The Elephant In The Room

ele 1.jpg.pngFacing addiction is hard, very hard, and the reality is you are never ‘cured’ its always a battle of wills and mental strength against the substance that has a grip on us. To always be on your guard is probably the best mindset so that you stay focused.

I have battled with my own, and the above rules apply to me as to all in recovery. I spent 4 months in rehab, and I found it fascinating  not just learning about myself and my own mind but also observing others and how they approach the process. After a few days of me settling in I was instantly focused and started in the gym, and the addictive personality and ‘all or nothing’ approach kicked in and within a week or so I was hitting the gym hard every day, obsessed. Now don’t get me wrong there are worse things to be addicted to than fitness however the addictive behaviour is something that we look to eliminate from ourselves rather than the substance itself. Its easy when you are in rehab to instantly go to an alternative to fill the void whether that be sugar, fitness, eating or anything else but the one thing that I find if nothing else but bizarre is smoking within rehab.

I think that its fair to say from my observations that 80% plus of the rehab patients I spent time with during my 4 months stay smoked either tobacco, cigarettes with a small percentage using E-Cigs or vaporizers.

The rehab unit I was in was based on Cognitive behavioural therapy (CBT) – which is in simple terms to change patterns of thinking and/or behaviour that are behind people’s difficulties, and so change the way they feel. For me CBT was the perfect approach, I looked into and researched other therapy but this made sense, it helped me understand my behaviours and why I kept going back to certain substances.

One thing that feels somewhat contradictory was the issue of smoking and how it comes across to me as the ‘elephant in the room’ in the way it’s approached and perceived within recovery.  Why is it not more taboo? furthermore it gets worse to the point of uncontrollable, like other substances were which led us to this point at in the very beginning.

Now I guess what most people will be thinking is its very common to replace one substance with another and if we are talking about smoking then surely other issues should be mentioned such as sugar intake, excessive exercise,  over eating and many more.

I heard people say on so many occasions that they have been advised not to give up smoking at the same time as either drugs or alcohol because it’s too hard but at the same time but surely if we are changing our behaviours then surely smoking comes under that as well as the other aforementioned replacements. So why am I emphasising so much on smoking? Well it’s for a few reasons really;

  1. It’s as dangerous to our health as other substances. That’s fact based on statistics.
  2. Rehab statistics of success. In rehab its roughly a 33.3% chance of recovering, the other 66.6% will either relapse or worse still die, and yet smoking accounts for 30% of all cancer related deaths and 87% of lung cancer deaths so surely that’s either contributing towards that low success rate or simply giving yourself an even slimmer chance.
  3. The economics of smoking. Research done as recently as December 2015 by ASH http://www.ash.org.uk/files/documents/ASH_121.pdf suggests that the cost to society is nearly £14 Billion per year, this is made up of cancer related diseases, premature deaths due to smoking,  costs of cigarette breaks to businesses and even the cost to companies through smoking related sick days.

Now I actually find this debate fascinating as a non smoker, who has smoked cannabis when I was using Cocaine, but have never smoked cigarettes and I’ve watched my Mother and Father both die of incurable lung cancer so have first hand experience of how destructive this addiction can be however in my rehab experience it’s almost like it is ignored and not looked at like an addiction and to a point it’s even almost encouraged with smoking shelters, no end of free time and the openness of staff smoking around clients and even with clients. It almost feels like a justification by all, or even just acceptance that ‘it is what it is’ and it’s the one addiction that is as harmful as drugs and alcohol that doesn’t get addressed for me.

From a rehab’s point of view if you if you had a ban on smoking within the premises like alcohol and drugs, then most who smoked would probably go elsewhere, that’s just my opinion but probably a good guess, so from a business or service perspective there is no value in that, after all if there are no clients then there is no service, so from that perspective it makes sense.

I guess it’s about balance, smoking is bad for you and its addictive and it should be treated as such within rehab centres differently in my opinion, because we are looking to change our behaviours and if you leave after 4 months equally or even more addicted than when you started your recovery then for me that’s extremely dangerous as the massive signs of addicted behaviour are still there, Its still dependency, in its purest form and smokers will give you every justification that it’s OK, in the same way I did with my drug addiction but is it, and it may be OK when the motivation to stay abstinent from drink or drugs is there, but when that motivation drops, that addictive behaviour will seek out something else and for me it will increase the chances of relapse and potentially returning to that substance misuse. Maybe this is one of the reasons why the statistics of success are so poor? Maybe we would see better results if smoking was looked at in the same light at the other substances or if there was a programme incorporated to encourage reduction? I don’t really know the answers, these are my opinions, and ones that I struggle to comprehend.

I understand (as I’ve said previously) that you could easily say the same about sugar intake, in my case excessive fitness, or obesity but smoking kills, just like drugs and just like alcohol, you can dress it up and sugar coat (excuse the pun) as much as you like but its a fact.

Is there an answer for whether smoking should be banned within rehab? It is still an addiction and I don’t know for sure, but I do believe a difference approach could be looked at because if a client came out of a recovery programme having given up a substance such as drugs or alcohol as well as cigarettes then that 33.3% success statistic may actually go up! It may not, but so long as it’s pushed quietly to one side I guess we will never find out.

If you are a smoker you may disagree, if you are an ex-smoker you may see both angles, if you’ve never smoked you will probably agree and I guess that’s why it has touched a nerve when I’ve asked for feedback and opinions from friends, family and peers alike, because it’s controversial, but more often than not its the things that touch a nerve which are uncomfortable mainly because there maybe some element of truth in it, and the truth usually hurts.

Its the controversial ones that are the best!!

 

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