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SKILL.md
Modern Drug Rehab Computer
Comprehensive knowledge companion for individuals in addiction recovery, whether in residential treatment or commuting from home for outpatient programs.
When to Use This Skill
Use for:
Evidence-based treatment modality information
Coping strategies and grounding techniques
Recovery resource navigation
Understanding medications (MAT, Suboxone, etc.)
Family dynamics and communication
Lifestyle and wellness guidance
Meeting/support group information
Trigger management strategies
NOT for:
Prescribing or adjusting medications → consult your medical team
Active overdose/medical emergency → call 911 immediately
Replacing your counselor or therapist
Making treatment decisions → discuss with your care team
┌─────────────────────────────────────────────────────────────┐
│ RECOVERY PROGRAM OPTIONS │
├─────────────────────────────────────────────────────────────┤
│ 12-Step (AA/NA/CA) │
│ ├─ Spiritual foundation (Higher Power concept) │
│ ├─ Sponsor relationship │
│ ├─ Steps and traditions framework │
│ └─ Widespread availability, community │
│ │
│ SMART Recovery │
│ ├─ Science-based (CBT/REBT) │
│ ├─ Self-empowerment focus │
│ ├─ 4-Point Program │
│ └─ No spiritual requirement │
│ │
│ Refuge Recovery / Recovery Dharma │
│ ├─ Buddhist-inspired, mindfulness-based │
│ ├─ Meditation practice │
│ └─ Eightfold Path framework │
│ │
│ LifeRing Secular Recovery │
│ ├─ Secular, self-directed │
│ ├─ "Sober self" concept │
│ └─ Peer support focus │
└─────────────────────────────────────────────────────────────┘
Note: These can complement each other. Many people use multiple programs.
Coping Skills Toolkit
Immediate Craving Response (HALT + STOP)
When craving hits, check HALT:
├── H - Hungry? (eat something nutritious)
├── A - Angry? (process the emotion)
├── L - Lonely? (reach out to someone)
└── T - Tired? (rest if possible)
Then STOP:
├── S - Stop what you're doing
├── T - Take a breath
├── O - Observe what you're feeling
└── P - Proceed mindfully
Grounding Techniques (5-4-3-2-1)
For anxiety, dissociation, or overwhelming cravings:
5 things you can SEE
├── Look around, name them out loud
4 things you can TOUCH
├── Feel textures, temperatures
3 things you can HEAR
├── Ambient sounds, near and far
2 things you can SMELL
├── Notice scents in your environment
1 thing you can TASTE
├── Focus on current taste in your mouth
DBT Distress Tolerance (TIP Skills)
For high-intensity emotional moments:
T - Temperature
├── Hold ice cubes, cold water on face
├── Activates dive reflex, calms nervous system
I - Intense Exercise
├── Run in place, jumping jacks, stairs
├── Burns off stress hormones
P - Paced Breathing
├── Breathe out longer than in (4-7-8 pattern)
├── Activates parasympathetic system
P - Progressive Muscle Relaxation
├── Tense and release muscle groups
├── Releases physical tension
Urge Surfing
Instead of fighting the craving, ride it like a wave:
1. Notice the urge (don't judge it)
2. Rate its intensity (1-10)
3. Observe where you feel it in your body
4. Breathe into that area
5. Watch the intensity rise...
6. ...peak...
7. ...and fall (cravings typically last 15-30 minutes)
8. Rate the intensity again
Key insight: Cravings are temporary. You don't have to act on them.
Medication-Assisted Treatment (MAT)
Understanding Your MAT Options
Medication
Used For
How It Works
Key Considerations
Suboxone (buprenorphine/naloxone)
Opioid use
Partial agonist, blocks cravings
Must be in withdrawal to start
Sublocade
Opioid use
Monthly injection of buprenorphine
Steady levels, no daily dosing
Methadone
Opioid use
Full agonist, daily dosing
Clinic visits required
Vivitrol
Opioid/alcohol
Blocks receptors, monthly injection
Must be opioid-free 7-14 days
Naltrexone (oral)
Opioid/alcohol
Blocks receptors, daily pill
Reduces "high" from use
Antabuse
Alcohol
Creates nausea if drinking
Deterrent effect
Campral
Alcohol
Balances brain chemistry
Reduces cravings
MAT Myths vs. Facts
MYTH: "MAT is just trading one drug for another"
FACT: MAT is evidence-based medicine that normalizes brain function,
reduces cravings, and saves lives. It's no different than using
insulin for diabetes.
MYTH: "You're not really sober if you're on MAT"
FACT: Recovery is not defined by the absence of medication.
Stability, function, and quality of life are what matter.
MYTH: "You should get off MAT as soon as possible"
FACT: Research shows longer MAT duration = better outcomes.
The decision to taper should be made with your doctor when stable.
Living Situation Considerations
Residential Treatment
Making the Most of Residential:
├── Engage fully in programming
├── Build relationships with peers and staff
├── Follow the structure (it's there for a reason)
├── Be honest in groups and with your counselor
├── Use free time productively
├── Start planning for aftercare early
└── Practice skills in a safe environment
IOP/PHP (Outpatient - Living at Home)
Commuting to Treatment Challenges:
├── Returning home to triggers daily
├── Managing home responsibilities + treatment
├── Partners/family who don't understand
├── Work/childcare conflicts
├── Isolation between sessions
└── Access to substances
Strategies:
├── Secure your home environment (remove substances)
├── Communicate with family about boundaries
├── Build structure into non-treatment hours
├── Attend extra meetings on non-treatment days
├── Keep your counselor informed of home challenges
├── Have phone numbers ready for crisis moments
└── Consider sober living if home isn't safe
Family & Relationship Dynamics
Communicating with Partners/Family
What families need to understand:
├── Addiction is a brain disease, not a moral failing
├── Recovery is a process, not an event
├── Their role: support, not control
├── Boundaries are healthy for everyone
├── Al-Anon/Nar-Anon exists for them too
What you can communicate:
├── "I'm in treatment and taking this seriously"
├── "This is what I need from you right now: [specific request]"
├── "I understand I've hurt you. I'm working on making amends"
├── "Recovery is my responsibility. I need your support, not your management"
├── "Let's work on this together with a family counselor"
Couples Therapy in Recovery
Why couples therapy matters:
├── Addiction affects the whole relationship
├── Communication patterns need rebuilding
├── Trust takes time and structured work
├── Both partners have healing to do
├── Codependency patterns need addressing
When to start:
├── Usually after initial stabilization (30-90 days)
├── When both partners are willing
├── With a therapist who understands addiction
├── As complement to individual work, not replacement
Holistic Wellness
Daily Recovery Structure
Morning Routine:
├── Gratitude list (3 things)
├── Meditation/prayer (5-15 min)
├── Healthy breakfast
├── Review daily intentions
└── Morning meeting (if helpful)
Throughout Day:
├── Regular check-ins with self
├── Meals at consistent times
├── Movement/exercise
├── Connection with recovery support
└── Practice skills from treatment
Evening Routine:
├── Review the day (what went well?)
├── 10th step inventory (if in 12-step)
├── Prepare for tomorrow
├── Wind-down activities (no screens)
└── Consistent bedtime
Nutrition & Sleep
Nutrition in Recovery:
├── Regular meals stabilize blood sugar and mood
├── Protein helps rebuild neurotransmitters
├── Reduce sugar/caffeine (can trigger cravings)
├── Stay hydrated
└── Consider consulting nutritionist
Sleep Hygiene:
├── Consistent sleep/wake times
├── No screens 1 hour before bed
├── Cool, dark room
├── Limit caffeine after noon
├── Address sleep issues with your doctor
└── Many in recovery have disrupted sleep initially - it improves
Common Challenges & Solutions
"I feel like I don't fit in at meetings"
Options:
├── Try different meetings (they vary widely)
├── Try different programs (SMART, Refuge, LifeRing)
├── Look for specialized meetings (LGBTQ+, young people, professionals)
├── Online meetings offer more variety
├── Focus on similarities, not differences
└── Give it time - connection builds gradually
"My family doesn't trust me"
Understanding:
├── Trust is rebuilt through consistent action over time
├── It's not about proving yourself - it's about being yourself
├── Their caution is protective, not punishing
├── Focus on what you CAN control (your behavior)
Actions:
├── Be where you say you'll be
├── Follow through on commitments
├── Accept accountability without defensiveness
├── Let time and consistency work
└── Consider family therapy when appropriate
"I'm bored without substances"
The Science:
├── Dopamine system is recalibrating
├── Things will feel less pleasurable for a while
├── This is temporary (neuroplasticity!)
Solutions:
├── Exercise (natural dopamine boost)
├── New hobbies (guitar, art, gaming, sports)
├── Service work (helping others)
├── Social connection (even when you don't feel like it)
├── Accept boredom as part of healing
└── Structure your time intentionally
partner-text-coach: Communication with partners/family
jungian-psychologist: Shadow work and deeper psychological exploration
hrv-alexithymia-expert: Emotional awareness and regulation
Core Philosophy: Recovery is possible. You are more than your addiction. This skill exists to provide information and support - but your treatment team, your sponsor/supports, and YOUR commitment are what make recovery real. Use this as a resource, not a replacement for human connection and professional care.
