symptons of alcoholism/addicition

SYMPTOMS OF CHEMICAL DEPENDENCY

1) Growing preoccupation

a) Anticipating the next time to drink or use drugs.
b) Increased involvement in activities relating to alcohol and/or other drug use.
c) Heightened awareness of amount used (ie: keeping careful count).
d) Changing doctors to ensure quantity or type of prescribed drugs.
e) Growing need to drink or use drugs during times at home, at work, or emergencies.

2) Growing rigidness in lifestyle

a) Set time for drinking or using drugs that is not changed without great fanfare.
b) Limiting or avoiding situations where the use of alcohol or drugs is moderate.
c) Avoids or criticize anyone who expresses concern about the use of alcohol or drugs.
d) Frequently carries a supply of alcohol or drugs that is secreted.
e) Frequently makes promises to quit or control the alcohol or drug use (this promise may be tied to someone else having to do something first).
f) Problems managing money develop, regardless of amount of money available.

3) Growing tolerance

a) "Wooden leg", able to consume greater quantities than others.
b) Ingenuity about the source of supply while often hiding the amount:
1) gulping drinks or self appointed bartender making own drinker stronger than others.
2) using multiple physicians/dentists
3) using multiple pharmacies
4) purchasing larger quantities than normally required
　
　
4) Loss of control

a) Blackouts. Periods of chemically induced amnesia
b) Binge periods of use, often followed by lethargy and great remorse.
c) Exceeding prescribed doses routinely.
d) Repeated harmful consequences in important areas of life:
1) legal
2) social
3) family
4) occupational
5) physical
6) spiritual (ie: an increase in cynicism)

5) Growing defensiveness and denial

a) Vague and evasive answers about:

1) chemicals used
2) frequency of use
3) periods of absence from the home
4) telephone calls and visitors
b) Inappropriate affect related to the consequences of chemical use
c) Repeated attempts to change the topic when alcohol or drug use is brought up

6) Medical problems often seen by family

a) Sinus problems (ie: frequent bloody noses)
b) High blood pressure
c) Insomnia and/or extreme periods of sleeping
d) Sexual dysfunction
e) Wide mood swings and changes in personality
f) Violent outbursts
g) Depression and/or talk of suicide

San Diego area talks

* I am presenting an MCLE program on July 16, at noon to the SD North County Bar association on Chemical Dependency in the legal profession/The Other Bar.

* I am presenting Risk Management Strategies to chemical dependency professionals at the SD - NCADD breakfast August 12

Recognition by a true professional!

My Intervention training serviecs are mentioned in a new book due out by Dr. Linnda Durre', called "Surviving the Toxic Workplace"

Her new book is being published by McGraw Hill in April 2010. Look for it, I know you'll learn a lot!

Check list for an Intervention

*Prior to your intervention make sure you cover all the bases.

_____ Draft a list of potential interveners. Remember to let them be responsible for saying yes or no.
_____ Contact each person on your list. Face to face whenever possible.

*Write Out List of Examples - no set number, the more the better

_____ Identify the changes in their pattern of chemical use
Amount consumed.
Denial of use, even when it’s obvious.
Hiding the frequency or amount being used.
Attempts to control or go on the wagon.

_____ Identify changes in personality
Angry outbursts followed by acting as if nothing occurred.
Violent outbursts.
Silly and irrational actions. (ie: Fantasy solutions to problems)
Obsessed with drinking or drug related activities.
How does this contrast with their sober behavior.

_____ Identify health problems
Broken bones and bruises, possibly unexplained.
Frequent stomach problems.
Blackouts (chemically induced amnesia).
Depression.
Use of multiple doctors/pharmacies for prescribed drugs.

_____ Identify disruptions in personal activities
Dropping hobbies or activities that interfere with chemical use.
Loss of jobs or promotions
Significant drop in grades at school.
A shift in usual circle of friends (usually towards others that use chemicals in the same manner).

_____ Identify problems that have occurred during special occasions
Christmas.
Thanksgiving.
Birthdays.
Anniversaries.
Parties.

_____ Investigate treatment center options.
_____ Verify treatment costs and insurance coverage.
_____ Set the group goals.
_____ Select the spokesperson for the group.
_____ Choose the order of presentation.
_____ Write a letter of concern that covers.

1) How you feel towards the person.
2) Address any feelings of fear you have.
3) Talk about how long you’ve been worried.

Remember that this letter will lead into your list of concerns.
_____ Fully rehearse all lists.
_____ Develop suitable answers to why "I can’t go right now."
_____ Select the time and the location for the intervention.

Intervention Strategies

INTERVENTION STRATEGIES

A successful Intervention is based on three keys:

1) Common sense
2) Open and honest communication
3) Compassion

What to do and what not to do for intervention:

DO

Use a written outline or letter to organize your thoughts
Detail specific examples (no set number required) - These examples should be related directly to alcohol/drug use. Each example should describe:
a) What happened
b) When the episode occurred
c) Where the incident took place
d) Who was present
d) The impact it had on the observer

Prepare in advance a list of potential excuses and alibis, for the behavior, and be prepared to address them;

Have a specific plan of action worked out in advance, that you are going to ask the individual to follow:

a) Prepare a list of potential excuses and alibi, s and be prepared to address them

Be prepared to define clear expectations for how family, friends or the employer will deal with the individual if
he/she refuses to seek help;

Begin the letter with "The letter of Concern", a statement of the writer feels about the individual aside from the addiction

DON' T

Diagnose the person
Make threats that you are not prepared to follow though on
Forget that the individual is responsible for getting help

Basics of Addiction - a Treatable Disease

General Information about Chemical Dependency

Primary Illness
There may be associated problems (ie: medical complaints, depression etc.) but until the chemical dependency is addressed, the other problems cannot be effectively resolved.

Progressive Illness

The illness will with time become worse. Almost all chemically dependent person’s exercise some measure of control over their addictive use until the day they die.

Chronic Illness

There is no know cure for chemical dependency. Numerous treatment strategies have attempted to identify a model to teach alcoholics to drink socially (never heroin addicts to shoot heroin socially). To date, no methodology has been able to clinically prove long term success.

Fatal Illness

Chemical dependency is thought to be the third most deadly illness. It is a contributor to illnesses such as cirrhosis of the liver; heart disease; liver cancer; automobile accidents; and domestic violence.

Phases of Use:

Experimentation
Social/recreational use
Abuse
Dependency

When to Intervene

When Should You Intervene?
1. Is the use of alcohol and/or other drugs causing problems in:
_____ Work or School (lost time, lower productivity or grades, warnings or suspensions)
_____ With the law (arrests for DUI or drug related charges)
_____ Family finances (income cannot be accounted for, bills unpaid etc)
_____ The health of the user (serious physical problems such as insomnia, bloody noses, weight changes, delusions)
_____ Family gatherings and/or Social settings (fights, change of social group in favor of drinking or drug using friends)
_____ Emotional stability (wide mood swings, over reacts to minor set backs)
*****
2. Is Chronic Pain causing the person you are concerned about to:
_____ Use someone else’s prescriptions
_____ Use more than prescribed, or for pain that hasn’t started yet?
_____ Have more than 1 doctor prescribing,
_____ Overstated symptoms to get meds.
Following a drinking or other drug-using episode by the person you are concerned about,
have you felt:
　
_____ Embarrassed or afraid of what others might think
_____ Scared
_____ Upset or angry
_____ If you were a better parent/spouse/friend, it wouldn’t have occurred
_____ Confused about what to do
Have there been:
_____ Family fights (separations or threats of divorce, young adults thrown out of the home)
_____ Promises or attempts to quit or control the chemical use
_____ Attempts by family members to control the chemical use (extracting promises, hiding the chemicals or alcohol, using with them to show its impact)
If you have answered yes to more than three of these questions, you will have enough information to intervene.

(c) M.D. Meagher 1987