The Weird Way We Treat Alcoholics

To understand the weird way we treat alcoholics lets imagine how diabetics would be treated if they got the same care as alcoholics.

First of all, diabetics would get no help until they were ready to accept abstinence. They would need to agree to eat no carbs at all. Their diet would be limited to meat, eggs, vegetables, and yogurt. If they refused to accept the MEVY diet we would say they are in denial. They would need to hit bottom: perhaps a diabetic coma or losing a toe will convince them to avoid all carbs. There would be no help early on. Pre-diabetic symptoms would be ignored, and the diabetic would be on their own until they were ready to accept the carb abstinence diet.

It sounds ridiculous doesn’t it? Who would expect a diabetic to never eat another carbohydrate? Yet that is how the disease of alcoholism is treated. We have a “one size fits all” approach to the treatment of alcoholism. We don’t help alcoholics unless they are willing to quit. According to the Center for Disease control, as reported in the CASA study Addiction Medicine: Closing the Gap Between Science and Practice, 73.2% of diabetics receive treatment for their disease, while only 10.2% of alcoholics ever receive treatment.

There were approximately 88,000 alcohol-related deaths in 2016. I wonder if there were more options available, over-drinkers might seek help earlier. As a former over-drinker, I could have used some early education about alcohol. Here are two things I wish I had known.

1. Females do not process alcohol as well as males.

If a woman and a man of the same body weight drink the same number of drinks per hour, she will become more intoxicated. Women who over-drink are more likely to become pregnant, and to pick up sexually transmitted diseases.

2. I would have liked to have been taught the basics of moderate drinking.

Like many, I tried for years to control my drinking — without the basic knowledge of how to do that successfully. I did not know how to track my blood alcohol level, or how to measure and track my drinks. I will never know if I could have successfully moderated my alcohol intake. If I’d had that information when I drank, I could have figured out in a few months if I was capable of it. To me this is an important point, that most over-drinkers do try to manage and control their drinking, but without some basic education they often flounder for years on end. With education, a problem drinker can give moderation a try and see if they are capable of controlling the amount they drink. If they succeed, great! If they learn that they cannot, most will opt for abstinence. A minority will choose to continue heavy and harmful drinking and for them some education about reducing harm would be useful.

There are other reasons why over-drinkers don’t seek or get help sooner. One reason is that the medical field ignores the problem. According to the CASA study, 2/3's of over-drinkers are in contact with a primary or emergency care about twice a year, yet physicians neither notice nor respond to the identifiable and treatable signs of addiction. This means that the person with the disease of alcoholism has to advance to late stages before the problem is noticed or addressed by the medical system.

Alcoholism is more likely to be noticed by the penal system. 44% of referrals to publicly funded treatment come through the court system. Employers make less than 1% of referrals to publicly funded treatment, while private insurance covers only 20% of the total costs of treatment for addiction.

Getting help for alcoholism is a challenge for most. Early help is practically non-existent. 90% of the treatment centers are abstinence-based and 12-step oriented. Even if a person is willing to go, the cost of private pay treatment is prohibitive for most. For publicly funded treatment there are often long waiting lists, lack of childcare, and numerous rules and regulations to be followed. And if treatment is available, practitioners with little or no medical training provide it.

If we treated diabetics like this it would be considered unethical. They would have to wait until their symptoms are dire to be noticed. They would have to break a law to get help. They would have to agree to eat no carbs in order to get in or stay in a treatment program. As the CASA study concludes,

“There simply is no other disease where appropriate medical treatment is not provided by the health care system and where patients instead must turn to a broad range of practitioners largely exempt from medical standards.”

I hope someday there is earlier and better care for alcoholics. I hope there is education that will help over-drinkers determine earlier whether they can control their drinking. I hope that someday the medical system, not the penal system, will notice, provide, or refer over-drinkers to better sources of care. I hope that moderation and harm reduction education will be commonly available for those who are not ready for abstinence. Mostly I hope that the weird way we treat alcoholics will end. 

Sponsor-caused Relapse

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A friend in AA told me recently how a woman in his home group relapsed. Let’s call her Sue. Sue had completed an inpatient treatment program, found work and a place to live and had six months of abstinence when she took her first trip in recovery, all the way to Alaska. The flight layover was in Seattle, Washington where the gal saw her first pot shop and legally bought a marijuana brownie, which she ate later in her hotel room.

The next morning Sue caught an early flight to Alaska, visited friends, enjoyed nature, went to meetings, and had a great ten day trip. She was pleased to have made it home safe and sound and excited to tell her sponsor about her trip. She even mentioned the marijuana brownie and was stunned when her sponsor said she had lost her sobriety. The sponsor told Sue that her six months off alcohol no longer counted because she had used a mind-altering drug. Sue was shocked, got flooded with adrenaline, and said, “In that case I might as well drink.” She hasn’t drawn a sober breath since.

I wish this were the only sponsor-caused relapse that I have heard of. Unfortunately this kind of thing is fairly common. Let’s look at what happened here, consider the sponsee’s losses, and think about how a sponsor could handled this situation in a way that didn’t lead to relapse.

Desire and Unity

In my opinion the sponsor forgot the third and first traditions. The third tradition says that the only requirement for AA membership is a desire to stop drinking. This sponsee had six months of continuous abstinence from alcohol. She had a desire to stop drinking and so was a member of AA-- even as she ate the pot brownie.

The first tradition states that personal recovery depends on AA unity. There was nothing unifying about telling a new comer that she had lost her sobriety when she had not had a drink. There is no step or tradition that suggests sponsors should punish or humiliate their sponsees. In fact it is quite the opposite. The first tradition says AA “jealously guards the individual’s right to think, talk and act as he wishes.”  So why was a member shunned over a marijuana brownie? How could a situation like this be handled differently? How could this sponsor have corrected an erring sponsee in a way that doesn’t result in relapse?  

A Softer Voice

The sponsor could have thanked Sue for having the courage and honesty to tell her about the marijuana brownie. She could have congratulated her on staying away from alcohol during her trip but let her know that the brownie was a bad idea. She could also tell her sponsee that many would not consider her “clean and sober” since she had used pot. She could have said the important thing was that Sue had not taken a drink, and warn her that using pot again would interfere with her recovery.  

First Do No Harm

Why is it so important that sponsors be gentle with their sponsees? Well, research shows that the more confrontational a counselor is with an alcoholic client the more that client is drinking a year later. A year later! I believe the same applies to AA sponsors. Sponsors should avoid taking a hard or judgmental line with their sponsees. If a client gets drunk after you have confronted them you need to change your methods. As Sue’s story shows, a sponsor can badly harm a newcomer.

Before telling her sponsor about the pot brownie, Sue had an AA home-group, a community she belonged to, a job and safe place to live, six months of sobriety from alcohol, and pride and dignity. Now she is drunk, unemployed and living on the street. That’s an awfully high price to pay for a marijuana brownie. I believe that sponsor-caused relapse is preventable and avoidable. Sponsors have a responsibility to help not harm those who come to them for support. Judgment and confrontation have no place in sponsorship

Write for us. Guest contributors welcome.

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Waiting for Good Enough

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I’ve finally noticed a pattern that I have had for my 30+ years in recovery: waiting to get my shit together before I take action. That’s a problem for me because the truth is I may never become the idealized person I’d like to be. I haven't yet. What I know at long last is that if I put off opportunities I may miss my chance. I can think of two people that I wanted to meet and could have met, but didn’t because I wasn’t ready, because I wasn’t good enough, because I didn’t have my shit together–yet. Both those people died while I was waiting to be a better person.

Thomas Leonard, pioneering how to coach “restoratives”

One was Thomas Leonard, the “father of coaching.”  I knew people who could have introduced me to Leonard. I wanted to talk with him because he knew a lot about coaching those he called “restoratives,” people who have experienced problems with addiction, trauma or mental health—the very people I work with as a professional coach with expertise in addiction. Thomas Leonard died in his forties of a heart attack. I missed my chance to hear his thoughts about how best to coach restoratives. I regret that. And there’s another person I missed, G. Alan Marlatt.

G. Alan Marlatt, pioneering prevention with Harm Reduction

I would have liked to have met G. Alan Marlatt. He did ground-breaking research on addiction at the University of Washington. I lived in Washington for twenty-one years, twelve of them in Seattle, nine in Port Angeles. I had a friend who knew Marlatt well and offered to introduce me, but I turned her down because I wasn’t ready. I’d gotten sick doing hospice work and didn’t have my shit together. I would have liked to talk about harm reduction with him. I would have liked to have talked about brief interventions with him. He was a pioneer in prevention, bringing Harm Reduction (HR) concepts to reducing campus drinking.  

Change is always an inside job.

I’ve missed my chance with Leonard and Marlatt. And I will miss other chances unless I change my thinking. I may never become the woman I want to be (darn it!) but I do have opportunities and need the courage to show up for them imperfectly. I need to be willing to show up as I am and let that be good enough.

No time like the present. I am more than good enough.

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There is one person I have wanted to meet for almost twenty years, another addiction professional. He is currently alive and well. I’m going to make a plan to meet him. Let’s face it, I may never feel like I have it all together. But rather than waiting until I’m a better, healthier, more ideal person, I need to recognize that I am good enough now to have a cup of coffee, good enough to have a conversation, smart enough to learn something and to contribute something. Just plain fine enough while the opportunity exists. Because opportunities are time-limited, and I don’t want to waste anymore of them waiting to be a better person.

 

No Matter What

Written 9/09/2016

No Matter What

Last month I celebrated thirty-three years of continuous abstinence from alcohol. Then a week ago I slipped going down a spiral staircase and descended to the bottom step on my bum. Quite a metaphor I thought, and it made me ask myself how I managed to stay sober all these years without slipping. I don’t think I would have lasted if I hadn’t made a decision—a decision to be on my own side no matter what.

Shame & Co.

The decision was made from shame, desperation, and determination. I was having an affair with a married man and struggling to stay sober and spiritually fit through all of it. I was discouraged that I could be so stupid stone cold sober.  How could I have fallen in love with the husband of a dear friend? Should I get drunk? Kill myself? What should I do?

Head Up

What I did was make a decision to be on my own side despite my stupidity and compulsiveness. I decided to save my own life for my own sake. I ended the affair to keep my recovery. And with the decision to be on my own side, I began to hold my head up, if only a little bit. I realized that I was an adult and that my recovery was my responsibility, that my life and well being were my responsibility—no one else’s. I decided that no matter what I did, said, thought, or felt that I would be compassionate to myself and be on my own side. I would hold my head up no matter what.

A Dirty Rag

It wasn’t easy being on my own side. I was a mess. An intuitive who met me at that time told me years later that when she met me she saw an image of dirty rag that had been used and tossed in the corner.  It was an apt metaphor. I did feel dirty and used, discouraged and lonely. But I had made a decision and I began to take care of myself. I stayed sober, began therapy, and kept myself very busy. I wrote and recorded affirmations and listened to them each night as I went to sleep. I went to meetings and didn’t drink. Slowly I healed.

The Biggest Difference

Of all the things I did to stay sober, I believe that my decision to be on my own side no matter what has made the biggest difference. When I am confused I ask myself, “What would I do if I were on my own side?” It isn’t that I don’t care about others. I do and make win-win decisions whenever possible. But I don’t forget the bottom line—that I am responsible for my own well being, and it is I who will live out the consequences of my choices. By taking responsibility for my recovery and the decisions I make and the actions I take, I know I have grown up. I am a full-fledged adult.

Bottom

When I landed at the bottom of the spiral stairs I was grateful that I hadn’t broken any bones. I was grateful that I wasn’t drunk, and that I could stand up and walk. I knew I would be sore and I was, but I got to have some quiet time. And so I noticed that I still make mistakes in recovery, even after thirty-three years. But I also noticed that no matter what happens, I am on my own side. That’s the bottom line—and it has made the biggest difference.

Some Thoughts about Opiate Deaths

I met my first opiate addict in the late 1960’s. We called them junkies back then. I was about 14 and “Crazy Al”, a disabled Korean War veteran, lived in the apartment below my friends. Crazy Al was the first person I saw shoot up, and in the next few years I would get to know five or six other junkies.

As a young female I rather liked junkies. They were kinder and calmer than speed freaks, more predictable than drunks, and they didn’t hit on me for sex. One guy had a steady job selling music records at a department store, one was a Vietnam veteran, a few were hippies, including a brother-in-law. I spent long afternoons listening to Nina Simone with one, and took walks with another opiate- addicted man. They all seemed pretty harmless to me and I’ve never understood why opiate addicts are so despised. What interests me now is that none of them overdosed and some are still alive today.

Why are so many opiate users dying of overdoses today? My belief is that it’s because the supply of opiates is far more variable. What you got in the 1960’s, ‘70’s, and ‘80’s was heroin, and heroin got weaker as it passed through the drug dealer chain, cut it with benign fillers.  One shipment might be a little stronger than the last, it wasn’t ten or fifty times stronger. That changed in the mid-1990’s when the fentanyl, a synthetic opiate said to be 50 to 100 times stronger than heroin, was approved by the FDA for “break through pain.” Illegally manufactured fentanyl is now commonly added to low quality heroin to improve its boost. Opiate products sold on the streets often contain unknown amounts of fentanyl and methadone (a longer acting synthetic opiate) as well as heroin. It’s the variability from dose to dose is killing even experienced opiate users today.

A gal I know lost her brother, a competent businessman and pilot, when he crashed his plane. He got hooked on painkillers after a car accident. After his doctors cut him off he started on street drugs. He died in his first year of shooting heroin.

Opiate and heroin-related deaths have tripled since 2010.  During 2014, 47,055 drug overdose deaths occurred in the United States. 61% of those were opiate-related. Some were prescription drug overdoses and some were related to street drug overdoses. Opiate overdoses occur when high amounts of opioids act on the part of the brain that regulates breathing. Opioids in high dosage cause respiratory depression whether the person is addicted or not. Fentanyl is known to produce more respiratory depression that other opiates, yet it is now commonly mixed with heroin. Naïve users may overdose the first time, especially if they mix in alcohol, benzodiazepines, or other central nervous system depressants. There are a lot of new opioid users. The number of opiate prescriptions issued in the U.S. soared from 76 million prescriptions in 1991 to 207 million prescriptions in 2013. But even careful and experienced opiate users now die due to the variability in street heroin.

There has been little mention or in news of the variability of opiates. There has been little effective public response to the opiate epidemic. Fortunately naloxone, an opiate antagonist, is becoming more widely available.  If naloxone is given soon enough it can bring someone back from an overdose.

Naloxone is available to hospitals, police departments and first aid responders, but still not available to drug users or their families. Many people object to helping opiate addicts. But imagine being the parent or friend of an opiate user and watching your child or loved one die before first aid responders arrive.  A European study reported that over half of the opiate users surveyed had witnessed at least one overdose. In Italy naloxone is available in pharmacies without prescription. Wouldn’t it make sense to make naloxone easily available to opiate users and their friends and family? The World Heath Organization recommends that naloxone be made available to anyone who might witness an opiate overdose.

Most people were horrified by Philippine President Duterte’s recent comments. He said, "Hitler massacred three million Jews. Now there are three million drug addicts. I’d be happy to slaughter them.” And he is doing just that. In the USA we don’t want to slaughter opiate addicts but we are allowing them to die in large numbers. The junkies I knew when I was a teenager would most likely have died of overdoses if they were using today. It didn’t used to be like that. But it is now.

Someone told me recently that Janis Joplin traveled with a man who bought and tested the heroin she used and let her know how strong a dose to take. Janis overdosed and died on a night when he was away. If naloxone had been available she’d still be singing. If we can’t stabilize the supply of street opiates the least we can do is make naloxone available.

Problem Drinking: The Help I Could Have Used

Sometimes I think about what sort of help might have shorten my years of active alcohol addiction, and what sort of help I would have accepted and found useful. I wasn’t trying to stop. I would have liked some help moderating my drinking—from someone who didn’t try to tell me to quit. Because I didn’t want to quit.

I wanted to drink like my parents who enjoyed several martini’s each night but never got drunk, and who never woke up with hangovers. That’s what I wanted when I drank, to drink without having problems. Learning about moderation would have been helpful—even if I found out I couldn’t do it. Because on my own it took years to determine and accept that I couldn’t control my drinking. With help I would have figured it out in months rather than years.

But no one offered me that kind of help, and it’s a shame because I barely survived my last years of drinking. In my last year of drinking one drunken man pounded my head into a concrete wall and bit me as I tried to escape. Another man, a Vietnam veteran trained in special forces thought he should kill me. And I could have killed someone myself, because I often drove drunk. Sometimes in a blackout. I really could have used some help.

It’s still hard for people to get the type of help they need when they need it. The USA gave birth to Bill and Bob and the 12-step abstinence movement. This movement gave rise to the belief that there are only two kinds of drinkers: alcoholics who can’t drink at all, and normal people who can drink safely. Addiction professionals now know that there is a continuum of problem drinking that ranges from experimentation and risky drinking to alcohol dependency to chronic alcohol abuse. We now know that problems with alcohol can be mild, moderate, or severe. But regardless of the nature of an individual’s drinking problems, the only solution typically offered today is abstinence.

Abstinence is not an attractive solution for most problem drinkers, so they don’t get help at all. They are left to find solutions on their own, or to drink until they “hit bottom” or die. We don’t make diabetics wait until they have a diabetic coma to get help, and we don’t make those with heart disease have a heart attack before they can get help—but that is how we treat problem drinkers. We only offer them help when we think they are ready for abstinence. We don’t offer problem drinkers the help they want. Here’s the help I would have liked.

I would have liked to been given William R. Miller’s book “Controlling Your Drinking” for my eleventh birthday. It would have gotten me off to a better start as a drinker, and if I had gotten it on my 17th birthday I would have understood why I was having multiple problems related to heavy drinking. As it was I spent years trying to figure out whether to stop between my 6th and 7th drink, or between my 4th and my 5th drink. I tried to avoid harm. I drank in gay bars to avoid being picked up by men. I didn’t mix alcohol with opiates. I learned to be mean and keep people away from me. But if I’d had a copy of Miller’s book I would have learned how to track my drinking and my blood alcohol level (BAL).

It’s a lot of work to track your drinking. And you have to do it while drinking! I might not have been able to moderate my drinking. I might have found that I couldn’t do it at all. But the point is I would have learned that sooner using Miller’s book.

By the way there good research has been done on Miller’s moderation program. In the previous year one in seven problem drinkers (15%) were able to maintain moderation by staying under 3 standard drinks per day and averaging only 10 drinks per week.  23% were able to reduce their drinking significantly to average 14 drinks per week, some still experiencing occasional alcohol-related problems. Nearly one in four (24%) had been abstinent for the previous year. Most quit either because tracking drinks and BAL was too much bother, or because they found that drinking wasn’t worth it if they couldn’t get drunk. Another 37% had continued heavy and harmful drinking.

I’ll never know if I could have stopped sooner, or learned to moderate my drinking. It’s a moot point for me since I have been continually abstinent from alcohol for 33 years. (And Miller recommends that those who are successfully abstinent stay that way.) I managed to live through 18 years of heavy and dangerous drinking, but many of my friends didn’t. I wish we all could have gotten the help we needed. So for those now struggling to manage their drinking I highly recommend Miller’s book, “Controlling Your Drinking.”

And if you need more help, hire a professional recovery life coach. They won’t tell you what to do, but they will help you sort out what will work for you. We’ve trained some really good coaches at Crossroads Recovery Coaching & Training. Get in touch if you are interested. We’ll tailor your coaching to the help you want now.

Fun with Food: its the right thing to do

Having Fun with Food (it’s the right thing to do…)

I am a foodie who prefers homegrown organic vegetables and wild caught fish, but I also like to have fun with food. I often eat with my fingers, and create weird combinations of ingredients. I never thought that having fun with food could be a protective factor until I heard about “Orthorexia” last week from Sean, one of my recovery coaching students. It turns out that healthy eating can become a deadly obsession.

“Ortho” is Latin for “right,” and Orthorexia Nervosa describes an extreme pattern of classifying foods as ‘good” or “bad,” as “pure” or “impure,” as “clean” or “dirty.”  Classifying food as good or bad results in food restrictions and the obsession to eat right—to eat only those foods that are good, pure, and clean and on ones current diet.  Eating the right foods each day becomes a source of pride while eating the wrong foods becomes a source of distress. Each day is a new chance to be good and pure through proper food choices and some orthorexics experience nausea or stomach pain at the mere thought of eating something they consider bad or unhealthy. For orthorexics, the right foods are regarded as a source of health rather than as a source of pleasure.

Eating wrong foods means one is bad or dirty and likely to get sick. Eating the wrong food means being weak, means failing to use strength and willpower to eat right. Violations of diet require fasting and cleansing in order to become healthy and pure again. Over time diets tend to become increasingly restrictive (for example, no dairy, no meats, no grains, only raw foods), and harder and harder to follow. As self-punishment for dietary transgressions increase, self-esteem declines, and enthusiasm for healthy eating becomes an obsession that leads to isolation, malnutrition, and sometimes death. My plan as a foodie who wants to avoid Orthorexia is to have fun with food and to experience eating as a source of pleasure.

For me there are various ways of experiencing pleasure from food. My favorites include eating delicious food with friends, letting myself eat weird things, and eating with my fingers. Yesterday for lunch, I combined honey and coconut oil and briefly heated that in a microwave, then mixed in breakfast cereal, cashews, salt, raisins, and potato chips. I ate it with my fingers. It was crunchy and tasty and my body liked it just fine. Today I will eat something different (my body wants some vegetables) and take the time to enjoy it. Here is a recipe from my foodie friend Kris. We have enjoyed this as desert after a healthy meal.

Heat and mix very dark chocolate with butter or coconut oil, add some honey and a few drops of vanilla extract. Stir, then lick off fingers.

And talk and laugh. Have fun with food. It’s the right thing to do.

Seven Things You Really Ought to Know About Hep C

I think it important to know about Hep C. It is associated with IV drug users but my mother got it from blood transfusions. She died in 1995 from liver cancer.  My sister was an IV drug user and got Hep C in her teens. She died in 2015 from liver cancer. I got Hep C in 2000 while taking care of JoAnn, my former drinking buddy, who was dying of untreated Hepatitis C. I had been sober for seventeen years and I didn’t realize how contagious the virus is. I should have been wearing gloves—I got the virus through a hangnail. I hope you will take a moment to learn about Hep C.

Seven Things You Really Ought to Know About Hep C

1. Hep C is really common. The Center for Disease Control  estimates that there are approximately 3.5 million people in the USA who have Hepatitis C Virus (HCV). Half of those who have HVC are unaware of it. Hep C is the most common blood borne disease in the USA.  Worldwide there are 130 to 200 million people infected with Hep C.

2. Many people contract HCV without knowing it. While some people experience flu-like symptoms within six weeks of exposure, many people do not experience symptoms. Most who get Hep C don’t have an acute illness and don’t seek medical care. It is estimated that that the incidence rate of non-reported to reported HCV cases is 12 to 1. Those who don’t know that they have HVC often spread the virus to others.

3. IV drug use is the most common way to contract Hep C, but any blood to blood contact with someone who has Hep C can cause infection. Blood to blood contact is the only way the HCV is spread—it cannot be spread by touching, coughing or sneezing, etc. However you can get Hep C by using personal items (toothbrushes, razors) of an infected person, or receiving contaminated blood transfusions (uncommon now in USA), having unprotected anal sex, getting tattoos in prison or in non-licensed tattoos parlors.

4. Hepatitis C is slow but deadly. It can take twenty years to develop cirrhosis. The rate of death due to HCV now surpasses the rate of death due to HIV/AIDS. Mortality rates of those with Hep C are twelve times higher than the normal population, and 75% to 85% of those exposed to HCV develop chronic infections. If you think there is even a slight chance that you have been ever been exposed ask your primary health care physician to order a test. It is a simple blood test for the HVC antibody and if you have Hep C it can now be cured.

5. Hepatitis C is hell on the liver and left untreated it will change your life. Long term effects of HCV include cirrhosis of the liver, and one in five develop liver cancer. But that’s not all. Extrahepatic (non-liver) symptoms affect 70% to 74% of those with HCV and include chronic fatigue, thyroid problems, digestive problems, joint pain, neuropathy, and blood sugar problems (diabetes, hypoglycemia).

6. There is not yet a vaccine to prevent Hep C. Public health prevention efforts includes harm reduction for people who use intravenous drugs (needle exchanges) and testing donated blood. There are vaccines for Hep A and for Hep B, and it is wise to get them because having more than one type of hepatitis is even more devastating to the liver.

7. There are now effective treatments for Hep C. The medications are very expensive. Whether insurance will pay for treatment may depend on a) how damaged your liver is, b) your viral load, that is, how much Hep C virus you have in your blood, c) the type of Hep C virus you have, d) other medical conditions.

10 Tips for Staying in Recovery

Written in January 2014

I wrote these tips in 2013. They are also available as a PDF that you can share with your friends or clients. Just email me at:coachalida@gmail.com and put “10 Tips” in the subject line. I recommend choosing one tip at a time and integrating it into your life. If you like these tips you will like Recovery Coaching. 

1.  Get clear about your values. You can discover your values by asking yourself which qualities you admire in others. Write them down. Which of those qualities warm your heart? Those are your values. Decisions based on them will turn out better than decisions based on circumstances or emotions. Honor your life in recovery. Make choices that align with your values.  

2. Eat 8 or more grams of protein for breakfast. Your brain will thank you and you will be less moody all day. 8 grams of protein is two eggs. Or peanut butter toast and a glass of milk. Or a bowl of high protein cereal with soy milk.  If you suffer from mood swings try eating protein every 3 hours to stabilize your blood sugar.

3. Start a list of safe things you enjoy doing. Come up with 5 or more activities.  Keep adding to your list and keep your list with you.  Do something you enjoy every day on purpose. Get in the habit of enjoying your life.

4. Research shows that people who have support from friends, family, groups, or churches do better than those who go it alone. Choose some form of social or group recovery support. Find people who have the same issues you do where you can talk freely about your experiences and struggles. If you can’t find face to face meetings look for online or phone-based support.

5. Create new rituals for relaxation, celebration, and reward. What would be safe and satisfying? How will you know your workday is done and it’s okay to relax? How will you acknowledge your successes? How can you celebrate and stay in recovery? Remember to involve your five senses of smell, sight, touch, hearing, and taste.

6. Get in touch with your inner adult. Just like you have an inner child you have a competent adult within. You can call on your inner adult to help you make good decisions by saying “Where is my competent adult? I am calling on my competent adult.”  Repeat several times. Talk things over with your inner adult to make decisions that protect your long term health and happiness.

7. Learn to watch yourself. Learn to watch your cravings. Notice that if you watch your cravings and do nothing they go will go away. It may take time but they will go away if you don’t act on them. Over time, as you practice watching, you will get good at noticing what you are doing, feeling, and thinking. As you strengthen the part of you that can observe you will be strengthening the healthy part of you that can make good decisions in recovery.

8. Get clear about your strengths. They are what allowed you to make it this far. Do you have a sense of humor? If so, that is strength. Did you choose to leave a bad situation? What strength allowed you to do that? Add that to your list. Did you ask for help? That takes courage.  Make a list of your strengths and use them as needed.

9. Exercise is a reliable way to improve mood. Even 5 minutes of movement will make your body feel better.  A 15 minute walk can make you more cheerful. A hike, swim, or other aerobic workout is exhilarating.  If you want to feel happy move your body.

10. Find one goal or dream that is not related to recovery. Is there something you have always wanted to do? Travel? Jump from a plane? Go back to school? Find something that inspires you and commit to doing it. Identify the first step to take make it happen. Now go do it. Keep going.