Get answers to your questions about topics covered in the latest Recovery and Policy: How States Transform Systems of Care. Watch for the next Road to Recovery Update to learn when the answers are posted on the Web site.

To view the Webcast, visit http://www.recoverymonth.gov/2005/multimedia/w.aspx?ID=413.

Ask the Expert Transcript

Question: I work in adolescent treatment and I also have been clean and sober for 7 years. My question is this: How would you handle a situation where co-workers declare they are in recovery, but do not abstain from alcohol? Thank you.

Janet Wood: First of all, congratulations on your recovery! It's difficult to provide a specific answer without knowing more about the individuals' circumstances. However, it sounds as though the co-workers are putting themselves at risk for relapse by continuing to drink alcohol or there is concern that the unclear message being sent by the "partial" recovery staff members could place the clients at risk.

Your primary responsibility should be to the adolescents who are at high risk for cross-addiction (both alcohol and drugs). It is appropriate to have a discussion with your co-workers as it relates to the performance of your job. Depending upon the relationship you have with your co-workers, it may make sense to talk to them about this "disconnect" you're experiencing. On the one hand, they openly say that they're in recovery, but on the other hand, they tell you they're continuing to drink. I'd suggest that you first listen to their perspective and understand their point of view in a non-judgmental way. If the coworker(s) agree(s) to make some changes, referrals out-side the work place should be offered.

It is also sometimes difficult for people with an AA recovery model to recognize what could be a reasonable state of "recovery" for others. A person may have been abusive of hard drugs, and now is a social drinker only.

Question: How does alcohol affect women more than men?

Janet Wood: I've provided a link to a very informative bulletin on how alcohol affects women, developed by the National Institute on Alcohol Abuse and Alcoholism (NIAAA). pubs.niaaa.nih.gov/publications/aa46.htm

Janet Wood: In general, women appear to be more vulnerable than men to many adverse consequences of alcohol use. Women absorb and metabolize alcohol differently than men. In general, women have less body water than men of similar body weight, so that women achieve higher concentrations of alcohol in the blood after drinking equivalent amounts of alcohol. Research suggests that women are more vulnerable than men to alcohol-related organ damage, trauma, and legal and interpersonal difficulties. The following link will direct you to information facts on women's treatment developed by the National Institute on Drug Abuse (NIDA). www.nida.nih.gov/Infofacts/TreatWomen.html

Question: I am a trainer for the Department of Human Resources in Alabama. I was hired to be a drug program specialist and I conduct all the substance abuse trainings. I have extensive experience in substance abuse treatment. However, I have a difficult time trying to get State office staff (consultants and management) to understand the dynamics of addiction and the disease concept. They seem to refuse to see addiction as a disease. They honestly believe that as long as an addictive parent does not drink or use around the kids or as long as they take them to a babysitter before they use that it is all right for them to use. It seems very difficult or maybe impossible for them to see the nature of the disease of addiction. Any suggestions?

Janet Wood: It can be difficult to feel like the only person who understands this illness. Sometimes aligning yourself with others who share this understanding can help in a few ways. First, you're not the only person talking about this issue (it can be exhausting), and second, it may take an outside expert to get the right people's attention. There are some wonderful resources such as the Physician Leadership on National Drug Policy (PLNDP) Position Paper on Drug Policy available at www.plndp.org/Resources/researchrpt.pdf and the National Institute on Drug Abuse has excellent information on its Web site about addiction as a brain disease at www.nida.nih.gov/consequences/. There are multiple speakers across the country who regularly address this topic. The National Conference of State Legislators (NCSL) is currently working with Dr. Tom McClelland to educate legislators around the country about this important issue.

Question: Is it safe to drink the wine for communion if you are an alcoholic? I'm afraid to take communion now, because I'm afraid if I drink that little sip of wine, I'm going to want to start drinking again. I'm sober now for 19 months and enjoying every minute of my sobriety. Thank you.

Janet Wood: Congratulations on your 19 months of sobriety. If you're at all concerned, it may make sense to either find a place of worship that uses grape juice instead of wine for communion, or if you really are committed to continue with your current place of worship, have a talk with the pastor/priest etc. and enlist their help in this issue. I believe they would be glad to support your efforts to remain sober.

Question: I live in Illinois. My grandson who has co-occurring, plus Mental Health, drug and alcohol problem has had partial treatment, and refusal into halfway houses, due to his medication Depakote for some kind of bipolar. Could you tell me why?

Janet Wood: There are still some places in the country that prohibit any type of medication in their program even if that medication is prescribed by a psychiatrist for the treatment of bipolar disorder. Those programs believe that any medication is "still a drug" and by allowing one client to take drugs sends a confusing message to other clients struggling with addiction. A better understanding of how to treat persons with co-occurring disorders is slowly spreading across the country, but in the meantime, I would suggest that you contact the State of Illinois, Division of Alcoholism and Substance Abuse at 312-814-2300 and ask for assistance in finding a program that treats persons with co-occurring disorders where they allow medications to be used. Your grandson will have better treatment outcomes when his bipolar disorder is being properly addressed with medication and counseling AND his addiction treatment needs are also addressed.

Question: As a treatment center director in Brazil, I wonder if you have any suggestions to share on how to approach the legal system in order to, instead of prison for drug addicts, get permission for treatment in recovery centers. Many thanks.

Janet Wood: I think the best approach is to avoid an either/or argument, meaning we either punish drug addicts or we treat drug addicts. The best outcomes result from the combined supervision and treatment of persons with addiction. Many professionals in the legal system have first hand experience with increased crime as a result of untreated addiction and they want to hold people accountable for those crimes. They also falsely assume that treatment doesn't hold people accountable and is just "hugs for thugs." Conversely, people who support only treatment for addiction without acknowledging the increased public safety risks associated with untreated addiction can come across as devaluing law enforcement. This sets up a dynamic where neither side is heard by the other. A powerful way to bring the two sides together would be to demonstrate how addiction treatment holds individuals accountable, results in better-shared outcomes, and utilizes the power of the legal system to get people into treatment (who without such coercion may never believe they need treatment).

Question: In 1976 I was convicted of armed robbery, a pack of cigarettes was taken, and no one injured. Can I have this removed from my record?

Janet Wood: This question is better asked of professionals working within the criminal justice system, such as a defense attorney specializing in criminal justice cases. If I were to guess, I would think that it is highly unlikely that a former crime (felony) would be removed from your record.

Question: Has alcoholism or addiction been proven without doubt to be an incurable disease?

Janet Wood: The National Institute on Drug Abuse, a part of the National Institutes of Health responsible for approximately 85% of the world's research on drug abuse, states that substance abuse is a preventable behavior and addiction is a treatable disease.

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