Answer Addiction

Author: The Fix

  • The Role of Psychedelic Plant Medicines in Addiction Treatment

    Psychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. 

    Psychedelic plant medicines have the potential to help many people who are in recovery from substance use disorder dig deep into the roots of their addiction and come out of the other side. Plant medicines like psilocybin, ayahuasca, and particularly ibogaine, have demonstrated unprecedented results for those who use them as a tool on their recovery journey.

    While the legal status of many of these substances is still murky (depending on where you consume them), the ongoing research, decriminalization efforts, and shift in public narrative is promising. Hope lies on the horizon for wider access to these medicines, but right now, what’s needed is raising awareness and informed decision-making around their consumption.

    Here is how psychedelic plant medicines can help those that struggle with addiction and what people should consider before choosing this path.

    Ancient healing practices reconcile with modern science

    Psychedelic plant medicines have been used for healing purposes by indigenous cultures for thousands of years, and there is mounting evidence that shows their ability to integrate with modern addiction therapy. 

    Research around the potential of ibogaine to treat opiate addiction is still in its infancy, but shows promising results. Ibogaine, which comes from the Iboga shrub, has been used historically in ceremonies in West Africa by practitioners of the Bwiti spiritual tradition since the late nineteenth century. The roots and bark of the tree are consumed ceremoniously in large doses to provoke a near-death experience, and in smaller doses during rituals and tribal dances. It is not considered a recreational substance by users, yet is classified as a Schedule 1 drug in the US.

    One 2017 study funded by the Multidisciplinary Association for Psychedelic Studies (MAPS) observed opiate addiction treatment delivered by two independent ibogaine clinics in Mexico. One month after the study, half of participants reported using no opiates in the month following the study. The researchers found that “ibogaine was associated with substantive effects on opioid withdrawal symptoms and drug use in subjects for whom other treatments had been unsuccessful.” 

    Another study on the long-term efficacy of ibogaine-assisted therapy in New Zealand found that a single ibogaine treatment reduced opioid symptoms and resulted in no opioid use or reduced use in dependent individuals over 12 months. 

    Healing that gets to the root

    Ayahuasca is a psychoactive Amazonian brew traditionally used in the indigenous communities of South America. Research on the brew is grounded in its potential to support healing by allowing for a deeper connection to oneself and due to the spiritual context in which it is taken. 

    One 2017 study published in the International Journal on Drug Policy used qualitative analysis through long-term field work and participant observation in ayahuasca communities, as well as conducting interviews with participants with problems of substance abuse.

    The study found that “ayahuasca’s efficacy in the treatment of addiction blends somatic, symbolic, and collective dimensions. The layering of these effects, and the direction given to them through ritual, circumscribes the experience and provides tools to render it meaningful.”

    Researchers from a 2013 Canadian study, sponsored by MAPS, concluded that ayahuasca-assisted therapy for stress and addiction was correlated with improved mindfulness, empowerment, hopefulness, and quality of life-outlook and quality of life-meaning. The same study found that ayahuasca, when administered in a ceremonial setting, may have contributed to reduction in cocaine use in dependent participants.

    There have also been studies that show the benefit of psilocybin mushrooms in allowing people to overcome addictive or damaging behavior. A 2014 study from the Johns Hopkins Center for Psychedelic and Consciousness Research found that 80% of previously addicted smokers abstained from smoking six months after they were administered psilocybin. Remarkably, 60% continued to abstain two and a half years after the study.

    “Institutions like MAPS and the Imperial College London are pioneering the way forward with this evidence-based approach to psychedelic medicine—a necessary effort if these compounds are to be integrated into the mainstream,” said Gaurav Dubey, clinical biologist and content editor at Microdose Psychedelic Insights.

    “Though, we have a lot of catching up to do,” said Dubey. “We need to do better in understanding the psychotherapeutic mechanisms of these incredibly unique compounds and the only way to uncover that is through science and research.

    “The clinical data that strongly supports the therapeutic use of these compounds in addiction treatment will be fundamental in making them accessible to recovering addicts around the globe,” he added.

    Journeys to an addiction-free life, supported by plant medicines

    Kat Courtney is the founder of AfterLife Coaching, a trained ayahuasquera, and has been working with the plant medicine ayahuasca for over a decade. Courtney first began her journey with ayahuasca in Peru in 2006, while suffering with alcoholism and bulimia.

    “Not only did ayahuasca help me face and deal with the traumas and programming that created these destructive behaviors, she helped me access an authentic space of self love and gave me tools to work with in lieu of the addictions,” said Courtney.

    “They fast-track the healing and awakening process and ground us into our bodies so we can move past stages of self-destruction. They help us to move the trauma that is stored in the body through crying, purging, and all kinds of different forms of release.”

    But Courtney stresses that the act of taking these medicines is only part of the deal: “We absolutely have to be committed to integrating these experiences and making the life changes that support sobriety,” explained Courtney. “Otherwise, plant medicine ceremonies can become distant memories.”

    Alternative approaches offer a chance for healing

    Aeden Smith-Ahearn is the founder of Experience Ibogaine Clinic, based in Mexico. Aeden first tried ibogaine in an effort to overcome his dependency on multiple substances, including heroin. 

    “Ibogaine got me comfortably off opiates,” said Smith-Ahearn. “I had almost no withdrawal symptoms, and I had a very profound experience which helped give me a motivational boost in the right direction.

    “The medicine put me in my place, and that’s exactly where I needed to be. I got a fresh start, on top of a head start into my recovery,” he explained.

    Prior to his ibogaine experience, Smith-Ahearn had tried several programs in an attempt to break free from his addictions, which he describes as “cold turkey, three meals a day, and a therapist once a week.”

    “These programs work for many people, but they didn’t do the job for me. The problem was that I did not want to change, and was therefore unwilling to work towards something I didn’t want,” he said.

    Smith-Ahearn credits ibogaine with huge potential for recovering opiate addicts specifically because of how it interacts with the brain’s receptors. “The hardest part about breaking out of opiate addiction is getting over withdrawals,” he said. “The medicine alleviates withdrawal symptoms [for some patients], which is a godsend for someone who is in over their head with opiate addiction.”

    Like Courtney, Smith-Ahearn stresses that ibogaine is not a cure-all. “It’s crucial that patients of the treatment put their effort into a quality aftercare plan.”

    Charles Johnston, director of client success at Clear Sky Recovery, has also historically struggled with opiate addiction and subsequently used ibogaine as a tool to help him overcome his dependency.

    “Ibogaine was the medicine that interrupted my addiction, and for the first time let me fully witness the root cause of my addiction: self-hatred. It provided me with a path, purpose, and mission to support others and see that addiction is a blessing of self-discovery,” explained Johnston.

    “Ibogaine allows the individual to feel how they would after months of detox with conventional methods and if supported properly, encourages a whole new paradigm of accountability and acceptance,” he continued.

    With these and other accounts of personal transformation, it’s clear that ayahuasca and ibogaine have potential to assist people struggling with addiction on a path to recovery. However, these treatments should not be treated lightly and come with a number of risks to the patient if not administered responsibly.

    What you need to consider before trying psychedelic therapy

    Psychedelics generally have very little risk of abuse, but when taken in the wrong setting, or without proper guidance or structured preparation and integration, they can result in negative consequences.

    There are some short term health risks which are important to consider. “Using ibogaine comes with risks to your physical health, such as seizures, gastrointestinal issues, heart complications, and ataxia,” says board-certified psychiatrist and addiction specialist Dr. Zlatin Ivanov. “There have also been unexplained fatalities in people who have ingested ibogaine, which may be linked to the treatment.”

    Charles Johnston of Clear Sky Recovery explained that “if someone has heart issues, liver problems, other major health complications, serious psychological issues, or are expecting a quick fix, ibogaine may not be the right path.”

    The same largely goes for users of other plant medicines, including ayahuasca. Users of SSRI antidepressant medication have run into an adverse reaction while drinking the medicine with the drugs still in their system.

    “People need to do careful research and not fall foul of misleading things that they see on the internet. A lot of people have expectations that the medicine may not offer, like profound psychedelic experiences guaranteed to change them or no withdrawal whatsoever,” said Aeden Smith-Ahearn of Experience Ibogaine.

    Those seeking treatment with psychedelic plant medicines should make sure they go to a reliable and reputable center. In recent years, the number of tourists flocking to Peru to drink ayahuasca has boomed, resulting in illegitimate retreats run by people lacking in the experience required to administer the medicine.

    In many countries, including the US, these substances are illegal to consume. Many people do however seek out treatment in countries where the medicines are not outlawed, such as Mexico, Costa Rica, Peru, and Colombia. In the US, ayahuasca is legal within specific religious groups, such as the Santo Daime.

    A path to accessibility

    Looking ahead to the future of psychedelic treatment, progress is being made on the legalization front, with Oakland and Santa Cruz, California, and Denver, Colorado, voting for decriminalization of psilocybin-containing mushrooms in 2019 and 2020. Oregon and Washington D.C. also have votes ahead on the decriminalization of psychedelic-containing plants and fungi.

    Meanwhile, Canada is seeing a number of legal ayahuasca centers open up, on the part of religious groups who have special permission from the government to use the medicine. However, ultimately, it will be a continuation of the scientific research that paves the way for increased access to psychedelic therapy.

    “We need more large scale, gold-standard clinical trials examining these compounds in the context of addiction treatment, such that their impact can no longer be ignored—even by the most stubborn of policymakers and world leaders,” said Dubey.

    “There needs to be a shift in global drug policy so these powerful medicines can be reclassified and reintegrated into our society in an effort to heal the masses.”

    In essence, psychedelics need to go mainstream and lose the stigma that they have held for decades so that the public appetite can develop and further drive policy changes. In addition to research, diverse voices and experiences, along with mainstream support, will be key in the psychedelic renaissance maintaining its momentum.

    The value of psychedelic plant medicines for addiction recovery is difficult to overstate, but is a path that should be explored carefully, mindfully, and while armed with the right information and support. And there’s hope that a future where accessibility isn’t an issue is on the horizon: The ongoing research and changing societal attitudes towards psychedelic plant medicines demonstrate promise. Education around these medicines and their proper use is vital for this renaissance to continue.

    By shining a light on the potential of psychedelic plant medicines to help and heal, we can contribute to forming more pathways to change and legitimate channels for people to benefit from their treatment.

    View the original article at thefix.com

  • For Pregnant Women, Stigma Complicates Opioid Misuse Treatment

    In Pennsylvania, one community health center is working with new and expectant moms to tackle opioid dependency.

    New and expectant mothers face unique challenges when seeking treatment for an opioid use disorder. On top of preparing for motherhood, expectant mothers often face barriers to accessing treatment, which typically involves taking safer opioids to reduce dependency over time. The approach is called medication assisted therapy, or MAT, and is a key component in most opioid treatment programs.

    But with pregnant women, providers can be hesitant to administer opiate-based drugs.

    According to a study out of Vanderbilt University, pregnant women are 20% more likely to be denied medication assisted therapy than non-pregnant women.

    “In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak of the Wright Center for Community Health in Scranton, Pennsylvania.

    The health center serves low-income individuals who are underinsured or lack insurance altogether, many of whom struggle with opioid misuse.

    “Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak, who is a board certified addiction medication specialist.

    On this episode of the podcast, we speak with Dr. Hemak about whether medication assisted therapy is safe for new and expectant mothers and how the Wright Center is helping women overcome opioid dependency during pregnancy.

    Direct Relief · For Pregnant Women, Stigma Complicates Opioid Treatment
    Listen and subscribe to Direct Relief’s podcast from your mobile device:
    Apple Podcasts | Google Podcasts | Spotify

    Direct Relief granted $50,000 to The Wright Center for its extraordinary work to address the opioid crisis. The grant from Direct Relief is part of a larger initiative, funded by the AmerisourceBergen Foundation, to advance innovative approaches that address prevention, education, and treatment of opioid addiction in rural communities across the U.S. 

    In addition to grant funding, Direct Relief is providing naloxone and related supplies. Since 2017, Direct Relief has distributed more than 1 million doses of Pfizer-donated naloxone and BD-donated needles and syringes to health centers, free and charitable clinics, and other treatment organizations.

    Transcript:

    When it comes to getting treatment for an opioid use disorder, pregnant women have an uphill battle.

    Most patients undergoing opioid treatment are prescribed safer opioids that reduce dependency while limiting the risk of overdose and withdrawal.

    This kind of treatment is called medication assisted therapy, or MAT.

    But with pregnant women, providers can be hesitant to administer opioids.

    According to a study out of Vanderbilt University, pregnant women are 20% less likely than non-pregnant women to be accepted for medication assisted therapy.

    “In the beginning, I was so scared as a new provider to write my first prescription for medication assisted therapy to pregnant women,” said Dr. Linda Thomas-Hemak.

    Hemak is a board-certified addiction medication specialist and CEO of the Wright Center in Scranton, Pennsylvania.

    “Pennsylvania was hit particularly hard by the opiate epidemic that really has plagued, terrified and challenged America,” said Hemak who has been practicing in the state for several years.

    In 2016, the health center launched a comprehensive opioid treatment program to address the growing crisis in their community. They quickly realized a number of patients were pregnant—and had specific needs, from prenatal care to job support. And so, a new program was born.

    “The Healthy MOMS program is based on assisting mothers who are expecting babies or have recently had a child, up until the age of two,” explained Maria Kolcharno — the Wright Center’s director of addiction services and founder of the Healthy MOMS program.

    “We have 144 moms, through the end of August, that we have served in the Healthy MOMS program and actively, we have enrolled 72.”

    The program provides new and expectant moms with behavioral health services, housing assistance, educational support; providers have even been delivering groceries to moms’ homes during the pandemic.

    But the crux of the program is medication assisted therapy.

    Moms in the program are prescribed an opioid called buprenorphine—unlike heroin or oxycodone, the drug has a ceiling effect. If someone takes too much, it won’t suppress their breathing and cause an overdose.

    Nonetheless, it’s chemically similar to heroin, which may raise eyebrows. But while some substances, like alcohol have been shown to harm a developing fetus, buprenorphine isn’t one of them.

    “Clearly there are medications, like alcohol, that are teratogenic. And there’s medications like benzodiazepines that have strong evidence that they are probably teratogenic. When you look at the opioids that are used and even heroin, there is no teratogenic impacts of opiates on the developing fetus,” Dr. Hemak explained.

    So, opioids like buprenorphine can be safe for pregnant women. What’s not safe is withdrawal.

    If someone is abusing heroin, overdose is likely. In order to revive them, a reversal drug called Naloxone is used, which immediately sends the person into withdrawal.

    But when a woman is pregnant and goes into withdrawal, it can cause distress to her baby, lead to premature birth, and even cause a miscarriage.

    Which is also why these women can’t just stop taking opioids.

    “Stopping cold a longstanding use of an opiate because you’re pregnant is a very bad idea and it is much safer for the baby and the moms to be transitioned from active opiate use to buprenorphine when pregnant,” explained Hemak.

    Because buprenorphine has a ceiling effect and is released over a longer period of time, women are less likely to overdose on the drug.

    Regardless, there’s still a risk their baby goes through withdrawal once they’re born. For newborns, withdrawal is called neonatal abstinence syndrome or NAS.

    Babies may experience seizures, tremors, and trouble breastfeeding. Symptoms usually subside within a few weeks after birth.

    Fortunately, the syndrome has been shown to be less severe in babies born from moms taking buprenorphine versus those using heroin or oxycodone.

    That’s according to Kolcharno who has been comparing outcomes between her patients and those dependent on opioids, but not using medication assisted therapy.

    “Babies born in the Healthy MOMS program, we’re finding, that are released from the hospital, have a better Apgar and Finnegan score, which is the measurement tool for NAS and correlates all the withdrawal symptoms to identify where this baby’s at,” said Kolcharno.

    But NAS is not the only concern women have post-partum.

    During and after delivery, doctors often prescribe women pain killers. For those with an opioid dependency, these drugs can trigger a relapse.

    Dr. Thomas-Hemak says preventing this kind of scenario requires communication.

    The Wright Center works with their local hospital to ensure OBGYNs are aware of patient’s substance use history.

    “We want the doctor to know that this may be somebody that you’re really sensitive to when you’re offering postpartum pain management,” said Hemak.

    That way, doctors know to tailor patients’ post-partum medication regimens. Instead of prescribing an opiate-based pain killer they can offer alternatives, like Ibuprofen or Advil.

    Maintaining an open line of communication between addiction services and hospital providers also helps to reduce stigma.

    Women with substance use disorders have long been subject to discriminatory practices by both providers and policy makers.

    From denying them treatment to encouraging sterilization post-delivery, women struggling with opioid dependency can be hard-pressed to find patient-centered health care.

    But Dr. Thomas-Hemak says, she’s learned to set her opinions aside.

    “I think one of the magical transformations that happens when you do addiction medicine really well is, it’s never about telling patients what to do.”

    It’s about allowing them to make informed choices, she says, and understanding it’s not always the choice you think is best.

    This transcript has been edited for clarity and concision.

    View the original article at thefix.com

  • Opinion: The Opioid Crisis + COVID-19 = The Perfect Storm

    How can the addiction treatment community continue to assist people who are now being left even more isolated and desperate?

    Addiction – a chronic relapsing brain disorder, and a disease that gets deeply personal. It gets low-down and dirty, too.

    If you’re not an addict yourself, you surely know someone who is.

    You know someone abusing their opioid prescriptions, not because it’s a barrier to their pain, but because it’s a potent way to make them feel happier. You know someone whose alcohol consumption is dangerously high and verging on alcoholic – if they’re not already there, of course. Your kids will certainly know someone who abuses recreational drugs like they were going out of fashion. They’ll also know other students who swallow ADHD prescription tablets (as a study aid) because it makes them get their grades, and keeps their parents, people like you, happy.

    Among the people who are in your extended family, among your circle of friends, or someone within your workplace – at the very least, one, probably several more, will be a secret drug addict or an alcoholic. At the very least.

    It doesn’t discriminate. It certainly doesn’t care where you live either, just like most other diseases, and now this new coronavirus – COVID-19.

    Arizona & The Opioid Crisis

    Over the last 3 years, in Arizona alone, there have been more than 5,000 opioid-related deaths. Add to that the 40,000-plus opioid overdoses that have taken place during the same period, and you realize that COVID-19 has never been the only serious health issue the state continues to face, or the rest of the U.S., for that matter.

    In our “new reality” of social distancing and masks, more than 2 people every single day die from an opioid overdose in Arizona. Nearly half of those are aged 25-44 years old – in their prime, you might say.

    Opioids are not the only addictive group of substances that is costing young Arizonan lives right now either.

    From the abuse of “study aid” drugs, like Adderall and other ADHD medications, to the “party drugs,” like cocaine and ecstacy, and so to opioid prescription meds, and, if circumstances allow, a slow and deadly progression to heroin – addiction is damaging lives, if not ending them way too soon.

    These drugs did so before anyone had ever heard of COVID-19, and they’ll continue to do so after, or even if the world ultimately finds another drug – the elusive coronavirus vaccine – it is hoping for.

    Opioids + COVID-19 = The Perfect Storm

    We now live in this time of coronavirus. With the ongoing opioid epidemic, the question arises:

    How can the addiction treatment community continue to assist people who are now being left even more isolated and desperate, still with their chronic desire to get as high as they can, or drunker than yesterday?

    Furthermore, coronavirus has raised questions itself about the ongoing mental health needs of our population as a whole, and drug addicts and alcoholics continue to feature heavily in any statistics you offer up about those in the U.S. living with a mental health disorder.

    In fact, around half of those with a substance use disorder (SUD) or an alcohol use disorder (AUD) – the medical terminology for addiction – are simultaneously living with their own mental health disorder, such as major depression, severe anxiety or even a trauma-related disorder like PTSD.

    How are these predominantly socially-disadvantaged people able to receive the treatment they really need when they have been directed to isolate and socially distance themselves even further?

    This is why I believe the conditions for a “perfect storm” of widespread deteriorating mental health and self-medication through continued substance abuse are here now, with overdoses and fatalities rising across the addiction spectrum.

    There will be many drug or alcohol abusers living in Arizona who will be lost to us, and the majority will be young people in the age group of 25-44 mentioned previously, left isolated and unnoticed by an over-occupied medical community.

    The U.S. opioid epidemic plus the global coronavirus pandemic.

    A deceitfully isolating disorder in a time of generalized social isolation. For some, there will be no safe harbor from this, and it will wash them away from the lives of their families and friends without any chance of rescue whatsoever. The perfect storm – our perfect storm.

    Today, the truth is that successful addiction recovery has become exponentially more difficult. Apart from ongoing isolation to contend with, there exists an unfounded but very real distrust of medical facilities per se, and a real personal problem in maintaining good physical and mental health practices, eg. through nutrition and physical activity.

    Innovation: The Ideal Recovery Answer for Isolated Substance Addicts?

    Digital technology has advanced far further than its creators and financial promoters ever envisaged – or has it? We have become a society where it doesn’t matter where you are in the world, you’re always close by to loved ones you wish to talk to, friends you want to have a laugh with, and colleagues you need to share information with.

    Communication anywhere with anyone is as simple as the proverbial ABC.

    However, if you think that innovation and digital technology – sitting in front of your laptop or tablet, in other words – can provide the answers to the questions raised earlier about the timely provision of professional addiction or mental health treatment to those that need it, then you’re wrong. If only it were all that simple and straightforward.

    Online meetings of 12-Step organizations, like Alcoholics Anonymous, Narcotics Anonymous, and others, have been available for many years. However, all of these support organizations realize that an online or virtual 12-Step meeting is not the real thing. They are a temporary substitute and no more.

    In fact, they are a poor substitute when compared to the face-to-face and hands-on meetings that continue to be held successfully all over the nation and all year round.

    The various “sober aware” and “sober curious” communities that are present online do not provide a realistic treatment option to any substance addicts whatsoever, whether their SUD or AUD has been clinically diagnosed or not. Furthermore, the current crop of online addiction treatment and recovery programs available are currently statistically unproven in terms of successful outcomes, and with no official accreditation.

    That said, there is limited evidence that “telemental health care” does have several benefits in terms of more timely interventions in those with mental illness generally, particularly when these people are located in isolated communities.

    I honestly wouldn’t know, as there is no official patient outcome data for these services. In fact, by the time that data is able to be impartially and officially collected, these groups and so-called programs may have already lost their internet presence.

    Online “help” (you honestly couldn’t call it an actual treatment) with addiction is severely limited and nowhere near approaching the answer. Here’s exactly why…

    Substance addiction is an utterly isolating disorder. It can obliterate close family bonds, destroy what keeps us close together as friends, and will happily rampage unabated through any social life you may still hold onto, accepting no prisoners. Bleak isolation like you’ve never known before.

    Corona has little on addiction.

    Addiction is the catalyst behind premature death, the end of families and their marriages, long-term unemployment, and endless legal issues. It costs financially too – countless billions of dollars every year are lost to this disorder, over double that of any other neurological disease.

    Let me be absolutely clear and concise – there exists no replacement whatsoever for your hand held by another when lying in an intensive care bed, scared you’ll become just another coronavirus statistic, and there exists no replacement for the smiles, warmth, and openness of fellow recovering drug addicts meeting in a daily support group, especially on those days when you came so close, so very close, to using or drinking again.

    There’s little difference between the two either.

    The online addiction treatment industry is still in its childhood. It truly is an industry too, as you’ll only buy the brand and the product; you’ll never actually meet those telling you how to best change your life.

    At present, it falls woefully short.

    Really, what would you prefer? A mask-wearing addiction professional, clinically qualified to assist with your detox, your medication if needed, and your psychological needs, located in an accredited treatment facility (formally certified as being coronavirus-free), among peers, fellow addicts, and trained medical staff?

    Or a video image on a computer screen of someone you will never meet, who is telling you to do things you’ve never done before? At least, successfully?

    As society moves towards a more home-orientated existence, with WFH (working from home) the new norm, consider this:

    Would a specialized medical professional treating your disease ask you to consider “getting better from home,” as an alternative to the hospital?

    All we can hope for – the best that we can hope for – is that coronavirus soon leaves the state lines of Arizona, and that can continue all of our recoveries as successfully as before. Until then, the advice is simple – take the best help you can from wherever you can get it. Sadly, you are yet to find it on a computer screen.

    One last thought before I sign off…

    Protective masks may well become standard attire in our unknown future. So why, oh why, can they not make these transparent? Just take a moment… We’d be able to see each other – our friends, our colleagues, even complete strangers in the street – smile again.

    View the original article at thefix.com

  • One Hit Away: A Memoir of Recovery

    Even though I know a lot of junkies who walk these streets with no life left in them, this is the first dead body I’ve ever seen.

    Sprawled across the side entryway to Beth Israel Congregation, I roll onto my side and wipe a palmful of dew off my clammy face. Everything about this morning is brittle, cold and still. Suspended in limbo, I’m drained from squirming all night on the slick ground like a caterpillar in a cocoon. As first light swirls around me and creeps into the shadows, I’m in no rush to greet it—there’s no point jump-starting the engines until the street dealers kick off their rounds. Having suffered through too many of Portland’s sunrises in recent years, the art on the horizon has either lost its beauty or I’m too jaded to see in color anymore. 

    Peeling my head away from an uncomfortable makeshift pillow made of rolled-up sweatpants, I see that both Simon and the surrounding streets are sleeping in. We’re nestled in darkness, lit only by the headlights of an occasional car that turns down Flanders Street. My sleeping bag is bunched under my hip to help relieve the pressure from the cold stone beneath me, but it’s not the only reason I had a hard time sleeping last night. 

    A few hours ago, I woke up to the alarm of Simon snoring and rattling away in his sleep—it was an eerie and guttural sound like an empty spray-paint can being shaken. I was still fighting to fall back asleep, long after his sputtering faded and drifted away with the breeze. So, while he put another day behind him, I was reminded that long nights take a toll and this life never pays.

    We both went to sleep with full bellies and a shot, so we’re fortunate that neither one of us will be dope sick. It’s nice to catch a break now and then and wake up without wishing I would die already. But it’s never enough—I’m still skeptical about how hard Simon crashed out and wonder if he’s holding out on me. Though if I were in his shoes, there’s no doubt I’d do the same. Riding high comes naturally in a free-for-all where everyone looks out for themselves. We all have it—a grizzly survival instinct to take what we can, when we can and figure tomorrow out if it comes. 

    This isn’t our land, but we periodically come here to stake a claim in the covered alcove guarding the ornate entryway. If unoccupied, I prefer this location because it’s a reasonably safe place to hang my boots. Not only is there protection overhead from the frequent rain that tends to ruin a good night’s sleep, but it’s also set back from the street enough that being noticed, roused and moved by the police is a rarity. 

    The groundskeeper here is a man of quiet compassion. It isn’t in him to run us off outside of business hours, and he refuses to call the police on us. For the most part, we are often gone before he would have to step over our bodies to open the temple doors. Scattering like roaches, we are sent packing by an internal alarm that forces us to get up at first light and attend to our bad habits.

    Simon is still asleep. He’s had it easy after spending all day yesterday collecting free doses from every street dealer he could pin down. This is common for any junkie recently released from a stint in jail. Any time after I’ve been arrested, all I have to do is show one of my dealers my booking paperwork and they’ll set me right. A freebie from them is a cheap investment in their own job security, reigniting the habit that was broken by an unpleasant jailhouse detox. Our dealers also need us back up and running again, racking up goods and on our best game. It’s no secret that a dope sick junkie is unprofitable.

    I pull myself together and pack with purpose, grabbing the dope kit I stashed in a tree nearby and then my shredded shoes that I left out to dry. I often struggle to tell whether my insoles are wet or merely cold, but when water oozes out of my shoelaces as I double-knot them, I take note that at some point today I need to steal fresh socks. 

    “Time to go,” I call out. 

    Simon, in one of the few ways that he is needy, often depends on me rousing him. He’s never been a morning person and is still sound asleep, his face buried in his sleeping bag. 

    “Come on, get up.” I spin in place and scan the ground to make sure I’m not forgetting anything. Eager to start the day, I nudge him with my toe a bit harder than I intended to. 

    When that doesn’t wake him, I reach down to shake his shoulder and feel an unnatural resistance. Something, everything, is wrong. His whole body feels stiff, and as I pull harder, Simon keels over, his rigid limbs creaking out loud like a weathered deck. There is lividity in his face—his nose is dark purple and filled with puddled blood. A pair of lifeless, open eyes stare through me and into nothingness. Instinctively, my hand snaps back and Simon sinks away.

    I stumble back and try to make sense of my surroundings. Nobody is around yet, but soon, the world will rise.

    “No, no, no.” I lose control of the volume of my voice and squeeze my throat. “Don’t be dead, please, don’t do this to me,” I chant as I drop to my knees, pleading over his corpse. 

    My hands hover over him as if trying to draw warmth from a smothered fire. I desperately grasp for a way to fix this. My heart is racing as though I just sent a speedball its way, but the surge doesn’t stop. A decision needs to be made, and fast, but before I can make sense of anything, a wisp of breath rolls down my collar and an invisible hand clutches my cheeks, forcing me to stare down death. 

    I snap the clearest picture in my mind and my eyes sting. Even though I know a lot of junkies who walk these streets with no life left in them, this is the first dead body I’ve ever seen. Looking down at Simon, I finally understand how pathetic this existence is and how lonely this life will always be. I see nothing beyond this moment for Simon, other than being hauled away like trash on the curb. We are forever trapped here, alone and useless, likely remembered only for our crimes, selfishness and former selves. Heaven is out of the picture, and because of that, I am okay with what I have to do next. I know the act is irreversible and unforgivable, but then again, if God has abandoned us, he’s not around to judge me.

    Dropping my sleeping bag onto the ground, I slide my backpack off my shoulders and let it fall like a hammer. I kneel over Simon’s body, steal one last look around and wince as I rummage through the front pocket of his jeans. I know he always keeps a wake-up hit on him. His pocket is tight and fights my hand as I dip into them. My fingers scratch around but keep coming up empty-handed. Time is running out and traffic is increasing. 

    I reach into his back pocket and soon realize the dope isn’t in his wallet either. The longer I search, the more determined I am, but I can’t bring myself to roll him over and disturb him further. By the time I give up, I sit back on my heels. I can’t believe what I’ve become. 

    “I’m so sorry, Simon.”

    Please stop looking at me. I can’t take it. Pulling my sweater cuff over my palm, I reach out with a shaky hand to close his eyes. My hand gets close, then backs off as I turn my head away to exhale. When my hand reaches forward once again, my palm lands on his face but fails to brush his frozen eyelids closed.Backing away, I grab my belongings and shrink into the distance.

    Excerpted from One Hit Away: A Memoir of Recovery by Jordan Barnes. Available at Amazon.

    View the original article at thefix.com

  • Forgive and Remember

    Better to face the discomfort than continue to trudge along under a false impression that it’s not dormant inside, oblivious to the ticking of the time bomb that will eventually go off.

    Weekday morning programming kept me company in the background. The crispy and cold bedspread gave me some solace. My parents had just left the apartment and I was curled up like a fetus at the foot of the bed. It had been a while since I entertained the unwelcome visitor. What the hell was he doing here? Everything was going great, or so I believed. Two days with them proved me wrong. What seemed to be progress in acceptance and personal growth was only a by-product of spending a year on the other side of the world. No wonder I wasn’t feeling good and stayed in that day. The illusion of the enlightened and perfect world I’d been living in was shattered. The mourning of this started as a slow downward spiral that quickly turned into a tailspin but felt more like a free fall. I had not wished I hadn’t been born for a couple years now. But it was as if it had never left my side felt stronger than ever. I was drowning and didn’t know which way was up. It seemed that no matter what I did, I’d always come back to this powerlessness. What was the point to keep on trying? “Forget this. Life is too hard. You wouldn’t have to deal with all this if you ended it”, he suggested.

    Awakened unresolved issues were kicking and screaming. This is a very scary place to be, especially in this dangerous company. Running in fear was actually the courageous thing to do. It was time to resort to what saved my life a couple years prior. It was time to go back to basics. I knew a lot of meeting rooms in Miami, but this one was my favorite. There were some faces I recognized and others I didn’t. Most were friendly; mine was not. There was a thick fog of negativity inside my head and it was probably clear in my blank stare. Like a good friend used to say, sometimes we go to give sometimes we go to receive. I was in dire need.

    Some say it’s magic, others call it God, to avoid charged debates most refer to a Higher Power. Whatever you choose to call it, there is Something that definitely moves through those present. I lost count of how many times I heard exactly what I needed in those circles. The first times it was unbelievable how the day’s conversation addressed exactly what was eating away at me. It’s not just me. Others share this surprise as well. Even though it’s happened too many times to keep count, I am still at awe when it happens. It makes me feel special and reminds me that I am not alone. It doesn’t surprise me like it did at the beginning. Don’t get me wrong, I don’t take it for granted. I guess it has to do with worthiness and accepting that I am loved and cared for. I appreciate it deeply and it definitely keeps me coming back.

    As soon as the chairperson started the meeting it was obvious, we’d be talking about forgiveness. There were many nuggets of wisdom as each person shared their experience, strength, and hope. I had not forgiven, or rather accepted parts of my childhood. Spending a year on the Beautiful Island made me believe I was at peace with my past, but crossing the Pacific was a wake up call I needed to escape denial once again. It’s always a rude one, but an awakening, nonetheless. Better to face the discomfort than continue to trudge along under a false impression that it’s not dormant inside oblivious to the ticking of the time bomb that will eventually go off.

    The last person that shared might as well have been the first and only. Her share is the only one I remember from that day and one I will never forget. She helped me see things in a new light. She was molested at a young age by her uncle. Hard to believe but she said it was fairly easy for her to forgive him. She had finally forgiven herself after years of struggle and anguish. Her reasons for this challenge had to do with guilt, shame, and self-image. It was a very moving story. It made me uncomfortable to hear, but honored and grateful at the same time. There are details that escape me, but she closed with a line that changed it all for me and I have shared with many when discussing these issues. She said, “forgive and forget? That’s bullshit! We forgive and remember without pain”.

    View the original article at thefix.com

  • Zion Recovery

    More than anything, survey respondents raved about the individualized treatment approach: “It was about focusing your energy toward what was good and positive and meaningful for each individual.”

    Zion Recovery makes it clear from the get-go that its approach to recovery is rooted in spirituality and that they are not like other treatment centers. In their unique approach, they consider each participant a “Student of Recovery” whose purpose in treatment is to attain the “tools, education, and spiritual connection” necessary to resolve their issues. Zion strongly believes that combining spiritual-based principles with the traditional 12-step program provides more effective treatment for addiction and mental health conditions than typical treatment centers. Part of that spiritual foundation comes from from the serenity of the canyons found at the gateway to Zion National Park, where the facility is located.

    Executive Director Robert Beatty has personal experience with addiction. He built Zion Recovery nine years ago after finally discovering a path to recovery.

    “I have a personal knowledge of the pain and destruction caused by addiction,” he says. “I watched it destroy my family, my spirituality and my life. I made a decision nine years ago to turn my life over to the care of God, and get busy living.”

    In addition to addiction, Zion Recovery offers inpatient treatment for depression, chronic pain, PTSD, and trauma. They also offer intervention help and other family services. Treatment includes equine/adventure therapy — Beatty is an avid mountain climber himself. They also offer alternative modalities such as Theta Healing and Whole Body Light Stimulation.

    Most alumni who responded to our survey entered the program for addiction disorders, with a couple seeking treatment for chronic pain. Fellow patients came from a range of income levels, professions, and age groups from their 20s to their 50s.

    “We were of multiple religions, backgrounds and occupations,” wrote one respondent. “We all had occupations and family situations that were unique, yet very similar aspects that brought us here. It felt as if we all gave enough of a damn to show up.”

    Some residents had a private room and others had roommates, but dividers were available for privacy. Living areas were described as “spacious” and beds as “comfy.” Daily life was described as structured with many activities available in addition to multiple educational sessions, group meetings, and therapy. Though residents are expected to keep their living areas clean, there were “no chores unless you asked for them.”

    Amenities and activities at the Zion Recovery include “Yoga, equine therapy, individual therapy, group educational meetings about the 12 Step Program, Pool in summer months.” One former resident appreciated that there was “Plenty of acreage to be able to be outside and enjoy the beautiful scenery.” They even took a memorable trip to the Grand Canyon, which was “magnificent.” A full gym is available, as well as a sauna and hot tub, plus a pool in the summer months. A trainer is available a couple times per week.

    Alumni generally rated the food at the retreat highly. Healthy eating is emphasized, with portion control and minimal sugar. Zion Recovery has a dedicated cook who makes all the meals and snacks “like moms make.” Snacks are always available, from chips to fresh fruits and vegetables. One former resident loved the “crock pot meals” and enjoyed eating with the staff “like a big family.” Another described “world class smoothies,” and while one respondent did not enjoy the pot roast, overall the food was described as good healthy home cooking.

    When it comes to phone and internet access, most alumni reported being able to use the phone daily during free time. One alum appreciated a break from their phone, saying “I needed to get away from all that stuff, old friend, Facebook, Instagram, too much drama.” Others said that there was limited access to the internet or that online time had to be scheduled in advance. TV is available for watching in the evenings and in between classes if there’s time.

    Rules are described as “common sense” and easy to follow. In fact, more than one alum reported that they weren’t aware of any infractions at all. Those who did noted that staff was very calm and respectful in how they handled it, with small violations being met with warnings. More serious infractions are handled privately between the resident and staff.

    “I was never put down or made to feel bad, but I would walk through what I did [and] they helped me to take responsibility and that was just what I needed,” said one person.

    Treatment at the center was generally described as more permissive rather than staff taking a “tough love” approach. Alumni described a structured atmosphere where they were encouraged to go outside their comfort zones, but nobody is forced to get better if they don’t want to. “It was about focusing your energy toward what was good and positive and meaningful for each individual.”

    There are medically-trained staff on site, and doctors who demonstrated “excellent care and concern” are “available as needed via TeleMed Video chat.” Most respondents rated the doctors and nurses highly, praising them for their understanding and individualized, “no cookie cutter treatment.” Another was grateful and credited staff for discovering a heart condition and saving their life. On the other hand, one client was unhappy with the sleep medication they were given while in treatment.

    Zion Recovery uses a 12-step program, and former residents report that although spirituality is emphasized, it is not specifically religious. One alum described it as “Not Religious, but Spiritual, based upon each student’s beliefs and experiences regarding Spirituality or Higher Power.” Those who wanted to attend religious services were accommodated: “Utah is mostly LDS, so church services are offered if that is desired.”

    More than anything, survey respondents raved about the personalized treatment approach that avoided one-size-fits-all solutions that had failed them in the past. One former resident was allowed to bring their dogs when they couldn’t find a place for them to stay, and others enjoyed working with Robert Beatty himself.

    “Robert is the only one that has been able to actually teach the Steps to me in a way I related to,” wrote one alum. “He taught us individually as needed as well. He does take a faith-based approach, but tailored to each student’s experience with their own spirituality.”

    Most of the alumni who took our survey report that they are still clean and sober since leaving Zion Recovery, attributing their success to what they learned while in treatment: “I have such a huge tool-box of sober living strategies I developed during my stay,” said one alum. Another agrees: “Going there was one of the best things I’ve ever done and the tools and inspiration I received there have helped me in faith, family, finance, and fitness.”

    To learn more about how Rehab Reviews are created by The Fix, click here

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  • Failing

    Would we be able to reach across the distance—and our failings—to touch each other, to smile?

    We’re together for the first time in five years, the three of us. Three sisters. Terry, the oldest, pastes us together with persistence and illusion. She believes we can be a family, that we are a family. Julie, the youngest, bites her lower lip and wears a worried brow, even while she drives her red Miata with the top down to her job as a South Carolina attorney. She left home for law school fifteen years ago and comes back only for weddings or other landmark celebrations like this, or for Christmas every two years. And me, in the middle. I moved to Connecticut almost twenty years ago to cut free from my tangled roots, I thought, and to be near the hospital where I learned to stop drinking and to want to live again.

    I suspect my newest illness—Chronic Fatigue Syndrome—structures my life in a way my family must find limiting. At least that’s what I think when I hear their voices in my head. You’re tired all the time? Go to bed earlier. You can’t think straight? You’re an Ivy League graduate, for heaven’s sake. Start jogging again. You’ll feel better.

    But when I’m tucked away, writing in the pretty place on Long Island Sound I call home, half an hour from Manhattan, surrounded by people who drive German and Italian cars and wear Prada and Polo, I pretend their success is mine and that my medical bills and dwindling bank accounts and lost jobs and derailed relationships don’t much.

    When I return Upstate to the tricky terrain on chilly Lake Ontario, though, my creative ambitions seem paltry and a little suspect. I feel I’ve failed. But, I remind myself, I’m thin. And I used to have enviable, respectable jobs. And I saw the Picasso exhibit at the Met. I hang onto those vanities like life preservers tossed to me in rough seas.

    We’re together to celebrate our mother’s birthday, her seventy-fifth. Each of us brings her gifts to the party. Collectively, we also bring 130 years of survival skills, learned, not on some Outward-Bound wilderness adventure with a trusted coach, but in this family, where I, at least, believed no one was to be trusted.

    *****

    For three weeks, we made plans. When I called to ask Terry what I could contribute to the buffet, she discouraged me from bringing anything other than Tom. “As for sleeping arrangements,” she mused. “I’ll put Julie and Ken in the guest room. You can sleep in Katie’s room, and Tom can take the den.” She paused. “But the pullout sleeps two if you want to stay with him.” 

    Terry and I have been sisters for forty-four years. We emerged, screaming, flailing, from the same womb, played hide and seek in the same neighborhood, suffered algebra in the same high school. But before that clause (“. . . if you want to stay with Tom.”), we never talked about touching men or sleeping with them. When I hung up and told Tom about this tender talk between my sister and me, I was baffled when he said, “I guess they think I’m okay.” How could he shape so private a moment between Terry and me into something about him? But I shook off his self-absorption. He’s not Catholic. He wasn’t raised in a home where no one touched without wriggling to get free. And he doesn’t know how important it is to try to get to know your sister when you’ve spent three decades shoring up the distance from her and you’re no longer sure why.

    When I called Julie, she railed because Terry decided the party date and time without asking her. “Why did I offer to help if she’s taking care of everything?”

    I’m the middle sister. I’m in the middle, again and always, but I welcomed Julie’s rant. Any connection would feel better than the unexplained plateau we tolerated between us since her marriage ten years earlier. “I don’t know what to wear,” she said, trying to regain her equilibrium.

    “Pants and a sweater maybe,” I posited gingerly, not wanting to sever the tentative thread between us. “April’s still winter upstate.”

    “I might need something new.” The thought of a shopping mission jumpstarted Julie’s party stride. “They’re all on special diets,” she said, “so we’ll need to make sure everyone has something to eat. Dad can’t have nuts, remember?”

    * * * * * *

    Tom and I set out late Friday morning, my mood dipping as we rode the thruway into Rockland County and beyond. The sky hung as heavy and gray as it did six months ago when we went home for Thanksgiving, me with the same faint hope. Maybe this time things will be different.

    When we pulled into Terry and Bill’s driveway five hours later, stiff from sitting, Dad rushed to the door, his hair whiter and thinner. For a moment I mistook him for his father. And before he hugged me, I remembered that one Father’s Day brunch, when my father raged at his father because Grandpa couldn’t hear the waitress when she rattled off the holiday specials. “Stop!” I yelled. Why did I need to tell him to stop hurting his father? All I wanted was to be his favorite girl.

    His favorite girl? A dicey proposition. “How’s my favorite girl?” he’d ask when he hustled in, late—again—for dinner.

    “We don’t have favorites,” Mom was quick to point out as she slid a reheated plate across the table to him.

    Stop. I pulled myself back to Terry’s foyer. We hadn’t yet said hello, and I had dredged the silt of the River Past. Say hello. My father hugged me tight—he at least was generous with his hugs, though from him they never stopped feeling dangerous. We don’t have favorites. Although I hugged back, I stiffened in his arms and drew away too quickly. “You remember Tom?” Then I kissed Mom who, smaller than she used to be, still held her affection in reserve. “Hi, hon.”

    “You made it.” Terry said, smiling as she came in from the kitchen, wearing a gingham apron over her Mom jeans. “How was the drive?”

    As soon as I answered— “An hour or two too long”—I wondered if she thought my words meant I didn’t want to be there. We attempted a hug, and I held on a little too long, searching for something bigger, warmer, because in her stiffness, I heard questions. Is she angry because I don’t do my share? (Who wouldn’t be?) That she’s the one who drives Dad to his cataract surgery and perms Mom’s hair? (Of course, she’s angry.)

    “Nice outfit,” she said, and I resisted suggesting a livelier hair color for her.

    When Terry offered her cheek for a quick kiss, I saw Julie at the edge of the foyer, half in, half out, arms crossed. “You look great,” I said, hoping to breathe a little fire into her. “Hi.” She stretched the one syllable to two, an octave higher than her normal speaking voice, trying to sound different than she looked, as if she were frozen, unable to come closer.

    Hungry?” Terry asked.

    “Starved,” I said, not letting on that, more than food, I wanted a belly full of comfort.

    Tom and I brought in the dinner fixings—ravioli and salad greens I bought at Stewart’s market, bread and cheesecake from Josephine’s bakery—and Terry, Julie and I set about making the meal. Before Terry lifted the lid from the cooking ravioli, I knew she would sample one before she pronounced, “They’re done.” Then she would wrap the dish towel around the pot so she wouldn’t burn herself when she lifted it from the stove and dumped the steaming pasta into her twenty-year-old stainless colander with the rickety feet in the sink.

    I knew, too, how Julie would stand at the counter, her shoulders sloping forward, while she diced tomatoes and chopped garlic.

    I knew their rhythms, their postures, but I wanted to reach to them, to ask them please, would they look at me, would they be my friends. Instead, I wondered why it seemed so hard to say something spontaneous, or to laugh from our bellies.

    “Stewart’s was so crowded when I shopped, I had to meditate to steady myself when I got home, even before I unloaded my bags.”

    They turned to me when I took a stab at something genuine, but their tilted heads, their uncomprehending eyes signaled they didn’t know know how post-shopping meditation worked or why it should be necessary.

    “How are the grocery prices in Connecticut?” Terry asked, and my hope for connection vaporized as rapidly as the steam rising off the ravioli.

    *****

    Party day. Relatives arrive from across the county. My cousin, Peter, the accountant, the one I was sure, when I was six, I would marry, with his wife, Marie, still perky, still chatty, still in love. My teacher cousin, Patricia, with her professor husband, Art, who sports a ponytail and more stomach than when I saw him last. Janice, married to Cousin Dave, squints as she walks in the door. “Madeleine?” She needs time to adjust to the light. “It’s been fifteen years!” She stretches out her arms and hugs me the way I want my sisters to hug me. “I’ve missed you.”

    One cousin, Karen, the one who took too many pills ten years ago, isn’t here. But her brothers are, and I feel like a part of them should be missing because their sister is dead. As if maybe each of them should be minus an ear or a hand, some physical part because Karen died. How is it you two are here when your sister isn’t?

    My uncles walk in, proud of their new plastic knees and hips. Here are my aunts, who shampooed my hair with castile soap, taught me to bake Teatime Tassies, and let me dress up in their yellowed wedding dresses in their dark attics. Each of them hobble-shuffles in, looking a little dazed by all the fuss.

    For almost twenty years, I kept my distance from these relatives, these potential friends, visiting every year or so for a day or two of polite, disingenuous conversation. I needed to banish myself, I suppose. After all, there was the drinking, and the fact that I hadn’t amounted to much, given all that potential they all told me I had. But at this party I look them in the eyes when I talk, trying to recover a little of what I lost by staying away. Uncle Frank tells me my maladies must emanate from some emotional twist, or from the fact that I’m alone, away from my family. Like a working man’s Gabriel Garcia Marquez, he confides magically real stories about men from the factory who went blind from jealousy or ended up in wheelchairs from unexpressed fears. “Why don’t you come home, honey?” Home? Is this still my home? Was it ever?

    There’s a lot of red in this house, I notice, when I scan the crowd. Except for Terry, whose hair still imitates the non-offensive light brown we were born with, each of us female cousins wear some shade or other of red hair: medium red beech; burgundy berry; Cinna berry; sunset blonde. And though my mother and her two sisters didn’t plan this, each of them is in red: tiny Aunt Emma in the knit dress she wore for last year’s Christmas portrait with her ten grandchildren; Aunt Anna in a red and black striped twinset with a black skirt; and Mom in a red blazer and skirt. They sit on the couch, one wearing a strand of pearls, another a locket, the other her “good” watch because this is a special occasion.

    All this red surprises me. We’re not what you’d call a red family. We may glower underneath; but as a rule, we don’t flare or flame. The Slavic temperament prefers to smolder chalky gray, while the red burns beneath the surface.

    They look too small, these women, sitting next to each other, after I ask to take their picture. And there’s too much distance between them. I want them to scrunch together—which they won’t—so they seem closer.

    No matter how far apart, though, it’s important that these three little women are together on this sofa, posing. Aunt Anna never used to let us take her picture. But maybe, like me, she knows there is something final about this portrait. Each of them is ill. Aunt Emma is diabetic; and, although we don’t yet know this, a cancer is growing in her left breast, just above her heart. Aunt Anna’s Parkinson’s disease is progressing, and Mom has a bad heart. I don’t know these specifics as I see these three women through my lens, but I know it’s inevitable. Something will happen to them soon.

    The flash goes off on my camera. Once. Twice. “That’s it.” Aunt Anna waves me away with her shaky arm. “Enough pictures.” She pushes herself off the couch and turns on the television to watch a golf tournament. The moment is over, but I have it on film, and in my heart.

    *****

    Mom is failing, Cousin Pat wrote in her holiday note about Aunt Emma. And when I called Aunt Anna on Christmas, she told me how she fell three times during the last month and Terry confirmed that, like Aunt Emma, Aunt Anna was failing.

    My father didn’t use the same word to describe my mother. Failing wasn’t a word that would come easily to him. But he apprised me in detail about Mom’s last neurologist appointment, when she would see him next, how he would adjust her medication schedule: eight in the morning, noon, four in the afternoon, and seven-thirty at night. I admired the way he structured her care. But when he barked at her to come to the phone, my stomach gripped. I worried he might be hurting her.

    After hanging up, I reached for the portrait of my mother and her sisters. I wondered. In twenty-five years, when my sisters and I are smaller, when we sit together for a picture on Terry’s seventy-fifth birthday, how much space would hang between us? Would we be able to reach across the distance—and our failings—to touch each other, to smile? I didn’t know. But I knew this: if I hoped to touch them in the future, I needed to reach to them now, as they are, not as I would have them be.

    Terry and Julie and I won’t sit for a portrait on Terry’s seventy-fifth birthday. She left us last year, victimized by a rare immune disorder, when she was sixty-two. So, there will be no photo. Only the memory of wanting one. And the hope, too long postponed, that the distance between us would narrow if we only reached to one another, even if just a little.

    View the original article at thefix.com

  • The Five Pillars of Recovery from Trauma and Addiction

    Believe in yourself. Tell yourself that you deserve happiness, joy, success, and a life free from the pain of trauma and addiction. You are worth your recovery.

    In my forty-five years, I enjoyed twelve years of quasi-normal childhood, which ended abruptly when I was raped. I spent the next ten years in a dangerous dance with addiction, suicide attempts, and more trauma. But then I reached a turning point, and my past twenty-three years have been spent healing and learning what works for me in building long-term recovery.

    There is no standard set of blueprints for long-term recovery, as everyone is different, but I have identified five pillars that have enabled me to build on a strong foundation of recovery. My daily choice not to use substances forms that foundation, and these rock-solid pillars stabilize that recovery into an impenetrable structure. These five pillars are not unique, and they do require work, but once built, they will stabilize your recovery fortress.

    1. Maintain rigorous honesty. In addiction, our lives were built upon lies and false narratives we told ourselves and others. But recovery demands honesty—only when we can admit the truth can we begin to heal. I had to get honest with myself about my addiction. I had to own it and then take a brutally honest assessment of my life. We cannot build a sustainable recovery on a false narrative. When we lie, we enable sickness, secrets, shame, and suffering.

    Dishonesty makes us vulnerable in all the wrong ways, but honesty conjures the true vulnerability we require to discover authenticity. Start practicing honesty in all your interactions—beginning with yourself. This must be the first pillar because without honesty, the rest will crumble. Anything created in a lie is chaos, and anything created in chaos will end in chaos.

    2. Expose your secrets. You cannot soak in the joy of today if your soul is still filled with yesterday’s garbage. Take out that trash. For me, this meant diving deep and pulling forth all the trauma, pain, and sorrow that I had packed tightly away. I thought this was for my benefit—why bring up old stuff? But in fact my secrets were keeping me sick. They were smoldering under this new foundation I was building in recovery, threating to burn it all down.

    Secrets require silence to thrive, and they allow shame to fester inside of us. Shame is an emotional cancer that, if left untreated, will destroy our recovery. I began by slowly exposing my secrets in my journal. At first, it was the only safe space for me. As I began to trust others in recovery, I began to share those secrets, and the smoldering was extinguished by their compassion and understanding. Begin exposing your own secrets. What thoughts and memories are you afraid to give voice to? Those are the secrets that will keep you sick if you do not get them out.

    3. Let go. All those secrets take up a tremendous amount of space in our mind, body, and soul. We must find ways to process that pain into something productive, useful, and healing. You must unleash this pain so it no longer occupies your mind, body, and soul. When you do this, you make room for hope, light, love, and compassion.

    Writing is my release. But when physical emotional energy rises in me, I need more intense physical activity to push the energy out of my body. I use a spin bike and weightlifting, but you might run, walk, or practice yoga—any activity that gets your heart rate up and helps you sweat, which I think of as negative energy flowing out. When I do this, I am calmer, I am kinder, and I am more the person I want to be. Meditation is another way for me to simply let go and sit with myself when my thoughts are plaguing me or I feel stuck emotionally. I often use mediational apps, guided mediations, or music to help me meditate. When you find what works for you, do it daily. Recovery is like a muscle; when it is flexed, it remains strong.

    4. Remember you aren’t alone. Connection is core to feeling hopeful. By interacting with other trauma survivors and others in recovery, you become part of a group of people with similar experiences who have learned how to survive. Being able to share those pieces of your past with others is incredibly powerful. Seek out support groups in your area, attend meetings, reconnect with healthy people from your past, and pursue activities you enjoy to help you meet like-minded people. Create the circle of people you want in your life—the ones who will hold you accountable yet provide you with unconditional support and love, without judgment.

    In our addiction, we push these people away. We run from them because they act like mirrors to our dishonesty. In recovery, these people become the ones we turn to when things get hard. Even one such person in your life—a family member, friend, sponsor, or trusted colleague—can make a difference. Surround yourself with those who seek to build you up.

    5. Know you matter. In order to grow, heal, and build upon your recovery foundation, you have to believe you are worth it, that you deserve joy and love. At some point in your recovery, you will have to rely on yourself to get through a rough patch. When this happened to me, I had to really dig down and get to know myself. I had to strip away all the false narratives I used to define myself, all the ways I presented myself to the world and to myself. Who was I? What did I love about myself, and what brought me enough joy to feel worthiness?

    I now know what I need to feel calm, to feel beautiful, and to feel deserving of this amazing life of recovery. I matter, and my life in recovery matters so much. It is this core truth that makes me fight for my recovery, my sanity, my marriage, and my job, because they are all worth it. I am worth the fight, and so are you. Believe in yourself. Tell yourself that you deserve happiness, joy, success, and a life free from the pain of trauma and addiction. You are worth your recovery. It is the foundation on which you build your new life.

    Building any structure requires hard work, and recovery is no different. While we each require different tools and plans to create them, these five pillars will sustain our recovery from trauma and addiction.

     

    Jennifer Storm’s Awakening Blackout Girl: A Survivor’s Guide for Healing from Addiction and Sexual Trauma is now available at Amazon and elsewhere.

    View the original article at thefix.com

  • Isolation, Disruption and Confusion: Coping With Dementia During a Pandemic

    The pandemic has been devastating to older adults and their families when they are unable to see each other and provide practical and emotional support.

    GARDENA, Calif. — Daisy Conant, 91, thrives off routine.

    One of her favorites is reading the newspaper with her morning coffee. But, lately, the news surrounding the coronavirus pandemic has been more agitating than pleasurable. “We’re dropping like flies,” she said one recent morning, throwing her hands up.

    “She gets fearful,” explained her grandson Erik Hayhurst, 27. “I sort of have to pull her back and walk her through the facts.”

    Conant hasn’t been diagnosed with dementia, but her family has a history of Alzheimer’s. She had been living independently in her home of 60 years, but Hayhurst decided to move in with her in 2018 after she showed clear signs of memory loss and fell repeatedly.

    For a while, Conant remained active, meeting up with friends and neighbors to walk around her neighborhood, attend church and visit the corner market. Hayhurst, a project management consultant, juggled caregiving with his job.

    Then COVID-19 came, wrecking Conant’s routine and isolating her from friends and loved ones. Hayhurst has had to remake his life, too. He suddenly became his grandmother’s only caregiver — other family members can visit only from the lawn.

    The coronavirus has upended the lives of dementia patients and their caregivers. Adult day care programs, memory cafes and support groups have shut down or moved online, providing less help for caregivers and less social and mental stimulation for patients. Fear of spreading the virus limits in-person visits from friends and family.

    These changes have disrupted long-standing routines that millions of people with dementia rely on to help maintain health and happiness, making life harder on them and their caregivers.

    “The pandemic has been devastating to older adults and their families when they are unable to see each other and provide practical and emotional support,” said Lynn Friss Feinberg, a senior strategic policy adviser at AARP Public Policy Institute.

    Nearly 6 million Americans age 65 and older have Alzheimer’s disease, the most common type of dementia. An estimated 70% of them live in the community, primarily in traditional home settings, according to the Alzheimer’s Association 2020 Facts and Figures journal.

    People with dementia, particularly those in the advanced stages of the disease, live in the moment, said Sandy Markwood, CEO of the National Association of Area Agencies on Aging. They may not understand why family members aren’t visiting or, when they do, don’t come into the house, she added.

    “Visitation under the current restrictions, such as a drive-by or window visit, can actually result in more confusion,” Markwood said.

    The burden of helping patients cope with these changes often falls on the more than 16 million people who provide unpaid care for people with Alzheimer’s or other dementias in the United States.

    The Alzheimer’s Association’s 24-hour Helpline has seen a shift in the type of assistance requested during the pandemic. Callers need more emotional support, their situations are more complex, and there’s a greater “heaviness” to the calls, said Susan Howland, programs director for the Alzheimer’s Association California Southland Chapter.

    “So many [callers] are seeking advice on how to address gaps in care,” said Beth Kallmyer, the association’s vice president of care and support. “Others are simply feeling overwhelmed and just need someone to reassure them.”

    Because many activities that bolstered dementia patients and their caregivers have been canceled due to physical-distancing requirements, dementia and caregiver support organizations are expanding or trying other strategies, such as virtual wellness activities, check-in calls from nurses and online caregiver support groups. EngAGED, an online resource center for older adults, maintains a directory of innovative programs developed since the onset of the COVID-19 pandemic.

    They include pen pal services and letter-writing campaigns, robotic pets and weekly online choir rehearsals.

    Hayhurst has experienced some rocky moments during the pandemic.

    For instance, he said, it was hard for Conant to understand why she needed to wear a mask. Eventually, he made it part of the routine when they leave the house on daily walks, and Conant has even learned to put on her mask without prompting.

    “At first it was a challenge,” Hayhurst said. “She knows it’s part of the ritual now.”

    People with dementia can become agitated when being taught new things, said Dr. Lon Schneider, director of the Alzheimer’s Disease Research Center at the University of Southern California. To reduce distress, he said, caregivers should enforce mask-wearing only when necessary.

    That was a lesson Gina Moran of Fountain Valley, California, learned early on. Moran, 43, cares for her 85-year-old mother, Alba Moran, who was diagnosed with Alzheimer’s in 2007.

    “I try to use the same words every time,” Moran said. “I tell her there’s a virus going around that’s killing a lot of people, especially the elderly. And she’ll respond, ‘Oh, I’m at that age.’”

    If Moran forgets to explain the need for a mask or social distancing, her mother gets combative. She raises her voice and refuses to listen to Moran, much like a child throwing a tantrum, Moran said. “I can’t go into more information than that because she won’t understand,” she said. “I try to keep it simple.”

    The pandemic is also exacerbating feelings of isolation and loneliness, and not just for people with dementia, said Dr. Jin Hui Joo, associate professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine. “Caregivers are lonely, too.”

    When stay-at-home orders first came down in March, Hayhurst’s grandmother repeatedly said she felt lonesome, he recalled. “The lack of interaction has made her feel far more isolated,” he said.

    To keep her connected with family and friends, he regularly sets up Zoom calls.

    But Conant struggles with the concept of seeing familiar faces through the computer screen. During a Zoom call on her birthday last month, Conant tried to cut pieces of cake for her guests.

    Moran also feels isolated, in part because she’s getting less help from family. In addition to caring for her mom, Moran studies sociology online and is in the process of adopting 1-year-old Viviana.

    Right now, to minimize her mother’s exposure to the virus, Moran’s sister is the only person who visits a couple of times a week.

    “She stays with my mom and baby so I can get some sleep,” Moran said.

    Before COVID, she used to get out more on her own. Losing that bit of free time makes her feel lonely and sad, she admitted.

    “I would get my nails done, run errands by myself and go out on lunch dates with friends,” Moran said. “But not anymore.”

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    View the original article at thefix.com

  • Finding Emotional Sobriety in a Pandemic

    I never realized I was the cause of my negative thinking by willfully trying to “make” my life happen then getting angry that everyone wasn’t doing what I wanted.

    I used to work at this weird hotel and one of the door guys told me when he was in prison he kept going to solitary confinement until he was sitting there one day and realized he was the problem. I was still using then and thought to myself “Weird. I’m going to go get high in one of the rooms upstairs and think about that.” Well, now I get it. Left alone with me during this quarantine I realized I was the problem.

    Unlike most people I was so excited for the quarantine because I cherish my alone time. I loved it! I cooked, I meditated, I read books and I did a bunch of writing. Auditions I would normally drive into the city for, I was able to do from my apartment, along with our podcast. I saved so much money in gas! I did service, and still went to meetings. I relaxed somewhat, and it seemed like a dream come true. A nice, long, staycation! Minus the complete panic over the economy, being worried about family members overseas, and my aging gracefully mother who would kill me if I called her elderly (she is). Then it happened…..

    The negative thinking.

    The repetitive, negative thinking.

    Feeling like a victim.

    Not of COVID-19, but of the past, alcoholism, and that thing that happened in 2004. Or 1997. Or the day before at Shoprite!

    This has happened to me many, many times since sobriety and many, many times before that but there was always a PERSON, or a SITUATION that “caused” it. Honestly, I couldn’t even blame my boyfriend during the quarantine because he kept leaving and going to his office every day. I was alone, working from home, and doing whatever I wanted. I was having a great time!

    I cleaned out everything! Put pictures in frames from 10 years ago! Cleaned out every drawer, closet, journal, and my entire bookcase. I donated books, clothes, shoes, and jewelry. But still – I was LOSING MY FUCKING MIND. Because unbeknownst to me I had not achieved emotional sobriety yet.

    And I was addicted to negative thinking.

    And it didn’t just happen – my realization of it just happened. I was sitting here alone with myself and my thoughts and realized I have still – after all this time – been people-pleasing. And doing it in large part to get what I want. I was like (subconsciously) “I want what I want and if I’m nice to people and do stuff for them – I AM GOING TO GET WHAT I WANT.”

    Well, it took sitting here alone for months to realize once and for all – there’s a 3rd step and I wasn’t doing it, and people-pleasing doesn’t work. It’s always an inside job. Inside our own heads and hearts. For me, it’s only when I let go that I have seen the evidence of my higher power.

    It’s so hard to trust.

    Once again I am seeing “spiritual road signs” on the ground whenever I am outside exercising, via fallen tree branches. For some reason I get direction from these twigs and branches and lately they are all right or left turns. So it feels like something very different, and I believe emotional sobriety is the path I am meant to turn on. It’s something I never even really thought about but it makes so much sense now. I need to be sober in my head and heart, not just my body.

    I mean I have heard so many people share about this – that they came for their drinking and stayed for their thinking. I have said it! And I meant it! I just didn’t realize I was the CAUSE of my negative thinking by willfully trying to “make” my life happen then getting angry everyone wasn’t doing what I wanted. So what do I do about this? Because I have realized that this negative thinking is toxic for me and my body and I can’t have that. I already had cancer once! And honestly and truly I value my sobriety more than anything. I am nothing without it. So this is the next layer of my stupid alcoholic onion. I want to grow. I know that my spiritual condition relies on daily maintenance and as I begin to train my thoughts to the positive it has become a moment to moment training. I had just been letting my thoughts go crazy all the time and I was too busy to realize it. It’s like early sobriety again – taking it moment by moment sometimes. I rage at someone in my mind and then say “No, no – let’s go with a different thought.” It’s so frustrating and tedious! I have made this analogy lately that came about from COVID-19 and the subsequent quarantine.

    A positive one! Say it to myself all the time.

    I wash my hands 30-50 times a day. At least 25!

    I cook all the time and was a big hand-washer before all this – regardless I wash my hands a lot – right?

    So why not do the spiritual work 30-50 times a day? If right now, that’s what I have to do to get my head sober then why not? Pray more. Meditate an additional time each day. Reach out to other alcoholics so I stop obsessing over myself – more often. Spiritual hand-wash all day long.

    I can do more work! I started to do the Traditions with my sponsor.

    I started to do what I did when I got cancer and beefed up my program.

    This is bringing me to freedom – even though I feel a little beat up from all of this. Not as beat up as after cancer treatment or at the end of my drinking and drugging! And I am almost positive I don’t feel as beat up as that poor guy being in solitary confinement. But that’s what it has taken for me to realize I’m the problem. 

    So ultimately it has been people-pleasing and willfulness. This willfulness has come from a lack of trust in my higher power.

    I have this beautiful higher power that has brought me so much peace and clarity – and I haven’t trusted the strength of that higher power. It’s like there’s been a higher power budget I thought I had to be on.

    I can rely on my higher power to not only carry other people’s stuff but to guide me while I take care of myself around other people. I can worry about myself and my inner life and turn to my higher power to guide me where I will be the most useful next. I don’t need to manipulate anything.

    My sponsor always says we can be happy. We can be happy, joyous, and free – and that we work so hard for that. So this new awareness is bringing freedom. Ah, what a place to be! Awareness!

    It’s a beautiful thing.

    A beautiful, uncomfortable, and freeing thing.

    Sometimes freedom isn’t comfortable.

    I am going to put that into my higher power’s hands, along with everything else in my head and heart.

    There’s a lot to lose our minds over right now. Wasn’t there always? It’s not easy waking up and recovering. I am going to practice (one day at a time) not fighting anyone or anything and accepting that I am enough – as is. I don’t have to pick up a drink, drug or thought today and I don’t have to fight with myself, or anyone at Shoprite. I don’t even need to take care of anyone at Shoprite! 

    I can also practice being grateful that this quarantine helped me to remember an amazing lesson I learned at a weird hotel in 2003 from a poor guy who–I just realized–was probably recovering, just like me.

    View the original article at thefix.com