Addiction is a serious problem

Sometimes making a new years resolution to quit drinking isn't enough to combat a serious problem.  We need support.  Dr. Barge weighs in. 

Dear New Shrink,

I have tried to stop drinking but have not been able to, even after getting a DUI. But I feel ready and have made a New Year's resolution to stop! My family wants me to go to rehab but I really do not think I need it. What do you think? How do others do it?

Signed,
Determined

 
Dear Determined,

You can resolve all you want but it won't help if you have a problem. I don't know you, so I cannot say what is best but with a DUI and your family thinking you need rehab, it looks like you just might have a problem that is a little more serious than you think. This is not to say you need a $60,000 rehab but you probably should not try to go it alone. Few people are able to do it on their own, without support you probably will not make it and if you do, you will be "white knuckling it," meaning that you will basically be what is known as a dry drunk and you won't have the serenity that can come with a recovery program.

The word rehab actually means rehabilitation and this can happen in a number of ways. It has come to be associated with in-patient programs but while they are fashionable, they are not always necessary. They actually are more of a luxury than necessity in many cases. Not everyone needs horses, pilates and a gourmet chef in order to get sober.

For more than half a century, most folks with a drinking problem just walked into AA meetings and with the love and support they found from others who really understood them, they often did just fine. Because of its success, there are now 12-step meetings for almost every form of addiction.

But as other drug use increased along with the use of alcohol, and because of what is known as dual diagnosis, some people required a lot more than meetings alone. Dual diagnosis is when there is a mental health problem along with substance abuse and/or other addictions.

In-patient programs started to spread in the 1980s but then many shut down because they were costly, insurance would no longer pay for them and they often did not yield better results. Now there are far fewer and many of them are very costly.

The advantage of course is that you are taken away from your current environment where there are multiple triggers and most likely, co-dependent relationships. You have lots of doctors and counselors helping you 24/7 while you focus on your addiction and recovery. For people with multiple addictions and serious situations at home, this is often preferred if affordable.

But while this might be nice, even ideal, not everyone has the money or can get away. Some people don't want it. They prefer to start privately and quietly. The good news is that out-patient treatment has worked very well for the majority of folks for many years now.

You have the option of seeking help with a physician who is certified in addiction medicine or you can see a psychologist who is certified in the treatment of substance abuse or addictions. Both will do thorough evaluations and you can begin an individualized treatment program. If detoxification is needed, it can be arranged. Most alcoholics or alcohol addicts can detoxify at home with minor medications. Your family may be asked to come in for some counseling with you. This is a critical step because the people who love you will often be your biggest enablers and probably have some feelings to work out themselves. You are going to need your relationships to be healthy. And for married alcoholics who get sober, there are only three options: get help together, go back to drinking or split up.

A good doctor that really knows about addiction will help you sort out your relationships, make a healthy environment for yourself and help you to identify and work on any psychological problems that contributed to this in the first place. Ideally you will also go to 12-step meetings where you have 24/7 support from people who truly care but some get sober without it. All of this can be done out-patient and is far less costly.

Bottom line, you have four choices: go it alone; go to 12-step meetings only; go into rehab; or see a specialist who can help you while you continue to live at home.

Good Luck!

Dr. Barge**
**Originally published in the Santa Monica Daily Press SMDP Dr. Barge