Family hope kit print and digital resource for families of individuals struggling with substance abuse

2. S E Q U O I A C L U B
3
Why is family involvement so important?
Addiction$ destroys$ families$ as$much$ as$it$ destroys$ the$ addict.$ $ Living$ with$an$addict$ is$ not$ easy.$ $ It$ is$
heartbreaking$ and$ exhausting$ to$ witness$ someone$ you$ love$ suffer$ from$ a$ chemical$ addiction.$ $ This$ is$
especially$true$when$you$realize$how$powerless$you$are$to$help.$ Often$a$family$is$torn$apart$deciphering$
between$the$blurred$line$of$helping$ an$addict$ and$being$ controlled$by$the$addict.$ $ Although$many$ times$
addiction$is$a$family$ disease,$you$did$not$cause$the$addiction,$ you$cannot$control$ the$ addiction,$ and$you$
cannot$cure$the$addiction.$ $But$you$can$heal$the$damages$caused$by$addiction.$You$may$ask$yourself$why$
your$involvement$is$important$when$you$are$not$the$one$addicted.$We$have$found$that…
• Being involved as a family is a positive way to move toward recovery as well as self-discovery
• Programs that include the entire support system have far better rates of recovery and long-term sobriety than ones
that do not include families and friends
• Families become disconnected and do not realize that addiction had affected the relationships within their family
system. Being involved in treatment will reconnect and heal the family system.
• Family therapy acts as a prevention of substance abuse impacting one generation to the next. Studies have proven
that family members of addicts have an increased risk of developing substance abuse problems.
• Family involvement has been shown to have a positive effect on the participant’s wellbeing as well as greater
emotional intimacy within the family.
• Family members are able to address and resolve traumatic experiences that may be related to the substance abuse.
Recovering from experiences like these take participation of the entire family.
• It is imperative for the family to know and understand the language of recovery to be able to provide better support
and understanding of their loved ones journey of Recovery.
• Educating family members with supportive and productive ways to relate to one another will maximize the help
they provide to recovery and to their family relationships.
• Knowledge about issues such as enabling and codependency will help families to react in a positive way when
pressed with these situations.

3. S E Q U O I A C L U B
4
Overview
DVD: The Disease of Addiction
This is a disease that
requires treatment
rather than a behavior
that requires punishment
The Disease of Addiction discusses
recognizing addiction and
alcoholism as a disease and how the
brain becomes addicted. The
Disease of Addiction explains how
addiction is a disease and why we
should consider it a disease. This
movie also discusses what addiction
is and how treatment works. Lastly,
The Disease of Addiction explains
how and why the disease affects the
family.
What is the cause of
addiction?
• Stress%releases%a%chemical%in%the%
brain%called%cortisol%that%reacts%
differently%in%an%addict’s%brain%and%
affects%the%brain’s%reward%circuit.
• Cortisol%resets%pleasure%levels%–%
things%that%once%brought%pleasure%
no%longer%hit%the%mark.%
• When%an%addict%becomes%abstinent%
in%recovery%their%pleasure%levels%
normalize%and%they%regain%their%
ability%to%naturally%cope%with%and%
enjoy%life.
How does treatment
work?
• The%willing%patient%learns%new%
coping%skills%to%achieve%
recovery%during%early%sobriety%
while%the%mind%normalizes%over%
time.
• Sobriety%enables%the%patient%to%
beneGit%from%therapy%and%
counseling%O%bringing%the%mind%
back%within%balance.
• Coping%strategies%reset%the%
pleasure%point%where%pleasure%
and%survival%no%longer%require%
drugs%and%alcohol%in%order%to%
cope%with%stress.
Why is the family so affected by addiction?
• Because%the%alcoholic/addict%will%violate%so%many%
boundaries%to%protect%his/her%drug%of%choice%(survival)
• They%will%step%over%their%marriage,%job,%family,%health,%God,%
etc.
• Family%members%build%resentments%towards%the%alcoholic/
addict%that%further%injure%the%entire%family%unit.

4. 5
E S T A B L I S H A S T R E S S F R E E E N V I R O N M E N T
While$your$loved$one$is$in$treatment,$there$is$much$you$can$do$to$prepare$for$their$return$home.$$Make$sure$
your$home$is$clean$and$free$from$clutter.$$This$is$important$to$reduce$stress.$$It$is$also$important$to$convert$
your$home$to$a$comfortable$place$to$live$without$the$temptations$of$drugs$and/or$alcohol.$$It$is$important$to$
create$new$habits$in$the$home$and$within$the$family$to$establish$routine$and$manage$stress.$$
E v a l u a t e y o u r l i f e s t y l e
It$is$important$to$model$healthy$
behaviors.$$Ask$yourself$–$how$do$I$
respond$to$stress?$Do$I$tend$to$overreact$
or$engage$in$other$unhealthy$behaviors,$
such$as$smoking$and/or$drinking$alcohol$
when$I$feel$stressed?$In$what$ways$could$
my$stress$coping$skills$be$improved?
O n e n e w h a b i t a t a t i m e
Changing$behavior$usually$takes$time.$$By$
starting$with$changing$one$behavior,$you$and$
your$family$are$more$likely$to$experience$
success$in$changing$more.$$With$each$single$
success,$you$and$your$family$will$be$
encouraged$to$tackle$other$challenges,$and$to$
continue$making$additional$healthy$changes.$
C r e a t e R o u t i n e s
Make$sure$you$have$a$healthy$routine.$$
Consider$what$structure$you$have$in$your$
home$and$what$structure$you$can$add.$$For$
example:$Do$you$have$curfews?$Do$you$have$
regular$mealtimes?$$Do$you$have$chores$for$
everyone?$$Help$your$loved$one$stick$to$a$
schedule$and$make$appointments.$$Help$them$
remember$to$take$all$prescribed$medications$
and$keep$track$of$the$amounts$they$take.$$Help$
them$keep$their$appointments$with$treatment$
providers,$doctors$and$employment$
opportunities.$
H e a l t h y E n v i r o n m e n t
Your$home,$work$space,$and$social$
environment$can$inFluence$your$behaviors.$$
Altering$your$environment$can$help$alleviate$
stress.$$For$example,$cleaning$up$a$cluttered$
environment$can$help.$$Look$around$and$ask$
yourself,$does$this$space$feel$clear$and$
relaxing?$$Those$in$recovery$are$especially$
sensitive$to$exposure$to$drugs$and$alcohol.$$
Even$the$smallest$amounts$can$trigger$relapse.$$
Encourage$total$abstinence$from$drugs$and$
alcohol.$$You$can$create$a$healthy$environment$
outside$of$your$home$by$helping$your$loved$
one$create$new$sober$hobbies$and$by$
encouraging$a$new$sober$social$group$for$your$
loved$one.$
P l a n f u n A c t i v i t i e s
Participate$in$fun$activities$the$family$can$do$
together$sober.$$A$family$game$night,$riding$
bikes$together,$hiking,$cooking$together,$or$a$
movie$night$are$a$few$examples.$Ta l k A b o u t I t
Talking$as$a$family$and$promoting$open$
communication$and$problem$solving$is$just$as$
important$as$eating$well$and$getting$enough$
exercise$and$sleep.$$Setting$aside$
predetermined$times$to$talk$as$a$family$will$
help$members$take$sensitive$issues$less$
personally$when$they$are$brought$up.$$Inviting$
and$scheduling$a$conversation$with$a$loved$
one$is$much$better$than$surprising$them$with$
it.$$$Discuss$how$you$as$a$family$treat$one$
another?$$Identify$issues$that$may$be$high$risk$
for$the$recovering$addict$when$they$return.
Here$are$some$habits$for$you$and$your$loved$one$to$help$manage$stress$upon$their$return$home.
WHATYOUCANDOTOHELPYOURLOVEDONE
INRECOVERY

5. S E Q U O I A C L U B
6
Be Empathetic
It$is$important$to$not$be$judgmental$while$listening$to$your$loved$
one.$$You$should$be$prepared$to$listen$and$give$them$your$full$
attention$when$they$need$to$express$themselves,$air$frustrations$or$
become$escalated.$$Remember$to$listen$to$what$the$person$is$really$
saying$and$try$not$to$let$your$personal$feelings$get$in$the$way$of$
hearing$them.$You$don’t$need$to$agree$with$someone$to$hear$or$
understand$them$?$most$of$the$time$you$just$need$to$listen.$
Experience$tells$us$that$most$people$simply$want$to$be$heard$and$
understood$far$more$than$they$want$or$need$to$be$agreed$with.$
Try Not to Rehash Old Hurts
Early$recovery$is$not$the$time$to$discuss$why$an$individual$may$
have$chosen$to$use$drugs$for$the$First$time.$Conversations$
surrounding$the$addiction$can$lead$to$blame$and$undermine$the$
recovery$process$in$its$earliest$stages.$$Instead,$keep$conversations$
positive.$$Talk$about$the$future$possibilities$that$will$be$available$
once$your$family$member$has$successfully$completed$treatment.$
Remember,$your$loved$one$is$in$Recovery,$and$that$is$their$
responsibility$now,$not$the$past.$Taking$responsibility$for$Recovery$
is$taking$responsibility$for$the$past.
Become Educated and Stay Involved
The$family$will$need$to$learn$the$best$ways$to$support$the$
recovering$addict$once$the$treatment$program$has$Finished.$$
Agreeing$to$participate$in$family$education$is$a$great$way$to$support$
the$addict’s$recovery.$The$video$included$with$this$kit$is$great$way$
to$begin$that$education.$Additional$resources$can$be$found$by$
contacting$AIA$Aftercare$and/or$your$own$family$doctor,$therapist$
and$counselor.
Common Sources for Stress
• Family$Con9licts/Relationship$
Problems>$For$someone$in$
recovery,$sobriety$might$be$the$
First$time$they$have$ever$been$
able$to$completely$feel$anything.$
It$takes$practice$to$learn$how$to$
react$in$healthy$ways$to$life’s$
stressors.$It$takes$time$to$learn$
how$to$do$the$right$things$for$the$
right$reasons.$$Have$patience$
with$your$loved$one$during$this$
transition;$things$will$get$better.
• Work/School>$$Going$to$work$or$
returning$to$school$is$exciting$
and$hopeful,$but$with$that$hope$
can$come$the$fear$of$failure.$$
Family$support$will$help$make$
hope$less$scary.$
• Health$Concerns>$Drugs$and$
alcohol$take$their$toll$on$the$
body.$Many$injuries$can$heal$but$
they$will$take$time.$The$body$
heals$fast,$the$mind$heals$slow.$
• Financial$Dif9iculties>$Coming$
from$a$life$of$chaos$and$
irresponsibility$takes$time$to$
repair.$Remember,$it’s$progress$
not$perfection$and$1$step$at$a$
time.
C O P I N G A N D C A L M I N G

6. S E Q U O I A C L U B
Tips for De-Escalation
• Control%your%emotions%and%DO%NOT%take%anything%personally%
• Prepare%yourself%mentally%before%diving%into%an%escalated%situation.%The%goal%is%never%to%establish%right%or%wrong.%
The%goal%is%to%calm%the%situation%down.%
• Take%a%breath%to%calm%yourself,%take%several%if%you%need%to.%Try%to%genuinely%listen%and%be%mindful%of%your%body%
language,%the%tone%of%your%voice%and%the%words%that%you%choose%to%say.%
• Know%that%your%loved%one%no%longer%has%alcohol%or%drugs%to%numb%their%feelings%and%this%can%be%overwhelming.%
Do%not%intimidate,%threaten%or%criticize%them%but%rather%seek%to%understand%them.%
• Try%to%wait%for%pauses%in%the%conversation%and%brieGly%communicate%your%willingness%to%listen%and%to%understand.%
Avoid%becoming%confrontational,%%and%continually%be%mindful%of%your%own%emotional%control.
Setting%boundaries%will%help%you%and%your%loved%one%recover%together.%%Setting%boundaries%sometimes%means%tough%
love.%Setting%limits%and%rules%that%were%not%enforced%previous%to%treatment%will%be%difGicult%at%Girst%but%will%help%your%
loved%one%in%the%long%run.%%This%will%help%create%a%healthy%relationship%between%your%family%members%and%will%help%
control%enabling.%%The%goal%of%having%boundaries%is%to%improve%the%health%of%the%family%as%a%whole.%%Do%not%use%
boundaries%to%punish%or%shame.%%Discuss%as%a%family%what%are%good%boundaries%to%establish.%%Ask%yourself%what%
boundaries%did%I%not%hold%up%before?%What%boundaries%would%be%beneGicial%for%my%family?%%Remember%boundaries%are%
healthy%limits%necessary%in%all%relationships.%%These%limits%should%be%known%and%agreed%upon%by%the%entire%family.%%
Boundaries%allow%us%to%understand%limits%which%creates%a%feeling%of%safety%(knowing%what%to%expect).
S E T H E A L T H Y B O U N D A R I E S
E X A M P L E S O F B O U N D A R I E S
• How$to$treat$other$family$members$(personal$space,$respect,$language$used$amongst$each$other)
• Going$out$–$Where,$when,$with$whom,$and$how$often
• Driving$and$use$of$cars$(who,$when,$who$pays$for$gas,$etc.)
• Knowing$where$family$members$are$when$they$are$out
• Having$guests$in$the$house
• Who$pays$for$what$
• Use$of$telephone$and$internet
• Sharing$housework$
• Curfew$
• Scheduled$mealtimes$–$being$present$at$mealtimes$
B E P R E P A R E D F O R E S C A L A T E D S I T U A T I O N S
Those%in%early%recovery%often%return%home%with%anxiety,%depression,%and%fear.%Persistent%
complaints,%increased%anger,%and%insomnia%may%be%related%to%stress,%feelings%of%
inadequacy%or%loss%of%control.%%It%is%easy%to%become%frustrated%and%angry%yourself%when%
dealing%with%this%type%of%behavior%fro%a%loved%one.%With%the%proper%mindfulness%and%
control%of%your%own%emotions,%you%will%be%able%to%refocus%the%discussion%and%ultimately%
save%your%loved%one%from%becoming%further%escalated%or%even%relapse.%%%DeOescalation%can%
simply%be%described%as%“defusing”%or%“talking%down”%the%agitated%individual%into%a%calmer%
state%without%the%need%to%either%agree%or%disagree%with%what%they%are%saying.

7. S E Q U O I A C L U B
While$your$loved$one$is$in$treatment$we$suggest$you$attend$Al?Anon$and/or$Nar?Anon$meetings.$$Al?
Anon$and$Nar?Anon$are$free,$anonymous$meetings$for$friends$and$families$of$loved$ones$who$suffer$
from$chemical$dependency.$$They$are$the$family$version$of$AA$(Alcoholics$Anonymous)$and$NA$
(Narcotics$Anonymous).$$Meetings$are$designed$to$share$experiences$in$a$safe,$non?judgmental$
environment$with$families$who$share$your$same$struggles.$Joining$a$support$group$gives$families$the$
opportunity$to$learn$more$about$addiction,$treatment,$and$the$recovery$process$from$people$who$have$
been$in$you$and$your$loved$one’s$shoes.$$You$will$Find$support$group$meetings$to$be$one$of$the$easiest$
and$most$beneFicial$aspects$of$recovery.
Family$support$groups$help$you$cope$with,$and$overcome$this$period$in$life$through$the$support$of$
your$own$family,$families$in$similar$situations,$and$by$using$a$12?step$method$approach.$$Please$
understand$genuine$12?Step$groups$are$not$religions,$but$rather$focused$solely$on$spiritual$principals$
such$as$honesty,$open?mindedness$and$powerlessness.$
There$are$few$social$opportunities$in$life$where$you$can$experience$the$level$of$honesty,$courage,$and$
support$that$you$will$Find$at$a$12?step$group$meeting.$$Being$involved$in$the$12?step$program$is$an$
amazing$experience.$$12?steps$groups$are$universally$available.$$You$will$Find$them$in$almost$every$
country$and$every$city$around$the$world$as$they$are$the$most$trusted$method$of$maintaining$sobriety$
on$earth.$Not$only$are$they$universally$available,$they$are$also$free$and$millions$of$people$have$
recovered$through$them.$$You$probably$understand$the$importance$of$doctors,$therapists,$and$
counselors$involved$in$recovery,$but$what$most$do$not$know$is$how$12?step$group$work$is$imperative$
to$long?term,$life$long$recovery.$
A T T E N D S U P P O R T G R O U P S / M E E T I N G S
BENEFITS(OF(12(STEP(MEETINGS(
• Overcome(denial(of(addiction%–%You%see%that%addiction%can%affect%anyone.%%Good%people%with%good%
jobs%and%good%families%can%experience%addiction.%%Sometimes%it%takes%seeing%other%people%going%
through%the%same%thing%to%understand%that%you%are%not%alone.%You%will%feel%stronger%when%you%belong%
to%a%group.%%Addiction%can%be%an%isolating%disease,%12OStep%groups%give%you%the%opportunity%to%reach%out%
and%ask%for%help%from%people%who%understand%what%you%are%going%through.
• Perception(of(recovery(–%Recovery%may%seem%like%a%farOfetched%idea.%%You%will%meet%people%who%have%
recovered%from%addiction%and%who%have%rebuilt%their%lives%and%families%from%the%ground%up.%%%You%will%
learn%they%didn’t%do%anything%extraordinary%or%have%special%privileges%to%get%where%they%are.%They%
worked%hard%and%followed%the%few%simple%principles%of%12OSteps.
• 12>Step(meetings(are(a(resource%–%You%will%be%given%the%opportunity%to%ask%questions,%learn%how%to%
handle%life’s%situations%in%a%healthy%and%positive%way,%overcome%the%overwhelming%urge%to%use%or%help%
your%loved%one%overcome%their%urge%to%use;%all%with%people%who%have%been%in%the%same%boat.%%
• Non>judgmental(environment(–%It%is%hard%to%share%your%emotions%when%you%are%afraid%of%being%
judged%or%criticized.%%When%you%join%a%12OStep%group%you%are%surrounded%by%people%who%have%heard%it%
before,%done%it%before%and%know%that%you%are%not%crazy%because%of%the%things%you%think,%say,%or%do%
when%you%or%a%loved%one%are%using.%%They%understand%you.%They%understand%addiction.%
• Safe(harbor(from(daily(stressO%12OStep%meetings%are%a%safe%harbor%when%you%need%one.%%If%you’ve%had%
a%bad%day%you%can%go%to%a%meeting.%%By%the%end%of%the%meeting%your%stress%will%be%less,%you%will%be%
reminded%that%troubles%are%part%of%life%and%that%we%all%share%them%O%just%as%we%do%joy%and%happiness.%
Meetings%are%a%wonderful%resource%for%gratitude%and%recharging%hope.%

8. S E Q U O I A C L U B
SUPPORT GROUP RESOURCES
$If$you$have$any$questions$regarding$recovery$resources$for$your$family$or$loved$one$feel$free$to$contact$the$$
$Above$It$All$Aftercare$Coordinator.$
William$Rosser$Tolan
$Aftercare(Coordinator
(909?744?2465
$william.tolan@aiatc.com
Al>Anon:$$Al?Anon$is$a$twelve?step$program$for$
friends$and$family$members$affected$by$someone$
else’s$alcoholism.$$To$Find$meetings$in$your$
community$log$on$to…
http://www.al?anon.org/local?meetings
Nar>Anon:$$$Nar?Anon$is$a$twelve?step$program$for$
friends$and$family$members$affected$by$someone$
else's$addiction.$$To$Find$meetings$in$your$
community$log$on$to$…
http://www.nar?anon.org/Find?a?meeting$$
Alcoholics$Anonymous$(AA):$$AA$is$an$
organization$of$alcoholics$whose$purpose$is$to$stay$
sober$and$help$others$recover$from$the$disease$of$
alcoholism.$$To$Find$meetings$for$your$loved$one$
log$on$to…
http://www.aa.org/pages/en_US/Find?local?aa
Narcotics$Anonymous$(NA):$$NA%is%
an%international%association%of%support%groups%for%rec
overing%drug%addicts,%with%a%12O
step%program%patterned%after%Alcoholics%Anonymous.%%
To%Gind%a%meeting%for%your%loved%one%log%on%to…
http://www.na.org/MeetingSearch/
F O R Y O UF O R Y O U R L O V E D O N E
Call Your Admissions Representative for More Information

9. S E Q U O I A C L U B
10
Above It All Aftercare Overview
Who is Aftercare and what does Aftercare do?
Aftercare$is$a$team$of$experienced$and$compassionate$staff$members$dedicated$to$making$your$loved$one$
feel$comfortable$and$cared$for$while$in$treatment$and$long$after$they$discharge$from$the$program.$Your$
loved$one$builds$a$supportive$relationship$with$our$Aftercare$staff$shortly$after$arriving$at$our$facility,$and$
learns$how$to$use$this$relationship$to$support$their$recovery$when$they$return$to$the$world.$In$addition$to$
long$term$peer?support$through$phone$calls$and$emails,$After$care$maintains$a$database$of$national$support$
resources$such$as$meeting$locations,$job$and$educational$assistance$programs$as$well$as$counseling$and$
therapy$resources$around$the$country.$
Above It All Alumni Program
The$Alumni$program$is$also$a$part$of$Aftercare$and$involves$an$online$support$group,$annual$events,$and$
inspirational$stories$and$thoughts$shared$amongst$clients$who$have$completed$our$program.$The$Alumni$
program$is$a$wonderful$tool$for$clients$to$stay$connected$with$the$many$supportive$relationships$they$made$
while$in$treatment,$this$includes$facility$staff$as$well$as$their$Above$It$All$peers$in$recovery.$
How will my loved one access Aftercare?
Aftercare$is$part$of$the$orientation$process$of$Above$it$All,$and$your$loved$one$starts$to$build$a$relationship$
with$Aftercare$while$they$are$in$treatment.$Post$discharge$Aftercare$will$follow$up$with$you$and$your$loved$
one.$$Aftercare$will$continue$for$a$year$following$treatment$at$Above$It$All.$$The$option$to$extend$your$
Aftercare$is$available$and$is$customizable.$You$can$continue$to$extend$your$Aftercare$every$year$for$as$long$
as$you$wish$free$from$charge!$
What can clients and their families ask Aftercare for help with?
The$client$and$family$can$reach$out$to$their$Aftercare$Coordinator$at$any$time$for$any$reason.$Since$our$
aftercare$program$is$customizable,$we$can$work$with$the$client$to$Find$what$the$best$way$to$keep$in$touch$is.$$
Whether$it's$calling$every$week$or$every$other$week,$looking$for$help$to$Find$new$meetings,$help$with$
Finding$employment,$requesting$more$recovery$CD's$or$just$checking$in$to$have$a$good$conversation$with$
someone$who$has$been$there$?$Aftercare$is$your$dedicated$support$resource.
What is the Aftercare Treatment Plan?
While in treatment, your loved one along with AIAAftercare as well as their therapist creates an Aftercare
Treatment Plan. This plan serves as a blue print for your loved one to follow once they return home. The plan
includes locations and contacts for sober support meetings, doctors and therapists, medicine regimens as well as job
and educational resources back home. Each$week$an$Aftercare$Coordinator$will$reach$out$with$weekly$calls$to$
check$on$your$loved$one’s$progress.$$Aftercare$will$also$include$weekly$mailings$of$motivational$audio$CDs$
from$recovery$speakers.$$Weekly$check?in$calls$will$continue$for$the$First$eight$weeks$after$treatment.$$After$
which$the$regular$check?in$phone$calls$will$happen$once$a$month$and$will$continue$for$the$remainder$of$the$
year.$$As$each$client$is$unique,$your$Aftercare$plan$will$be$catered$and$scheduled$to$your$needs$and$likings.$
$If$you$have$any$questions$regarding$Aftercare$or$the$Aftercare$treatment$plan$please$feel$free$to$contact$the$$
$Above$It$All$Aftercare$Coordinator.$
William$Rosser$Tolan
$Aftercare(Coordinator
(909?744?2465
$william.tolan@aiatc.com
RECOVERY HAPPENS IN LIFE, TREATMENT IS JUST THE
BEGINNING

10. 37 Warning Signs of a Relapse
The Phases And Warning Signs of
Relapse
by Terrance Gorski & Marlene Miller
(This is taken from a paper written by Terence Gorski and Marlene Miller.
THE RELAPSE SYNDROME
Relapse does not happen when the addict takes the first drug or drink.
Relapse is a process that starts long before the addict begins to use. The
relapse process causes the addict to feel pain and discomfort when not
using. This pain and discomfort can become so bad that the addict
becomes unable to live normally when not using. In Alcoholics
Anonymous this is called a dry drunk but the syndrome is recognized in
all areas of addiction and is in essence, abstinence without recovery. The
discomfort can become so bad that the addict feels that using can’t be
any worse than the pain of staying clean.
PHASE 1: RETURN OF DENIAL.
During this phase the addict becomes unable to recognize and honestly
tell others what s/he is thinking or feeling. The most common symptoms
are:
1. Concern about well-being: The addict feels uneasy, afraid and
anxious. At times s/he is afraid of not being able to stay drug-free. This
uneasiness comes and goes, and usually lasts only a short time.
2. Denial of the concern: In order to tolerate these periods of worry, fear
and anxiety, the addict ignores or denies these feelings in the same way
s/he had at other times denied being addicted. The denial may be so
strong that there is no awareness of it while it is happening. Even when
there is awareness of the feelings, they are often forgotten as soon as the
feelings are gone. It is only when the addict thinks back about the
situation at a later time that s/he is able to recognize the feelings of
anxiety and the denial of those feelings.

11. PHASE 2: AVOIDANCE AND DEFENSIVE BEHAVIOUR.
During this phase the addict doesn’t want to think about anything that will
cause the painful and uncomfortable feelings to come back. As a result,
s/he begins to avoid anything or anybody that will force an honest look at
self. When asked direct questions about well-being, s/he tends to become
defensive. The most common symptoms are:
3. Believing “I’ll never use again”: The addict convinces self that s/he
will never use again and sometimes will tell this to others, but usually
keeps it to self. Many are afraid to tell their counselors or other fellowship
members about this belief. When the addict firmly believes s/he will never
use again, the need for a daily recovery program seems less important.
4. Worrying about others instead of self: The addict becomes more
concerned with the recovery of others than with personal recovery. S/he
doesn’t talk directly about these concerns, but privately judges the
recovery programs of other recovering persons. In the fellowship this is
called “working the other guy’s program”.
5. Defensiveness: The addict has a tendency to defend when talking
about personal problems, feelings or his/her recovery program even when
no defense is necessary.
6. Compulsive behavior: The addict becomes compulsive (“stuck” or
“fixed” or “rigid”) in the way s/he thinks and behaves. There is a tendency
to do the same things over and over again without a good reason. There is
a tendency to control conversations either by talking too much or not
talking at all. S/he tends to work more than is needed, becomes involved
in many activities and may appear to be the model of recovery because of
heavy involvement in Fellowship 12 step work e.g. chairing meetings. S/he
is often a leader in counseling groups by “playing therapist.” Casual or
informal involvement with people however is avoided
7. Impulsive behavior: Sometimes the rigid behavior is interrupted by
actions taken without thought or self- control. This usually happens at
times of high stress. Sometimes these impulsive actions cause the addict
to make decisions that seriously damage his/her life and recovery
program.
8. Tendencies towards loneliness: The addict begins to spend more
time alone. S/he usually has good reasons and excuses for staying away
from other people. These periods of being alone begin to occur more

12. often and the addict begins to feel more and more lonely. Instead of
dealing with the loneliness by trying to meet and be around other people,
he or she becomes more compulsive and impulsive.
PHASE 3: CRISIS BUILDING
During this phase the addict begins experiencing a sequence of life
problems that are caused by denying personal feelings, isolating self and
neglecting the recovery program. Even though S/he wants to solve these
problems and works hard at it, two new problems pop up to replace every
problem that is solved. The most common symptoms are.
9. Tunnel vision: Tunnel vision is seeing only one small part of life and not
being able to see “The big picture.” The addict looks at life as being made
up of separate, unrelated parts. S/he focuses on one part without looking
at other parts or how they are related. Sometimes this creates the
mistaken belief that everything is secure and going well. At other times,
this results in seeing only what is going wrong. Small problems are blown
up out of proportion. When this happens the addict comes to believe s/he
is being treated unfairly and has no power to do anything about it.
10. Minor depression: Symptoms of depression begin to appear and to
persist. The person feels down, blue, listless, empty of feelings.
Oversleeping becomes common. S/he is able to distract self from these
moods by getting busy with other things and not talking about the
depression.
11. Loss of constructive planning: The addict stops planning each day
and the future. S/he often mistakes the slogan “One day at a time” to
mean that one shouldn’t plan or think about what s/he is going to do. Less
and less attention is paid to details. S/he becomes listless. Plans are
based more on wishful thinking (how the addict wishes things would be)
than reality (how things really are)
12. Plans begin to fail: Because s/he makes plans that are not realistic
and does not pay attention to details, plans begin to fail. Each failure
causes new life problems. Some of these problems are similar to the
problems that had occurred during using. S/he often feels guilty and
remorseful when the problems occur.

13. PHASE 4. IMMOBILISATION
During this phase the addict is totally unable to initiate action. S/he goes
through the motions of living, but is controlled by life rather than
controlling his/her life. The most common symptoms are.
13. Daydreaming and wishful thinking: It becomes more difficult to
concentrate. The “if only” syndrome becomes more common in
conversation. The addict begins to have fantasies of escaping or “being
rescued from it all” by an event unlikely to happen.
14. Feelings that nothing can be solved: A sense of failure begins to
develop. The failure may be real, or it may be imagined. Small failures are
exaggerated and blown out of proportion. The belief that “I’ve tried my
best and recovery isn’t working” begins to develop.
15. Immature wish to be happy: a vague desire “to be happy” or to have
“things work out” develops without the person identifying what is
necessary to be happy or have things work out. “Magical thinking” is
used: wanting things to get better without doing anything to make them
better.
PHASE 5. CONFUSION AND OVERREACTION
During this period the addict can’t think clearly. S/he becomes upset with
self and others, becomes irritable and overacts to small things.
16. Periods of confusion: Periods of confusion become more frequent,
last longer and cause more problems. The addict often feels angry with
self because of the inability to figure things out.
17. Irritation with friends: Relationships become strained with friends,
family, counselors and fellowship members. The addict feels threatened
when these people talk about the changes in behavior and mood that are
becoming apparent. The conflicts continue to increase in spite of the
addicts efforts to resolve them. The addict begins to feel guilty and
remorseful about his/her role in these conflicts.
18. Easily angered: The addict experiences episodes of anger,
frustration, resentment and irritability for no real reason. Overreaction to
small things becomes more frequent. Stress and anxiety increase
because of the fear that overreaction might result in violence. The efforts
to control self adds to the stress and tension.

14. PHASE 6: DEPRESSION
During this period the addict becomes so depressed that s/he has
difficulty keeping to normal routines. At times there may be thoughts of
suicide, using or drinking as a way to end the depression. The depression
is severe and persistent and cannot be easily ignored or hidden from
others. The most common symptoms are.
19. Irregular eating habits: The addict begins overeating or under eating.
There is weight gain or loss. S/he stops having meals at regular times and
replaces a well balanced, nourishing diet with “junk food.”
20. Lack of desire to take action: There are periods when the addict is
unable to get started or get anything done. At those times s/he is unable
to concentrate, feels anxious, fearful and uneasy, and often feels trapped
with no way out.
21. Irregular sleeping habits: The addict has difficulty sleeping and is
restless and fitful when sleep does occur. Sleep is often marked by
strange and frightening dreams. Because of exhaustion s/he may sleep for
twelve to twenty hours at a time. These “sleeping marathons” may happen
as often as every six to fifteen days.
22. Loss of daily structure: Daily routine becomes haphazard. The addict
stops getting up and going to bed at regular times. Sometimes s/he is
unable to sleep, and this results in oversleeping at other times. Regular
meal times are discontinued. It becomes more difficult to keep
appointments and plan social events. The addict feels rushed and
overburdened at times and then has nothing to do at other times. S/he is
unable to follow through on plans and decisions and experiences tension,
frustration, fear, or anxiety that keep him/her from doing what needs to be
done.
23. Periods of deep depression: The addict feels depressed more often.
The depression becomes worse, lasts longer, and interferes with living.
The depression is so bad that it is noticed by others and cannot be easily
denied. The depression is most severe during unplanned or unstructured
periods of time. Fatigue, hunger and loneliness make the depression
worse. When the addict feels depressed, s/he separates from other
people, becomes irritable and angry with others, and often complains that
nobody cares or understands what s/he is going through.

15. PHASE 7: BEHAVIOURAL LOSS OF CONTROL
During this phase the addict becomes unable to control or regulate
personal behavior and a daily schedule. There is still heavy denial and no
full awareness of being out of control. His/her life becomes chaotic and
many problems are created in all areas of life and recovery. The most
common symptoms are.
24. Irregular attendance at fellowship and treatment meetings: The
addict stops attending fellowship meetings regularly and begins to miss
scheduled appointments for counseling or treatment. S/he finds excuses
to justify this and doesn’t recognize the importance of fellowship and
treatment. S/he develops the attitude that meetings and counseling aren’t
making me feel better, so why should I make it a number one priority?
Other things are more important.
25. Development of an “I don’t care” attitude: The addict tries to act as
if s/he doesn’t care about the problems that are occurring. This is to hide
feelings of helplessness and a growing lack of self-respect and self-
confidence.
26. Open rejection of help: The addict cuts self off from people who can
help. S/he does this by having fits of anger that drive others away, by
criticizing and putting others down, or by quietly withdrawing from others.
27. Dissatisfaction with life: Things seem so bad that the addict begins
to think that s/he might as well use because things couldn’t get worse.
Life seems to have become unmanageable since using has stopped.
28. Feelings of powerlessness and helplessness: The addict develops
difficulty in “getting started;” has trouble thinking clearly, concentrating,
and thinking abstractly; and feels that s/he can’t do anything and begins
to believe that there is no way out.
PHASE 8: RECOGNITION OF LOSS OF CONTROL
The addict’s denial breaks and suddenly s/he recognizes how severe the
problems are, how unmanageable life has become, and how little power
and control s/he has to solve any of the problems. This awareness is
extremely painful and frightening. By this time s/he has become so
isolated that there is no one to turn to for help. The most common
symptoms are.

16. 29. Self pity: The addict begins to feel sorry for self and often uses self
pity to get attention at Fellowship meetings or from members of family.
30. Thoughts of social using: The addict realizes that drinking or using
drugs would help him/her to feel better and begins to hope that s/he can
drink/use normally again and be able to control it. Sometimes these
thoughts are so strong that they can’t be stopped or put out of mind.
There is a feeling that drinking/using is the only alternative to going crazy
or committing suicide. Drinking/using actually looks like a sane and
rational alternative.
31. Conscious lying: The addict begins to recognize the lying and the
denial and the excuses but is unable to interrupt them.
32. Complete loss of control: The addict feels trapped and overwhelmed
by the inability to think clearly and take action. This feeling of
powerlessness causes the belief that s/he is useless and incompetent. As
a result there is the belief that life is unmanageable.
PHASE 9: OPTION REDUCTION
During this phase the addict feels trapped by the pain and inability to
manage his/her life. There seems to be only three ways out – insanity,
suicide, or drug use. S/he no longer believes that anyone or anything can
help him/her. The most common symptoms are.
33. Unreasonable resentment: The addict feels angry because of the
inability to behave the way s/he wants to. Sometimes the anger is with the
world in general, sometimes with someone in particular, and sometimes
with self.
34. Discontinuance of fellowship attendance and all treatment: The
addict stops attending Fellowship meetings. When a helping person is
part of treatment, tension and conflict develop and become so severe that
the relationship usually ends. The addict drops out of professional
counseling even though s/he needs help and knows it.
35. Overwhelming loneliness, frustration, anger and tension: The
addict feels completely overwhelmed. S/he believes that there is no way
out except using, drinking, suicide, or insanity. There are intense fears of
insanity and feelings of helplessness and desperation.

17. PHASE 10: ACUTE RELAPSE PERIOD
During this phase the addict becomes totally unable to function normally.
S/he may use drugs or alcohol or may become disabled with other
conditions that make it impossible to function. The most common
symptoms are.
36. Loss of behavioral control: The addict experiences more and more
difficulty in controlling thoughts, emotions, judgments, and behaviors. This
progressive and disabling loss of control begins to cause serious
problems in all areas of life. It begins to affect health and well-being. No
matter how hard s/he tries to regain control it is impossible to do so.
37. Acute relapse period: The addict experiences periods of time when
s/he is totally unable to function normally. These periods become more
frequent, last longer, and begin to produce more serious life problems.
The relapse cycle is ended by a serious crisis which causes the person to
become totally unable to function for a period of time due to one or more
of the following:
A. DEGENERATION OF ALL LIFE AREAS: The addict may become
unable to contribute to the work, social, family, and intimate areas of life.
As a result, all life areas suffer due to neglect.
B. DRUG OR ALCOHOL USE: The addict may begin to use drugs or
alcohol as a means to escape the pain and desperation. There may be an
attempt to control using/drinking by limiting the amount or attempting one
short term binge. The ability to control using/drinking is soon lost. This
sometimes happens very quickly. Sometimes it occurs after a period of
controlled using/drinking. The addict returns to out of control
using/drinking with symptoms experienced during the last period of
addictive use.
C. EMOTIONAL COLLAPSE: The addict may become emotionally unable
to function, may overreact or become emotionally numb, or cry or fly into
a rage for no reason at all.
D. PHYSICAL EXHAUSTION: It may become impossible for the addict to
continue to function due to physical exhaustion.
E. STRESS RELATED ILLNESS: The addict may become physically sick
due to the severe stress that has been occurring for a long period of time.

18. F. PSYCHIATRIC ILLNESS: The addict develops a severe psychiatric
illness such as psychosis, severe anxiety, or severe depression. The
psychiatric illness may be so severe that it forces the addict into
treatment.
G. SUICIDE: The addict may become suicidal and may attempt or actually
commit suicide.
H. ACCIDENT PRONENESS: The addict may become careless and
unable to take normal precautions in acts of living, resulting in a sequence
of accidents. These accidents may take the form of car accidents, falls,
burns, etc. Often the accidents are life threatening or create serious injury.
I. DISRUPTION OF SOCIAL STRUCTURES: The addict may be unable to
maintain involvement in normal life activities, may become socially unable
to function
CONSTRUCTING A PERSONALISED RELAPSE WARNING SIGN LIST
Check three to five warning signs from the preceding list that you find most
interesting or relevant to you. In your own words, rewrite the summary title
of each warning sign that you checked. The summary title is the
word or short phrase at the beginning of each warning sign.
1.Write a brief paragraph that describes, in your own words, each of the
warning signs that you have selected.
2.Read your warning signs (as you have written them) to an addictions
counselor, your fellowship sponsor, or a friend, and ask for
feedback. Rewrite the warning signs if they are unable to
understand clearly what you mean.
3.Review the list every morning and every evening to remind yourself to
look for the presence of these warning signs.
4.Discuss the list with your group, friends and family and ask them to tell
you if they see any warning signs