What to do about mental obsession?cravings?

January 27, 2013 9:06 PM

I have been sober for 8 months. I was on suboxone for 16 months then got off in May of last year. I have not taken pain pills in 2 years. I never attended any AA or NA program. IT is not for me. The problem is over the last 9 weeks I have been obsessing over my past use. This scares me and makes me fear I will relapse. I never want to do that stuff again, but it scares me that it is always on my brain. My therapist said sometimes it takes a year to die down. I hope I make it. Anyone have any previous experience with this?
posted by Truts83 to Health & Fitness (26 answers total)

I don't know what to tell you. Seems like all the people I know who have kicked a serious habit went to some meetings. If you've never been to *A, how do you know it's not for you?
posted by ottereroticist at 9:28 PM on January 27, 2013 [4 favorites]

I think it will be really helpful to hang out with people who are in the same boat. Try a few AA or NA meetings, try a SMART recovery meeting, try LifeRing.
posted by small_ruminant at 9:35 PM on January 27, 2013

Is there any way to assure that your drug of choice is permanently inaccessible? Delete all telephone numbers of former dealers and addict friends, toss out any hidden stash, etc. Complete unavailability of drug will help you think about it less.

When you get the impulse to use drug you can do several things. Confront the issue head on by writing about the cravings. Do a free flow journaling session to find out what events or thoughts in your life triggered the craving. Or, have a distracting activity to do when you feel a craving. Every time you think about using, go do 45 push-ups.
posted by Jason and Laszlo at 9:47 PM on January 27, 2013

Yes, I have some previous experience with this.

That thing you used to do was part of your life, and now you're living your life without it, every day. You miss it. I don't think it goes away after a year, any more than grief does. It just changes.

Obsessing for the last 9 weeks? Take the hint: some part of you wants it back, and you're trying to convince yourself. Seek more help, soon. Those people in AA or NA know what you're going through, and normal people do not.
posted by the Real Dan at 10:06 PM on January 27, 2013 [7 favorites]

IT is not for me.

It may not be, but there’s not a person that ever went to AA or NA that didn’t say that. No one ever said "I think AA sounds like just the thing for me!". (Well, someone probably did, there’s a lot of people out there.)
posted by bongo_x at 10:36 PM on January 27, 2013 [5 favorites]

You guys might want to read his previous questions before answering. He's been struggling with this for a while.
posted by empath at 10:37 PM on January 27, 2013 [2 favorites]

I heard a psychiatrist talking about this once. He said that one of the keys of AA is that you learn to replace one addiction and thought pattern with another. You change the whole "trigger -> using" dynamic to "trigger -> AA meeting / call my sponsor." You can never get rid of the trigger, though.

Removing addiction created a huge void in your life. What are you going to replace it with?

Also I don't think a year is going to cut it. When I talk to addicts they're never, ever over it unless they're bullshitting themselves. Also I hear that you have to cycle through several different groups until you find one that you're compatible with. They're not all the same thing, even within a given organization.
posted by hobo gitano de queretaro at 10:38 PM on January 27, 2013 [2 favorites]

Have you considered meditation? 12 step programs are not for everybody (and I am in two) and the whole group thing is not for everyone.....the obsessive thinking thing took a long time to leave for me and I had people to call. But I also meditated and that helped me a lot...just sitting quietly and breathing till it passes, and it will, and then it will come back and then I would do it all over again. Also checking in with myself about thirst and hunger. Those two things make me more vulnerable to obsessive thinking. I think everyone has their own triggers and it is important to find out what yours might be. Sometimes I fantasize about using or drinking and I need to play it all the way out...not just think of the fun or relief I got but the absolute strung-out misery it created in my life. Good luck.
posted by cairnoflore at 11:16 PM on January 27, 2013

MEDITATION!!!

Download an app, especially with binaural beats. Relax. Enjoy.

I like the app MINDIFI, but there are hundreds.so much better than drinking!!

Guided Meditation with Binaural Beats.

Don't wait to do this.
posted by jbenben at 11:21 PM on January 27, 2013

I think it was helpful for me to have someone say that they thought if addiction was like a train track, sobriety was walking alongside it for the rest of your life. It is easy to imagine that after one or ten or twenty years your path has led you far far away from that track but in fact it is still right there beside you, one or two steps away. Saying AA is not for you is like saying dialysis isn't for you, don't go if you don't want to but know that if you need it, it is there and could help you to save yourself.
posted by InkaLomax at 4:06 AM on January 28, 2013 [1 favorite]

I've read your previous questions, and this is clearly a massive struggle for you: you've decided that AA/NA aren't for you, and although as bongo_x has pointed out up-thread most people sat in the rooms thought exactly the same before they walked through the door, your earlier AskMe posts speak of generalised anxiety that's contributing to keeping you away. First of all, though: fucking serious congratulations on eight months sober. If you've just gripped the fuck on and kept away from all the bad stuff and you're still hanging in there, reflect on the good work you've done. You've been strong, you've kept it together, and there's no reason at all why you can't go another eight months, and eight more after that. Feel good about what you've done to get this far. Equally though, fearing relapse isn't uncommon at all: it's natural, and it sure as hell doesn't simply mean that because you think about it, it's going to happen. A lot of mental effort went on thinking about and obsessing on substances when we were abusing them, and those thought processes can't be shut off at the wall like a faucet. It takes a long time to unlearn patterns of thought and behaviour. But that doesn't mean you've got to just put up with them when they arise: as others have said, find something distracting to get out of your own head if you can: exercise, meditation, whatever.
Finally, inevitably, I'll add to the chorus and urge you towards face-to-face help. It's not a co-incidence that just about everyone in the thread is telling you the same thing. Going to a meeting isn't like signing something in blood, it's not like high school, it's not (or it ought not to be) like church: it's about doing exactly what you're doing here in AskMe, only in person: asking people who have experience with this sort of thing for their advice. That's all it is: sharing problems, seeking solutions. You don't have to say or do anything other than that. If you're here asking for help, and you're willing to reach out and take the advice of an internet bunch of strangers, why not at least give the in-person thing a spin? It might just save your life, or quiet your head, and isn't that worth taking a chance on?
posted by hydatius at 5:42 AM on January 28, 2013

Response by poster: ThAnk all of you for your responses. They are greatly appreciated. I didnt mean to say I never been to an aa/na meeting. I have been and when I go and ask for help everyone tells me I need to do the steps. I am not comfortable with the steps. I do a few things to help with my recovery. I see a recovery coach. I see a therapist, i started exercising, i go to the continuing care at my rehab.
posted by Truts83 at 6:24 AM on January 28, 2013

Talk to your therapist about it. If they have some expertise with addiction recovery, they'll have strategies that will help you cope... if they don't, see if they can recommend a colleague who does.
posted by Slap*Happy at 6:27 AM on January 28, 2013

A keyword that may be helpful to you is "intrusive thoughts." There are many strategies for coping with intrusive thoughts.

I see from your post history that you've experimented, and struggled, with CBT. Have you tried relaxation techniques, like Progressive Muscle Relaxation? I can recommend the album Guided Relaxation for Teenagers. Ignore the name and cover art; none of the exercises are age-specific, and it's not as new age hippy dippy as a lot of recordings I've tried.
posted by Juliet Banana at 7:06 AM on January 28, 2013 [1 favorite]

A friend who successfully used AA/NA to stay sober told me that it was all about taking what you needed, and leaving the rest. He also said he had to go to a lot of different meetings before he found one that worked for him and the people he clicked with.

The thing about AA/NA is that instead of having to ask the internet for tips on dealing with cravings, you could ask a group of trusted other people who have been in the exact same boat as you. Maybe think of it as a support group that complements everything else you are doing, rather than a whole THING that you MUST use to recover. Kind of like the way a lot of people go to the Catholic mass because they like some parts of it (like the ceremony, the quiet, the other people) but ignore the parts they don't like (the pope, etc).
posted by yarly at 7:22 AM on January 28, 2013 [3 favorites]

I am not comfortable with the steps.

It’s not supposed to be comfortable. Comfortable is often not a great life plan. That word is over rated these days.
posted by bongo_x at 8:10 AM on January 28, 2013 [4 favorites]

Listen, whenever you start talking about recovery people are seriously going to push AA/NA on you because it's the most well-known program and because everybody knows somebody who used it and got some results and because they're really well "marketed" (not really the right word but I think it gets my idea across) as being the only possible way to recover. But it's not for everyone and there's a fair amount of research indicating that for many people, it's not at all helpful.

I recovered without ever going to meetings and so did a few other people I know. I'm on the bus right now but look for a memail later tonight.

In the meantime, be proud of yourself. You're doing awesome and you will win this fight. You will win this fight, and whenever you feel discouraged, remind yourself of that. As long as you don't give up, you win.

Stay strong and rock on.
posted by windykites at 8:11 AM on January 28, 2013 [1 favorite]

The steps did help me a lot and I never EVER thought they would.

Aside from that, talking to other people in recovery, because it helps when people understand what you are talking about. I am still NOT good at this, I don't like to let people in, but it was really important and has saved me more than once to find people that I can really tell my true thoughts to. I find that it gives the thoughts less power and I find it really true that secrets and keeping things in just makes me feel worse.

The little tricks of distraction do help, I am sure you have heard all the little sayings that and I thought they were so dumb but I just decided what the hell do I have to lose if I try them and sometimes they will work and I get better as I practice them. They do become learned behaviors.

Time: It gets better and less difficult with time.
posted by heatherly at 8:30 AM on January 28, 2013 [1 favorite]

Mod note: Now is probably the point to let the AA/NA stuff go and stick to the question. Thanks.
posted by restless_nomad (staff) at 10:25 AM on January 28, 2013

ottereroticist: If you've never been to *A, how do you know it's not for you?

12-step programs assume and pretty much require a monotheistic belief. Your statement rings to this atheist like the sad and clicheed pick-up line, "Well, how do you know if you've never had sex with a ____?"

--

The obsessive thoughts recede like most other obsessive thoughts, only more slowly. "What if I had her back?"/"Just one more hit..."/"It'll be OK this time, but then I will really quit." In one year they are mostly background noise, perhaps more noticeable at certain times, but mostly easy to ignore. In three years (IF you don't follow the obsession backwards) they are dim, and even during most bad times the voices sound like A Bad Idea(tm). In ten years the voices are still there, if you listen... but who wants to?
posted by IAmBroom at 11:35 AM on January 28, 2013 [1 favorite]

First of all, congratulations. That's a lot of hard work to get where you are now. Second, it sounds like you have a number of people to work with on this -- therapist, recovery coach, etc. What are they recommending here? Are they all working together as a team with you to help get you through this challenge? Are there more things that they could be doing to support you? Third, knowing that AA doesn't work for you is a useful piece of information, and don't get pressured into doing something that will make you feel worse instead of better. I know it works for a lot of people, but it doesn't for everyone. And fourth, would you consider going back on suboxone to get through this? Does that sound like it would be helpful, or a step backwards? And lastly, what are the things you're doing to replace drugs in your life? Is it exercise, service, meditation? Do more of it. Take up that space in your head with something else.
posted by gingerbeer at 11:37 AM on January 28, 2013

In a way, your therapist is somewhat right. The physiological symptoms (short term memory, emotional stability, sickness, etc) will die down at a predetermined stage, which is defined by the substance, the amount taken, and the duration of use. Whether this is a week or two years is entirely up to those factors. (Look up: Post Acute Withdrawal Symptoms)

The mental obsession with the substance, however, may not necessarily diminish with time, but becomes something which is fought on a daily basis, called "white knuckling" by the *A groups, but something I refer to as the "dull hum." Ever present, ever hovering, always flickering at the edge of every thought. Always tainting every joyous moment, always promising to bring comfort to every tragedy, always preaching release from boredom. I lived in and out of this stage for about 2 years, once I began attempting to stop, and could never successfully shake it until I really gave up trying to fight it. It cost me a lot: relapses, detoxes, hospitals, jails, etc. but it was a battle I could never win on my own.

That said, as someone who is coming up on 3 years of substance-free living, I can tell you that I no longer obsess about substances. My wife has never had a problem, and we have alcohol in the house that I usually don't even remember being there. Do I get cravings? Sure. But with the same force I get cravings for veal (which I haven't eaten in about 11 years). I would say about 95% of the time, it's not even a thought in my head, no more than I have thoughts of my favorite stuffed animal I could never be parted with when I was five.

I do have to say, however, that I found my solution in one of the *A groups, and I wish I had something more productive to help you with for your own personal preference. To qualify myself a little bit, though, I hated the thought of *A. It was cheesy, lame, fake, and the whole God thing just drove me nuts. It was cowardly, ignorant and for other weak minded followers to try. It wasn't until I had drank myself about 6 inches out of the grave that I honestly gave it a try, and I was surprised at how well it works. I still think it is cheesy and lame sometimes, but given the alternative, I don't mind so much.

And as for this comment above: "12-step programs assume and pretty much require a monotheistic belief..." A little knowledge is a dangerous thing.

I can't speak for all groups that some people may have been unfortunate enough to come into contact with, but to blanket all 12-Step programs with this is patently untrue, and borderline homicidal. Many desperate, suffering people will seek every solution available to them with this life threatening illness, but like me, walk in having a severe problem with any kind of silly theological belief, monotheistic or otherwise.

The *A programs do not have a monopoly on recovery, I know several people who have used behavioral modification and other treatments, but please don't irresponsibly bias others from even trying it with incorrect information.
posted by Debaser626 at 1:55 PM on January 28, 2013 [4 favorites]

Response by poster: I have been making changes in my life. I quit eating junk food. I have become more spiritual. I hang around my family more often. I exercise. I cut all drug femriends out my life. I attend my continuing care program at my rehab. I wish they had a smart meeting down here where i live. I started working on my memtal health. I feel better than when i started this process. I just want to feel better and quit thinking about drigs. I want to live a normal life. Thanks everyone again for your help.
posted by Truts83 at 3:44 PM on January 28, 2013

Yes I have experience with this. Many people on suboxone relapse after they taper to zero, so say the statistics. (Don't let that get you off track, though.) You are not alone. It might be better to go back on a low dose of suboxone (2mg/day?) and taper down again over a period of a year or so rather than relapsing. Can you afford that? Would your doctor consider it? Realistically, not everyone can stay off forever and it's the longer term cravings that are indeed what can get people to relapse. What you are experiencing is 100% normal.

BTW great job tapering down over 16 months and staying off for 8 months.

Also, consider Ibogaine. It could buy you another few months to a year, if not a lifetime with repeated doses. Mileage may vary. Memail me if you want to chat more about that option.

I'm sorry you are going through this.

One other tip: intense exercise can be better than casual or occasional exercise. The reason is that intense exercise causes GDNF to increase in your brain, which causes growth of new neuronal connections. That slowly but surely helps with cravings. So if you can switch your exercise program to some intense 2hrs/day program of any kind, be it yoga or weightlifting, for a few months, you might see improvement in the cravings. (And also get into good shape.)

Other stuff that ups your GDNF is novelty. If there is any way you can completely change your surroundings or do something super different in your daily life, that can help. The benefit is that these changes can help you stay clean in the longer term, they are not temporary fixes. As your brain grows and changes, it takes you farther and farther from the addiction.
posted by kellybird at 4:28 PM on January 28, 2013 [1 favorite]

Realistically, not everyone can stay off forever

I meant suboxone. Under a doctor's supervision. This does not mean pain pills.
posted by kellybird at 4:31 PM on January 28, 2013

When I have drinking dreams or other unwanted thoughts about my past use, I see it as a reminder that I have a chronic condition that I have been able to keep in remission through doing recovery work on a regular basis.

Of course, obsession and disruptive fear is different thing. For me, early sobriety involved a lot of emotional re-calibration. My only tool for dealing with fear and obsession was drinking, so I hadn't yet developed other tools. It is not fun, but it does not necessarily mean you are sliding backwards.

Nthing face-to-face *A (despite my having tried and dismissed it initially). Also consider online AA (and online SMART, which I have no experience with).
posted by neutralmojo at 2:27 AM on January 29, 2013