- Has anyone ever suggested you cut back on your drug or alcohol consumption?
- Has drinking or using affected your reputation?
- Have you made promises to control your drug or alcohol use and then broken them?
- Have you ever switched to different drinks or drugs or changed your using pattern in an effort to control or reduce your consumption?
- Have you ever gotten into financial, legal or relationship difficulties due to your drug or alcohol use?
- Have you ever lost time from work because of drinking or using?
- Have you ever sneaked or hidden your drug or alcohol use?
- On occasion, do you feel uncomfortable is alcohol or your drug of choice is not available?
- Do you continue drinking or using when friends or family have e suggested you’ve had enough?
- Have you ever felt guilty or ashamed about your drinking or using or what you did while under the influence?
- Has your efficiency decreased as a result of drinking or using?
- When using or drinking, do you neglect to eat properly?
- Do you use or drink alone?
- Do you use or drink more than usual when under pressure, angry or depressed?
- Are you able to drink or use more now without feeling it, compared to when you first started using?
- Have you lost interest in other activates or noticed a decrease in your ambition as a result of drinking or using?
- Have you had the shakes or tremors following heavy drinking or using or not using for a period of time?
- Do you want to drink or use at a particular time each day?
- Do you go on and off the wagon?
- Is drinking or using jeopardizing your job?
Okay, so after I first took a test like this, I thought the people who created it were out of their mind. They suggested that if I answered ‘yes’ to three or more questions then I was an addict who should seek help. Three or more? I answered yes to every damn one. In fact, I was almost certain that all my friends would have answered the same. There’s nothing wrong with me, there’s something wrong with this quiz. However, the fact is that many of us addicts eek out people similar to ourselves, co-dependents who foster and re-enforce each other’s behavior. The objective reality is that most people ARE NOT this way. That was the hardest thing for me to grasp. At least, that is, until I hit rock bottom. That’s when it occurred to me that I couldn’t go on like that and found many people who clearly thought this was a fair and reasonable test. So, if your initial reaction was the same as mine, I suggest you do an accounting of the ‘people, places and things’ you surround yourself with and seriously question whether it’s you and not the quiz that requires some serious modification.
Shame and its Impact on Addiction
When we discuss shame and addiction, there are really two elements that need to be addressed. The first is shame that can lead to addiction. This is extremely prevalent and can arise from a number of different root causes. The second is the shame that comes from addiction, which often gets in the way of people’s desires to seek help as they try to hide their addiction from friends and loved ones.
The following are some of the types of trauma and violence that can lead one into addiction:
- Sexual abuse or assault.
- Physical abuse or assault.
- Emotional abuse or psychological maltreatment.
- Serious accident, illness or medical procedure.
- Victim or witness to domestic abuse.
- Victim or witness to community violence.
- Historical trauma.
- School violence.
- Natural or manmade disasters.
- Forced displacement.
- War, terrorism or political violence.
- Military trauma.
- Victim or witness to extreme personal or interpersonal violence.
- Traumatic grief of separation.
As you can see, it’s a fairly extensive list, and it’s not exhaustive. Just because someone experiences one of these types of trauma or violence does not guarantee that they will become an addict. However, it does make them a more likely candidate and both them and their loved ones need to be more vigilant in monitoring behaviors in order to help avoid the addiction cycle.
What is shame? Shame is an intensely painful feeling of experience of believing we are flawed and therefore unworthy of acceptance and belonging. While individuals can experience a healthy dose of shame to encourage positive behavior, the following types are ones experts generally regard as unhealthy.
- Toxic Shame, which is connected to trauma, is a belief that the individual is fundamentally flawed and defective to the point his own self becomes an object of scorn or contempt.
- A Shame Spiral is a recycling of Toxic Shame that’s difficult to escape and then accompanied by feeling like a victim.
- Shame Webs, on the other hand, are layered, conflicting, and competing social expectations (who, what, where and how someone should be). Entanglement in a Shame Web can result in fear, blame and disconnection.
- The most common shame categories are appearance and body image, money and work, motherhood/fatherhood, family, parenting, and mental and physical health, and the development and internalization of it must be understood.
All of the foregoing can be precursors to addiction and also unfortunately help foster it. The addict is already used to hiding and screening his thoughts of shame and insecurity. It also stands to reason that when he starts using, as a result of the shame or trauma, he will continue to hide his shame, but now it is also the shame of being an addict. This makes it much harder to get the addict to reach out for and desire the help. It’s important to try and recognize and be aware of the initial signs of the shame, the precursors to addiction. Awareness of these stressors can be a critical tell in the early warning of the possibility of addiction, and also make it easier to reach out and offer help to the addict who has succumbed to his shame by using drugs or alcohol to drown out his demons.
Patient Centered Addiction Treatment
(Upcoming Legal Changes Should Improve Addiction Treatment Quality)
By 2018, the Centers for Medicare and Medicaid Services (CMS) plans to transition 50% of all reimbursements to ‘value based’ models instead of the ‘fee for service’ model currently in place. It has further pledged to push that ratio to 75% by 2020. In other words, CMS will be emphasizing quality over quantity, for the first time, in reimbursing Addiction Treatment Facilities and that’s great news for patients.
Addiction treatment is one sector of the medical field that has a clear opportunity to build upon its legacy of individualized programming. Most substance abuse centers started out as small groups or facilities providing guidance along the lines of the 12 Step Program. They evolved into behavioral modification but tended to lump people together in a ‘one size fits all’ approach that allowed people to sink or swim based upon their progress. That model surely helped a lot of people, but it also allowed many unfortunates to slip through the cracks. In the last few years, there’s been a tendency to develop a more consumer driven approach, focusing on the long term success of the individual and his or her own personal needs within treatment. This has proven to be much more viable and successful in achieving permanent progress, as compared to the antiquated ‘tough love’ approach.
Government agencies and insurance providers have long been reluctant to switch from group therapy to individualized treatment due to the fear of the long term costs. However, what they’ve come to learn is that as a result of the relatively high relapse rates, the group therapy has cost them more over the long haul. They now finally appreciate the value of the individualized treatment, which is both better for the addict and, as it turns out, to their own budgets and financial interests. The CMS’ actions is a major catalyst in motivating private insurance providers, following in their wake, and that will lead to better overall care and lower costs in waging our nationwide battle against addiction.
Addiction Treatment Facility Management
(How Data Management Affects Recovery and Why You Should Care)
Google, Facebook, Amazon, Oracle – what do all these companies have in common? Yes, they’re all Fortune 500 companies, name brands, whose founders are mega-billionaires, but they all share the same fundamental secret behind their success – the intensive integration of their data management. This unique approach in considering analytics in the field of addiction, can yield a treasure trove of useful information in developing synergies to more easily spot trends, as and when they happen, on both a broad based and deeply inter-personal basis, to help better get treatment they need and increase the prospects of success for such treatment.
The federal, state and local governments are overwhelmed with people in dire need of drug and alcohol addiction treatment, and are woefully under staffed to handle the problem. It is time consuming and difficult to effectively diagnose each individual in a bona fide and constructive way. As a result, many government therapists have no choice but to punt their excessive case load, with the criminal justice system typically picking up the slack. Using drugs is a crime, being aggressive while drunk is a crime, we’ll just throw them in jail for a while and put off the problem for another day. However, that ‘another day’ often never comes and just forms the beginning of a cycle of non-treatment. Data management and analytics in the field of addiction and recovery are starting to prove themselves as an essential missing link enabling those therapists to better manage and handle their caseload to treat an ever growing number of patients.
In addition, private addiction treatment facilities are also adding new technology in order to better improve their quality of care and level of assistance. They are better able to monitor and analyze which treatments are more likely to be effective on which type of patient with a certain type of issue. While each individual is certainly unique, their are trends within certain drug and alcohol categories that can be identified and utilized for more effective treatment. Professionals are able to utilize past information to better anticipate future demands and how to best service the needs of their addicted clients. As a result, they are seeing significant increases in the success of both their ‘in house treatment’ and their ‘out patient’ ongoing maintenance.
The medical field has up until recently been lagging behind the times in information management. Fears and consequences of not effectively maintaining patient confidentiality, overwhelmed the incredible benefits of better and wider access to information. Even something as simple as setting up an appointment, which people regularly now do for everything using the internet or a smart phone, still had to be handled by a regular phone call. Thankfully, that reluctance has begun to abate, bringing greater use of information technology into addiction treatment and maintenance. It is playing an ever more important role and will only further help improve addiction recovery and maintenance performance.
Help and support is within reach for you or a loved one battling addiction. Explore InRecovery’s national addiction treatment center directory now.