Sherry Gaba, LCSW, is a licensed psychotherapist/author specializing in addictions, codependency, and underlying issues such as depression, trauma, and anxiety. I remember being at a meeting of supervisors of treatment programs in my area and one program manager said At my program, the policy is: Two positive urines and you are discharged! I remember questioning myself quietly how someone could put an arbitrary number on something as complicated as relapse when substance use issues and recovery issues vary such a great deal from person to person. Hold on to the stroller. Did You Know Anxiety Can Enhance Our Relationships? Is it fair to cut off payment for treatment just because someone does not respond to the most highly recommended and accepted form of treatment? Do You Really Need to Avoid Alcohol on Antibiotics? Moving upward is a gradual, steady process of getting better, improving and developing. GOALS! However, abstinence isnt always practical for everyone. It did not take long for me to curiously wonder about those people who could not make it in treatment due to an inability to accept key 12 Step concepts such as powerlessness or Higher Power. How to Get Everything You Want Faster Than You Ever Thought Possible. Now suppose, in this example, that after a few weeks the house is built so clumsily that it does not pass inspection and cannot be lived in. So instead of sobriety as our goal, the Escalator uses Inspired Progress as the standard to work toward. What makes a lot more sense is to provide the necessary treatment for people at the level where they enter treatment, based solely on their individual needs. Abstinence is often the ultimate goal, however people, often guided by their level of motivation and insight, often take many different paths toward that goal. Lets start by examining the commonly accepted: Disease Model of Addiction: *All words and phrases in this book where definition is provided was taken completely or in part from the online dictionary: www.dictionaryreference.com. toregainaformerandbetterstateorcondition. If youre struggling with a cross addiction in recovery, youre not alone. Does Your Health Insurance Cover Treatment? Are you confusing a low probability with a high probability? To create this article, 11 people, some anonymous, worked to edit and improve it over time. As a small thank you, wed like to offer you a $30 gift card (valid at GoNift.com). Its not always easy to tell if youve developed a cross dependence, especially when it comes to behavioral addictions. Now compare a similar situation with a 20 bag day IV heroin addict. Rather than letting the steps prescribe the path through the change process, the Escalator allows ones changing circumstances and needs to define exactly what is involved in next phase in the upward change process. This often happens after a person has quit one substance, and is looking for new ways to cope. Over the years I saw that this younger group had progressively become more and more resistant to 12 Step groups and philosophy. Listen to friends and family like the original addiction; it is common for people with cross addiction to minimize the reality and to make excuses for the behavior. When one is taught the disease model of addiction, one of the most powerful illustrations is the comparison of addiction to a widely accepted disease like cancer. The Escalator consists of the following areas of focus: Your email address will not be published. I was in an induced coma for a week, and I remember having these powerful, vivid dreams. In other words, even if someone never stops using substances (abstinence) there still can be a measurable level of progress. Thus, individuals who were unable to address their original substance use issue were more vulnerable to developing other substance use issues than individuals who were successful in addressing their substance use disorder. Nonetheless, individuals in recovery should remain vigilant and follow the treatment regime of their aftercare program in order to ensure that they enjoy continued success and abstinence. Once again, the reason is that 12 Step involvement improves outcomes is because those who become engaged in 12 Step groups like Alcoholics Anonymous or Narcotics Anonymous have a statistically better chance of staying sober. Taking your stroller on the escalator can be dangerous for kids. When I started in this field most substance abuse programs were still 12 Step based. I would wake up in the morning and have vodka before work, then a few pints at lunch in the pub, and then more after work. Research source This desire for pleasure or relief becomes part of the self-perpetuating cycle of addiction as the person suffers the discomfort of withdrawal that comes when they are unable to use the substance or engage in the behavior. Compulsive behaviors can be physical acts, like repetitive hand washing or hoarding, or mental exercises, like counting or memorizing books. Academia.edu no longer supports Internet Explorer. Our program is an affordable alternative to mainstream rehab, and can allow you to work towards change long-term, without turning your life upside down. This blog is a space for sharing ideas, experiences, links to books, articles, and websites in relation to recovery from alcohol & drug addiction. On the other hand, you might more easily identify a cross addiction when youve swapped one substance for another. If you need to balance it on more than one step, push it in front of you. Time is such a valuable resource and it is important to stay in the habit of using it wisely by reserving time on a regular basis for taking care of our physical, emotional and spiritual health and growth. This new perspective behind the Escalator can be best explained by first expanding upon the way we look at addiction, recovery and sobriety. Inspiration is like the fuel that powers our engine that gets us moving toward our eventual destination and our desired goal. Other methods are very much needed for this population. I used to be a big drinker thats why I tripped over. A good question is; What should be done about people who are not ready or not willing to try abstinence (even if it is what they need)? And I had epileptic fits every day. Hence, the point is not to undermine the relevance of the concept of addiction or dismiss those who wish to identify themselves as addicts or addicted because they themselves have come to that conclusion. Taking the Escalator needs you - Click here to see how you can support - (It won't cost you a cent), Finally a New Way to Combat the Opioid Epidemic, Alternative Counseling & Recovery Coaching Tools. Updated: August 15, 2022. To browse Academia.edu and the wider internet faster and more securely, please take a few seconds toupgrade your browser. Researchers in future should use objective measures of substance abuse in similar studies. Better outcomes means having to pay out less for treatment and 12 Step meetings are free. 400+ Curated Sober, Mental Health & Addiction Recovery Apps, Podcasts & Resources. In a nutshell, it refers to a new addiction following in the footsteps of another. Even if we go backward after a period of progress, the next time we travel that road moving forward we know the way a little better. This book is not designed to put down or disparage any 12 Step programs like Alcoholics Anonymous or Narcotics Anonymous or anything at all involved with those programs or concepts. Visit website. According to the Elevator Escalator Safety Foundation, over 210 billion passengers use elevators in the U.S. and Canada each year. Alcohol Use Disorder (AUD) is an inability to control or stop drinking despite experiencing negative consequences. But I was completely different my daughter brought me a teddy bear and I started biting it. The answer starts with a combination of two key concepts: >stimulationorarousalofthemind,feelings,etc,tospecialor unusualactivityorcreativity, >thestateorqualityofbeingsostimulatedoraroused, Inspiration is a combination of motivation and insight, which are at the very core of the Escalator. Beside the millions who have benefitted from the 12 Steps there have always been those lost individuals who just didnt catch on to 12 Step philosophy and programming. In most cases, even in treatment environments where a supposed disease viewpoint is accepted, many of this mans treatment providers, along with most of his family would view this person as still an addict and noncompliant with treatment despite in reality the presence of observable, measurable progress. Myth #1 Cross-Addiction. Another way to look at this same question when examining the goals of the process of getting better is: The next section searches into this sometimes controversial topic, Answering the Questions about Abstinence . Understanding Withdrawal & Detox by Substance. This article has been viewed 70,994 times. How Psychologically Conditioned Rats Are Defusing Landmines, The Innate Intelligence Observed in the Dying Process. This lack of research was noted by a team of researchers at Columbia University Medical Center who performed an exhaustive study on the notion of cross addiction in over 34,000 adults as part of the National Epidemiological Study on Alcohol and Related Conditions (NESARC). 10. Thats the most important thing for me now. A compulsive behavior is an action that a person feels compelled or driven to do over and over again. Although, experience is commendable and highly useful, someone does not automatically merit more consideration as being an expert based only on clean time. Although it has no official "phobia" name, the fear of elevators is relatively common. While there is no cure for OCD, its symptoms can be managed through medication, therapy, or a combination of treatments. -. For example, many people simply may not feel like their personal situation or circumstances coincide with some of the more traditional views on recovery and self-improvement. Nevertheless, I and many of the colleagues I have worked closely with have seen a need for an inclusive, comprehensive design specifically created for the changing needs of problem substance users in the modern world. Still, once again, what about those individuals who do not experience a benefit from 12 Step meetings? The researchers concluded that evidence that individuals who recover from one substance use disorder are more vulnerable to developing a cross addiction in the future is not supported by the data. When someone ends up staying inspired long enough to maintain the changes, improvement and progress that they made in the upward change process that is the most desirable outcome. A compulsion is different from an addiction. An ambulance came and took me to hospital. To the contrary, groups when functioning like they are supposed too are the most effective modality for substance abuse treatment for the vast majority of people However, those individuals who do not feel comfortable with groups should not be left out by a method that caters only to groups. Recognizing, understanding and gaining insight into ones behavior and accepting that there is some degree of a problem that needs changing is enough, regardless of what one may try to call it or label it. Just like abstinence with regard to sex is the surest way to avoid consequences associated with sex such as diseases, unwanted pregnancy, etc, complete abstinence from substances is the surest way to avoid substance abuse related consequences such as legal problems, family problems, etc. Recover -. The other accidents happened when the kid was riding the escalator outside of the stroller. In other words, you dont have to start at a specific point and then try to make progress by following the predetermined steps in successive order. I found myself growing in my concern for those individuals who disagreed with or had difficulty grasping the 12 Steps and other similar or related concepts. For example, it would not be advisable for someone who has a history of serious suicide attempts when they are drunk to attempt controlled drinking. Apply the breaks of stroller and hold it steady with both of your hands. The process outlined in this book is called the Escalator. This method is in part designed for the growing number of individuals who are not yet ready or able to strive for the ideal recovery as outlined in the 12 Steps. However, more and more people who use substances in a problematic way are starting younger. At Ria, we offer weekly meetings with certified counselors to help members stay on track and build skills for long-term change. The term cross addiction is relatively new but is something that has always been seen in clinical practices. In addition, diseases, like substance abuse or dependence tend to be progressive in nature but not everyone progresses in the same way or to the same level. Whether or not someone is trying to recover what they once lost, or they may be moving upward for the first time, the Upward Change Process is the journey toward self-improvement and self-development that the Escalator is founded upon. There is some scientific support for this idea. "The Psychology of Compulsive Behavior." The main point of this book is to outline some of those tools and strategies in a constructive and practical manner to help the reader better help others. There were three questions/goals of the study: The findings have some interesting implications regarding the notion of cross addiction: In fact, the researchers concluded that the opposite of the notion of cross addiction was more likely that individuals who have successfully negotiated treatment for a substance use disorder were less likely to develop another substance use disorder. The Escalator emphasizes quality over quantity when it comes to levels of inspired progress. Consenting to these technologies will allow us to process data such as browsing behaviour or unique IDs on this site. The Escalator is designed to be interchangeable and adaptable for both groups and for those who are more comfortable staying out of groups by working individually. How many individuals who developed a new substance use disorder had overcome or successfully treated their initial substance use disorder? One does not have to call themselves and addict or an alcoholic in order to get better. Risk of harm must always be factored into this equation. This post discusses everything you should know about cross addiction, including what it is, the research behind it, and whether or not you should worry about it. It is a situation where an individual has more than one addiction or uses more than one . Longley, Robert. Many past programs that teach controlled use of substances have failed. Obsessive-compulsive disorder is a form of anxiety disorder that causes a recurring, unwanted feeling or idea that a certain action must be done repetitively no matter what. While many people compulsively repeat certain behaviors, those behaviors do not interfere with their daily lives and may even help them structure their day in order to complete certain tasks. The 2 Most Psychologically Incisive Films of 2022, The Surprising Role of Empathy in Traumatic Bonding. The Escalator itself is designed so that even when activities or stages are repeated there is always something new to learn about ourselves and there are always different ways we can learn to develop and sustain motivation and improved coping abilities. Below is a simple but effective list of 5 things that can inhibit the upward change process and five things that are helpful with regard to enhancing the upward change process: 5 Things to Avoid - 1 - Discouragement-This includes both discouraging thoughts and discouraging people. A huge collection of non 12 step, free addiction and recovery tools, including PDF worksheets, handouts, assessments, and videos. Make sure to hold on to the stroller the whole time you are on the escalator. It is crucial to consider this broader spectrum in order to fully understand the nature of substance abuse and the people affected by it. Evan is a deep believer in fact-based, empathic communicationwithin business, arts, academia, or any space where words drive action or change lives. At first, I would go to the centre and just sit in the corner and not talk to anybody; but then I met people who were in a similar predicament, and who understood what I was going through. The compulsive behavior can be a physical act, like hand washing or door-locking, or a mental activity, like counting objects or memorizing telephone books. Enter the email address you signed up with and we'll email you a reset link. It is important to note that the Escalator is primarily focused on substance use however, any difficult to stop, compulsive habit can be interchanged with substance use issues. At the heart of it is understanding that you do not need alcohol to function and have a good time. Sometimes it is important to remember that the journey is often not as important as the destination. Half of the accidents were kids falling, while about a third were kids getting something caught in the escalator. The one rule often ignored with labels is that they must be accepted by the person being labeled. X (Keep in mind; this is not meant to say anything against group therapy. Therefore, the discussion of labels is often irrelevant and unnecessary and in many cases can even be a distraction as opposed to being helpful. Consider the fact that the person who worked on the house now still has some of the tools that they bought. The Escalator promotes abstinence as the ideal way to stay out of trouble and then make progress and positive change but at the same time this method acknowledges that people have different paths toward their goals that are not all abstinence based. Even if the now 350 pound man is still considered morbidly obese with a cholesterol level twice the acceptable limit, his doctor and family likely would still embrace his progress in a positive encouraging way with the hope he will continue in that positive direction. Addiction is based on a form of dependence, and as a result, the two words: addiction and dependence have become synonymous ** It is well documented that addiction is growing problem over the years affecting the lives of millions. The Escalator therefore was born from a desire to provide an alternative but reasonable, sensible, yet comprehensive and effective option for those with substance use issues who fall into one or more of the following categories. Treatment is for the sick, not the well. These comparisons disregard a large portion of people who abuse substances. % of people told us that this article helped them. They may resort to: Additionally, some believe that people with alcohol or substance use disorders are prone to cross addictions involving similar substances. Try finding an elevator instead. Interestingly, there is a commonly accepted contradiction when it comes to abstinence when viewing addiction as a disease. Understanding the Fear of Elevators. That choice was either to try to fit themselves reluctantly or insincerely into the 12 Step model or be discharged from treatment programs for noncompliance, which for some meant going to jail. Old Medication, New Use: Can Prazosin Curb Drinking? One 2014 study investigated whether or not those in recovery are actually more prone to developing another addiction in the future. The harm reduction perspective understands that some people will not be perfectly abstinent from all substances in recovery. Take what you can from feedback and leave the rest The rules for people answering questions are: Use polite and respectful language - Speak to others the way you want to be spoken too Do not be insulting or hurtful (When in doubt, leave it out- If you think the person may be offended then do not say it) Focus on the inner person, not appearance, The findings would also suggest that the development of a cross addiction is the exception and not the rule, but it is something that individuals in recovery should be aware of. Learn which signs to look out for, and how to care for your well-being. Consider the definition of Upward . Substance abuse problems are just as varied; from the weekly drug experimenter whose parents are complaining to the daily 20 time a day emaciated, disease infected, homeless intravenous speedball addict. In other words, many individuals start using drugs and alcohol so early in life that they never had a truly developed a state or level of functioning that they could recover to. For instance, exercise may have helped calm your anxiety early in recovery. Since then, other non-12 Step methods and techniques have been in use by treatment providers. Alcoholism on the other hand is essentially just an addiction to or dependence on alcohol. Sorry, preview is currently unavailable. In the results, those who successfully recovered from a substance use disorder were significantly less likely to struggle with a cross dependence after three years, compared with those who did not recover from their first addiction. It also hopes to generate healthy discussion on the topic and welcomes diversity of opinion. But in the vast majority of cases in the real world of substance abuse it is not so obvious when we consider the whole spectrum of substance use issues. Evidence Based Online AlcoholAddiction Treatment Program. Joining a coaching program can help you build adaptive skills for long-term recovery, and healthier habits to replace addiction. How many of the participants with a substance use disorder developed a new substance use disorder in the three-year period? For example, although we may be aware that we are brushing our teeth, we almost never wonder why we are doing it or ask ourselves, Should I be brushing my teeth or not?. If you sign up to the 28, 90 or 365-day challenges then you get daily emails and video support that []. There is something to be gained each time anyone attempts the process of upward change. Some of the more potentially damaging compulsive behaviors often associated with OCD include eating, shopping, hoarding and animal hoarding, skin picking, gambling, and sex. So for some, abstinence is not a choice, it is an absolute necessity. By signing up you are agreeing to receive emails according to our privacy policy. It means slightly longer but it's safer. However, the actual empirical evidence for the notion of cross addiction was mixed until very recently. For example, research suggests cross-sensitivity is possible for sugar and alcohol among some individuals. Suppose that over the course of the next year, he lost 50 pounds and lowered his cholesterol 25%.