During early recovery, the primary focus is on renunciation, though people also begin the integration and repair process and at least think about their personal growth and spirituality.

For some, renunciation gets a bad rap. People think of it as deprivation. This could not be further from the truth. Rather than depriving yourself of anything, renunciation is a gift you give yourself. In fact, you get something great in return. It is the act of liberating yourself from compulsively grasping for something you want because of destructive cravings, even when the harm outweighs the benefit.

The disease of addiction entails compulsions and cravings. In early recovery, we wake up to the truth that satisfying compulsions and cravings only perpetuates them…and the destruction that comes with addicting. Addiction entails damage to the brain’s drive-reward system. We feel this damage in the form of withdrawal symptoms, cravings, and compulsions. Knowing your drive-reward system is damaged, you renounce artificially stimulating it with any addictive substances.

The most common renunciation issue in recovery is smoking. There is an adage, “one addiction at a time.” This turns out to not be true. People increase their chances of successful recovery by 25% if they renounce all addicting, including smoking.[1]In one study, patients who were not allowed to smoke during detoxification from opioid had lower cravings and higher treatment completion rates.[2] Quitting smoking reduced cravings and improved treatment outcomes. Conversely, continuing to smoke is associated with an increased risk of relapse on other substances.[3] Intuitively, it makes sense that stimulating the brain’s drive-reward system with nicotine—continuing to addict—could trigger cravings for other substances. Addicting creates distress, including addicting with nicotine, which causes increased rates of anxiety, stress, and depression.[4]We used to think that smoking was benign, or perhaps even beneficial in patients with other mental illnesses. The truth, however, is that smoking is actually associated with an increased risk of suicide by 24% for each increment of 10 cigarettes smoked per day.[5]The truth is that quitting smoking is associated with reduced depression, anxiety, stress and a lower risk of suicide. It is also associated with improved mood and quality of life.[6]There is also simply the fact that smoking kills two thirds of people who smoke.[7]

Another common addiction issue where the fatal consequences are delayed is food addiction. Like with smoking, overeating has unpleasant but tolerable immediate consequences for many, yet results in significant increases in mortality in those with a Body Mass Index (BMI) greater than 35.[8]

If we are in recovery, we practice love. It is simply not loving to hurt ourselves in any way, including smoking and overeating.

Thus, out of love for ourselves and others, we renounce all addicting. We commit to managing cravings with the help of others. We take responsibility for our well-being. We become loving parents to ourselves. We take action to resolve urges to addict—even if just to sit in still presence, compassionately observing our pain—and do what we need to nurture and soothe ourselves in nonaddictive ways.

We put our dorsolateral prefrontal cortex back in charge, thinking through what is best for us and others despite addictive urges to do otherwise. We replace immediate addictive gratification with the full abundance of delayed fulfillment. Like a loving parent, we commit to what is good, right, and true for us and others. Seeing that addicting is destructive, we renounce addicting. As the first step of recovery, we take the “no harm” vow; we vow not to harm Life—ours or others—to the fullest extent possible. We recognize the awesome responsibility Life has given us, to nurture our life and the lives of others.

Image from: http://www.toomanly.com/7148/heres-how-much-weed-it-takes-to-kill-you/.

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[1]Prochaska, J, Delucchi, K, Hall, S. A Mete-Analysis of Smoking Cessation Interventions with Individuals in Substance Abuse Treatment or Recovery. J Consulting and Clinical Psychology. 2004. 72(6); 1144-1156.

[2]Mannelli P. et al. Smoking and Opioid Detoxification: Behavioral Changes and Response to Treatment. Nicotin Tob Res. 2013 Oct;15(10):1705-13.

[3]Weinberger, A. et al. Cigarettes Smoking is Associated with Increased Risk of Substance Use Disorder Relapse: A Nationally Representative, Prospective Longitudinal Investigation. J Clin Psychiatry. 2017 February; 78(2): e152-e160. Doi:10.4088/JCP.15m10062.

[4]Compton, W. The Need to Incorporate Smoking Cessation Into Behavioral Health Treatment. Am J on Addictions, 27: 42-43, 2018.

[5]Li, D. et al. Cigarette Smoking and Risk of Completed Suicide: a Meta-Analysis of Prospective Cohort Studies. J Psychiatr Res. 2012 Oct;46(10):1257-66.

[6]Taylor, G. et al. Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ 2014;348:g1151 doi: 10.1136/bmj.g1151.

[7]Pirie, K. The 21st century hazards of smoking and benefits of stopping: a prospective study of one million women in the UK. Lancet. 2013 Jan 12; 381(9861): 133-141.

[8]Flegal, KM. et al. Association of all-cause mortality with overweight and obesity using standard body mass index categories: a systematic review and meta-analysis. JAMA 2013 Jan 2;309(1):71-82.

 

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