Category Archives: Toolbox

Naltrexone cousin gets OK in UK for alcoholism

Nalmefene, known commercially as Revex, has been approved in Britain to help problem drinkers by reducing their desire for alcohol.

A clinical trial into the drug helped patients cut the amount they consumed from 12.75 units a day to five units a day – a 61 per cent reduction. And patients who underwent counselling as well as taking the drug reduced their “heavy drinking days” from 23 days a month to nine days a month after undergoing the treatment for six months, researchers said.

Nalmefene is touted as having a longer half-life than naltrexone and less effect on the liver, per the first link.

While the study didn’t focus on people wanting to quit drinking, it seems this is an obvious use for it.

Sounds like a good addition to the toolbox. That said, per the first link, I do not know why it is not available in the US if it has some superiority to naltrexone.

Does your brain know if you’re likely to relapse?

Some interesting research funded by the National Institute on Alcohol Abuse and Alcoholism says yes.

Using brain scans, researchers found that people in recovery from alcoholism who showed hyperactivity in areas of the prefrontal cortex during a relaxing scenario were eight times as likely to relapse as those showing normal brain patterns or healthy controls.

The prefrontal brain plays a role in regulating emotion, the ability to suppress urges, and decision-making. Chronic drinking may damage regions involved in self-control, affecting the ability to regulate cravings and resist relapse.

It certainly sounds sensical. That said, it will be a long time before rehabs, let alone general medical clinics, are offering fMRI scans to people in early recovery to check this.

But, we can take away from this that the idea of “triggers” is a real concern, if long-term drinking has affected those regulatory abilities.

And, the difference is significant:

The investigators found that individuals in recovery who showed patterns of heightened activity in the prefrontal region during the relaxing situation were much more likely to experience cravings for alcohol and subsequent relapse. These patterns of craving-related activity increased the likelihood of early relapse by 8.5 times and relapse to heavy drinking by 8.7 times. Abnormally low activity during the stressful scenario was also linked to greater number of days drinking after relapse.

So, while we’re far from the point of offering fMRIs, it seems like the need is there.

Meanwhile, keeping that idea of “triggers” handy sounds good.

New Article From Main Speaker at 2010 LifeRing Annual Meeting

Candice Shelby, Ph.D., who gave a much-talked-about and much-appreciated presentation at the LifeRing Annual Meeting last June in Denver, has written an essay that I am very pleased to publish here for the first time. The essay is titled “Addicts are NOT Powerless — the Trick is Knowing Where the Power Is.” The essay explores the role of the mind in recovery from addiction and draws on Dr. Shelby’s studies in neurobiology and the nature of the mind.

Dr. Shelby’s piece focuses on the importance, in recovery, of the role played by the unconscious — but trainable — parts of our mental processes.  Click here to see the article.

Dr. Shelby, an associate professor of Philosophy at the University of Colorado Denver campus, earned her M.A. and Ph.D. from Rice University. She served as Chair of the UC Philosophy Dept. for three years and has, in recent years, studied intensively the Philosophy of the Mind. She is currently at work on a book examining addiction from physical and psychological standpoints, focusing in particular on semantic elements in addiction and recovery.


When this newly redesigned Website was unveiled in June, there were some sections that didn’t make the initial transition. Since then, a LifeRing volunteer, Alceon, has done the necessary work to bring back the Keepers section and now has unveiled the new Toolbox section. Both are listed in the Categories menu along the right side of this page and can always be accessed using that link. Alceon’s work is greatly appreciated but she is not resting on her much-deserved laurels: she’ll be moving on to move the old website’s Poetry section next, followed by the Food & Beverages contents. LifeRing gains immensely from the efforts of members such as Alceon.

The LifeRing Recovery Toolbox

There are as many different ways to get clean and sober as there are alcoholics and addicts.  There is no magic formula that works for everyone at all times.  All the different “Programs” contain some useful ideas.  No one approach has a “lock” on recovery.  Every method produces some success stories.  Every method produces some relapses.

The LifeRing approach to recovery lays emphasis on self-help and on learning through experimentation.  LifeRing members are not expected to present identical profiles, and there is no fixed therapeutic pathway through which everyone must pass.  The common goal is a full life with zero consumption of alcohol and addictive mind-altering drugs; but there are many roads to get there, and all are equally valid.  You, as a recovering person, are a scientist conducting a series of experiments of which you are also the subject.  You will try different ideas and different behaviors and see if they help keep you sober.  If they work for you, you will probably retain them; if they lead you into relapse, you are encouraged to change them and try something else.   The set of ideas and behaviors that work for you compose your personal recovery program.

As a participant in LifeRing groups, you will be exposed to ideas that have worked for others, and you will be encouraged to try those that appeal to you.  But you will not be required to model your program after anyone else’s.  Ordinarily, no one will offer to tell you what to do, or give you advice, unless you expressly ask for it.  However, participants will freely share what worked and didn’t work for them.   You may see a considerable diversity of approaches.  Feel free to pick and choose whatever appeals to you.

You will get support from other participants for each milestone you pass.  The credit for each day of your sobriety belongs to you.  LifeRing will not try to take away the credit for your sobriety efforts.  And if you fall, LifeRing will not try to shame you or make you feel that you were not following The Program (there is none).   On the contrary: a relapse may be a key part of your learning experience.   “A fall into the pit, a gain in your wit.”  If you have a relapse, feel free to share the experience with your group promptly, and pick up where you left off.

The ideas in this section are called “tools” because they worked to keep some people sober.  This section presents only a small sampling of the universe of possible sobriety tools.  People invent new ones all the time, and you are encouraged to add yours as you develop them.  This toolbox is like a potluck, with everyone bringing their favorites to share.  None of these is compulsory.   In fact, some people say they don’t use any tools at all; they just don’t drink or use, period.

Much of the material that follows was originally published in the Handbook of Secular Recovery by LifeRing Press (now out of print).  A much expanded set of tools is comprised in the Recovery by Choice workbook from LifeRing Press.  Also check out the Keepers section of this website for additional sobriety ideas.

From LifeRing Press:

A tool for building your
personal recovery program.
300 pg.