Tuesday, 21 November 2017

Celebrate the Holidays Safely, Comfortably, Joyously

Celebrating the Holidays with Recovering Family Members and Friends
Peter Gaumond, Chief, ONDCP Recovery Branch

Holidays in RecoveryThis time each year can be stressful for anyone, but the holidays present a special challenge for people recovering from a substance use disorder. Those in long-term recovery typically are adept at navigating the minefield of temptation at holiday social gatherings. But many of those in their first year of recovery, their friends, and family members wonder how best to celebrate the holidays safely, comfortably, and joyously.

If your festivities will include someone with a year or more in recovery, you may simply want to ask if there is anything you can do to make the holiday better for them. They may want to bring a friend who’s also in recovery. They may have beverage preferences or want the flexibility to step out for a short while, either to attend a mutual aid meeting (e.g., Alcoholics Anonymous, Narcotics Anonymous, or SMART Recovery), make a call, or get some fresh air.

The holidays may come with expectations, such as shopping, travel, cooking, and multiple social gatherings. People in early recovery are often experiencing difficult personal or financial circumstances while at the same time trying to learn to live without the substance that had become central to their lives. While the holidays are a time to celebrate family and good cheer, they are also a time when other feelings can be heightened. Such feelings can include a sense of loss about a deceased family member, or feelings of hurt, resentment, anger, shame, or guilt about the past on the part of the recovering person, other family members, or both.

Early recovery brings reawakened awareness of the harm one caused oneself and one’s family and friends during the course of the addiction. It is also a time when the brain and body are still actively recovering from the effects of addiction. Those in early recovery are relatively new at learning to experience, process, and manage feelings and to function in social situations without the use of a substance. Alcohol or other drugs may have served the recovering person as a social lubricant during the early stages of their use, helping alleviate social anxiety and feelings of not fitting in while simultaneously lifting their guard, making it easier to speak and act spontaneously.  The social events of the holidays can be challenging in a number of ways for the individual who is new to recovery.

Fortunately, many in early recovery do well during the holidays. The experience of sharing the holidays with family or friends can strengthen their recovery and reinforce the value of the fuller, more authentic way of life they are entering. The holidays can, in effect, be a time to reconnect and restore. To help foster a positive holiday environment for those in recovery, please keep in mind the following:

Tips for celebrating the holidays with family or friends in early recovery:

  1. You are not responsible for your guest’s recovery, even if that guest is your child, sibling, or parent. Behind the scenes orchestration to “help” the recovering person through the event can sometimes be unhelpful. Instead, reach out to him or her to see if there’s anything you can do to help the event  go smoothly. If you do, be ready and willing to accept “No, thank you” as the answer.
  2. Ask yourself if you and your family are ready to celebrate the holiday with the recovering person. Are there unresolved hurts or resentments that could make the holiday difficult for all? Does your family understand addiction and embrace recovery or is the topic shrouded in shame, an “elephant in the room”? Addiction affects not only the addicted individual, but the family as a whole. Denial or shame around addiction, if not appropriately addressed, can make the holiday difficult for the family and risky for the recovering person. So, it’s worth asking: Are you and your family ready?
  3. Ask your friend or family member if they are comfortable taking part in the celebration this year. Make sure they understand that it is perfectly OK to miss the celebration if that is what is best for their recovery. Their recovery comes first. It’s better to miss them this time around in order to increase the likelihood that they will be alive, well, and able to participate in future events.  Think of it as an investment that will pay dividends.
  4. If you will be serving alcohol, check to see if your invitee is comfortable with that. Note, even if you’re willing to host an alcohol-free holiday event, your family member or friend might not be comfortable attending if alcohol is not served simply because he or she is present.
  5. Ask if they’d like to invite someone or invite others who do not drink. Regardless of whether alcohol is served or not, the recovering person may want to invite a recovering guest. If you’re serving alcohol and have family members or friends who are in recovery or who do not drink, you may want to ask your guest if he or she would like you to invite them so that there will be other non-drinkers with whom to socialize.
  6. Ask what kinds of beverages they would like to have. While non-alcoholic “mocktails” may seem like a good idea—and many in recovery do enjoy them—they  may actually be a trigger for some people in early recovery, either because they visually remind the guest of cocktails or because they remind the individual that he or she can no longer drink. Despite all the pain and aggravation that alcohol and drugs may have caused the recovering individual, giving them up can result in a powerful sense of loss. Beverages such as hot spiced cider, hot cocoa, iced or hot tea or coffee are often welcomed. Some people in long-term recovery drink so-called “non-alcoholic” beer and wine. If this works for them, it is of course perfectly acceptable. It should be noted, though, that these beverages generally do include small amounts of alcohol. For people in the early stages of recovery from alcohol addiction, these beverages should be avoided.
  7. Provide time and space to step away from the group, if needed. Being able to take a walk, relax in a quiet room, step away to connect by telephone with another person in recovery, attend a mutual aid meeting, or gracefully depart early can be very important to a person in early recovery.
  8. Listen to them. If they don’t want any special steps taken to accommodate them, and both you and they are comfortable with them taking part this time, then simply go ahead.

Tips for individuals or families in early recovery:

  • Have a plan for the holiday, including mutual aid meetings and calls to sponsor, mentor, recovering peer, counselor, clergy or others central to your recovery.
  • Identify risk factors that should be avoided and know how you will respond if they’re encountered.
  • Know your signs of potential relapse and take steps to address them.
  • Stay in touch with your key supports, such as counselors, sponsors, mentors, or recovering peers.
  • Keep it all in perspective: Nothing that happens, no matter how painful or unpleasant, is worth giving up one’s recovery.
  • If relapse does, occur, don’t delay acting out of shame or guilt. Get help immediately. There is still an opportunity to build on the progress you’ve made.

    Source: The Whitehouse ONDCP Blog


Tuesday, 14 November 2017

How to improve your sleep while in addiction recovery

Sleep disorders are a common struggle in recovery from addiction

Guest blogger, Alisa, Nestmaven.com

According to a study in the Journal of Addiction Medicine, the incidence of insomnia is five times higher in early recovery than in the general population. Insomnia is not the only sleep disorder associated with addiction; contribute to the development of circadian rhythm disorders, parasomnias and sleep apnea.

The relationship between sleep and addiction goes both ways: while the mechanisms of addiction and withdrawal cause sleep disorders, the resulting sleep deprivation can inhibit the recovery process. The consequences of sleep deprivation include low mood, impulsivity, and poor emotional regulation which increase the likelihood of relapse.

The SMART recovery approach can be used to identify areas in your life where you are lacking balance. If you are experiencing sleep issues while recovering from an addiction, making changes in your lifestyle and environment can dramatically improve your symptoms.

Light Exposure

Light is the most powerful cue for our circadian rhythms which are responsible for guiding the sleep-wake schedule.

Timing light exposure for the correct times of day, while avoiding unnecessary light sources as bedtime approaches. Basking in light — especially sunlight — first thing after waking up can help combat sleep inertia; while dimming house lights in the evening signals that it’s time to start winding down for sleep.

Blue light is emitted by electronic device screens (including computers, laptops and smartphones) and is responsible for blocking the release of the sleep hormone melatonin. These devices should be avoided at night, and, when their use is necessary, nightmode should be activated.

Light Therapy is used to treat circadian rhythm disorders and insomnia, the two disorders with the highest incidence in recovery. Light therapy is also a useful tool in treating the depression which frequently occurs alongside drug addiction.


Diet, while an important part of any healthy lifestyle, lends additional benefits to those struggling with sleep disorders.

Foods that inhibit sleep include those high in sugar and refined fats, as well as spicy foods and chocolate depending on its caffeine content. People suffering from sleep disorders should avoid these foods, particularly after midday.

Foods that promote sleep do so by either inducing drowsiness or through inducing muscle relaxation to relieve discomfort. Experts recommend natural sources of magnesium, potassium and B vitamins such as legumes and leafy green vegetables. Dairy products and animal proteins contain tryptophan — a precursor to the neurochemicals serotonin and melatonin which are essential to sleep.

The timing of meals is just as important as their content. It’s recommended to avoid eating — especially large, heavy meals — late at night as it can make falling asleep difficult. Additionally, consuming regularly spaced meals and snacks throughout the day can help prevent dips in energy level.


Both physical and mental exercise play an important role in regulating circadian rhythms and increasing relaxation.

Studies have shown that performing aerobic exercise 3-4 hours before bed has the greatest effect on sleep: reducing sleep latency and increasing overall sleep time. A short workout of 15-30 minutes per day is sufficient to see an effect.

Meditation is exercise for the mind and with consistent practice has been proven to reduce stress and promote restful sleep. One popular form of meditation, called mindfulness, focuses on bringing attention to the present moment and foster a nonjudgmental mentality.

Sleep Environment

The bedroom environment should be designed in a way to promote comfort and relaxation, while simultaneously reducing factors which inhibit sleep.

Bedding should be selected to fit each individual’s needs. One must consider sleep position, weight and physical complaints when choosing a mattress and pillows. It’s likewise important to replace items within the recommended time frame to ensure that the body is properly supported during sleep.

Temperature plays an important role in circadian rhythms. During the night, body temperature drops to its lowest point, before steadily rising again by morning. Setting the thermostat lower at bedtime (around 60 – 70 degrees Fahrenheit) promotes more restful sleep.

Noise at night, particularly for light sleepers, can make it difficult to drift off and stay asleep. Even when not consciously perceived, environmental sounds can cause restlessness. White noise can be used to dampen these sounds, whether played through a dedicated machine or a mobile application.

Colors have influence over mood and energy levels. Research indicates that those who sleep in a blue colored room tend to get more sleep and wake up feeling more refreshed. Experts recommend choosing a color scheme which instills an atmosphere of calm in the bedroom.

Bedtime Routine

According to leading sleep specialists, maintaining a bedtime routine is one of the most effective strategies for combatting insomnia and promoting quality sleep.

A relatively set sleep-wake schedule should be adhered to every day (weekends included). This allows your circadian rhythms to adjust to a regular pattern, preventing desynchrony that results in sleep disorder.

Reserve the bedroom for sleep and intimacy only. Sleep experts warn against using the bedroom for other activities as these habits can inhibit the association between the space and sleep.

A bedtime routine including relaxation helps make the transition from a state of wakefulness to sleep more natural. Recommended activities include yoga and meditation, as well as simple comforts such as taking a hot bath or reading a story.

It’s important to discuss your sleep issues with your doctor and others in your recovery support system to ensure your needs are being properly addressed. Better sleep leads to healthier living, and better empowers you to take the steps towards sobriety.



Alisa is the editor in chief at Nestmaven.com where she writes about all things sleep related – from how to improve your sleep hygiene, how to find the best mattress or tips on sleep meditation techniques. She has a Bachelor of Honors in Information Science, loves yoga, healthy food and chocolate (and is totally fine with that contradiction).


We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org





Tuesday, 7 November 2017

Book Review: Alex Korb’s The Upward Spiral

Using Neuroscience to Reverse the Course of Depression, One Small Change at a Time. Oakland, CA: New Harbinger Publications, 2015, 225 pp.

Review by Ted Alston, facilitator

Bad feelings and bad habits fly together, and evasive maneuvers for one may serve for both. Accordingly, students of SMART Recovery may enjoy this book that addresses depression. Alex Korb, PhD, is an expert on neurotransmission, but he presents a model permitting self-management and and self-empowerment to have roles in mental health. In this model. a prescriber might help someone with a medication molecule that modulates neurotransmission, but readers have the power to choose other reasonable tactics that are non-pharmacological but have neurotransmission aspects.

Korb puts forth the important and attractive concept that neuroscience does not doom anyone to depression or addiction, nor to various other conditions with labels. He emphasizes that we all have pretty much the same instrument of thought and behavior. Whatever genetic or experiential differences may be, the troubled brain is usually out of tune rather than defective. Korb has a gift for analogy, and I do not want to spoil the encounters of his readers with those gems, but I will mention one. I liked when he said, “There’s nothing wrong with your brain, just like there’s nothing wrong with the air in Oklahoma–despite the devastating tornados.” This excerpted quote might seem inscrutable, but Korb’s full argument is easy to follow.

Korb offers much advice that is in line with the philosophies of SMART tools. For instance, a section of Chapter 2 is subtitled “The ABCs of Anxiety.” The Korb ABC is different from that of Albert Ellis, but it rhymes. One could delete all of the neuroscience from the Korb book and be left with a practical and reasonable pamphlet collating many SMART concepts. However, Korb offers a lot more than that. His every point includes a rationale based on what is known about neuroanatomy and neurophysiology. The book is intended for a broad audience, so the science depth is limited. However, the work is a superb introduction to neuroscience. Even a professional neuroscientist might appreciate the book for Korb’s power of explication.

Pharmacological and procedural therapies are beyond the scope of SMART Recovery, but the subjects are of wide interest. This book is a great introduction but does not attempt to handle issues such as the potential for adverse effects. However, too much information would have detracted from the superb readability. Consequently, there are a few glib statements. For instance, electroconvulsive therapy “increases BDNF, which helps grow new neurons.” (BDNF is a protein called Brain-Derived Neurotrophic Factor.) Anyway, ECT is not a focus of the book. Korb has much more to say about other antidepressant strategies, such as cultivating social interactions. According to Chapter 10, boosting gratitude is just the thing for your serotonin. Be that as it may, from a SMART standpoint, grateful beliefs tend to be more rational, helpful, and realistic than ones of ingratitude. And considering your gratitude is a way to examine your beliefs.

Albert Ellis spoke of bibliotherapy for depression and other disturbances. David Burns cited a study showing that the act of reading his book Feeling Good has a measurable antidepressant effect. Korb suggests that a read of Upward Spiral is one small but appreciable change away from depression. The suggestion is plausible.

We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org


Tuesday, 31 October 2017

Getting a Fix: Preventing Opioid Addiction

A three part video series

The SMART Blog editors received the following press release and link for a video addressing the opioid situation. The video does not directly pertain to SMART but could be of interest.

“In the three part series, Getting A Fix presents an on-the-ground look at solutions to the devastating opioid epidemic in the United States. Newsy and the Scripps Washington Bureau investigative team research the emergence of synthetic opioids, like fentanyl and carfentanil, while providing an in-depth look at who is trying to solve the crisis and how.”

Link to story:  https://www.newsy.com/stories/painkiller-alternatives-offered-to-prevent-opioid-addiction/

We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org



Tuesday, 24 October 2017

The REBT Opp, a Useful Abbreviation

Author: Ted, SMART Recovery Volunteer Meeting Facilitator


Bringing SMART Recovery into state prisons has rewards but also poses bureaucratic challenges. Difficulties in regularly covering a Tuesday afternoon meeting in Massachusetts prompted the recruitment of a third volunteer facilitator. With obstacles, the new volunteer was able to schedule an in-person orientation class that was required but was officially offered at erratic and infrequent intervals. This volunteer traveled many miles to show up for a SMART meeting a week later. He got to the door and was denied admission because he was not yet “in the computer.” (Of course, the delinquent cyber entry happened a few hours later, after the group meeting.)

When the new volunteer was denied entry after his paperwork, classwork, and travel, the three of us looked briefly at each other. All that was said was, “Well, an REBT opportunity.”

With practice, it is often effective to quickly recognize that many potential frustrations are “just REBT opps.”

The phrase said a lot. It seemed to say it all. As SMART facilitators, we had absorbed the Rational Emotive Behavior Therapy (REBT) concepts of Albert Ellis. Faced with an invitation to disturb ourselves, we could have done an ABC exercise. We could have examined the unhelpful Beliefs that were permitting the Activating Event to invite negative Consequences. We could have proceeded to Dispute the Beliefs. We could have done all that, but we did not take the time. Basically, we had done plenty of ABC exercises over the years. We knew that, if we did one more, it would just show that there was no value in getting disturbed about this problem. With practice, it is often effective to quickly recognize that many potential frustrations are “just REBT opps.”

Practice of SMART tools may lead to other shortcuts. For instance, upon substantive recovery from a bad habit, it becomes increasingly hard to list the user benefits in a Cost-Benefit Analysis (CBA). Attempts to propose benefits are automatically thwarted by disputation. Indeed, some REBT practitioners may come to feel that it is no longer worth their time to list any benefits of an addicting problem. After all, the benefits are just going to be effectively disputed.


We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org







Tuesday, 17 October 2017

Register: Helping Families Cope with Addiction webinar with Dr. Robert Meyers

Talk with Dr. Bob Meyers about how families and friends can help when a loved one drinks or abuses drugs.

Saturday, October 21, 5:00 pm EST

Register for This Webinar

As concerned significant others, families and friends, our intimate connection should make us natural allies, but we often don’t know how to talk with each other or work together when it comes to addiction, with all the emotional intensity that brings to relationships.

SMART and CRAFT work beautifully together to encourage healthy, productive efforts towards an improved quality of life for everyone, and we are particularly proud of our association with Dr. Meyers, and the growth of our efforts to help SMART Recovery Family & Friends based on CRAFT, Community Reinforcement and Family Training.

Robert Meyers has pioneered the study of how families can help support those with addiction and is a creator of CRAFT, the scientifically validated and widely acclaimed alternative to “intervention,” as we widely think of it. His book, Get Your Loved One Sober: Alternatives to Nagging, Pleading, and Threatening, co-written with Brenda Wolfe in 2003, has already become a classic.

Dr. Meyers is an internationally renowned speaker and gives CRAFT training workshops around the world. He has been in the field of addiction treatment for 38 years and long affiliated with the University of New Mexico. He is currently director of Robert J. Meyers, Ph.D. & Associates.

SMART Recovery is pleased to continue to offer its Special Event Webinars and subsequent podcasts free to everyone who may have interest in topics related to addiction and recovery, in addition to our extensive community of participants, facilitators, professionals, and friends, and of course, the family and friends of loved ones. SMART celebrates its 23rd anniversary; we hope you’ll join our warm community of support!



Tuesday, 10 October 2017

Review of “Over the Influence: The Harm Reduction Guide to Controlling Your Drug and Alcohol Use” (2nd ed.), by P. Denning and J. Little, published by Guilford Press, 2017

Book review by A.Tom Horvath, Ph.D.

Although harm reduction is commonly used in other countries, this approach to coping with problematic addictive behavior is unfortunately uncommon in the US. The authors are two US harm reduction leaders. They founded the Center for Harm Reduction Therapy in the San Francisco Bay Area in 2000. This book is intended for persons considering change. The authors have also written a book for professionals, the acclaimed Practicing Harm Reduction Therapy, now in a 2nd edition.

To provide an overview of this impressive work I will extensively quote it. In response to the question “What is Harm Reduction?” they provide the following three paragraphs (p. 197)

“Harm reduction is a way to help people change their substance use without demanding immediate and lifelong abstinence. It uses many creative strategies to keep people alive and safe while they figure out how to develop a healthier relationship with drugs. For some people, that means abstinence; for others that means moderate or safer use.”

“Harm reduction takes a health perspective rather than a moral or legal perspective, on drug use. Drug use is not bad. It is normal human behavior, and most people don’t get into trouble with it. Drug misuse is a habit that has gotten out of hand, or it is a signal of other co-occurring problems.”

“Harm reduction attends to every aspect of health—physical, mental and emotional, social and economic. It is nonjudgmental, compassionate, and pragmatic—it starts where the person is, stays with the person through the entire process of change, and never ever kicks anyone out.”

The sections of this book are:

Preface: How did we get here?
Introduction: Why harm reduction?

1) Welcome to harm reduction
2) Why do people use drugs?
3) When is drug use harmful?
4) Why do some people get into trouble while others don’t?
5) How do I know if I am in trouble?
6) How do people change?
7) You don’t have to quit to change?
8) Substance use management
9) Taking care of yourself while still using
10) How can I tell if harm reduction is working?
11) Finding the right help
12) A letter to family and friends of people who use drugs

What should you know about drugs: A quick reference

For SMART meeting leaders many of the chapters or appendices alone would be sufficient reason to purchase this book. In particular the quick reference to drugs (the 1st appendix) includes a section, for each drug or drug class, on the “beneficial effects.” This section is consistent with how SMART conducts a cost-benefit analysis (CBA), and provides essential information for understanding the user’s motivations.

SMART meeting leaders will find the entire book to contain familiar language and a familiar motivational perspective. Chapter 7 includes specific mention of the Stages of Change (p. 131) and provides an extended presentation that weaves together the underlying concepts of the Change Plan Worksheet and the Cost Benefit Analysis. Chapter 8 includes Triggers (p. 145), as well as classic harm reduction steps to reduce harm while not stopping or reducing use.

Some SMART meeting leaders might view SMART’s abstinence approach as very different than a harm reduction approach. I suggest the alternative perspective that all approaches to problematic addictive behavior involve making changes that are appealing in the long term but not so appealing in the short term. The extent to which each person is willing to honor the long term over the short term varies person to person, and time to time in the same person. Harm reduction provides a unifying framework for helping anyone, at any moment, in their personal change process.

It falls outside of SMART meeting guidelines to discuss classic harm reduction methods (like changing your route of administration). However, we do focus on “stopping,” which is also a unifying framework. Anyone who wants to honor the long term over the short term will need to “stop” something, to some extent, at some point. The harm reduction approach is larger than, and includes, the SMART approach. It would benefit any SMART meeting leader to be familiar with this larger perspective.

In full disclosure, the back cover of this book includes the following quote from me: “A highly informative, practical, passionate and moving guide…The stories on these pages are reminders of the power of the human spirit.” I’m pleased to say that, after reading this book a second time (for this review), this quote seems even more applicable.

We invite SMART-related blog entries from all interested readers. Entries should have strong pertinence to SMART. Queries are welcome. Send manuscripts or queries to blog@smartrecovery.org