alcohol withdrawal and blood pressure

Alcohol dependency creeps in stealthily, like a thief in the night. What might have begun as an evening relaxation ritual slowly encroached into your daily life. As tolerance to the effects of the alcohol increased, higher consumption seemed to follow. Over time, what started out as a panacea for stress or emotional issues became its own serious problem.

When facing the prospect of getting treatment for an alcohol use disorder, the thought of going through the detox and withdrawal stage may seem daunting. This initial hurdle, one that is essential to recovery, may be so dreaded that it becomes a serious barrier to treatment. In this event it is important to take the long view, to envision detox as just a short-lived challenge to overcome in order to enjoy a life free from the grip of alcohol.

Alcohol detox and withdrawal, however, does come with some risks. Although alcohol withdrawal symptoms can vary significantly from one individual to another, ranging from mild to severe, because of the unpredictable nature of these symptoms it is always advisable to obtain a medically monitored detox. Alcohol withdrawal and blood pressure elevation, or any one of several other serious symptoms, can evolve quickly into a medical emergency.

About Alcohol Use Disorder

Alcoholism is a chronic relapsing disease that impacts brain chemistry and the central nervous system. Once the body has become accustomed to the daily consumption of alcohol it will react when alcohol is withheld, initiating withdrawal symptoms that send you right back to the alcohol for relief. The symptoms of alcohol addiction or chemical dependence include:

  • Unable to stop drinking once started, never feeling sated
  • Being able to drink increasing levels of alcohol
  • Blacking out, having no memory of actions, whereabouts, or conversations
  • Lying about your level of drinking
  • Hiding alcohol from family members
  • Neglecting responsibilities at home or work
  • Relationship problems caused by excessive drinking
  • Attempting to stop drinking but cannot
  • Withdrawal symptoms emerge when attempting to stop

Alcohol use disorder has the potential to cause a slew of significant disruptions and negative consequences in one’s life. These might include:

  • Loss of employment
  • Damage to professional reputation
  • Legal problems, such as getting a DUI
  • Interpersonal problems, divorce
  • Social withdrawal and isolation
  • Financial problems
  • A co-occurring mental health disorder may develop

There are many reasons to take that first step toward sobriety. When facing down the detox and withdrawal phase of recovery, it is best to view it as a necessary first step to a new, healthy, and productive life.

The Importance of a Medically Monitored Detox

When someone with an alcohol use disorder decides to get sober there are some important things to consider. First, it is generally considered a bad idea to attempt to detox without a trained detox team supervising the process. The spectrum of withdrawal symptoms during alcohol detox is wide, from minor tremors and insomnia to the delirium tremens (DTs). Because of the potential for a serious medical emergency occurring during detox and withdrawal, it is usually recommended that the individual have a medically monitored detox.  This type of detox will provide the appropriate medical attention should alcohol withdrawal and blood pressure increases team up to cause a serious medical condition.

A medical detox provides the safest route to sobriety, where trained detox medical providers monitor the detox and withdrawal phase of early recovery. While supervising the process, the detox professional will utilize various medical and holistic interventions to help alleviate the painful withdrawal symptoms. Without this support, the difficulty experienced during detox can derail recovery right at the outset. The detox support team will provide medications, such as benzodiazepines, to assist with anxiety and insomnia, which can also help with alcohol withdrawal and blood pressure spikes, as these drugs are sedatives. In addition, they will access over-the-counter medications to help with fever and chills, nausea and vomiting, diarrhea, and other symptoms. The psychological support provided by a medical detox team is critical to helping the individual get through the challenging detox process and then safely transition to active treatment.

What to Expect During Alcohol Detox and Withdrawal

Upon entering the residential program a thorough intake interview will be conducted.  Health status, addiction history, and mental health history will be assessed in an effort for the provider to anticipate any potential risks during the detox process. The severity of symptoms is determined by various factors identified during the initial evaluation. These factors include:

  • The age of the individual
  • The general health status, if there are any medical conditions present
  • The length of history of the alcohol use disorder
  • The usual amount of alcohol consumed on a daily basis
  • The existence of another substance use disorder
  • The existence of a co-occurring mental health disorder

When an individual abruptly discontinues alcohol intake they will begin to experience withdrawal symptoms within 6-8 hours. Withdrawal symptoms are in response to the brain and central nervous system having made adjustments over time in response to the alcohol. Brain hyper-excitability ensues when the alcohol is withheld, leading to a range of highly uncomfortable symptoms.

Alcohol detox typically occurs in three stages. The first stage begins within 8 hours after the last alcoholic beverage and lasts about 24 hours. During this first stage, withdrawal symptoms include sweating, nausea, vomiting, hand tremors, irritability, and sleep difficulties. The second stage occurs on days 2-4 and involves the most intense symptoms, such as increased heart rate, elevated blood pressure and body temperature, mental confusion, mood swings, alcohol cravings, anxiety, and depression. The final stage, starting at day 4 and lasting 3-5 days, is the phase when symptoms begin to subside.

Alcohol withdrawal symptoms may include:

  • Shaky hands
  • Irritability
  • Nausea
  • Vomiting
  • Sweating
  • Headache
  • Agitation
  • Insomnia
  • Anxiety
  • Confusion
  • Hallucinations
  • Disorientation
  • Seizures

In some cases, unpredictable withdrawals symptoms can suddenly emerge on days 3-4, called the delirium tremens (DTs). For this reason, having medical personnel available who can manage the DTs is essential during the first 3 or 4 days of detox.

What Are the Delirium Tremens (DTs)?

In a small percentage of individuals, or 3%-5%, a medical emergency called the DTs can present a serious medical condition. The DTs might catch the individual completely off guard, which is why the development is so dangerous. In 5%-15% the DTs can lead to death. Alcohol withdrawal and blood pressure that rises dangerously, in addition to these symptoms, requires immediate medical intervention:

  • Grand mal seizures or convulsions
  • Delirium
  • Hallucinations
  • Hypertension
  • Very high fever
  • Cardiac arrhythmias
  • Hyperthermia

Getting help with DTs may mean a hospital stay to help stabilize the individual and improve the outcome. Treatment will involve benzodiazepines and/or barbiturates or phenobarbital, often using IV infusion for quick relief until symptoms stabilized and begin to subside. Dosing is determined by the specific withdrawal signs observed, such as delirium, and will incrementally be reduced over a period of several days once the severe symptoms have stabilized.

How is Alcohol Use Disorder Treated?

Alcohol addiction treatment immediately follows detox and withdrawal, and may involve an extended recovery program. The residential treatment setting provides the highest level of care, with 24-hour support and monitoring and a full schedule of daily treatment elements designed to help the individual overcome the alcohol addiction.

Alcohol recovery elements include:

  • Psychotherapy. Psychotherapy is the cornerstone of alcohol recovery, as it helps the individual examine underlying emotional issues or past traumas so these can be worked through. Cognitive behavioral therapy (CBT) provides a roadmap for making core changes in thought-behavior patterns that have kept a person trapped in addiction behaviors. The recovery skills learned in CBT help reframe disordered thinking into more positive, affirming thoughts.
  • Group sessions. Meeting with peers or family members to discuss topics related to recovery can help those in recovery learn how to communicate, and listen, more effectively.
  • Education. Learning about the impact of alcohol on brain chemistry and structure can be a deterrent to relapse, and includes guiding the individual with relapse prevention strategies and new coping skills.
  • Naltrexone. Naltrexone is a non-narcotic medication that can assist in reducing alcohol cravings and relapse for those who meet criteria for usage.
  • 12-step or similar programming. The meetings provide important peer support and the opportunity to share experiences, challenges, fears, and goals with others in recovery.
  • Adjunctive activities. Rounding out rehabilitation are several activities that augment the evidence-based therapies, including mindfulness training, yoga, massage, art therapy, acupuncture, recreational therapy, EMDR, equine therapy.

The Importance of Aftercare in Recovery

Consider addiction treatment and recovery as an ongoing continuum of care. The detox and withdrawal phase launches recovery, followed by therapy in a residential treatment program. But that is only the beginning of the therapeutic process. Aftercare, or continuing care, in addiction recovery involves ongoing interventions that can help to solidify and support recovery.

Through engagement in activities that reinforce sobriety, the chances of maintaining a sustained recovery are greatly improved. Individuals in early recovery are bound to encounter challenges to sobriety. These challenges may be emotionally overwhelming, possibly triggering a relapse. Aftercare options provide an added safety net where the individual will receive peer and professional support to help navigate these stressors as they occur. Aftercare efforts should include ongoing outpatient therapy, group therapy, and engagement in a recovery community.

Elevation Behavioral Health Provides Medical Detox for Alcohol Use Disorder

Elevation Behavioral Health is a Los Angeles-based residential recovery program that offers medical detox services and comprehensive addiction treatment for individuals with an alcohol use disorder. Our luxury accommodations and stunning setting help to provide comfort and healing while engaging in the comprehensive treatment program. For more information about the program, please contact Elevation Behavioral Health today at (888) 561-0868.

addiction and natural disasters

Substance Abuse Increases After Natural Disasters

Right now the news is saturated with heart wrenching stories about the victims of hurricane Harvey. It seems everywhere we turn there is more bad news about the damage done, people who will be displaced for years to come, and even fatalities. In addition to the aftermath of the hurricane in Houston, there are over 8,000 acres of wildfires currently burning in California caused by a severe heat wave.

Unfortunately, these tragic circumstances are often accompanied by something that is insidious and not quite as obvious as demolished houses: substance abuse. Psychology studies suggest that people abuse drugs and alcohol more often after natural disaster. While we cannot know the exact reasons for every case, it seems substances are often used to sooth psychological distress.

The Risk for People with Mental Health Disorders

Research shows that people who already have a mental health disorder are more likely to abuse substances after a natural disaster. One study assessed survivors for substance abuse after the Oklahoma City bombing. Researchers found that 6% of people without another mental health disorder used substances to cope. However, a staggering 13% – 40% of people with a mental health disorder abused substances as a coping mechanism.

If you or someone you know has been affected by the hurricane or fires and they have a mental health diagnosis, you might want to be extra cautious about substance use. It is important to offer people with these diagnoses mental health resources following tragic events. If we do not provide such support conditions can get worse as substance abuse rates rise.

Poverty and Proximity

Two of the biggest risk factors for substance abuse related complications are poverty and proximity to the natural disaster. One study published on looked at how often people were hospitalized for substance abuse disorders following Hurricane Katrina. The study found that people were hospitalized more for substance abuse ofter the hurricane. However, they found that this increase was even more dramatic among certain people. Specifically, low-income individuals and people living closer to the flood zones had a dramatic increase in the number of hospitalizations following the storm

Here is what we can assume based on this research: people who have less money and face the most devastation are at a higher risk of substance abuse after natural disasters. So, what can we do in order to help? You can donate money that will help the victims, support first response organizations, and make recovery easy to find. This means trying to find places for recovery meetings following disasters or volunteering to lead phone meetings.

Mental health and disasters

Statistics About Substance Abuse Following Disasters

Numerous studies about different disaster all over the world show the same thing. When a disaster happens the rates of substance abuse and even addiction go up.

  • In New Orleans, hospitalizations for substance abuse increased 2.5% in the years following Hurricane Katrina
  • Following 9/11, alcohol consumption went up 24.6%, smoking went up 18%, and marijuana use went up 3% among New Yorkers
  • After the devastating earthquake in Haiti, the rate of substance addiction went up more than 4%


Heads Up

The Global Journal of Mental Health

Why Substance Abuse Increases

It is impossible to say with certainty what causes substances abuse to rise after disasters. However, one good explanation is that people use drugs and alcohol in order to self soothe. Most of the studies mentioned above found that people had all kinds of psychological distress after disasters. In some cases this manifested as an increase in PTSD, depression, or anxiety. In others, people just reported feeling worse after these traumatic events.

Alcohol and other depressants effect the brain in such a way that it often has a down-regulating effect. In other words, these types of drugs feel calming for the mind and the body. To learn more about how some of these kinds of drugs effect your brain you can click here. People sometimes use these types of substances because it helps them relax or feel better. When you consider people often feel stressed and agitated after disasters, it makes sense why they would turn toward these substances for help.

Another reason that substance abuse might increase is that there are less available mental health services or places for social support. If you were in treatment for a mental health disorder and now you are unable to see your care provider or get your medication, it might make you feel like turning to substances. Likewise, if you went to church every week and now you are unable to you might start to feel isolated and alone. This lack of social support might be one big reason that substance abuse increases after natural disasters.

Healthy Ways to Cope with Stress

We know that a lot of this post has focused on what can go wrong after a natural disaster. However, there are ways to cope with psychological stress that are much healthier than drugs or alcohol. Of course, one of the big issues is that people are often torn from there homes and have few resources. So, it is important to remember the coping mechanisms that require little or no money and are relatively easy to do.

You can try meditating. Even just a few minutes of meditation might help boost your mood and calm you down. You don’t need any special equipment or even a phone. You can just sit on your bed for 2-5 minutes and focus on relaxing the different places of tension in your body. You can try other breathing exercises like taking in a deep inhale and making a “s” sound as you exhale very slowly. Elongating your exhale will engage the parasympathetic nervous system and help calm you down. You might also try striking up a conversation with a stranger, focusing on something that feels positive, or taking a short walk. All of these things have been shown to improve mood and functioning.

We know that it is hard to find healthy ways to cope when things get tough. There is arguably nothing more difficult to get through than the aftermath of a natural disaster. However, we hope that you are able to remain vigilant about the increased risk of substance abuse and hopefully find another way to get through the hard times.

Percocet Withdrawal Symptoms

Percocet Withdrawal Symptoms, Timeline, and Treatment

Prescription painkillers have been an increasingly popular recreational drug in the past few decades. As opioid use has been on the rise, much attention goes to heroin and not to it’s prescription cousins like Percocet®. SAMHSA’s 2014 National Survey on Drug Use and Health found that non-medical use of opioid painkillers is more common than many people realize.
Here are a few of their findings:

  • Almost two million Americans met criteria for prescription painkiller use disorder
  • About 1.4 million Americans tried painkillers recreationally for the first time in 2013
  • About 4.3 million Americans use prescription painkillers recreationally every month
  • The average age of first-time users was only 21.2 years

What is Percocet?

Percocet is the trade name for a mix of acetaminophen and oxycodone. Acetaminophen is a pain reliever and fever reducer best known by its trade name Tylenol®. Oxycodone is a semisynthetic opioid painkiller made from thebaine. It is commonly sold by itself under the trade name Oxycontin®. Together they make Percocet, a potent painkiller.

Percocet is most commonly taken orally as a pill, and may be prescribed for a number of different pains. According to the National Institute on Drug Abuse’s 2016 Monitoring the Future survey, over 11% of eight graders reported that it would be “fairly easy” or “very easy” to get prescription painkillers. People acquire oxycodone for recreational use by purchasing it from drug dealers, getting it from a doctor, or stealing it from a medicine cabinet. Because there are so many prescriptions written, it has be come relatively easy to acquire.

Withdrawal Symptoms

Like many other drugs, removing Percocet from your system may result in severe withdrawal symptoms. Unlike alcohol withdrawal or klonopin withdrawal, oxycodone withdrawal will not directly kill a person. However, the symptoms of withdrawal may be dangerous and indirectly lethal. Because of the level of discomfort withdrawal symptoms drive many individuals to return to using opioids.

Physical symptoms of Percocet withdrawal may include:

  • Nausea and vomiting
  • Diarrhea and irregular bowel movements
  • Fever and chills
  • Aching and sore muscles
  • Irregular heart beat
  • Heightened blood pressure
  • Irregular sleeping patterns, especially insomnia
  • Extreme fatigue
  • Changes in appetite and eating habits

The psychological symptoms may include:

  • Anxiety or panic
  • Intense cravings to use drugs
  • Difficulty concentrating
  • Impaired memory
  • Fits of anger or rage
  • Extreme mood swings
  • Depression and lack of motivation
  • Agitation and irritability


Timeline of Withdrawal

Percocet’s timeline of withdrawal symptoms depends on many factors, including length of use, amount of use, age of individual, general health of individual, and outside factors such as mental health disorders or disabilities.

First Few Days

During the first few days after quitting Percocet, withdrawal symptoms will generally peak. Because oxycodone has a relatively short half-life of about four hours, the detox process usually begins withing the 24 hours after the last dose is taken. During this period, individuals are likely to experience physical discomfort and pain, intestinal problems, and intense cravings to use.

This is an incredibly vulnerable period in the detox process, and it’s important to be in a safe place during this time. Without proper care, the withdrawal symptoms can be overwhelming and drive the individual to seek out more opioids to cope with the pain.

Weeks One and Two

After the first few days, it’s common to experience muscle aching, difficulty sleeping, and fever and chills. Anxiety may grow and the individual may find themselves experiencing moments of agitation or anger. Again, this is an important period in the process, and professional care can help get one through these symptoms with minimal discomfort.

Weeks Three and Four

Even after the drugs have left the system, a person may continue to experience symptoms of withdrawal. As an opioid, Percocet can cause a lingering withdrawal, perhaps persisting for more than a month after quitting. People may experience depression, dopamine depletion, and heightened anxiety as they learn to cope with life without the drugs.

Percocet Addiction Treatment

There are many different ways to treat Percocet addiction. suggests social support, counseling, and reaching out for help. The first piece of the puzzle is detoxing off oxycodone safely. With the help of medical professionals at a detox facility, you can go through the detox process with the least amount of discomfort. Those that try to detox at home often find it too difficult and end up relapsing.

Detox isn’t the only phase of treatment. People who continue into residential treatment and outpatient programs have much higher rates of success in staying sober. Although removing the opioids from your body is a great first step, you also must learn to face life without drugs. In order to prevent relapse, it’s best to seek professional help to move on with your life!

Klonopin Withdrawal Symptoms

Klonopin® is the trade name of clonazepam, a benzodiazepine approved by the FDA to treat seizure disorders and anxiety disorders. Klonopin was patented in the 1960’s and became available in the US in 1975. Since then, it has become a commonly abused recreational drug for its relaxing effects.

How Does Clonazepam Work?

Clonazepam increases gamma amino-butyric acid in the brain, which is more commonly known as GABA. The neurotransmitter works by inhibiting the central nervous system, creating a sense of ease, comfort, and muscle relaxation. Because it acts on the GABA receptors, withdrawal and detox from clonazepam can be quite uncomfortable and physically dangerous.

Klonopin has a longer half-life than many other benzodiazepines. The half-life of a drug is how long it stays in your system, and clonazepam’s is over twice as long as the related drug alprazolam (Xanax®). This makes clonazepam better suited for longer term care of anxiety disorders, and alprazolam more effective in short-term interventions. However, the long half-life leads to a long withdrawal process as it can take weeks or months for the drug to leave the system completely.

Like all benzodiazepines, Klonopin has a very high risk for abuse and addiction. The body becomes increasingly resistant to its effects, which prompts the individual to ingest higher or more frequent doses of the drug to achieve the desired effects. Over time, the brain will adapt to the chemical response to the Klonopin, eventually causing the individual to become chemically dependent on the drug. Klonopin is both psychologically and physically addictive.

Klonopin Withdrawal

Klonopin withdrawal can be serious or fatal if not treated properly. As such, it is not advisable to stop taking clonazepam “cold turkey.” Generally, your doctor will wean you off the drug slowly over time in order to minimize discomfort and danger. It’s important to come off benzodiazepines correctly in order to maintain your health and comfort.

Klonopin Withdrawal Symptoms

The severity of symptoms in withdrawing from clonazepam depends largely on the individual. Factors in severity of withdrawal symptoms include amount of use, length of use, the individual’s health, and the presence of any co-occurring disorders.

Klonopin withdrawal symptoms may include:

  • Headache
  • Nausea and/or vomiting
  • Hallucinations and/or nightmares
  • Memory loss/lapses
  • Irritability and mood swings
  • Anxiety and panic
  • High blood pressure
  • Impaired motor control
  • Depression, fatigue, and lack of motivation
  • Seizures

Psychological Symptoms of Withdrawal

Like the withdrawal process from many substances, coming off Klonopin can cause intense psychological symptoms. An individual coming off this benzodiazepine may experience waking hallucinations, intense nightmares, pervasive sadness, heightened anxiety and panic, severe drug cravings, and bouts of anger or rage.

Those detoxing from Klonopin use are at a heightened risk of suicidal ideations. Along with the previously mentioned psychological symptoms that may arise, this makes Klonopin withdrawal a dangerous process to go through alone. With proper medical attention and therapeutic care, these psychological symptoms can be eased in order to help the person detox with minimal discomfort.

Physical Symptoms of Withdrawal

As clonazepam impacts the GABA receptors in the brain, the withdrawal process is physically dangerous as well. When suddenly ceasing Klonopin use, an individual may experience headaches, nausea, shaking, irregular sleep patterns, heightened blood pressure, dizziness, muscle tension and spasms, and irregular bowel movements.

In addition, more severe cases of Klonopin withdrawal can result in the individual having seizures or falling into a coma. It’s important to know that the detox process can be incredibly dangerous and fatal. The physical symptoms of withdrawal make it imperative that you seek professional medical help when coming off Klonopin.

Klonopin Withdrawal Timeline

Because Klonopin is a long-acting benzodiazepine, the withdrawal process takes time and patience. Generally, withdrawal symptoms begin arising 2 or 3 days after the last use, which is when it begins to leave your system. During this time, an individual is likely to experience anxiety, insomnia, heightened blood pressure, fatigue, and mental confusion or memory lapses. During this period, the cravings for more clonazepam are often strong.

After a couple weeks, the acute withdrawal symptoms generally begin to subside. However, an individual may experience continued physical and psychological discomfort for weeks or months after. The longer-term withdrawal symptoms are often more mild, but may include anxiety, irregular sleeping patterns, and increased sensitivity to stress.

The timeline of withdrawal depends on the nature of the use and the individual’s biology. The longer you used Klonopin, the more likely you are to experience a lengthy withdrawal process.

Klonopin Withdrawal Help

If you or somebody you know is coming off Klonopin, it is crucial to seek help. Without professional help, Klonopin withdrawal can be lethal. In addition to the physical dangers, the cravings from withdrawing can be overwhelming and lead the person to abruptly stop the detox process and revert to the Klonopin.

Unfortunately, Klonopin withdrawal needs to be monitored by professionals even if you’ve been taking it as prescribed. With a trained medical team, you can come off clonazepam and stay completely safe. At a quality treatment center or detox, you may be treated with medications, constant monitoring of vital signs, and therapy. This level of care helps ensure your safety and comfort throughout this difficult process.

Comprehensive Treatment for Klonopin Dependency

Some may be so happy to have successfully completed the Klonopin detox and withdrawal process that they make the mistake of thinking they do not need addiction treatment. While that is understandable, it would be a significant misstep in the goal to remain Klonopin-free. This is because the drug is psychologically addicting, and has resulted in a thought-behavior response that keeps the individual hostage to the addiction cycle.

Overcoming a Klonopin addiction relies heavily on changing those distorted thought and behavior patterns. This is only achieved through a structured rehab program using evidence-based therapies such as cognitive behavioral therapy (CBT) and others. The individual in recovery must replace their response to triggers with new healthy responses, and this process takes time, practice, and patience. CBT, combined with several other treatment elements within a comprehensive program, provide the interventions needed to achieve a sustained recovery from Klonopin addiction.

An integrative rehab program will include the following:

Psychotherapy: The centerpiece of addiction treatment is evidence-based psychotherapy. These one-on-one talk therapy sessions are essential in helping patients examine the underlying factors that may be contributing to the substance abuse.

Group therapy: Peer support is an important aspect of establishing trust bonds that can foster a source of mutual support while in treatment. In group therapy, the members of the small group will be invited to openly share their personal feelings and experiences with the others, while under the guidance of a clinician.

Family therapy: Addiction can significantly impact the family dynamic, causing broken trust, financial troubles, and codependency. Family group therapy helps family members address any frustrations or ask questions about how best to support their loved one’s recovery.

Dual diagnosis treatment: Klonopin is often prescribed for patients with an anxiety disorder. When treating the individual for the Klonopin addiction it is important to also address the co-occurring anxiety disorder at the same time for the best recovery result.

Complimentary therapies: Treatment of a Klonopin dependency will be enhanced when complimentary therapies are added to the treatment protocol. Holistic and experiential therapies can help patients learn techniques to help regulate the stress response associated with benzodiazepine addiction. These activities are included in treatment to help reduce anxiety, which can in effect augment treatment results. After the patient has completed treatment, they are able to access these same therapies and incorporate them into their aftercare plan. The activities may include yoga, meditation, art or music therapy, acupuncture, massage therapy, mindfulness exercises, equine therapy, journaling, and aromatherapy.

Continuing care planning: Completion of a comprehensive rehabilitation program is the first important step on the recovery journey, but just as important is the continuing care planning that will follow treatment. Recovery exists on a continuum, meaning that ongoing efforts will help ensure that recovery is sustained over time. These measures can include scheduling weekly therapy sessions, living in a sober living home during the early months of recovery, and participation in a recovery community.

What is a 12 Step Call?

What is a 12 Step Call?

A 12 step call is an important part of the recovery process for many. Generally, an individual or group sits or speaks with somebody suffering from addiction in order to help them find recovery. It has become less popular as treatment has grown in availability, but it still is an important part of the process.

Interventions may be seen as a type of twelve step call, although they often cost money. Traditional twelve-step calls are free and done in the spirit of service. People may call into AA Central Office or reach out to a trusted friend or family member. A member of the twelve-step community volunteers to either speak to the struggling individual or meet with them in person.

What is the Twelfth Step?

The twelfth step of Alcoholics Anonymous reads: Having had a spiritual awakening as the result of these Steps, we tried to carry this message to alcoholics, and to practice these principles in all our affairs. This is the step in which sober individuals begin helping those who are still struggling with addiction. This may come in the form of sponsoring other people, taking service commitments, or participating in things like twelve step calls.

Why do a Twelve Step Call?

The main purpose of a call is to offer the person struggling a friendly and nonjudgmental ear. The belief is that there is just nothing quite the same as one alcoholic talking to another. As such, the person who is struggling to stay sober can hopefully trust the person making the call.

Often, the ultimate goal of a 12 step call is to get the person to commit to a first step toward recovery. This may be something simple like coming to a meeting or seeing a therapist. As with cases like interventions, it may be to get the person to admit to detox or treatment. Recovery may look different for different individuals, but the intention remains the same: to help the person recover from the suffering caused by addiction.

Sometimes, those of us in recovery or surrounded by recovery forget that many individuals don’t know sober people or have sober friends. When people reach out to a Central Office or ask a friend for help, it’s a courageous and scary thing to do. The person who shows up or calls the individual has a really powerful opportunity to impact their life.

12 Stepping Someone

When to do a 12 Step Call

Sometimes we are asked to participate in a call, while other times we may do so out of care and worry for a friend or loved one. Whatever the case may be, it’s important to remember a few things about your choice of timing. First, it’s not advisable to do a twelve step call when somebody is still intoxicated. When somebody is high or drunk, they are not clear-minded. Furthermore, we tend to be less desperate when we are intoxicated and feeling alright. It generally is best to work with someone when they are sober.

If the person who needs help is sober, it’s best to make contact as soon as possible. If you have experienced addiction yourself, you know how fast the mind can change. One moment we are desperate for help, and the next we have succumbed and are getting high. If someone is reaching out for help, we can make a huge difference by responding in a timely manner.

You may show up for an individual even when they don’t necessarily reach out for help themselves. Sometimes, a family member or friend may reach out for help. There’s also the intervention-style method in which the person is surprised with the helping individuals. We must be careful about when we show up to intervene on somebody. It can be a fragile situation and we want to be mindful of their needs and health. We also need to know our limitations and when somebody needs professional help.

Twelve Step Call Tips

Jumping into a 12 step call is a big task, so we thought we’d offer a few tips we’ve found helpful in our personal and professional experience.

Be Present

First, do your best to really be present for the person suffering. If they call, try to answer. If you can’t make sure to call them back! They’re in a vulnerable state and you have a lot of power in your hands to make them feel welcome. Of course you’re not in charge of their recovery, but you do have the opportunity to help.

It can also be helpful to really be present and not distracted. When we’re struggling, simply having someone there to listen to us can make a world of difference. Practice compassionate listening and really make an effort to be present with the person as they share their struggles.

Get the Individual Alone

First, it must be mentioned that we have to be careful in making these calls. We don’t want to make anyone feel unsafe or activate any trauma. As such, we must be mindful of gender differences and the dangers associated with working one-on-one with an individual of another gender. It’s generally best on a 12 step call for the people to be of the same gender.

With that out of the way, it may be best to separate the person from any loved ones or family members. A person is generally more likely to be honest and open when speaking without these people around. If you’re doing a twelve step call and the person’s spouse is home, it may be best to try to speak with the person without the spouse present.

Be Aware of Needs

These calls are valuable methods of helping others get sober, but they can’t fix everything. Sometimes, we go on a twelve step call and see that the person needs immediate medical attention, psychiatric help, and/or emergency services. This may be because the person has taken a lot of drugs, is considering causing harm to themselves or another, or is physically hurt.

Although the twelve steps have helped millions of people get clean and sober, they can’t address absolute everything. Know your own limitations and be aware of the person’s needs. Keep in mind that the person may need more than you can offer. It doesn’t make you a bad twelve-stepper; it just means the person needs a different type of help in this moment!

Share Your Story

Although listening is one of the most important pieces of 12 stepping someone, it can also be helpful to share a bit of your story. By sharing your story honestly, you can let the person know they’re speaking with someone who understands and is not there to judge you. You can share as deeply as you’re comfortable with, showing the addict or alcoholic that they’re not alone in their experience.

When you share your story, make sure to include what it’s like today! Offer some hope to the person. By giving them a glimpse of your addiction and your recovery, you can offer them something to work toward. Maybe they don’t want their life to look exactly like yours, but the principle of hope will come through.

Leave Them with Options

This can make a huge difference. When you get off the phone or leave the individual, don’t just leave them hanging! You want to offer a next step, some way to take action, and/or an actual path toward recovery. This can come in many forms, and will vary depending on the situation. You can’t force the person to take the next right action, but you can do your best to make sure it’s accessible to them.

You may consider leaving a meeting directory, giving them some phone numbers for detox facilities, private treatment centers, or free drug rehabs, or making a plan to go to a meeting together. Use your best judgement and perhaps you can ask your own mentors or sponsors, but make sure you offer the person a way to move forward. In that moment of desperation, they may be willing to take action where they weren’t previously.

Don’t Judge Yourself too Harshly

Finally, remember that your job isn’t to cure or fix anyone. You’re only in charge of your own behavior. Show up, be honest and open, and don’t cling to any specific result. You may do the best 12 step call ever, but the person isn’t ready. You also may make many mistakes but the person still gets sober! Do what you can, be willing to learn new things, and remember that you cannot control the behavior of anyone else!

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Self Compassion in Recovery

For many of us, our addiction is filled with thoughts and behaviors that cause harm to ourselves and those around us. Part of the difficulty we face getting sober is that often we beat ourselves up for our behavior, past and present. We are incredibly harsh on ourselves, sometimes treating ourselves worse than we would ever treat others. Although it is beneficial to push ourselves to grow, we must find a way to change our relationship to ourselves. Our habits of self-resentment and self-blame can cause quite a bit of suffering in our lives, and bringing forgiveness, compassion, and acceptance into our sober lives can help us recover.

The Blame Game

We often play the blame game in our using and early recovery. Unfortunately, the nature of addiction is that we often hurt those we care about, including ourselves. These realities can be hard to face when our minds clear and we don’t have drugs or alcohol to subdue the thinking mind. Whether we are recovering from an addiction, a mental disorder like depression, or a co-occurring disorder, we behave in ways of which we aren’t proud. We respond by judging ourselves, holding onto resentment toward ourselves, and even harboring anger.

The harsh self-judgement seems to serve us at times. I have felt like it helps me set boundaries for myself and prevent me from causing harm in the future. Our self-talk can serve as a protector against the truth of what we’ve done in the past, and make us feel like we are preventing ourselves from causing future harm. These adversarial relationships we build with ourselves bring us out of touch with what is really going on, and prevent us from actually feeling what is present.

Self Kindness in Recovery


Self-forgiveness is one of the first steps toward a healthy relationship with ourselves. Self-forgiveness is the ability to let go of resentment toward ourselves for something in the past. Perhaps Lily Tomlin said it best when she said, “Forgiveness means giving up all hope for a better past.” Forgiveness is allowing ourselves to move forward. The Vietnamese Buddhist monk and author Thich Nhat Hanh reminds his students the forgiveness requires us to forgive ourselves for not being perfect.

“Forgiveness means giving up all hope for a better past.”
-Lily Tomlin

It’s important to note that forgiveness is not an act of giving ourselves permission to behave poorly in the future. We can forgive ourselves for causing harm without endorsing the behavior or allowing it to happen again. When we work on forgiveness, it becomes a constant attitude, not just a one-time effort. Developing a working attitude of forgiveness can be greatly beneficial in our recovery. A 2005 study by Romero, et. al. investigated self-forgiveness in women with breast cancer and found that an attitude of forgiveness toward self was linked to less mood disturbances and better quality of life.

So how do we jump into a state of self-forgiveness? It takes time. We can’t suddenly change the way our minds work just by making a decision. However, we can start on the path of forgiveness right away. Try noticing how you’re talking to yourself during the day. What happens when you think of your past or when you make a mistake? You don’t need to push down any harsh thoughts. Instead, just notice them and try to bring a little bit of kindness to the thoughts. You don’t have to buy into each and every thought you have!


This is likewise a powerful way in which we can change our relationship with ourselves. Humans, especially those struggling with addiction, have a tendency to dislike unpleasant emotions and experiences. Rather than feeling what is present, we push the feeling down or take ourselves away from the situation. Of course, this can be beneficial if we are in serious danger. However, we often respond with aversion when we are actually rather safe.

Maybe you have a painful thought about some harm you caused a loved one. In the past, you may have taken a drink or used drugs to keep this thought away. Without substances to push these thoughts down, we may turn to process addictions, sleeping, or any number of other behaviors. Instead of finding another way to not feel, we can try responding with some self-compassion. By caring about our pain, we can learn to be with our experience without needing to use drugs or other experiences to run away. A 2007 study by Neff, et. al. found that increased self-compassion led to increased psychological well-being, suggesting there is some truth the power of compassion.

Like we may do with self-forgiveness, self-compassion takes repeated effort. It is not our habit to respond to pain with care and attention, so we may benefit from letting go of expectations. We can forgive ourselves for not being perfectly compassionate! Here’s a practice to try: When you notice that you’re having an experience of pain, offer yourself a phrase of kindness such as “I love you” or “I care about you.” This simple act of trying to care about ourselves can really help retrain the mind to respond with care when we’re in pain.

Self Compassion in Recovery


It feels sometimes like we’re so often focusing on the difficult experiences when we get sober. We do an inventory in twelve-step programs, talk about difficulties in therapy, and have to deal with some wreckage of our past. These are all incredibly useful pieces of recovery, but we mustn’t forget to tune into the happy moments as well. When we experience joy in early recovery, we glaze right over it or feel unworthy. Dr. Mario Martinez has done research on this, finding that joy releases cortisol, the stress hormone, in the brain. If we feel unworthy of the joy, the body physically becomes stressed when happiness is present.

To grow happier, we have to learn to be with the moments of happiness and appreciate the joy we experience. In any given day we go through a number of emotions, pleasant and unpleasant. We unfortunately tend to focus on the unpleasant experiences, and they stick in our minds with more weight. Bestselling author Dr. Rick Hanson points out that we can help ourselves by pausing when joy is present and really taking it in. Whether you’re noticing a beautiful sunset, grateful to be sober, or proud of yourself for the work you’re doing, take a moment and really allow yourself to appreciate yourself and your joy!

The journey away from self-hatred and toward self-love isn’t easy. It takes time and persistence. We don’t just wake up one day with unconditional kindness toward ourselves. What we can do is hold the intention to respond with more forgiveness, compassion, and appreciation, and make an effort to take action to cultivate these new states of being.


To paraphrase the law of attraction, the thoughts, energy and actions that you put into the universe will come back to you in some way shape or form. The power of our thoughts and actions are powerful enough to attract whatever goals or objectives you have in mind. This can also be true of negativity. Sometimes when we are sick, and we think about how sick we are and we end up feeling worse than we did before we thought about it. Our symptoms start to show, and we become hyper-sensitive to sensations we may not have felt before.

In recovery from addiction, one of the most powerful skills to learn is to keep a positive mindset. If the law of attraction (which has great examples to support it) is in fact true, then keeping positive in early recovery can be crucial. Telling yourself that you are going to succeed can lead to success, simply by putting that thought into the universe. This can also be called self talk. In recovery from addiction, negative self talk gradually lessens through actions such as attending recovery support meetings, talking to a therapist, attending an outpatient rehabilitation or treatment program, taking medications that are prescribed by a physician or psychiatrist, and/or meditation and a spiritual practice. These are all things that can help support a healthy and positive mental mindset.

Saying Yes to Life

Often times, when asked in early recovery from addiction to attend support groups or to go out on activities our first instinct is to say no. If we begin to be conscious of this habit, we may see that we pause before answering. A pause between answering questions of whether or not we would like to attend some sort of social or leisurely activity may allow us the opportunity to consider whether or not we honestly want to attend, or if our habitual use of the word no is driving our thought process and decision making skills. By eliminating or considering minimizing the use of the word no we allow ourselves the space to have new opportunities; opportunities we may not have had experienced if it weren’t for this pause.

Do the Next Right Thing

Many addicts in early recovery hate this phrase or “cliche.” Doing the next right thing simply means taking action instead of remaining stagnant. By doing the next right thing, we may eliminate our negative self talk completely, or at least take time away from our negativity to allow ourselves new experiences, such as a recovery meeting or a leisure activity as mentioned. A body in motion stays in motion, and a body in motion seldom allows a mind, after time, to stay negative or to remain in a state of contemplation. When we are moving we aren’t thinking, unless we are thinking about what action we are taking or what motion we are engaged in. Movement is beneficial, and doing the next right thing or even the next thing can be essential for recovery in early recovery from drugs and alcohol.

Don’t Give Up

We can learn from each other, which is an important factor in growth. Sometimes, our mindsets can be affected by those we surround ourselves with. Considering our surroundings, our support systems, and our friends, we can quickly analyze whether or not we are setting ourselves up for success. Through practices like meditation we can learn to quiet our minds, or at least learn to observe our thoughts and to let them come and to pass. Remaining positive is essential in recovery, and many successful people will confess that their success is a direct result of remaining positive and believing in themselves. If you have recurring negative thoughts, talk to a friend or a therapist about them, try journaling about them or meditating. There are many ways to remain positive. Your reality is created by your thoughts; you attract what you put into the universe, and if you believe that you can live a happy, healthy, sober life, then you’ll put the action in to do so, and the universe will conspire in remarkable ways to show you that it is in fact listening, and it may surprise you that it is working in your favor. Remember, you may be amazed before you are halfway through!