WeConnect is an app to support addiction recovery

https://techcrunch.com/2016/09/13/weconnect-is-an-app-to-support-addiction-recovery/

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Keeping close, quantified track of personal progress is absolutely imperative for one group of people: recovering alcoholics and drug addicts. And it’s this often isolated segment of society that the startup behind the WeConnect app is aiming to help.

The team was chosen as today’s wildcard battlefield startup here at TechCrunch Disrupt SF 2016, plucked from silicon alley to present their product on stage. They also won theTechCrunch Seattle Meet-Up this summer.

Their app-based support platform includes context-sensitive notifications to encourage timely communication within support groups; a dashboard view that structures the user’s day with activities they view as beneficial to their wellbeing (such as prayer or meditation); and ongoing tracking of their personal progress at attending recovery program meetings — including using geofencing to determine they really attended a particular meeting and even how long they spent there.

It also includes an SOS button a user can press to send a message requesting specific pre-slected contacts get in touch — for moments when they’re feeling really low or in need of immediate support.

The startup behind WeConnect, which describes itself as a social purpose corporation, is using technology to try to combat the sense of isolation that can cause addicts to relapse, says co-founder Daniela Tudor.

Tudor, a former addict herself, came up with the idea for the app during her time in rehab after realizing she wanted a way to stay in contact with the people she met during her recovery program — and who helped her stay on track.

“There’s three components to recovery,” she explains, demoing the app. “One is communication. So adding your connections; the second is clarity — so that’s whatever activity you consider part of your recovery, that keeps you centered and a good connection in relation with yourself. The third party of the recovery, which is probably the most crucial, initially especially, is what your in person support routine is — so that’d include any of these 12-step or CBT cognitive behavioral therapy sessions.”

There’s also a rewards element built in to the app, with users able to earn things like coffee coupons and yoga lessons as they build progress towards their goals. She notes the team intentionally stayed away from loading too much gamification into the app to avoid making the technology itself potentially problematic.

“We give rewards that feedback into your recovery loop, like yoga, fitness classes, coffee coupons. We didn’t want to gamify it too much because we believe that triggers another addiction — which is technology. So we’re giving only activities out or rewards that feed the person’s soul or their connection to their community or their own recovery.”

Unlike other recovery or wellness apps she says WeConnect is private — pointing out there’s no way to search for other users on the app; it’s necessary to have a fellow user’s email and phone number in order to add them as a contact.

“They have to confirm that you want them as part of your network. We’re also HIPAA compliant,” she adds.

As well as helping former addicts to keep on track, the team is also providing data to the treatment providers who are working with them. They’re intending to monetize via this route in time, although their primary mission is a social one, to support as many addicts as possible, says Tudor.

“For the treatment providers the huge value adds that we are is obviously improving outcomes gets them more referrals. The other part is that we provide them valuable data. Insurance companies are starting to cover treatment less and less — they’re looking for actual data-centric tools that can measure the success rate of programs, and how effective the approach,” she says.

“The data’s out there that relapse rates are extremely high… It’s actually an opportunity for them to take that data and improve, and keep also centres and other providers accountable to a healthy treatment program that actually saves lives and reduces relapse,” she adds.

Tudor has been working on the app since 2014, meeting one of her co-founders at a Startup Weekend event.

The closed beta of WeConnect was launched this June — it’s currently being used by in-patient treatment/rehab centers in Arizona, Washington and California as the team gathers more data to be able to prove their app can reduce relapse rates. After that, they intend to make their pitch to insurance companies.

Beyond the initial focus on drug and alcohol addiction Tudor says they see potential to expand the support tech to address a broad spectrum of recovery needs, such as eating disorders and even people on domestic violence rehab programs.

They’ve raised a $525,000 seed round of funding thus far, from strategic investor Steve Moak of Benevolent Ventures — and are now looking to raise a $3 million Series A at a $15 million valuation.

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Judges Q&A

Q: Have you tested this and do you have evidence of success and efficacy?
A: We just started our early adopter program but we’ve had clients that have been using the platform who’ve told us it has definitely improved their accountability and communication. And we also track data on a daily basis to see how much people are on the app, what they’re interacting with on there, and what they’re staying accountable to.

Q: One thing I was wondering is can individuals who use WeConnect find someone else to connect to on the app?
A: When they’re on-boarded they have to add a minimum of two connections… but that’s up to the individual to be empowered and create that accountability community around them.

Our app is very private so you’re not searchable. And we’re also HIPAA compliant so you create your own circle of accountability on there.

Q: I see why you’re going to treatment programs first. It is a smaller market but you have a better chance of having people fully engage with the product… But what use cases could you potentially just use parts of the product for? Is it an all or nothing thing? Or is there a partial way that still has value for a potentially larger market.
A: We’re planning to also go for eating disorders, domestic violence recovery, and create another standalone product for tech recovery. And then there is potentially even larger markets beyond that.

Q: The people who were facing these programs before you had this app, it was all paper and phone calls? Tell me more about that? And from your tests what is the most valuable feature people have said they found in the app?
A: When I walked out of treatment 28 days sober I had to get out of a bad relationship and go to meetings… all of that is extremely overwhelming… This creates a tight accountability and instant support network in your pocket… That’s how we’re solving that problem.

The second question, they’ve said there’s two things: one, just seeing their progress from the past week when they’re getting down on themselves has been rewarding. And then the rewards themselves, they’re motivating them to do more activities than they would do in the first place.

Q: Is it too early to tell or could it dramatically increase results in recovery?
A: Yes, that’s our goal.

Q: What’s the business model thinking?
A: Currently we’re in the early adopter program. That price point is $365 – so $1 a day for a 12 months subscription per patient that we provide to the patient treatment center. That’s just our early adopter program pricing because it’s new. So we’re going to determine a different pricing model after that. But b2b.

Q: So the treatment provider pays not the patient?
A: So it depends. Some treatment centers are footing the cost themselves and some of them are taking that cost and putting it within the aftercare plan that they have for their patient – which also includes outpatient and check ins and a couple of oher features. So it depends. It’s a personal choice for the treatment center. But we bill the treatment center.

Q: Do insurance companies or medicare cover addiction programs?
A: They do. And we were approached today by two insurance companies and they’re really excited about what we’re doing but again the reason we want to be patient first is to get that data to give a really robust presentation to insurance companies.

Q: What’s your specific advantage? The technology is not difficult right so anyone could potentially do the same thing. Is your advantage in your experience?
A: I come from tech but I’m also in recovery. And my business partner also came from that space but having relationships in the recovery community that are really important to have. He does strategic partnerships and we both have experience in this space… Not anybody can just do this.

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BOOK: Between Breaths by Elizabeth Vargas

From the moment she uttered the brave and honest words, “I am an alcoholic,” to interviewer George Stephanopoulos, Elizabeth Vargas began writing her story, as her experiences were still raw. Now, in BETWEEN BREATHS, Vargas discusses her accounts of growing up with anxiety-which began suddenly at the age of six when her father served in Vietnam-and how she dealt with this anxiety as she came of age, to her eventually turning to alcohol for relief. She tells of how she found herself living in denial, about the extent of her addiction and keeping her dependency a secret for so long. She addresses her time in rehab, her first year of sobriety, and the guilt she felt as a working mother who had never found the right balance.

Honest and hopeful, BETWEEN BREATHS is an inspiring read.
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Can a pill cure alcoholism? Film looks at how prescription drugs can fight addiction

http://www.cbc.ca/radio/thecurrent/the-current-for-january-20-2016-1.3411477/can-a-pill-cure-alcoholism-film-looks-at-how-prescription-drugs-can-fight-addiction-1.3411539

Between one and 10 per cent of Canadians receive evidence-based treatment.

Mike Pond,Vancouver psychotherapist and an alcoholic, and his partner, Maureen Palmer, set out to make a film exploring the latest science on addiction treatment.

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VIDEO: http://www.cbc.ca/i/caffeine/syndicate/?mediaId=2680839377

Research shows that addiction is approximately 60 per cent inherited and 40 per cent environment.

Their documentary Wasted by Bountiful Films, airs Jan. 21 on The Nature of Things on CBC-TV

video2

VIDEO: http://www.cbc.ca/i/caffeine/syndicate/?mediaId=2680642946

 

People with a substance abuse problem are three times more likely to have a mental illness.

In this segment The Current spoke to:

  • Mike Pond,  psychotherapist in private practice.
  • Maureen Palmer, filmmaker and journalist.
  • Dr. Evan Wood, professor of medicine and Canada research chair at UBC.  He’s also an addiction physician and medical director for Addiction Services for Vancouver Coastal Health.

If you, or a loved one, have struggled with alcoholism and getting treatment, or if you have experience with the medications for alcoholism, let us know how effective they were for you.  

Send us an email. Reach out on Facebook or on Twitter@TheCurrentCBC.

This segment was produced by The Current’s Liz Hoath.

Professional cellist reveals she hid her alcohol addiction by sipping vodka on stage from a water bottle

Read more: http://www.dailymail.co.uk/femail/article-3397499/Professional-cellist-reveals-hid-alcohol-addiction-sipping-vodka-stage-water-bottle.html#ixzz3xKTka6KF

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Rachael, pictured performing Scala at London, recalls how she would perform on stage at venues like The Royal Albert Hall and lean down to have sips of alcohol from her water bottle in every break

 

An award-winning cellist who has been on tour with London Grammar and worked with Beyoncé and Alt-J has revealed how her life was nearly ruined by an addiction to alcohol.

Rachael Lander, 31, from South London has been sober for eight years after realising she was risking her career, health and happiness with her dependency.

At the height of her problem, she was decanting vodka into water bottles first thing in the morning in supermarket toilets so she could sip the alcohol in secret on stage.

‘I was doing some high powered stuff playing in professional orchestras but I was doing it drunk,’ she admitted, sharing her story in a new Channel 5 documentary on alcoholism airing this evening.

Rachael recalls how she would perform on stage at venues like The Royal Albert Hall and lean down to have sips of alcohol from her water bottle in every break in her performance.

She said: ‘I would think “I just have to get through to that sip”, that was how I was living.

‘I spent a lot of time in the public toilets of supermarkets putting own brand supermarket vodka into water bottles and then wrapping the glass bottle and putting it in the Tampax bin quietly.

‘I would see myself from above and think “what is wrong with this picture? How did this happen?”‘

She believed her high-pressured career was to blame after she discovered her love of the cello at the age of eight and followed in the footsteps of her parents to become a professional musician like them.

‘I really fell in love with the instrument, I really wanted to be the best cellist and I worked really hard, sometimes I think it was my first addiction, it gave me an escape from myself,’ she said.

She attended the Royal Northern College of Music (RNCM) in Manchester and then joined the National Youth Orchestra where she would take part in the BBC Proms led by world-class conductors.

But as much as she loved the cello, she said performing under such pressure in front of large audiences with renowned conductors caused her to feel anxious and nauseous.

‘When I was sitting in orchestra sections my heart would start beating and I could feel adrenaline like a chemical,’ she said.

‘I was really conscious of the fact there was lots of people there looking at me and I had to keep my s**t together otherwise everyone would know.

‘I was angry with myself all the time, I thought “pull yourself together”.’

Teenage heartbreak then led her to discover that alcohol could banish her feelings of fear and anxiety.

She said: ‘I had a break-up when I was 17, I felt awful and I drank a brandy and it took the edge off.

‘I thought, “hello that’s it”, from that minute the link had been made in my head, you don’t have to take it anymore, you can feel like this, I used to take it like medicine.’

Rachael said she started to carry vodka in her handbag ‘just in case’ she needed a sip to calm her nerves ‘and be able to function’ and this led to her drinking it throughout the day.

Like many alcoholics, she didn’t think she had a problem.

‘The real tragedy of alcoholism is you are the only person who doesn’t know you have got it,’ she admits.

As she continued to feel unhappy, she believed her career was to blame so she decided to give up playing the cello and become a waitress.

‘I thought there is no way I will drink like this as a waitress because I won’t be scared all the time,’ she said.

However she admits it was then ‘bewildering and depressing to find on her way to work as waitress I would feel panicky and need a drink and then I would be a drunk waitress.

‘I remember thinking “f*** it is not the cello, it is me”.’

Rachael shares her story in the Channel 5 documentary along with other alcoholics who reveal how they became addicted and then finally found the road to recovery after realising they had a problem.

As she kept losing jobs because of her alcohol addiction she knew she had to get help as ‘I couldn’t live the way I was but I couldn’t live without the alcohol either.’

After confiding in a therapist, Rachael was referred to group therapy sessions with other addicts which helped her deal with her problem.

She said speaking to others who knew exactly how she felt made a huge difference.

‘People would say “just cut down” they didn’t understand,’ she said.

‘At the meetings I met people who did understand and they didn’t judge, they weren’t even sympathetic, they just said “yes”.’

It was also at the meetings that she met her husband, Rob, and they now have a baby together.

Rachael has been sober for eight years and picked up her cello again with her career going from strength to strength.

In recent years, she has recorded with artists including Beyoncé, Rudimental and George Michael.

She also appeared on a Channel 4 programme Addicts’ Symphony in 2014, where ten classical musician – whose lives had been blighted by addiction – were brought together for a special concert.

However mother Rachael admits she is ‘terrified of falling off the wagon’ and now won’t touch alcohol at all.

She said: ‘I don’t think I am recovered alcoholic. I am a recovering alcoholic. If I have a drink I know all the good stuff I have done will be gone.

‘People say “you will have a drink eventually right?” But now I feel would rather have my leg amputated than have a drink.’

Speaking about how she has managed to kick the habit, she said: ‘To get to that point of realising I could never drink again it had to sink in.

‘I had to realise I am an alcoholic, I am powerless over my desire to drink and when I start, I can’t stop drinking.

‘Sobriety has been an exercise in feeling difficult stuff and not using anything on it.’

I’m An Alcoholic: My Name Is is on Channel 5 this evening (Wednesday) at 10pm 

Read more: http://www.dailymail.co.uk/femail/article-3397499/Professional-cellist-reveals-hid-alcohol-addiction-sipping-vodka-stage-water-bottle.html#ixzz3xKUMYGEQ

THE LAST HURDLE: How chef Matty Matheson beat alcoholism

http://www.theglobeandmail.com/life/health-and-fitness/health/how-chef-matty-matheson-beat-alcoholism/article27982486/
AS TOLD TO JON SUFRIN
Special to The Globe and Mail
Published Friday, Jan. 01, 2016 1:59PM EST
Last updated Friday, Jan. 01, 2016 2:27PM EST

The Globe and Mail

The Globe and Mail

What does it take to vault a personal obstacle? This is part of a collection of stories in which five Canadians reflect on leaping over the barrier that was holding them back. Read the other stories here.

I have been a psychopath since forever, an all-or-nothing kind of guy. I remember going to concerts at an early age. I would sneak into bars at 16, and I got my first tattoo at 17. I got kicked out of high school for fighting. I beat up a kid pretty bad.

Me and my friends would drive around on the hoods of our cars. We were the kings of bush parties. We’d bring out drums and have big fires, and the after-party was always at my house.

Eventually, I got into culinary school at Humber. It was the only college I got accepted to. I had a natural ability, and I instantly loved it. After, I got a job at Le Sélect Bistro. That was where I learned to make classic French food, where I fell in love with everything.

Then I worked at La Palette, and that was debauchery. You want to talkKitchen Confidential? That was us drinking every night, doing drugs, partying. It was an actual pirate ship. I’ve never listened to more Tom Waits in my life.

When I opened Oddfellows, it was just an extension of that. All I had to do was cook good food, and I could party. You drink till 6 a.m., you sleep till 11. Then on your days off, you drink really hard.

When Parts and Labour hit, it got crazy. There were no rules. It was the craziest restaurant, the loudest restaurant in the city. I could party even harder, because I had a team, and I didn’t have to cook cook any more. I was doing drugs and alcohol every day. We had the perfect space for it. I’d do anything. I loved coke, I loved MDMA, ecstasy, K. I’d take any pill. Smash three Ms, do an eight-ball.

Then, when I was 29, I had a heart attack. Everything kind of caught up. I woke up with this crazy pain. It was like something was gripping my heart, and I couldn’t make it stop. It was something I’ve never felt.

Doctors said I was lucky to be alive. I was in the hospital for five days, back to work in 10. I was supposed to take time off, but restaurants don’t stop. I quit partying for about three months. Then I had a drink, and all of a sudden, I was back in the grips of partying.

My friends, my girlfriend, everyone was worried about me. I didn’t care that I’d had a heart attack, but everyone else did. I had drug dealers that wouldn’t sell me drugs. I started going to different bars, and I started getting different drug dealers.

I didn’t want the party to be over, but everyone was getting off the party. Everyone was growing up, and everyone was trying to make Parts and Labour a really good restaurant. And I kept on being the kid. Everyone was just tired of Matty fucking everything up.

I kind of had an intervention. It was three friends, and they just said, “You’re done.” And I said, “Okay, I’m done.” I haven’t had a drop in two years. It’s still an ordeal every day. I travel the world, and I can’t drink wine. I miss drinking really good wine and beer.

My identity was the party guy. Any chef that came from out of town would come and want to party. Chefs love living well, but there’s a fine line between living well and going past excess. Like why are you chugging champagne? I was the loudest, the craziest. I was the showboat.

Everything has changed in those two years. I’ve filled up with other shit. I oversee four restaurants. I’m working on an international show with Vice; I’m working on a cookbook. I’m about to have a kid. I can do everything, because I’m never hung over. I wake up in the morning, and I get a lot done before noon. I never used to wake up before noon.

This has given me everything I ever wanted. Now I’m at the beginning of who I actually am. The best version of me is this. It’s not the party guy, it’s not the drunk funny chef. It’s me.

How Much Alcohol Is Safe? Perhaps Less Than We Thought

http://www.forbes.com/sites/alicegwalton/2016/01/08/how-much-alcohol-is-safe-perhaps-less-than-we-thought/

JAN 8, 2016 @ 01:00 PM

The British government has just updated its guidelines for how much alcohol is safe to consume, based on the latest research. The recommendations are stricter than earlier ones, which had been issued back in 1995, and were due a tweaking. And interestingly, they come in the same week as the U.S. issued its new and somewhat vaguer dietary guidelines, which sparked serious controversy in the other direction–with critics arguing they were far less strict and scientifically grounded than they should be. So should we follow the more sciencey lead of the Brits? Possibly–but remembering that moderation is generally good advice for most things.

Photographer: Martin Divisek/Bloomberg

The major change in the U.K.’s new guidelines, issued by Dame Sally Davies, Chief Medical Officer for England, is that both sexes should follow the same advice: Men and women alike should stick to no more than 14 units of alcohol per week, which is the equivalent of five to six pints of beer, or six to seven glasses of wine, per week. The previous upper recommendation for men had been 21 units per week, and 14 units for women. So what’s really changed is that the recommendations for men have been reduced to what they’ve been for women for a long time. The hope is that the risk of disease, cancer in particular, will also be reduced with the new recommendations.

The authors add that there’s really no safe level of drinking–any level, they say, carries some health risk with it–except for women over 55. “Drinking any level of alcohol regularly carries a health risk for anyone,” said Davies, “but if men and women limit their intake to no more than 14 units a week it keeps the risk of illness like cancer and liver disease low.” For women over the age of 55, five units per week offers some heart benefit, but over this amount, the benefit disappears.

And for pregnant women, a glass here or there won’t do. Although total abstinence during pregnancy has in the U.S. been somewhat more a subject for debate in recent years, the new recommendations in Britain make clear that abstinence is best. “I want pregnant women to be very clear that they should avoid alcohol as a precaution,” said Davies. “Although the risk of harm to the baby is low if they have drunk small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant.”

Finally, a person shouldn’t “save up” their drinking all for one night of the week. That is, 14 units on a Saturday night is much more hazardous to one’s health than having two units per night. Binge drinking has in recent years had some damning research behind it, as at the same time it’s become clear that more people binge drink than previously thought.

Some critics have condemned the new recommendations for being too strict and serving as an example of government fear-mongering. But as Davies told the BBC, this isn’t scare tactics, it’s science. “If you take 1,000 women, 110 will get breast cancer without drinking. Drink up to these guidelines and an extra 20 women will get cancer because of that drinking. Double the guideline limit and an extra 50 women per 1,000 will get cancer. Take bowel cancer in men: if they drink within the guidelines their risk is the same as non-drinking. But if they drink up to the old guidelines an extra 20 men per 1,000 will get bowel cancer. That’s not scaremongering, that’s fact and it’s hard science.”

Whether other countries will follow suit remains to be seen. The new U.K. recommendations are now the tightest in Europe–and given how fuzzy the new dietary guidelines in the U.S. are, we may not jump on the strict-and-sciencey bandwagon any time soon. But if nothing else, maybe the U.K.’s move will make policy makers in the U.S. and other countries think about putting science first, and standing behind it.

http://www.forbes.com/sites/alicegwalton/2016/01/08/how-much-alcohol-is-safe-perhaps-less-than-we-thought/2/

What It’s Like To Go A Month Without Alcohol, Sugar, And Caffeine

https://www.yahoo.com/health/what-its-like-to-go-a-month-without-alcohol-109506721152.html

Amanda Chan
Deputy Editor
January 29, 2015

Could you do it? (Photo courtesy of Phoebe Lapine)

Phoebe Lapine is a food writer, chef, and creator of the website Feed Me Phoebe. She’s also undergoing a year-long endeavor, which she calls “The Wellness Project,” that involves a new health- or beauty-related challenge every month. Yahoo Health is catching up with Phoebe each month to see how she fared — so you can take her tips and teachable moments and apply them to your own life.

Yahoo Health: What was the challenge for January?

Phoebe Lapine: For this month’s experiment, I chose to go off of my two vices — caffeine and alcohol — along with added sugar. I also did it last March because my skin was a disaster at the time.

What was the hardest part about it?

Cutting out added sugar. The thing with cutting out added sugar is that you’re also cutting out processed foods. I swapped out sugary breakfast bars for homemade smoothies, I limited packaged foods, and I treated myself to other indulgences — like massages — instead of sugary indulgences of the dessert variety. But the problem with cutting out sugar is that there are so many not-obvious foods that have it.

For alcohol, the hardest part was surprisingly the loneliness and social isolation. It’s not that I needed alcohol to have fun, but I felt like I was missing out from connecting with other people.

Caffeine was surprisingly not that hard to go without. I realized that I was drinking caffeine-filled drinks as part of my morning ritual. After the initial withdrawal hump, I didn’t really need the caffeine to function.

What changes will you make going forward?

For sugar, I try to read ingredient labels. I don’t drive myself crazy trying to calculate the added sugar, but I do use the sugar information on labels to make decisions about what I do and don’t consume.

For alcohol, I drink now for the taste. I drink more slowly, and if I don’t like what I’m sipping, I’ll put it down and socialize sans drink.

And for caffeine, I now have a cup of green or herbal tea in the mornings. It allows me to keep my morning ritual.

For Phoebe’s full rundown of her month without sugar, caffeine and alcohol, be sure to check out her post on her website Feed Me Phoebe. You can also follow Phoebe on Facebook, Twitter, Google+, Pinterest, and Instagram.

Going Public With Alcoholism

http://www.huffingtonpost.com/fran-moreland-johns/going-public-with-alcoholism_b_5569484.html

by 

Writer/blogger and Author of ‘Perilous Times: An inside look at abortion before – and after – Roe v Wade’

 

I am, among other things, an alcoholic.

When describing myself list-wise, alcoholic would probably come after writer, wife, activist, mom etc; but I am still, and in a very public way, an alcoholic. It’s the business of being public that puts me at odds with a lot of my fellow alcoholics. But I haven’t had anyone complain, and I am increasingly certain that going public isn’t such a bad idea.

Most alcoholics have very good reasons for keeping their anonymity. Outside of AA meetings their addiction — conquered or not — could cost them jobs, friendships, reputations. I lost some of all the above in my drinking days, but letting people know that those days are behind me poses no identifiable risks.

At six years alcohol-free, I moved to San Francisco in 1992 to marry the old friend known ever since as my Final Husband. I had to make a choice: Spend the rest of my life saying “No, thanks, I don’t care for one right now,” or, “You know, I’m an alcoholic. I can’t handle the stuff.” If I chose the latter, I figured I would soon not have to say it very often, if at all. I chose the latter, and never looked back.

The Final Husband, a man who does love his cocktail hour martini (gin, of course, up with a twist) and a good wine with dinner, bought into the plan. He would have far preferred a wife who would join him in wine appreciation, but took my word for the fact that I am an addict and vowed to support me. For the first several years of our alcohol-bifurcated union, he quietly took a bottle of non-alcoholic wine to cocktail parties so I could be comfortably unobtrusive. (This led to one rather hilarious episode that has become a favorite family story: From across the room in a crowded party thrown by one of San Francisco’s impeccably elegant hostesses, I once spotted a gentleman filling his lady friend’s glass from my non-alcoholic wine bottle. Unable to dive over the crowd to intercept, I watched as her pleasant smile turned to a disbelieving grimace and she set the glass down rather abruptly on a nearby table. We have imagined all manner of repercussions from this incident, but thought better of telling the hostess.)

From the beginning, I worked hard to craft comments that would not come across as judgmental or argumentative. Those were mild-mannered remarks like “I was a ‘social drinker’ for a long time but my drinking changed and became very bad for me.” Or, “Some of us can handle alcohol and some can’t. I really can’t.”

But I also fought hard against the common, almost reflexive attitude that being alcohol-free must leave my life barren and deprived, supremely dull. So I tried to say things like, “Whoa. I hated feeling like my words and thoughts were not super-sharp.” Or, “I really love waking up in the morning without feeling blurry, let alone hung over.” In the land of perpetual cocktail events, wine etiquette and Nectar-of-the-Gods believers, living outside that culture is generally assumed to be the worst of all worlds. I took the attitude that I’m delighted to see others enjoy themselves with alcohol, but for me, being without it is far more of a delight. Unadulterated joy, as a matter of fact. My comments at least carried the weight of demonstrated truth.

After the first few responses of shock and disbelief, my new friends on the Left Coast fairly quickly adapted to this strange situation and joined me in laughing about it all… or soon, ignoring the issue completely. I never imagined that it mattered to anyone but me. But here is why I suspect being public about being alcohol-free does indeed matter, and perhaps more of us should consider doing that.

One day I received a Valentine that reinforced my conviction about having taken the right course. It was from a woman I had known, though not intimately, for several years; we had frequently been together at concerts and parties. She is bright, pretty, accomplished in many areas, widely admired and respected. If anyone had ever suggested to me that she had an issue with alcohol I would have scoffed in utter disbelief.

The Valentine included several brief lines. She said she was sober now. She said I had influenced her to try that route to new life. Over the years I’ve gotten several other notes, like the email that just came, wanting to make sure I saw John Skoyles’ essay in the New York Times Sunday Review “about his coming of age with the bottle. I am 14 years plus now,” she wrote. “I have you to thank.”

It may be mid-summer, but that’s the best Valentine’s gift I’ve ever received.

Free Downloadable Therapy Worksheets & CBT Tools

Cognitive Behaviour Therapy (CBT) has been proven to help mental health problems.

This website (http://www.getselfhelp.co.uk/index.html) offers CBT self-help information, resources and including therapy worksheets on the FREE DOWNLOADS PAGES:  worksheets & handouts
The following Adobe documents are freely available for you to download for therapy purposes – just click on the picture to open the file (in a new tab/window), then save a copy to your computer.  Thumbnail pictures show only top half of portrait format documents.

CBT Self-Help Information Leaflets
Cognitive Models & Formulation Templates

http://www.getselfhelp.co.uk/freedownloads2.htm
http://www.queensu.ca/hcds/cs/resources/documents/ThoughtRecordSheet7.pdf

A Different Path to Fighting Addiction

JULY 3, 2014

http://www.nytimes.com/2014/07/06/nyregion/a-different-path-to-fighting-addiction.html

Carrie Wilkens works with substance abusers and families at the Center for Motivation and Change in Manhattan. Credit Kirsten Luce for The New York Times

When their son had to take a medical leave from college, Jack and Wendy knew they — and he — needed help with his binge drinking. Their son’s psychiatrist, along with a few friends, suggested Alcoholics Anonymous. He had a disease, and in order to stay alive, he’d have to attend A.A. meetings and abstain from alcohol for the rest of his life, they said.

But the couple, a Manhattan reporter and editor who asked to be identified only by their first names to protect their son’s privacy, resisted that approach. Instead, they turned to a group of psychologists who specialize in treating substance use and other compulsive behaviors at the Center for Motivation and Change.

The center, known as the C.M.C., operates out of two floors of a 19th-century building on 30th Street and Fifth Avenue. It is part of a growing wing of addiction treatment that rejects the A.A. model of strict abstinence as the sole form of recovery for alcohol and drug users.

Instead, it uses a suite of techniques that provide a hands-on, practical approach to solving emotional and behavioral problems, rather than having abusers forever swear off the substance — a particularly difficult step for young people to take.

And unlike programs like Al-Anon, A.A.’s offshoot for family members, the C.M.C.’s approach does not advocate interventions or disengaging from someone who is drinking or using drugs. “The traditional language often sets parents up to feel they have to make extreme choices: Either force them into rehab or detach until they hit rock bottom,” said Carrie Wilkens, a psychologist who helped found the C.M.C. 10 years ago. “Science tells us those formulas don’t work very well.”

When parents issue edicts, demanding an immediate end to all substance use, it often lodges the family in a harmful cycle, said Nicole Kosanke, a psychologist at the C.M.C. Tough love might look like an appropriate response, she said, but it often backfires by further damaging the frayed connections to the people to whom the child is closest.

The center’s approach includes motivational interviewing, a goal-oriented form of counseling; cognitive behavioral therapy, a short-term form of psychotherapy; and harm reduction, which seeks to limit the negative consequences of substance abuse. The psychologists also support the use ofanti-craving medications like naltrexone, which block the brain’s ability to release endorphins and the high of using the substance.

A 2002 study conducted by researchers at the University of New Mexico and published in the journal Addiction showed that motivational interviewing, cognitive behavioral therapy and naltrexone, which are often used together, are far more effective in stopping or reducing drug and alcohol use than the faith-and-abstinence-based model of A.A. and other “TSF” — for 12-step facilitation — programs. Results of an updated study have not yet been released.

Researchers elsewhere have come up with similar findings. In 2006, the Cochrane Library, a health care research group, reviewed four decades of global alcohol treatment studies and concluded, “No experimental studies unequivocally demonstrated the effectiveness of AA or TSF approaches for reducing alcohol dependence or problems.” Despite that research, A.A.’s 12-step model is by far the dominant approach to addiction in America.

Jack and Wendy’s son, who is in his early 20s, began drinking to alleviate crippling anxiety and ease persistent depression. His drinking, while worrisome, was not an entrenched pattern, his parents believed. Some of Jack’s friends suggested that if their son did not attend A.A. of his own volition, the only thing Jack and Wendy could do was attend Al-Anon.

“The implication was that there was no other solution,” Jack said. “There was a great deal of sadness on their part, empathetic sadness, which in some ways was frightening in itself.”

“A lot of people credit A.A. with saving their lives,” he added. “It’s understandable that they can’t dissociate themselves from a program that worked for them. But it’s an all-or-nothing commitment for life. That really freaked me out.”

In A.A.’s literature, “alcoholism” is defined as “a progressive illness that can never be cured.” Members describe themselves as being “in recovery,” which translates to lifelong abstinence and adherence to the 12 steps mapped out in the Big Book, published four years after the organization was founded in 1935. First among them is the obligation for members to admit their “powerlessness” over alcohol. It also relies heavily on faith; God is mentioned in five of the 12 steps.

On a warm evening last month, about a dozen parents gathered to hear Dr. Kosanke describe the center’s program for families, which goes by the acronym Craft, for Community Reinforcement and Family Training. It rejects, she said, the use of three words: “addict,” “alcoholic” and “enabling,” a term often used to describe the acts of loved ones that help perpetuate unhealthy behaviors.

Instead of addict or alcoholic, she prefers the terms favored by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, or the DSM-V, which says that patients suffer from “alcohol use disorder” or “substance abuse disorder,” terms that convey a spectrum of severity.

“Substance use takes on a lot of different shapes and sizes,” Dr. Kosanke said. “There are real downsides to labeling a child with a lifetime identity, when that truly may or may not turn out to be the case.”

And calling caring behavior enabling, she said, has a way of turning even acts of kindness into something negative. “Our field hasn’t done a good job of defining it in a narrow way that’s appropriate,” she said. “If you give your kid money knowing he will go buy pot, that’s enabling. If you take your kid to soccer practice, you’re encouraging healthy behavior. That’s not ‘enabling.’ ”

Part of the Craft approach has parents take care of themselves, too, said Lorraine McNeill-Popper, who volunteers for the parent hotline at thePartnership for Drug-Free Kids, a nonprofit group devoted to recovery for young people. “If you are sleep-deprived and stressed out, how can you think clearly?” she said.

Ms. McNeill-Popper has her own family history of drug abuse. Her twin brother died of an overdose, and she adopted his son, who later became a heavy marijuana user and ended up in rehab. “I tell parents, ‘It’s like when you’re on an airplane, and they tell you to put the oxygen mask over yourself first. That way you can help with the others.’ ”

The center’s approach is controversial in the recovery world. David Rotenberg, executive vice president of treatment at the nonprofit Caron Treatment Centers, a large drug and alcohol rehabilitation provider with branches in several states, cautioned against approaches that do not set abstinence as a goal.

“The majority of people who are chemically dependent would love to be able to drink and drug in a more moderate fashion,” Mr. Rotenberg said. “Most drug addicts and alcoholics would love to drink just a couple of drinks, and they try to do so, with poor results.”

The C.M.C. doctors say treatment for young people needs to be tailored for them, since teenagers and young adults are neurologically, psychologically, socially and legally different from adults, and have different treatment needs.

Dr. Wilkens founded the center with a fellow psychologist, Jeffrey Foote, in 2003. The two had worked together in larger hospital-based treatment centers where they struggled to introduce evidence-based treatments, she said. When it opened, the C.M.C. was one of the few centers in the nation that were not tethered to the 12-step model, she said.

“It was our strong belief that you can work with people at any stage of change, ranging from ‘I’m not even sure I have a substance problem’ all the way to ‘I just got out of rehab and want to go to A.A. meetings every day,’ ” Dr. Wilkens said. “We don’t have a judgment on how you address your substance use problem. Maybe A.A. is helpful to you and you find everything you need there. If it’s not, we genuinely believe there are many strategies for helping to resolve them.”

In fact, a majority of college binge drinkers do not go on to become alcohol dependent, said Stanton Peele, a Brooklyn psychologist who has studied substance use for decades and is a longtime critic of the A.A. model. While binge drinking and other drug use are risky, multiple studies show that most people “mature out” of such recklessness when they begin to have increased responsibilities.

A federally financed study of 43,000 randomly selected Americans, called the National Epidemiologic Survey on Alcohol and Related Conditions, orNesarc, found that 75 percent of those who are heavy drinkers eventually regain control without rehab or A.A., Dr. Peele said. The survey, which was conducted in the early 2000s and was designed to be representative of the larger United States population, was aimed at helping researchers understand high-risk drinking patterns, design better-targeted treatment programs and monitor recovery. It found that over half of those who recover managed to cut back instead of abstaining, Dr. Peele said.

“Isn’t it more encouraging to know that most people are going to outgrow these habits than to think they’re going to have a disease for the rest their lives?” Dr. Peele asked. “The data show that the odds are in your favor.”

Dr. Wilkens is familiar with that pattern. She was a college binge drinker herself and also struggled with bulimia. Once she left her home state of Kansas for New York City, where she attended Hunter College, she felt culturally stimulated and intellectually challenged, she said, and the drinking and disordered eating disappeared.

“When you focus on building up the world around you, you find stimulation and rewards that are very different from using drugs and alcohol. You find other ways of soothing yourself, and things can get better,” she said.

That is precisely what L.S. learned five years ago. L.S., a Manhattan lawyer in his early 30s who asked to be identified only by his initials to protect his privacy, spent nearly a decade as an episodic binge drinker. He began drinking as a student at his large Midwestern university, where he played rugby and where many of his best friends belonged to fraternities. Alcohol, he said, flowed freely through both subcultures. L.S. said he thought his drinking — weeks of no drinking followed by serious binges of a few dozen drinks over several days — would end after college. Yet the behavior did not fade. The morning after his wedding, he awoke with a hangover that lasted a day and a half.

His father, who drinks socially, told him that people either were alcoholics or were not. But L.S. was unprepared to accept that label and began researching moderation on his own. He found a New York branch ofModeration Management, or M.M., a secular, peer-led support group that takes a cognitive behavioral approach.

In contrast to A.A., which stresses a drinker’s lack of power in the presence of alcohol, M.M. encourages personal responsibility for drinking. The group, founded in 1993, encourages members to start with an alcohol-free month, and then allows for the reintroduction of moderate amounts of alcohol. (Critics note that one of its founders, Audrey Kishline, was involved in a fatal accident while driving drunk. She left the group in January 2000 with the intention of joining A.A., and three months later, crashed head-on into another vehicle, killing the driver and his 12-year-old daughter.)

L.S. now attends hourlong meetings once a week at which he and about a dozen others discuss their goals for moderate drinking, as well as tips, challenges and progress on avoiding triggers. Since he began attending, L.S. limits himself to about five drinks a week, well below the 14 drinks M.M. advises as a safe limit for men.

L.S. is convinced that there is no single approach for all problem drinkers. “M.M. doesn’t profess to work for everybody. It has a scientifically based approach that works for some people,” he said.

The C.M.C. psychologists are blunt about the reasons many teenagers and young adults use drugs: When it comes to decreasing anxiety and relieving depression, substances tend to work for the short term. “Kids aren’t crazy for using them,” Dr. Wilkens said. “They have an effect that is reinforcing in some way. If you understand that, you can strategically work to support and reinforce other healthy, competing behaviors.”

That approach runs through the book she wrote with Dr. Foote and Dr. Kosanke, “Beyond Addiction: How Science and Kindness Can Help People Change.” It was published in February, just as the death of Philip Seymour Hoffman from a heroin overdose struck fear in the hearts of many parents whose children use drugs. It landed Dr. Wilkens on several talk shows and drew scores of calls to the center. (In addition to its New York office, the group has opened a residential treatment center in the Berkshires.)

Dr. Wilkens’s message struck a chord with Wendy. Her son had just left school, and the couple was exploring treatment options. Wired in the evenings with extreme anxiety, he drank excessively to get himself to sleep. Once in bed, he’d stay there till 5 p.m.

Before she read the book, Wendy said, she would stomp upstairs hourly to announce in an exasperated voice, “It’s 2 o’clock. You’ve got to get out of there.”

“I’d do that three or four more times and then be fuming,” she said. “I’d be fuming all day, at home doing my work and knowing he was upstairs sleeping off whatever he’d been drinking the night before.”

After learning the Craft approach, Wendy said, she stopped nagging, changing her negative, accusatory tone to a more pleasant one by asking open-ended questions.

Today, Wendy and Jack’s son is working with his psychiatrist and getting help for his depression and anxiety. He seems to be bingeing much less. When the family went out to dinner on a recent night, the parents each ordered a beer or a glass of wine and sipped slowly through dinner. “How will he learn moderation if he doesn’t see it modeled?” Wendy asked.

Ellie hopes her daughter, too, will be able to change her drinking patterns. Ellie is a New York editor, who asked that her last name be withheld to protect her family’s privacy. Her daughter, 23, has struggled with binge drinking since she was 16. While her daughter graduated from college and holds a responsible job, she still binges on weekends. “It’s so much a part of the culture, it’s everywhere,” Ellie said. “She says she’d have no social life if she stopped drinking.”

Ellie, who grew up in a home in which many relatives attended A.A., at first tried Al-Anon. “They talk about ‘disengaging,’ ” she said. “But it’s your child, and I’m not one of those people who can put her out on the street.”

While their daughter has resisted treatment so far, Ellie and her husband have begun seeing a therapist at the C.M.C. to better navigate their relationship.

“My child is much more than a label or a diagnosis,” she said. “She’s not a problem to be solved, but a child to be loved and guided toward a better life.”