Author: Justin Mckibben
Here we are going to discuss some expert opinion on the molecular neurobiological aspects of each of The 12 Step Program.
Understanding of the neuro-molecular biological keystones of The 12 Steps may actually be an important step toward sobriety for some, especially those who rely heavily on the tangible logic of scientific reasoning. To understand and embrace principles of molecular neurobiology could ultimately lead to a better quality of recovery from addiction.
Step 1- We admitted that we were powerless over alcohol-that our lives had become unmanageable.
There is science behind the “powerlessness” of the first step. Admitting personal powerlessness over addiction is actually supported by the mechanisms involved in the neurobiological circuits of our brain. Stress and the toxic-effects of the drugs themselves induce changes in brain functions such as:
These changes create:
So scientifically it is very true that the individual is powerless. The substances themselves continually short out the circuits in the brain that are meant to give people control. The recipe requires genetic predisposition and environmental elements, but everyone is technically susceptible depending on these variables.
Step 2- Came to believe that a Power greater than ourselves could restore us to sanity.
Breaking down the wording of the step one could infer:
- Sanity- sound judgment
- Insanity- repetitive behavior despite the harm
Poor judgment, or “insanity,” could be a cause of unusual substance seeking behavior despite risk of harm. These decisions are made worse by environmental factors including:
- Drug availability
- Non-nurturing parents
- Social-economic burdens
The individuals sanity also may be impacted by their relationship with a “power greater than themselves.”
In this case, let us look at relapse. The prefrontal cortex and cingulate gyrus are critical areas involved in relapse regulation. Impaired neurochemical functioning of these regions obstruct recovery and induce relapse, typically due to:
- Toxic substances
- Toxic behaviors
Understanding the molecular biology of the brain reward system highlights the importance of positive input from a fellowship such as the 12 Steps offer. Positive input from peers can offset unwanted gene expression. Ultimately, this can enable an individual to achieve a state of sanity and make right choices. The power greater than yourself can simply be the environmental element of your recovery.
Step 3- Made a decision to turn our will and our lives over to the care of God as we understood him.
Will-power is extremely difficult to regulate in individuals born with a compromised reward system and low levels of endorphins. Will-power is based on both the interplay of genes and environmental elements in society, such as stress or shock. Early stress can cause substance use disorders in adult life as seen with epigenetic effects on Glucocorticoid receptor express.
Because the hard wiring of our brain’s reward circuitry is so difficult to override, it only makes sense the recovering addict seems obvious to look for reward outside of our genome. So in this step, the idea is to turn that focus away from drugs and toward something such as the fellowship or a spiritual path.
Step 4- Made a searching and fearless moral inventory of ourselves.
Fearless moral inventory must include the drug of choice and other Reward Deficiency Syndrome (RDS) related behaviors. A particular drug or behavior is not the only element of an addiction, it includes a range of observable characteristics resulting from the interaction of its genotype with the environment..
However, the inventory cannot be labeled as “right” or “wrong” because it their own evaluation of self. To understand that there are genetic and environmental aspects to addict means to understand that blame and guilt are not conducive to true self-appraisal.
Step 5- Admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
This step involves open reflection on our issues with using drugs. This includes the toxic effects of recurrent exposure to these substances on our minds and how that translates into our actions that impact others.
The damage of drugs on the brain’s reward networks is very physiological, and these physiological changes can result in psychological effects such as anxiety or aggression. By evaluating the inventory we have taken, we can consider the “nature of our wrongs” as being the psychological deterioration caused by drugs.
Step 6- Were entirely ready to have God remove all these defects of character.
Many would argue that technically our character is shaped by genetic (evolutionary) forces far outside our individual control. So in that mindset it is not necessarily within our ability to change who we are genetically speaking. So, wouldn’t it be up to something greater than us, be it a ‘God’ or our own evolution of perspective, to remove the character traits that do not serve us?
With that said, our environment may influence how we have developed our responses and attached meanings to circumstances. Achievement of step 6 requires:
- Deep character analysis
- Painful realization
- Ability to dissociate the present self from the past self
By rethinking in terms of the “wrong” or “right” of an individual act, we can leave behind our attachments to actions or behaviors and offer up our character defects to the province of a higher power.
Step 7- Humbly asked Him to remove our shortcomings.
Humility is accompanied with gratitude and grace. Spiritual faith and humility challenge someone to accept that good intentions and honest effort alone will not always be enough to succeed. This could lead to chronic depression and relapse, especially with genetic predisposition.
However, the 12 Steps and the 12 Traditions together ask the person to believe that evil, injustice and cruelty will not necessarily always win either.
Humility and faith are not necessarily synonyms for passivity. They actually support the belief that our shortcomings can be removed by our willingness to believe that things can work out. Positive feelings translate to positive epigenetics in the brain, enhancing the chances of removing our shortcomings by expressing more effective and positive genes.
Step 8- Made a list of all persons we had harmed, and became willing to make amends to them all.
Behind part of this step is the old saying “water seeks its own level,” because it may be an effect of a genetic association. People often seek friends who not only have similar characteristics, but similar genotypes.
So by making amends which may eliminate certain friends that would not be conducive to recovery, an individual is truly going against the genetic grain on a molecular neurobiological level.
A form of happiness is that people exist in comfortable networks of social collectives. So as we reach out to those we have hurt to amend our relationships and our character, we reconnect with a new source of happiness.
Step 9- Made direct amends to such people wherever possible, except when to do so would injure them or others.
In Step 9, the achievement of making amends is subject to correlations among:
Relationships and happiness are based on neuronal hard wiring. So overcoming relationship issues is both an arduous challenge and a clear answer to achieving healing.
The degree to which someone can make amends is crucial to a healthy recovery. This is partly because mending of relationships is a gateway to the attainment of happiness. Making amends can also activate a natural release of dopamine in reward centers of the brain.
Step 10- Take personal inventory and admit to being wrong
Step 10 is the maintenance for Steps 4 and 5. It continues the practice of taking personal inventory in the 12 Steps to evaluate the self. It is important that addicts realize that depending on their genetic risk taking inventory and feeling good about the self-appraisal is a temporarily “dopamine fix”.
Beyond just having the ability to keep yourself in check and have a positive impact, when addicts continue to “work the steps” on a daily basis it also gives them a primary source from which to replenish dopamine in the brain.
Step 11- Sought through prayer and meditation to improve our conscious contact with God, as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
Meditation and prayer, as suggested in step 11, increases the release of dopamine at the synaptic level. Applying the process of step 11 on a daily basis will also offset the genetically induced “hypodopaminergic brain function” by continuing to release dopamine in the synapse.
Increased dopamine will result in a subsequent proliferation of dopamine receptors, even in those with the most sensitive predisposition. The increase in D2 receptors translates to enhanced dopamine function, which will ultimately promote:
- Greater confidence
- Better comprehension
- Stress resistance
Looking outside the 12 Steps, most who study spirituality know the positive effects of prayer and meditation on the brain.
Step 12- Having had a spiritual awakening as the result of these steps, we tried to carry this message to alcoholics and to practice these principles in all our affairs.
Here it says that working all the steps can allow an individual to have spiritual awakening. For some, one of the most fulfilling experiences they can have is sharing emotions with others. This experience itself and the impact may be decided by the synthesis and release of the brain chemical oxytocin.
Oxytocin is an important human bonding neuropeptide. However, independent of personal genetic makeup, alcohol and opiates significantly impair the synthesis and release of this chemical. So it is important to take advantage of this opportunity to create positive emotions while establishing connections.
So, by carrying the message and sharing experience we can bond further in our recovery, which helps us to rewire the brain with expressions of positive genes while also letting us detach from old meanings and produce more dopamine. All in all the 12 Steps have a pretty decent formula for working with the science of the brain to recover from a pattern of destruction.
The 12 Steps and similar programs of recovery are all very powerful tools. A holistic treatment program like Palm Partners respects the science of addiction, and many seek help here in order to establish a strong footing to move forward. If you or someone you love is struggling with substance abuse or addiction, please call toll-free now.
CALL NOW 1-800-951-6135
Author: Justin Mckibben
As hard as it is to admit, that’s the first step.
Once upon a time the forces of evil gave us this great conspiracy that we are separate; the truth is we never were. We have been lied to long enough that we are defined by our differences. We were told the borders mankind created for each other are valid reasons to hate and hurt one another. They said the shades in our skin and the climates and economic categories we live in made some of us better or worse… and the greatest tragedy is- we believed it.
The 12 Steps and the ‘anonymous fellowship’ model of recovery are actively used all over the world for those looking to recover from drug or alcohol addiction. There are even other addictions such as gambling or over-eating that people use the 12 Steps’ strategies to overcome. Anonymous support groups meet to work with one another to fight the obsessions that rule over their lives.
While some debate the effectiveness of groups like AA or NA, thousands upon thousands of people in over 150 countries all over the world have found their salvation from substance abuse through 12 Steps.
So, the question is… will it work for racism?
Some would insist that to even suggest racism is still a reality in America is to contribute to the race-baiting that drives division. However, the truth is no matter how far we like to think we have come- racism is still real. Now, Racists Anonymous (RA) aims to help those struggling with their own prejudices to overcome them.
Racism in America
While it may be hard in a politically-correct America to understand the gravity of it, racism is not extinct. No one likes to admit they are racist, especially in the modern society that preaches tolerance and acceptance. It is probably much easier for some to admit to their innermost self they’re an alcoholic or an addict than it is to admit they suffer from a serious racial bias.
Today we are still bombarded with police-related shootings involving young black men and women in the media. Meanwhile, we have the biggest protest by Native Americans in our history happening right now, and the brutality being inflicted on these people is truly deplorable.
Regardless of whether or not you believe that race is responsible for these injustices, the nature of these events leads some to think discrimination is the only explanation. The way these events are shown impacts the country, also driving a wedge between its people, inspiring even more division. Tragically, despite having an African American president, many insist this is the most racially divided we have been in decades.
One pastor in Sunnyvale, California is so concerned with the status of stigma and racial tension he is taking the unlikely step of offering a 12-step program for people who wish to heal from racism.
Pastor Ron Buford of the Congregational Community Church knows well that the first step of basically every recovery fellowship is to acknowledging the problem. He stated,
“That is something that we as Americans don’t want to do. We all swim in this culture of racism. It’s impossible to not be racist to some degree.”
Pastor Buford, who is himself an African American, makes no effort to point the finger and say this is a problem unique to one race or another. Back in 2015 Pastor Buford began to host meetings of the newly formed Racists Anonymous in what he says was a response to the police shootings all over America, exacerbated by the shooting rampage of Dylan Roof at a black church in Charleston, South Carolina.
Slowly but surely the fellowship of Racists Anonymous did actually grow! Since its conception, at least a dozen people regularly attend the weekly Racists Anonymous meetings. The RA meetings host a majority of Caucasian members, but also various other races are adamant attendants. Seems like having members who would not normally mix is a big understatement here.
Still, the Racists Anonymous fellowship follows the path set out by the original 12 Steps. For example:
- Making a list of people they have harmed
- Making amends to those they have hurt
- Taking personal inventory
- Admitting and recognizing racist behaviors
RA meetings also include sharing experiences and feelings regarding race.
One thing very different about RA from most 12 Step fellowships is these meetings is the mediator. RA meetings have someone working to directly confront members with scenarios. The mediator, typically Pastor Buford, then challenges members to explore their attitudes and actions concerning other races. This kind of mediation is not the norm for many 12 Step meetings. What many might call “cross-talking” seems to be acceptable in the RA format.
Expanding the Fellowship
Beyond the reach of Congregational Community Church, over 30 other churches across the country are in the process of establishing Racists Anonymous groups. Buford says he hopes to make RA just as available as AA or NA all over the U.S. of A. Still there are many hurdles to overcome before this fellowship can hope to grow.
A large obstacle is that not many people are willing to admit they are racist to a group of strangers. Reverend Nathan King of the Trinity United Church of Christ in Concord, North Carolina, introduced the meetings to a mostly white congregation. Reverend King said,
“People are in different places. Some say, ‘I’m a racist.’ Or they say, ‘I don’t know’ or ‘I’m not sure.’”
Some would protest the comparison between alcoholics and racists. One might say that one is a choice and the other is a disease. But then again, some people still claim alcoholism or addiction is a choice, but anyone who has been there or been on the frontlines in fighting addiction knows better than that. So, is it fair to say that the idea of supporting people in recovering from racism is not a worthy task?
Stephen Mosier, a 74-year-old RA member is a retired college administrator who stated,
“We have all got some residual racism in us no matter how good we think we are at it,”
Pastor Buford believes that racism could very well be a lifelong issue one struggles with. Whether you believe people choose racism or not, the hope is to eliminate the spread of racism for future generations. Either way, this seems like as good a reason as any to try and make a change.
Racism is an Addiction
In the end if we are all as introspective as we can be, we will see that as imperfect people we have a tendency to make assumptions or misconceptions based on the ideas we were conditioned with throughout life. In a combination of our environment and the more drastic experiences we have, we can subconsciously create stereotypes or expectations, and our culture may only feed these beliefs. But it is our responsibility to fight back and grow out of these lies.
We become addicted to these stereotypes and presumptions. We may even realize we are wrong, but somehow we cannot let go of the crutch of our conditioning. The truth is, no one is born racist. Racism is taught. So love and tolerance must be learned in order to escape these archaic lessons. RA may not be the only way to teach love, but it’s an interesting take on an old way of working for an awakening.
While many are far from able to take that first step, others who have fought to overcome drugs and alcohol already know just how difficult of a step that can be. Having that clarity isn’t always easy, but once you see the problem for what it is you have a window of opportunity to get the help you truly need to change. If you or someone you love is struggling with substance abuse or addiction, please call now!
CALL NOW 1-800-951-6135
Author: Shernide Delva
California is in the middle of their worst drought in 1200 years. Recently, I wrote an article about how marijuana farms are draining the state of its water supply. The growing season for marijuana plants comes during California typically dry summer months. An article in The Rolling Stone pushed for regulating the drug stating their needs to be a crackdown on water usage.
As a side effect, Marijuana Reform is now being viewed as a possible solution for California water drought problem. The legalization of marijuana is now heavily promoted as a way to save California’s water crisis.
Marijuana plants require six gallons of water a day per plant to grow. Often, this large water supply is diverted from rivers, lakes, and streams or even stolen from farmers whose water use is already strictly regulated. The majority of marijuana is produced in an area known as the Emerald Triangle consisting of Humbold, Mendocino, and Trinity counties.
Unfortunately, much of the Emerald Triangle is currently classified as ecologically vulnerable. Writer S.E Smith argues in one article that the solution is to legalize pot so that large marijuana growers would go away from ecologically vulnerable areas.
The legalization of marijuana would result in environmental benefits, the article mentions. Marijuana growers would be required to grow their crops next to other farms and thereby have to follow the same water regulations. It would allow regulators to monitor the growth of the plants and offer guidelines for reducing water usage such as establishing a rainwater collection for the summer months.
The full legalization of marijuana in California is seen as inevitable for many corporations. In efforts to prepare, The North Coast Regional Water Control Board is in the process of setting up permits associated with marijuana cultivation. Other pilots programs across the states have implemented new guidelines to cultivate marijuana in an environmentally conscious manner.
What this means for Marijuana Reform:
So what does this all mean? Essentially the drought in California is making the fight for legalization easier. In addition to all the health benefits and revenue that marijuana has the potential to bring; the environment is another reason for reform.
California has one of the largest running medical marijuana programs, but in the past, recreational marijuana has been voted down. Since the drought has gotten to be so horrible, most people will lean towards supporting any legislation that will improve the water shortage. California’s significant loss in agricultural yield, income and employment will likely influence the decision to legalize recreational marijuana.
Furthermore, the higher tax revenues generated from marijuana will result in other states to want to cash in on marijuana as well. Legalization in California is predicted to generate a rippling effect influencing legislation in states nationwide. As more states legalize marijuana, there will be less of a need to grow only in one area and farms will spread in other areas of the country.
Until recently, farmers sought out hidden nooks and crannies of the state to cultivate their crops. They were not conscientious about water usage or environmental regulations. Marijuana still remains largely in the shadows because its illegality makes it impossible to regulate. How do you regulate a crop that people can’t legally produce?
For now, as long as farmers offer documentation that they are growing plants on behalf of those with medical marijuana prescriptions, they can continue to grow. Unless marijuana legalization occurs, this will be an uncertain situation with minimal solutions.
Marijuana is an easily abused drug, and legalization poses other consequences. However, medical marijuana regulations are not beneficial to the environment. The next step for California may be to protect the environment by legalizing the drug and enforcing proper regulations.
Marijuana is a mind-altering substance that can be abused just like any other drug. Research is suggesting there could be health implications from heavy use. Although marijuana reform is getting significant amounts of attention, it is important to recognize if your drug use is becoming an addiction.
Remember, legal or not, drugs can be abused and drug addiction can occur. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135.
Author: Justin Mckibben
Recovery from alcohol or drug addiction can seem like a world of confusion, convoluted approaches and misunderstood opinions, especially from the outside looking in. No method has proven to be perfect, and 12 step fellowships like AA or NA do not claim to be perfect; each has received their fair share of criticism. So to say that any program is the end all be all is impossible and would only be arrogant, but some are speculating that the future lies with another two side-by-side letters… MM. Moderation Management (MM) is a program that has existed since 1994 and recently is claiming to have a rising popularity and success rate. So now it seems MM is posing the first real challenge in decades to the traditional approaches to addiction treatment and continued sobriety, and some are wondering if MM could really work for them.
Off to a Rough Start
After being started in 1994, the growth of Moderation Management was stalled in controversy over its founder, Audrey Kishline from 2000 to 2012. After starting MM, Kishline left the group when she realized that she herself could not moderate her drinking after all. Kishline returned to AA, then relapsed back into drinking. In March of 2000 Kishline was involved in a drunk-driving accident, killing a man and his 12-year-old daughter. She was released from prison in 2003, and in 2012 she killed herself after being plagued by guilt.
Since Kishline’s death, MM has had something of a rebirth, which was reinforced by the launch of the US National Institute of Health’s Rethinking Drinking program. Then there came a report from the Centers for Disease Control in 2014 that described “excessive drinking” as a major public health concern that was independent of alcohol dependence and that it is not being addressed by programs that typically dominate.
MM has started to add more in-person meetings and last year, the organization launched a campaign on what they called “Dryuary”, encouraging people to abstain from drinking for the entire month of January. “Dryuary” was so successful that MM is looking toward making this an annual event.
The MM Movement
The program typically starts with what frequent attendees would refer to as “doing a 30”, which means 30 days off booze altogether, followed by a slow reintroduction of alcohol into the individuals life, and eventually the strategy leads into a plan to limit your intake. That plan is typically based on the ideas of:
- No more than 14 drinks a week for men
- 9 drinks a week for women
- No drinking more than 3 or 4 days a week for either
There’s increasing talk of applying MM to marijuana use as well, although that’s not officially condoned by the nonprofit of the same name, which administers the program. Marc Kern, the organization’s director, acknowledges that since there are states legalizing cannabis use, there will soon probably be the Marijuana Moderation version of MM.
There is a framework to MM based on Kern’s book Responsible Drinking, but it’s also a program that prides itself on flexibility and enabling people to find their own paths forward.
Kern himself admitted that historically MM has been shunned as a program that enables alcoholics, but feels this is an oversimplified explanation. Kern stated,
“Before MM there was no book or guidelines or anything, so people would just go out and try moderation naively on their own, and without any support a lot of them would fail.”
For over a decade Kern has been helping patients with moderation in a clinical setting, including using a formal therapeutic protocol that includes using a Breathalyzer and closely monitoring patients’ progress. Kern was even able to get MM approved as a program for first-offender drunk drivers 15 years ago by the city of Los Angeles and the state of California, although the primary course of action is still typically abstinence based groups.
For Kern, it’s not a case of MM versus AA, or moderation versus abstinence. I a way he has even described MM as a stepping stone toward knowing what you truly need.
“I often think of MM not as a treatment program but as a strategy tool. We will help people strategize about a party coming up, for example. And for some people, going through MM is almost like a diagnostic tool – they realize they can’t moderate and end up going to AA or another abstinence group. But there’s at least a sense of ‘I gave it a try’, and a lot of people need to do that before they’re willing to accept that they need to abstain.”
The part that seems to appeal most to MM members: the sense that they have options available to them and that the ultimate decision is theirs to make. Kern is openly able to say MM is not for everyone, and that lots of people who try actually need to be abstaining, but it is an option that each individual may have to see for themselves.
The “Real Deal”
As a “real deal” alcoholic in active recovery, I found a solution through a 12 step fellowship. Given my own experience I feel that it was absolutely necessary for me to separate myself from the alcohol and drugs, and given my own history and attempts to moderate or use casually (which all failed miserably) a program based around counting my drinks with the intent of measuring and monitoring my level of intoxication would probably not go over too well for me.
I do agree with the idea that not every program is for everyone, most programs will admit to that. Not everyone is a “real deal” alcoholic/drug addict, and for some people who are defined as “hard drinkers” or “heavy users” it probably makes sense to start with a period of separation, followed by careful moderation, but is this in itself a ‘safer’ approach? Or is it just taking a breather between dangerous binges?
As far as whether or not MM could ever replace AA, I don’t see that as a practical reality. While the MM approach may help people who still have the “heavy drinker” status, the obsessive alcoholic of the hopeless variety- like I was before getting sober- typically can’t safely risk moderation. Again, that is my opinion, so feel free to disagree. One thing I know for sure is that we all have a right to choose what action to take to change our lives, as long as we are willing to take action.
Whatever program you choose, make sure it is one that will empower your future. Choose a method that can keep you healthy, honest, and as happy as possible, and share that experience so that others who are suffering can find their solution. Addiction and alcoholism is a deadly disease, and too many people never make it out alive. If you or someone you love is struggling with substance abuse or addiction, please call toll-free 1-800-951-6135. We want to help. You are not alone.
Do I really need rehab first? Can I just go to AA, NA or CA?
I went to three different rehab programs before I got sober. I went to group therapy, cognitive behavioral therapy, trauma resolution, anger management, and family therapy. I saw psychiatrists, psychologists, acupuncturists, addiction counselors, life coaches, and social workers. I acted out my feelings in psychodrama. I made collages in art. I learned to salsa.
And still, I got high; again and again.
I learned that this isn’t that uncommon in addicts and alcoholics. My three trips to rehab seemed modest in comparison with a lot of the people I was “in” with. On my second day at my third rehab center, I met a guy who at 19 years old was in his thirteenth treatment center. Many addicts get locked into an expensive cycle of detox, rehabs, and outpatient treatment that’s largely ineffective.
For me, what changed is that I changed what I did when I got out of rehab. I went to a halfway house. I got a sponsor. I worked the steps. I went to outpatient treatment.
So the short answer is no, you do not really need to go to rehab first. I’ve met plenty of addicts and alcoholics in the rooms who never had to shell out $30,000 for an inpatient treatment center. They went to meetings, worked the steps, and they stayed sober.
However, that doesn’t mean that treatment is a waste of time. For me, it was absolutely essential. The last time I was in treatment, I was coming off of Suboxone, a long-acting opiate. For the first 18 days, I couldn’t eat, I couldn’t sleep, and I wanted to die. If I had not been in treatment, I would’ve definitely gone back to using, just to relieve the discomfort and that process would’ve been a lot worse without the detox meds. Also, convincing me to get sober in the first place would’ve been next to impossible without the promise of medication to ease some of the withdrawal symptoms I knew were coming.
I also met a lot of other addicts in treatment. There were the ones in treatment with me, and the ones I met at outside meetings the treatment center brought us too. When I got out of treatment, I already knew people who had more sober time than me and I was familiar with meetings in the area. It made the transition a lot easier.
Rehab bought me sober time, which was a valuable gift in the beginning. I was in a safe, regulated environment where it would’ve been really difficult for me to get my hands on drugs or alcohol. For this, I will be eternally grateful, because those first 90 days were some of the hardest. The cravings were still there, and the emotional ups and downs may have caused me to relapse in a less secure environment. Using wasn’t an option in rehab, though, so I had to start practicing dealing with life without drugs.
That is the truth gift of going to rehab before trying to work any program. You learn to stay sober and cope with all your problems.
Rehab also reminded me of the gravity of using. Being there kept me constantly aware that I was damaged enough to need treatment. Whenever I would hear that voice in my head telling me I could probably drink normally, the stark reality of my situation would hit me. Would someone who could drink normally end up in three different treatment centers? I don’t think so.
If you or someone you know needs treatment for Alcohol or Drug Addiction please call us at 800-951-6135 or visit us online at www.palmpartners.com.