Photo credit Stephen Leonardi

4 Tips For Staying Positive During Addiction Recovery
​
Starting on the road to recovery from addiction is challenging even for the strongest of people. Common struggles include:
 
●Fears, such as failure in recovery or rejection by loved ones.
●Feeling stuck, frustrated, and unable to move forward with recovery.
●Guilt and shame over the past.
●Avoiding a relapse.
●Struggling to socialize again without revisiting old habits.
●Stress over all these struggles.
 
Remember that addiction itself is not defined as bad behavior. The American Society of Addiction Medicine (ASAM) defines it as “a primary chronic disease of the brain’s circuitry related to reward, motivation, and memory.” In other words, the disease serves as a way to find relief or reward through substance use and abuse. It is challenging to overcome because your brain has learned this repetitive behavior. However, the brain is flexible and can change and adapt to learn new behaviors.
 
As emotional challenges arise, you must learn to address them. Here are some critical things to consider as you move forward in recovery.
 
Take Time To Develop Emotional Maturity
 
One important task to address as you work with your support group and counselors is to grow your emotional maturity. As you move forward in recovery, you will develop this skill, giving you the ability to handle emotions better and control your impulses. Many people turn to substances because they don’t know how to handle their emotions effectively. Alcohol or drugs can provide some temporary relief, but it’s important to be able to manage your emotions to live a more fulfilling life. Developing emotional maturity will make it easier to be positive. 
 
Change Your Perspective; Be Patient
 
Knowing how far you’ve come since you’ve started your journey is important. You are on a path of growth, and growth takes time, just like learning those new habits will. Remember that addiction is a disease and recovery can be a lifelong process. Rather than despairing over this, think of this as your journey to a new, improved you. It takes time, dedication and learning for anyone to better themselves – no one can run ahead and skip the important parts.
 
Cultivate A Positive Attitude
 
Although “positive thinking” sounds like a cliché, research shows it may have real benefits. Studies show that negative thinking narrows your options on how to respond to something. That’s because negative thinking evolved from people’s need to escape danger. You need to focus sharply to escape from a predator.
 
But positive thinking allowed people to consider more options and even helped build skill sets that had a lasting effect. Thinking positively allows you to lose the focus that comes with negative thinking; instead, you start seeing unlimited possibilities. Meditation, creative writing, and relaxation can help you have a more positive outlook on the world.
 
While you are working on your recovery, a positive outlook is hard to maintain. But you can choose to see the best in yourself by journaling, writing down things you are grateful for and choosing the best support systems. Success also recommends  focusing on the good things, even if they’re small and finding the humor in bad situations.
Making a Clean Slate
 
Part of the recovery process includes removing yourself from old patterns and old habits. This typically means finding a different group of people to socialize with, but it can also mean moving. Those in recovery often find it especially helpful to start fresh with a new living arrangement. This ensures you’re upending old habits, like driving by the same liquor store on your way home from work. When looking for a new place, budget shouldn’t be the only concern. Survey the neighborhood and any amenities close by.  For example, look for a new apartment or house that is near a large park and within walking distance to grocery shopping.
Keep in mind that moving to a new location does not guarantee success if you are determined to use you will.
Getting Additional Help
 
Take stock of the current systems you are using to get through recovery. Are they enough? Are your support systems helping you develop self-confidence, responsibility, and emotional maturity?
 
If not, you may need to add support groups, therapies, or activities to your program. Pursuing creative activities, volunteering efforts, and learning a new skill are great ways to improve your self-esteem. You should also ask your therapist for more suggestions.
 
Getting to the root of your addiction will be a confusing and emotional experience, and you may never find the actual cause but taking the journey is important and having a good counselor to guide and help you understand your addiction may lead to you understanding your substance abuse problem completely which is an important step in conquering it. Additionally, family counseling can help facilitate healthy conversations with your loved ones and help them understand what you are going through and may increase the level of compassion, and pave the way for stronger relationships.

Thank you Claire for sharing your article with us and we look forward to seeing more articles from you in the future. 

​Pregnant with her second child, Clarissa Collins was at her methadone clinic when a woman walked in with a box of doughnuts and a baby doll. 
The woman, Tara Sundem, was partway through a five-year effort to open Hushabye Nursery and launch a novel family-focused program that would treat substance-exposed infants and offer care and support to their caregivers. 
Hushabye Nursery recently celebrated one year in its current care facility in Phoenix and Collins now works there as a peer support specialist, helping others in recovery. 

The center houses a 12-room inpatient nursery for infants suffering from neonatal abstinence syndrome – newborns experiencing withdrawal from opioids they were exposed to in the womb, such as heroin and prescription painkillers. 
 
But on that day in 2019, Collins begrudgingly attended Sundem’s support group for pregnant women with opioid use disorder. By the second group meeting, she decided to come back every week. 
“I looked forward to it. I wanted to see the other girls; I wanted to hear their stories. I wanted to meet the baby,” Collins said. “And we became this little family. We became very close friends.” 
As the opioid epidemic worsens nationwide, neonatal abstinence syndrome (NAS) cases are increasing, too. Nationally, the number of babies born with the condition increased 82% from 2010 to 2017, according to the Centers for Disease Control and Prevention. 
The national trend in NAS cases holds true in Arizona and has worsened since the Covid pandemic began. Arizona’s NAS rate in 2020 was 9.1 per 1,000 newborn hospitalizations, up from 5.67 per 1,000 in 2015, according to Arizona Department of Health Services vital statistics reports. In 2010, that figure was 2.65 per 1,000.  

​Clarissa Collins, a peer support specialist at Hushabye Nursery, sits in one of the 12 private rooms where babies with neonatal abstinence syndrome and their families weather the withdrawal process. PHOTO BY KYRA HAAS/ARIZONA CAPITOL TIMES
Some of the increase can be attributed to better reporting and other factors, not the opioid epidemic itself, said Sara Rumann, with the department’s Bureau of Women’s and Children’s Health.  
“But we can say overall the general trend is that it has increased over the last 10 years,” Rumann said. 
Symptoms of NAS can include a high-pitched cry, vomiting, diarrhea, trembling, seizures, stiff limbs and trouble sleeping, eating and breathing, according to the department. The babies experience a withdrawal syndrome, not an addiction. 
Collins had her first daughter in 2012, but started using heroin shortly thereafter. The Arizona Department of Child Safety got involved, and Collins ended up relinquishing her parental rights. Her daughter now lives with family in Louisiana. 
“I had gotten strung out right after she was born; I had no history of addiction prior,” Collins said. “But one thing led to another, and a lot of it was I was desperate for my friends. I was 17. I had just had a baby. I wanted my friends back, so I did whatever they were doing.” 
This time would be different. 
Sobriety was part of that, and so was the Hushabye Opioid Pregnancy Preparation and Empowerment (HOPPE) program. Collins still has her green HOPPE binder, which she calls the bible, that helped her prepare for her baby’s arrival, gather information for the DCS investigation and document her classes. 
Medication-assisted treatment (MAT) uses medications like methadone or buprenorphine in combination with counseling and therapy to treat opioid-use disorder. Hushabye staff recognize MAT as the “gold standard” of care, Sundem said. It’s recommended for pregnant women with opioid-use disorder because it’s often unsafe for women to completely stop taking opioids while pregnant. The change can trigger a miscarriage, preterm labor or fetal distress.  
But because the medications used are opioids, Department of Child Safety is still contacted because the baby is still substance exposed. 
“Whether it be prescribed or unprescribed, that’s for DCS to figure out, but it has to be reported to the state,” Collins said. 
The increase in NAS cases is something Sundem, a neonatal nurse practitioner, saw firsthand. She has spent most of her nearly 30-year nursing career in neonatal intensive care units. About eight years ago, she said, something changed. 

​Clarissa Collins, left, chats with Hushabye Nursery executive director and founder Tara Sundem at the facility. Sundem and Collins first met in 2019 when Collins attended one of Sundem’s support groups for pregnant women with opioid use disorder. PHOTO BY KYRA HAAS/ARIZONA CAPITOL TIMES
“We just started seeing this surge of babies coming in and withdrawing,” Sundem said. “When we started seeing that influx, I was like, ‘What do we do?’” 
About six years ago, Kelly Woody, who co-founded Hushabye with Sundem, had the answer. The fellow neonatal nurse practitioner had watched a segment on the “Today” show about Lily’s Place, a first-of-its-kind Neonatal Abstinence Syndrome center in West Virginia. 
Woody told Sundem, “This is what we’re going to do.” 
“I’m a believer, and I prayed on it and prayed on it and prayed on it, and went, ‘OK, I guess I’m supposed to do this,’” Sundem said. 
They spent the next five years developing their care model and trying to find funding. 
“I begged, I borrowed, I asked favors,” Sundem said. 
Hushabye’s current facility opened in November 2020. Hushabye is licensed with the state health department and is accredited through the Commission on Accreditation of Rehabilitation Facilities International. 
The nursery’s approach is family-centric, with programs for women prenatal and postpartum.  
Postpartum care for mothers is important because the relapse rate in the first six months is high – nearly 80%. Alicia Allen, an associate professor at the University of Arizona’s Department of Family and Community Medicine, studies substance use in women. She said while postpartum is an especially vulnerable time, it’s also a good time for health care professionals to interact with people who are struggling with substance use. 
“During pregnancy, there’s a lot more motivation, there’s a lot more support and there’s a lot more access to health care, so that’s a perfect place to start,” Allen said. 
With in-patient infants, Hushabye uses the Eat, Sleep, Console method, a newer approach to treating NAS that prioritizes the comfort of the baby and non-pharmacologic treatments, shifting away from scheduled postnatal opioid treatment to “as needed” dosing. Parents stay with their babies during their time at the nursery. 
“Our patient in-patient is that baby, but that baby’s therapy is their family,” Sundem said. 
The Eat, Sleep, Console approach is effective. Babies withdrawing at Hushabye stay an average of about 6 to 7 days. The national average stay for a baby with NAS in a neonatal intensive care unit was 11 days in 2018.  
Banner University Medical Center Tucson was the first Arizona hospital to learn about Eat, Sleep, Console, a model that got its start at Yale University through the research of pediatrician Dr. Matthew Grossman.  
“What we’ve been doing for the last 40 years is not working, and everybody’s cranky. Not only the babies – the families are cranky; the nurses are cranky,” Lisa Grisham, director of Banner’s Family Centered NAS Care Program, said. “When you look back, we thought we were doing the best we could. And now we realize there’s a better way to do it.” 
In addition to Hushabye, nine hospitals in Arizona use Eat, Sleep, Console for at least some of their NAS patients, depending on the individual situation.  
 At Hushabye, there are 12 private rooms where babies can withdraw in a dark environment and their families can stay 24/7. Usually, there are five or six babies at any one time, though Sundem said there was recently a span of three weeks where they were at capacity.  
“We encourage (caregivers) to stay, even if they’re struggling. As long as that’s safe and they’re not dangerous, we want them to stay,” she said. “What they are doing for their baby just by being present in the room – they’re helping with the wiring of the brain, something that you and I can’t do.” 
When a family comes to Hushabye, Sundem said staff meet them where they’re at — and connect them to resources for food, transportation and housing if needed. She said she thinks families stay in part because the staff are trauma-informed. They know that many people have experienced trauma, that trauma affects health and behavior and that it should be factored into how people are treated to avoid retraumatizing them. 
If parents are able, staff help teach them how to care for their baby. With all families, Sundem said staff try to help them avoid shame or guilt by understanding that they have opioid use disorder, a medical condition, not some sort of moral failing. 
Many of the parents, Sundem said, started taking an opioid after it was prescribed to them following something like an accident or a C-section and then developed a dependence. Three out of four women who use heroin were initially prescribed opiates. 
“When you talk to families, it is to function – it’s not to get high,” Sundem said. “They literally say that they’re dope sick, that they use to get well.” 
In an effort to reduce stigma against pregnant women with opioid-use disorder, the health department launched its campaign “Hope Heals” earlier this year, following a recommendation in the state’s Opioid Action Plan 2.0. Rumann worked on the campaign, as did Jacqueline Kurth, the office chief for injury and violence prevention in the department’s Bureau of Chronic Disease and Health Promotion. 
“There’s a lot of stigma that is a barrier for people seeking help for mental health disorders and for substance use disorders, in particular for pregnant and parenting women,” Kurth said. 

The green Hushabye Opioid Pregnancy Preparation and Empowerment (HOPPE) program binder helps women prepare for their baby’s arrival, gather information for the Department of Child Safety and document their classes. PHOTO BY KYRA HAAS/ARIZONA CAPITOL TIMES
On the outpatient side, Hushabye has a licensed marriage and family therapist and two case managers. One case manager focuses specifically on helping families navigate interactions with the Arizona Department of Child Safety. Sometimes, Sundem said, families are so stressed that they don’t really hear what DCS is saying they need to do. 
“Sometimes it’s because they’re not healthy, but sometimes it’s just because it’s so stressful,” Sundem said. “And sometimes, they speak a completely different language.” 
That was Collins’ experience after the birth of her first child. 
“I had no clue what the hell I was doing back then,” she said. “I went through DCS; I went to court; I did all of that. I tried going to treatment, but I had no clue what I was doing. I was physically present, but I had no clue what was going on.” 
Collins and the other peer support person have both been through the Hushabye program. Collins’ daughter recently turned 2. The other peer support’s baby will be 1 in February. 
The facility has two nurses on duty around-the-clock, even if there’s only one baby, to be able to resuscitate if needed. While not a hospital, Hushabye provides the care a baby with NAS needs. If something goes wrong, Banner – University Medical Center Phoenix, Valleywise Health Medical Center and Phoenix Children’s Hospital are all a 5- to 7-minute drive from the nursery.  
Out of the more than 180 babies treated at Hushabye, only three have been sent back to the hospital for additional treatment, Sundem said.  
For Collins, working as peer support for others in recovery has helped her, too. She still attends groups and lives with her daughter and her fiancé, who is also in recovery. She knows what the women at Hushabye are experiencing because she’s been through it.  
“It’s healing to me,” she said. “Because it’s like I’m almost able to close a chapter in my past knowing that, OK, I got somebody somewhere farther than I could go.”