Personally I think everyone should have their picture taken at their first AA/NA meeting and the copy given to them to keep forever in their wallet.  They should be able to see how they looked at the beginning and how much better they look now.  It would speak volumes.

Family and friends can see the difference, even though they may have quite a time trusting. And no one can blame them for that. But, everyone who knows the recovering person is aware that something hard to define is very different.

And that is a very good thing.

Newly sober or clean people have little defense against anxiety, and the only relief they know is to medicate it one way or another as quickly as possible.  So the wisdom of AA/NA, is to use the slogans such as One Day at a Time or Think, Think, Think or Easy Does it to remind themselves to bring the anxiety into the present moment where it can be mediated personally.  And it works.

Mental Health sets up their path at exactly this point by either using Cognitive Behavioral techniques that do not work, or advising either anti anxiety medications or anti depressants.  At this point the paths diverge and for many never converge again in natural abstinence.  Diagnoses are made to comply with insurance regulations, the client is labelled as mentally ill and the need to continue the medication becomes pivotal to continued care.

It all could have been avoided with the 12 Step approach.  But for many it is the beginning of many years of decreased capacity due to mental health drugs they never needed in the first place.

It is the cherished desire of the majority of early recovery folks to get back on the track and salvage their former career.  That usually is foolhardy. We are so lacking in emotional and social skills that we are mostly unemployable, regardless of our former position.

If we are fortunate to be able to continue with the job we had when we hit bottom our performance and efficiency will be altered, at least at first. We have no real respite for the roller coaster of our emotions at first. For years we moderated them instantly with chemicals of one sort or another. Now they are out of the box running loose every day.

Here is where the wisdom of the ‘getting sober’ job comes in. Not challenging oneself about what one can really handle is very smart. Better a physically oriented rather than intellectually oriented position at first. This phase is best planned on for at least 6 months, and better a year. Seriously.

We are talking about life or death here. If you had cancer wouldn’t you expect a period of recuperation? Why not alcoholism or drug addiction then?  Take it slow, go to may meetings, develop a support system in the fellowship and ease on down the road.

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The sponsor’s role is to guide you through the 12 Steps. not an easy job for them as most folks are really nuts when they arrive at AA/NA doorstep. They are blithely unaware of their emotions, and what they have are largely unidentified and uncontrolled. Their lives are in shambles from the effects of their substance use, and the call to repair that comes from many angles at once.  The ability to regulate emotions, time, finances, communication, are all compromised through the years of addiction.

And it is the sponsor’s job to try to mediate all that while keeping the sponsee on the path of working the 12 Steps.  That’s why the sponsor has to keep very good boundaries about what their responsibility to the newcomer really is.  It is only to guide the sponsee through the Steps into the beginning of a new life.

Whatever the reason for the change it is heartening and very visible. One day a newly recovering addict or alcoholic starts to look different. They can see it in the mirror and you can see it looking at them.  African American skin gets lighter, caucasian skin looses the blotchy pink appearance, and the eyes get brighter and hair shines.

Alcoholics and addicts clean up well. It isn’t long before the early recovering person looks like he or she was never a chronic substance user. This is a plus and a minus. Along with this comes fragile self esteem and confidence that could lead to the completely addictive thinking concept that they can jump right back into life with vigor.

At that point, the AA/NA sponsor is hopefully in place to guide them to staying focused on the goal of long term clean and sober living. This is where the smart move is to get a ‘getting sober job.” This phase is where many well meaning early recovery folks pick up something and fall back into the dark pit of addiction.

This reality dawns in the first few days of abstinence. This thought is highly anxiety producing to the addict or alcoholic and the desire to continue whatever interface worked between the drug/alcohol meant to buffer life and the real meeting of life on life’s terms becomes irresistible.

Life on life’s terms is the issue. No mediating life with substances that color it different than it is seen by the majority. This is a tall order for the alcoholilc/addict. Enormous, earth-shaking, monumental changes done in a whisper.

Early recovery is a tight rope. It gets easier as the days accumulate, but at first balance is fleeting. So it is the same with emotions. Balance of emotions is pretty much impossible.  Duck and weave as the emotions show back up like a bad penny, greeting the newly abstinent with situations that challenge constantly.

Here is where the One Day at a Time philosophy fits right in.  Using that way of looking at the world makes it possible to maintain while the sober/clean world spins around you.

Treatment is totally unnecessary, it is a choice. It should only be a short term choice. The minimum option is 3 day hospital detox.  This is prudent, particularly if the person involved is addicted to alcohol. Seizures are very possible in alcohol detoxification. Other painful, totally unpleasant symptoms of any withdrawal will be present. Being in a hospital or other facility that is experienced in medical detox is smart.

Nowdays, however, these options are less and less available. Often what you can get is 3 days of medication such as  Librium from a family doctor or emergency room and the detox is your responsibility.

This is not the best situation. Not having experienced staff observing the detox is definitely indicated. It is not uncommon to find that the dose of withdrawal medication needs to be tailored to the person and altered during the detox time.  This cannot be done at home. But, often this is all that you can access for the person you are helping.

AA’s history and treatment before medications used alcohol tapering to detox.  Again, this should be done by someone who is experienced.

The good thing is the most acute withdrawal usually only lasts about 3 days. However, that is not the end.  Post acute withdrawal symptoms can last up to 6 months. Seriously. The damage done by long term alcohol or drug abuse is extensive.

The best advice is during the 3 day period to go to as many meetings as possible. Three a day is smart. The person experiencing the detox will find some relief in each meeting, despite their being very uncomfortable. They will find support from many others who have gone through the same experience.

That poses a problem. What is available, in all reality, is mental health/psychology based treatment.  This is especially true for those who do not have money to pay for private care. Most do not have any money left at the end of a chronic addiction or alcoholism.

In most areas of the country today programs for addiction treatment are few and far between. What there are are funded by government funds for the most part and those are definitely mental health/psychology based programs. They are only funded under that philosophy, with staff who have been trained in that philososphy.

So, what if that is not the path you wish to tread in your journey into recovery?  Then there are two options. First is detox on your own with some Librium type medication from a family physician.  Due to risk of seizure, this can be risky, especially with chronic alcoholics .  But it really may be all that is available.  At the risk of being simplistic, most withdrawal is over in 3 days.

Or, you can be selective, which probably means paying for private treatment. Or, do some serious research BEFORE it is necessary. Look ahead, call talk to the programs listen to what they say, target those who are clearly based in 12 step thinking and process. If you are helping someone, you know you are going to need help at some point.

The first realistic option will probably be a sober living house that gives long term support. This may follow the detox period, although a treatment program first would be optimum. And the addicted/alcoholic person will probably have to wait days or weeks to get a bed. In the meantime they need to go to a minimum of one AA/NA meeting per day. More is realistic. That is the only real support available.

The point being, just like anything else you have to be an intelligent, informed consumer of drug and alcohol treatment. And doing this while in denial, thinking you don’t have a problem, is the real trick.

Because what is learned by alcoholics and addicts experientially is that it is never going to get better on it’s own and it is going to get progressively worse. All of us who are grateful for our own abstinence completely concur that once you pass through the invisible line it’s going to go, usually slowly, downhill.

What is the invisible line? That is when you no longer have control over your drinking or drugging.  It has you, you no longer have a choice. This can easily be 20 or more years from the time you face jails, institutions or death or enter into the fellowship of AA/NA and live a sober/clean life.

This knowledge can be only really grasped in entirety by those who have stopped drinking and using. They learned it personally in the club with the most expensive dues in the world.