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Therapy to "Control" Addiction... Is it a Thing?

Asparagus_Prince

Bluelighter
Joined
Jan 19, 2021
Messages
203
Is there such a thing as a therapist/counselor/coach that helps addicts "manage" their addictions without necessarily steering them towards complete sobriety?

I'm sure the answer to this question is yes, that exists. But how common is it? Is it hard to find?
 
yes. of course

plenty of initiatives work on a primalrily harm reduction basis as opposed to complete abstinence (here in the uk anyway - I'm sure must also exist in US just research)
 
Thanks. I might look into it. I think I do a good job of respecting drugs, taking frequent breaks, and sticking to a plan. But I really want someone knowledgable to be honest with.
 
Maybe try a regular old therapist until one fits; or go to a SMART meeting. SMART groups believe in personal empowerment and encouragement over abstinence.
And approach the meetings differently than AA; working towards a more sober life; like sharing the best parts of your day. If you relapse, it's called a lapse. So not a real preachy experience. Lots of therapists also are trained in drugs and alcohol; call around. I'm dependent on lots of substances; but don't drink or smoke. I have a really empathetic therapist and a good phsychiatrist. My primary doc, however, is fairly preachy and is trying to get me off of drugs; period. Maybe I need a new primary doc.
Support at Bluelight ain't bad at all either! I'm new here, lol. SMART don't use terms like alcoholic; rather substance use disorder; you talk about stuff and are welcomed whether sober or Cali sober, or drunk. No judgement like at AA.
 
Is there such a thing as a therapist/counselor/coach that helps addicts "manage" their addictions without necessarily steering them towards complete sobriety?

I'm sure the answer to this question is yes, that exists. But how common is it? Is it hard to find?
SMART Recovery is a support group that is based on Cognitive Behavioural Therapy (CBT) and the current evidence on addiction -an alternative to Narcotics Anonymous (NA). It’s concerned with understanding your cravings and learning to have more “control” over those behaviours.

Peace.
 
Maybe try a regular old therapist until one fits; or go to a SMART meeting. SMART groups believe in personal empowerment and encouragement over abstinence.
And approach the meetings differently than AA; working towards a more sober life; like sharing the best parts of your day. If you relapse, it's called a lapse. So not a real preachy experience. Lots of therapists also are trained in drugs and alcohol; call around. I'm dependent on lots of substances; but don't drink or smoke. I have a really empathetic therapist and a good phsychiatrist. My primary doc, however, is fairly preachy and is trying to get me off of drugs; period. Maybe I need a new primary doc.
Support at Bluelight ain't bad at all either! I'm new here, lol. SMART don't use terms like alcoholic; rather substance use disorder; you talk about stuff and are welcomed whether sober or Cali sober, or drunk. No judgement like at AA.
I might look into the SMART meetings! That might not be a bad idea.

I'm like you. I consider myself dependent. But I've never been to the getting arrested/losing my job/life falling apart type of level. I think I do a good job of staying quite a few steps away from the cliff, knowing when to slow down, etc. Using has benefited my life far more than it's harmed it. But I've gotten to a point where I need to be careful. I've discovered a few things lately the hard way. And I'm not sure anymore if I'm suffering from withdrawals when I take a break from certain drugs, or if that's the same level of pain I used to have before I ever started self-medicating. Just stuff like that. I'd like to talk to a 1-on-1 therapist that knows their stuff. That would be preferable to a group. But I still might look into the SMART meeting thing.
 
Is there such a thing as a therapist/counselor/coach that helps addicts "manage" their addictions without necessarily steering them towards complete sobriety?

I'm sure the answer to this question is yes, that exists. But how common is it? Is it hard to find?
That's how my only experience with an addiction treatment went.

My goal was stopping drinking. There were more then 1 reason I opted for 0.0%.
The psychiatric nurse had other idea's. Totally unrealistic ones in my case.

He basickly said that 5/ 6 beers a few times a week was what we were working towards. As that was not an option the treatment ended in a bit of a dissapointement for me. Now I am attending NA and their approach seems more logical. 0.0%. But like I said that's me, others might get away with regulating their drug use. Not me.
 
You going to pay big bucks on hoping you get an unbiased “addictions therapist?” First question is, is your substance use negatively affecting your life and in which ways? And why do you think you’re using? Many biased ORT pushers out there.
 
You going to pay big bucks on hoping you get an unbiased “addictions therapist?” First question is, is your substance use negatively affecting your life and in which ways? And why do you think you’re using? Many biased ORT pushers out there.
No, my substance use has greatly affected my life positively.

But I'm getting to the point where I don't function well without substances. Earlier this week I went 3 straight days without anything other than nicotine gum, and it's been a long time since I've done that. Maybe the first time this year. I was ok. I don't think I was withdrawing, exactly. But I was so lazy and unmotivated and in pain. But if you take away the physical pain I wasn't really feeling I "bad", exactly. In fact, it was sorta like I was on Xanax. I was relaxed and comfortable and perfectly ok with being lazy. But I had to remain very still because of my pain.

I'm in my 40s but for those few days I felt like I was in my 80s. It's like I was an old decrepit man that was slow to get up and move around. I know I can't continue to function like this on my job without substances.

So... I guess it hasn't affected my life negatively yet. It's not like I need to take more and more to maintain functioning. But, I worry that maybe that day will come?

Maybe the good news for me is that I'm not the type that looks to get "high". I have a good life and I rarely use substances to "cope". 70% of the reason I use is to alleviate pain, and the other 30% is to address my ADHD because I can be so lazy and unproductive. I love how I'm more enthusiastic and enjoying life when I'm using. So maybe that's a good sign? Maybe that means I'm a "functional addict?" I don't know. Or if I really need these drugs, like some people absolutely have to have their anti-depressants, then maybe I should just look at it like that? As opposed to thinking of myself as an "addict".

These are the types of things I want to talk about. Those 3 days earlier this week... was it a drag because I've wired my brain to depend on substances? Or was I feeling the same exact way I always did before I ever used? Which was 5+ years ago. I really don't know. Maybe it was the same. Or a little worse. Or if it's a little worse maybe that is simply because I am 5 years older now? My problem is that I'm a very curious person and I don't like not knowing for sure!

I post on here sporadically so most people probably don't recognize me. But I've definitely used some tips on here to make big improvements in my habits.
 
It's weird because I feel like my story is almost reversed from the stories of recovering addicts. Those in recovery try to remind themselves of the damage drugs caused in the past. They know they must avoid that rabbit hole.

I'm afraid of going back to the day where my life was damaged from NOT using drugs! If my substance use ever became out of control and had to adopt a 0.0% approach like emkee_reinvented said, that would be as discouraging as it gets. Because my pre-use life was such a struggle.
 
I don't identify with being an addict, addiction being a progressive disease (this has been widely disproven, it's a behavioural process which can be influenced by environmental factors more than anything else), or abstinence based recovery. Ive done 12 step programs and they weren't for me and actually a lot of the ways they viewed addiction made my use worse.

I view my sobriety through a lens of cumulative sobriety where I aggregate the basic amount of time I've spent sober since I entered intensive outpatient in 2017 which is when I started taking recovery seriously and which marked the end of my compulsive and destructive drug use. Between August 2017 and now, I've probably been sober between 60-80% of the time, give or take. It's hard to put an exact number on it but it's a good guess based on what I remember and how I've kept track of times I've been using for any longish period. Considering during 2017 it was close to 100% of the time when I relapsed then and was life threatening, as it was in 2016 when I used for around 10 months before sobering up when I moved in with a friend it's a substantial improvement.

I also don't at all believe in the notion that if you use after a period of abstinence that you lose all your progress. I find that utterly absurd. Between 2017-2020 after entering rehab, I had one off uses of meth for single nights then would not use again for 3-9 months. Eventually I didn't use for 18, but I did use other substances, in less problematic ways.

Ive been continuously engaged in drug and alcohol treatment since 2016 when I attended youth counselling, and even during my last relapse from December until a couple of weeks ago when I got my old social worker back and stopped using, it wasn't negatively impacting my life much beyond financially. I was still living a decent life. It may not have continued like that forever, but I made a point of stopping before it got to that stage again, if it ever did.

I find SMART meetings great. They're not at all the same as 12 step and I think their approach is better. That's just me. I like the self empowerment and the way that I'm acknowledging that I do actually have control over my drug use and I decide whether or not I do it, and it is a choice. Using is always a choice - it's not always an easy choice to not use, but most drug dependant people have quit at one stage or another for a period of time and if you can choose to quit, then logic follows using is also a choice.

Additionally, it's not as if most people are actually forced to take drugs. I acknowledge that this does sometimes unfortunately happen and that truly is terrible, but not often are people forced to stick a needle in their arm or forced to snort something. The choice may be a shitty one - use the drugs or go into withdrawal, but it's still a decision. And to even use the drugs, people have to make a string of numerous decisions to get to that point. Choose to message a dealer, choose to withdraw money, choose to meet the dealer, choose to leave the house, choose to put on shoes to leave the house, choose to get dressed to leave the house, choose to wait for the dealer (let's face it, you're gonna be waiting), choose to go back home, and finally, choose to use the drugs.

I like knowing that all of those things are choices and therefore I can choose to do something different and have a different outcome. I didn't like being told that it wasn't a choice and I had no control becsuse I felt powerless. It feels automatic when you are deep in addiction but the more you choose other options, the better you get at resisting the choice to use and going down a different path and that is just neuroscience.

My social worker doesn't preach abstinence to me, in fact he's told me to use harm reduction and just aim to minimise my use as much as possible. That is a much better way of being in recovery for me.
 
I got a therapist for the first time after going on state insurance.

as I couldn't afford one on my own. Using pain meds has allowed me to work surf skate and raise my kids and it really helped but now it isn't enough to keep me functional; so after 15 years I am at a crossroads. Thinking about going off of my pain contract and drop the meds Im dependent on; and replace them with good old beer and pot. Which was what I gave up to rationalize opiates and benzos.
so I am looking for help making that transition; abstinence is not the goal. Being functional is.
 
You going to pay big bucks on hoping you get an unbiased “addictions therapist?” First question is, is your substance use negatively affecting your life and in which ways? And why do you think you’re using? Many biased ORT pushers out there.

What's wrong with ORT? I use sublocade and I couldn't be happier with it. Suboxone allowed me to complete my law degree with a 5.5/7 GPA. I would have dropped out if I kept using opiates at the rate I was going. It led me to doing the worst type of sex work possible, now I haven't even had a single passing thought about using any opiates in more than a year and all I need to do is go to a clinic for 30 minutes one day a month to get a shot. I can travel anywhere I want, I'm not tied to a chemist for daily dosing, it doesn't affect me mentally or physically or cognitively.

What's the issue?
 
What's wrong with ORT? I use sublocade and I couldn't be happier with it. Suboxone allowed me to complete my law degree with a 5.5/7 GPA. I would have dropped out if I kept using opiates at the rate I was going. It led me to doing the worst type of sex work possible, now I haven't even had a single passing thought about using any opiates in more than a year and all I need to do is go to a clinic for 30 minutes one day a month to get a shot. I can travel anywhere I want, I'm not tied to a chemist for daily dosing, it doesn't affect me mentally or physically or cognitively.

What's the issue?
Nothing is wrong with ORT as I have benefited from it as well. However the OP says that their use hasn’t affected his life negatively. And so what I’m saying is one size does not fit all.
 
I also don't at all believe in the notion that if you use after a period of abstinence that you lose all your progress. I find that utterly absurd.
I agree with you, so don't get me wrong here. But can this^ type of thinking be harmful too? Can it lead to the addict lying to him/herself? "I can use a little today. It won't. hurt anything".

A lot of times it's when people are relapsing that they throw logic out the window and make excuses for their use. But if you're sober and not committed to 100% abstinence, isn't it easier to say fuck it?
 
I agree with you, so don't get me wrong here. But can this^ type of thinking be harmful too? Can it lead to the addict lying to him/herself? "I can use a little today. It won't. hurt anything".

A lot of times it's when people are relapsing that they throw logic out the window and make excuses for their use. But if you're sober and not committed to 100% abstinence, isn't it easier to say fuck it?

I'm not an addict, and I don't actually believe much in the notion of being an addict. When I went to intensive rehab, I would periodically slip up on IV meth once every 3-9 months over 4 years until I finally got a longer string of time together and I only ever used it for a night at a time. Prior to going to intensive rehab my use was out of control and likely going to kill me, so how was I able to limit myself to just one off uses? By the logic of 12 step programs that's supposed to be impossible, or I'm not a real addict. Anyone who knew me when I was using would argue that my addiction was very very real. No, it was because I was engaged in treatment and was due to show up again for group within a day or two after using and would tell the lead psychologist running the session I used who would then pull me aside for a private session to discuss what happened without getting punished so there was one incentive to not use for more days, then there was the fact that I would immediately tell all my closest friends who were supporting me in my recovery and they would schedule time over the next week or two to meet up with me and have a coffee or a meal and hang out with me, so I was seeing a bunch of friends on consecutive days and that was a huge incentive not to use. Why would I want to use again when instead I could spend time with people who didn't judge me for my lapse, who wanted to support me, and who loved me unconditionally?

In fact I was practically allowed to use meth once to twice a year by all of them because it was such an improvement on previously and due to my family situation they all understood that some triggers were impossible for me to work through, like times I would get memories back of my childhood and not be able to cope with that. Most of the time I did reach out for help when I needed support too, so they all knew I tried not to use more often than I used.

I never used thinking 'ill just do it once' or 'just a bit won't hurt me' what was usually going through my head, and what caused my friend to voice his preference for me to actually use in these situations rather than the alternative was that I often was thinking 'i need to use or I'm going to kill myself' and using seemed at the time to provide enough relief for me over that period and act as a sort of reset button. It was like a bottle of soft drink where I constantly got shaken up until the lid was about to come off, and just before everything just exploded I'd use to prevent that, and start the process again. This friend even said to me at one point that if I was choosing between shooting up meth or killing myself he actually wanted me to shoot up meth every time I was faced with that choice.

Eventually I managed to develop some coping mechanisms that enabled me to extend the time I went between uses, but even when I relapsed in December and started using heavily again each time I've not been happy with my use whether it be to much dose wise resulting in me taking a break or too much frequently wise resulting in me restricting the times I use, I've been able to adapt my use to better suit what I want. And then when I decided to a couple of weeks ago I just stopped after I organised to get my old drug and alcohol social worker back who I disclosed to previously so we can work on my actual problem which is self punishment often using substances.

So yeah, I don't understand how thinking you lose all the progress you've can't be anything but harmful, and the opposite not be. How is it possible that you forget things you've learnt in recovery if you've been actively engaged in treatment just because you use. Even if you relapse, you don't unlearn things you've previously learnt just because you aren't actively doing them. The reason I won't go back to intensive rehab even though I'd qualify for it at this stage is that it's pointless, I know the program back to front, over and over. I could teach it at this stage, so why bother? Relapsing didn't strip me of my knowledge, it's all there, it's just a matter of me actually making the decision not to use (and it's always a choice to use or not, but not always an easy one) and committing to that, and putting into practise the skills I was taught years ago.

They didn't just get wiped from my brain because I stuck a needle in my arm for 8 months, not has my progress as a person gone straight back to the start like I was in 2017.

I have an addiction, and I have an issue with problematic use of substances but I'm not a drug addict. People who actually get to know me tend to notice this pretty quickly, especially if they self identify as addicts because I can go periods without using at all, like when I relapsed I'd use IV meth once a week to a fortnight for the most part, and restrict it to that. That's pretty unusual for IV meth, but it's because I actually don't like meth all that much, I just really have a problem with shooting up.
 
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I had a guy tell me to just keep my dose as low as possible. He was very real about addiction. I was honest with my drug use. He said" it looks like you found something that works for you at the moment" dude was pretty cool. He basically just blamed my parents for everything, he seemed kinda unstable too lol. He was a licensed therapist, who also used to use coke and h in the 90s
He said ," yo , one day this stuff stops working , but until that day, you're not going to quit, you know it , and I know it, so until that time, save your money, stay out of jail, and keep the dose as low as possible. Anything else you wanna talk about today? "

I was 21 I think , I remember coming out of that meeting like" what a cool guy, fuck y'all I'm just going to keep doing my own thing " and I did for 4 more years . Then I got clean , but that guy was the realest therapist I've ever been to.

And that's the thing that's the difference between people who study addiction in college or they read about depression, and the people who've actually been there and walked that same road as you.
 
OAT or Opioid Agonist Therapy I don’t know why I’m mentioning something as obvious as this. That is, Methadone and Suboxone used to supplement and move away from often poisonous street-opioids of today. To restore balance within daily life while hopefully adopting more healthy lifestyle habits.
But it’s a bit funny and hypocritical too. Going from buying prescribed oxys and percs to now consuming my government-sponsored opioids. What has that accomplished except the government is the drug dealer now.
 
I've heard of places that do that, but I've never tried it because I simply cannot control my intake of most drugs.

Cigarettes and cannabis are probably the only two substances that I can use in extreme moderation. Opioids, alcohol, amphetamines... no way! I've been trying for 25 years to no avail. I can go without them if I want or need to, but I always substitute it with something else.

Just my own personal experience,
Dreamflyer
 
Without reading through everything that has been posted I would opine that yes this is possible and a "thing" for me.
I am using my therapist in my efforts to get to the core of my sometimes overwhelming anxieties and deal with them without medications. It is not the funnest, most enjoyable experience I have been through but can say that in my case it has proven effective so far.
Got tons of benzos and steadily dropping dosages and implementing the tools provided to replace them. Works for me but ymmv.
A lot of work, though and at the beginning it was a freaking nightmare but after a few months life has been brightening steadily and my need for benzos has sharply decreased... to the point that I do not really like them anymore but occasionally imbibe when alone and loneliness sets in.
Workin on that as well as a few other unhealthy thought patterns and actions engraved from decades of covering up the hurt.
If it werent for the muscle relaxing and mild pain relieving properties I feel that I would never need to take another drug in my life. Its a work in progress, though, but it is working for me.
 
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