Sobriety and Environment

environment-HEADER

Environment makes or breaks a person’s recovery. The personal sphere a person inhabits – home, work, family and friends – needs maintenance to build a successful recovery. At its core, recovery is about the building blocks: knowing how to fill big blocks of time, making the effort to get enough sleep and eat the right foods and spending time with supportive people. When a person stops managing his environment in this way, things fall apart.

Trouble at Home

Our environment influences our reactions, our behavior and how we think and feel. If a person’s day-to-day includes conflict and chaos – a dysfunctional family or a stressful job –her outlook on life and coping skills are compromised. Generally speaking, unhealthy outlooks lead to unhealthy coping methods.

For example, a home environment with a constant stream of verbal abuse and violence is a breeding ground for the stress, depression and anxiety that precedes a substance use problem. A child seeing parents argue or fight may feel threatened and fear for his own safety, even if the child is not the target of abuse. A vulnerable child who grows up exposed to the traumatic sights and sounds of domestic violence develops a brain that is markedly different from a child who grows up in a household without such endangerment.[1]

child abuse statResearchers at the University of Texas describe these brain differences as “connectivity problems” in the brain. Teenagers who experienced traumatic events during childhood have brains that struggle to connect the regions dealing with emotional processing to the regions dealing with thought. Since it is more difficult for them to make sense of emotions with rational thought, the teenagers struggle responding to stressful events. The inability to process the trauma in a healthy and constructive way puts the teenagers at risk of feeling isolated, depressed and scared. These emotional struggles make them more likely to use substances as a way to cope or feel included in social circles.[2]

Even bullying between siblings or playground bullying that goes on unmonitored contributes to an unhealthy environment. A study of thousands of U.S. children found bullying was associated with lowered mental health prospects for children and adolescents. Thirty-three percent of children physically or verbally bullied by siblings or parents developed mental health symptoms much later in life, compared with children who experienced no such abuse and developed no such symptoms.[3]

All Work and No Play

averageAn unhealthy home environment is not the only place that breeds substance abuse issues. Time spent at workplaces accounts for large chunks of a person’s life. Americans spend more time every day working (8.8 hours) than they do sleeping (7.8 hours), participating in leisure or sports activities (2.6 hours), or attending to household responsibilities (1.1 hours), according to the Bureau of Labor Statistics.[4] Unsurprisingly, spending five days a week for more than 50 weeks a year at an unsatisfying job leads to tension, frustration and mental and physical exhaustion.

Some additional reasons time at work leads to addiction include the following:

  • Lack of job satisfaction
  • Long hours away from family and private life
  • Dangerous working conditions
  • Workplace access to drugs or alcohol
  • Isolation and loneliness
  • Boredom and repetition[5]

Whether a job involves time spent on an assembly line or office work in a law firm, the potential for stress is real and that stress contributes to risk factors for an addiction. Jobs with high levels of physical or mental stress create multiple problems. These jobs deprive workers of control over their hours, tasks or work-life balance, making workers at the jobs more likely to self-medicate to make it through the day, according to research in the Alcoholism: Clinical and Experimental Research journal.[6]

doctor lawyerSimilarly, positions associated with a high degree of power – chief among them lawyers and doctors – are notorious for the pressure they exert. Doctors make life and death decisions,and they often are on call throughout weekends, holidays and regular sleeping hours. In addition, they often don’t have the chance to mourn the death of a patient, as there are dozens of other people who need their immediate attention. Lawyers also have a brutal schedule and face long hours preparing for cases.6

Naturally, this takes a toll. Lawyers are twice as likely to battle alcohol abuse as people in other jobs, according to the Lawyer Assistance Program.[7] In addition, lawyers are 3.6 times more likely to develop major depressive disorder than people in other professions.[8]

As for doctors – a profession The Daily Beast called “the most miserable”[9] – a possible 400 of them commit suicide every year due to undiagnosed, untreated or unreported depression.[10] Furthermore, doctors have immediate access to prescription medication, and the Journal of Addiction Medicine reports physicians are up to five times more likely to abuse these drugs than the general public.[11]

Mental health symptoms commonly go along with addiction. People struggling with hostile or stressful environments feel overwhelmed, depressed and anxious and may turn to substances as a way to cope. When an addicted person has depression or an anxiety disorder or any other mental health problems, he needs specialized treatment to manage all the symptoms at the same time. Too often, addiction treatments ignore mental health problems, leaving people unprepared to live a sober life. Sobriety is a day-to-day commitment and people need to feel emotionally and physically healthy to be successful.[12]

Complete Life Overhaul

One case of a physician who struggled to quit substances shows the challenges people in the medical profession face. The doctor eventually admitted to stealing prescription drugs from his own patients in order to fight feelings of depression and feel less anxious. His medical director and a facility administrator confronted him, and he checked in to a treatment program. He was surprised, however, at the change she needed to make to control drug cravings. His reliance on medical training and intellect only got him so far before several relapses led to the suspension of his medical license. The suspension served as a wakeup call and forced him to reevaluate other aspects of his life – a process that saw him reinstated as a physician. He now serves as the director for a program that helps health care providers who struggle with stress and depression related to their jobs.[13]

People who are successful at recovery must address all the factors leading to addiction, not just some of them. Plenty of insight and substance detoxification won’t have a lasting effect if a newly sober patient returns to a world where the same triggers, stressors and risk factors exist and he doesn’t have the right coping skills. For a doctor, the road to relapse might mean going back to seeing 45 patients a day, working weeks on end without breaks or not spending enough time with his or her family. For someone else, it might mean going back to old friends and old haunts from the drinking and drug use days. Either way, the effect of a detox program is temporary if someone returns to old habits within a few months, weeks, or even days. Addiction treatment must include talk therapy to help patients understand why they used drugs and how to fight cravings and negative thoughts in the future.

The Importance of Environment

familyA good environment is the glue that keeps a person’s efforts to stay sober attached to her. The chance of relapse is highest in the first three months after a patient completes treatment.[14] If she returns to a home affected by abuse, neglect or violence, or a job where the phones don’t stop ringing and the stress level is high –relapse might only be a matter of time.

To combat stress-filled environments and to help create a home situation that fosters better mental health, a comprehensive treatment program involves family members. Through the process, everyone learns to create a patient, understanding, transparent and loving atmosphere in the home. Therapists talk with parents, spouses, siblings and children about ways to improve communication, trust and behavior, so the home environment becomes one that is positive and healthy. With counseling and commitment to change, risk factors are gradually and systematically removed.[15]

In practice, creating healthy homes embraces time together and understanding. Parents adopt a healthier work-life balance, spend more time at home and less time in a high-pressured work environment. The family commits to do activities together. They actively and frequently show love and support to one another, and they employ compromise and understanding to resolve conflict.[16]

Sober Living Rules

RulesEven families that work on making positive change are sources of inevitable stress. Patients who are just out of treatment must prepare for the challenges of moving back home and meeting day-to-day responsibilities. The transition back to being a member of a family, even in a household with an improved environment, is sometimes overwhelming for someone new to sobriety.

For that reason, a sober house often provides a bridge between the structure of treatment and the twists and turns of regular life.[17] In such places, the owner/manager of the house enforces sobriety by laying down a number of rules for residency:

  • Strict curfews and wakeup times
  • Random drug tests and room searches
  • Timely rent payments
  • Holding down a job or going to school
  • Assisting in household chores
  • Regularly attending 12-Step meetings

Sober homes provide a halfway point between regulated treatment and everyday life, especially for people who are not yet ready to make the transition back home.[18] At these locations, addicts must meet a standard of behavior and responsibility – with very real consequences for failure. The advantage, however, is a living situation devoid of the traps and triggers of substance abuse. The emphasis on sobriety, structure and group cohesion helps people return to a less-structured environment when they live on their own or in the company of people who don’t understand the challenges of sober living.

Support Systems

exerciseThe key to sobriety is having a good support system, whether that’s in a sober home, among family members or with the members of a 12-Step group. The consistency of sober routines –  requiring the patient to do her part in keeping the home clean, regularly spending time with her kids and spouse and regularly attending meetings –trains the patient’s brain to be positive instead of reaching for a bottle or a joint.

Plugging into a support system keeps the patient accountable and holds him to a higher standard. The knowledge that a number of people actively support him against a relapse is inspiring and motivational. Doing whatever is possible to cultivate that kind of setting, regardless of the living situation, is an immense help in the battle to stay clean.[19]

Support systems don’t need to be rooted in the therapeutic setting to work, although such groups are the most helpful. People in recovery also find support by joining an exercise team, since there is a direct relationship between the benefits of regular physical exercise and boosting mental health. Many such groups exist –yoga, dancing, running, hiking, etc. – under the banner of sobriety, but with a focus on the physical and group activities that bring participants together.[20]

Building Structure

As important as structure and the right environment is for sobriety, people should fill their time with activities that boost mental and physical health. The better they are in body and mind, the less room in their lives for substance use.

For example, a clean house helps a depressed mind.[21] Being surrounded by filth and junk at home makes an indifferent day a bad day, and the temptation to take the edge off with a drink or a pill counteracts months of hard work. Making routine cleaning a timely habit provides much needed order and routine and reinforces a sense of pride in one’s surroundings.

dietDiet also makes a huge difference in the fight against the triggers of addiction. The relationship between healthy food and mental health covers such items as:

  • Fatty acids
  • Amino acids
  • Vitamins
  • Complex carbohydrates
  • Water

Without these important nutrients, the brain struggles to function to its fullest abilities, opening the door for thoughts of using. Fatty acids and carbohydrates also play important roles in boosting moods, so keeping a kitchen well-stocked with healthy foods goes a long way toward creating a positive and uplifting living situation.[22]

Maintaining a healthy diet also opens the door to what many mental health counselors call cooking therapy – investing in the art, science and creativity of cooking to fight depression, anxiety and other mood disorders. Discovering new tastes and coming up with surprising concoctions builds self-esteem and discourages negative thinking. Cooking redirects stress into something personally rewarding, financially beneficial and downright tasty.[23]

Sleep

sleepPerhaps the best component of a sober environment is a healthy, regular sleep schedule. This not only means the nightly standard of eight hours of sleep; it also means going to bed at the same time and waking up at the same time, regardless of weekends or holidays. Plus, a doctor should clear any medications that might affect sleep, such as antidepressants or sedatives.

Solid sleep is integral for healthy brain function and emotional well-being; without sleep, brain activity changes and decisions are hard to make. Regulating thoughts, emotions and behavior is more difficult. A living situation where a patient cannot get regular and consistent sleep is destructive to sobriety and recovery.[24]

Treatment and Aftercare at The Canyon

Environment is everywhere, from what we see when we wake up to the air we breathe. For a patient who leaves behind a life of drugs or alcohol, the right environment is the difference between a new life of purpose and a life of out-of-control habits. Recovery is a lifelong process, and there’s much more to it than simply keeping the house clean. A person who is deliberate about positive surroundings and a healthy mind and body greatly reduces his chance of relapse.

At The Canyon, staff members give patients a comprehensive foundation for living in recovery. Through treatment plans that address all of a patient’s symptoms, including mental health issues like depression or anxiety, people learn to fight cravings and change their behaviors. If you or a loved one struggles with addiction, please call our toll-free helpline today.


[1] Center for Nonviolence & Social Justice. (n.d.). What is Trauma? Retrieved Feb. 6, 2017 from http://www.nonviolenceandsocialjustice.org/FAQs/What-is-Trauma/41/

[2] Szalavitz, Maia. (2012). How Childhood Trauma May Make the Brain Vulnerable to Addiction, Depression. Time. Retrieved Feb. 6, 2017 from http://healthland.time.com/2012/08/01/how-childhood-trauma-may-make-the-brain-vulnerable-to-addiction-depression/

[3] Sifferlin, Alexandra. (2013). Bullying in the Family. Time. Retrieved Feb. 6, 2017 from http://healthland.time.com/2013/06/17/bullying-in-the-family/

[4] Bureau of Labor Statistics. (2015). American Time Use Survey. Retrieved Feb. 6, 2017 from https://www.bls.gov/tus/charts/

[5] Canadian Centre for Occupational Health and Safety (CCOHS). (2008). Substance Abuse in the Workplace. Retrieved Feb. 6, 2017 from http://www.ccohs.ca/oshanswers/psychosocial/substance.html

[6] Crum, R. M., Muntaner, C., Eaton, W. W. and Anthony, J. C. (1995), Occupational Stress and the Risk of Alcohol Abuse and Dependence. Alcoholism: Clinical and Experimental Research. Retrieved Feb. 6, 2017 from http://onlinelibrary.wiley.com/doi/10.1111/j.1530-0277.1995.tb01562.x/abstract

[7]Abruzzese, Ron. (2013). Lawyers struggle with substance abuse at nearly twice the rate of general population. Brooklyn Daily Eagle. Retrieved Feb. 6, 2017 from http://www.brooklyneagle.com/articles/lawyers-struggle-substance-abuse-nearly-twice-rate-general-population-2013-03-28-190800

[8] Eaton, W.W.; Anthony, J.C.; Mandel, W. & Garrison, R. (1990). Occupations and the prevalence of major depressive disorder. Journal of Occupational Medicine. Retrieved Feb. 6, 2017 from https://www.ncbi.nlm.nih.gov/pubmed/2258762

[9] Drake, Daniela. (2014). How Being a Doctor Became the Most Miserable Profession. The Daily Beast. Retrieved Feb. 6, 2017 from http://www.thedailybeast.com/articles/2014/04/14/how-being-a-doctor-became-the-most-miserable-profession.html

[10] Andrew, Louise B. & Brenner, Barry E. (2016). Physician Suicide. Medscape. Retrieved Feb. 6, 2017 from http://emedicine.medscape.com/article/806779-overview

[11] Merlo, L.J.; Singhakant, S.; Cummings, S.M. & Cottler, L.B. (2013). Reasons for misuse of prescription medication among physicians undergoing monitoring by a physician health program. Journal of Addiction Medicine. Retrieved Feb. 6, 2017 from https://www.ncbi.nlm.nih.gov/pubmed/24089039

[12] Substance Abuse and Mental Health Services Administration. (2016). Co-occurring Disorders. Retrieved Feb. 6, 2017 from https://www.samhsa.gov/disorders/co-occurring

[13] Reese, Shelly. (2014). Drug Abuse Among Doctors: Easy, Tempting and Not Uncommon. Medscape. Retrieved Feb. 6, 2017 from http://nationalrxdrugabusesummit.org/wp-content/uploads/2014/02/Medscape_on_addicted_physicians.pdf

[14] Calland, Claire. (2013). Aftercare: A Fundamental Tenet in Attaining Long-Term Recovery. Intervene. Retrieved Feb. 6, 2017 from http://www.intervene.org.uk/aftercare-for-long-term-recovery/

[15] Center for Substance Abuse Treatment. Substance Abuse Treatment and Family Therapy. Treatment Improvement Protocol (TIP) Series, No. 39. Retrieved Feb. 6, 2017 from https://www.ncbi.nlm.nih.gov/books/NBK64265/?report=reader

[16] Palmiter, David & Alvord, Mary K. (n.d.) Managing stress for a healthy family. American Psychological Association. Retrieved Feb. 6, 2017 from http://www.apa.org/helpcenter/managing-stress.aspx

[17] Waterman, Elizabeth. (2012). Sober Living is More Important than You Think. Western Pennsylvania Healthcare News. Retrieved Feb. 6, 2017 from http://www.wphealthcarenews.com/sober-living-is-more-important-than-you-think/

[18] Teehan, Sean. (2013). Unlicensed and plentiful, sober houses offer place after rehab. Cape Cod Times. Retrieved Feb. 6, 2017 from http://www.capecodtimes.com/article/20130409/NEWS/130409846

[19] Nichols, Cindy. (2013). The Importance of Good Support Systems in Sobriety. Psych Central. Retrieved on Feb. 7, 2017, from https://psychcentral.com/blog/archives/2013/11/26/the-importance-of-good-support-systems-in-sobriety/

[20] Dailey, Kate. (2009). From Excess to Exercise: Group Helps Men and Women Live Sober Through Sweat. Newsweek. Retrieved Feb. 7, 2017 from http://www.newsweek.com/excess-exercise-group-helps-men-and-women-live-sober-through-sweat-222478

[21] Thompson, Dennis. (2009). 6 Ways to Clean House When You’re Depressed. Everyday Health. Retrieved Feb. 6, 2017 from http://www.everydayhealth.com/depression/clean-house-when-youre-depressed.aspx.

[22] Helper, Linda. (2016). Healthy Eating for Depression. Healthline. Retrieved Feb. 6, 2017 from http://www.healthline.com/health/depression/healthy-eating#Overview1

[23] Whalen, Jeanne. (2014). A Road to Mental Health Through the Kitchen. The Wall Street Journal. Retrieved Feb. 6, 2017 from https://www.wsj.com/articles/a-road-to-mental-health-through-the-kitchen-1418059204

[24] National Heart, Lung and Blood Institute. (2012). Why is Sleep Important? Retrieved Feb. 6, 2017 from https://www.nhlbi.nih.gov/health/health-topics/topics/sdd/why

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