work in progress last update 3/20/2026

Intensive Addictions program (IAP)	Make the commitment to detox for a while and get into support groups. Tell yourself daily, get sober for a few weeks to months to years:
	1. I will tell the truth to myself and others.
	2. I will do my work to the best of my ability.
	3. I’ll be constructive in my interactions with others.
	4. I’ll respect feedback.
	5. I’ll accept authority.
	6. I’ll follow the instructions.
Relapse Prevention: Problem solving	Society is not good at problem solving.
	1. identify the problem: key word “exactly”. Negative consequence of it. Example: Pot smoking is causing me trouble.
	2. Clarify the problem: Who, what, when, Where, How, and Why of the problem.
	3. Identify alternatives: Can it be solved? Do nothing? Move/expand? Reschedule?
	4. Examine alternatives: What it is best thing that can happen? What is the worst thing that can happen? What is most likely to happen?
	5. Decision: commit or cancel.
	6. Action: Do it. “Easy does it, but do it”.
	7. Evaluation: Did it work? (solution)
Relapse Process	Relapse is a return to old behaviors, process of return back to use. Event- Thought- Behavior.
Symptoms of beginning to Relapse	1. Triggers: internal or External. Internal: emotions, Fear, self-pity. External: smells, commercials, people, places, and things.
	2. High Risk Situations: Red Zone, Bars, Family, Friends, Clubs, Dates, holidays.
Peronality Traits that lead to relapse	1. Compulsiveness. Perfectionism
	2. Dependency- indecisive, clinging, then go back to drugs when people abandon them.
	3. Passive Aggressive- resistive, procrastination, blaming.
	4. Self-Centeredness: egotistically, pushy, not admitting they are or have a problem.
	5. Rebelliousness: impulsive, anti-social, resentful, resistive to help.
Relapse Prevention	1. Define relapses: return to thoughts, feelings, and behaviors.
	2. Define Prevention: measure you take not to start.
	3. Relapse warning signs: attitude, denial, overconfidence, bored.
	4. Recognition High risk situations: bars, reminders, weddings, concerts, clubs, parties.
	5. Triggers: internal and external events, these bring back memories and times.
	6. Preparing for relapse in Advance: Plan, Awareness/mindfulness, have a good daily schedule, role play. Get treatment, rehearse.
	Maintain a balanced lifestyle, walk, work, talk, rest, recreation.
Circumstances in which people relapse	1. Negative emotions: anger, depression, boredom, stress
	2. Social situations: arguments with spouse, friend, co-worker.
	3. Peer Pressure: being around people who use drugs and alcohol.
Definitions:
Peer Group:	A group of residents assigned to some primary counselor, with the purpose of establishing truth and honesty.
Personalizing:	A tendency to be incorrectly think the actions or statements of others are personal attacks.
Blow you image	Being able to function without regard to what other people may think.
Confrontation	Present a person with a description of his/her behavior and its effects within request that they explain and/or change it.
Encounter group	A group in which residents encounter or confront other residents about negative attitudes, values, or behaviors. Challenging and demanding change.
Cardinal Rules	Rules considered absolute and breaking these rules results in very serious consequences, including discharge of detox rehabilitation.
On the floor	An area outside of a group setting.
Lip service	Any unwarranted comment in response to a direction from another resident, coordinator, and staff member.
Bogus	Phony, untrue
Tight house	A limited situation for the entire house to bring about change in the entire house.
General meeting	A meeting in which the entire house is present, for the purpose of making the house aware of a situation that pertains to the entire house.
Off the top	A superficial conversation
Pushing buttons	To deliberately provoke or attack a person in a sensitive area to make him/her react and release hostility on you.
Being Aware	Knowing whats going on at all times around you.
Projection	Seeing negative in others because you yourself possess them.
Taking a Trip	Evading a question
Negative Contract	Two or more people in a program with a spoke or unspoke agreement to cover each others negative behavior for example not confronting each other in a group.
Manipulating	indirect way of getting what you want.
Bad Rapping	Belittling someone who is not part of or present in the conversation.
Learning experience	an assignment given to a resident for exhibiting negative behavior to bring up the residences awareness.
Hang tough	Being patient and doing what is expected of you even when the pressure is on.
Splitting	Going to someone else when you are already told by someone what the answer was, bypassing or going around until you get the answer you want.
Education: recovery is an inside job. Drug use and HIV	Substance Use and Abuse, HIV/AIDS
early 2000.	Handle one disease at a time: first substance abuse, then HIV.
	Handle the stress, anxiety, depression, remove drugs and alcohol to boost immunity and lessen HIV.
	Laughter is also helpful for the immune response.
	Anticipation of the virus causing health problems is worse than HIV itself.
	Immune response is higher in homosexuals than it is in IV drug users like heroin addicts.
	AZT- RNA to DNA anti-transcript HIV in the DNA. T4 cell macrophages to fight HIV.
	Asymptomatic: no sign of the disease
Today:	We have anti-virals that can kill the virus, or make undetectable.
Marijuana:
THC (Tetro hydro Cannabol)	Active ingrediant that is Fat soluble. Can hang out in fatty tissues like brain, adipose, reproductive organs.
	Smoking it is immediate effect can last 45 to 1 hour peak and then taper off for 3 to 4 hours.
	Ingesting: takes about 30-40 minutes for effect. 1.5 hour peak, 5-6 hour lowered effect.
	Changes how you feel: euphoria, “high”, with an altered sense of time and space.
	Effects: red eyes, dry mouth, sweating, coordination problems, paranoia, drowsy, strong appetite, palpitations.
	Addictive: physical addiction: Withdrawal: headaches, irritable, sleep disorders, appetite changes, cravings.
	Tolerance: heavy users have higher tolerance.
	Fat Soluble: Brain is 1/3 fat and our reproductive organs, it can stay in placenta and sperm. Infertility can occur.
	Cancers: Head, neck, and lungs most common.
	Psychological: can cause emotional bubbles, addictive behavior within self, not care of others and society barriers.
	Health: cause sinus and respiratory/pulmonary issues.
Alcohol	Alcohol is a depressant
Factors that influence a persons reaction to alcohol:	1. Body Weight
	2. Age
	3. Gender. Females have less enzymes
	4. Food in Stomach or not.
	5. Guzzling
	6. Tolerance
	Alcohol is a protoplasmic poison, it is one of the oldest substance that is pre-biblical.
	Effects the muscles, respiratory, nervous, and digestive systems strongly
	Alcoholism is a progressive to chronic to a potentially fatal disease.
	Fetal Alcohol Syndrome (FAS): baby has low birth weight, facial features, arrested brain growth.
	Effects to society is car accidents, fights, theft, death.
	Liver and Brain and the organs strongly affected.
	Alcohol lowers your inhibitions: things you wouldn’t do sober, you would do when you are drunk.
	Alcohol irritates the lining of the stomach mucin.
	Medications and Alcohol often have a synergism and can make medicine stronger and dangerious. With a CNS depressant is very harmful.
	Malabsorption syndrome in alcoholics, non-absorption of vitamins and minerals for the body.
	Othe rhealth problems: Hepatitis, pancreatitis, gastritis, ulcers, Insulin resistance, diabetes, Bile, Jaundice, Cirrosis,
	including Albumin (maintain health cells), globulin (protect from infections), Fatty acids/Trigylcerides, fatty liver, Hyper/hypo-glycemia, Gout, Thrombosis,
	more: heart conditions like myocarditis, heart beat irregularities, high blood pressure, Kidney disease, bladder, prostate issues.
Narcotic Medications
	O.T.C. (Over the counter)
	Analgesic: pain killers with or without a loss of consciousness
	Narcotics: need a prescription. Habit forming, drug that dulls the senses, relieves pain, induces sleep.
	Medicine: substances used for treatment or prevention of disease
	Opium Poppy: Demerol, morphine, codeine, Delauded, Percocet.
	Synthetic: methadone
	Opiates have been around since 3rd century: Galen, Paracles “laudnum”, Opium.
	Somatic: for bones, muscles, pain.
	Visceral: pain from organs, tissues of the body
	Introvert/extrovert: degree where the pain occurs.
	Nociceptors: receptors to pain
	Thalamus: brain pain terminal
	Anxiolytics: anxiety drugs
Tobacco use:	It takes 7 to 8 attempts to quit smoking
	tobacco is a 5.2 billion dollar industry (2003)
	50 million people in the USA smoke
	Diseases: COPD, Lung Cancer, Heart Disease
Hallucinogens and PCP	LSD: thought process distorted, potent. Take in micrograms, lasts 8 to 12 hours.
	Ecstacy: stimulant effect, neurotoxin.
	PCP- distorted thoughts, anesthesia
	Mushrooms/Mescaline: change in perceptions, sensory overload, increase heart rate, BP, sweating, dry mouth, dilated pupils,
	senses heightened, switching of senses. “Trails and Flashbacks”.
Stimulants	Speed, Uppers, Cocaine, Amphetamines, crystal meth.
	Stimulate the CNS, spine, brain, peripheral and autonomic nervous system.
	Fetus: spontaneous abortion, fetal death, premature labor, still born
	Stimulants associated with weightloss suppress the appetite, burn calories, energy.
	Physical effects: hunger, fatigue, chemical dependency, loss of sleep.
	Psychological effect: dopamine, the pleasure neurotransmitter is weakend for the fake drug dopamine
	adrenaline: adrenal burn-out, fake energy over real adrenaline energy
	Serotonin” lack of emotional stability from normal serotonin.
	TX: SSRI: serotonin reuptake inhibitor usually prescribed.
Stress Management and Coping
	P.A.W.: Post Acute Withdrawal. It is the first few hours to 1st week of withdrawal.
	Stress: pressure, tension, strain, worry, anxiety, anger, aggravation, depression, discomfort. “Force that causes a strain”.
	2 weeks to 2 year (severe trauma) can be a time frame until normal again.
symptoms of P.A.W.	Cravings, desire
	Dreams that are vivid and intense
	Mood Swings
	Sleeping problems, waking up in the night, insomnia, not able to sleep
	Appetite changes: food cravings
	Fatigue: general weakness
	There can be cycles of Stress + PAW = more stress requiring more P.A.W + stress…vicious cycle. “setting self up for failure”.
Stressors:	Traffic, no money, car broke, getting sentenced, job hunting, family, work deadlines, 1st date, consequences for actions.
Coping:	Reading, pets, music, dance, massage, meditation, timeout, counting, praying, exercise, talking, asking for help, being truthful.
	management: minimize and lessen stress, get organized, identify stressors, problem solve.
	Distress is negative stress
	Eustress is positive stress
Process of Addiction
Signs and symptoms	1. Disease: condition in the body that presents with signs, symptoms, and characteristics particular to a specific illness.
	a. Primary- treat this first. Example alcoholism.
	b. Secondary: Cancer, diabetes, or other aliments. The alcoholism needs to be treated first otherwise the other treatments will fail.
	c. Predictable: following a pattern
	d. Chronic: no cure
	e. Progressive: mild, to moderate, to severe.
	f. Potentially fatal
Physical symptomes	Withdrawl
	Tolerance: heavey users have higher tolerance.
	Blacking out
	memory Loss
	Accidents
	Over dosing
	Organ and tissue damage
	Sleep disturbances
	Malnutrition
Emotional symptoms	Mood swings
	Instability
	Family problems
	Loss of control
	Impulsiveness
	Destructive Behavior
	Instability in job, or moving house to house.
Spiritual= values	Denial and avoidance
Progression of Addiction:	Experiment stage: tired, made decision to use, like or not like
Social stage	Early: not addicted yet, some consequences, responsible, rationalizing, denial
Mild stage	Blackout, Mood changes, use
moderate- middle stage	anxiety, no responsibility, drinking at parites, needing a designated driver
Problem	Drinking and Driving, protecting supply, attempts to quit, using drugs, consequences, irresponsible, depression
severe- late stage	Loss of respect, guilt, alibi system, severe consequences
Anger Management	Relationships come with baggage and expectations
	Anger is a response, emotion
	Threat- loneliness, losing something, physical, intelligence.
	Fear- inadequacy, unknown. Can make you angry.
Physical symptoms	blood pressure rise, breathing, lack concentration, racing thoughts, guilt, anxiety, adrenaline, fist, sweating, shakes, red face, face expression.
	displaced anger- taking it out on someone else less threatening.
	Stuffed anger- holding it in, afraid to express it.
	Residual anger- lingering, not dealt with, unresolved business.
	management techniques: cooling, breathing, counting, walking.
	Triad: threat- fear- anger.
Requires effective communication	conflict as a bargaining table
	constructive ways of conflict: collaboration and compromise.
	Selfless not selfish
	Insecurity and anger: people who are insecure are angry.
Roles and Rules of the Addicted Family
	Scapegoat- hurt, negative
	Victim/Dependant- pain/shame
	Lost child- loneliness
	Hero- guilt
	chief Enabler- anger
	Mascot- fear/insecure
Dysfunctional family	Don’t talk: keep secrets, dishonest, “Everythings fine”.
	Don’t trust: broken promises, failed expectations
	Don’t Feel: shutdown, hide feelings
Rules	Do Deny
	Do rationalize
	Do criticize
	Do minimize and control
	Do protect and project
	Do intellectualize- thinking to loud
	Do divert: cange the subject.
Boundaries and codependency	Boundaries are defined areas, limits, barriers, personal space, defined areas, rules, control.
	Taking care of yourself, you set your own limits.
	Relationship: interaction with other, partnership, connection, companion.
	Relations is important to know before boundaries.
	Healthy relationships need boundaries.
Inner self:	likes/dislikes
	wants/needs
	morals/values
	feelings
	thoughts
	beliefs
	experiences
	intuition
	decisions
	hopes/dreams
physical:	touching, hitting, privacy, home, clothes, money
mental/emotional	feelings, thoughts, love, wants/needs
Spiritual	higher power, beliefs, values, morals
Defense Mechanisms	Unconscious psychological strategy to help cope with anxiety, stress, internal conflict by distorting reality
	Anger- covers feelings
	Minimizing- reduces the truth
	Rejection- verbal/non-verbal attack or avoidance
	Rationalization- illegal thinking to support irresponsible actions.
	Silence- shutting off communication
	Inappropriate humor- changes the subject, humor at the expense of others.
	Withdrawal- non-verbal body language
	Peace at any price- people pleasing at cost of self worth
	Evading- circumventing an issue
	Escaping- leaving a situation to avoid dealing with it.
	Day dreaming- withdrawal from a situation to pleasant things
	Denial- refusal to recognize facts
	Shifting/switching- getting focus off topic
	Projection- shifting feelings on someone else.
	Blaming/scapegoating- focusing on someone else
	confusion- getting others to do work for you by not understanding
	Intellectualizing- impressing others with academic approaches.
	Tears- getting sympathy from others
	Sex- inappropriate sensual presentation masking low self esteem
	Physical sickness- heard to comfort ill people