What is Addiction

An Eplanation

In order to understand addiction it is important to first understand the definition of what constitutes an addiction from different perspectivies.

Defining Addiction

A substance addiction meets two criteria:

01

Difficulty with Control

You have difficulty controlling how much you use or how long you use. For example, one drink leads to more drinks, or one line of cocaine leads to more.

02

Ignoring Negative Consequences

You continue to use even though it has negative consequences to your life. For example, you continue to drink even though it has hurt your relationships.

Those two criteria define all addictions. They are true for alcohol and drug addiction, but they're also true for gambling addiction, eating disorders, and sexual addiction.

There are different stages of addictions. The late stage is the non-functioning addict. They've lost their job and have to use every day. It's what people think addiction is like, but that stereotype is rare.

The early stage is the functioning addict. They still have a job and their relationships are intact, but their life is suffering because of their addiction. That is the most common scenario. You don't have to suffer major losses to have an addiction.

The consequences of addiction get worse over time. Addiction is a progressive disease. It's never easy to quit. But if you've already suffered negative consequences and don't want them to get worse, there's never a better time to quit than now.

What is the medical definition of addiction?

An addiction must meet at least 3 of the following criteria. This is based on the criteria of the World Health Organisation (ICD-10).

1.

Tolerance. Do you use more alcohol or drugs over time?

2.

Withdrawal. Have you experienced physical or emotional withdrawal when you have stopped using? Have you experienced anxiety, irritability, shakes, sweats, nausea, or vomiting? Emotional withdrawal is just as significant as physical withdrawal.

3.

Limited control. Do you sometimes drink or use drugs more than you would like? Do you sometimes drink to get drunk? Does one drink lead to more drinks sometimes? Do you ever regret how much you used the day before?

4.

Negative consequences. Have you continued to use even though there have been negative consequences to your mood, self-esteem, health, job, or family?

5.

Neglected or postponed activities. Have you ever put off or reduced social, recreational, work, or household activities because of your use?

6.

Significant time or energy spent. Have you spent a significant amount of time obtaining, using, concealing, planning, or recovering from your use? Have you spend a lot of time thinking about using? Have you ever concealed or minimised your use? Have you ever thought of schemes to avoid getting caught?

7.

Desire to cut down. Have you sometimes thought about cutting down or controlling your use? Have you ever made unsuccessful attempts to cut down or control your use?

The Consequences of Addiction

People only stop using drugs and alcohol when they have suffered enough negative consequences.  
When you've suffered enough pain and enough regret you are ready to stop.  You are ready to stop when the two sides of addiction collide. On the one hand, addiction feels so good that you want to use more. On the other hand, addiction leads to negative consequences.  After a while, something has got to give.

You don't have to hit rock bottom.
The purpose of websites like this is to show you the potential negative consequences of addiction so that you will be ready to quit before you've lost everything. You can imagine what it would be like to hit rock bottom. And that can help motivate you.

The most important consequences of addiction are social, emotional, and psychological.
People usually think of the physical and economic consequences of addiction. "I don't have a serious addiction because my health is fine, and I haven't lost my job."  But those are very late stage consequences.  As far as work is concerned that's usually the last thing to suffer. You need your work in order to pay your bills, so that you can continue your addiction. When your work begins to suffer, you've slipped from being a functioning addict to a non-functioning addict.  The damage addiction does to your relationships and self-esteem is far deeper and takes longer to repair. You've hurt friends and family. You've disappointed yourself. You've traded important things in your life so that you could make more time to use. You've lived a double life. You've seen the hurt in your family's eyes, and the disappointment in your children's faces.  

Those are the consequences that can motivate you to begin recovery.

Tranquilisers

Benzodiazepines, Tranquillisers, and Sleeping Pills
Here are some of the common tranquillisers and sleeping pills, and their generic names:
  • Valium (diazepam)
  • Ativan (lorazepam)
  • Xanax (alprazolam)
  • Klonopin or Rivotril (clonazepam)
  • Restoril (temazepam)
  • Rohypnol (flunitrazepam)
  • Dalmane (flurazepam)
  • Imovane (zopiclone)
  • Ambien (zoldipem)
  • Lunesta (eszopiclone)
A Benzo Story

It's easy to become dependant on tranquillisers.
People sometimes become dependent on tranquillisers inadvertently. You can become dependent on them if you take tranquillisers for more than a few months. For example, if you followed your doctor's orders and never abused your prescription, you could still experience significant withdrawal symptoms if you stop them suddenly.

This is a true story about dependence to prescription tranquillisers (sometimes called benzos). Unfortunately it is a story that happens almost every day. Cheryl (not her real name) came to me after ten years of being prescribed Ativan. Although the story is about Ativan, I have heard similar stories about all tranquillisers. 

Cheryl was a happy young lady at twenty years old. She rarely took Tylenol for a headache. Life was good, except for her stressful job. 
Then one day Cheryl felt a tightness in her chest and had difficulty breathing. Her heart began to race. Her palms were sweaty and her hands were shaking. She was overcome with worry, but didn't know what she was worried about.

Cheryl went to her doctor who listened to her story and told her that she was experiencing an anxiety attack. The visit lasted less than 15 minutes and at the end of the visit he handed her a prescription for Ativan.

The tranquilliser worked exactly as expected initially. Within a few days Cheryl was more relaxed, and she was sleeping better. Sometimes she slept so soundly that she woke up feeling groggy the next morning. But that passed. Even the stress of work was easier to handle. Both Cheryl and her doctor were relieved. 

For the next two years Cheryl continued to use Ativan on and off as needed. She never abused it, and never used more than her prescription. For two years her doctor kept on prescribing Ativan with little reassessment. As time went on Cheryl started using it a little more often. Eventually she was taking a tranquilliser almost every day. Sometimes her family doctor would simply renew the prescription over the phone. Cheryl was just happy that the anxiety attacks had gone. 

By the end of the third year Cheryl was concerned, and approached her doctor. Was Ativan addictive she wondered? He assured her it was not. But Cheryl had her doubts and she persuaded her doctor to take her off the drug. One week later, Cheryl was hit with series of anxiety attacks. She felt a little guilty that she questioned her doctor, and he immediately restarted her on Ativan.

What Cheryl didn't know was that the anxiety attacks may have been avoided if she had been tapered off the drug correctly. In fact suddenly stopping tranquillisers can be dangerous.

There is a significant risk of seizure, strokes, heart attacks, or hallucinations if you stop tranquillisers suddenly.
Two years later, still not convinced that this was the harmless drug her doctor said it was, Cheryl took herself off the tranquillisers. The withdrawal was rough. Cheryl experienced all kinds of symptoms, including anxiety, mood swings, and poor concentration.

Her husband started to lose patience. But she persisted. Then one day, her boss told her that she had to take on more responsibilities at work. Cheryl tried to explain that she was going through a difficult time and that she wasn't sure she could take on more stress right now. But her boss said that the company was restructuring and Cheryl's job might be on the line. 

Despite all that stress, Cheryl managed to remain off the pills and get through the withdrawal. But during that time she didn't dare see her doctor once, because she was afraid that if he made the slightest suggestion she would lose her resolve and go back on Ativan. 

Cheryl managed to stay off tranquillisers for a whole year, and was feeling stronger all the time. Given enough time we know she would have done well. It takes about 2 years for patients fully recover from the effects of tranquillisers. But Cheryl's mother fell ill and Cheryl took on the responsibility of her medical care. 

One night, Cheryl suddenly woke up with her heart pounding in her chest. She had difficulty breathing, and she thought she was going to die. She went to the emergency room, and after a full examination was told that there was nothing wrong with her. She had experienced another anxiety attack. 

The emergency room sent a follow up letter to her family doctor who booked an appointment to see Cheryl. He said he wanted to refer Cheryl to a psychiatrist. 

The psychiatrist explained that Cheryl had a chemical imbalance, and that this was the cause of her anxiety. He said that it was not uncommon, and there was an effective treatment for it. He assured her that it was not addictive, and his very words were, "You can take this medication for the rest of your life." Then the psychiatrist did something that set Cheryl back another five years. He wrote her a prescription for Ativan. 

Now events started to happen a little more quickly. The Ativan wasn't as effective as it had been in the past, and there were days when Cheryl needed more than her usual dose. The psychiatrist agreed that on bad days Cheryl could take 1 or 2 more pills to deal with her anxiety. By the end, Cheryl was being prescribed 4 times her initial dose. But at each visit her psychiatrist reassured her that she was doing well. Gradually, he spent less and less time with her since the Ativan was working. Some visits consisted of him just writing a prescription. 

Cheryl had become dependent on tranquillisers. The more she took them, the more her brain adapted to them, and the more she needed. Whenever she tried to slow down, her withdrawal symptoms forced her to start up again. 

The irony of tranquillisers is that they're prescribed for anxiety and sleep. But the longer you take them the more they increase your anxiety and disturb your sleep.

The doctors had said that Cheryl could take these pills for the rest of her life. And sure enough it was coming true. Tranquillisers are the perfect addictive drug. The longer you take them — the more you need them.

After a while Cheryl began to experience new symptoms. She started feeling depressed. Initially she had a hard time describing it. She was less interested in things. She didn't have as much energy as she normally did, and she wasn't as happy. She complained to her psychiatrist who eventually decided to start Cheryl on an antidepressant. But he continued to prescribe the tranquilliser. 

Most addictive drugs if taken long enough can cause depression. It is quite common with tranquillisers. Cheryl had been given a tranquilliser that caused depression, and now she was taking an antidepressant to counteract the tranquilliser. 

Ten years had passed in one person's life. What started out as anxiety, probably brought on by work stress, had gradually escalated into dependence and depression. 

Finally, it was Cheryl herself who took the initiative and sought help to come off her drugs. She was gradually tapered off her Ativan, and counselled on post-acute withdrawal. Her withdrawal was uncomfortable, but with support she managed to get through it. 

Cheryl completed her taper, went through withdrawal, and is now living a better life. Her symptoms disappeared after about two years. She will now happily tell you that she feels better than she's felt in years, and that it's good to no longer be dependent on tranquillisers.

Why are benzodiazepines still prescribed?
If they're that awful why do doctors still use them? Because they can be helpful if taken for a short time. Some people need them to deal with unusually stressful situations. But if you take them for longer than a few weeks or months, your body will adapt to them, your anxiety level will rise, and you will need more of them over time.

Potential Symptoms of Long-term Use
The longer you use tranquillisers and sleeping pills the more anxious you become. In the beginning the help you relax and fall asleep. But after a few months they have the opposite effect.

One of the most disturbing symptoms of long-term benzodiazepine use is depersonalisation. It means not feeling quite real. It's impossible to describe unless you've experienced it, but tranquilliser patients often say things like "I don't feel quite real," or "my arms don't feel connected to my body," or "when I'm in a group of people I somehow feel outside of myself." All bizarre descriptions that mean the person is experiencing depersonalisation. 

Depersonalisation is usually worse during post-acute withdrawal. I have known patients who thought they were going crazy because they had depersonalisation, when in fact they were experiencing typical tranquilliser withdrawal. The depersonalisation will go away eventually, but it can take many months. Of course, you should always see a doctor if you have any unusual symptoms – preferably one who is familiar with addictions.

Post-Acute Withdrawal Symptoms 
Some of the symptoms of tranquilliser post-acute withdrawal are:
  • Anxiety
  • Mood swings
  • Depersonalisation
  • Poor concentration
  • Social isolation
  • Low energy
  • Disturbed sleep
Post-acute withdrawal gradually gets better over two years. Your symptoms should show gradual improvement. Measure your progress month to month. If you measure your progress day to day, or week to week, you'll often have one week that will be worse than the week before. But if you measure your progress month to month you should see steady improvement. If you take care of yourself, and you're patient, you can get through this. 

Look at the post-acute withdrawal page to learn more about those symptoms and how to deal with them. 

Recovery and Relapse Prevention Strategies
If you have decided that you are addicted, this is your opportunity to change your life. Learn more about recovery skills and relapse prevention strategies in the following pages. You can recover from addiction and be happier.

Marijuana

Cross Addiction

Marijuana is one of the most difficult drugs to give up.
Not because it's more addictive than other drugs, but because addicts are more reluctant to let it go. They see it as their final vice.  If you want to recover from addiction, you also have to stop using marijuana. If you continue to use marijuana, you're saying that you don't want to change your life and you don't want to learn new ways to relax, escape, and reward yourself, which means nothing will have changed. 

The Consequences of Marijuana Use
Significant brain abnormalities were found in 18 to 25 year olds who smoked marijuana at least once a week.  The abnormalities were in the emotion and reward centres of the brain. This suggests that even casual marijuana use can increase the chance of developing other addictions later on, and may affect people’s ability to feel and deal with emotions. 

Marijuana is neurotoxic to the adolescent brain.
One study followed over 1,000 individuals who began using marijuana as adolescents. The study compared their IQ at 13 and 38 years old. During this period IQ would normally remain stable or slightly increase. But for regular marijuana users their IQ declined by 6 point on average. Furthermore, stopping marijuana use did not fully restore the damage. The authors conclude that marijuana is neurotoxic to the adolescent brain.

Marijuana users are 4 times more likely to develop depression.
One study looked at 1,920 people, and followed them for 16 years. It discovered that people who smoked marijuana were 4 times more likely to develop depression.

Another study looked at 1601 students aged 14-15 and followed them for seven years. Approximately 60% of the students had used marijuana by the age of 20, and 7% had become daily users. The young women of the group who were daily users had a five time greater chance of developing depression.

Marijuana almost triples the chance of developing psychotic symptoms.
A 3-year study followed 4,045 psychosis-free people. It came to the conclusion that marijuana smokers are three times more likely to develop psychotic symptoms (including manic-depression) than non-smokers.

Marijuana and Pain Control
Marijuana is no more effective in controlling pain than codeine.  One study reviewed 9 clinical trials that compared marijuana with other pain medication in a total of 222 patients. The study looked at 5 cancer pain trials, 2 chronic non-malignant pain trials, and 2 acute postoperative pain trials. The review showed that marijuana was no more effective in controlling pain than 60-120 mg codeine. But it also showed that marijuana had more side effects than codeine including the fact that it caused more depression.

Cocaine

No drug takes you down faster or harder than crack.  
There are two forms of cocaine, the powdered form that you snort, and crack that you smoke.  Cocaine is so addictive that if you give a mouse a hit of cocaine every time it presses a lever, it will do nothing else but press that lever. It won't stop for a minute to take a sip of water or a bite to eat, and eventually it will die from a cocaine overdose. The only thing that prevents people from overdosing on crack is their bank account. Once people are addicted to crack, they will sell their soul for another hit. 

The Consequences of Cocaine Use
Cocaine is a stimulant, therefore it causes your heart to beat faster and your blood vessels to constrict, which can lead to high blood pressure, heart attacks, and strokes. Heart attacks in young patients without a history of heart disease are so frequently due to cocaine that emergency room doctors are taught to consider it as one of the first diagnoses.

Cocaine is an important cause of cardiac arrest.
Cocaine causes your heart to speed up, and in some cases go so fast that it actually stops. What is especially deadly about cocaine is that there is no correlation between how many times you've used cocaine or how much you used, and when you will suffer a cardiac arrest. Some people die after their first use. Other people have used cocaine hundreds of times, and then drop dead on the very next time. Some university athletes who suddenly drop dead are discovered to have died from a cocaine induced cardiac arrest.

As with all drugs, the most important consequences of cocaine addiction are psychological, social, and emotional. But with cocaine they happen faster and harder than with other drugs. If you are a cocaine addict, you don't have to wonder if you've hurt your friends and family. You can be sure that you have.

Withdrawal Symptoms 

The withdrawal symptoms of cocaine are emotional.
There are no physical withdrawal symptoms from cocaine, which is why people sometimes trick themselves into thinking they aren't addicted to it. "I'm not physically addicted to cocaine." But there's no physical addiction and non-physical addiction – there's just addiction. All addiction occurs in the brain.

Even though there are no physical withdrawal symptoms, cocaine still satisfies the criteria of addiction. People have difficulty controlling how much they use, and they continue to use even though it has negative consequences to their life. 

The emotional withdrawal symptoms of cocaine are: 
Tiredness
  • Depression
  • Anxiety
  • Moodiness
Post-acute withdrawal.
Look at the post-acute withdrawal page to learn about those symptoms and how to deal with them. The post-acute withdrawal symptoms for cocaine are similar to those of other drugs:
  • Mood swings
  • Variable energy
  • Low enthusiasm
  • Poor concentration
  • Sleep disturbances
Cross Addiction

Most cocaine addicts struggle with the idea of total abstinence.
If you're addicted to cocaine, you know you never want to use cocaine again. Cocaine has ruined your life, it has cost you a lot of money, but you're not sure about stopping alcohol. Maybe alcohol has never been a problem. But because of cross addiction, if you want to stop using cocaine you must also stop all addictive drugs including alcohol and marijuana.

Alcohol is a common trigger for cocaine use.
You'll start with just a few drinks a week. Maybe you'll drink moderately for weeks or even months without using cocaine. But then one week, you'll have a bad week. Bad things happen. During that week, everything will go wrong. You'll be stressed out at work. You'll have an argument at home. And by the end of the week, you'll really want a drink. But instead of just a few drinks, you'll want maybe three or four drinks to take the edge off. After the first one or two drinks, your inhibitions will be lower. After two or three drinks, you'll reach a magic number, and your brain will suddenly say "Bingo. I remember this feeling, and I remember something that feels even better." And you'll be off using again.
Recovery requires total abstinence.

Opiates

Opiates (Narcotics): Addiction, Withdrawal and Recovery

A List of Common Opiates in Increasing Strength
These are some of the common opiates and their generic names. They are listed in order of increasing strength.
  • Codeine
  • Vicodin, Hycodan (hydrocodone)
  • MS Contin Kadian (morphine)
  • Oxycontin, Percoset (oxycodone)
  • Dilaudid (hydromorphone)
  • Duragesic (fentanyl)
What are Opiates?
Opiates are a group of drugs that are used for treating pain. They are derived from opium which comes from the poppy plant. Opiates go by a variety of names including opiates, opioids, and narcotics. The term opiates is sometimes used for close relatives of opium such as codeine, morphine and heroin, while the term opioids is used for the entire class of drugs including synthetic opiates such as Oxycontin. But the most commonly used term is opiates.

Opiate Addiction

Opiates produce a sense of wellbeing or euphoria that can be addictive to some people.
Opiates are legitimately used for treating pain. When used for pain relief, many people develop tolerance, meaning they need more and more to get the same effect. Some people go on to develop an addiction to opiates. They begin to obsessively think about getting more opiates and in some cases engage in illegal activities such as double doctoring.

A high dose of opiates can cause death from cardiac or respiratory arrest.
Tolerance to the euphoric effect of opiates develops faster than tolerance to the dangerous effects. Therefore people often overdose by mistake because they are trying to get a higher high and take too much.  Opiate overdose can be reversed in hospital with intravenous naltrexone. Please contact emergency services if you feel you are in danger of an overdose. 

Opiate Withdrawal
Opiate withdrawal can be extremely uncomfortable. The important thing to remember is that opiate withdrawal is not life threatening if you are withdrawing only from opiates and not a combination of drugs. (Withdrawal from alcohol and some drugs such as benzodiazepines is potentially dangerous)

Opiate withdrawal symptoms include:
  • Low energy, Irritability, Anxiety, Agitation, Insomnia
  • Runny nose, Teary eyes
  • Hot and cold sweats, Goose bumps
  • Yawning
  • Muscle aches and pains
  • Abdominal cramping, Nausea, Vomiting, Diarrhoea
Opiate withdrawal symptoms can last anywhere from one week to one month.
Especially the emotional symptoms such as low energy, anxiety and insomnia can last for a few months after stopping high doses of opiates.
Once the early stage withdrawal symptoms are over, you will still experience post-acute withdrawal symptoms. These are less severe but last longer.

Do You Have an Opiate Addiction?
  • Has your use of opiates increased over time?
  • Do you experience withdrawal symptoms when you stop using?
  • Do you use more than you would like, or more than is prescribed?
  • Have you experienced negative consequences to your using?
  • Have you put off doing things because of your drug use?
  • Do you find yourself thinking obsessively about getting or using your drug?
  • Have you made unsuccessful attempts at cutting down your drug use?
If you answered yes to at least three of those questions, then you are addicted to opiates.

A Recovery Plan
Break the cycle of guilt and shame. Do your recovery with other people who are going through the same thing. This is the benefit of going to 12-step meetings such as RHM Recovery groups or NA or Alcoholics Anonymous AA.
  • Ask for help. Have a strong support system.
  • Be honest, and practice sharing how you feel.
  • Avoid high risk situations.
  • Learn relapse prevention strategies.
  • Do your recovery one day at a time.
Medications Used to Treat Opiate Addiction
  • Suboxone, Subutex (buprenorphine)
  • Revia (naltrexone)
  • Methadone
What is Suboxone - Buprenorphine?
IMPORTANT: This is general medical information, and is not tailored to the needs of a specific individual. This material is NOT complete. It does not cover all possible precautions, side effects, or interactions. You should always consult your physician when making decisions about your health.

Suboxone is a medication used for withdrawing and detoxing from opiates.
It is a combination of buprenorphine a mild opiate, and naloxone a medication that reverses the effects of opiates if taken intravenously.
Buprenorphine is unlike other opiates in that it does not lead to a greater high the more you take. It is a partial opiate agonist, meaning that it produces a mild high at most. Therefore it is sometimes used to get people off more addictive drugs such as Oxycontin or heroin.

The reason for combining buprenorphine and naloxone is that it reduces the risk of intravenous use.
Suboxone is supposed to be taken as a tablet and held under the tongue. But if Suboxone is dissolved and taken intravenously, the naloxone reverses the effects of the buprenorphine, which blocks the high. Therefore there is less danger of diversion.
Patients do not have to go to special clinics to get their Suboxone as they do with methadone. Physicians with proper training and certification can prescribe Suboxone in their offices, and patients can take it home.

The Effects, Side Effect and Dangers of Suboxone
  • Suboxone is potentially addictive.
  • You will probably experience withdrawal symptoms as you come off Suboxone.
  • If you take Suboxone too soon after another opiate, you may experience withdrawal symptoms.
  • Suboxone can increase the drowsiness due to other drugs or alcohol.
  • Suboxone overdose can cause slow breathing, seizures, confusion, loss of consciousness, coma, and death.
Suboxone Withdrawal
Suboxone causes withdrawal symptoms, similar to other opiates, if stopped too quickly: low energy, irritability, anxiety, hot and cold sweats, muscle aches and pains, abdominal cramping, nausea, diarrhea. Some people feel that the withdrawal from Suboxone is just as difficult as the withdrawal from methadone.

Smoking & Nicotine

How to Quit Smoking

You can quit smoking with a little help.  
If you’re anxious about quitting, this website will take you through the stages of quitting smoking step-by-step. You will learn how to get ready, how to quit, and how to make sure that you don’t relapse. You will also learn tips that make quitting easier.

You are probably at the stage where part of you wants to quit smoking, but part of you doesn’t.
Maybe you’re worried about withdrawal, or afraid that you’ll fail. Put those thoughts aside for now. Focus on why you want to quit, and that will give you the motivation to succeed.  The good news about smoking is that it doesn't matter how much you’ve smoked, or how long you have smoked. If you quit now, your body will begin to repair itself and will take care of you even after years of neglect. 

Nicotine Addiction 
An average smoker gets about 200 hits of nicotine a day, and over 70,000 hits per year. Ten puffs per cigarette, times 20 cigarettes a day gives you about 200 hits of nicotine a day. That’s partly why smoking is so addictive. Your brain constantly waits for the next nicotine hit. Some studies have suggested that nicotine is as addictive as crack cocaine.

Nicotine Withdrawal
These are some common symptoms of nicotine withdrawal:
  • Irritability, Anxiety
  • Difficulty concentrating
  • Headaches
  • Food cravings
  • Cravings for cigarettes
What causes nicotine withdrawal?
Smoking increases the number of nicotine receptors in your brain. When you stop smoking, those receptors continue to expect nicotine, and when they don’t get it, they begin to adjust. That adjustment process, is what causes cravings and withdrawal.

How Long Do Nicotine Withdrawal Symptoms Last?
Nicotine is out of your body 72 hours after you quit smoking. Nicotine withdrawal symptoms usually reach their peak 2 to 3 days after you quit, and are gone within 1 to 3 months. It takes at least 3 months for your brain chemistry to return to normal after you quit smoking. The last two symptoms to go usually are irritability and low energy.  Any effective smoking cessation program has to take into account this long adjustment period. It is why some doctors recommend weaning off nicotine slowly with nicotine replacement therapy.  In summary, most people start to feel better after 1 week, and the symptoms are usually gone within 3 months. 

Quit Smoking (Step-By-Step)
A step by step plan to help you quit smoking. You will find guidelines, best practices, facts and tips to help you successfully reach your goal. The basic steps of quitting are the following:
  • Make the Decision to Quit
  • Understand Your High-Risk Times
  • Stock Up on Supplies
  • Pick a Quit Date
  • Let People Know
  • Remove Smoking Reminders
  • Your Quit Date and the First 2 Weeks
  • Maintenance and Coping Strategies
Step 1: Make the Decision to Quit
Identify your reasons for quitting smoking. Quitting is challenging. You can rise to the challenge, but it helps if you have your goals in mind. Review your mental list as you approach your quit date.  If you have tried to quit smoking before and failed, don’t let that be an obstacle. The more times you try to quit, the greater your chance of success. Maybe you weren’t ready last time. Maybe you didn’t take the rights steps. 

Step 2: Understand Your High-Risk Times
Smoking is more than just a physical addiction to nicotine. It is also a psychological addiction. Why do you smoke? Is it a break from your hectic day? Is it a moment of peace when you can be alone with your thoughts? Most people smoke for the same reasons alcoholics drink. It’s a chance to escape, relax, or reward yourself.  Anticipate your high-risk situations and plan for them. This will help you deal with them better. Here are some common triggers for smoking cravings: 
  • Drinking coffee
  • Finishing a meal
  • Driving your car
  • Using the phone
  • Stressful situations
  • Drinking alcohol
  • Social events
These are some strategies for dealing with your triggers:
  • If you smoke with your morning coffee, plan to have your first coffee at work where you probably can’t smoke.
  • If you smoke while driving, plan to take a different route. It will keep your mind occupied, so that you won’t be on autopilot.
  • If you smoke after meals, plan to get up after a meal. Go for a walk, brush your teeth, do something.
  • If you smoke when you’re on the phone, put one of those stress balls next to your phone to keep your hands occupied.
  • Plan to keep yourself busy in the beginning. Too much unstructured time is not a good thing when it comes to smoking cessation.
What should you do if you slip?
A slip is also a high risk time. You don’t need to slip. Many people have quit without a slip. But if you do, it’s good to have a plan.
  • The most important thing you can do is avoid all or nothing thinking. Don’t give up and let a slip turn into a major relapse.
  • Throw out the rest of the pack.
  • You’re not a failure if you slip.
  • The more times you try to quit, the greater your chance of success.
  • Learn from your experience. What you could have done differently.
  • Never forget your reasons for quitting in the first place.
Step 3: Stock Up on Supplies
Every smoker understands that smoking is also an oral addiction. When you quit smoking your brain will still crave the oral sensation of a cigarette. As part of your smoking cessation plan, stock up on oral substitutes like gum, raw vegetables, carrot sticks, hard candy, coffee stirrers, straws, etc.  

If you’re planning to use nicotine replacement or smoking cessation drugs talk to your doctor at this point. Learn how to use them. Find out about potential side effects and what to look out for. 

Step 4: Pick a Quit Date
A quit date is a personal commitment. It is important because it prepares your mind subconsciously. Pick a date within the next month. It doesn’t have to be a special day.

Avoid a day when you know you’ll be busy, tense, or have a special event that could be a trigger. Write down your quit date somewhere, and look at it every day. Let your determination build as you get closer.

If you are going to use smoking cessation medication like Zyban (Wellbutrin, bupropion) or Chantix (Champix, varenicline), your doctor may have suggested that you start using them now. Ask your doctor how far ahead of your quit date you should start taking your pills. 

Step 5: Let People Know
Quitting is easier with support. Choose people who you think will be helpful. Tell them your plan and how they can help. Also tell them how they cannot help.
  • Friends can help distract you.
  • They can listen to you.
  • Sharing your struggles makes them lighter.
  • But explain that you want to keep your conversations light. Nothing serious that will add to your tension.
Step 6: Remove All Smoking Reminders
Smoking like any addiction is triggered by people, places, and things. For other addictions, the objects that are triggers are usually drug paraphernalia.

In this case the paraphernalia include cigarettes, matches, lighters, and ashtrays. Get rid of all of them. Don't save anything “just in case.”

Freshen your environment at home, work‚ and in your car. The smell of cigarettes is definitely a trigger, especially in the beginning. 

Step 7: Your Quit Date and the First 2 Weeks
The first two weeks are critical for your success. If you can get though the first two weeks your chance of success is much higher. Therefore it is important to give yourself the best chance you can during these critical weeks.

The first two weeks are all about distractions, keeping busy, and being good to yourself. Keep busy with fun, low stress activities and avoid high stress ones.

Stay Busy 
  • Plan lots of dates with friends. Get out of the house. Go for walks, bike rides, or go to the gym. Go to a movie. Be good to yourself.
  • Keep your hands busy. Some people like to use a pen, a straw or a coffee stirrer.
  • Drink lots of water.
  • Call the people who have offered to help. Everyone understands how difficult this is. People will be happy that you’re doing it. Don’t try to do it alone.
  • If you just sit there with your cravings, you are giving them room to grow.
  • Relax and breathe deeply.
Avoid High Risk Situations
Don’t hang out with smokers. That’s like a crack addict hanging out with crack addicts. No matter how friendly and supportive your smoking friends are, they are still a high risk environment for at least the first several months.
  • Practice saying, “No thank you, I don’t smoke anymore.”
  • Understand that you will encounter high risk situations that you haven’t thought of. If you find yourself triggered, plan to get up and leave quickly.
  • A change of scenery can make all the difference.

Talk to Yourself
Most cravings only last 10 - 20 minutes. Distract yourself, and the cravings will pass. When you think about using, talk to yourself and keep yourself busy.
  • “I refuse to believe that smoking is more powerful than me.”
  • “I won’t give smoking any more power over my life.”
  • “I chose to be a non-smoker.”
  • “One day at a time.”
Step 8: Maintenance and Coping Strategies
Quit smoking one day at a time.
Don't think about quitting forever. That can be overwhelming. Deal with right now, and the days will start to add up. 

Self-care
Be good to yourself. This is probably the most important and undervalued coping strategy in quitting smoking. It is one of the most difficult things for anyone to do, especially someone with an addiction.

Your tendency will be to not reward yourself while you’re quitting. You’ll think that you don’t deserve it yet. You will think that you only deserve a reward once you have had a long stretch of not smoking. But that’s old thinking. This is your opportunity to learn better coping strategies.

How you can be good to yourself is different for everyone. Pursue new ways of rewarding yourself the same way you pursued your addiction. You are learning new thinking patterns that will be helpful in the rest of your life.  Don't try to diet while quitting smoking. Too much deprivation is bound to backfire. Instead, try eating more fruits and vegetables. 

Celebrate Your Victories
Don’t focus on your struggles and ignore your successes. You probably tend to disqualify the positives and focus on the negatives. But don’t underestimate how far you have come. Reinforce your victories.

Take the money you’ve saved and buy yourself a treat once a week. Or save the money for something bigger like a trip.

Plan ahead for your milestones and make sure you recognise them with some celebration, big or small.

Rewards don’t have to be financial. You could plan to get together with your friends and do something.

Stress Management
Get plenty of rest and eat healthy. Lack of sleep and excessive sugar are known triggers.

Use substitutes for oral cravings like gum, raw vegetables, carrot sticks, hard candy, coffee stirrers, straws.

Stress is a big trigger for smoking.

Relax by taking a few slow, deep breaths. Inhale through your nose and exhale through your mouth. Repeat it 5 times and see how you feel.

Maintenance
When you have cravings, think of how strong you have been so far.
Remember your reasons for quitting.
  • Refuse to let your addiction win.
  • Think of the benefits to your health, finances, and family.
  • Remind yourself that there is no such thing as just one cigarette.
  • Start to see yourself as a non-smoker. That is the ultimate payoff. You are freeing yourself from the control of your addiction.
Reasons to Quit Smoking

Some Things You Probably Don’t Know About Smoking
Here are just a few smoking facts. Not a long list, but some key facts about the dangers of smoking.

Smoking causes more deaths each year than all of the following causes combined:
  • Alcohol abuse
  • Illegal drug use
  • Murders
  • Motor vehicle accidents
  • AIDS and HIV
If you are recovering from drug or alcohol abuse, it doesn’t make sense to have worked hard for your recovery, and then drop dead from smoking.

Both the founders of Alcoholics Anonymous, Dr. Bob and Bill W. dropped dead from smoking. Smoking statistics tend to feel impersonal. But if you’re in recovery, that makes it up close and personal.  Smoking kills 6 million people each year worldwide. In the United States, smoking kills more than 480,000 people each year. That is the equivalent of two jumbo jets crashing every day with no survivors. (The number of passengers in two jumbo jets crashing every day for one year: 500 * 2 *365 = 365,000.) 

More smokers die of heart disease and stroke rather than lung cancer. This is why people often underestimate how deadly smoking is. Perhaps your grandfather smoked his whole life and never died of lung cancer. Most smokers die of heart disease or stroke.

Smoking causes type 2 diabetes. Smokers are 30 – 40 percent more likely to develop diabetes.
Those are just a few of the diseases caused by smoking. There is not an organ or system in your body that is not affected by the dangers of smoking. The full list of smoking diseases is too long and depressing.
Here are some reasons why people quit smoking:
  • Are you worried about your health?
  • Do you resent being controlled by your addiction?
  • Do you know someone who has had health problems because of smoking?
  • Are you trying to be a positive role model for your family?
  • Do you want to save money?
Second Hand Smoke Facts

Second hand smoke causes the same kinds of deaths as smoking.
There is no safe level of second hand smoke. Here are just two of the consequences of living with a smoker or working in a smoking environment.
Nonsmokers exposed to second hand smoke at home or at work are at higher risk of the following:
  • 25 – 30 percent more likely to develop heart disease and stroke
  • 20 – 30 percent more likely to develop lung cancer
Children and Second Hand Smoke
Second hand smoke has been proven to damage children’s health and increase the risk of the following:
  • Asthma, pneumonia, and bronchitis
  • Ear infections and the need for ear tubes
  • Sudden Infant Death Syndrome (SIDS)
Isn’t it time you said enough?

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We also provide training to any organisation seeking to implement a recovery centre in their community.

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