I’m in treatment and on a stable dose. Yet sometimes I still have urges to use drugs. I’ve been thinking about getting clean for a while now. How do I make up my mind?

Ask yourself the following questions:

• Do you have more problems now than you did before you started using?
• What do you miss most about your old life?
• Who is the first person you will get back in touch with once you are clean?
• What are the things you used to do for fun before you started using?
• If the person you care most about in life told you they wanted to start using illegal drugs what advice would you give them?

What you just did is a bit of what is called Cognitive Behavioral Therapy. This type of therapy can provide the exercises to help you find out why you started to use drugs and find the motivation to stop using drugs.

A doctor cannot make you better. Nobody can make you better except you. The truth is aside from managing your healthcare the doctor plays a small part in getting better. You are the one who will be working towards making the change.

You don’t have to do it all at once. Just take steps forward and progress. Recovery can take a long time especially if you have legal, financial, and relationship problems.

Okay, I’ve thought long and hard about getting clean. I’m in the program and I’ve tapered down to a comfortable dose. What is the next step?

The next step is CBT and CBT counseling that is effective in treating conditions like:

Generalized Anxiety Disorder (GAD), Panic Disorder (PD), Agoraphobia, Specific Phobias, Systematic Desensitization, Social Anxiety Disorder (SAD), Obsessive Compulsive Disorder (OCD), Post Traumatic Stress Disorder (PTSD), and Illness Anxiety Disorder.

I’ve heard of some of these medical conditions before. Don’t people normally take medication for these?

Yes, many of those people experience these medical conditions because of a chemical imbalance.

However, in the case of people addicted to drugs many times the condition is caused by an actual real life problem that can be solved or otherwise dealt with.

CBT helps relieve these conditions without the cost, side effects, addictions, withdrawal effects, and inconvenience of medications.

Do I have to do counseling?

Counseling is optional and is available when you are ready for it. You can take the OST medication but if you don’t solve the problems that got you using in the first place you can end up right back where you started.

Is this the kind of counseling where we just sit and talk in circles?

No. The patients do a mental self-examination and determine the course of their actions based upon their inner thoughts, feelings, and motivations. Nobody will tell you what to do. You’re going to tell yourself what to do.

Do I have to tell all my problems to a bunch of strangers?

No. CBT sessions will be one on one and any CBT exercises can be done on your own time in privacy. Your CBT sessions are confidential.

Why can CBT work?

Lectures, taunts, threats, punishments, and yelling are things that our patients learned to block out a long time ago. Telling a patient what to do does not work because they’ve learned to tune it out. CBT allows the patients tell themselves what to do.

What do you learn from CBT?

Patients learn about focusing on positive ideas and behaviors. They set and reach their own goals. They learn how to recognize and deal with bad thought patterns and habits.

They learn practical problem solving. They learn to challenge themselves and cast doubts on their current behaviors and learn that their openness is valued and highly constructive.

What is the typical end result of doing CBT?

Patients typically express, a reduction in emotional stress, reinforcement of co-operation, adaptation to changing situations, and recognition that working with the system and following rules can have benefits.

How is counseling different from therapy?

Counseling includes securing the “basics” like food, shelter, and clothes. Taking care of any legal issues you have, dealing with stress and boredom, avoiding situations and people that put you in contact with drugs, working on your relationships with people, and having fun and enjoying your life again.

Once I’m off OST do I have to stop going to counseling?

No. In fact we encourage everyone to continue counseling so that they can stay off drugs for good.

Is it true that I’ll never feel excitement in my life ever again?

Since you started taking opioids your body has stopped making endorphins. These are natural chemicals that cause a euphoric effect and a pain dulling effect. Now that you are off hard drugs you’ll be more likely to trigger an endorphin rush through physical activity and life experience.

You mean like running a marathon or skydiving?

Those are two examples but they do not have to be that extreme. We have patients that experience genuine excitement when they go fishing.

What if I relapse?

Relapse is part of the recovery process. Everyone has heard the old saying about learning from our mistakes. You can learn from relapse about situations and people to avoid.

Sometimes people forget how bad things were in the past and relapse reminds them of the life they do not want to go back to.

If I relapse have I messed everything up?

No. You can’t relapse unless you’re clean and getting clean is a great accomplishment. Relapse does not remove the milestones and goals you have already met.

People in the medical community have come to realize that relapse is a natural part of the process. The important thing is to learn from your relapse and go right back to building the investment that you have made in yourself.

If you learn from your relapse it will happen less often. After a while you’ll learn enough to keep yourself out of situations that cause a relapse.

What happens when I taper off my OST medication and I don’t need it anymore?

You’re free. If you relapse you’re welcome to come back. If you stay off for good it’s time to start over in life. Leave your old life and old problems behind and keep looking forward into the future.

If you decide to come back and visit us some time just to say “hi” and let us know how you are doing that’s fine. We always enjoy seeing people succeed.