A podcast I often recommend to patients is The Bubble Hour (www.thebubblehour.com). On a recent episode the discussion was about relapse. Two women in long -term recovery discuss what it's like for them when friends relapse. One of them quoted Anne Lamott, who says, "Lighthouses don't go running all over an island looking for boats to save; they just stand there shining."

I really appreciate that notion.

At the Coleman Institute we recognize that addiction is a chronic illness. I often tell my opioid or alcohol dependent patients, when a person with diabetes gets his/her blood sugar under control, I don't say, "Great! Now eat whatever the hell you want, you've made it!" On the contrary, the "gift" of having diabetes, is the opportunity to intentionally look at what you are choosing to consume and how you are choosing to exercise to keep your precious body at its best.

Likewise, with addiction.

Each day a patient in recovery is given the choice to become closer and closer to the person he/she was meant to be. That means being present with urges and triggers, noticing and allowing them, and then choosing not to use alcohol or other drugs.

People relapse. A lot. They deem the present moment unbearable and choose to change it with chemicals. It works nicely for a minute. Then the consequences begin to roll in: broken relationships, loss of trust, loss of job, disintegrating integrity, the shame cycle is back.

At the Coleman Institute, we understand people in their disease. Sometimes they don't come back for follow up. Some patients return to the office for naltrexone therapy even after they have recently used. There is a part of them that longs to be clean, and another part of their brain that feels like life is being choked off if anything gets between them and their drug. Some fool us by using someone else's urine so they can get their naltrexone shot or implant and experience precipitated withdrawal. That's part of the insanity of this condition.

But. . . that's why I like the lighthouse analogy. We get the craziness, but we are here for our patients. It can be discouraging for family and loved ones to see people fail and fall and lose ground. Sometimes it's hard for a relapsing patient not to lose hope, to know that they can turn things around. And even though we're in the business, it is not fun seeing a patient relapse.

Sometimes people return for a 2nd or even 3rd detox. If they haven't committed to working on their recovery with counseling, rehab or 12 step groups, and if they stopped using Naltrexone, this helps provide the blueprint for creating a better plan for change this time. Patients begin to recognize that simply to stop using isn't the fix; it's a process.

So at the Coleman Institute we are here for our patients, over on Hamilton Street in Richmond. Shining. Willing to offer advice on your recovery journey. Available to support you if there is a need to return.

Joan Shepherd, FNP