Pursuing optimal health in recovery: EA professionals can help addicted clients minimize the risk of relapse by promoting wellness-oriented behaviors and encouraging them to pursue their purpose in life.

Employee assistance professionals are fully aware that alcoholism and drug addiction are deadly diseases with devastating consequences. They are also intimately familiar with the fact that alcoholics and addicts whose diseases go untreated eventually suffer adverse health consequences, often dying decades before their times. What they may not know is that millions of people in recovery--perhaps the majority--also shortchange themselves of years of joyful living as a direct result of nicotine addiction, compulsive overeating, junk food addiction and/or other self-destructive behaviors they carry into recovery.

These unhealthy lifestyle patterns can also play a major role in setting the stage for alcoholics and drug addicts to relapse to their former patterns of drinking and drug use. Fortunately, the converse is also true, as a growing body of evidence suggests that a wellness-oriented lifestyle can make a significant contribution m forestalling relapse.

This article reviews available evidence concerning the role of healthy lifestyles in minimizing the risk of relapse for recovering alcoholics and addicts and helping them enjoy a high quality recovery It also highlights practical ramifications for both employers and employee assistance professionals.

WELLNESS AND RELAPSE PREVENTION

What is wellness? Briefly stated, wellness can be defined as a dynamic process of taking charge of one's health and "programming" oneself to attain optimal health and well-being. This concept is critically important to EAP clients recovering from substance addiction, as they may well have inflicted serious damage on their bodily systems as a consequence of years of excessive drinking and/or drug use. Equally important, their lives generally are out of balance in relation to both the spiritual and qualitative aspects of wellness.

Figure 1 depicts the key dimensions of wellness as I envision them currently I firmly believe that the driving force in wellness--upon which all else hinges--is finding and manifesting our unique sense of purpose for being on this planet. When we are living in accord with a strong sense of purpose, we are motivated to take care of ourselves by way of sound nutrition, exercise, and other healthy lifestyle behaviors. If we are in recovery, we are also strongly motivated to follow the path of our chosen recovery program.

[FIGURE 1 OMITTED]

Taking charge of our health entails proactively pursuing optimal health and quality of life by means of engaging in regular physical exercise, practicing sound nutritional habits, curbing "substitute addictions" to nicotine and caffeine, and connecting with pursuits in life and with people around us in ways that are truly meaningful and fulfilling. For EAP clients in recovery, an earnest commitment to taking charge of their health goes hand m hand with "working" their recovery program to safeguard against relapse and enjoy high-quality sobriety.

Let's take a closer look at the role that a wellness-oriented lifestyle can play in the critically important area of relapse prevention. A number of studies suggest that a definite and positive association exists between pursuing a wellness-oriented lifestyle and maintaining successful sobriety following completion of primary treatment. (1,2,3) My own research, which focused on a group of 50 multiple-substance abusers who had completed residential treatment, revealed a positive association between following a healthy lifestyle and reducing risks associated with relapse. (4)

In this study I administered a comprehensive Wellness Lifestyle Assessment Questionnaire, which covers a broad range of attitudes and behaviors generally associated with a wellness-oriented lifestyle, to two groups of subjects. The 25 subjects in the successful recovery group reportedly had maintained abstinence for at least six months following completion of treatment (subjects' self-reported sobriety status was corroborated by program staffs), whereas the 25 subjects in the relapse group subsequently returned to alcohol/drug use following completion of treatment.

In relation to the maximum attainable wellness index score of 90 points, the 25 subjects in the recovery group registered a mean score of 54.8, compared with a mean of 39.1 for the 25 subjects in the relapse group (the likelihood of this association occurring by chance is less than one in 1,000). Furthermore, subjects in the recovery group registered higher average scores for virtually all component items in the wellness index. An equally striking finding was a strong association between regular 12-step meeting attendance and sustained sobriety maintenance: While 88 percent of subjects in the recovery group reported at least weekly meeting attendance, only 36 percent of subjects in the relapse group reported a comparable frequency of attendance. I submit that these findings suggest that following a wellness-oriented lifestyle dearly goes hand in hand with actively pursuing one's chosen recovery program.

But how can following a wellness oriented lifestyle help EAP clients in recovery guard against relapse? For one thing, living well helps anchor recovering alcoholics/addicts in their recovery, reinforcing their commitment to clean and sober living. This is particularly important in safeguarding against relapse during the early months of recovery, when one's mind and body are most vulnerable. (5)

Developing effective stress management skills, an important component of a wellness-oriented lifestyle, helps people in recovery acquire the resiliency needed to deal with life's ups and downs. Bringing one's diet into balance is critically important in combating the biochemical triggers frequently associated with relapse, while regular physical exercise is associated with increased production of endorphins, which tend to promote a natural sensation of calmness and well-being. In addition, regular exercise and other behaviors associated with a wellness-oriented lifestyle can serve as "positive addictions," which help reduce one's cravings for alcohol and drugs. (6)

PROMOTING QUALITY SOBRIETY

True sobriety encompasses far more than maintaining abstinence and healing the damage caused by addiction. Recovery in its fullest sense means embracing a lifestyle that promotes continual physical, psychological, social, and spiritual health and growth. I like to call this "encouraging your clients to experience their recovery in full-blown Technicolor."

Helping clients lay a solid nutritional foundation for their recovery is critically important in promoting long-term sobriety maintenance and quality recovery. As alcohol is really a highly concentrated form of sugar, many recovering alcoholics develop cravings for sugar and tend to "overdose" on sugary snacks. This often disrupts the body's blood sugar balance, triggering a "roller coaster" cycle that can lead to increased risk of relapse absent an intervention to break the cycle.

In the interest of helping clients in recovery normalize their blood sugar levels throughout the day, I generally encourage them to eat three small meals daily, interspersed with three nutritious snacks. Clients in recovery are well advised to consciously transition toward a healthy diet that emphasizes nutrientdense whole foods, including fresh vegetables and fruits, whole grain products, and lean sources of protein.

EA professionals would do well to provide active support to clients in recovery who are addicted to nicotine. Alcoholism and cigarette smoking are closely intertwined co-addictions. According to the National Institute on Alcohol Abuse and Alcoholism, between 80 and 95 percent of alcoholics smoke cigarettes, and 70 percent are heavy smokers, (7) Notwithstanding these percentages, the majority of alcoholics and drug abusers in recovery who are caught up in this deadly addiction would really like to quit. (4,8)

Fortunately, a number of organizations (such as the American Cancer Society and American Lung Association) offer effective, low-cost smoking cessation programs designed to help smokers who are truly motivated to quit. The interactive group support emphasis of these programs appeals to many clients who are following 12-step regimens. In concert with participating in a structured smoking cessation program, other wellness-oriented behaviors--including regular physical exercise, sound nutrition, and meditation--can play an important supportive role in helping clients successfully navigate the early stages of nicotine withdrawal.

SERVING AS A WELLNESS ADVOCATE

In the interest of reducing the risk of relapse and promoting quality sobriety for clients in recovery, EAPs should actively support clients in recovery in pursuing healthy lifestyles. By doing so, EAPs will render a valuable service to these clients and also assume a proactive posture in helping employers contain health care costs.

How can you, as an employee assistance professional, serve as an effective catalyst in promoting wellness and recovery? By monitoring the treatment programs to which you refer your clients, you can encourage these programs to fully integrate a wellness-oriented approach into both their primary treatment and continuing care components. You can also forge a strong alliance with employer-sponsored wellness programs, actively encouraging your clients to participate in fitness, nutrition and weight loss, and smoking cessation programs sponsored by the employer and/or the various employee health plan options. It is also important to utilize follow-up counseling sessions with clients in recovery as an opportunity to reinforce the importance of integrating wellness-oriented behaviors into their recovery programs.

Finally, I would encourage you to practice healthy behaviors yourself. To the extent you personally embrace a wellness lifestyle, you will be able to serve as an effective role model for your clients in this critically important area. To your health!

References

(1.) Sinyor, David, et al. 1982. "The Role of a Physical Fitness Program in the Treatment of Alcoholism." Journal of Studies on Alcohol 43 (3): 380-386.

(2.) Marlatt, G. Alan and Judith Gordon, eds. 1985. Relapse Prevention: Maintenance 5trategies in the Treatment of Addictive Behaviors. New York: Guilford Press.

(3.) Newport, John. 2000. "The Wellness, Recovery Connection." EAP Digest Winter: 28-30.

(4.) --. 1998. "Influence of a Wellness-Oriented Lifestyle on Successfulness of Recovery from Chemical Dependency." Doctoral dissertation. California Coast University: Santa Ana, Calif.

(5.) Gorski, Terence T. 1989. Passages Through Recovery: An Action Plan for Preventing Relapse. Center City, Minn.: Hazelden.

(6.) Glasser, William. 1976. Positive Addiction. New York: Harper & Row.

(7.) National Institute on Alcohol Abuse and Alcoholism. 1998. "Alcohol and Tobacco." Alcohol Alert 39.

(8.) Bobo, Janet K. et al. 1986. "The Double Triumph: Sustained Sobriety and Successful Cigarette Smoking Cessation." Journal of Substance Abuse Treatment 3: 21-25

John Newport is a wellness counselor, freelance writer, speaker, and consultant based in Port Townsend, Washington. He is author of The Wellness-Recovery Connection: Charting Your Pathway to Optimal Health While Recovering from Alcoholism and Drug Addiction (Health Communications, Inc., 2004). To contact him or obtain more information on wellness and recovery visit www.wellnessandrecovery.com.