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A good Article on PAWS aka Flare Ups

Discussion in '~ Articles ~ Info ~ Links ~ Data ~' started by spring, Mar 17, 2004.

  1. spring

    spring Guest

    The term "flare up periods" or "flare ups" refer to definite time periods during which the recovering alcoholic/addict experiences an increased amount of tension and anxiety. Should he return to the use of alcohol or drugs, it will most likely be during one of these flare up periods. It is important, therefore, that the recovering alcoholic/addict, his family, his friends, his employer and anyone else who may play an important role during these periods become aware of how to recognize the onset of a flare up period and what to do when one occurs.

    Flare ups occur at predictable intervals: five to six days, four to five weeks, eight to ten weeks, thirteen weeks, six months, nine months, and eleven to thirteen months after the last use of alcohol/drugs.

    Factors in recognizing the onset of a flare up include feelings of irritability, moodiness, boredom, restlessness and difficulty in eating and sleeping. These emotional states grow in intensity and come to a peak which lasts up to three days. During these three days, the recovering alcoholic/ addict may be extremely depressed and irritable. He may feel all is hopeless, that nothing can go right and display outbursts of anger for almost no reason or because of something which would ordinarily be considered insignificant. There are also some physical signs indicating that he is approaching a danger zone. He may develop aches and pains, he may perspire more than ordinary and he may have headaches.There also may be behavior changes. These changes are sometimes so slight that they would be passed off without undue attention unless one is watching for them. Uncharacteristic juvenile behavior, unreasonable giggling and joy, expressions of weariness, restlessness or boredom, and a sudden concern about his health, job, family, loneliness, etc. are examples of such behavior changes.

    The first step in dealing with a flare up is to expect them and watch for the signs.
    When you suspect that you are entering a flare up period, seek help from someone who will understand what you are going through, your counselor or therapist, your spouse, a fellow group member, AA, CA or a good friend (who won’t offer you a drink or drug) are possible sources of help. Sometimes just calling someone to talk to , going for a drive or working on a hobby will help reduce the tension of a flare up. In any case, it is best to keep busy.
    Realize that the storm will pass. Flare ups usually last from one to three days. After it passes, things will return to normal again.
    DO NOT DRINK! DO NOT USE DRUGS! One drink or drug will set off a chain reaction and you’ll find yourself completely loaded and right back where you started!
    given to me by a counselor long ago -Dan


    Hospitals have studied druggies/alkies that were brought in with brain damage severe enough to induce coma. The patients had to be fed through a tube. While they were hooked up to the IV's they took daily blood samples. A curious pattern started to emerge when they compared the tests for several hundred people who had stopped drinking/drugging when they were admitted to the hospitals. (coma's do that ya know... help you stop using that is...)

    They found that the level of endorphines (pleasure receptors) dropped to zero after 4-7 days. Then after about 24-72 hours the endorphines came back AT A HIGHER LEVEL than they had been. Then at about 30 days the levels dropped to zero again. But after another 24-72 hours they came back, again at a higher level! This phenomenon repeats itself at a suspiciously familiar interval...

    ~~~~~~~~~~~~~~~~~~ normal endorphine level
    ~~++++++++++++++++ users level -- drugs/alcohol (+) provide the balance
    ~~ 1st week sober (notice the lack of drug support)
    FLARE UP (24-72 hours each time)
    ~~~~ after 1st flare up (4-7 days)
    ~~~~~~ after 30 day's flare up
    ~~~~~~~~ after 60 day's flare up
    ~~~~~~~~~~ after 90 day's flare up
    ~~~~~~~~~~~~ after 6 month's flare up
    ~~~~~~~~~~~~~~ after 9 month's flare up
    ~~~~~~~~~~~~~~~~ after a year's flare up
    ~~~~~~~~~~~~~~~~~~ normal level reached after 1 1/2 years or more.

    Notice how the Flare-ups occur in the same time periods as we give chips? Makes one wonder doesn't it?

    I imagine you are asking yourself... So?
    So... if you relapse, you start back at the beginning of the chart because your body stopped making endorphines when the drugs/alcohol started supplying them. That is one of the reasons people don't want to come back - they don't feel all right. Another reason is ego. Hang in there and you WILL feel better.

  2. Loop

    Loop Well-Known Member

    That's good to know but 1 1/2 YRS to get back to normal?Oh dear god,will I live that long?

    Or will I feel better in 3days?
  3. spring

    spring Administrator

    When I did my last bout of long term clean time....I followed the pattern almost to a "T".

    I did a cold turkey and never touched another opiate after that for close to 4 years.
    I remember it felt like forever for me to get to the 30 day mark, but once I made it, it just kept getting better and better. By the end of the 60 day mark I was feeling SO GOOD the desire to use any drugs was GONE! I did not want to mess it up. I felt too good. Life was falling into place very nicely.

    I did hit that 1 year mark where I almost felt like I was going into a mild W/D. BUT....I had gone to enough meetings and talked to a therapist 1 on 1 and in group therapies for that first year and that is what saved me from relapse. I knew what to expect and I knew what it was when it hit me so I was able to ride it out with no problem. Knowledge is power!!

    After that first year it was like I had never used.

    Unfortunately for me tho....After 3 years of clean time, I hooked up with another recovering addict. I blame that on my low self esteem....(which was an issue that I chose to ignore). Therapists had told me that it was CRUCIAL that I raise my self worth by facing, dealing with, and then forgiving myself for my past lifestyle while in the depths of my addiction. It was the only way I was going to be able to let that "old me" go and learn to like myself again.

    IF I had higher self esteem at the time I would have felt worthy of the straight guys who were paying plenty of attention to me. Instead I opted for another addict with the same drug history as mine
    ....stupid move.

    He relapsed and it didnt take long for me to follow. Stupid move!!! Even if I had hooked up with an alcoholic or coke addict it would have been safer for me since I dont like either one of those drugs. But I felt that I needed to have another heroin addict in my life who could "understand" me.
    Now that I look back on it and know what I know now....I can plainly see that it was only a ploy by that little addict inside my head setting me up for an eventual relapse. I was warned by many but went full steam ahead into the relationship anyway. After close to 4 years of being wonderfully clean, I threw it all away just like that!
    Now it is 3 years later and I am STILL dealing with it. I WOULD have 10 months clean by now if I hadnt opted for Sub maintainence...but then again maybe that's just it...maybe I WOULDNT be "clean" at all if I hadnt opted for a year long maintenace treatment.

    My story is one reason why I STRESS to eveyone that therapy is important, and/or meetings, whatever....but a person HAS to have someone to be accountable to, And it's very important to LEARN HOW to stay clean.
    Pinkie is an excellent example of gut level honesty. She has had her fill of relapse and has taken every step posssible to ensure that she doesn't relapse again.
    I'm not saying this to compare your situation to hers Loop, I just wanted to point out the things that Pinkie changed in her life to make recovery possible.
    Everyone is different and requires a custom-made plan of attack. Yet we are all the same and there are many things that we all need to do the same in order to recover.
    Sadly we usually find it by trial and error. Another reason why I am so passionate about sharing my successes and failures hoping I can help save someone from wasting half their life trying to achieve a successful recovery.

    Do the Right Thing and Risk the Consequences

  4. ashley80

    ashley80 Well-Known Member

    It just seems so endless and HARD! I have so much respect for Pinkie and you, Spring, for being able to get to this place. I know I have to face my past, and my failure to do so is why I am still where I am today. I had this really obnoxious therapist back in the 1980's who told me the exact same thing, and I blew him off. I just really wanted to think I could do it by myself, and I don't think I can. I know I can get clean again, but how will I stay that way? Am I ready to change my life so thoroughly?
    You've made me think here. Thank you.
  5. pinkie

    pinkie Well-Known Member

    Don't look to me, look to yourself. If you put one foot in front of the other, and start listening to all those feelings you've been socking away behind the opiates, you'll start to know what you need to do to get/stay clean. I KNOW it's really scary, and so often, as women, we are the caretakers. It's time for you and I to find our place in this world, and know that we deserve to be taken care of too. I've spent so much time asking the wrong people, that I have this overwhelming sense that I can't get what I want, even if I do ask. But, when I ask those that I've either paid, shared pain with or who love me, things come.

    Connect, connect, connect. Keep talking and being honest. Slowly start to face those things that you know in the back of your head but have been denying, for whatever reason, and you will actually start to get excited at the possibility of happiness, even in the face of the fear.

    Maybe this is a good place to start. What's your deepest darkest secret? I think you know what it is, and are just really really afraid to say. I bet it's that secret that's keeping you a junkie. Maybe if you can say it here, you can start to punch a hole in it. We're all here, and I promise to protect you if someone gets on your case. I know others will as well. We can make it a safe place for you to start, and many of us are willing to listen without judgement. You've judged yourself enough, there's no time like the present to wake up and start living.

    My secret is that I've been living with a man who gives me almost nothing in return. The bank account is now dangerously low, and I have all sorts of guilt, that I made this relationship and after 14 years am facing my failure. I made the decision to be here, and I tried for all these years, in an uphill battle, to make myself happy in spite of being sucked dry. I am afraid of being 41 and starting over. I am afraid that I will leave him and find myself the same desperate, lonely, needy girl I was when I was in my twenties. I am afraid that I haven't grown up, and that this relationship is masking that fact. I'm afraid to ask other people to help me. I am afraid that I am SO needy that I am actually a bottomless pit, which can never be filled. There's more, but that's enough for now.

    What are you afraid of Ashley???
  6. Bup4pain

    Bup4pain Well-Known Member

    "It just seems so endless and HARD!"

    If I look at it this way I too will fail. ;)

    As much as some of us hate to hear it..... "One day at a time"

    Just be clean ONE day. Just worry about today. Don't project.

    Try to focus on the now. It's the only way that works for me.


  7. ashley80

    ashley80 Well-Known Member

    I hear you, Bup and Pinkie. And I agree. I just lose sight of it sometimes, when it's all so overwhelming. I know I have to get to first base before I can score (bad metaphor, sorry!).
    Pinkie, you are not the same scared inscecure girl you were in your 20's. One has only to read your posts to know that. You have been through hell and back since then, and undoubtedly are wise beyond your years. You may yet make mistakes, but it will never be with same recklessness or un-self-awareness you had in your 20's.
    And I admire your sharing your secret. Mine is much worse, and I don't think I could ever post it here. Maybe, I could tell someone, I think I know that I have to.
    And I do have a plan, and don't laugh Lily, it is at least a sensible plan this time. Lol, at least I think so. I cannot keep on like this for much longer. I know it. I will soon get found out by my husband or kids, or will sink back into that all day stupor again where nothing has any meaning at all. I'm not quite there yet. At any rate, I plan to put this stuff down immediately after my biopsy, when I will be out of meds anyhow. And this time round I am going to finish or flush the bupe. No keeping it around just in case. I know that contributed to this screw up.
    And I'm going to have support for the PAWS that I KNOW will show up. That's about all I can manage right now.
    PS, I have tons of bad qualities, addictive personality being one of them, but I DO have one good quality that drives my husband crazy. I am very determined when I want to do something, so I hope that quality will keep me on the right road when I finally put this down.
  8. pinkie

    pinkie Well-Known Member

    Thanks Ashley, we'll see about me. I'm doing what I can, and that's all I can do. Whether I'm a 70 year old or a 21 year old in a 41 year old body, it's all I've got to work with, so onward...

    You KNOW you need to find somewhere to tell your secret. If you don't, I think it will continue to fester, and infect you to the degree that you may have no option but to stuff it down with the opiates. Secrets that we keep from others, but especially the ones we keep from ourselves eventually become unmanagable.

    If nothing else, telling someone may help you see things in a different, more realistic or hopefull light. Or help you find your motivation to do this.

    Flushing is a good a step towards your committment, but I think telling may be the KEY you're looking for. It's worth turning the key, 'cause the alternative isn't working, is it?

    Your fear is your "town crier", telling you that something needs to be changed. It's a barrier that you need to break through by taking small steps towards action. The danger may not be as bad as you imagine. You've already answered your own question (I think that's gigantic!), now you just need get somebody to show you the steps that will lead you towards the solution, one step (or day) at a time.
  9. spring

    spring Administrator

    bumping up to top for a friend

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