I don’t want to go to Rehab!

What to do when your loved one refuses to go to Rehab

The first step is to ensure that your own or other family members understanding of the situation is honest and true.  Addiction split families as one member tries to help by covering up and minimising the damage that might occur from the addictive behaviour, whilst others become angry, judgemental and withdrawing.  Families themselves may find themselves in denial about their loved ones using as the truth is too painful to bear.  Ensure that you are all standing together and are prepared to instil the same boundaries with the using loved one.  It may be helpful to seek a professional consultation in order to put together a family plan.

Educate yourself about resources that can provide professional help for your loved one.  Find out costs and procedures for admitting someone into treatment.  Addiction treatment is expensive but there are means based or even free help available.  It you know what substances are being used – find out what detox support may be needed.

Then decide what limits and boundaries you are prepared to put up with the loved one if they continue using.  This may be anything from not being invited to family events to withdrawing financial support or telling them they need to move out of the house or removing children from their care.  A professional counsellor can assist you in deciding which boundaries would be most effective.

Confrontations about your loved ones abuse of drugs or alcohol often happen after some kind of incident which has put either themselves or someone else at risk.  This can be useful as the person concerned may considered the negative impact of their using more seriously.  However, the confrontation often occurs when the loved one is either high or drunk or in withdrawal.  No amount of rational reasoning will work at this time.  It is important to choose the time carefully.  It may be helpful to have a professional counsellor to assist you in the intervention, or least a good friend or someone that your loved one respects.

Addiction distorts rational thinking leading to a belief system that supports the ongoing use of the substance or alcohol.  This means that your logical evidence of the damaging effects of the abuse will be met with blank faced denial, or at least lies, minimising and justification.  Remember that the person being most lied to is themselves.

Express your ongoing love and concern for the person.  Attacking their character or ‘poor self control’ will only alienate themselves from you and lower their already undoubtable low self esteem.  Keep calm even in the face of an angry reaction.  Withdraw yourself if the using loved one becomes abusive or aggressive.

Tell your using loved one how their using is affecting you – emotionally, physically and financially. Give specific examples.  Try to avoid blaming them or making them feel guilty. Be prepared to also listen and let your loved one have their say.  Don’t interrupt even when what they are saying does not make sense.  Remember to point out your loved ones good qualities and times in their life when they have achieved and done well, and how you want that for them again.

People abusing mind altering substances, whether alcohol or drugs, struggle to make the connections between their using and the detrimental effects that it has on their lives.  Make a note of how the using has affected the person concerned emotionally (mood swings, irritability, aggression, depression, anxiety), socially (relationships with family and friends have broken down, no longer enjoying hobbies and other pastimes), work (unemployment, absenteeism, lack of motivation), spiritually (little meaning and purpose in life) and lastly financially (broke, borrowing money, stealing).  Your loved one may have put themselves or others at risk by drunk driving, going into risky areas, engaging in unhealthy relationships or having unprotected sex.  Use opportunities during the confrontation to point out these problems.

It may help to talk about going to see a counsellor together as a family rather than talk about rehab which can be very scary for someone in the grips of addiction.  The counsellor will then be able to assist your loved one to move towards accepting help.

If your loved one is unable to admit that the using is causing problems in their life and has no desire to stop using then it is time to communicate the limits and boundaries that you have already decided upon.  Tell them that you love them and that you cannot sit by and watch them harm themselves and others around them.  Tell them the limits and boundaries that the family have agreed to lay down – even write them down and hand them the paper.  Tell them that you will assist them in every way you can should they decide to get help in stopping their using.

If your loved one agrees to stop using (as perhaps they have done in the past many times) put an agreement in place that if they relapse then they agree to go into treatment.

Your loved one may agree to stop using and get help but will then put excuses in place – “I may lose my job” or “I will go after Christmas”.  Remain firmly together and respond that treatment must commence now or the boundaries will be put in place.

Be prepared for emotional blackmail – being accused of being the worst parents in the world, or of not loving the person concerned or even that it is your fault.  Ignore any emotional battery and stick to your boundaries.

If you find that your attempts to help your loved one fail then this is the time to put those boundaries in place to protect both yourselves and your loved one.  Seek professional help if you are unable to keep the limits in place.

Cape Town rehab.  Contact Ixande for a free family help.  Tel 021-7617348 or email info@ixande.co.za


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Scared of going to Rehab?

There are many myths about Rehab – from they are only for rich and famous celebrities to they are places of punishment and pain.

Neither are true and these thoughts can keep you or your loved one back from making the important decision to get some help.  Professional help is available – whether as an outpatient or inpatient and you will be cared for and supported during the treatment process.

Detox symptoms and withdrawals are managed by Doctors and Nursing staff to ensure that you are comfortable and not in any pain.

Another misconception is that you need to have hit rock bottom to be ready for rehab.  Getting help before life changing negative consequences occur is better for both you and your family.  Even binge abusers of alcohol and drugs need help staying stopped.

Very few people can do it on their own.  Rehab provides connection to others going through the same experience and challenges and helps you to reconnect to your true self.  The structure and support provide a recovery base to help keep you clean going forward.

Another scary factor that keeps people from getting the help they need is ‘stigma’.  Many people feel they may be labelled with negative stereotypes associated with addiction in the past.  However, today almost everybody knows someone who has overcome addiction and they are garnered with the respect they deserve.  Recovery from addiction is something to be proud of.  Celebs have helped by proudly advertising their recovery from addiction or alcoholism.

A lot of people suffering from addiction are scared to enter rehab as they are worried that they might fail.  They would have exposed the problem but fear they may not be able to follow through on recovery.  This is understandable but relapse does not mean you have failed – it just means you need more help in staying stopped.  Any intervention with the disease is worthwhile.

On the other hand, it can be scary to think about never using again and not having the drugs and alcohol as a coping mechanism.  That is what treatment is about – developing new and more helpful coping mechanisms so that you don’t need to rely on old behaviours.  And if you think you may never have fun again – think about your using and whether it really is fun anymore.

Trauma can be kept at bay with drugs and alcohol, but it always pokes through in the end.  Stopping using means you may have to come to terms with your trauma and find healthier ways of coping.  This can be very scary and difficult, but treatment professionals can help you through this process and help you to manage the symptoms and deal with your trauma.

Not one that is easy to admit but many people fear Rehab as they are worried that they may not be liked or get on with the other clients.  One of the most amazing things about Rehab is the sense of community and connection that develops so quickly amongst clients from all walks of life.  At last you will find people around you who you can relate to and accept you as you are.

If the list of things putting you off going to Rehab is long, try making a list of the reasons why you should go to Rehab – guaranteed it will be much longer!

Cape Town rehab. If you or a loved one needs help in making the decision to get some help please contact us on Tel. 021-7617348 or email us on info@ixande.co.za

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Do I have a substance-use Disorder?

The Diagnostic Manual of Mental disorders – Fifth edition (DSM-V) is utilised world wide to diagnose substance use disorder.  The diagnostic criteria (or symptoms) of addiction is based on decades of research and clinical knowledge.

There are 10 different classes of drugs acknowledged by the DSM-V:

Alcohol, caffeine, hallucinogens (eg LSD), inhalants (eg glue), opioids (eg codeine or heroin), sedatives (eg diazepam and sleeping tablets), hypnotics (eg valium or rohypohl), stimulants (eg cocaine or ‘Tik’), tobacco or unknowns.

Everybody reacts differently to substances and some people will be more vulnerable to developing a substance abuse disorder than others.  Each of these substances activate the brains reward system and produces feelings of pleasure.  When this reward of ‘high’ is sought after at the expense of other activities that are considered normal to everyday life, then symptoms of substance-use disorder may emerge.  Simply speaking, substance-use disorders are patterns of symptoms that result from using a substance that is taken – despite experiencing problems as a result of the using.

There are 11 different criteria that ones can ask oneself to determine if substance use is a problem.  How many do you or a loved one identify with?

  1. Taking the substance in larger amounts for longer that you meant to
  2. Wanting to cut down or stop using the substance but not managing to
  3. Spending a lot of time getting, using or recovering from use of the substance
  4. Cravings or urges to use the substance
  5. Not managing to do what you should do at work, home or school because of the substance use
  6. Continuing to use the substance even when it causes problems in relationships
  7. Giving up important social, occupational or recreational activities because of substance use
  8. Using substances again and again, even when it puts you in danger
  9. Continuing to use, even when you know you have a physical or psychological problem that could have been caused or made worse by the substance (eg poor health, depression or anxiety)
  10. Needing more of the substance to get the effect that you want (tolerance)
  11. Development of withdrawal symptoms, which can be relieved by taking more of the substance

If you can identify with 2 or 3 of the symptoms then it indicates a mild substance use disorder.

If you can identify 4 or 5 symptoms then it indicates a moderate substance use disorder.

If you can identify 6 or more symptoms then it indicates a severed substance abuse disorder

Cape Town rehab. Contact us if you or a loved one are struggling with a substance- use disorder.  We can arrange a free assessment.    Tel. 021-7617348 or email us on info@ixande.co.za


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There are more than 15 different types of FDA-approved benzodiazepine medications. These drugs
are referred to as Benzos and are widely prescribed for a variety of medical and mental health
concerns. The benzodiazepine drug Xanax is the mostly widely prescribed psychiatric
medication. Other types of Benzos include Alzam, Xanor, Zopax, Urbanol, Rivotril, Lorazepam,
Librium, Pax, Rohypol, Dormonoct, Ativan, Dormicum, Zopiclone and Valium.

Why do people use Benzos? They can provide anxiety relief and are often prescribed to treat anxiety
disorders including social anxiety and panic disorders. They are also used to treat alcohol withdrawal
and to assist for the first few days of starting an anti-depressant. They are only intended to be used
for short term acute symptoms. This is because long term use leads to tolerance (the need for more
to get the same effects) and dependency (compulsive use with withdrawal symptoms if the drug is

How do they work? Benzos are central nervous system depressants. Our central nervous system
regulates our heart rate, breathing, blood pressure and temperature. When we take a Benzo these
functions slow down by interrupting the brains messages to our bodies through our
neurotransmitters. Whereas stress stimulates our brains and central nervous system, Benzos slows
down the brain by inhibiting the production of neurotransmitters. The result is a feeling of calm and
relaxation. However, the brain quickly adjusts to Benzos and they have less and less effect on the
brain over time, and thus less effect on the body’s central nervous system. This is called tolerance.
Symptoms of tolerance and over-sedation are extreme sleepiness, problems with memory, cognitive
impairment, mood swings, shallow breathing, depression, psychosis and even death. Mixing Benzos
with alcohol increases their potency and risk of overdose.

Withdrawal symptoms include insomnia, anxiety, confusion, inability to focus, irritability, restlessness,
muscle weakness, shakes, difficulties concentrating, irregular heartbeat, sweating, hallucinations,
depression and craving. You may also notice behavioural changes such as withdrawal from social
activities, secretiveness, stealing of money, visits to different Doctors and extreme defensiveness
when questioned or confronted.

Benzos detox and treatment must take place under the close supervision of a trained Medical Doctor
and nursing staff. It is possible to have a severe reaction if Benzos are suddenly withdrawn.
Medically assisted detox ensures that the process is safe and thorough, and comfortable for the
person concerned.

Thereafter a non-judgemental treatment process will assist in determining how the dependency
began and address the underlying triggers that developed the dependency, along with learning
coping tools and strategies to maintain abstinence.

Ixande rehab in Cape Town. If you or your family member are struggling with a dependency of any kind, contact us for a free
assessment. Tel: 021-7617348 or email info@ixande.co.za.

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What does cocaine do to the brain?

Cocaine is an illegal and powerfully addictive stimulant drug.  It is made from the leaves of the coca plant originally found in South America.  It looks like a fine white powder or small opaque yellowish crystals (‘rocks’).

Cocaine is often mixed with other substances like talcum powder, cornstarch or other stimulants like amphetamines or opioids.

Cocaine is usually snorted through the nose through a straw, or in the case of crack cocaine (‘rocks”) it is heated and the vapours are inhaled.

Use of cocaine gives a short lived intense ‘high’ as it is absorbed by the blood and travels to the brain.  This is caused by the cocaine preventing dopamine from being recycled causing large amounts to build up in the space between nerve cells.  This flood of dopamine in the pleasure centre of the brain is what gives the pleasurable feeling.  However, very quickly the reward circuit of the brain adapts to the excess of dopamine and the brain develops tolerance to the drug.  This means more cocaine is needed to achieve the same high.

What are the short-term effects of cocaine

  • Intense euphoria for a short space of time
  • Increased energy levels
  • Mental alertness for a short space of time
  • Constricted blood vessels
  • Dilated pupils
  • Raised blood pressure
  • Irregular heart beat
  • Hyperstimulation
  • Restlessness
  • Muscle spasms
  • Anxiety
  • Paranoid feelings
  • Loss of appetite
  • Disturbed sleep patterns
  • Erratic behaviour

In some cases:

  • Heart attack
  • Stroke
  • Seizure
  • Respiratory failure
  • Sudden death

Long term effects of cocaine use:

  • Tolerance
  • Cravings
  • High blood pressure
  • Permanent damage to brain, heart and lungs
  • Destruction of nose tissues and septum
  • Irritability and mood disturbances
  • Sleeping problems
  • Apathy and anhedonia
  • Risky behaviour
  • Agitation
  • Severe anxiety
  • Severe depression
  • Psychosis

At Ixande, detox can be followed by our Addiction Treatment Programme where therapeutic methods are used to help you identify your dependency, tackle your symptoms, address underlying triggers, improve your self-confidence and help you to manage your anxiety. The therapy you receive will be entirely tailored to you, as we help you to get your life back on track in a safe and non-judgemental space.

Cape Town rehab. If you or a loved one are struggling with cocaine dependency please call us on +27 21 7617348 or email us on info@ixande.co.za

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How do I know if I or a loved one is an alcoholic?

How do I know if I or a loved one is an alcoholic?

We often perceive an alcoholic as a down and out person living on the streets begging for money for booze.
However, some of the ‘best’ alcoholics I know are high functioning CEO’s and professionals.

So what does an alcoholic ‘look like’?

We now call someone who is struggling with alcohol as having an alcohol use disorder which may be mild,
moderate or severe depending on the number of symptoms that are being experienced. Have a look through the symptoms below. Anyone meeting any two of the 11 criteria during the last year can expect a diagnosis of an alcohol use disorder.

 Had times when you ended up drinking more, or longer than you intended?
 More than once wanted to cut down or stop drinking, or tried to, but couldn’t?
 Spent a lot of time drinking? Or being sick or getting over the aftereffects?
 Experienced craving — a strong need, or urge, to drink?
 Found that drinking — or being sick from drinking — often interfered with taking care of your home or
family? Or caused job troubles? Or school problems?
 Continued to drink even though it was causing trouble with your family or friends?
 Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order
to drink?
 More than once gotten into situations while or after drinking that increased your chances of getting hurt
(such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?
 Continued to drink even though it was making you feel depressed or anxious or adding to another health
problem? Or after having had a memory blackout?
 Had to drink much more than you once did to get the effect you want? Or found that your usual number of
drinks had much less effect than before?
 Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble
sleeping, shakiness, irritability, anxiety, depression, restlessness, nausea, or sweating? Or sensed things
that were not there?
If you have any of these symptoms, your drinking may already be a cause for concern. The more symptoms
you have, the more urgent the need for change.
Some questions to ask yourself:
 Do you or your loved one drink more than 3-4 drinks per day?
 Do you or your friends and family ever joke that you or your loved one is an alcoholic?
 Has the GP flagged that your or your loved one’s liver is in in distress?
 Do you or your loved one need alcohol in order to relax or sleep?

Heavy drinking is very risky for your body and emotional health. Liver disease, cancer and heart disease are all
linked to heavy drinking of alcohol. Depression and anxiety are also linked to heavy drinking.

Contact a professional for an assessment if you or your loved one’s drinking is cause for concern.
Ixande undertakes free assessments.

Ixande rehab in Cape Town. Please contact us on 021-7617348 or email info@ixande.co.za

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