Dear Annie: This is about the 40-year-old alcoholic with two kids who is refusing rehab. “Hitting bottom” is unwise advice, and unwarranted. He yet may end up homeless and on the streets or worse, but there are more options needed. Don’t fall for the AA 12-step “hitting bottom” credo -- it is not supported by the data. There is no other medical illness where we would take that approach.
He needs to see an MD who is a specialist in addiction medicine. Several medications could help.
I would also recommend a mental health therapist who specializes in work with substance abuse, using a harm reduction model, and someone who is well versed in a style of communication known as motivational interviewing).
There is more, but that would be a good start.
All of this can be done on an outpatient basis. It is a way to get him started in treatment, build trust and to help evaluate the situation.
Maybe rehab is needed, maybe not. It isn’t for everyone. The data is marginal, and these outpatient steps are a good way to start.
I hope this helps. You have an important platform and the word needs to get out about more options. -- Follow the Data
Dear Follow the Data: Thank you for offering your perspective from the inside of addiction medicine. The goal is to help the young man take his life back through sobriety. If your suggestions work for him, wonderful. I know they do work for some people, which is why I am printing your letter.
However, your disparagement of AA’s approach and rate of success is not something I can agree with. There is a saying at AA meetings, which is that the program works “if you work it.” That is the key to the sobriety of millions of alcoholics who have been helped by AA. They succeeded because they worked the program. Just ask the reader below, “Anonymous in California.”
Dear Annie: I was very touched by the letter from your reader, “Out of Options.” I am a sober alcoholic and have been sober since Nov. 24, 2008, which is a little over 12 years now, in Alcoholics Anonymous. I was 23 when I stopped drinking.
You are right. We DO recover, but it takes time and commitment.
I hurt my mother and oldest daughter very deeply when I was drinking and running amuck. It took my mother almost walking out on me for me to get clean and sober. Dear “Mom Seeking Answers,” the best thing for your son is for you to abandon him. I know that sounds very harsh and unloving, but it’s the only way.
I would suggest that you get a copy of our basic text, “Alcoholics Anonymous,” lovingly referred to by our members as the “Big Book.” Annie’s advice to join Al-Anon is very sound. There are thousands of people like yourself who lead happy, fulfilled lives despite having a family member or friend who is getting sober.
I wish you great luck. And please remember that his choices are not your responsibility to “fix.” It may take him losing his children and life as he knows it to get his “stuff” together.
I have been in recovery for 12 years and have seen great successes and heartbreaking tragedies. Always remember that God has a plan, and we need to trust in him (which is certainly NOT easy when it comes to our children), but you will get to the other side and one day, life will be better. Much Love. -- Anonymous in California
Dear Anonymous in California: Congratulations on your success, one day at a time, and your commitment to sobriety. So many readers, like you, have been helped by Alcoholics Anonymous and Al-Anon. I just can’t say enough good things about these groups.
View prior ‘Dear Annie’ columns
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