“I used to get angry and get drunk. Now I just get angry.” I first heard this phrase about a year ago from one of my group members. I cannot think of a better illustration for everything that Recovery is about: what do we do now?
In What World
A good friend in Recovery from opioid use once related their frustration to me about an upcoming medical procedure. In response to the typical practice of throwing opioid pain pills at a patient post-surgery their question was “in what world do we live in where we are not supposed to feel pain?” Wow. How true is that? It’s not that they were asking to just “gut it out” but that they were stating a clear distinction between being pain-free and being pain-managed. They had learned that escape comes with a price, but pain management is, well, manageable. The same can be said about all of our emotions, anger included.
Self-Medication
I often relate the phases of substance use disorder in a simple progression: start because you like it, use it enough it becomes a habit, use it for self-medication, use it because you have to (addiction). The two real risk points become the habitual use and the self-medication use. Outside of repeated use (habits) the single greatest risk indicator for developing a substance use disorder is through using for self-medication.
Self-medication can mean many things – relief from pain, relief from anxiety, relief from anger and other stressors, relief from your daily reality, and more. The point is using substances to hit the “easy button” as an escape from having to deal with what is right in front of you.
Alcohol decreases anxiety – why it is called the “social lubricant.” Opioids bring the highest level of dopamine release. Cocaine derivatives come with a flashbang in your brain and THC is the king of mellow. You name it, there is a substance for it. Here’s the thing – they all work as intended. You want to escape? Here’s your ticket out. But they come with a steep price.
I Used to get Drunk
So let’s put this together with the topic at hand. I learned over time that alcohol was a great way to deal with overwhelming emotions. I understand that alcohol can certainly amplify your emotions in either direction, but in any case, it is an escape. I would bottle up my frustration and anger until I could get home and drink it into oblivion. Then I would not have to deal with what was actually bothering me (which frankly was me – that’s a continuing conversation between me and my psychologist). I learned that drinking would let me escape my anger. I used to get angry and get drunk.
What Now?
So what happens when you don’t have your easy button to use anymore? Aha – that is the rub. This is what every Recovery program is designed to answer – what do we do now?
The “Just Say No” program championed by Nancy Reagan in 1983 had no statistical bearing on later teen and adult substance use. I should know – that is my generation – and I am one of those failed statistics. You ever wonder why? It is simple: the word “no” is a negative. It means just not doing something. Which is something dead people are really good at. Those of us who are alive do better when we do something else instead.
Recovery is not about not doing something. It’s about finding something different to do. Getting sober is only the first step in the solution. We have to learn how to deal with the life realities we used substances to escape from. If we do not develop these new coping skills then it’s only a matter of time before we go back to that easy button.
To those in Recovery: welcome back to real life. It’s hard and you have to learn new methods of dealing with really uncomfortable things. But here’s the deal – there are over 7.5 billion people in this world, and you are not the first person to feel this way. You can learn, you can survive, and you can conquer. And there is a whole world of loving people in Recovery to help you along the way.
To the rest of the world: sobriety is only the first step. Stop treating substance use “treatment” as the one-stop be-all-end-all that insurance thinks it is. I can’t count the number of people I deal with who got into a great treatment center, but their insurance won’t cover a single outpatient follow-up visit with substance use providers. Congratulations, you paid us to stop doing something – I guarantee it’s cheaper to pay us to find something different to do then to keep paying for repeated single-focused treatment. You have to treat the reason we self-medicated.
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