Relapse

Pain Pills
1
the below is from a handout that is available at the pasadena, california pills anonymous meetings, regarding pill addiction and relapse. it discusses relapse and how some of us from pills anonymous regard it.

although there is no "formal" pills anonymous organization such as alcoholics anonymous or narcotics anonymous, the fellowship has been around for quite a few years throughout various states within the united states.

i read a lot here about chronic pain and conditions that affect one's recovery. i hope this helps anyone who is searching for an answer the 12 steps way.

namaste'

sammy

___________

There are SO many questions from pill addicts on the subject of relapse. We thought you might find this useful. There is, of course, no "official PA literature" because PA does not yet exist as a formal organization. This handout reflects the understanding of the authors only -- but, for what it's worth, they both have a fair amount of time in recovery from prescription drug abuse.

What is a Relapse?

We think it important to provide members of Pills Anonymous with a means of self-determining whether they have suffered a relapse.

Many dictionaries use terms such as "slipping back" to define the word "relapse," which is probably why we hear our fellows in 12-step programs talk about having suffered "a slip." But when mind-altering prescription drugs are sometimes required and can even be used by many of us under very tightly controlled circumstances, how do we make it clear what constitutes a relapse for a prescription drug addict without being either too harsh or too easy on ourselves?

Before we suggest an answer to that conundrum, we need to examine why we're insisting on defining this concept when books such as Alcoholics Anonymous do not. The following true anecdote reveals at least some of the reasons why.

One of our members -- an alcoholic who had relapsed twice on prescription pain medications after multiple years sober from alcohol -- shared in an A.A. meeting that he was suffering from significant pain originating with some legitimate spinal disc problems. He was expressing gratitude that he didn't have to drink or use mind-altering prescription drugs for the pain, but asked for the support of the group during this difficult period.

An A.A. friend of his -- someone with long-term sobriety -- came up to him after the meeting. The friend shared that he had to take prescription pain meds on a number of occasions as a result of chronic bad back conditions, and said that, in his opinion, "all you have to do is just take the medications as prescribed and it's OK -- even A.A. literature says it's OK!" To which the P.A. member replied, "I'm happy for you that you can do prescription drugs safely, but tell me, can you take just one drink?"

The friend said, "no, of course not, one drink and I won't stop until I drop." The pillhead said, "that's what happens to me when I take one pill." Yet his friend still didn't "get it" anymore than a non-drinker really understands the craving felt by an alcoholic. In our experience, there are people with other addictions who can take prescription drugs without triggering a craving, without having the out-of-control reaction that we experience. And there are a lot of people with other addictions who "thought" they could take prescription drugs normally and ended up stunned, declaring themselves relapsed and re-setting their "sobriety clocks".

From the time A.A. was formed, a relapse for a drinker has been a pretty black and white affair. If the alcoholic drank, unless the consumption was blatantly accidental, it was a relapse. If he didn't, it wasn't. The high incidence of cross-addiction present in A.A. today was not anticipated. Today, P.A. members who are also in A.A. and other 12-step programs find that many other types of addicts do not seem to understand the phenomenon of prescription drug addiction and can even make suggestions to their pill addict friends that, in fact, put them at great risk. Horror stories abound about P.A. members whose AA or NA sponsors have told them "all you have to do is use them as prescribed." While that statement is true, our minds are such that they can create actual symptoms for which are pills are needed, fully justifying a prescription and often leading quickly to out-of-control pill abuse.

Another major reason for defining relapse in Pills Anonymous is the infamous capacity of prescription drug addicts to deceive themselves and others. All too often we have heard members rationalize that just because their primarily abused drug was Xanax, for example, taking Vicodin could not constitute a relapse. Yet the same person will usually think it's appropriate for A.A. members to consider marijuana use a relapse. Might there be a time when Vicodin use or even marijuana use (where legal) is appropriate? Yes! However, in cases such as these, we believe that it is best to seek the counsel of another person in P.A., most preferably one's sponsor, and not make that decision ourselves. Honesty must be our watchword. The quantity of prescription drugs taken is not the principal issue we believe our relapses can be identified before, or after, they happen by looking at the intent which accompanies our using.

We suggest the following self-examination questions be asked:

1. Is the mind-altering drug I'm considering taking, or taking, being prescribed by a physician who understands addictions or who is consulting with one who does?

2. Have I thoroughly explored alternatives to taking a mind-altering prescription drug and, even after close consultation with my P.A. sponsor and addiction-savvy physician, found them to provide insufficient relief?

3. Am I self-prescribing a particular drug for my current condition e.g., did I already have the drug as given to me for a past condition but making my own decision, without a physician's or sponsor's help, that I need to take the drug again now? Or am I taking a prescription written for someone else?

4. Am I taking the prescription drug beyond the dose prescribed for this particular situation?

5. Am I taking the prescription drug for longer than necessary, after I might have switched to a treatment which doesn't involve mind-altering substances?

6. Am I taking the drug to avoid a feeling rather than to treat a legitimate symptom?

7. Have I taken any other form of mind-altering substance (since we in Pills Anonymous, like our brothers and sisters in Narcotics Anonymous, believe that it is necessary to avoid the use of all mind-altering substances)?

If honest, soul-searching examination of your answers to the above lead to the conclusion that rationalization and self-delusion are at the core of your prescription drug use, then we suggest that a relapse has occurred.

There are, of course, extraordinary circumstances, which change the interpretation of any of these questions -- e.g., if we're stranded many hours from any medical care, suffer a compound fracture, and a companion happens to have pain medication with him. Would it be a relapse to self-prescribe under these circumstances? We think it's up to the individual to decide that for himself or herself, but most of us would say "no." We have found that such situations are rare, while situations in which we delude ourselves are common. In the rooms of Pills Anonymous there are members who have had to or might still be taking mind-altering prescription medications as prescribed because they have absolutely no other choice. We all help each other survive those times without engaging in addictive behavior.

Sometimes we balk at declaring ourselves relapsed. Our egos don't want to take another self-administered blow. We deride ourselves for our weakness and foolishness in the immediate wake of using the drugs inappropriately.

But, looking back on it, those of us who have relapsed, sometimes repeatedly, realize that it took both courage and honesty to admit our behavior and renew our commitment to the 12-step way of life. For what good is "time" in sobriety without the quality of sobriety that can only come with rigorous honesty? Thank God for our sponsors and others that went before us, who could remind us of this, and tell us that a relapse does not mean that we have lost all that we have learned to date -- only that we obviously missed a lesson or two and needed to re-focus on all the elements of putting sobriety first.

We only have today. If today we are blessed with not using at all or, at an absolute minimum, don't use in a manner which reflects the sick thinking of our disease, then, for today, we believe that we have done God's will. And if we have relapsed and have been able to stop, then at least God has saved us from ourselves, again, perhaps for the last time. We would be wise not to throw away the opportunity for honest recovery.

www.pillsanonymous.com
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Thanks, Sammy. At one point, I learned that marijuana is sometimes prescribed for cancer patients and this little tiny addict inside me said "SWEEET!" I related that anecdote to a friend of mine who now works as an addiction counselor and he had exactly the same reaction! We never fully recover, do we?

I remember your giving me this literature earlier this year when I was grappling with my pain med issues and it was extremely helpful to me.

Thanks again.

August
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Thanks sammy....that helped me so much. I love your posts...
kerry