Recent Relapse - question on CBT and different drugs

[silverjohn]

I currently had a pretty bad relapse., I've been diagnosed with severe Alcohol Use Disorder. I've been through a number of 30-day rehabs, in countless IOP program, in the past 2.5 years. I have a psychologist, psychiatrist. I'm on gabapentin, zoloft, antabuse, and naltrexone. They do't appear to be working too well.

I'm a 30ish professional who's been relatively successful, so I like to think I know what I'm talking about.

Would anyone know of good CBT (Cognitive Behavioral Therapy), or at least non-AA rehabs on the East Coast, preferebly closer to DC. All the ones I research seem to be out west or Minnesota. Or at least not-too-much AA, I'm not too against it but I can only handle so much of it. I've been to smart recovery, but it's been hard to get to given my schedule.

Also, any advice on medication would be useful. I wonder about topiramate, baclofen, and nalmefene. I don't know my doctor would subscribe any of those, though. Also, I'm wondering if I really need to be away for so long. I don't think there's evidence in 30-day rehabs, patients tend to relapse just as frequently as people in outpatient programs. I would miss my son's 2nd birthday.

Unfortunately alcohol doesn't have many proven treatments. Certainly not AA (for some people, but not on average), CBT is slightly more effective for people in general. Also, group therapy doesn't have a great track record (for some people, but again not on average). Naltrexone only seems to work for some poeple. I've discovered I can drink on antabuse with few severe consequences. The gabapentin works at reducing stress for sure, but it's no silver bullet.

Any suggestions on what to do. Personally, I'd like to stick to my current treatment, but maybe investigate new medication, but I'm getting all sorts of pressure from friends and family to do the 30-day thing, which I don't think they really understand is like (they'll send me magazines that get confiscated, e.g.). I've had bad experiences with in the past (I can't stand the crazy rules and being treated like a teenager). I know some aren't like that though.

Also, part of my resistance to 30-days is I have two young children, they are staying with their mother, we are separated, but I can't stand being away from them.

Any ideas, especially people with experience with CBT, topiramate, baclofen, nalmefene, would be great.

[bobbo1]

May sound strange but reading a book helped me. 'The Easy Way to Stop Drinking' by Allen Carr. It's a little tedious to read but it sure puts a lot of sense into the whole situation.
'

[Guitarista]

Hi Silver John,

It's a headgame this boozing caper for me. So i need to get my head where i want it.

So, CBT, mindfulness, meditation, yoga, exercise, fresh air/breathe, vegetables, fruit, and a huge decisive mental turnaround with some serious, committed, daily self care using any or all of the above with daily action is a successful recipe for many. P.S. I found CBT beneficial and it made complete sense to me so i could use the strategies.

If i can get my thinking right, i'm ahead of the game. For me it was my thinking not my drinking that was the problem. All of these strategies are thousands of years old and we know they bring with them positive outcomes. But only you can know what will work for you through trial and error.

Best wishes friend. You can do it. G

[badger]

you may want to take a look at "The Sinclair Method" using Naltrexone/Nalmefene:

http://en.wikipedia.org/wiki/Sinclair_Method

Nalmefene is much the same as Naltrexone & the effect is to block opiod receptors in the brain. neither works particularly well (for most people) as an anti-craving med (which is presumably how you're using Naltrexone currently), but it does have a good success rate using The Sinclair Method. more info here:

http://www.thesinclairmethod.net

there is an outpatient program in Florida I think, but most people do it themselves, either via a prescription from their Doctor, or via purchasing the meds online

hope that is of some help/interest

-badger

[Pavati]

I agree, it is a headgame.

What if instead of thinking you were being treated like a teenager at the rehab or therapy, you gave up your ego and were willing just to do what they said, suspending your disbelief and working on accepting that they might know what they're doing. I didn't spend time in rehab, but I heard from someone who did that checking his ego at the door was what made it work. He didn't always WANT to do what they said, but he just, as our NoSugar would say, faked it until he made it.

Just realized this is an old post - you probably won't see it, but there it is. I hope you found your way out!

[jane27]

any good rehabs on east coast you know - not personally
has baclofen been effective for you - have not tried it, have read some stories that made me nervous about its safety
has topiramate been effective for you - killed drive to eat and drink. couldnt sleep. made me very depressed w/suicidal ideation
has cognitive behavioral therapy been effective for you - yes, in part

[hoping4better]

Hi Silver,
I am heading to a non-12-step recovery center in Florida on sunday. I have done a ton of research and this seemed like a good option for me. I also have kids (a 9 yr old and teenage triplets -- with all of their drama) and I hemmed and hawed for years, trying baclofen, the Sinclair method, etc. But I know myself and, at this point, don't have the discipline for outpatient therapy. And I couldn't connect with AA. Been to many of those meetings and it made me want to go home and have a drink....

My husband filed for divorce and has temporary custody of our son, so this was a no-brainer for me. But I was ready to do something about it. I think that's the key -- you have to really want to be free of the substance abuse chains. I never quite could. But in the face of a glass or 6 of chardonnay vs having my son -- well, that was my wake-up call.

The place I am going to uses neo-CBT, as well as a bunch of other therapies (some holistic) to empower you and give you tools for coping with life and your addiction. I can't vouch for it yet, but if you're interested it's Gulf Breeze Recovery in Florida.

I will report on my stay in 6-8 weeks. Hope you find your peace.