought them. “This is how I view Twelve Step recovery and Thanksgiving now,” Patricia says. “I welcome it as a time to take stock of past experiences and meditate on the lessons I’ve learned—seeing those lessons as my ‘harvest,’ my protection for any future difficulties. Then I find ways to express my gratitude for all I’ve been given.”

Two years after her brother began recovery, for example, Patricia gave him a little music box for Thanksgiving that played “We’ve Only Just Begun,” thanking him for rekindling the flame of family that was almost extinguished in the winds of his alcoholism.

Patricia describes herself as a spiritual person who sees Christmas as another opportunity for deep reflection. “To me, Christmas is about love, acceptance and expectancy—a symbol of birth and hope,” she says. “I try to carry through with the ‘attitude of gratitude’ that I learned about in Twelve Step recovery, and use Christmas as a time to help others.”

Some years she and her husband and daughter play “secret Santa” and buy gifts for a family in need. Sometimes they serve meals at a homeless shelter or take an elderly friend out for a holiday lunch. She also likes to write letters of appreciation at Christmas to the special people in her life, letting them know what gifts they are to her.

“Recovery has been transformative for me, for my brother, and for my whole family,” she says. “Twenty years ago, I hated the holidays and feared what my brother would do. But then he sobered up and I got my big brother back. Along the way, I discovered the Twelve Steps. I guess miracles really do happen. Isn’t that what the holidays are all about?”

Alive & Free is a health column that offers information to help prevent and address addiction and substance abuse problems. It is provided by Hazelden web site at www.hazelden.org.

OA offers a spiritual solution to compulsive overeating

“I did not enter my first meeting with hope,” recalls one member of Overeaters Anonymous. “I entered with despair. But I left with hope, because it was the first time in my life that I realized or heard that I was not morally imperfect, that I was not weak-willed, that I was not some defect. I had a disease—the disease of compulsive overeating.”

These words capture some core principles of Overeaters Anonymous (OA). One is that its members have an abnormal relationship with food. Another is that no plan for healing this relationship can succeed when it’s based on personal willpower alone.

As an alternative, OA suggests reliance on a “power greater than ourselves,” also referred to as God or a Higher Power. This frankly spiritual approach sets OA apart from other responses to overeating.

Atheists and agnostics may well express skepticism: What can a relationship to God or a Higher Power possibly have to do with overeating? What can possibly work other than dieting, exercise, and self-control?

OA offers three answers to these questions:

First, you are free to define God or Higher Power in any way that you choose. These words refer to any source of help outside ourselves—for example, fellow members of OA. No belief in a supernatural being is required. As a result, OA’s doors are open to atheists, agnostics, and members of any religion.

Second, any solution to overeating must address mental obsession with eating. “Overeaters Anonymous,” the group’s core text, includes stories of people who lost dozens of pounds through dieting, exercising, and purging—only to regain the weight later. Even when these people shed pounds, their thoughts focused on food.

One OA member describes this mental state: “My whole life was about getting the food, buying the food, preparing the food, sneaking the food, and hiding the food from morning until night.”

Another person said, “I used food for everything. It was my excitement. It was my entertainment. It was my antidepressant. It was my social life.”

Driven by such compulsion, OA members recall doing things that no sane person would do: Eating stale, spoiled, or rotten food. Stealing from other people’s plates. Picking up food off the ground.

Third, abandon all attempts to remove the obsession by yourself. After all, your attempts to do this in the past have consistently failed. Instead, turn to your Higher Power for help.

“Overeaters Anonymous” the book puts it this way: “This mental obsession was something we couldn’t be rid of by our unaided human will. Another power, stronger than ourselves, had to be found to relieve us of it, if we were to stop eating compulsively and stay stopped.”

This solution might sound vague or impractical. But OA offers practical suggestions for getting daily guidance from a self-transcending source. For example:

• Rather than eating in response to a craving, attend an OA meeting or call someone in the program.
• Meet regularly with a sponsor—someone with longer experience in OA who serves as a mentor.
• Instead of acting on impulse, pause to pray or meditate.

You can learn more about OA by going online to www.oa.org. The Web site explains how to find OA meetings and related resources near you. The above quotes from OA members are samples from “Hearing Is Believing: OA Members Speak,” a recording available from OA on CD or cassette.

The following books may also be of interest:

• “Overeaters Anonymous, second edition” (Overeaters Anonymous World Services, Inc., 2001).
• “The Twelve Steps and Twelve Traditions of Overeaters Anonymous” (Overeaters Anonymous World Services, Inc., 2002).
• “Compulsive Overeater: The Basic Text for Compulsive Overeaters” by Bill B. (Hazelden, 1981).
• “Twelve Steps for Overeaters: An Interpretation of the Twelve Steps of Overeaters Anonymous” by Elisabeth L. (Hazelden, 1993).

Alive & Free is a health column that offers information to help prevent and address addiction and substance abuse problems. It is provided by Hazelden web site at www.hazelden.org.

Report Explores Barriers to Treatment

Although people recognize that they have a problem with alcohol, a survey finds that many don’t seek treatment because they’re not ready to stop using, according to the US Substance Abuse and Mental Health Services Administration (SAMHSA).

The SAMHSA report, “Reasons for Not Receiving Substance Abuse Treatment,” also found that many people fail to seek out treatment because they think they can’t afford it.

Of the 761,000 individuals who recognized that they needed treatment for alcohol addiction, 49 percent were not ready to stop drinking and 40 percent thought the cost of treatment was prohibitive.

“It is tragic that a major reason people continue to abuse alcohol is that they do not believe they can afford appropriate treatment,” said SAMHSA Administrator Charles G. Curie. “President Bush has proposed a three year ‘Access to Recovery’ program to provide $200 million more each year for substance-abuse treatment. This program would provide someone in need of substance-abuse treatment with a voucher to pay for the services. We really need this program if we are to provide treatment to the large numbers who say they cannot afford it.”

The report was developed from SAMHSA’s National Survey on Drug Use and Health.

There are two benefits from recovery: we have short-term gains and long-term gains.

The short-term gains are the things we can do today that help us feel better immediately.

We can wake up in the morning, read for a few minutes in our meditation book, and feel lifted. We can work a Step and often notice an immediate difference in the way we feel and function. We can go to a meeting and feel refreshed, talk to a friend and feel comforted, or practice a new recovery behavior, such as dealing with our feelings or doing something good for ourselves, and feel relieved.

There are other benefits from recovery, though, that we don’t see immediately on a daily or even a monthly basis. These are the long-term gains, the larger progress we make in our life.

Over the years, we can see tremendous rewards. We can watch ourselves grow strong in faith, until we have a daily personal relationship with a Higher Power that is as real to us as a relationship with a best friend.

We can watch ourselves grow beautiful as we shed shame, guilt, resentments, self-hatred, and other negative buildups from our past.

We can watch the quality of our relationships improve with family, friends, and spouses. We find ourselves growing steadily and gradually in our capacity to be intimate and close, to give and receive.

We can watch ourselves grow in our careers, in our ability to be creative, powerful, productive people, using our gifts and talents in a way that feels good and benefits others.

We discover the joy and beauty in ourselves, others, and life.

The long-term progress is steady, but sometimes slow, happening in increments and often with much forward and backward movement. Enough days at a time of practicing recovery behaviors and piling up short term gains leads to long-term rewards.

Today, I will be grateful for the immediate and long-term rewards of recovery. If I am new to recovery, I will have faith that I can achieve the long-term benefits. If I’ve been recovering for a while, I will pause to reflect, and be grateful for my overall progress.

From The Language of Letting Go by Melody Beattie.

Teenage girls in the United Kingdom consume more alcohol than their male peers, the Western Mail reported.

According to a survey conducted by the Schools Health Education Unit, 44 percent of girls aged 14 and 15 had at least one alcoholic drink a week, compared with 42 percent of boys. While boys generally drank more beer, girls consumed more wine, spirits, and alcopops. Teen girls were also more likely to smoke.

The researchers attributed the increase in drinking to teen girls trying to emulate the behavior of older peers and to outdo their male counterparts.

“They are going out and losing control as a result of alcohol and we are seeing them then putting themselves at risk through casual sex and all the infections that go with it,” said Baroness Finlay of Llandaff, a professor at the University of Wales College of Medicine. “We know chlamydia is on the increase. My impression from talking to students is there is a culture that to have a good time you have to go out and get smashed. There’s this huge peer pressure that you are only having a good time if you are drunk. Some of these girls look so grown up. They are so provocatively dressed, it’s quite difficult for somebody running a bar or pub to know if they are under-age.”

The survey was based on responses from 15,500 children from 196 primary and secondary schools across the UK.

Aim: Women have a higher susceptibility to alcohol-induced liverdisease (ALD) than men. Gender-related differences in food preferencewere described in previous studies for several populations,but not in alcohol abusers. As certain micronutrients are reportedto take influence on the development of ALD in animal experiments,the hypothesis of the present retrospective cross-sectionalstudy was that gender-dependent (micro-) nutrient intake inpatients with ALD may cause the higher susceptibility of womento this disease. Methods: In 210 patients (male: 158, female:52) with different stages of ALD (ALD1: mild stage of liverdamage; ALD2: moderately severe changes of the liver with signsof hepatic inflammation; ALD3: severely impaired liver function)and in 336 controls (male: 208, female: 128), nutrient intakewas determined by a computer-guided diet history, and relatedto the severity of ALD in dependence on the sex of the patients.Results: No significant differences between males and femaleswith ALD were calculated for the intake (per kg body weight/day)of protein, carbohydrates, fat, and the intake (per kg bodyweight/day) of most micronutrients. In females with ALD, higherintake was found for vitamin C (ALD3), calcium (ALD2), iron(ALD1 and ALD2), and zinc (ALD1), but the consumption of noneof these micronutrients seems to contribute to a higher susceptibilityto ALD in females. Conclusion: Though the present study confirmsthe higher susceptibility to ALD in women, the data of calculateddaily macro- and micronutrient intake do not suggest any explicitinfluence of gender-specific nutrition in the development ofALD.

Detachment and recovery from alcoholism

Like alcoholics themselves, the families and friends of alcoholics display symptoms

• denial,
• anxiety,
• guilt and
• require treatment.

Al-Anon groups have proved to be an excellent resource for these people.

But Al-Anon’s central concept, that of detachment, is resented and rejected by many prospective members of Al-Anon.

Detachment involves realizing that the family member or friend

• cannot control the alcoholic’s behavior,
• accepting this powerlessness, and
• separating one’s self from the behavior though not from the person.

It also means that family life must not revolve around the alcoholic’s problems and behavior and that the alcoholic must be allowed to take the consequences of his or her behavior.

It does not mean a block in communication; in fact, as a family practices detachment it will learn to let the alcoholic know its feelings.

Reddy, Betty; McElfresh, Orville H. (1978), Detachment and recovery from alcoholism. Alcohol Health & Research World. Vol 2(3), Spr 1978, 28-33.

Alcoholism may be a disease of isolation, but it is rarely an individual problem.

Understanding how “enabling” works is the first step in helping both the alcoholic and the co-dependent seek help.

Enabling is any action by another person or an institution that intentionally or unintentionally has the effect of facilitating the continuation of an individual’s addictive process.

Who Is An Enabler?

• Most often, enablers are persons who genuinely care about the alcoholic — family, friends, co-workers, clergy.
• Their love and concern, unfortunately, often leads them to do things that actually help the alcoholic stay that way.
• They “cover” for the alcoholic, inventing excuses for absenteeism, tardiness, or inappropriate behavior.
• They “save” the alcoholic by taking on the alcoholic’s responsibilities or sharing in the denial of the problem.

Yet, in their attempts to “help,” they are in fact encouraging alcoholic behavior by shielding the alcoholic from the consequences of his or her drinking.

Games Enablers Play

There are Many Ways to Enable an Alcoholic

As the saying goes, you are not the cause of someone else’s drinking problem, you cannot cure it and you can’t control it.

But there are ways that you may be contributing to the problem.

Before placing the blame for all the problems in your family or your relationship on his (or her) drinking, it might be wise to examine how the other person’s drinking may have affected you, and how you have reacted to it. For example, does the following statement sound familiar?

I don’t have a problem with my drinking! The only problem is your attitude. If you would quit complaining about it, there wouldn’t be a problem!

Well, obviously that statement is not completely accurate; after all denial of the problem is one of the more frustrating parts of the problem. On the other hand the statement may not be completely false either.

How do you react to the alcoholic’s drinking? Could your reaction be a part of the overall problem? Have you fallen into “role playing” in the family? Is there anything that you can do to improve the situation?

The following describes an incident that could be an example of alcoholic behavoir, and some examples of reactions to the incident. Does any of these sound familiar?

The alcoholic comes home late and he is drunk, too drunk in fact to get the key into the front door lock. After several futile attempts, he decides that it is a lost cause. Since he does not want anyone in the house to know that he is too drunk to unlock his own door, he makes a brilliant decision that solves his problem. He goes to sleep in the front yard!

How would you react?

The Rescuer

The “rescuer” doesn’t let the incident become a “problem.” Since she has been waiting up for him anyway, she goes out in the yard, gets the alcoholic up, cleans him up, and puts him into bed. That way the neighbors never see him passed out in the flower bed!

She never mentions the incident to him or anybody else. If anyone else mentions it, she denies there is a problem. She lies for him, covers up for his mistakes, and protects him from the world.

As the problems increase and his drinking gets worse, she takes on responsibilities that were once his. She may get a job or work extra hours to pay the bills. And if he gets in trouble with the law, she will move heaven and earth to come up with his bail.

The Provoker

The “provoker” reacts by punishing the drunk for his actions. She either waits for him to wake up the next morning and gives it to him with both barrels, or she goes out and turns the water sprinklers on!

She scolds, ridicules, and belittles. She nags. She screams insults at him loud enough for everyone to hear. She gets on the telephone and tells all her friends he’s a loser. She is angry and she makes sure that the alcoholic and everybody else knows it. Or she gives him the cold shoulder and doesn’t speak to him. She threatens to leave.

She doesn’t let it go, either. The anger and resentment continue to build as these incidents become more frequent. She never lets him forget his transgressions. She holds it against him and uses it as a weapon in future arguments — even months or years later.

The Martyr

The “martyr” is ashamed of the alcoholic’s behavoir and she lets him know it by her actions or words. She cries and tells him, “You’ve embarrassed us again in front of the whole neighborhood!”

She sulks, pouts, and isolates. She gets on the telephone with her friends and tearfully describes the misery that he has caused her this time! Or she is so ashamed of it she avoids her friends and any mention of the incident.

Slowly she becomes more withdrawn and depressed. She may not say much about it to the alcoholic, but she lets him know with her actions that she is ashamed of him. Quietly she tries to make him feel guilty for his behavoir.

Which is the Enabler?

The above examples may be somewhat of an exaggeration, but then again they may be very typical of what goes on in an alcoholic home. The “roles” the nonalcoholic spouse plays in the family may not be as well defined, as they are outlined here. Depending upon the circumstances, the spouse may fall into one of these roles, or may switch back and forth between them all.

So which of the spouses described above is an enabler? Which one is actually helping the alcoholic progress in his disease? Which one, although they are trying to make things better, are actually contributing to the problem?

All of them.

Al-Anon may be of help for you

Sex is supposed to be enjoyable, but for countless women suffering from vulvodynia, that’s not the case. 

Characterized by;

• pain or discomfort with sexual intercourse,
• rawness,
• stinging,
• itching and
• burning in the vagina or vulva,
• vulvodynia is a common condition, but it is often undiagnosed or misdiagnosed.

“The symptoms of vulvodynia mimic those of other, common vulvovaginal infections,” explains Christin Veasley, associate executive director of the National Vulvodynia Association in Silver Spring, Md. “Women are routinely and incorrectly told that they have a yeast or bacterial infection over and over again.”

Vulvodynia is more prevalent than most health practitioners realize. Roughly 16% of women between the ages of 18-64 have experienced chronic vulvar pain for at least three months or more, according to a survey by Brigham and Women’s Hospital in Boston, Mass.

The word “vulvodynia,” literally means “painful vulva,” which is the part of female genitalia that consists of the mons pubis (fatty tissue at the base of the abdomen), the labia (lips), the clitoris and the vaginal opening. Women who suffer from vulvodynia may experience intermittent or constant pain which can persist for months to years.

Making matters worse, vulvodynia is difficult to diagnose. A diagnosis often occurs only after other conditions are excluded. “Vulvodynia is diagnosed when other causes of vulvar pain, such as yeast or bacterial infections, or skin diseases, are ruled out,” Veasley said. The tissue of the vulva region may appear swollen or inflamed, but more often than not, it looks normal.

The cause of vulvodynia is unknown. This is partly because there has been a lack of research on the disorder in recent years. What is known is that vulvodynia is not caused by a sexually transmitted disease. According to the National Vulvodynia Association, potential causes include:

• An injury to, or irritation of, the nerves that innervate the vulva.
• An abnormal response of different cells in the vulva to environmental factors (such as infection or trauma).
• Genetic factors associated with susceptibility to chronic vulvar vestibular inflammation.
• A localized hypersensitivity to yeast.
• Spasms of the muscles that support the pelvic organs.

Currently, there is no cure for vulvodynia, but it is important for women to seek medical attention because the pain can be managed and treated. “Treatment is directed at symptom relief and includes drug therapy to ‘block’ pain signals,” Veasley said. “In women who have associated pelvic floor muscle spasm or weakness, physical therapy, biofeedback and/or Botox injections may be incorporated into the treatment plan.” Because each case is different, treatment tends to be tailored based on individual needs and responses.

Some women find self-care measures to be helpful in alleviating the symptoms of vulvodynia. These include:

• cold compresses,
• anti-histamines,
• the use of lubricants before sexual intercourse and
• avoiding triggers like
• hot tubs,
• tight-fitting undergarments and
• irritating soaps and detergents.

It is highly recommended to work together with a health care provider who can help identify the approach that works best for each individual.  

The National Women’s Health Resource Center also has a number of consumer-oriented materials on vulvodynia available online at http://www.healthywomen.org/.

SOURCES; NIH Office of Research on Women’s Health. “NIH Launches Campaign to Raise Awareness of Vulvodynia, a Painful Disorder Affecting Many Women” (Oct. 24, 2007). http://www.nih.gov/news/pr/oct2007/od-24.htm.

Along with taboo topics such as politics and religion, many people are reluctant to discuss managing a chronic illness with family or friends, according to a new survey of more than 1,000 adults.

The survey found that 82 percent of respondents said they knew someone with a chronic illness, but only 34 percent were likely to suggest ways for this person to better manage their care. That’s about the same number who said they’d debate politics (37 percent) or religion (33 percent) with a loved one or friend.

only 34 percent were likely to suggest ways for this person to better manage their care

Respondents were more likely to;

• discourage friends or loved ones from buying the wrong house (65 percent),
• loan them a large amount of money (56 percent),
• advise them against taking a job they didn’t think was right for the person (48 percent), and
• tell them their spouse was unfaithful (41 percent).

The reasons why many Americans are reluctant to offer advice to chronically-ill friends or family include:

• They think the person has the situation under control (66 percent);
• they are not a health care professional (31 percent);
• they don’t want to seem like a nag (31 percent) or
• rude (29 percent);
• they don’t believe the person would listen to them (27 percent); or
• they didn’t think the matter was that important (15 percent).

Other findings:

• Twenty percent of respondents said their spouse was the easiest person to give advice to about health, followed by a child (20 percent), mother (13 percent), and father (5 percent).
• Most respondents said they’d prefer to receive advice about managing a chronic illness from a health care professional (67 percent), followed by a spouse (10 percent) or parent (7 percent). Men were twice as likely as women (14 percent versus 7 percent) to have their spouse give them such advice.
• Men have an easier time offering health advice to their spouse (28 percent) than women (19 percent). Women have an easier time offering health advice to their children (24 percent) than men (16 percent).
• Thirty-four percent of respondents said the person closest to them with a chronic illness is a parent (34 percent), followed by another relative (16 percent), spouse (14 percent), friend (11 percent), sibling (8 percent), and child (6 percent).

Tips on how to help family or friends, or even patients with a chronic illness:

• Talk to them in order to get an understanding of their goals. Get the conversation started by discussing events or activities they used to enjoy or future events they want to be part of, such as a family reunion. Once you understand their goals, you can help them achieve them along with health care providers, doctors or community service agencies.
• Appoint an “ambassador” — a friend or loved one feels comfortable talking with and respects enough to heed his or her advice. This person can help the ill person manage their condition.
• If you don’t already know, increase your comfort levels by educating yourself about the person’s chronic illness. This will make you feel more comfortable speaking with them about the condition and reinforcing professional advice.