Table of Contents

Introduction: I Know Your Pain Because I Am One of You

PART ONE: KNOWLEDGE Image

Understanding Substance Abuse and Addiction, Treatment, and Recovery

“Why Can’t She Just Stop?”

1    Addiction Is a Disease, Not a Matter of Choice

Evolution of the Science of Addiction

Drugs of Abuse Change the Reward Pathways of the Brain

The Symptoms of Withdrawal Promote Continued Drug Use

Psychoactive Drugs Impact Cognitive Function and Decision Making

Gambling Changes the Reward Pathways of the Brain and Impairs Brain Function

Why It Matters: The Significance of the Disease Model of Addiction

“He Must Be on Something, but What Is It?”

2    Drugs of Abuse and Their Effects on the Body

How Drugs Enter the System Has an Impact on Their Effects

Classification of Drugs of Abuse

Stimulants (Uppers)

Cocaine

Amphetamines Including Methamphetamine

Synthetic Cathinones, Including Bath Salts

Attention Medications

Depressants (Downers)

Alcohol

Opioids

Heroin

Prescription Pain Relievers

Fentanyl

Methadone

Sedative-Hypnotics

Barbiturates

Benzodiazepines

GHB

Hallucinogens

LSD

Psychedelic Mushrooms

Peyote (Mescaline)

DMT

MDMA (Ecstasy)

PCP

Ketamine

DXM

Salvia

Inhalants

“It’s Just Pot.”

3    Debunking the Myths: The Facts about Marijuana

The Basics: The Plant, the Drug, and Its Uses

Synthetic Cannabinoids

Increased Potency

Effects, Symptoms of Intoxication, and Immediate Health Risks

Tolerance, Withdrawal, and Addiction Potential

Adolescent Vulnerability to Marijuana and Other Drugs

Serious Long-Term Risks Linked to Heavy Use That Begins in Adolescence

Effects of Marijuana on the Adolescent Brain

Learning and Lifetime Achievement

Anxiety, Depression, and Mental Health

Cardiovascular and Respiratory Impairments

Prevalence of Use

Legalization Contributes to the Perception That Marijuana Is Not Harmful, Resulting in Increased Use

“But I’m Not an Addict!”

4    The Criteria for Diagnosis of Addictive Disorders

Substance Use Disorders under the DSM-5

Gambling Disorders under the DSM-5

“How Could This Have Happened to Us?”

5    Understanding Risk Factors and Accepting That Causation Is “No Fault”

Genetic and Biological Factors

Early Onset of Use and Developmental Factors

Environmental Factors

Experiential Factors: Neglect, Trauma, Grief, and Loss

Co-occurring Disorders

“Doesn’t He Have to Want to Get Better?”

6    Treatment: How and Why It Works

Screening and Brief Intervention

Clinical Assessment and Diagnosis

The Continuum of Care

A Difference in Philosophy: Abstinence-Based and Harm Reduction Programs

Detoxification

Time in Treatment: The Therapeutic Benefits of Abstinence

Getting Past Denial: The Stages of Change

The Treatment Plan

Medication-Assisted Treatment

Therapy Models

Group Counseling

Skill Training

Recovery Support Systems

Treatment in the Context of Co-occurring Disorders and for Specific Populations

Co-occurring Disorders

Trauma-Informed Care (TIC)

Women

Veterans

Adolescents

The LGBTQ Community

Older Adults

Treatment of Gambling Disorders

“What Is Going to Happen after She Leaves Treatment?”

7    What Recovery Means and How It Can Be Sustained

Recovery Goes Far Beyond Abstinence

Planning for Supported Recovery after Discharge

The Twelve-Step Recovery Fellowships

There Are Many Different Paths to Wellness

“He Can’t Wait to See His Old Friends.”

8    Obstacles to Recovery, and Relapse

The Reality of Relapse

Risk Factors for Relapse

Relapse Prevention Strategies

Response to Relapse

PART TWO: ACCEPTANCE Image

Understanding the Impact That Another’s Disease Has on You and the Need for Your Own Recovery

“We Aren’t the Problem, They Are.”

9    The Parallel Roads to Recovery for the Addicted and Those Who Love Them

“Will I Ever Be Happy Again?”

10  How to Facilitate Your Own Recovery

Defense Mechanisms

Stress Management in Crisis

Health, Family, Purpose, and Community

Processing the Past to Clear the Way for the Future

Fostering Resilience

Mindfulness and Meditation

Finding Purpose

Building Your Personal Recovery Program

A Checklist: 50 Recovery Tools

PART THREE: INFORMED ACTION Image

Bringing It All Together to Support Recovery for Yourself and Your Loved One

“How Do We Get Her in a Program?”

11  Making Reasoned Decisions to Facilitate Treatment

Action Without Enabling; Letting Go Without Giving Up

The Initial Investigation

Adolescents

Adults

How to Choose Appropriate Treatment Providers

Resistance to Entering Treatment

“We’re Walking on Eggshells.”

12  Taking Action to Live Comfortably with the Recovering Addict

Preparation: What to Do while Your Loved One Is in Treatment

Traversing the Minefield of Early Recovery

Work Your Own Program

Maintaining Healthy Boundaries

The Money Chase

Financial Considerations in the Presence of Disordered Gambling

A Community of Support

Healthy Patterns of Communication

Rebuilding Trust

“Practicing These Principles in All of Our Affairs”

Conclusion: The Search for Peace and Serenity

Acknowledgments

Table Summarizing Drugs of Abuse: Drug Types (Classifications), Street Names, Methods of Administration, Effects on the Body, Imminent Risks Presented, Symptoms of Intoxication, and Symptoms of Withdrawal

Glossary

Bibliography