Any money left?
Money is one factor. It is unusual for a gambling addict to be solvent by the time they seek help. But if any type of addict still has cash available or a health insurance policy that will cover treatment in a rehab clinic, this will often be the first option. The treatment will be more feather-bedded than a cold turkey in an unheated bedsit. But beware, if the treatment center is more like a five-star hotel than a hospital it may be too comfortable for the patient to face up to harsh realities. More than one successful non-drinker has told me that first they went to a clinic which treated them very nicely and it didn’t work. The ones that did work on a later occasion had a much tougher regime. I would avoid clinics that look like a five-star hotel in the brochure or on the internet with a swimming pool set out for sun bathing. These are more appropriate for temporary detoxes.
After an addict’s condition has been stabilized – with the help of prescribed medication if necessary – then the group therapy, one-to-one counseling, and lectures on addiction will begin. Sometimes a 12 step program will be embarked on in the clinic, to be followed up with a recommendation to attend meetings after the treatment ends. More often than not 12 step programs will be recommended as a maintenance program after treatment. These include NA (Narcotics Anonymous); AA; OA (Overeaters Anonymous); one of the Sex Anonymous groups; and GA (Gamblers Anonymous) or DA (Debtors Anonymous).
But not always. Sometimes the line is: “you’re OK now, off you go and if you have any problems come back and see us.” Sometimes clinics run their own weekly meetings of patients after they have left treatment. I know many alcoholics who don’t go to meetings, but keep in touch with other alcoholics through regular lunch dates or social encounters. However, knowing how many addicts that don’t attend meetings relapse, I would recommend continued attendance. (I have experienced relapse in OA due to not taking the process seriously enough just because it is a secondary addiction.) Further, my observation of addicts who attend meetings but don’t do the steps is that they are in a limbo land somewhere between white-knuckling it (with no meetings) and being a happy, contented individual (who does the steps thoroughly). I would recommend thorough application to the program.
Options are fewer if resources are limited. It may be possible to negotiate an outpatient program with a treatment centre or there may be publicly funded beds available but there will usually be a waiting list for these, which lengthens if you’re a second-time or third-time applicant. I have met someone who went into clinics 27 times but his funding was private. For some lucky addicts there may be a charity-funded place available on a two-year program with one year in a clinic and one in a half-way house before being turned out to face the world alone. Most of these organizations are keen for patients to attend 12 step meetings as well. A drawback of these treatments is the wait for a place. Some suggest that addicts continue using until a place becomes available. This doesn’t seem right to me. If there is some willingness to attempt to give up the addiction, it seems a pity not to tap into it while it exists.
But I suppose these places aim to cater for no-hopers who have tried everything else. It is often said that people need to seek help for themselves, it is no good trying to do it for a wife or family or employer. That is because, unless we are clinically insane, we cannot be locked up against our wills to prevent addictive behavior. And this option of willing admittance to a closed unit is the nearest addicts can get to being locked up against their will.
Some addicts gain admittance to hospital or clinics on an emergency basis when they have almost used to death. But it is not a course to be recommended on purpose because the tolerances are very hard to estimate and it is easy to end it all by mistake. One of the more spectacular ends associated with cirrhosis of the liver is an esophageal haemorrhage whereby the body drains of blood via a fountain that hits the medical room ceiling.
One of the sales pitches by clinics is for an individually tailored, custom-built treatment, implying other options are one-size-fits-all. But 12 step programs are designed to be custom-built, too. Don’t assume they are rigidly applied to all alike.
I went to AA meetings as a condition of my outpatient program at a clinic. The initial six-week course gave me and my family access to separate post-treatment meetings at the clinic which lasted for a year or two, but I have continued in AA ever since. Only I have rewritten the steps to suit my atheist convictions.
I first went to OA meetings at the same clinic where I’d quit alcohol. Concentrating on my prime addiction, I had let my eating slip out of control. I gave up sugar and white bread and after a few hiccups (for some reason I thought that sorbet and honey didn’t contain sugar) the process worked well. But I was still confused about different higher powers in different programs. This, and my attendance at meetings gradually dwindling to zero, led to a relapse. Now I am having more luck once more through applying my own atheists steps six and seven to the overeating problem. Rewriting the steps to suit my atheist convictions is having positive results.
A 12-step program requires members to admit they are addicts, which has made their lives unmanageable. This is the surrender, admitting the addiction has beaten them and that they will not fight it. This is how addicts achieve victory, not by trying to win each battle with the addiction by willpower, but by refusing to fight it and adopting the 12-step program which will keep them clean from day to day.
Some members mistakenly think they have to surrender to god or their higher powers to achieve the victory. This is not the case. Since there is no god there can be no help from that quarter and members are foolish to rely on their imagination. If they choose a real higher power such as the program itself, this can give support, but they must do the work themselves. We say: “you have to do it yourself, but you don’t have to do it alone.”
We let go of self-will. This means we no longer try to force outcomes by bullying and manipulating other people, but do the spadework and then wait to see what the outcome is. It is usually different from the one we had thought would be best for us and often better than what we had envisaged.
We made a moral inventory of ourselves and set out to improve our behavior. We made amends for past wrongs. We sought to improve our spiritual awareness and to help others. Eventually the craving for a hit disappeared and we realised we were different people from the addicts we once were. We were clean from our habit, abuse had ceased and we were useful, contented human beings.