Thursday, December 16, 2010

HOPEFUL PERSPECTIVES



Step 12
“Having had a spiritual awakening as the result of these steps, we tried to carry this message to other addicts and to practice these principles in all our affairs”

                I love art!  It moves me, excites me, angers me, gives me joy, brings up sadness, and a host of other emotions.  So, I found a picture I’d like to share with you this month at the top of this article.  It’s a very simple shot of a cathedral/sanctuary somewhere in the world.  I don’t know anything about what building it is a part of or how long it has been there.  I only know what I see….a small entry in the distance and wide row of columns that expand as the picture gets closer to the viewer. 
                If you look near the center of the picture, you’ll see a small doorway.  This is a great image for the small bit of hope many addicts see when someone invites them on the journey of the 12 steps.  It’s a hope that is full of light but a very small, narrow, even square, light that quietly whispers, ‘this is the way’.  Just as the steps expand our hope and the possibilities of sobriety and recovery, so too as we travel from the small doorway in the picture and out into the cavernous, stony, Gothic structure our vision expands until we reach the widest point closest to the viewer.  This is the perfect segue for the step of the month: 
Step 12.  
                When we started down the “12 Step Road” this past January, we began with a sliver of hope offered by an admission of powerlessness in Step 1.  We continued to expand our hope in Steps 2 and 3 through the exploration, discovery of, belief in, and surrender to a higher power of our own choosing.  Our journey took a look back at our past in Step 4 so we could be thorough as we sought to clean our spiritual/moral house.  We experienced acceptance and community as we shared these things with a sponsor and our higher power.  Steps 6 and 7 widened our hopes by help us face our character defects and releasing them to our higher power for spiritual surgical removal.  Once surrendered, we continued down the path of hope by listing all the people we had harmed because of our addiction and got ready to make amends through Step 9.  Once this work was complete, we learned a new, hopeful way of daily living through Step 10 (daily amends) and Step 11 (daily spiritual reflection).  And now, we stand at the widest part of our path and our last step of the year, Step 12.  Let’s do it!
                Step 12 is so important in recovery for several reasons.  First, it helps the sober addict to get outside of his/her own head.  Often times, we get stuck in our own obsessive thoughts and not outside of our heads into actual reality.  Getting outside of our minds helps keep relapse away by dealing with reality as it is.  The reality is that there are many people still lost in addiction who need to hear the message of hope.  They need someone to open that small door of hope and invite them in to a different journey and lifestyle. That someone just may be you!
                Second, Step 12 helps the sober addict to stay sober by reminding him/her of where they came from: a dark, windowless space that was lonely, scary, and pitiful.  By speaking with another addict who is currently active in their addiction, the sober addict should get a sober reminder (pardon the pun) of what active addiction looks like, sounds like, thinks like, and even smells like (unfortunately lol). 
                Last, Step 12 helps the sober addict remain sober because it instills a vision for life that is greater than him/her, namely, helping others.  It is in helping others that we help ourselves.  Compassion towards others can also help us practice compassion towards ourselves as well. 
                As we close down 2010, let me invite you to take a look at your perspective towards sobriety and recovery at this point in the year.  Is it hopeful or hopeless?  How has it changed?  How has it stayed the same?  Where could you go from here to have a fuller, more vibrant sobriety?  What things about yourself would you like to change in the coming year?  What kind of perspective would you like to have regarding sobriety this time in 2011? 
                Finally, remember that life is about perspective and I invite you to embrace 2011 with a ‘hopeful perspective’!  Enjoy this season of the year and all that it means to you and yours!

Chris Newcomb, Aftercare Coach/Coordinator

A New Combination Medicine for Weight Loss: Naltrexone + Wellbutrin


     
     I have already treated a couple of patients with a combination of Naltrexone and Bupropion (Wellbutrin) for weight loss, and the results have been quite impressive.  Now an FDA panel has given its recommendation for the approval of a new combination pill containing Naltrexone with Bupropion (Wellbutrin).  It is becoming more apparent that combination's of drugs can be more powerful when they are given together rather than just using each of them alone.  There is good reason to think that combining Naltrexone with Wellbutrin would be useful to help patients with weight loss.
     Naltrexone is, of course, quite a powerful drug used to treat addictive disorders.  We use Naltrexone Implants as part of our routine treatment for opiate and alcohol dependencies.  Our experience with Naltrexone Implants in opiate addicts is that over 50% of these patients report virtually no cravings.  In a similar way our alcoholic patients treated with Naltrexone implants usually report much reduced cravings.  A recent newsletter article of mine reviewed studies that showed that Naltrexone can greatly reduce the memories of getting pleasure from using drugs and alcohol.  But when it comes to food addiction or obesity, the evidence shows that Naltrexone, either pills or implants, is a lot less powerful.
     Bupropion (Wellbutrin ) is an antidepressant that has been in use for many years.  It is not in the SSRI family like most antidepressants such as Prozac and Zoloft.  It acts more on the dopamine system, which is also the neurotransmitter that is related to addiction (although in a different part of the brain).  Because it acts on dopamine, a number of physicians have tried using it for addictive diseases.  It has been approved by the FDA for tobacco dependence and it has showed some benefit.  Unfortunately, it has been tried for cocaine and other addictions but has not shown a lot of usefulness.  So, Bupropion clearly has some effect in some addictive diseases, just not a very strong effect.
     Combining these two medicines makes sense.  By targeting two separate pieces of the addiction puzzle, it makes sense that there could be an additive effect.  The results of the clinical trials are positive but not overwhelming.  The studies show that patients taking the combination for 12 months achieved about a 5% weight loss. This is better than placebo and better than many other treatments for obesity.  There is some concern about side effects but both of these drugs have been used for many years and have been found to be very safe.
     As mentioned earlier, I have treated a couple of patients with this combination.  One patient reported her cravings for food were virtually gone and she had never had such a powerful effect from any other weight loss treatment.  She lost over 10 pounds in a couple of months!  We are open to trying these medicines if patients want to try to see if this combination will work for them.  Similar to our experience with alcoholics and opiate addicts, it may be that the Naltrexone Implant will be more powerful than the oral tablets.  Like all other addictions, we believe that medicines alone are not enough.  We believe that the best recovery from addiction requires a holistic approach including other treatments such as the 12 steps, individual/group counseling, as well as inpatient/outpatient aftercare.  
Dr. Peter Coleman


Thursday, December 9, 2010



"Ask Alice"

     If you are getting pills from your doctor, don’t assume he’s got your best interest at heart. Just ask “Alice” (Not real name) …
     Last week one of our Accelerated Opiate Detox patients told me she was able to keep herself in denial for a long time because her doctors continued to prescribe pain medication for her. She justified this beautifully, telling herself, “Well, they clearly think I need it, so it must not be a problem.”  Little did she know how much her complicity with the doctor's orders would empower her addiction to opiates!
     Of course, she’d known for a long time it was a problem. The opiates were serving their purpose however. Alice had divorced three husbands, and her thirteen-year old daughter was driving her crazy.  To make matters worse, an uncle abused her when she was a child. The opiates were doing their job of keeping her safely not feeling or dealing.  To be fair to 'Alice', she had a lot of trauma to deal with but drugs only made that trauma worse!
     Recently, Alice met someone who seemed to really like her. She liked him but was ashamed of her pill use. She hid it from him as long as she could, but then totaled a car, and the truth came out. This guy was healthy and concerned enough to tell her that unless she got help, he couldn’t stay in a relationship with her. They split up for 3 months.
     Alice started going to NA meetings, got a temporary sponsor and contacted The Coleman Institute. Her friend returned and was a great support person during her 3-day detox, giving her a little slack when she needed it and a compassionate roll of the eyes when she needed that too!
     Alice’s chances of having a good relationship with a good guy are stellar. She is making choices to support her values. Some baby steps, some giant leaps.
      If you are getting pills from your doctor but want to talk about it, give us a call. Twice a month, Dr. Coleman has an open phone line to answer any questions you might have.  The next call in will be on Wednesday, December 15th - 1:00-2:00pm (EST)

Joan R. Shepherd, NP


“A man dies daily, only to be reborn in the morning, bigger, better and wiser.” – Emmett Fox

     We are entering the final stretch of 2010. The temperatures are dropping. The turkey has been digested. Christmas lights are starting to light up the avenues, byways, and highways of our nation. And yet at this time of year, people tend to be so stressed out. Whether they are celebrating Christmas, Hanukkah, Kwanzaa, or just being with family and friends, this time of year lends itself to stress, frustration, and sickness more than most of the rest of the year. Why? I wish I knew the answer.
     However, one thing remains constant regardless of what day of the year the current one is, we always restart who we are and where we’re going at the start of each new day. Psychologists say that one of the best times to figure out what is really important to you is by paying attention to your first thoughts when you wake up in the morning. It is during the first moments that we wake up that we are most vulnerable.
     Think about it: You’ve been asleep, usually all night, and now you have woken up to a new day. Your body begins to charge up. Your mind starts to wander and race about the day ahead. And you receive what might be termed a ‘daily rebirth’. That is, seeing that you are 6 feet above ground, you get another chance to go through life. This is GREAT news! Unfortunately, most of us never choose to see our lives this way. Instead, most of us get stuck thinking about bills to paid, deadlines to be met, kids to get to school, significant others to please, and rest and relaxation that seems unattainable. I think there is a better way to begin our new days ahead.
     Mr. Fox rightly asserts that each of us die daily. Biology proves that fact. All you have to do is look at our culture’s obsession with youth and beauty (read: cosmetic industry in the U.S. makes over 1 billion dollars annually) in spite of the fact that aging is an unalterable fact of life! However, what he says after that fact is pretty astounding. First, his perspective is positive. He doesn’t say that we wake up smaller, worse, and more stupid although that may happen to a few select individuals (see the Darwin Awards). His vision is that we awake to a new day bigger than the last because we got through it. We survived the soaring highs and low lows. That is something to be happy about it!
     Fox also makes note that we wake up better than we did a day earlier. Of course, many days we don’t feel that way but it’s true. If I face the challenges of the day and fail, I am still better for having faced them. It’s when we run from the challenges of life that we get ‘worse’, so to speak, in our personal growth.
Finally, Fox adds that we get wiser with each new day. Nothing could be more true! I’ve learned so much throughout my short life. And the more I learn, the more I grow. And the more I learn, the more I want to learn. And, the more I grow, the more I want to grow. It is addictive, pardon the pun.
     So, as you face the stress of this time of year, I encourage you to take those first few twilight moments as you wake-up and remind yourself of how much bigger, better and wiser you are on this day than you were just 24 hours ago. Believe it or not, you’ll be surprised at what you find. Submit yourself to a rebirth each morning. Embrace the re-calibration of the new day. Finally, embrace the rebirth of a new calendar year and all that it can bring to you and yours!

- Chris Newcomb, Aftercare Coach/Coordinator

Monday, November 15, 2010

Step 11

“Sought through prayer and meditation to improve our conscious contact with God as we understood God, praying only for knowledge of God’s will for us and the power to carry that out”

     I am a big Star Wars fan. Ok, a HUGE Star Wars fan. I know way too many lines from those movies. But, despite my cinematic geek tendencies, my vast space movie knowledge will prove helpful for this article. “The force is strong in this one,” as they say!
     Did you know there is actually a Jedi religion? Yes, there are Star Wars fans that, in their dedication to all things Lucas, have gleaned a theology of sorts from the Star Wars films and adapted it for everyday use in their day to day lives. I’m not kidding, seriously, stop laughing!
     Upon closer inspection, it appears that Jedi-ism is a conglomeration of world views. These beliefs share themes such as loving your neighbor, doing good, avoiding evil, being good stewards of the Earth, etc. All good principles, for sure!
     When we talk about addiction recovery, no conversation is complete without discussing the issue of prayer and meditation. Regardless of one’s theological preferences, prayer and meditation are important in the life of recovery for several reasons. First, prayer is the way that a person communicates with his or her higher power. It is a way to laugh, cry, vent, yell, scream, plead, and thank our higher power for the things we experience in life. It is the language of relationship with our higher power.
     Remember, our higher power is just that, a power greater than ourselves that is living and cares intimately about the details of our lives. As in all relationships, communication is essential to grow the relationship. Otherwise, it becomes stale even lifeless. Therefore, step 11 calls us to be in contact with our higher power on a daily basis through prayer.
     If prayer is speaking to our higher power, than meditation would be the act of listening to our higher power’s answer. I once heard someone respond to the question how does our higher power answer our prayers by saying, “Our higher power answers with three words…yes, no, and wait.” I think that is a great way to understand prayer requests we make to our higher power. There is always an answer even if it is not the answer we want to hear.
     In meditation, we intentionally set aside time to reflect on our lives. It is a time to look inward and take stock of our thoughts, feelings, and impressions we receive from our higher power about the people, places, and things that direct the course of our lives. If we are quiet and listen, we will hear the faint, whisper of our higher power calling out to us with wisdom, guidance, and direction.
     The practice of Step 11 is essentially a daily renewal of the reality we came to accept in Step 1, namely, that we are powerless over alcohol and drugs and that our lives had become unmanageable. The practice and renewed commitment of such truth will yield healthy results in our day to day lives. When we practice these habits, we remain right-sized. By being right-sized, we remain humble and thus are teachable. No one can accept help from an extended hand if his/her own hands are full. We must drop our preconceived notions and highly regarded opinions and open ourselves up to the reality that we are small, finite creatures in need of an infinite power that is greater than us to help us continue on the daily path of recovery!

Chris Newcomb – Aftercare Coordinator/Recovery Coach

Vivitrol Approved for Opiate Addicts!


The treatment options for patients with an addiction to opiates - Heroin, Percocet, OxyContin, Methadone, etc. - have been very limited. Patients who try to go drug free have not been very successful because the pull back to the opiates is so high that almost everyone relapses within the first three months. The relapse rate is so high in fact that, many years ago, the government essentially gave up on the idea that most patients could go drug free and recommended giving them a highly addictive substitute drug called Methadone. Finally, this month the FDA has now approved Vivitrol – a monthly injection of Naltrexone that helps patients stay off drugs. What are its strengths and weaknesses and how will it fit into the treatment landscape?

Naltrexone is a powerful opiate blocker. If patients just took it, Naltrexone would completely prevent them from relapsing. But patients don’t take it. It doesn’t make much sense, but study after study has shown that patients don’t take oral Naltrexone. It has been available in an oral form since around 1982. The pills last about 24 hours and they definitely do work. But patients don’t take them. It is hard to understand why patients wouldn’t take a medicine that can completely prevent them from relapsing back to Heroin or OxyContin, but they don’t. The only way I can think about it, is to just accept this fact as evidence of how amazingly powerful the addiction process is. If there was a pill that prevented cigarette smokers from smoking, would they take it? It is an interesting question, and now there is somewhat of an answer. Chantix is a pill that blocks nicotine and is now approved for use with cigarette smokers. It does block the effects of Nicotine but the research shows that, at the end of 12 months, only about 7% of smokers are still quit. So maybe the experience with Naltrexone is not so different.

For over 30 years, physicians have realized that if they could just force patients to take their Naltrexone, then the patients would stay off heroin and other opiates. Some research was done with prisoners and sure enough since the prisoners were forced to take it, they stayed off drugs. But this is unrealistic in the real world. Early research was done around 1980 with long lasting Naltrexone injections but there was some tissue reaction and the research was abandoned. Then some Naltrexone implants came on the market and a few physicians started to use them. Here at the Coleman Institute we started to use Naltrexone implants around 1998 and we have been using them ever since. We have had great success. Patients usually lose all cravings and seem to recover from their post acute withdrawal symptoms quicker. Over the years better implants have come along. The original implants lasted only 4 – 6 weeks. We are now using implants that last over 3 months in half of the patients, and we are about to start a small research study on implants that may last 6 months.

Now Vivitrol has been approved by the FDA for the treatment of opiate dependence. Vivitrol is a one month injection of Naltrexone microspheres. It is a pretty cool technology. The Naltrexone is mixed with poly-lactates. Lactic acid is a natural breakdown product in the body so it is very safe. Poly-lactates are molecules where the lactic acid has been linked together into a chain which takes the body some time to break down. Poly-lactates are used in absorbable sutures. To make Vivitrol, the company takes poly-lactate powder and mixes it with Naltrexone powder and then makes the final powder into small spheres – micro spheres. The microspheres are small enough to go through a syringe and large enough to take one month to fully break down and release their Naltrexone. The result is a medicine that can reliably deliver Naltrexone for one month.

Like all medicines Vivitrol has some advantages and some disadvantages. It is an injection which means patients can’t not take it. It reliably gives them Naltrexone for a whole month. One advantage is that Vivitrol treatment is easier for patients than our implants - just a simple injection. Also if patients have insurance there is a chance the Vivitrol may be covered, although it is not clear yet just how generous the insurance companies are going to be. The medicine is very expensive.

On the negative side is the fact that once Vivitrol is injected into the body, it can’t be taken out. The Naltrexone implants we use can be removed in the rare situation that patients need to get narcotic painkillers. With Vivitrol you really have to wait one month until it wears off before you can get any pain relief. While this is rare, it did happen with one of our alcoholic patients last month. He got an implant but started drinking again and developed pancreatitis. Pancreatitis is extremely painful. Fortunately for him he had an implant and we were able to have it removed, so within 24 hours he was able to get good pain relief.

Vivitrol is also very expensive. Without insurance, it usually costs over $1100 for one month of treatment. I don’t know of many patients who will be willing to pay $1100 month after month. Our Naltrexone implants are only about $250 per month which is much more affordable and is actually much cheaper than most Methadone programs.

A very important thing to know about Vivitrol is that patients must be fully detoxified before they can start on it. If patients start on any form of Naltrexone while they still have even tiny amounts of opiates in their system they will go into complete withdrawal which is very painful and can be very dangerous. Getting patients fully detoxified so they can get started on Naltrexone is not easy. Suboxone is now being used by some doctors for detoxification, but it is a very long lasting opiate and so patients need to be off Suboxone for at least 14 days before they can start on Naltrexone. Most patients will relapse back to their street drugs before the 14 days is up and then they can’t start on Vivitrol.

We have over 12 years experience now in helping patients detoxify before they start on Naltrexone therapy. Most patients are simply not able to detoxify themselves and need medical assistance. Our Accelerated Opiate Detoxification (AOD) program uses light sedatives and other medicines to make patients comfortable and actually speed up the detox process. It is an outpatient program that patients find very easy to complete. Our success rate in getting patients onto Naltrexone is over 98%.

In summary, I think it is fabulous to have Vivitrol available for opiate addicts. It works well and will be a good option for a lot of patients who don’t want to be on Methadone Maintenance or Suboxone Maintenance. Some patients will be lucky enough to have the medicine covered by their insurance plan, but others may be able to use Naltrexone Implants as an alternative. All physicians and patients will have to be very careful to make sure that patients are fully detoxified before they start on this new treatment.

Facing the Obstacles of Maturity: Using the "Maturity Prayer!

(Loosely based on "The Serenity Prayer" by Reinhold Niebuhr)

“God grant me the maturity, to accept what I am feeling, and the courage to correct the actions that I took that made me feel this way"  
- Dallas B. 

      Maturity is overrated. I once saw this on a t-shirt and laughed out loud. I wish that were true in the real world! Wouldn’t it be great if your bank that it was overrated for you to pay your monthly mortgage? Or how about if your boss thought that it was overrated for you to actually do your job and instead invited you to sleep for the first half of the day so you would be better rested for the second half? Reality is not so kind, unfortunately!
      Maturity is essentially about personal growth. It is the process of leaving one station in life to move to a higher, better, more excellent one. Sometimes we choose maturity and sometimes maturity chooses us. And oftentimes, we don’t enjoy either experience. Yet, we always have a choice when life presents us the opportunity to move further down the maturity trail. This is where the “Maturity Prayer” can be useful.
      Maturity can be defined as, “full development or perfected condition”. In the case of the Maturity Prayer’s opening statement, “God grant me the maturity (full development, perfected condition) to accept what I am feeling", we are invited to accept our feelings as they are. This is especially difficult when we perceive them to be negative. It is a hard thing to do. We ask God to give us the ability to recognize and accept our feelings particularly as it relates to our part in creating those feelings. While it is true we may have strong feelings about a certain situation or person, place, or thing, the reality is the only thing we can change in life is ourselves. The prayer continues saying, “the courage to correct the actions that I took that made me feel this way.” This is the second and also difficult part of maturity, namely, correcting negative actions for which we are responsible.
      In the end, this prayer is all about asking for the power to better manage ourselves. While maturity may not be highly rated, we can definitely say that immaturity is definitely overrated. Which will you choose in the face of obstacles that threatened to stunt your maturation process?

- Chris Newcomb, Aftercare Coordinator/Recovery Coach

Wednesday, November 10, 2010

BOOK REVIEW: The Book of Qualities

BOOK REVIEW:
The Book of Qualities
by
J. Ruth Gendler

      We live in a society that is focused on quality. A major car manufacturer even uses the word in their marketing campaigns…”Quality is job #!” – Ford Car Company! Why all this emphasis on quality? The word itself stands for, “a degree of excellence”. Thus, if one is to make an excellent product, provide an excellent service, or engage in excellent business products, he or she would be said to be providing “quality” in each of these areas. 
     In a related sense, people are often defined by their individual, unique qualities. Fiery red-hair. Deep blue eyes. A dry sense of humor. Bad breath. You get the point. People have both good and not- so-good qualities that we get the joy (or pain) of experiencing on a day-to-day basis. For example, movie goers always seem to experience of sense of refinement and civility when they watch Sir Sean Connery act in a James Bond movie. He is known for such qualities. What qualities are you know for?
     The Book of Qualities by J. Ruth Gendler is a fascinating, creative look at some of humanities common personal qualities and how they affect our lives. This makes for great reading when dealing with an addiction. Part of recovery is dealing with those qualities (read character defects) that trip us up and make us fall into our addiction. A few of these qualities include, but are not limited to, rage, jealousy, resentment, boredom and fear.
     If you’re looking to understand more about your own inner qualities, this is an excellent book. Each quality is described in about a paragraph or two so it is quick and easy to read. Many of the qualities have artwork as a visual representation of the printed description of that quality. I encourage you to read this little gem of a book. Who knows, in the end you may end up discarding out-of-date qualities and replacing them with new and fresher ones! I’ll end with this quote on ‘Change… “Change is very musical, but sometimes you must listen for a long time before you hear the pattern in his music” (p. 33).

Chris Newcomb - Aftercare Coordinator/Recovery Coach

Thursday, November 4, 2010

Should we raise the tax on alcohol?

In 2009 there were 25 states that introduced laws to increase tax on alcohol but only 6 states actually were able to pass the laws to increase the tax. Most states have not increased their tax on alcohol for decades so that after adjusting for inflation there is actually less tax now. The net effect of this is that the cost of alcohol is actually less now than it was 10 or 20 years ago.

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There is good evidence that an increase in alcohol tax produces positive changes to help decrease alcohol abuse. It decreases underage drinking, reduces traffic accidents, and reduces liver disease and other medical complications. Any extra money that is raised by higher alcohol taxes can easily be dedicated to being used to pay for alcohol related costs or treatment or prevention programs.

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In these days of tight budgets it just makes sense all around to let the people who drink alcohol pay more of the costs of their drinking.

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Dr Peter Coleman

Sunday, October 31, 2010

Seattle Office Opening Nov 1st

Dr Michael Rosenfield joined us in Richmond earlier this month to complete his clinical training and is now ready to open our newest clinic serving the Pacific Northwest, including Portland, Seattle, Vancover and Anchorage.

Patients wishing to see Dr Rosenfield in Seattle should contact Jennifer at 1-877-77-DETOX (33869) or e-mail Jennifer@thecolemaninstitute.com.

Saturday, October 30, 2010

Blame the dog

Anyone with a current DEA license to prescribe has heard the stories from patients: my prescription for percocet blew out of the car window…my oxycontin tablets accidentally fell into the toilet….i was house-sitting and my fentanyl patches disappeared….the dog ate my vicodin.

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Funny how dogs just hate blood pressure medication but have a real penchant for opiates.

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So, it was kind of a relief when one of my delightful patients who is getting himself off suboxone through our Accelerated Opiate Detox program showed up yesterday and told me his dog ate his blood pressure cuff.

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This, I can handle. No 12 step program for that pooch.

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Joan R. Shepherd, NP

Wednesday, October 27, 2010

AA celebrates its 75th Anniversary

It was pretty big party down in San Antonio, Texas this past July. Over 50,000 people came from all over the world to celebrate, participate, and share their recovery. There were Key note speakers and lots of recovering alcoholics sharing their experience strength and hope. AA has a convention every 5 years.

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It is times like this we can reflect on how much this organization has contributed to our world and helped change so many lives. AA has helped many people stop their own personal suffering and helped them start to contribute back to society and lead productive and happy lives. It has helped many of their wives, and children get their loved ones back.

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AA has spawned many other 12 step programs including Narcotics Anonymous, Gamblers Anonymous, Al-anon, and others.

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AA was also instrumental in helping us understand this disease of addiction and instrumental in even accepting it as a disease. From the early days in 1935, AA taught that Alcoholism is a physical disease. I think that this helped the medical profession to accept this and then continue ongoing research into the disease. These days, of course we have much more understanding of how the brain works and it is easy to understand and accept alcoholism as a disease. But in the early days it took a few drunks to sober up and realize they weren’t crazy. Once they saw that they weren’t crazy and that pretty much anyone could get sober it became a lot more clear that this really is a disease. An early AA saying went like this - “We aren’t bad people trying to get good, we are sick people trying to get well”.

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After 75 years I am glad the medical profession has caught up.

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Dr Peter Coleman