Dr. Milgram has been a prominent physician in San Diego and has served as a well-respected OB/GYN and a leader in Addiction Medicine in our community. But part of the perspective that Dr. Milgram brought to SoAP was from his three decades of recovery.
What is Recovery?
“People think they are in recovery just because they are abstaining,” Dr. Milgram observed. He insisted that isn’t recovery.
Recovery is more than that. Addicts are self-centered. They experience the world as if it’s focused on them. Psychology calls that an “imaginary audience.” They fear they are “showing their cards” or giving away key information. Life is all about them.
They believe they are victims, and they likely have been victimized, but Dr. Milgram emphasized that staying in the victim role is an absolute killer for the recovery process.
The goal is to get “right-sized.”
“Recovery is changing…working to be a better person, learning to be honest and caring…How do we get a person to change — to be a person truly in recovery?” He asks.
A Better Past
Dr. Milgram observed that a good portion of the people who speak about their addiction and recovery talk about their past, but they don’t bring things into the present and that is something that needs to be done. A person in recovery is often grieving a life that they didn’t have. They hold onto the idea that their lives should’ve been better.
People recovering with addiction need to come to terms with their past — ugly, inadequate, and painful; full of shame and guilt.
“I forever gave up the hope of having a better past,” he shared. And that made a difference in his recovery.
Those starting down the road of recovery need to hear “you can have a life after royally fucking up.”
Without that, it’s hard to believe that there is more to the future besides shame, guilt, and hopelessness; that there are ways to improve and heal low self-esteem.
“The best way to build low self-esteem is to do esteemable acts,” Dr. Milgram said, focusing on loving and helping others – family, friends, neighbors.
NAD as a Detox Treatment
Addicts don’t live more than 24 hours at a time. They focus completely on the present. It’s about the next hit. When an addict gives in to their addiction, “every single cell is going to breathe out in relief like a hundred orgasms. You can’t fight that with willpower.”
An addict comes in to the center with little hope that they will be able to stay away from drugs.
After 3 days of NAD, they start thinking “maybe I really can get clean.” The Nicotinamide Adenine Dinucleotide works on healing the brain. Then it is up to those involved in the recovery process to “take that spark and fan it into a passion for life.”
The clinic focuses on nutrition during the detox process.
After that, it is time for the recovery process which should:
Address the past and family of origin issues. AA is well-suited for this.
To develop gratitude.
To learn what can be controlled and what can’t be.
To address any co-occurring disorders — 50% have psychological issues.
Our thanks to Dr. Milgram for his insights and his perspectives. There was so much more that he shared, but we couldn’t cover everything here.