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  • Does Everything Actually Happen for a Reason?

    Does Everything Actually Happen for a Reason?

    “Everything happens for a reason” conflicts with AA principles: it misleads recovering alcoholics into thinking they are special—that they are somehow more worthy of salvation than the addict or alcoholic who perished.

    “Because genocide.”

    That was me, in my typically understated fashion, explaining to a newly recovering alcoholic why he shouldn’t heed the single silliest phrase permeating the rooms of Alcoholics Anonymous: “Everything happens for a reason.”

    In my seven-plus years attending AA meetings, I’ve come to know and loathe my share of cliché recoveryisms. For example, to me, “Let go and let God” overshoots otherwise sound advice against trying to control everything into a place of irresponsible complacence. “If you spot it, you got it” blames an observer simply for noticing wrong behavior or thinking, while “All of us only have today” weighs equally the experience, strength and hope of a wise old-timer and a wild-eyed newcomer. We don’t all just have today—we have all the days before it.

    And it is baffling why the Our Father—a prayer praising a conventional paternalistic, heaven-dwelling religious deity—still closes many meetings, as it directly contradicts the organization’s stated non-alignment with any sect or denomination, per its Preamble.

    So yes, AA phraseology has its share of eye-rolling headscratchers. But none are as cringe-worthy and counterproductive as the concept that every single thing that transpires in life does so as part of a grand, predestined scheme.

    In an everyday setting, “Everything happens for a reason” can be brushed aside easily enough. Outside the realm of recovery, it becomes little more than a difference of opinion; your churchgoing aunt believes God is in heaven treating us like marionettes, while you prefer a puppeteer-free existence. To each his own.

    However, AA’s penchant for preordainment is particularly problematic, due to the specific forum in which it is propagated. In a recovery setting, the notion that all occurrences— good, bad or indifferent—are part of some predetermined master plan is a double-edged sword that does a disservice to all involved, believer and nonbeliever alike.

    Unreasonable Expectations

    Let’s start with those in my column: recovering alcoholics who, though they may embrace a spiritual higher power—a rhythm of the Universe, let’s say, don’t ascribe to a god that directly intervenes in our lives. If you wonder why athletes thank the Lord after a big win, you’re in my boat. Call it the “God doesn’t score goals” perspective. 

    When people who don’t believe in an interventionist deity are told to see the hands of God in everything, there is no common ground. Many of us, myself included, were stone-cold atheists upon entering AA; some of us, myself not included, still are. A healthy agnosticism is the best many of us can muster while—and this point is crucial—retaining a recovery-capable level of self-honesty. Few stay sober by lying to themselves about something as mission-critical as spirituality.

    Upon entering AA, we were assured by both literature and longstanding members that our spiritual skepticism was fine, as long as we were willing to put faith in some sort of higher power. Many of us took Step 2 with the group itself in that role and, in Step 3, turned our will over to… well… something as best we could without the whole endeavor feeling so forced that it forced us out the door.

    And then… “Everything happens for a reason”? That’s a bridge too far­—and one apt to collapse carrying newcomers who are left feeling betrayed by the agreed upon rules of repeated spiritual engagement. It also leads to inferiority complexes, when these newcomers compare themselves to AA members who seem to take God’s Great Chess Game of Life at face value.

    Replacing that collapsed bridge is a wall. There’s no kind way to say this: Many people who don’t believe everything happens for a reason find those who do simultaneously pretentious and unsophisticated—an oxymoronic mélange of know-it-all-ism and naiveté. When I hear someone in AA insist upon God’s almighty plan, it makes me respect what they say next significantly less.

    And no, comment thread, that isn’t my arrogance—it’s the phrase’s. “Everything happens for a reason” is a condescendingly cocksure nonstarter that cleaves members off from each other. Worse, it does so completely unnecessarily, since its veracity is entirely irrelevant to the greater principles and practices of AA’s primary purpose: recovery from alcoholism and addiction.

    How many newcomers, I often wonder, have gone back out and died because they didn’t realize “Everything happens for a reason” is by no means AA dogma, but rather AA dog… something else. Even one is too many.

    And if the true believers can’t stop saying it for nonbelievers, maybe they can stop saying it for themselves. Here’s why.

    No Good Reason

    In Alcoholics Anonymous, “Everything happens for a reason” conflicts directly with the program’s principles. It does so by misleading recovering alcoholics into thinking they are special—that they are somehow more worthy of salvation than the addict or alcoholic who perished. The result is a sort of unintentional hubris that flies in the face of sobriety-bolstering ego deflation.

    By implication, declaring yourself selectively saved by an all-intervening God acknowledges that this same deity let others perish. He took Prince, Amy Winehouse and Philip Seymour Hoffman, but left… you? Forgive me if I find that conceited.

    On a macro level, I also find it insulting. This Calvinistic approach to human existence means God assents to tsunamis, earthquakes, war crimes. If you sincerely believe that God greenlighted the Holocaust, I simply don’t have much to say to you. Again, this notion of intra-organizational separation is all caused by a concept completely unnecessary to that organization.

    Unfortunately, a major obstacle in all this is utter obliviousness. From where I’m sitting, the vast majority of those who espouse, ad nauseam, that “Everything happens for a reason” do so from custom rather than castigation. By and large, religion—or, rather, a sophomoric interpretation of religion—has weaned them to believe they are somehow saved, chosen or otherwise privileged. There is an entrenchment to this flawed view of eminence that makes it as intractable as it is unpalatable.

    In this manner, “Everything happens for a reason” is an unreasonable phrase often repeated for no good reason other than a “sure, why not” reluctance to challenge outdated thinking. It’s one of those grandfathered-in phrases that should be retired, along with the uber-sexist “To Wives” chapter in the AA Big Book.

    In late 2011, as a 32-year-old just drying out off a DUI and with a wife halfway out the door, AA’s preordainment problem nearly made me explore other sobriety options. This would have been a mistake, considering how well-suited the literature, the 12 steps and the fellowship turned out to be for my recovery.

    It is in line with this concern—attracting and retaining newcomers—that a concerted effort should be made to retire “Everything happens for a reason” from the rooms of AA. And I for one believe that doing so depends entirely on our efforts, not God’s plan.

    View the original article at thefix.com

  • So You Want to Move to a New City in Recovery? First Ask Yourself These Five Questions

    So You Want to Move to a New City in Recovery? First Ask Yourself These Five Questions

    Moving might be the right choice, but examine your motives. When we were drinking and using, we were irrational, impulsive, and at the whim of our heartbreakingly horrible decisions. We get into recovery to be more than that.

    The journey of a thousand miles begins with a single step. – Lao Tzu
    Wherever you go, there you are. – Unknown

    We’ve all heard or tried the myth of the geographic cure: that we can change the unmanageability of our addictions simply by changing locations. The program suggests waiting a year to make major changes in our lives, such as moving to a new place or getting divorced. That suggestion directly contradicts another recovery recommendation: that we should change people, places, and things. And some of us, myself included, struggle for years or even decades to get to that one-year mark, and finally decide—maybe on our own, maybe after a psychic brings it up dozens of times—that the place we are living in isn’t working for us and it’s time to make a move. How do you know if it’s a viable idea? Here are five questions to ask yourself when considering a move.

    1. Do you have a safe, sustainable place to live?

    I cannot stress this enough, especially for the dream cities like New York and Los Angeles. Success in one does not necessarily translate to success in another. This may seem like common sense to some of you, but something about Los Angeles, where I currently live, makes people think they can show up with a dream, a few grand, and a month in an AirBnb in Koreatown.

    The feeling of home, sanctuary, and security is important for all humans, but it’s of paramount importance for those in recovery. The refrain I frequently hear is: “I never felt like I belonged anywhere.” Well, this feeling is exacerbated dramatically by a less than ideal living situation, so make absolutely sure you have a safe place. Is it as good as or better than where you currently live? And can you stay there for at least four to six months?

    1. Is this an impulse move?

    I’ve wanted to live in California my entire life, so much so that when I partied at the University of Hartford at the ages of 14 and 15, I told everyone I was a student at UCLA. I exposed myself when someone burst into the dorm asking where the Bruin was and I stared blankly ahead, not knowing the mascot of the school I pretended to attend. However, there were other moves I made or contemplated that were pure fantastical escapism; in fact, for a few years while I struggled in fauxbriety (marijuana and/or kratom and kava kava, Adderall, Xanax if you’re holding, mushrooms in the summer), I seriously contemplated moving to nearly every place I visited. I travel for my job as a stand-up, and for a few years I traveled desperately trying to “find myself.” Each and every time, I was sure the move would solve the problem of myself. I am now grateful I didn’t have the money and agency then.

    A lot can be said for waiting in recovery. Waiting for the miracle to happen, waiting to date, waiting to speak (so guilty on this), waiting to move. Most things in life that are meant for you will be there when you are ready. Unless you relapse. Sobriety is the only thing that is imperative to grab onto NOW.

    1. Do you know what it’s like to actually live in this place rather than be a tourist?

    Visiting a place is often not a good indicator of whether you will like it as a resident. I really thought I would hate LA. When I got here, it hit me that what I really hated (other than myself and my fauxbriety) were all the costs and inconveniences of staying in a hotel, and not knowing anyone or where the good meetings were. In short, #touristprobs.

    If you’re a person who goes to recovery groups or does a community-based activity like yoga, this is the time to use those resources and talk to other people. If for some reason you aren’t able to spend time in a place before you move there, get creative in searching out Facebook groups, Insta hashtags (actually maybe not that one) and message boards (Miami has an excellent resource for this: MiamiBeach411.com).

    1. Are you motivated by people, places, and things or is this a geographic trap?

    This one is perhaps the trickiest question of all. For me, I don’t know if I would have been able to stay away if I hadn’t first moved away from my ex-husband. Moving away from a person can also lead you to the important but painful conclusion that the hate is coming from inside the house. Our external realities reflect our internal state of being. There are always more of that archetype waiting for you wherever you go. Even Thailand. Costs and benefits, baby.

    Miami, for me, was a people, a place, and a thing. I can go there now if I have a reason to, and even enjoy it. At one year out, I went to meet with my divorce lawyer and send some stuff home that I had left at a friend’s. I relapsed off the plane on mojitos, which led to cocaine, which led to spending days holed up with my ex-husband, missing my meeting and flight home, and trusting him to ship off my journals and personal effects. Soon I received an email that said, “You wrote in here I was BAD IN BED, here are detailed instructions on how to hang yourself, I threw out your shit.” I guess what I am saying is: usually you don’t have to make a dramatic move, like crossing state lines, to escape people, places, and things. However, if you have been in an abusive relationship where you were using together, moving across state lines or even across the country may be the best thing to do—that is, if you have a safe place to live. Which leads us to the final question…

    1. Work, work, work, work, work, work?

    It is a sometimes unfortunate fact of life that most of us must work, even in early sobriety. If you are lucky enough to not have to, I say hold off as long as you can. Your career isn’t going anywhere. Momentum is somewhat of a myth. It can be achieved later, from a more stable foundation. But if you can’t afford or don’t have time to scope out the job situation in advance of your move, you might not be able to make this move in a healthy and sustainable way.

    Imagine this scenario: You are a sober bartender in New York to great applause. However, you don’t have a great online presence, which seems to matter here in Los Angeles. Pride keeps you from raising your hand when suggested, but eventually sharing outside of meetings gets you an offer with a sober-owned cater waiter company. It isn’t bartending, and doesn’t fit in with your idea of yourself, so you decline, deciding the problem is that you keep getting asked about your Insta followers at interviews. Soon you will know what it’s like to follow your dreams across the country; you’re gonna sleep in your car. My point is this: manage your expectations on the job front, and research as much as you can. Visit and meet locals. Ask them questions. Listen… If you are working on recovery, less than stellar work opportunities are SO temporary. I promise you that. So take them. And try to appear grateful.

    I hope I’ve got you thinking seriously about your possible plan to move, or perhaps made you feel a little better about your lack of plan to move. Either way, amassing information and managing pride and expectations, otherwise known as willingness, stands at the forefront. It all comes down to love and fear. Examine your motives. Safety concerns are paramount. Talk to someone (you are welcome to email me: [email protected]) before you go. Get a second opinion. Nobody knows everything. Meditate on it. Make lists of pros and cons. Pray.

    When we were drinking and using, we were irrational, impulsive, and at the whim of our heartbreakingly horrible decisions. We get into recovery to be more than that. Perhaps you are thinking, well, that just isn’t how I operate! Try it. I spent years wanting to move to California. Now that I am finally here, I am so grateful I didn’t move one moment earlier—had I done so, I’d be smoking meth in a tent in DTLA right now. I’m really glad I don’t have to do that. And that you don’t either.

    Did you make a move in early recovery? Give us the details: was it a good or bad experience? 

    View the original article at thefix.com

  • Is AA Too Religious for Generation Z?

    Is AA Too Religious for Generation Z?

    “What I try to teach is: if you don’t buy into any kind of a supernatural higher power, navigate the 12-step world, filtering the god-stuff out, working the program in your own way; there is lots that really works.”

    Are today’s mutual-aid recovery groups ready to satisfy Generation-next?

    “More than any other generation before them, Gen Z does not assert a religious identity. They might be drawn to things spiritual, but with a vastly different starting point from previous generations, many of whom received a basic education on the Bible and Christianity. And it shows: The percentage of Gen Z that identifies as atheist is double that of the U.S. adult population.”

    Released early this year, Barna Group’s Generation-Z Report (Americans born between 1999 and 2015) surveyed over 2,000 13 to 18-year-olds. The oldest of this generation turn 20 in 2019.

    According to AA’s most recent triennial membership survey, 1% of AA is under 21—that’s about 20,000 sober teenagers in AA rooms right now. What’s my personal affinity with this demographic? It’s two-fold: I have two millennial children and one 18-year-old stepson; secondly, while I am a grey-haired Baby Boomer, I was a teen at my first 12-step meeting. My 20th birthday was 1980, three months shy of my fourth anniversary clean and sober.

    I was a second-generation AA member and—like Barna’s youth focus group—my worldview seemed incompatible with the old fogies of 12-step rooms. My mother mused about finding god’s will for her from meditation or her daily horoscope. She was such a Virgo, you know. Horoscopes, higher powers, legends of Sasquatch, these were all fictional symbols as far as I was concerned. Reasonable people didn’t take such constructs literally, did they?

    Bob K, like me, is a second-generation AA. He’s currently between historical book projects; Key Players in AA History will soon have a prequel. Bob’s follow-up research will produce a book about pre-AA addiction and treatment. At age 40, Bob made it into AA as a result of his dad 12-stepping him. He also was uncomfortable with the emphasis on “God.” 

    “When I was a month sober, it was ‘God-this, God saved me’ and I was going to put my resignation in. I didn’t think I could stand it in AA any longer. I went to the internet of the day—which back then was the library—and I looked for non-religious alternatives to AA. They had them in California but nothing in Ontario Canada. So it was AA or nothing. If I tried to brave it alone, I’d be drunk; I knew it.”

    Today, Bob enjoys the likeminded company at his Secular AA home group, Whitby Freethinkers, which meets in the local suburban library just East of Toronto. 

    If I were confronting addiction/recovery as a teen today, I wonder if I would go to AA or NA? If AA was once “the last house on the block,” today it’s one house in a subdivision of mutual-aid choices. Today, newcomers have access to Refuge Recovery, SMART Recovery, Secular Organizations for Sobriety (SOS), or Medically Assisted Treatment, none of which existed in the 1970s.

    On Practically Sane, therapist Jeffrey Munn states: “I like to take a practical approach … I’m not a fan of the ‘fluff’ and flowery language that is often associated with the world of psychology and self-help.” Jeffrey came into the rooms at 20, stayed sober for 2 ½ years, relapsed, came back and is now 13 years clean and sober.

    “I was mandated to three 12-step meetings per week to stay in the program I was in. Since I was young I have been agnostic. I wanted to find a higher power that was common sense-based, but in the rooms I felt pulled towards a more dogmatic spiritual idea of higher power. Back then, I needed to come up with my own conception of what was happening on a psychological level.” Recently, Jeffrey wrote and published Staying Sober Without God: the Practical 12 Steps to Long Term Recovery from Alcoholism and Addiction.

    “I looked at SMART Recovery,” Jeffrey tells The Fix. “I looked at Moderation Management, too—that one struck me as being an organized resentment against AA—I wasn’t feeling it. When it comes down to social support and a practical plan of action, it’s hard to beat 12-step programs. What I try to teach is: if you don’t buy into any kind of a supernatural higher power, navigate the 12-step world, filtering the god-stuff out, working the program in your own way; there is lots that really works.”

    Barna reports, “Nearly half of teens, on par with Millennials, say, ‘I need factual evidence to support my beliefs.’” Jeffrey hopes Staying Sober Without God—which joins a growing secular 12-step recovery offering—offers the rational narrative today’s youth crave. Barna calls today’s youth “the first truly post-Christian generation [in America].”

    Certified Master Addiction Counselor David B. Bohl of Milwaukee understands the value of other-oriented care. David tells The Fix: “As head of a 20-bed coed dual-diagnosis treatment center, emerging adults, 18 to 25 years old, came into our care. I wouldn’t say that they universally shrugged off the 12-step approach but almost universally, in reaction to our volunteers, alumni, and traditional AA community, younger clients didn’t want what the volunteers and alumni had. And I wouldn’t say it was the religiosity always. Sometimes it was an age-thing or life approach. So, our recovery management function became that much more important in terms of building individualized treatment that suits everyone.

    “In the USA, 75% of all residential treatment centers identify as 12-step facilitators,” David tells us. “In the simplest form, our job is to introduce people to the language and the concept of the 12 steps and then to introduce the clients to support groups or people in support groups when they are discharged from acute care.

    Where trauma is involved—religious trauma in particular—traditional AA language and rituals trigger that shame they feel from negative formal religion experiences.”

    Let’s put this overbearing religion caution to a real-life test: Suwaida F was the second oldest of 11 children to Somalian refugee parents who fled to Canada in the 1980s.

    “In Kindergarten I didn’t have to wear a hijab; my parents weren’t super religious. I went to an Islamic school in grade one. It was normal for teachers to have belts with them, they would hit you; child abuse was normalized. They didn’t really teach us that much math, science, history. The Islamic teachers weren’t that educated. My parents took me out and put me in public school. Then, some of my mom’s Somalian-Canadian friends started moving their kids to Egypt. My friends would stay in Egypt two years, finish the Qur’an and the girls came back wearing burqas and head-scarves. Some Muslim friends would come to school in their hijab, take them off and put them back on when they went home. We called them The Transformers.

    My parents really wanted us to learn the Qur’an; I don’t speak Arabic, so it was difficult. And I never believed it. I asked my mom and dad, ‘How do you know that this stuff is real?’ They got frustrated and mad and said, ‘Don’t ever ask that question again.’ I knew it wasn’t real. Mom got more and more religious. Pictures of her at age 19 — she wore no head-scarf when she was my age. My mom expected me to be religious and I rebelled. I had to leave home.”

    Suwaida misses her sisters. She feels unwelcome in the family home unless she is dressed in the Islamic custom and that wouldn’t be true to herself. Away from home, Suwaida found the welcoming community she craved in the booze and cocaine culture.

    “It wasn’t a matter of having no money; I had no sense of hope. People at work didn’t know I was hopped from shelter to shelter at night. One winter I was told, ‘Suwaida, you’ve been restricted from every youth shelter in the city of Toronto.’” As addiction progressed, Suwaida recalls an ever-descending patterns of compromises, bad relationships and regrets.

    “Today, it’s like I still never unpack my suitcase; I’m always ready to go.” During a stay at St. Joe’s detox, Suwaida went to her first NA meeting.

    “At 7 PM, a woman spoke. I made it clear that I thought it was stupid; I wouldn’t share. At the end, everyone was holding hands to pray and I said, ‘I’m not holding any of your hands.’ I didn’t go back. When I was discharged, I went drinking at the bar with my suitcase, not knowing where I was going to stay that night.

    My second meeting I consider my first, because I chose it. I thought I should go to AA. I googled atheist or freethinker AA to avoid a repeat of my NA experience. I found Beyond Belief Agnostics and Freethinkers Group on the University of Toronto campus. I went there last February. For a while, I had wine in my travel-mug, and I didn’t say anything. In August I felt like the woman beside me knew I was drinking, and I ask myself, ‘What am I doing?’ So, my next meeting, I went sober. I’ve been clean and sober ever since.”

    Despite the child-violence of Islamic school and rejection from her family, Suwaida isn’t anti-theist. “I do believe in God or in something. I feel like I’m always looking for signs. I don’t believe in a god in the sky but to say there’s nothing beyond all this doesn’t make any sense to me. Sometimes the freakiest things happen. Maybe it’s because I’m a storyteller, I try to make a story out of everything; you think of someone, then they phone you, is that random?

    I feel a part-of in secular or mainstream AA meetings. My self-talk still sounds like, ‘Don’t share Suwaida, you have nothing to add.’ Maybe it comes from not being able to express myself when I was growing up. I have no sense of self. I guess I have something special to offer but I don’t know how to articulate it. It’s hard; I have limited self-confidence.”

    “Give them their voice; listen to them,” is Kevin Schaefer’s approach. He co-hosts the podcast Don’t Die Wisconsin. He’s also a recovery coach.

    “I’ve been in Recovery 29+ years. I’m a substance abuse counselor and I got into addiction treatment through sober living. When I started working in a Suboxone clinic, I came to realize that AA can’t solve everything. I always come from a harm reduction standpoint: meth, cocaine, benzos; I ask, ‘Can you just smoke pot?’ and we start building the trust there.

    Medically Assisted Treatment (MAT) is geared towards this generation. Most kids coming through my door know a lot about MAT, more so than people in AA with the biases and stigma that they bring. Kids sometimes know more than the front-line social workers. Their friends are on MAT, that’s how they gather their information (not to say their information is all correct). But a lot of therapists don’t understand medication. Medication can be a ticket to survival out on the streets.”

    The Fix asked Kevin his opinion on the best suited mutual-aid group for this generation.

    “Most of the generation you’re talking about walks in with anxiety and defiantly won’t do groups.” We talked about the role of online video/voice or text meetings for a tech-native generation. “Yes—where appropriate. Women especially, because from what I’ve seen, most females have suffered from trauma. I have heard women who prefer online recovery; that make sense to me. I’ve been to InTheRooms.com; as professionals we have a duty to know what’s out there. And there are some crazies online.

    If someone has an Eastern philosophy bent, I’ll send them to Refuge Recovery; I’ve been there. If I can, I’ll set them up with somebody that I know can help them. And let’s not forget that some youth, if Christianity is your thing, Celebrate Recovery is amazing — talk about a community that wraps themselves around the substance user. There are movie nights, food, all kinds of extracurricular activities. The SMART Recovery Movement? Excellent. SMART momentum is building in Milwaukee. They are goal-oriented and the person gets supported whether they’re on Suboxone or, in one case I know, micro-dosing with LSD for depression; they’ll be supported either way. My goal with youth is: ‘Try to get to one meeting this month; start slow.’ Don’t set the bar too high and if they enjoy it, then great.

    The 12-step meeting I go to, it’s a men’s meeting. There are people there on medication and they don’t get blow-back. I wish more of AA was like this. When I came in, almost 30 years ago now, I saw all the God-stuff on the walls and I thought, ‘Nah, this isn’t going to work’ but thank G… (laughs), thank the Group of Drunks who said, ‘You don’t have to believe in that.’ The range in my meeting is broad—Eastern philosophy, Native American practices, Yoga, I was invited to Transcendental Meditation meetings at members’ houses. I was fortunate to fall into this group. You know, the first book my sponsor gave me was The Tao of Physics—not The Big Book—it was this 70’s book with Buddhism, Taoism, Hinduism, correlated to physics and contemporary science.”

    So, as to the question that kicked this off, some mutual aid meetings are ready to meet the taste of a new generation; results may vary. Who’s heard: “If you haven’t met anyone you don’t like in AA, you haven’t gone to enough meetings”?

    The reverse is true, also. If the peer-to-peer meetings I’ve sampled seem too narrow or dogmatic, maybe my search for just the right fit isn’t over. And if I don’t want a face-to-face meeting, there’s always Kevin’s podcast, virtual communities like The Fix, or I can order one of Bob or David or Jeffrey’s books if that’s more to my taste.

    View the original article at thefix.com

  • Addiction or Mental Illness: Which Should You Treat First?

    Addiction or Mental Illness: Which Should You Treat First?

    Substance use can alter behaviors, moods, and personalities so severely for people with addiction that without specialized knowledge and experience, it’s difficult to determine underlying causes such as mental illness or trauma.

    I credit psychological intervention for pushing me into recovery from alcoholism.

    Addiction is a mental illness, but is it one that needs to be treated before anything else? Or should we be stopping people from hitting their addiction bottom and helping them recover from their comorbid conditions concurrently?

    What Is Addiction?

    Before we can discuss treatment, we need to understand what addiction is and how it is defined. The two major guidelines for diagnosing mental health conditions around the world are the DSM and the ICD. The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the standard diagnostic tool for mental health conditions in the United States and often used in North America. The ICD (International Classification of Diseases) is endorsed by the World Health Organization and often used in Europe.

    In the DSM-5, substance abuse and substance dependence are combined under the same name of substance use disorder, which is diagnosed on a continuum. Each substance has its own sub-category, but behavioral addiction is also in the DSM-5, with gambling disorder listed as a diagnosable condition. Other similar entries, such as internet gaming disorder, are listed as needing further research before being formally added as a diagnosis. In the ICD-11 there is a subset of mood disorders called “substance-induced mood disorders,” which are conditions caused by substance use. To qualify for this category, one must not have experienced the mood disorder symptoms prior to substance use.

    Hypothetically, a person who has alcohol-induced mood disorder might find health with abstinence alone, but substance use disorders do not occur in a vacuum and no one can go through the experience of addiction without it altering their mind and body, sometimes irreversibly. With enough time, substance-induced disorders change the function of the brain and alter emotion regulation. That doesn’t mean that addiction will cause another mental disorder; addiction is a mental disorder.

    Not everyone with an addiction is concurrently experiencing another mental disorder. Substance use can alter behaviors, moods, and personalities so severely for people who are addicted that without specialized knowledge and experience, it’s difficult to determine what, if any, underlying cause is responsible for the changes. Drugs, even those that are prescribed and used as directed, can have side effects that seem to mimic the symptoms of other diagnosable conditions. These effects can also appear if a person is in withdrawal. Because of this inability to isolate co-occurring conditions, there was a time when it was popular for doctors and clinicians to first treat substance use disorders before exploring the possibility of other mental illnesses. That is no longer considered the best approach to care.

    My Story: Therapy Helped Me Recognize My Alcoholism

    I started therapy before I could realize my excessive drinking was actually alcoholism. I was riddled with anxiety and constantly on edge. I lied compulsively about the most unnecessary and mundane things. My partner helped me start therapy, calling the first point of contact for me and taking me to my first two appointments, and then patiently waiting outside for me. He wasn’t enabling me by keeping me from hitting bottom, he was supporting me and protecting me in a loving way; in a way that worked.

    In the early days of therapy, my psychologist gently guided me towards recognizing my alcohol use as problematic. My therapist convinced me to go to a psychiatrist who started me on antidepressants and gave me anti-anxiety medication to use when needed. My treatment was moving forward, but I was still drinking. I spent most therapy sessions crying, but my ability to live day to day was slowly changing.

    I was Googling local 12-step meetings while hungover and then deleting my search history while drinking. I was taking my medications but still getting drunk on the regular. I had to do some work on my crippling anxiety and debilitating depression to get to the point that I could even fathom walking into a new space with new people. I drank because alcohol made it easier to have fun and to talk to people. I was living with undiagnosed post-traumatic stress disorder (PTSD) and alcohol worked to calm symptoms like hyperarousal and insomnia. I was using alcohol to cope with issues that my shame wanted to keep buried and my therapy wanted to draw forth. It took nearly nine months of therapy before I quit drinking.

    Once I was able to cross that threshold, things really began to change for me. My medication was able to work as intended because I wasn’t combining it with other mood-altering substances, and my therapeutic work could go deeper because I wasn’t self-medicating with alcohol. I gained tools to manage my mental health challenges. My alcoholism treatment has gone so well because I have concurrently received care for my comorbid conditions.

    Integrated Treatment

    That’s just one personal story of recovery and successful treatment of co-occurring mental illnesses. But it turns out that’s actually the best treatment: individualized integrated care. In the book The Anatomy of Addiction, Dr. Akikur Mohammad writes that the “best approach to treating a dual diagnosis…is…integrating mental health and addiction treatment in a single, comprehensive program designed to meet the individual needs of the specific patient.” How do we determine a patient’s needs? According to Dr. Mohammad, “the best diagnostic instrument is the clinician’s experience in treating addiction.”

    How many times have you heard the adage: “You have to let an addict hit bottom”? If you take a seat in any 12-step recovery meeting, you’ll likely hear someone speaking about their own experience hitting bottom. The idea is that one must reach a point of complete and utter desperation before being able to start recovery. Being desperate enough to change because your life is wretchedly entwined with addiction makes for a good story, but waiting to fall into such desperation doesn’t make for a solid treatment plan. The evidence base supports this view, but people don’t necessarily believe it.

    Generally, public views about drug addiction are incongruent with current medical knowledge on the disease. A 2014 study that surveyed over 700 adults across the country found that the majority of Americans hold stigmatized views. Forty-three percent of those surveyed said they oppose giving people with drug addiction equivalent insurance benefits compared to 21 percent who believe the same about those with mental illness. Half of all respondents were against increased government spending for treatment of drug addiction, compared to 33 percent for mental illness. About a third of folks don’t believe recovery is even possible for someone with either a drug addiction or a mental illness. And the number of people who believe that treatment options are not effective? Fifty-nine percent for drug addiction and 41 percent for mental illness.

    Consequences of Discrimination Against People with SUD

    These public opinions have real world consequences. They translate into low support for policies that could provide equal insurance coverage and policies that could allocate government funds into public health programs to improve the success rate of (and access to) evidence-based treatment. Drug addiction or substance use disorder (SUD) is a mental illness, but in the United States it’s treated as distinct from mental illness as a whole.

    Did I hit bottom? In retrospect, I find solace in the narrative that I hit “my” bottom. That’s the problem with the notion of rock bottom, it is a storytelling plot point that can only be defined in hindsight. Not even the precepts of Alcoholics Anonymous (the original peer support program that all 12-step groups are derived from) says that a person needs to hit rock bottom. According to the 12 Traditions, which are the general guidelines for 12-step groups, “The only requirement for membership is a desire to stop [fill in behavior or addiction here].”

    One thing is undeniable: people with real or perceived substance use and/or mental disorders face discrimination and an uphill battle to a healthier life. Everyone is different, and different treatment plans will have different outcomes for different people. Relying on one method of recovery for all people is irresponsible, illogical, and ineffective.

    View the original article at thefix.com

  • Their First Day of School Was My Last Day of Drinking

    Their First Day of School Was My Last Day of Drinking

    That day was the last time I bought into the lies that one drink will somehow not send me on that downward spiral to insanity and destruction of everything I love and care about.

    The kids were still sleeping when I woke up early just to start drinking. The wine was hidden in its usual spot, my closet, and I stood in there at 6 a.m. to choke down whatever I had left. Not because I wanted to, but at that point in my alcoholism my poor body depended on those swigs simply to function normally. I downed enough to stop the shakes, the sick feeling creeping all over my body, the ringing in my ears. Today was the first day of school and a big one at that. My youngest was starting kindergarten.

    Spenser

    He and I had quite a history. I was standing at a nurse’s station in a detox center when I found out I was pregnant with him. I had no idea. And now here we were, my baby with his little backpack, the youngest of four kids, heading to his first day of school. What the hell have I been doing all this time? The grip of addiction was still strangling me and all I could hope was that I’d get better sometime soon. I was so tired.

    The Secret

    I took a quick shower, skipping out on washing my hair. I didn’t have the time or the energy to fix it today. After I got dressed, my husband was already in the kitchen. Coffee was brewing, and silence filled the room. He knew about the closet, knew what I had done. I had looked into those broken eyes countless times, and this morning’s overwhelming feelings of self disgust were the same as all the times before. Graciously he hugged me without saying a word. And we stood there holding each other, like soldiers witnessing a gruesome battle, carrying on a conversation without uttering a single word until I finally let go to wake up the other kids.

    “I’ll start putting your bags in the car,” he said.

    “Okay.”

    And the sad secret being kept from the kids remained intact.

    Shelby

    It was her senior year of high school. My first-born baby girl had seen it all, from happy times in sobriety to life with a mom in rehab for the sixth time. Shelby was done with hearing apologies, but old enough by now to know I didn’t want to drink. She knew I tried, but she wanted her mother. I had one more year before she was gone and I felt every tick of the clock counting down as I wasted yet another day stuck in the fear and shame of it all. How many times had I failed her, and what if I did it again? She’d get her own ride to school, she’d hear the news, but would she forgive me one more time?

    Rebecca

    She had woken herself up for her first day of fifth grade, her last year in elementary school. I couldn’t help but think back to preschool days, her bright blonde hair and toothy grin. But like many memories, flashes of alcoholic moments clouded over the good times and I forced myself to think about something else. She was only four years old when she watched me get handcuffed out of the car and led away for my first DUI. I desperately needed to make new memories, not just for her but for me, too. All of my thoughts were killing me.

    Stella

    Since Spenser had snuck into our bed the night before, I only had one child left to wake up. Stella was still sleeping. She’d been waiting for this day — the beginning of third grade — for two weeks, excited to get back and see her friends again. I sat on the edge of her bottom bunk, reaching for her wavy brown hair. She rolled over and stretched, asking if it was morning. I realized this was it. I wouldn’t be back here for a while, wouldn’t be tucking her in tonight. Desperately wishing I could push rewind for the hundredth time, I just stood up and headed downstairs, feeling sad and scared and awful.

    Eventually the backpacks we ready and the lunches packed. I took one last look around my house, swallowing the waves of tears ready to spill out of my eyes and ruin the picture of normalcy I was trying to paint for my kids. We got in the car, my husband driving, and headed to the school a couple blocks away.

    A Long Good-bye

    “Focus on the kids,” is what I kept telling myself. “God, just get me through this without crying.”

    Hallway after hallway, at every turn was a flood of smiling parents with their best-dressed kids. The excitement was bubbling around me like Christmas morning. I, however, was in a private hell. Physically already feeling the effects of my maintenance wine consumption wearing off, I was dizzy, fluctuating between hot and cold. I thought I looked different than every other mom, so I kept my head down with a fake smile plastered on my face. I was an outsider, uncomfortable and out of place. We went room by room, starting at fifth grade, then third, and finally kindergarten. Each time I walked my precious child in and hugged and kissed them, holding back everything I wanted to say but couldn’t. I left parts of my heart, then grabbed my husband’s hand as we forced our way through crowds and out the door so I could breathe again.

    At 3 o’clock, school would get out, but I’d be gone. My kids wouldn’t see me again until weeks later during visitation day at my seventh treatment center for drug and alcohol addiction. My bed had been reserved since the previous Friday. I’d begged both my husband and the rehab facility to let me wait so that I could do what I just described: take my kids to school for their first day of school, walk Spenser to his first day of kindergarten.

    A Grateful Last Day

    That was August 22, 2016 and I haven’t picked up a drink since that morning. There was no hard bottom circumstance like other times I tried to quit, just sick and tired of being sick and tired. I couldn’t do it anymore. I knew what was left for me: death. I’d been carrying it around with me for months like a dark cloud, convinced the impending death wouldn’t be easy enough to be mine. More than likely it would be one of these precious kids because I always found a reason to drive after I drank.

    But that was the last time my body needed alcohol pumping through my bloodstream just to operate normally. It was the last time I needed to sneak away and find my liquid problem solver and stress reliever, my life-buffer that told me I needed a drink to cope. And it was the last time I bought into the lies that one drink will somehow not send me on that downward spiral to insanity and destruction of everything I love and care about.

    First day, last day, same day. Sometimes a thousand failures lead up to that one success, but that one is all you ever needed. True freedom is accepting it happened the way it was supposed to; taking what you have and making a purpose out of it. I was tired of being sick, and sick of being beaten down by this disease. Sick of always having shame take me out, sick of drinking to escape the self-hatred of not being able to stop drinking. 

    In sobriety, our last day is our first. Sometimes we show up in hallways of institutions and sometimes in closed rooms, feeling uncomfortable and out of place. But once we lift our heads and open our minds, hope comes sneaking in. It’s that moment where recovery is possible — for anyone, even a mother like me.

    View the original article at thefix.com

  • Alcoholics Anonymous: A Different Perspective

    Alcoholics Anonymous: A Different Perspective

    Rather than seeking knowledge through scientific methodology to gather more and more evidence regarding the factual attributes of successful recovery, AA emphasizes scripture, tradition, and the word of authority figures.

    I recently read an essay on another recovery-oriented site, a site whose focus is on people in 12-step recovery yet who are disinclined to religion. The topic was “moments of clarity.” Now, this phrase, for those who have spent years in the 12-step subculture, has obvious connotations. Having the knee-jerk, familiar response to the phrase is one of those cult-like behaviors which make me happy I am no longer an AA member, no longer speaking the lingo nor “drinking the Kool-Aid.” For this free-thinking addict/alcoholic, 60 years old and having spent more of my life in recovery than out, it brought to mind something very different from what was intended. This was a profound and life-changing experience I had, in which the following truths hit me like the proverbial ton of bricks:

    1. I am an atheist.
    2. Alcoholics Anonymous is a religion, like Christianity and Islam.
    3. Such religions tend to impede the development of scientific knowledge regarding natural phenomenon.
    4. Alcoholism, addiction, and the process of recovery are entirely natural phenomenon.
    5. AA has a very low success rate.

    Before going on, I should make clear that I am not merely another AA-basher. I am a former long-term member and Alcoholics Anonymous was central in my life for decades. I learned a great deal, much of which I utilize to this day. I also mean no disrespect whatsoever to the author of the original essay, and I apologize for being tangential. I have problems with the “program,” but not with any individual members. My focus is on all those who suffer because, like myself, they are forced to choose between the rock of active addiction and the hard place of joining what is essentially a Christian sect.

    Alcoholics Anonymous as Religion

    “If it walks like a duck and quacks like a duck…”

    • Twelve Steps

    The chapter We Agnostics is a thinly veiled effort at proselytizing by a devout Christian. Its goal is to use the concept of “open-mindedness” to convince readers to buy into the dualism of old-time religion, with its antiquated belief in the existence of both a natural and a supernatural realm, complete with supernatural entities or “higher” powers. Attaching “as we understood him” to a couple of steps is similarly disingenuous. It is nothing more than a manipulative sales pitch by a professional salesman, one which pales in the shadow of the heavy-handed religiosity of his “12 steps of recovery.” So, for example, in Bill Wilson’s steps you will find: 

    God four times,
    Him or His four times
    Prayer and meditation
    Spiritual awakening and
    A power greater than ourselves.

    Surrender of the personal will, faith in God, confession, prayer and meditation, ultimately even proselytizing and missionary work are promoted as essential attributes of recovery. Here again, the steps promote religious dualism, with its denial of the value of naturalistic, or scientific, knowledge. Even in the 21st century I distinctly recall hearing this erroneous, anti-science perspective espoused in meetings, with god and the supernatural realm presented as the source of all the good stuff, while the natural realm and the animal known as Homo sapiens served as the source of all the bad.

    • Scripture

    The highlighting, underlining, and prodigious dog-earing; treating the book as a sacred object like the Quran; studying and re-reading, with study groups like the Bible; carrying it everywhere; quoting and citing as if anything between the covers is self-evidently true or “gospel,” so to speak; and the unwillingness to change a word of the first 164 pages: all of these attest to a belief in the Big Book as the kind of scripture or divine word which serves as the foundation for religious traditions like Christianity, Islam, and others. I can recall many times in the rooms when I heard the view that the Big Book was divinely inspired, the ludicrous notion that a supernatural entity was speaking through Bill Wilson when he wrote Alcoholics Anonymous.

    • Tradition

    Rather than seeking knowledge through scientific methodology to gather more and more evidence regarding the factual attributes of successful recovery, AA emphasizes scripture, tradition, and the word of authority figures. These are the criteria that many religions use to justify “knowledge” as they understand it. Ironically, even though America is one of the greatest scientific nations in history, we also suffer a populace which is largely hostile to science and academics. The members of AA comprise a microcosm of this larger population.

    • Faith is NOT a Virtue

    Faith is claimed to be a virtue, but in the 12-step context it is actually the acceptance of something for which zero evidence, facts, or data exist. That is, the adulation of ignorance, a trait which walks hand-in-hand with America’s mistrust of science and of academics more generally. This approach teaches us to be mistrustful of science, yet obedient and sheep-like with religious authority. The main reference to science in the “first 164 pages” is one line which states that “science may one day cure alcoholism, but it hasn’t done so yet.” Importantly, this one reference is often read sarcastically, with derisive snickers and mocking asides, illustrating a cocky certainty of its implausibility.

    • Authority and Obedience

    As with religions like Christianity and Islam, unquestioned obedience to authority figures is of the utmost importance in Alcoholics Anonymous. We are all familiar with the phrase “take the cotton out of your ears, and put it in your mouth.” In some places this is an actual rule, with newcomers in their first 30, 60, or 90 days advised to only listen. Unquestioned obedience to authority is a major distinction between religious perspectives and secular, humanist, and scientific approaches. The adulation of Bill, of Bob, of circuit speakers and old-timers, of sponsors, the use of quotes as meeting topics, and the current emphasis on temporally-measured sobriety, encouraging both pride and the development of a hierarchy, all convincingly mirrors the religious emphasis upon blind faith and obedience to the words of authority figures.

    • Conservatism

    Conservatism in this context means a profound reticence to change. I believe that the Catholic Church recently apologized to Galileo, only 450 years overdue. Both Christianity and Islam still treat women as if we were living in Biblical times. This intransigence, this resistance to progress, is one of the primary characteristics of Alcoholics Anonymous. AA causes people to become narrow-minded and inflexible, unable to consider new, different, or contrary approaches to treatment methods. When I have broached these subjects with current members, they have consistently become defensive and “circled the wagons.”

    Religion as Impediment

    “So what?” you might ask. “So what if AA is a religion?”

    The problem is, as a result of their fundamental dualistic nature, these types of religions stand in the way of us acquiring knowledge and, in particular, cultivating a more naturalistic, scientific understanding of addiction, alcoholism, and the truly essential attributes of recovery.

    Problems and Solutions

    You admit you have a problem. Then you find a “spiritual solution.” What do you do? In AA, as with Islam and Christianity, you are discouraged from seeking an alternative solution. You are even encouraged to proselytize, to go out and “spread the good news.” Religious converts, recipients of the “one true word,” are trained to be blind, even hostile, to alternatives, particularly naturalistic ones, while enthusiastically promoting the one and only true supernatural solution.

    So around 8 or 10 years into sobriety we go and get our counseling certificates, then get a job working or volunteering at a nearby treatment center. The faculty, staff, and volunteers at the facilities, and at the couple of behemoths in the addiction treatment field, are largely AA members, AA trained, and generally convinced that with the 12 steps and our “spiritual solution,” the problem has been solved. I believed this too, for many years. This fundamentally biases the treatment process, leaning it towards 12-step and away from any alternatives.

    Conservatism Revisited

    Another consequence of AA’s conservative bent is that people in the program become so convinced that the Big Book and the program are perfect exactly as they are, that they do not hear what atheists or skeptics like myself have to say. This is a form of cognitive bias called confirmation bias, which simply refers to how, even when confronted with facts or data challenging their beliefs, people will nonetheless cling to their original views. In fact, people will even double-down on their faulty original position when confronted with fully rational, fact-based alternatives. This bodes ill for our efforts to update recovery by embracing more empirical, evidence-based knowledge, especially if it conflicts with AA tradition, scripture, or authority.

    Anti-Naturalistic Thinking

    These religious traditions started out as pre-scientific efforts to understand ourselves, the greater cosmos, and our place within it all. Their most significant error was the introduction of the afore-mentioned dualism, an imagined schism between the natural and the supernatural. Ever since Darwin, we have known that the 100% natural animal Homo sapiens builds new knowledge on top of old knowledge, accumulating knowledge over time until we figure out how to solve all manner of worldly, natural problems. This includes curing diseases that were once deemed completely beyond our comprehension or scope, requiring prayer, sacrifices, and incantations to mysterious gods.

    Rather than attributing meaning to the words “bless you” when someone sneezes and seeking to bring supernatural elements to bear on the demonic entities which allegedly cause a person to become sick, we have instead discovered the germ theory of disease. I am simply suggesting that we stop thinking in such medieval, archaic terms when it comes to addiction, alcoholism and recovery and instead fully embrace empirical, scientific methods which might yield more fruitful results.

    God of the Gaps

    The strongest argument for religion as an impediment would be the “god of the gaps.” For millennia humanity has inserted supernatural answers into the gaps in our knowledge. If a hurricane blows or an earthquake hits, god (or, if you prefer, a higher power) did it. However, over time, naturalistic answers have replaced supernatural answers, one by one, consistently, and with far more accuracy.

    Complex psycho-social maladies like ours are particularly mysterious and therefore highly prone to such supernatural interpretations. AA’s founding fathers were steeped in a social context in which radical personal transformations were deemed mysterious and supernatural. We had absolutely no idea what was involved, so we labeled such experiences as “psychic” (Silkworth) or “spiritual” (Jung), which merely perpetuates the fallacious dualism, as a result of both the unclear meanings and supernatural undertones of such key terms.

    Over the course of human history our questions have found their best, most accurate answers not in the supernatural but instead in knowledge gained through approaches emphasizing the scientific method. As atheist author Greta Cristina and others have wisely observed, there exist precisely zero accounts of this process moving in the opposite direction. Nonetheless, AA remains an obstinate hold out.

    It’s time to embrace facts and data, to give science a real shot at addressing this global scourge. AA members must become more open to approaching the problem anew. If, when confronted with Galileo holding that the earth revolved around the sun, the church had simply said “well, let’s check out what the evidence says,” that would have been great. But they did not. Instead, like AA members have done to me—and I’m no Galileo—they cry “trouble maker” and play hear no evil, see no evil…

    Alcoholics Anonymous as a Failure

    None of the above would matter if Alcoholics Anonymous really, truly worked.

    But it does not.

    I was told by the senior counselor in my second treatment center that only 10% of us would “make it”. That’s an admitted failure rate of 90%. This was not merely manipulative sales-speak. Such extremely poor success rates are similar to what a variety of differing studies have found. We all know this, anecdotally. If you look, you can see that the only thing busier than the coffee pot at an AA meeting is the revolving door. And such disheartening research does not even scratch the surface of our failure, as most of the world’s millions of addicts and alcoholics never even darken the doorways of AA in the first place, for a number of very good reasons.

    “It works if you work it” is a classic example of the kind of un-falsifiable claim which characterizes religious traditions. Scientific claims, on the other hand, are characterized by falsifiability, which simply means that they can be tested. Then we can either discard them, modify them, or build upon them. It is by utilizing precisely such scientific approaches that we have discovered cures for polio, small pox, malaria, and so much more. The more complex, psycho-social disorders, such as depression or bi-polar disorder, are likewise yielding to our efforts to address them as purely natural phenomenon.

    By any and all measures, there is a staggeringly large amount of room for improvement. The religious perspective merely serves to block our way at this point in history. In the short time it took you to read this essay, thousands of lives were shattered or ended. It’s time to move on and aggressively seek empirical, naturalistic solutions to this deadly global scourge.

     

    Thoughts? Rebuttals? Please share in the comment section below.

    View the original article at thefix.com

  • Artists in Recovery Find Their Fix in "The Creative High"

    Artists in Recovery Find Their Fix in "The Creative High"

    Creativity — making art — is another way to find that aliveness and spiritual connection often sought through drugs and alcohol. The creative process can be transformative for people with addiction.

    Recovery that consists of meetings, step work, and an unfulfilling job makes for a very black-and-white life — at least for me it did. That wasn’t the recovery I wanted. I was bored. When I got involved in creative endeavors, however, it was like adding color back into my world. For some people, creative expression becomes a new high.

    As I started to explore creativity and art, I realized that I’d opened a door to a part of me that had been closed since I started using drugs. As a child, I loved painting and crafting. I reignited that passion and began expressing myself in new ways: blogging, writing and journaling; painting and drawing; making art and attending craft classes; and creating new recipes. My world feels so much more livable with art in it.

    I’m not alone, fellow creative Jules tells me: “Art is everything, really. I don’t care if you write, paint, dance, sculpt, make movies, or whatever. It’s a way to choose an expression to share who you were and who you’re becoming. We’re all messes of insecurity and works in progress. The key is to keep working.”

    A big stumbling block for many of us is that we don’t know where to start, and, like Jules says, we have insecurity about our work. That’s where artist Tammi Salas comes in. Over the past few years, Tammi has been sharing her creative journey in recovery. Through Instagram, the #RecoveryGalsArtExchange, her podcast The Unruffled, and other ventures, Tammi gives us a starting point and inspires us to play.

    “Art helped me fill the void alcohol once occupied. My entire recovery is centered around making and creating art,” she says. “Not a day goes by without me tapping into my creative groove and seeing what comes out. Art anchors me and helps me reframe old stories and visually create new ones.”

    San Francisco-based filmmaker, educator, and arts therapist Adriana Marchione finds her creative outlet in film. For the last 20 years, she has been dedicated to supporting people struggling with substance use disorder and other addictions. Recently, she directed a new a documentary feature-length film, The Creative High.

    The Creative High Footage Teaser, Spring 2018 from Adriana Marchione on Vimeo.

    The documentary shares the stories of working artists — including Wesley Geer of Rock to Recovery and Ralph Spight, a punk musician who plays with Jello Biafra from the Dead Kennedys — who have faced addiction. The film reveals their transformational paths to recovery, and the natural “high” of making art. The Creative High brings the viewer into the world of hip-hop, drag performance, punk music, dance, theater, and visual art, demonstrating “the tension that exists between the altered states of creativity and addictive behavior.”

    Andriana Marchione took some time out of her schedule to discuss her creative process with The Fix.

    The Fix: How has art and creativity influenced your own journey in recovery?

    Adriana: I came into recovery 25 years ago as a photographer/visual artist, and at that time I didn’t see a lot of creative role models in recovery. To be safe and away from triggers around my addiction that mainly stemmed from alcohol abuse and unhealthy relationships, I felt that I needed to move away from my creative life and artist connections. Life slowly became manageable. I started to heal, I found peace of mind, but I missed the excitement and vibrancy that my art making gave me. I found more internal ways to express myself (art journaling, poetry, small collages) versus making art to exhibit or be in environments where I mingled with other creatives and had to confront drinking and social life — galleries, parties, bars. This led me to study expressive arts therapy after several years into recovery, and then I made a career out of this. This has been incredibly rewarding to me, giving me a life of purpose, and also finding a focus where I specialize in working with addiction recovery, and artists who face addictions and eating disorders.

    Along the way, I have found new ways to express myself: improv performance, Argentine tango, being an art curator for many years, and coming back to my love of media through filmmaking over the last five years. It also took a while (and continues to challenge me) to find the balance with creating art and being public in art making, taking risks but still being grounded in recovery.

    What motivated you to create this film, and what does it represent to you?

    Being dedicated to a creative project of substance and collaborating with the film team has been one of my hopes and visions in recovery. For the last 25 years, I have focused on art therapy and supporting people one-on-one or in a teaching setting, but when I started making documentaries I felt a strong calling to tell stories and make a larger statement through my art. Films have the power to do that.

    My first documentary film, When the Fall Comes, was released in 2014 and was about my personal journey with grief and using the arts to heal. This film gave me the inspiration to do more films because I realized how many people a film can reach and what a rich experience it is to be involved in the making of a film. It is also a passion project since the topic of creativity and addiction is so close to my heart. This is something I have lived and watched others struggle with in my work — how to have a creative life successful in recovery. I wanted to tell the artist’s story from a new perspective, with many voices. I wanted to give hope to artists in recovery and artists who are still caught in addictive cycles, but I also wanted to show how the arts can be an important vehicle for healing in recovery.

    In what ways do you think the film will speak to both people in recovery and to those seeking it? 

    I hope this film will give people a window into the real challenges and successes that artists who have suffered from substance use disorders face. I also think it is important for people to speak publicly about their addictions, so the public can see that recovery happens and so that we can continue to combat stigma that comes along with the disease of addictions.

    Some of the artists in the film have had to go through a process with this, and I applaud their courage and willingness to reveal their stories with the public. I hope that people viewing the film will have a deeper sense of the highs and lows that accompany the creative process and take the risk to create. I also want to convey the fact that seeking an alternative “high” through making art gives another channel to find that aliveness and spiritual connection often sought through drugs and alcohol. Art can be the new medicine, one that is productive and meaningful rather than destructive and life-diminishing. 

    You chose nine working artists from diverse backgrounds to feature in the film, rather than choosing celebrities. What unique qualities do you think that will bring to the overall production?

    It felt very important to tell a different story than the celebrity story. So many films, TV shows, memoirs have been put out that tell the dramatic story of famous people struggling with addiction. Addiction affects us all in some way, and there are so many artists who live ordinary lives (and extraordinary as well) who are trying to be successful with their art without falling into addictive behaviors. Documenting a variety of stories, from musicians to dancers to visual artists, shows all different sides of life. We wanted to show many recovery perspectives and how each one is unique but they all experience the power of the arts practice. 

    Conceptualizing and producing a film is a huge task. What other challenges have you faced making a film that was funded through donations?

    Making a feature-length documentary is a huge feat that requires endless determination. We have been making The Creative High and are now in post-production, which is the most expensive part of making a film. We have pursued many avenues for funding including applying to grants, crowdfunding, reaching out to private foundations, and seeking investors, sponsors and executive producers. In general, funding is not easy to procure for independent films, and we have found that the most effective way to gather the funds has been through individuals making small donations that add up. We are very open at this completion stage to have sponsors and executive producers join us with larger donations to help us get to the finish line!

    Last, how can we support your fundraising?

    You can support our fundraising by making a donation here. The sooner we gather our remaining funding, the faster we can complete the film and get its message to the public. All donations are tax-deductible. 

    Find out more about director Adriana Marchione’s work: www.adrianamarchione.com

    How do you express yourself in recovery? Tell us below.

    View the original article at thefix.com

  • Death by Fentanyl: Should the Powerful Opioid Be Used in Lethal Injections?

    Death by Fentanyl: Should the Powerful Opioid Be Used in Lethal Injections?

    When it comes to executing people by lethal injection, “Fentanyl is just an obvious choice. You have unfortunately an inexhaustible supply of this drug in state custody – why can’t it be used?”

    As the end drew near, Carey Dean Moore’s face turned red, and then purple. He breathed heavily, according to the witnesses who were there to see it, and coughed. Roughly 20 minutes later, he died.

    In his final weeks, the two-time killer had given up efforts to seek a reprieve. He’d expressed his scant apologies and written the final words condemned men write. 

    It was the 1,481st execution in the modern era of capital punishment, but Moore’s death was a first on more than one front. Not only was it the Cornhusker State’s first execution in more than two decades, but also it was the nation’s first ever lethal injection using fentanyl, the deadly drug at the center of the opioid crisis.

    More than 28,000 Americans — none of whom were on death row — died in connection with the powerful painkiller in 2017, according to federal data.

    Yet, as politicians and public advocates wrung their hands over how to stem the flow of drugs and stop the scourge of overdoses, behind closed doors corrections officials quietly asked a very different question: Can we use this drug in executions?

    As long as it’s available, the answer is yes.

    But as death penalty states struggle to obtain lethal drugs, it’s unclear whether fentanyl is the future of death chambers or just a fleeting interest. Will more states switch to opioid-based execution? Or will the course of capital punishment take a different direction?

    “It’s Not Like Anyone Thinks This Makes It Less Painful”

    Nationally, executions have been on the decline for close to two decades. But last year saw new legal developments and twists in the process. Washington outlawed capital punishment, Alabama witnessed a badly botched execution attempt, Tennessee returned to using the electric chair and Nebraska carried out Moore’s execution, which was the first time fentanyl was used as part of the lethal injection.

    Initially, Nevada was slated to be the first state to use the powerful painkiller in its death protocol, for the planned July execution of Scott Dozier. But a last-minute lawsuit halted the procedure after a pharmaceutical company — the maker of one of the other drugs in Nevada’s three-drug cocktail — accused the state of illegitimately acquiring the sedative midazolam. (Dozier later killed himself before the state could execute him.)

    For the execution of Moore, the state used a previously untested four-drug cocktail. The protocol first called for a dose of diazepam, which is the generic name for Valium. Executioners followed that with a dose of fentanyl — at which point Moore began coughing and breathing heavily before turning purple, according to the Lincoln Journal-Star. One minute later, Moore was given cisatracurium, a paralytic that would have rendered him unable to breathe. Finally, the protocol ended with a shot of potassium chloride to stop the heart.

    All three of the other drugs have previously been used in executions, with some controversy — especially in the case of the cisatracurium, which experts worry could just mask signs of suffering with its paralytic effect.

    Supposedly, the fentanyl ensures the condemned is not conscious to feel the effects of the drugs that follow, but Dr. Joel Zivot, an associate professor of anesthesiology at Emory University School of Medicine who has testified as an expert in lethal injection litigation, questions that assumption.

    “Having given narcotics to maybe 10,000 or more people in my career, I can’t tell you that everybody gets high or gets pleasure out of it and even the pain relief is uneven,” he told The Fix. “I have certainly never given narcotics and thought, ‘This is going to take away the pain of dying.’ It’s not like anyone thinks this makes it less painful per se to die – it’s unmeasurable and unknowable.”

    It may be tempting to think that using a painkiller is a humane final gesture, but Zivot cautions against seeing it that way.

    “The Constitution doesn’t ask that you trade off cruelty for being stoned,” he said. “It’s not one or the other, or that being stoned takes away cruelty. It seems like a rather horrible and insensitive way of taking advantage of a terrible national epidemic.”

    To death penalty supporters, the opioid’s efficacy in killing — along with the ready abundance of the drug in confiscated supplies — is a selling point.

    “Every day people die from this, so it’s obviously effective,” said Houston-based capital punishment advocate Dudley Sharp. “Fentanyl is just an obvious choice. You have unfortunately an inexhaustible supply of this drug in state custody – why can’t it be used?”

    “Raised More Questions Than It’s Answered”

    Despite the finality of the outcome, some experts say it’s not entirely certain that the first fentanyl execution went as anticipated — because the witnesses couldn’t actually see key parts of the process.

    “The Nebraska execution has raised more questions than it’s answered,” said Robert Dunham, executive director of the Death Penalty Information Center. “It isn’t clear that the execution went as planned because the Nebraska prisons dropped the curtain before Carey Dean Moore died, and so none of the witnesses saw the actual death.”

    For 14 minutes, witnesses weren’t privy to the goings-on inside the execution chamber.

    And given the facial discoloration and signs of “air hunger” before the curtain closed, Dunham said, there’s a possibility the procedure “did not go properly,” a concern that could make fentanyl death protocols less appealing for other states considering the switch.

    “Had it been more transparent,” he said, “it might produce a different response from the other states – but the absence of transparency and the questions resulting from that make it unclear whether this was a quote-unquote ‘successful’ execution or just another problematic protocol.”

    Because They Could Get It

    Even though it’s come to be associated with overdoses, there’s no particular pharmacological reason to start adding fentanyl to death cocktails, according to experts.

    “Narcotics are not poison. You can die as a consequence of them,” Zivot said, “but they’re not poison; fentanyl is not made to kill.”

    It doesn’t kill better or quicker, and it’s not clear that it does so less painfully. But that’s not necessarily what states are looking for when they pick a new death drug; instead, they’re concerned with availability.

    “The way states have selected the drugs is pretty much: they see what other states do and then if it appears to work, they do it too,” Dunham said. “The history of which lethal injection drugs are used can be traced to which ones became unavailable and once drugs became unavailable — because drug companies didn’t want to sell them to prisons for executions — then states began looking for different drugs.”

    In recent years, drug companies have refused to provide their products to prisons planning to use them for executions and in some cases, as in Nevada, they’ve even filed suit to ensure their products aren’t used to kill. As a result, some drugs have become harder to get into the death chamber and new combinations have become more appealing.

    “When Nevada officials were asked why they chose fentanyl, they essentially said, ‘Because we could get it,’” Dunham said. But even fentanyl could become harder to obtain.

    “Eventually with any drug that the drug companies learn is being used in executions,” he continued, “the distribution controls will get progressively stricter.”

    But there’s one way to avoid the hurdles of those particular supply-side controls: use something that’s not a drug.

    “You Can’t Withhold Nitrogen Gas”

    1976: In Room 17 of a seedy Fort Worth motel, a handsome man named Charlie Brooks Jr. stuck a pistol to the face of used car dealer David Gregory.

    Six years later, Brooks became the first man in America executed by lethal injection. It was widely touted as a more “humane” way to kill, but the 40-year-old’s death gave pause to that claim.

    The four reporters who witnessed it all “appeared shaken by the experience” which “did not appear to be painless,” according to the New York Times.

    More than three decades later, the amount of pain condemned prisoners feel is still a source of debate and legal wrangling. It’s made its way into multiple lawsuits over the past year, formed the basis of last-minute appeals and requests for reprieve, and prompted some inmates to beg for alternate methods of execution.

    When Doyle Lee Hamm — who survived Alabama’s painfully botched execution attempt early in the year after executioners couldn’t find a suitable vein — sued the state, he cited the bloody procedure as reason not to try again. In June, Houston serial killer Danny Bible unsuccessfully argued that he, like Hamm, was in such bad health that any attempts to execute him could result in a similarly gruesome spectacle. (They did not.) Then in November, Joseph Garcia — one of the notorious “Texas 7” escapees — challenged his pending execution with questions about the safety record of the compounding pharmacy that allegedly supplied the drugs earmarked for his death. The courts refused his last-minute legal claims.

    And this winter in Tennessee, death row prisoners begged to die by a different method, ultimately choosing a return to electrocution rather than face the possibility of a botched injection.

    These concerns combined with the spread of roadblocks preventing states from getting the drugs they want could be enough to prompt a shift away from lethal injection altogether, some experts believe.

    “Lethal injection in the long-term is not viable,” said Sharp. “That’s why a lot of people have been saying to use nitrogen gas because you can’t withhold nitrogen gas.”

    In fact, Alabama, Oklahoma, and Mississippi have included nitrogen as part of their execution protocols, though none has actually used it yet. But, experts say, nitrogen might be the next logical option for executions, rather than fentanyl or any other injected drug.  

    So far, though, it’s an untested procedure.

    View the original article at thefix.com

  • 11 Ways to Heal a Broken Heart in Recovery

    11 Ways to Heal a Broken Heart in Recovery

    When your broken heart goes into cardiac arrest and your old “coping mechanisms” are more likely to lead you to flatline than recovery, try these 11 resuscitative tips and heal yourself.

    Heartbreak. At 14 or 54, we’ve all been there, but today we push through the pain, one-day-at-a-time, cold brew sober. And here’s what’s helping me now, because, despite what still feels like an endless volley of water balloons hitting concrete beneath my breastbone, the fibrillation is in my mind, not my chest cavity, and that scrappy muscle thumps on, still propping me upright each morning to face my new reality.

    1. Find that God of Your Understanding and Glom On

    When I reached Step 3 with my sponsor, I got an assignment: flesh out your concept of a higher power, in writing. Lisa M. wanted detail, a God I could see and talk to, and grab by the elbow. And because I’m neither original nor progressive, I came up with a male God in human form — a cross between Santa Claus and Mr. T. to be exact. With a twinkle in his eye and a glint off his gold tooth, my HP is jolly and generous, strong and sexy, and funny as hell.

    And at this moment, when I’m finding myself on the sucky side of one-sided love, it’s not bad to have a real hunk who loves me for an HP. After an especially vicious salvo, when the heartbreak balloons start to leak out the eye sockets, I can HALT, remember the in-breath, and picture HP (and yes, predictably, I’m looking heavenward). Funny, his response is always the same: with bronzed torso and silver beard, forearms flexed and crossed over a white undershirt, the big man in the sky stares down at me, then starts nodding reassuringly. Suddenly, he flashes that easy smile and I know I’m good.

    2. Slam the Slogans

    H.A.L.T., Easy Does It, Turn It Over, Just for Today, Live and Let Live, This Too Shall Pass, When One Door Shuts Another Opens, Fear Is the Absence of Faith, The Elevator Is Broken – You’ll Have to Use the Steps. I’ve become something of a short-order chef when it comes to using a few well-chosen words to support my sobriety. Day and night, I sling slogans, flip affirmations, and call out quotes from famous dead people. I’ve scotched them to the inside of my kitchen cabinets, along with the 3rd, 6th, 7th and 11th step prayers. They are the comfort food my soul craves now. “Success is moving from failure to failure with no lack of enthusiasm.” – Winston Churchill. “If you want to be loved, love and do loving things.” – Ben Franklin. Words that nourish, as I’m waiting for the kettle to boil. Having well-chosen words highly visible in the kitchen (or as a screensaver) can be a real lifesaver!

    3. Phone Therapy

    And here’s a slogan I’m slamming hard today: “We drank alone, but we don’t stay sober alone.” The old timers carried quarters, and I make sure I leave home with my phone fully-charged. I listen to a morning meditation walking to the train, text three newcomers on the platform, compose a longer text to my sponsor in transit, then dial my best sober gal pal as I push through the turnstile on the final leg to work. I send silly GIFs to lift spirits, including mine, and add a trail of emoji butterflies, praying hands, and peace signs. By 8:00 a.m., the lonely in me already feels not so alone.

    4. Explore Podcasts

    Recovery Radio Network, Joe and Charlie, and the Alcoholics Anonymous Radio Show are three in my queue. On my lunch hour or driving upstate, I take 30-60 minutes to laugh, cry, and identify…

    5. Make a Gratitude List

    My first sober Christmas, going through a divorce with two kids still believing in Santa, the above-mentioned sober gal pal suggested I find ten things for which I was grateful, save them to my phone, and recite them like a mantra through the Twelve Days of Christmas. I did:

    1. My sobriety
    2. My sons
    3. AA program of recovery
    4. AA fellowship
    5. Food in my stomach
    6. Roof over my head
    7. Colombian coffee
    8. My dog
    9. My extended family
    10. God (HP has since moved up to the #1 slot)

    It worked. I said no to nog that first Yuletide, and made merry for my sons instead. And counting off my blessings still works today, when I’m a shallow-breathing shell just going through the motions.

    6. Make an Extended Gratitude List

    When the restless, irritable and discontent in me keeps spilling the glass half-full and this positive punch list isn’t getting me over the hump, I pour out ten more things to celebrate, like: my pre-war bathtub, which holds upwards of 60 gallons of bubble bath and the fact that I live within easy walking distance of two subway lines so I can always get into the city on weekends.

    7. Make Meetings

    “Meeting Makers Make It,” “Get Sober Feet,” “Carry the Body, the Mind Will Follow.” These three slogans in particular encouraged me as a newcomer, and I’m calling upon them now, in cardiac arrest, when my heart needs serious heartening. So I’m hitting my home group, and getting hugs from retirees with double-digit sobriety who pass fresh Kleenex and envelop in equanimous smiles. I’m also checking out other meetings across town, then going out for…

    8. Fellowship Afterwards

    I’ve started tucking my Boggle into my handbag when I head out to my Friday night meeting. At the secretary’s report, I pull out the box, shake it, and invite anyone interested to a nearby diner for passable pie a la mode and a few rounds of a three-minute word game. Sometimes it’s Yahtzee. We roll the dice and down bottomless cups of bad coffee. Last week someone brought cards, and I lost badly at hearts (ha!). It’s good, wholesome fun, and by the time I hit my pillow, I’ve significantly pared down the number of waking hours I could have spent obsessing over-ahem-HIM.

    9. Self-Care

    Self-care is somewhat self-defined. These days, after I’ve covered the basics—eat, sleep, bathe—I’m noodling what more I can do to support my mental, physical, and spiritual self. Prone to self-pity and self-indulgence just now, self-care is really urgent-care. So I ask: am I under-meditating and over-caffeinating? Am I speeding up at speed bumps? Am I four months behind in balancing my bank statement? Am I using money to buy what money can’t buy and damn the consequences? Am I treating every Monday like Cyber Monday and abusing the free delivery feature of Amazon Prime? Have I forgotten yoga and found red velvet cake in Costco’s freezer? Are my spot checks spotty lately because I just don’t want to cop to this alcoholic acting out, and instead keep blunting the full force of feeling??? Yes to all of the above. And this leads me back to Step 2: turn to top management for a takeover.

    Working Steps 2 and 3 is probably the most caring thing I’m doing for myself today: seeing the unmanageable, then seeing the way out. And also forgiving myself for these self-indulgent splurges. So what that I’ve added three pounds to my midline and three pairs of silver sandals to my shoe rack? The rent is paid, and my latchkey kids still let themselves in after school and seem content to eat my crockpot soup and call this home.

    10. Get on your Hobby Horse

    When was the last time you read “Chapter 6: Getting Active” in Living Sober, that handy paperback that’s not just for newcomers? This month I’ve been making good use of subsection 6B: “Activity not related to A.A.”

    The anonymous authors suggest “trying a new hobby” or “revisiting an old pastime, except you-know-what” (Yea, Amstel Light). Fat chance I’ll pick up cabinetmaking, leathercraft or macramé, but I am baking granola and simmering bone broths.

    I’m also revisiting my adolescence with amateur YouTube ballet routines by hammy-thighed figure skaters and dancing to Heavy D. music videos late into a Saturday night. I’m choosing happy music over sad, and tuning in to The Messiah, not Blue Christmas.

    I’m even considering “Starting on long neglected chores” like editing my nearly obsolete recipe binder, now that I’ve found Pinterest. And while I can’t claim to be going out of my way “Volunteering to do some useful service,” I am trying to be more useful on my job. And just as helping a newcomer find a meeting helps me, helping a kid graph algebraic equations makes me feel purposeful (when otherwise I feel like a mess).

    11. Become a card-carrying member of the “No Matter What Club”

    For God’s sake, whatever skillful or unskillful actions you end up taking during this time of triage, please don’t drink over him or her. They are not worth it. (And I’d put money down—money that I don’t have—on a bet that they’d agree with me.)

    Voila! My top eleven tips to help you over the hump of heartbreak! Take what you like and leave the rest.

    Have you had your heart broken in recovery? How did you heal? Let us know in the comments.

    View the original article at thefix.com

  • How I Supported My Heroin Addiction by Selling Meat

    How I Supported My Heroin Addiction by Selling Meat

    After I pushed in the plunger, all the anguish, self-hatred and regret faded into blackness. Heroin was an anti-depressant and the only thing I found to ease the constant sadness that clutched my throat.

    It was the blistering hot summer of ‘75 in Los Angeles. I was over-dressed as I headed to the supermarket in a brown corduroy jacket, jeans, and a faux leather purse that bounced off my bony hip.

    I pushed my cart through the automatic doors, my eyes darting back and forth behind my $10 aviator shades. I was on the lookout for the store manager. I knew that he was in his early 40’s, with a crew cut and a paunch belly that hung over his belt.

    Relieved that he was helping a customer on the far end of the store, I rolled straight for the cereal aisle, but I wasn’t there for the Cocoa Pebbles or Frosted Flakes. I just used the boxes for cover. I was there for meat. And not just any meat would do. I wanted only the most tender, most expensive cuts, with the USDA stamp of approval on them.

    I was 21 and strung out on heroin for the first time. I had been shooting up in moderation for years until my boyfriend Max and I crossed some sort of invisible line. I can still remember the first morning I ran to the toilet throwing up until there was nothing but slimy yellow bile.

    That was a game changer for me. I was now addicted and had to find a way to support my habit. But how? I couldn’t sell my body like some of the junkie girls did. The thought of sleeping with a greasy old man made my skin crawl. Instead I asked Sammy, another junkie, to teach me his trade. Boosting: what the police would refer to as petty theft.

    At my first day of on-the-job training with Sammy, we pretended to be a married couple grocery shopping. But in reality I was watching him steal with laser-like focus. By the end of the day it was apparent I had a natural talent for stealing meat. After we stole the meat we’d sell it half price and get our dope money. It didn’t take long before I had customers all over town who wanted to buy my meat. I soon had a reputation with other junkies for being the best cattle rustler west of the 405.

    I sped down the cereal aisle and grabbed three boxes of Corn Flakes. I then headed to the butcher section. My gaze landed lovingly on the bulging pink meat packaged in tight saran-wrap that lined the open freezer. I took a deep breath before loading my cart up with filet mignon, New York and T-bone steaks. In less than a minute I had what I considered to be a pretty good haul. I covered the packages with my Corn Flakes boxes and did a 180 with my cart.

    I headed down the back of the supermarket until I found an empty aisle. There, I stopped midway and loosened my belt. My heart pounded so loudly I could hear it beating inside my brain. I bent over, grabbed a steak, and shoved it down the back of my pants. It was cold. Goose bumps erupted all over my sun-starved flesh. I moved fast, stuffing one steak after another around my waist.

    Suddenly, a fresh-faced mother with a toddler tucked in her cart headed toward me. I dropped the steak back into my cart and reached for a can of Campbell’s soup, pretending to read the ingredients. The click-clacking of the other cart’s wheels drew closer.

    Whenever I boosted, my super powers kicked in. My mind could easily shift between thinking, observing, and analyzing my surroundings for any threats. This hyper-vigilant state was the direct result of growing up with a schizophrenic mother who was loving one minute and ballistic the next. When I was 7, my mother drowned herself in the bathtub but by then the neural pathways in my brain had already been set. This vigilance, which had once been a handicap, became a gift whenever I boosted.

    The cart was behind me now and the mother’s voice sounded soothing as she spoke to her child: “You can have a cookie after dinner sweetie.”

    Hearing their tender interaction turned my stomach into a tight fist. I felt the familiar pang of resentment. I often imagined how things might have been different if my family hadn’t been so fucked up. What if I’d had a loving mother who was there for me through all the benchmarks in my life? Maybe, just maybe, I wouldn’t be standing in a market with a steak stuck in my pants and blood dripping down the back of my legs.

    I watched them disappear around the corner before stuffing more meat around my emaciated waistline. By the time I was done I resembled a suicide bomber ready to blow the place up. With meat.

    Once the last two steaks were securely tucked away I abandoned the cart and moved stealth-like towards the front of the store. My goal was to slip out without any employees noticing me. But with blood seeping down my legs I was afraid I’d draw unneeded attention to myself. All my favorite jeans were ruined.

    My breath grew shallow as I turned sideways through a closed cash register aisle. I was several feet from freedom when the paunch belly store manager yelled from his station, “Excuse me miss. Hold it right there!”

    I quickly assessed the situation. The manager was walking toward me. I could see my car parked close to the front of the store. I asked myself if I should run or wait to see what the manager wanted. It turned out to be a no-brainer. My foot instinctively hit the rubber mat causing the automatic doors to spring open. I ran as fast as I could, my arms and knees pumping, my tennis shoes slapping the hot asphalt ground beneath me. A steak slipped out of my pants. I hoped this minor obstacle would slow the manager down. But no.

    Having watched plenty of nature shows as a kid, I could imagine how this scene might have resembled a cougar chasing his prey. Unfortunately, in this action adventure I was the prey and I was afraid a claw would reach out and grab the back of my coat any second. And then what? I’d be arrested. I’d heard plenty of horror stories from junkies kicking heroin in jail. I was determined not to let that be my fate.

    I don’t know if I imagined it but I felt the manager’s hot breath at the base of my neck. I leaped inside my Volkswagen Bug and punched down the lock. The manager grabbed the door handle at the exact same time. With his face inches away, I could see his nostrils flaring, his eyes wild with rage.

    “Open this fucking door!” he yelled.

    My hands shook as I fished inside my jacket pocket for the keys. The car rocked as he pulled on the door, the peace sign hanging from the rear-view mirror swaying back and forth. I slipped the key into the ignition and the engine sputtered and popped. I made a mental note: If you don’t want to go jail, get a frigging tune up ASAP.

    I hit the clutch and threw the gears in reverse. As I backed up the manager pounded the driver’s window with his fist and yelled “Get the hell out of the car!”

    After clearing the parking spot, I shifted into first gear just as this wannabe hero stepped onto the running board. He grabbed the mirror with one hand and the door handle with the other. All I could think was: What the fuck? What the hell is wrong with this crazy idiot?

    I pushed the pedal to the floor, picked up speed, and shifted into second gear thinking surely he would jump off. But he appeared to hold on even tighter. I yanked the steering wheel and made a hard right. He finally lost his grip. I watched him in my rear-view mirror tumble away like a loose hubcap.

    Oh God! Had I killed him?

    Relief coursed through me when he hopped up, yelling and waving his fist as I pulled onto Venice Boulevard. My chest heaved as I peeled the steaks from my waist and tossed them onto the passenger side floor. My mind raced with paranoid thoughts: someone must have gotten my license plate number, the entire police force would be out looking for me. I had to get the hell out of there.

    My eyes darted to the rear-view mirror and I twisted my head from side to side like the Exorcist on the lookout for any patrol cars. I had to get rid of the evidence and fortunately, I had plenty of people around town who would buy it.

    Fifteen minutes later I pulled up in front of a house in the suburbs. I hopped out of the car, walked up the path and rang the front door bell as casually as an Avon lady. Moments later, Mrs. Wilson appeared, dressed in polyester pants, head crowned with pink sponge curlers under a paisley scarf. She squinted over my shoulder. “Oh, hi there, Wendy.”

    I nodded toward my car. “I have something for you, Mrs. Wilson.”

    After we did a quick exchange, I had 100 bucks and she had double that in meat.

    Ten minutes later, I was a rat-a-tat-tatting on the drug dealer’s door. Eddie opened it just a crack and glared at me with bloodshot eyes. With a taut nod of my head I handed over all my cash. In return, I got four colored balloons the size of marbles. I followed standard junkie protocol and tossed them inside my mouth. This was done as a precaution in case you got busted. Hopefully you’d have enough time to swallow the evidence before the cops could get their hands around your throat. Thankfully, I made it home that day in one piece.

    Max was still at work so I had the place to myself. Our apartment was six blocks from the beach. A tourist destination for some, but the ocean wasn’t even on my radar back then. Beauty and nature ceased to exist when I was doing drugs.

    The living room was a strange landscape of overflowing ashtrays, beer bottles, and trash from the night before. Others could accuse me of slacking on my domestic duties but who had time for dishes or dusting when you were supporting two people’s habits every day?

    After retrieving the tied red bandana in my panty drawer, I headed for the bathroom and straddled the toilet to face the wall. I laid everything out on top of the tank. Syringe, matches, a cup of water, spoon and cotton. Biting the tiny knot of the balloon I ripped it open with my teeth. I was careful not to spill any as I poured the contents into the spoon. I used the syringe to squirt water and then lit an entire book of matches, holding the flame underneath the spoon until it started to simmer. As the powder dissolved, the smell of Sulphur, burnt sugar and dope filled the air.

    I pulled the brownish liquid into the syringe, spun around and wrapped my left bicep with a belt. There was a bit of resistance before the needle popped through my calloused vein and then my blood mushroomed like a bomb going off inside the syringe. I pushed down on the plunger with my thumb and I was instantly filled with a soothing warmth as the heroin turned me inside out.

    Afterward, I dabbed the blood with toilet paper while my chin drifted down to my chest.

    All the anguish, self-hatred and regret faded into blackness. Heroin was an anti-depressant and the only thing I found to ease the constant sadness that clutched my throat.

    My life was never meant to look like that. I went to a private Catholic school, for Christ’s sake. I knew the difference between right and wrong. When I was a little kid I didn’t see myself growing up to be a junkie. What happened to the little girl who desperately wanted to make a difference in the world? Sadly, she was in a dark place where she would remain for nearly two decades before reappearing tattered and broken in the county jail.

    It was there, while lying in a cell, I realized I had been blaming others for everything that was wrong with my life. It was my mother’s fault, my father’s fault, and then, in a moment of clarity, I realized I was the one who had broken my own heart. And if that were indeed the case, only I could fix it. But how?

    I knew I’d have to be sober to find out.

    In the last 25 years I’ve learned that my mother’s absence left a huge black hole inside my heart. Everything I knew, planned, or imagined for myself changed in an instant. But I was a 7-year-old child and no one seemed to notice my despair. My sadness eventually morphed into anger and I took my anger out on the world. If I were to stay sober, I needed to forgive my mother. It didn’t happen overnight but over time. When I was finally able to let her off the hook, I was the one who was set free.

    I underwent a deep and profound transformation, but some things never change. Every once in a while I find myself craving a steak: medium rare.

    View the original article at thefix.com