The Link Between Addiction and Sleep

Addiction seeps into every part of your life, including the quality and duration of your sleep. Poor sleep can be an obstacle during recovery due to the mental, emotional, and physical changes that take place in the body. However, you can influence when, how quickly, and how long you sleep by changing a few personal habits.   


Sleep and addiction have a chicken and egg relationship; it’s hard to tell which came first. Let’s start by taking a look at how addiction can cause initial sleep loss.

Addiction to Sleep Loss

Some addictive substances directly affect the circadian region of the brain. The circadian rhythms control many of your body’s behaviors that repeat in a cyclical 24-hour pattern, including the sleep cycle. Many addictive substances affect this area of the brain, resulting in various symptoms of insomnia like delayed sleep onset, wakefulness, or early waking.    


For example, cocaine addicts have been shown to spend less time in the deep sleep phases. Heroin prevents cells from entering recovery cycles, and scientists hypothesize that the impulsive and cognitive deficits associated with ecstasy use may stem from changes in sleep neurobiology.    


Poor sleep also reduces the effectiveness of the immune system, slows muscle recovery, and alters appetite and metabolism. Not to mention destabilizing moods and opening the door to increased chances of anxiety and depression.

Sleep Loss to Addiction

However, addiction isn’t always the start of sleep problems. Poor sleep can often be a catalyst that leads to addiction. When insomnia hits with no relief in sight, some people turn to addictive substances, alcohol being the most common, to help them sleep. Sometimes it’s a matter of forgetting problems while for others, the addictive substance is a way to relax.    


While alcohol is a popular way to fall asleep faster, it actually increases sleep problems. Yes, alcohol helps you feel sleepy at first, but mid-sleep cycle, it keeps the brain in the light sleep stages. In light sleep, the body doesn’t enter restorative slow wave sleep. In those light sleep stages, it’s easier to be awakened again and again.

Working Towards Better Sleep

Whether your sleep problems started with addiction or addiction began with sleep problems, there are ways to help regulate the sleep cycle.   


  •  Set the Bedroom Up Right: The body and mind can’t relax if you’re not comfortable. Turn down the thermostat, make the room as dark as possible, and keep it quiet. Your mattress should accommodate your weight and preferred sleep style. If a new mattress is out of your budget, mattress toppers are a less expensive way to add support.   


  • Create Predictability: The body relies on consistent schedules to correctly time the sleep cycle. You can help by going to bed and waking up at a consistent time every day, even weekends.  


  •   Start a Routine: Addiction can get in the way of the natural release of sleep hormones. A bedtime routine retrains the brain. Calm, relaxing activities like reading or taking a warm bath are excellent traditional choices. If you need more help, a consistent meditation or yoga practice works wonders. Yoga can help reduce inflammation due to stress while meditation stabilizes emotions.     


  • Skip Stimulants and Bright Light: You’ll have to take more care of your sleep than normal when working through addiction, which means avoiding anything disruptive to your sleep. Caffeine blocks sleep hormones for several hours so cut it out of your diet early in the day. Watch out for bright light, including that of phones, laptops, and televisions. Put them on night or night shift mode or turn them off two to three hours before bed to prevent the light from suppressing sleep hormones.

Conclusion

Better sleep will take commitment and maybe a few changes to your nightly schedule. However, it’s worth it to have your own biology working for you rather than against you. It might take more time than average for your body to adjust based on the type of addiction you’re overcoming, but be patient with yourself and keep trying. It’s worth it to have good sleep on your side.

Guest Author: Ellie Porter

The Sleep Help Institute, SleepHelp.org

What to Do When Someone You Love is Living with Addiction

Addiction, recovery, rehab, alcoholism, drugs, help, sobriety

Addiction. It’s a scary word, but pretending it doesn’t exist won’t make it go away. If someone you love is living with addiction, it’s important to take action. Unfortunately, many people do not, simply because they don’t know where to start. The following guide serves to help you lead the path to recovery!

Know the Warning Signs

You cannot help a loved one suffering from addiction, if you are not able to recognize warning signs and symptoms. 

The following are just a few of many warning signs that may indicate a drug or alcohol problem:

  • Changes in eating and sleeping patterns.
  • Unexplained tiredness, energy, or agitation.
  • Deteriorating physical appearance, including sudden weight loss or gain.
  • Bloodshot eyes, or constricted or dilated pupils.
  • Mood swings, irritability, and other abrupt personality changes.
  • Declining performance at school, work, and home.
  • Sudden changes in social relationships.
  • Unexplained financial problems.

In addition to these signs, the Indian Health Service outlines symptoms of several commonly-abused drugs.

Sometimes, loved ones are aware that a person uses drugs or alcohol, but aren’t sure if it’s a problem. If a person is using drugs and alcohol despite negative consequences, abandoning responsibilities and enjoyed activities in favor of substance use, using drugs or alcohol to reduce withdrawal symptoms, or exhibiting other signs of a problem, it’s time to talk about it.

Use Non-Judgmental Communication

When confronting someone you love about a drug or alcohol addiction, it’s important to be sensitive and avoid confrontational behavior. Interrogating, attacking or antagonizing them can make matters worse. If your loved one feels attacked and becomes defensive, they will most likely be unreceptive to the conversation. Use non-judgmental communication tactics such as expressing observations, not conclusions, and being mindful of your tone. For additional insight into nonjudgmental communication, read more at The One Thing.

Don’t broach a conversation about your loved one’s addiction while they’re under the influence. Wait for a time that everyone is sober and relaxed to explain your concern. Some may benefit from group intervention in which friends and family (and sometimes a professional) all express their concern and support, while others may benefit from a one-to-one intervention.

Assess Treatment Options

There’s no guarantee an intervention will persuade your loved one to seek treatment. Nonetheless, you should enter the conversation with knowledge about available treatment options. If your loved one is receptive, knowing the options allows you to act swiftly, which is critical. Treatment programs are organized as follows:

  • Inpatient: Inpatient addiction treatment requires the individual to reside at the treatment facility, usually after completing detox. Detox will help stabilize and prevent life-threatening complications. This is generally the best option for someone beginning the recovery process. Keep in mind, treatment programs do NOT "cure" people from this disease. Rehabilitation programs serve to aid in making significant life changes in order to overcome addiction.  
  • Outpatient: Outpatient treatment allows patients to continue living at home, while participating in scheduled groups and activities throughout the week. Outpatient rehabilitation is best as a continuation of care after finishing inpatient treatment. When trying to get sober for the first time, outpatient care often is not enough considering the complicated nature of early recovery. While outpatient treatment is less expensive, a significant downside is that it does not prevent access to substances.
  • 12-Step or Non-12-Step: 12-step programs follow the format of Alcoholics Anonymous. It involves coming to realize that when it comes to drugs and alcohol, the individual does not have control over their lives. Furthermore, the key is to learn to heed advice from other who have made it well into recovery. The fellowship and guidance found in AA has led to the recovery of many. 
  • Non- 12 -Step programs may use holistic therapies or medical treatments like drug and nutritional therapy to promote recovery.
  • SMART Recovery: SMART Recovery, like AA, is a self-help group. However, the recovery process is approached in a different manner, with focus on self-empowerment and strengthening one's own motivation.
  • Religious or Non-Religious: In addition to 12-step programs, there are faith-specific treatment centers that integrate religious teachings into the treatment process. Non-religious treatment instead focuses on counseling, behavioral therapy, and other secular approaches.

In addition to these options, there are treatment centers that cater to men, women, business professionals, adolescents, LGBTQ, and other groups. Research your options well, as not all programs or treatment centers will be the right match.

Plan for Ongoing Support

After treatment, your loved one will need ongoing support to maintain their sobriety and prevent relapse. Once again, this is a life-long process. This includes psychiatric treatment, cognitive behavioral therapy, meditation, interpersonal therapy, financial support, among others, as they get on their feet to begin a new life. A substance-free living environment and emotional support are critical as they cope with the damage caused by addiction. At the same time, there is also a thin line between supporting a loved one through addiction recovery and developing dependent/co-dependant behavior. It’s important to set personal boundaries. Avoid enabling behaviors or triggering activities.Be aware, relapse is common; while sometimes deadly, others may proceed without another drink or drug for the rest of their life. It's incredibly important to be vigilant with the recovery process. Many family members and friends of those in recovery or trying to recover find strength in support groups like Al-Anon, Nar-Anon, and Adult Children of Alcoholics, among others.

Despite our best efforts, it’s not always possible to get a loved one help for their addiction. Ultimately, it’s up to the addicted person to choose sobriety and accept help. If your loved one isn’t ready to get clean, all you can do is leave the offer open, be patient, and keep loving them — and yourself.

Guest Author: Bethany Hatton http://preventaddiction.info/


Editor: Theodore Germanos, MD



Questions?

2018: Your Year to Shine

New Year New You

It’s a new year, and your addiction has become your past. You want your present to embody the new you but aren’t sure how. Here are a few tips on how to keep addiction at bay and get your life back on track for the long haul.

Create New and Sober Relationships

Creating new friendships as an adult can be summed up in one word: hard. It’s not impossible, however; you just have to find the right fit for your sober lifestyle. When you were drinking or using, you already had a common interest with your “friends.” While you don’t have to leave everyone behind, you may need to get rid of the negative influences and seek friendships based on healthy interests. Fast Company recommends joining a pre-designed group (networking, book club, etc.). These provide consistency, the #1 ingredient needed to craft new friendships.

Consider a Change of Scenery

Moving away from bad memories and influences may be a wise choice, especially if you don’t have a support network at home. Relocating gives you a clean slate, a chance to begin anew without the social stigmas surrounding your addiction. Make your move as stress-free as possible by hiring movers to help with the heavy lifting. Likewise, pick a day and time to move when your crew is likely to be rested and ready to tackle the day without fatigue from overworking. June is the busiest month in San Diego to hire movers; January, February, and November, according to Hire A Helper, are the least demanding on your moving company.

Recommit to Your “WHY”

You may not have had a reason for taking drugs in the first place, but you do have reasons to stop. Whether it’s for your health, family, or career, take some time to recommit to your sober stimulation. Don’t fill your days with pointless activities in an effort to ignore your addiction; instead, spend your time working on the things that make you want to be the best version of yourself.

Spend More Time Outdoors

You might not be a hiker, biker, or gardener, but your brain is wired for time outdoors. So much so that the simple act of being outside triggers a positive response in your grey matter. National Geographic explains that the brain changes when we are outside. Its alpha waves, those responsible for calmness, grow stronger while the frontal lobe, which keeps us on high alert, relaxes. Many studies have found that the act of looking at nature in the form of art has a similar effect. When you are outdoors, you are also more likely to exercise, which is another important facet of your recovery.

Find Something You Love and DO IT!

Think about what makes you happy and content. What activities make you feel calm and at-ease with the world? No matter what it is, find ways to do it. If you like to create art, learn to paint. Take up an instrument if sounds soothe your soul. You may even find that spending your time volunteering at a homeless shelter or as a mentor for others in recovery gives you a renewed sense of pride in yourself. Volunteer at your child’s school or spend a weekend each month cleaning up local parks. Hobbies are known to make us happy and increase overall quality-of-life so don’t be afraid to pick up a new habit that lets you express yourself in ways you’ve never done before.


Guest author Adam Cook is passionate about helping people find the necessary resources to save their lives from addiction. He is also the founder of Addiction Hub, a service that locates and catalogues addiction recovery resources. 

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Serenity

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The Power of Self (8/17/17)

The phrase "power of self" carries a certain weight and a broad definition. The simplistic meaning that many attribute to this phrase is that an individual has the capability to accomplish anything they put their mind to. However, this view will only lead to disappointment and frustration as it is completely normal for human limitations to exist.


In recovery, as one focuses on personal growth, the commonly referenced serenity prayer reveals a deeper meaning to the power of self. "God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference." The key here is that we will never find true peace, unless we learn to differentiate between what we can and cannot control and build upon that which we do have power over. We must focus on self-improvement, while letting go of that which we do not have control over. A perfect explanation of this is given by Mark Manson in his book "A Subtle Art of Not Giving a F***", in which he states:


"There is a simple realization from which all personal improvement and growth emerges. This is the realization that we, individually, are responsible for everything in our lives, no matter the external circumstances. We don't always control what happens to us. But we always control how we interpret what happens to us, as well as how we respond."


By learning how to properly deal with life's stressors and frustrations, we can practice self-discipline and unleash the self-fulfillment, happiness, and serenity that comes with this true power of self.


Theodore Germanos, MD

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Intervention essentials

Who Needs an Intervention?

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An addict is usually in denial that they have a problem. The point of having an intervention is to metaphorically hold a mirror up to the addict's face so that they may see the harm they are causing to themselves and those around them.

When is an Intervention Necessary?

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The right time is always now. The next time an addict uses could be their last. Negative consequences may not be enough to stop the addict from using. Interventions are necessary to help the individual stop before they cause further irreversible damage and ultimately avoid the most drastic and very real consequence of death. Things could get worse, and the time to stop is always now.

Interrupting the Cycle and Sparking Change

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While some believe the addict must come to realize they need to stop on their own terms - medicine, psychology, and addiction science all refute this idea. Addiction is a disease and the addict may never come to this conclusion on their own. Treatment is necessary and it often becomes the responsibility of those around the addict to push them to seek treatment and provide that opportunity for change. 

A Better Life

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Interventions have been largely successful in providing individuals suffering from addiction that necessary push to turn their life around. While the work to being clean and sober never ends, it has to start somewhere. An intervention could be that starting point to a healthy and happy life. Enlist the help of a specialist by clicking below and filling the contact form.

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Opioids - digital press kit

NIH Targets Opioid Epidemic (8/3/17)

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The National Institutes of Health has released a new digital press kit regarding the opioid epidemic, providing information, images, and videos on the topic. Click on the image above to check it out!

Theodore Germanos, MD

Meditation

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What is meditation anyways? (8/2/17)

Just hearing the word meditation generally triggers eye rolls. At least that was my response anytime someone asked me if I meditate. However, once I actually gained a better understanding of what meditation really is, I was able to find the benefits of the practice. 


Contrary to popular belief, meditation is not the imagining of black nothingness and trying your hardest to erase all thoughts from your mind. That already is a large reason why many hate meditation; trying to do the impossible due to a misunderstanding of the exercise. So what is meditation then? Theres is no one specific way to meditate. 

  • For instance, some people prefer silence, while others prefer relaxing music to keep them calm (see an example below!).
  • The key to meditation is to make several small changes to our mind and body that will leave us in a much more relaxed state. 
  • Closing ones eyes and depriving the brain of the intense constant stimuli that vision offers is a way in which we can slow down the hyper speedway inside our heads
  • Focusing on slowing down our breathing, counting 4 seconds while breathing in, holding for 4 seconds, then breathing out for 4 seconds, then holding again for 4 seconds, and repeating this exercise, is a proven method that triggers a series of reactions in the human nervous system telling the body to relax. This parasympathetic reaction is the opposite of the "fight or flight" response triggered when anxious. 
  • What should you be imagining while your eyes are closed? Anything that makes you feel comfortable. Some people like to visualize a stream of water flowing by in the dark, in which all their thoughts flow. Anytime a stressful or random thought arises, one places it back in the stream and watches it quickly flow away. This example illustrates that meditation involves visualizing relaxing images as opposed to trying to completely clear the mind, which is quite difficult for those just starting to meditate. Other examples of what to imagine include natural landscapes, such as the ocean or forest, or a place you associate with comfort and happiness (which does not even have to be a real place).
  • Yet another technique, is to be aware of your posture and body, meaning you think about your body from head to toe, which parts are touching the ground, the chair, a table, which parts feel tense, which are relaxed, etc. Slowly then tighten the tense areas and allow them to let go and relax. You may notice we naturally harbor so much tension that you can release as you slowly relax your body further.
  • How long should you meditate? It's always a good idea to start with 5 minute sessions, in the morning, throughout the day when you need to reset from stress (even for 1 minute), and at night. Slowly, as the practice becomes more in-tune, you'll find it easier and will effortlessly enjoy longer meditation sessions.

While there is much to be said about meditation, this is a great way to start and with these tips you can make a huge difference in your state of mind and body. In today's world, it's quite normal to harbor tension, worries, and stress. But with practice, we have the power to alleviate these negative feelings and transition to serenity.


Theodore Germanos, MD

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Meditation and Relaxation

Here is a great example of the power of music to help you relax, whether you are meditating or trying to fall asleep. 


Exercise: Try closing your eyes and see if you can visualize the soothing sounds.


Source: MeditationRelaxClub. Sleep Music Delta Waves: Relaxing Music to Help you Sleep, Deep Sleep, Inner Peace and Autogenic Training. Relaxing Sounds for Relaxation Meditation, Tai Chi and Reiki. Meditation Music Video. Retrieved from www.youtube.com/watch?v=xQ6xgDI7Whc

Warning Signs

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Warning Signs of Addiction (7/30/17)

When it comes to discussing the signs and symptoms of addiction, it often becomes clear that addiction is not some sort of moral fault or string of bad decisions. Rather, addiction is a disease rooted deep in parts of the brain responsible for human behavior.


Here are some things you should look out for (1):

  • Physical Dependence - feeling that you have to use the drug regularly — this can be daily or even several times a day. In other words, getting so used to the drug that you cannot function without it.
  • Cravings - Having intense urges for the drug. This can be best described as feeling 'hungry' for the drug.
  • Tolerance - over time, needing more of the drug to get the same effect. The drug no longer causes the desired result and more must be taken to achieve this result. Furthermore, the high most likely never reaches the same level of high as compared to initial usage. This makes it easier for overdoses to occur as higher and higher doses are taken.
  • Drug-Seeking - making certain that you maintain a supply of the drug. Focusing more and more time and energy on getting and using the drug. An addict will go to tremendous lengths to obtain the drug. Some examples include spending hours in the ER to be prescribed pain medication or faking an illness/condition to be prescribed narcotics.
  • Financial Trouble - spending money on the drug, even though you can't afford it. It is very common that an addict may resort to buying illegal drugs due to being unable to obtain them any other way. As usage increases, so does spending; debt becomes very common.
  • Neglecting Responsibilities - not meeting obligations and work responsibilities, or cutting back on social or recreational activities because of drug use. While the addiction continues to grow, more and more time is spent on the addiction whether that be in using or trying to obtain the drugs. That means less time for everything else. (This goes along with one of the major harms of addiction as an addict experiences impairment of function and life-quality. The others being injury, illness, and death).
  • Engaging in Illegal Activities - Doing things to get the drug that you normally wouldn't do, such as stealing. Desperation is a common end-point in addiction. Addicts often resort to prostitution, stealing, lying, manipulation, or other behaviors they would not normally engage in just to obtain the addictive substance.
  • Poor Judgement - Driving or doing other risky activities when you're under the influence of the drug. Many drugs impair a person's control of their own actions, as well as altering capabilities and perception.
  • Unsuccessful in Trying to Quit  - failing in your attempts to stop using the drug. It is not unusual to be unable to stop on your own. Like any disease, addiction needs to be treated.
  • Withdrawal - experiencing withdrawal symptoms when you attempt to stop taking the drug. Not having the drug leads to negative physical and psychological effects.

Note, addiction extends beyond drugs and can exist in the form of many activities and behaviors, such as eating, sex, watching TV, or even something considered healthy, such as working-out. And as so, the above list can be applied to most other addictions, substituting the drug for the addictive behavior or activity.


Theodore Germanos, MD

Source

  1. Mayo Clinic. (2014). Symptoms.

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Relapse prevention

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Relapse Prevention (7/26/17)

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect those of Living Above Addiction.


Among one of the most difficult things of addiction and recovery is the dreaded word: relapse.  So many debates and arguments are to be had around this word. They say relapse is a part of recovery, relapse is normal, relapse is a sign of failure, relapse is inevitable, I’ve even heard some utter that you're not a true alcoholic/addict unless you have relapsed.  Relapse is among one of the most insidious words in the world of addiction and recovery because it carries such loaded connotations and implications behind it - bringing with it freedom and chains; responsibility, accountability, and misplaced intentions. We addicts have the impeccable ability to manipulate, deceive, lie, and maintain denial not only to others and loved ones but especially to ourselves.  Oh how we enjoy dwelling in that space of uncertainty and the shades of grey, deftly dwelling and being intimate with all it’s forms.  How easily have I used the idea of relapse as a shelter from responsibility and don the excuse in order to place blame elsewhere. “I’m sorry, I really did try, but you got to understand that relapse is a part of recovery.” Yes, on face value this has some truth, but in the manipulation of that statement, the true meaning is a shirking of responsibility. Responsibility is placed elsewhere on intangible things such as “the disease” or the idea that treatment doesn’t always work, at least for me.  


The idea that responsibility is directly with me or in the choices I make, or the avoidance of real underlying causes, or denial of feelings and emotions.  One can clearly see how dangerous this line of thinking can be and how slippery this slope is. Yet, once again there is truth hidden in that word, in that phrase. You can see the path of good intention that lays there. The idea of solace and hope is birthed and offered to those who have tried time and time again returning to treatment multiple times. One can easily see how there is no other choice than to believe this idea and spin relapse into a positive renewal of effort. One must be able to pick themselves up and be able to move on and without hope and extracting important lessons from the ashes one will only be stuck and mired, quickly consumed.


So the question becomes: are those good intentions and desire to provide hope and forward movement worth the potential quagmire? Can we as addicts truly understand the idea of relapse and harness it to benefit our recovery? Can we deny an aspect that is plainly there in the process of addiction and recovery? How can we come to terms with this term, this idea in proper measure? Do we accept relapse as a normal circumstance or do we fight the good fight and hope against all odds yet not give into naiveté? 


I and many others have struggled with this word and what whirlwinds it brings on it’s coat tails. I am not the first and will not be the last to ponder this enigma. But as it is a part of my story, I will venture to come to my own understanding of it and try to in right measure wrestle with it. I want to examine my own experience and try to answer these questions knowing that there is no one true answer that is definitive. One thing I do believe in, it is the journey not the destination. So, it is far more important to ask the question than to find the answer. I also know for myself that addiction is a disease that requires constant work to maintain sobriety and be in recovery. It is this work that requires prioritization, it is a process, and a fight, one well worth being in and it is this musing of relapse that falls directly in line with this pursuit of never resting on one's laurels and being actively vigilant in the ongoing process of being in recovery. So now that the problem is posed and the questions asked, what answers will present itself and can the lens of my own experience provide illumination and focus rather than muddying and making opaque the view, because despite all the academics and philosophical wonderings, experience is the true king. 


R. L. 

Addiction Counselor and Guest Blogger

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Overcoming Addiction (7/4/17)

The decision to get clean and drug free is an intimidating decision. Just making that decision is half the battle. Living Above Addiction is here to help and support you in taking that step, while developing a personalized treatment plan that will markedly increase your chances of success. 


Detox, Inpatient, Residential, Partial Hospitalization, Outpatient, Individual Therapy, and Self Help/Support Groups. Confusing, right? Our experts can help explain the benefits and drawbacks of each type of treatment and match you with the best fit for you.  OK, once you know what type of treatment is best suited for you, how do you choose from the hundreds of different facilities and programs in Southern California? Passages? Betty Ford? Salvation Army? Everyone is different and consequently there are no one-size-fits-all programs. 


We can help you find the perfect place for you to begin the road to recovery from addiction based on your personality, goals, and other factors. Finding the right place on the first try is important as it will not only save time from having to repeat the process in your journey to long-term sobriety, it will also save you from spending large sums of money. If finances are an issue, there are many programs/centers that cost little or nothing! Studies have shown that long-term success is correlated with getting it right on the first try. 


Let us help you do just that and navigate the process to becoming sober. Contact us 24/7 at 858-609-9493 or by email at LivingAboveAddiction@gmail.com for a free consultation today! 


Theodore Germanos, MD

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