Alcoholics Anonymous

Yesterday, I attended an Alcoholics Anonymous meeting with another classmate, Adam. I was really nervous to get out of the car  because I had no idea what to expect. We pulled into the parking lot at a building called the 521 Club. We knew we were in the right place because many people were outside smoking. Once we finally worked up the courage to get out of the car, we walked inside. We were welcomed by a very nice man who told us to grab some coffee and take a seat anywhere. We were 15 minutes early but a good amount of people had already arrived and more continued to file in. 

Me and Adam sat at one of the tables that surrounded the outside of the room. All the seats in the inner circle were filled and many of the tables were too. There were about 40 people there. The best way to describe them is as average. Everyone in the room was someone you could pass on the street and never know that they are an alcoholic. There were many more men than women, about 30 men and 10 women. The age of people in the room ranged from about 25 to 65. More members were older than younger. Most of the people were Caucasian. About half the people have been sober for over a year. The rest were in the process of getting there. 

 

The meeting was ran by one women in the group. The members alternate the running of the meetings. The meeting opened with a reading of the preamble, which was followed by the reading of the 12 steps of the program. She asked if anyone wanted to introduce themselves to the group. Me and Adam introduced ourselves and let everyone know that we were there to observe. They were accepting of it and just told us to not take pictures because it is anonymous. Everyone laughed. After that, the women asked if anyone had a topic that they wanted to discuss at this meeting. A lady raised her hand and said that she wanted to talk about acceptance. The room was then open for discussion. Members were all told to avoid crosstalk and profanity. One at a time, people started discussion how acceptance has played a part in their daily lives and in their recovery. Each member began by stating their name and "I am an alcoholic." Everyone would say "Hello" followed by their name. At the end, they would say "thanks for letting me share" and the group would respond "thanks for sharing." After the discussion was over, pins were handed out to members celebrating anniversaries. No one was celebrating anything but one man said his son celebrated 25 years of sobriety at the 12 o'clock meeting earlier that day! The meeting concluded with everyone holding hands in a circle. The Lord’s Prayer was said and everyone ended by saying “Keep coming back; it works if you work.” After the meeting, many people stood around and talked. They all seem to have a close bond on one another. We did not participate in discussion during the meeting, but afterwards, many people came up to us with question about where we are from and what we thought of the meeting. They welcomed us back anytime.

I believe these meetings really help those who attend them. The members opened up and discussed parts of their life that are struggles for them and how much this process and sobriety has changed them. As a group they can get things off their chest and be honest. They encourage and accept each other. No one has to feel alone in the process. They are there to help others through the process. Each member is at a different step, and they can exchange advice. Through the discussions everyone bonds and it seemed like true friendships were formed. As someone who is not suffering from alcohol addiction, I could still  relate to people's stories, and I felt like I took something away from this experience. 

This meeting was quite the learning experience. In class, we discussed the 12 steps of the program and the addiction cycle. The people in the meeting were living examples of these.  Each member was was at a different stage in the process but the main topic was step 1, acceptance. In part with the steps, some people discussed how hard the addiction cycle is to break. Overcoming their addictions to alcohol must start with them, but the group helps them to maintain it. One man asked another women, "How are you today?" She replied, "Well, I'm here."

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Strengths-based Approach

Harm Reduction refers to policies, programs and practices that aim to reduce the many health, social and economic consequences of the use of legal and illegal drugs without necessarily reducing drug consumption. This approach towards substance misuse and addiction goes beyond the one size fits all model of abstinence ("What is harm," 2013).

Since its initial identification in the 1980s, harm reduction has evolved to combat the negative consequences of a multitude of addictions. G. Alan Marlatt, PhD was a professor of Psychology and director of the Addictive Behaviors Research Center at the University of Washington. His pioneering research with harm reduction has had a huge impact on the treatment of addictions in the United States and abroad (Victor & Yalom). 

There is no concrete formula for how harm reduction works, but it is a respectful, client-centered and individualized approach to reducing the harm caused by using substances, engaging in risky behavior and other addictions. It aims to keep people safe and minimize death, disease, and injury ("What is harm," 2013). Harm reduction accepts that many people who use drugs are unable or unwilling to stop using drugs. Instead of forcing abstinence, reduction provides support services and strategies to provide knowledge, skills, resources, and supports for individuals, families and communities to be safer and healthier (Bigier, 2005). This approach works by helping individuals from "where they are". From there, small steps are taken to increase safety and well-being while completing individuals' goals. This approach views people as responsible for their own choices. G. Alan Marlatt, PhD explained that in this program, "We'll help you, whatever your goal is. You want to quit, we'll help you. You want to cut back, we'll help you. We're not going to shut you out." Many other traditional treatment programs would say, "Unless you're totally committed to abstinence, we're not going to work with you" (Victor & Yalom).

Addiction: This approach can have a large impact on the addiction cycle. In the cycle, an individual experiences depression and negative feelings so they use their addiction to cope with these feelings. The negative feelings disappear and they feel good. However, then the individual experiences some kind of negative consequences. Then, the individual feels guilty, shameful or angry about their actions. They become upset again and the cycle continues (From class notes). The harm reduction approach could stop this cycle before negative consequences occur. If the individual is educated and steps are taken to prevent these negative consequences, the individual might be less likely to give into their addiction again. Even if they continue to engage in their addiction, they will be more educated about how to be safe while using. 

Example of Harm Reduction: Needle exchange programs are one major harm reduction strategy. These programs aim to reduce the spread of viruses such as HIV and Hepatitis C among injecting drug users. With an estimated 1 in 5 injecting drug users worldwide infected with HIV, these programs are key to getting the epidemic under control ("Needle exchange and," 2013). It is hard to get users to stop, but we can at least make sure they are safe while using. If we do not give them clean needles, they will use use dirty ones anyway. These programs have proven to be successful. A study of HIV among IDUs in New York, between 1990 and 2001, found that HIV prevalence fell from 54 percent to 13 percent following the start of needle exchanges ("Needle exchange and," 2013). However, these programs are subject to much criticism. It can be thought that "there’s a mixed signal when we're telling kids stay off drugs, but in some cases 200 feet away, we're allowing people to exchange needles" ("Needle exchange and," 2013). This video further explains needle exchange programs:  http://youtu.be/wQYWw2UERHE

Use of Harm Reduction in my Career: I am a social work major, and as a future social worker, I will be using many strengths-based approaches with my clients. The preamble to the National Association of Social Worker's Code of Ethics notes that the primary mission of the social work profession is to "enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty" (Bigier, 2005). I may encounter many people who suffer from addiction and are also vulnerable, oppressed, or living in poverty. I believe that the harm reduction approach can help these people the most. I can offer many strategies to my clients that will minimize the potential harm that may result from their behaviors and environment while helping them reach their personal goals. 

References:
Victor, R., & Yalom, A. Alan Marlatt on harm reduction therapy. Retrieved from http://www.psychotherapy.net/interview/marlatt-harm-reduction

What is harm reduction?. (2013). Retrieved from http://www.ihra.net/what-is-harm-reduction

Needle exchange and hiv. (2013). Retrieved from http://www.avert.org/needle-exchange.htm

Bigier, M. (2005). Harm reduction as a practice and prevention model for social work. Retrieved from http://www.olc.edu/~jolson/socialwork_old/OnlineLibrary/Bigler 

Photo Links:
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Behavioral Addiction

Bulimia nervosa is one type of eating disorder. Bulimia nervosa is characterized by the following symptoms:

• Repeated episodes of binge eating, known as binging, characterized by eating excessive amounts of food within a small period of time and lack of control over eating
• Recurrent behaviors, such as self-induced vomiting or misuse of laxatives, enemas, or other medications or excessive exercise, to prevent weight gain, called purging (Van Wormer & Davis, 2008)

 When bad-habits become addiction:

When both of these behaviors, binging and purging, occur on average at least twice a week for 3 months and create a cycle, it becomes an addiction (Van Wormer & Davis, 2008). However, many people with bulimia binge then purge, on average, 11 times per week. Bulimia becomes long-term, chronically relapsing, and life threatening. Food serves as a drug that stimulates mood enhancers in the brain that can curb the feelings of shame, self-disgust, and depression ("Statistics on bulimia," 2013) 

Who suffers from bulimia?

• approximately 1 in 50 women between the ages of 15 and 24 years suffer with bulimia
• most common among Caucasians
• most common during the late teens and twenties
• at least 95% of all bulimics are female  
• of the few males with this disorder, those on a wrestling team are 7 to 10 times more likely to develop bulimia
• it has been found to occur in children as young as six years old and can occur in older adults
• far more common in industrialized, westernized countries with media images of thin women
• individuals often have history of weight gain or come from families in which being overweight is a problem
• many bulimics suffer from depression or drug abuse
• 35% of women with severe bulimia reported that they suffered childhood sexual abuse ("Statistics on bulimia," 2013)

 Treatment:

The successful treatment of bulimia includes both medical and psychological treatment as well as nutritional counseling. Treatment needs to be ongoing, lasting a total of three to six months or more. Treatment is very important because eating disorders can be fatal in as many as 20 percent of all cases.

The choice treatment for bulimia is cognitive-behavioral therapy. Cognitive-behavioral therapy targets the unhealthy eating behaviors of bulimia and the negative thoughts that go along with them. The steps of therapy are breaking the binge-and-purge cycle, changing unhealthy thoughts and patterns, and solving emotional issues ("Bulimia nervosa," 2013)

Sources:

Bulimia nervosa. (2013). Retrieved from 

    http://www.helpguide.org/mental/bulimia_signs_symptoms_causes_treatment.htm

Statistics on bulimia. (2013). Retrieved from 

     http://www.mirror-mirror.org/bulimia/statistics-on-bulimia.htm

Wormer, Katherine & Davis, Diane Rae (2008). Addiction treatment: A strengths perspective. 

     California: Brooks/Cole

Picture Links:

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