new habits

How the Abstinence Violation Effect Affects Recovery

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

Have you ever made a determination to start a new habit and have you been able to stay 100% dedicated to it through the remainder of your life? (insert cricket sound…) Of course, if you are reading this then you are still living and cannot confirm nor deny the attainment of this goal. If you are like most people, you set a goal to establish some new behavior which can be performed consistently and probably have sometimes where you fall short of your idealized expectations. Perhaps you said you would start waking up an hour earlier so you can exercise, or you’ve sworn off some specific type of food, only to find yourself having periodic success.

This is all a normal part of the change process. Setting a goal, taking steps to achieve it, and at times falling short. For those struggling with some form of addiction, this is a very relatable topic. Making a commitment to stop drinking only to find yourself days, weeks, months or years down the road ingesting alcohol. If you can relate with this, I’d like you to think of a time when you deviated from your goal to abstain and what your mind told you the moment you veered off that path. Did it say something to the effect of “Well, you’ve had one so you might as well drink the rest of the 6 pack…” or “I knew I couldn’t do this, afterall I am an alcoholic and I always screw things up and get drunk”, or even “I slipped yesterday so I am only at day one so I might as well keep going and I can start again tomorrow”. This type of thinking is a prime example of the Abstinence Violation Effect, or AVE.

The Abstinence Violation Effect is when there is any deviation from a desired behavior goal and this deviation is viewed as a total failure. This viewpoint that the deviation is a total failure is then used as a further justification to continue using or doing the addictive behavior. I have had clients that expressed after having one sip of a drink, they felt so badly and shameful for failing that this was the permission giving thought that getting drunk wouldn’t be any worse. After 5 years of sobriety, someone had a glass of champagne at a wedding and then felt that they had wasted their 5 years of sobriety and would have to start over anyway, so they ended up going on a binge for the next 18 months for fear of having to “start over”.

While this phenomenon is common with all types of people, it is often seen the most in those who put a strong emphasis on total consecutive days sober, as opposed to cumulative days sober. If you’ve struggled with an addiction, imagine the most acute period when you were struggling, and then imagine if someone told you that you would have 5 years sober, with only a glass of champagne, or one use of your addiction over the course of those 5 years.  Would you see that as a victory, or would you focus on the fact that you had one day out of 1,825 days where you engaged in your addiction and therefore failed?

It is suggested to work on staying in the moment and not beating yourself up for deviating from the path of your desired goal. Just like your phone navigation system will autocorrect when you drive off the assigned path, so too can you make a course correction if you fall back into an old behavior pattern, however short or long in duration. One sip is better than one beer, one beer is better than dusting off the whole 12 pack and so on. We need not use one slip to justify continued slips. An old quote I enjoy: Start where you are, use what you have, and do what you can!

Reducing Harms Associated with Substance Abuse

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment

For many who have been using alcohol or drugs problematically, the advice given from loved ones and many mental health professionals is they must remain abstinent from all mind-altering substances and any deviation from complete abstinence is a cause for major concern. This approach to substance abuse follows an all-or-nothing model that does not consider all the gray areas between severe problematic addiction and complete abstinence, and can often have devastating consequences when a slip, or a lapse, occurs.

Harm reduction is about reducing the harms associated with substance abuse. It can be applied to any circumstance where there is less harm, or the potential occurrence of harm, due to specific interventions or actions to reduce, substitute, or replace the use of a harmful substance. In the case of alcohol, if someone were drinking a fifth of vodka a day, and is now drinking a bottle of wine, the harm would be reduced because a bottle of wine has much less alcohol content.  If someone has been using heroin and now strictly uses cannabis, they will have reduced the harm of a potential lethal overdose. 

Harm reduction can come in many forms and will be greatly needed during a time when addiction is expected to climb 100% over the next two years (CCAPP, 2020). For opioid use disorder, there are two main medications, Naltrexone and Buprenorphine, both of which can come in oral or subcutaneous once-monthly injections. Naltrexone can also be used for those who are wishing to stop drinking or reduce their alcohol intake as it helps with cravings and reduces the euphoric effects of alcohol. Often times, people may not want to use medications to help them cut back, taper or assist them in maintaining their abstinence, but harm reduction approaches have been shown to be highly effective when compared with total days sober, and not just total days abstinent (Peele, 2020).  

When working with clients, my goal is to always help them find ways to reduce the harm, or the potential for harm, caused by their problematic use.  Expecting or demanding complete abstinence, when that is not the goal or desire for someone only sets them up for guilt, shame, and a potential self-fulling prophecy if a slip occurs, giving them the opportunity to tell themselves, “See, I knew I would fail at this.” Following a harm reduction model for those who are seeking it or require it based on medical necessity helps individuals build the self-efficacy and belief that they have power to change their behaviors and live a balanced life, free from the grasp of addiction.  

If you or a loved one have been told abstinence is the ONLY WAY, give Realize Recovery a call today and we can discuss options and provide education on the evidenced based treatments that have been proven to work. 

Peele, S. (2020, March 19). So Alcoholics Anonymous Is “Proven” to Work After All? Not So Fast. Retrieved October 12, 2020, from https://filtermag.org/alcoholics-anonymous-cochrane/

The Disease of Addiction Thrives on Isolation (Rep.). (2020, May 12). Retrieved https://www.ccapp.us/application/files/9715/8932/2072/Addiction_Thrives_on_Isolation.pdf

Mindfulness – Where is your mind?

Bryan Vasquez, CATC III, Certified Addiction CounselorLeave a comment
Mindfulness: By thinking differently, we develop new neural connections and diminishing the use of old connections, changing the landscape of our brain.

Many of us have heard of the term mindfulness and may feel like we have a general understanding of what mindfulness is about.   Common answers I hear when asking clients what mindfulness means to them are being aware, present, not focusing on negativity, and being in the here and now.  What commonly follows their definition is that mindfulness is very difficult to do regularly, doesn’t help them much, or it is a struggle to practice with so many distractions vying for their attention.  Being someone who has been practicing mindfulness daily for over a decade, I can agree that it is a challenge and a battle.  Just like any other learned behavior or habit change, it takes patience, consistency and determination to establish the habit of mindfulness on a regular basis. 

Why is mindfulness helpful?  Numerous studies strongly suggest that by practicing mindfulness one can lower anxiety and depression, cope with life stressors more effectively, improve life satisfaction and increase one’s sense of self-esteem and many other synergistic health benefits.  While all that sounds good, from a practical standpoint I find mindfulness helps me enjoy each day more fully, the time spent with others and activities I engage in.  The older we get the faster time seems to move. By practicing mindfulness, I find I can retain more information and fully experience each moment.  My attention isn’t concerned about the past (which is associated with regret or depression) or worried about the future (associated with anxiety and fear).  

Mindfulness can be so impactful because it is literally regrooving our brains.  By the simple act of thinking differently, we are developing new neural connections and diminishing the use of old connections, thus changing the landscape of our brain.  This is a subtle change and something that does not happen overnight.  An analogy: look at a picture of yourself 10 years ago, do your notice that you have changed physically?  Most of us would notice specific changes in our appearance when referencing a photo but we did not notice these changes happening daily, in the moment.  The same thing occurs with cognitive changes because they are so subtle, but when we look back a year or more we may notice we are completely different people.   

I’ve trained myself to get in the habit of thinking, where is my mind?  By being in the present moment, focused on the task or activity at hand fully and completely, I can plan for the future, handle stress, interact with others authentically, and live a life with no regrets because I am here now, experiencing the moment and nothing else.  This mindset helps me reflect on the past and what I have learned as well as plan for the future consciously and objectively, if those are things I need to think about.  I am no longer at the mercy of my intrusive thoughts aimlessly dragging me through the mud of regret, resentment, sadness, anxiety and fear.   

Next post we will jump into techniques and strategies for integrating mindfulness into our daily life and how to overcome common roadblocks which continue to pull us into fear, anxiety and depression.