Answer Addiction

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  • The Current Status of Addiction Recovery in Pennsylvania

    The pandemic continues to affect virtually every aspect of American life, and that, sadly, also includes those suffering with an addiction – including opioids.

    It’s holiday season, 2020. Undoubtedly, a different kind of festive season than normal for many Americans, but… it’s still the holidays, nonetheless.

    However, for many families, there’ll be empty places at the dinner table this year – loved ones missing not because of the dreaded and awful coronavirus pandemic that continues to tragically affect the U.S., but from fatal opioid drug overdoses, part of a national epidemic that was here long before COVID-19 ever became part of our vocabulary.

    Take a few moments out of this day to look back at the statistical data for the U.S. opioid epidemic, and you’ll see the highest peak in opioid-related fatal overdoses was during the first half of 2017 – in virtually every state across the nation. Only 3 short years ago, U.S. citizens were dying at a rate of around 130 every single day.

    It’s difficult to fully comprehend, but it happened – surely, we’d never see such death rates again (we’ll get to the dreaded “corona” shortly, which is now, more tragically, taking many more lives per day).

    Back to the opioid epidemic.

    A range of pain-killing medications, arguably misbranded by Big Pharma, were being prescribed freely across the U.S. in a practice that went on for over 20 years, leaving thousands upon thousands unknowingly dependent on powerful narcotics, and with a chronic medical condition – opioid use disorder (OUD).

    Like the layered tragedy of a Shakespeare play, just when you thought things were actually looking up (as the national rate of opioid-related deaths began to noticeably fall), along came a global accident-waiting-to-happen – the COVID-19 pandemic.

    Take a further few moments to access everyone’s favorite search engine, type in “US Covid Latest 2020,” and you’ll see the latest statistics about how badly the nation has been hit by the pandemic. Over 335,000 deaths, and still rising.

    However, the pandemic continues to affect virtually every aspect of American life, and that, sadly, also includes those suffering with an addiction – including opioids.

    In Beaver County, Pennsylvania, District Attorney David Lozier recently spoke about how his region is being affected by the virus in terms of the detrimental impact on people’s mental wellbeing, including rates of opioid use and addiction:

    “COVID has sucked the wind out of every other issue. Now this year, the [drug overdose] numbers are going up like 2016 and the first half of 2017. We’re seeing an increase in domestic violence, Childline and child abuse calls, a worsening mental health picture, and worsening drug and alcohol pictures. The people who need support services or who are in treatment… It’s all been by phone. They haven’t had the in-person contact they need.”

    So it begs the question – what exactly is the current status of addiction recovery in Pennsylvania?

    To answer this, we first need to look at how Pennsylvania stood last year (2019 seems a remarkably long time ago now, doesn’t it?) with respect to substance addiction rates and addiction treatment levels, and how the state stands now, after around half a year of severe socio-economic disruption, including mandatory lockdowns and long periods of social isolation for its residents.

    How COVID-19 Has Radically Altered Addiction Recovery

    2019:

    According to the Substance Abuse and Mental Health Services Administration (SAMHSA), in 2019, Pennsylvania rehab centers saw more than 19,000 admissions. There’s little doubt, the fight against the opioid epidemic was still being fought (a situation destined to last many years). However, many thousands of Pennsylvania residents were still becoming addicted to the prescriptions written out by their family doctor.

    According to a research study by the Perelman School of Medicine at the University of Pennsylvania, in Philadelphia, it was found that excessive, high-dose opioid prescriptions were still being routinely prescribed following common, minor day-patient surgeries – at a strength strictly advised against by the Centers for Disease Control & Prevention (CDC), for the purpose of reducing the number of opioid-related fatal overdoses.

    So how was the level of access to opioid addiction treatment at this time?

    In short – increasing. For example, under the Blue Guardian program in Lehigh County, PA, police and other first responders would notify the program when they had responded to an opioid overdose. Later, an officer and a certified recovery specialist would visit the person to follow up and discuss their treatment options.

    This hands-on approach was highly successful, as confirmed by Layne Turner, Lehigh County’s drug and alcohol administrator. She stated that, “Of the 52 individual face-to-face meetings, 34 individuals entered treatment. The lesson learned is when the face-to-face contacts are made, 65% of the time individuals enter treatment.”

    Clearly, the state of Pennsylvania was moving in the right direction when it came to accessing and providing opioid addiction treatment for opioid abusers and addicts. In fact, a rate of 65% is far, far higher than the national average for the numbers of drug addicts who make it into such treatment. In 2019, that national rate stood at a lowly 10-13%.

    When you consider that recent estimates say one-fifth of U.S. citizens who have clinical depression or an anxiety disorder will also have a substance use disorder (SUD), like OUD, you quickly understand that the very last thing the nation needed in fighting addiction was the soon-to-arrive COVID-19 pandemic, with its resulting lockdowns and isolation.

    “The concerns we have are related to the big challenges people are facing right now with COVID: isolation and uncertainty resulting in very high levels of stress.”  
    Nora Volkow, Director of the National Institute for Drug Abuse

    2020:

    The (first) year of the COVID-19 pandemic arrived, leading to the “isolation and uncertainty” and “very high levels of stress” quoted above. Fatal drug overdoses – not just from opioids, but now including cocaine and methamphetamine – are spiking alarmingly across the nation.

    Just like any other U.S. industry, the addiction treatment field has been hit hard, with many rehab centers, including those in Pennsylvania, facing financial collapse if things don’t improve soon. Many treatment centers report clients not making their scheduled treatment appointments – either the simple fear of coronavirus infection, or, worryingly, because more and more of those in recovery are experiencing overdoses and relapses.

    In an effort to meet the changing conditions, addiction treatment centers have also had to invest in new “telemedicine” technology to be able to provide services, where clients receive counseling and other treatment via their computer screens.

    Nonprofits have struggled to treat their clients. In a recent survey, 44% of members from the National Council for Behavioral Health say they will easily run out of money in the next 6 months.

    Interestingly, if you look at the 2019-related paragraphs above, you’ll see words like “admissions,” “individual face-to-face meetings,” “right direction, “access” and “contact.” All of these are being heard less and less, if at all, for many recovering addicts in 2020.

    The sad proof of this lies in the national rise in fatal drug overdoses, as described by the American Medical Association in its updated Issue Brief (October, 2020), which reports that more than 40 states have “reported increases [around 18% – nearly a fifth] in opioid-related mortality, as well as ongoing concerns for those with a mental illness or substance use disorder.”

    And, lo and behold, guess what? Yes, sadly, Pennsylvania is again one of those 40.

    Addiction Recovery = Hope

    However gloomy-sounding this article may appear at first glance, there is a distinctly positive and hopeful side.

    The sphere of addiction treatment, providing long-term, sustainable recovery for OUD sufferers and those with other SUDs, is recovering itself, and this is happening in a number of essential ways:

    • More and more of Pennsylvania’s facilities and clinics are becoming accustomed to the necessary COVID-19 protocols and regulations required in running their treatment options, from residential care, to Partial-Hospitalization Programs (PHPs), Outpatient Programs, and their own counseling sessions and group support meetings.
    • Telemedicine technology, with the addiction experts looking on, is growing, expanding and even researching its own effectiveness as a method of healthcare provision for those with SUDs and mental health issues.
    • As for the telemedicine “patient,” they are becoming more accustomed to accessing their treatment, care and support online, just like the vast numbers of those in AA and NA when virtually “attending” their own 12-Step meetings.
    • If you’re looking for Pennsylvania’s online 12-Step meetings, the links for these are provided here:
    • Finally, the use of Medically Assisted Treatment (MAT), such as the provision of methadone and other MAT drugs for opioid replacement, has had its own regulations relaxed, thus increasing its range of access to those who need it.

    Dr. Mark Fuller, the Medical Director of Addiction Medicine at the Center of Inclusion Health, part of the Allegheny Health Network in Pittsburg, PA, recently stated, “Some folks say that the opposite of addiction is connection – connecting with a therapist, or other friends in recovery, or your 12-step meeting. Those connections are a really powerful part of recovery and really a key step in helping people stay clean and sober.”

    How many of Pennsylvania’s reported 800 licensed drug abuse and addiction treatment centers, both nonprofit and for-profit, will survive 2021 remains to be seen. Without the vital professional connections these treatment centers provide, and without the social “recovery community” connections referred to by Dr. Mark Fuller in the quote above, there will clearly be fewer inspiring stories of real addiction recovery happening across the state during this year of coronavirus.

    However, for now, with the excellent strategies listed above, the vast field of addiction treatment – just like the rest of us – is starting to get to grips with the strong and undeniable challenges that lie ahead.

    View the original article at thefix.com

  • Return to Sender: What an Unsent Postcard Taught Me About Addiction

    A timely message from my much younger, unsober self.

    Summer, 2020

    The Unsent Postcard

    I have a stack of unwritten postcards, collected from my travels, purchased with the intent of sending them to those back home. In recent months, I have taken to writing out these postcards to friends and family, both to cheer them with sunny images as they shelter in, and to support the United States Postal System.

    Not long ago, I came across a card featuring a hand-colored photograph of a windmill in East Hampton, New York. To my surprise, it was not blank. Tightly scrawled sentences, in rudimentary French, it was meant for a friend in Paris.

    No postage, never mailed.

    17 Septembre, 1991

    Chère Delphine,

    Salut! I am at the beach with my mother. My God! My poor back! I am ready for a big change in my life. We must talk. I’m going to write you a real letter soon.

    Ton Amie, Maria.

    Here I was, standing at the edge of big change, poised to plunge into some grand announcement, too large for the 4” x 6” space given. These words never crossed the Atlantic. Instead, I held them now, between my fingertips, twenty-nine years later.

    What are the chances of this? I thought. Of all these blank cards, only one has writing, and not just any writing, but words that speak to my alcoholic “bottom” — the physical, mental and spiritual low-point of my young life.

    My back hasn’t bothered me for years, thank heaven. I take it for granted. I walk with ease everywhere today. Until this moment, I’d forgotten just how bad things were with my lower lumbar at age twenty-four, that hell year when I couldn’t stand up straight without sciatica shackling my ankles, seizing my spine, and clamping down hard at the cervical vertebrae. This physical agony — an exclamation point to my mental and spiritual state — had literally brought me to my knees.

    I spent weeks in bed self-medicating on whiskey sours and muscle relaxants. Somehow I’d convinced the corner pharmacist to dispense refills beyond the legal limit.

    I‘m skeptical when people make meaning from random events. It feels self-indulgent to interpret every rainbow as a reference to my personal recovery. Yet finding this card, all these years later, didn’t feel like coincidence. It felt intentionally planted to remind me of why I’d sobered up.

    It also felt like something I had to share with others.

    September, 1991

    Watching waves

    In those mellow days following Labor Day, when the water is warmer than the salt air, I was with my mother in a rented bungalow at the tip of Long Island, now emptied of humans. I was twenty-five, unemployed, and reeling from a bad break-up.

    I remember the lunch mom served on or about the day I’d written that postcard: linguine with shrimp and mussels, and flutes of rosé wine. Mom was a faithful clipper of the Wednesday food section of The New York Times. Maybe she’d sourced this seafood pasta recipe there, or maybe she’d been inspired by one of the influencers of Hamptons entertaining at the time: Martha Stewart or The Barefoot Contessa.

    However it came to be, it was a memorable meal presented with panache, from a bare-bones rental kitchen. And it was a meal where my mother enjoyed alcohol as she always did, in moderation. More often than not in my childhood home, there was an appropriate wine, served in stemware, to compliment every dish.

    My mother drank the way Jacques Pépin did on public television, and the way I always wanted to, but never could — with class. At the end of an episode of making something like, say, classic Beef Bourguignon, he would raise his glass of Cabernet Sauvignon in a toast: “Aah-pee Coo-keeeng!” and tilt it lightly to his lips.

    But that’s not the way I drank this glass of blush wine. I downed it.

    Plagued by sciatica, a still larger pain loomed; it had been moving in slowly for years, like a cold front, now dipping as an arctic depression over this lovely lunch.

    I remember craving more flutes of Zinfandel than that one bottle held, but I was checked at two because mom was watching. Two drinks were the limit if you were female, and raised right — and you cared about appearances — which we did. But I couldn’t comply.

    I found myself watching the waves from that deck all afternoon. I watched them crest and crash, one after the other, in rhythmic indifference to my pain. Then it hit me. It felt big. Big like the feeling I get reading an inspirational poem from an anthology with a daffodil or seagull on the cover. Though the feeling was big I, myself, suddenly felt small. And weirdly enough, I was okay with that.

    It was a relief. The waves kept rolling in, oblivious to my situation. It was freeing to see that my pain — sharp and ugly — couldn’t stand up to the beauty of light and dark scattering the water’s surface.

    Scared, self-involved me was no match for the folding waves. For hours I watched them flatten at the shore and return to the sea, gradually eroding the moat I’d dug around myself. Yes, my experience of this landscape could be captured in a bad sonnet in a book with a hokey cover — the kind you’d find in a hospital gift shop.

    It was neither subtle nor original, my “white light” oceanfront awakening, but it was genuine.

    The next day, a masseuse with strong hands and a soft voice got me to open up about my drinking on a massage table in Amagansett. A recovering alcoholic himself, Sean R. is much of the reason I made it to my first Alcoholics Anonymous meeting when I returned to Brooklyn that next week.

    1991–2013

    A Bridge Back to a Good Life, Then Some Slippery Turns

    As the postcard predicted, big change followed. “A.A. is a bridge back to life.” That’s true. I did cross over to a full life with marriage, kids, and a semi-detached house. But it was a life further into Brooklyn, and further from my home group, the A.A. group where I had first gotten sober and stayed that way.

    Yes, I was still not drinking, but I can’t claim I was emotionally sober. Somewhere along the way I stopped going to meetings. Lost touch with my sponsor. Quit working with other recovering alcoholics. You know where this is going. Eventually, I drank.

    It started small: communion wine on Sundays, the occasional “non-alcoholic” beer, and the argument with my dentist. He wanted to give me local anesthesia for minor dental work, but I pushed for hit after hit of nitrous oxide on top of that. I wanted to numb my brain, not just my molar.

    “The idea that somehow, someday he(she/they) will control and enjoy his (her/their) drinking is the great obsession of every abnormal drinker.” — from Alcoholics Anonymous, Chapter 3, ‘More About Alcoholism’

    I went along like this for years, skating on the edge of my sobriety, doing figure-eights on April ice, until seven years ago I found myself sitting in the sun porch of my friend Samantha’s historic, center hall colonial home.

    Our kids were playing together somewhere on the periphery. I always found my way here, to this snug room off the parlor, with floor-to-ceiling bookcases and a loveseat. I’d marked it as my space, where I could step away, sink into the cushions and watch the cardinal at the feeder.

    On this day I was thinking about my marriage. It had been a good run, but after fourteen years, two sons and a poodle, it was over. During the past months, this reality had settled over me like snowfall hitting pavement at the freezing mark, melting first, before catching hold, white landing on grey, gradually building, til nothing remained of the sidewalk below. I was scared as hell now.

    Samantha stood over me with finger sandwiches and two flutes filled with golden bubbles on a silver tray. It had been so long since I’d been to a meeting, so long since I’d said out loud to a roomful of people: “I’m an alcoholic.” So long that I had a new circle of friends that never knew I had a problem and older friends who had forgotten that I didn’t drink.

    In that moment, I forgot I didn’t drink.

    Alcohol, catching sunlight, was presented to me on a slender stem, the way it had been twenty-two years earlier at the beach.

    Why not? If ever I deserved a mimosa, it’s now.

    I took a sip.

    Holy shit, what the hell am I doing?

    I ran to the powder room and poured the rest down a sink with a swan head faucet.

    “The alcoholic, at certain times, has no effective mental defense against the first drink. Except in a few rare cases, neither he (she/they) nor any other human being can provide such a defense. His (her/their) defense must come from a Higher Power.” — from Alcoholics Anonymous, Chapter 3, “More About Alcoholism”

    It had happened —I had drunk again. I never thought I would. It had been more than two decades since my last real drunk, and I had good reason never to drink again — actually two very good reasons, their names were Leo and Liam. Sure I could rationalize the Sunday morning communion wine and the occasional hit of laughing gas — after all, I was accountable to no one for my behavior now— but when I let that bubbly pass my teeth and slide down my throat, I recognized that for what it was —a slip.

    I remember the taste of it clearly — that citrus effervescence in my mouth — and I remember my conscious decision to swallow. Like countless alcoholics before me, I had now proven what the Big Book drives home in the conclusion of Chapter 3.

    I had had “no effective mental defense against the first drink.”

    September, 2013

    The Room Above the Fish Store

    Thankfully, at the same moment, I realized my problem when I took that sip of spiked o.j. , I also remembered the solution.

    Alcoholics Anonymous had worked for me, for as long as I had shown up for myself and others. What became obvious to me with this slip was that I’d do well to return to a community of recovering alcoholics if I wanted to get sober again, and stay that way. I needed to plug back into a sober support network.

    So on the heels of my slip in late September, 2013, I climbed a staircase to a room above a fish store filled with retired seniors and flies circling overhead. I’d stepped into an A.A. Big Book meeting, already in progress. They were reading one of the personal stories from the back of the book, round-robin style. Right away I could see myself in ‘The Housewife Who Drank at Home.’ When she described herself as a ‘Jekyll-and-Hyde’ PTA mom, I lost it. That was me. Someone passed me a box of Kleenex. I will never forget that kindness.

    September, 2020

    Today

    Willpower and the passage of time are no guarantees against the first drink. I was humbled by this realization when I slipped.

    I like my life today; some days I love it. I don’t live in unreasonable fear, but I accept this fact: on any ordinary day, my alcoholic mind could observe the oven clock turn five and think: A snifter of eighteen-year-old single malt whiskey, served neat, alongside a bowl of salted cashews, would be a fine idea!

    And today I understand, right down to the jelly marrow of my bones, that this is typical alcoholic wishful thinking.

    I also recognize — and appreciate — other approaches to solving problem drinking, or at least to blunting the devastating effects of alcohol and other addictive substances and habits. Some of these solutions have developed in my lifetime, and some have been there all along.

    I have a friend who threw herself back into her childhood faith in earnest, and another who found help in Buddhist-inspired Refuge Recovery. I am happy for these friends, and for everyone who finds lasting recovery, however and whenever. And for those who have chosen the A.A. path, I am especially gratified to welcome back those like me — humbled humans who have returned to the fellowship later in life.

    On the last day of this month, I’ll have seven years back in the rooms. Once again, Alcoholics Anonymous has been a bridge back to a good life. I’ve got a sunny apartment, two sturdy teens, and an Australian lizard. The ex and I have each other’s back in the co-parenting game. I’ve got a day job where I feel purposeful, and my writing at night, which lights a votive in my soul.

    I was lucky to find my way back to A.A. at forty-seven, and lucky to turn up this picture-postcard now — this four-by-six inch card stock talisman, a reminder of who I was at twenty-five, and who I am now, twenty-nine years later — sandwiched between sunbathers on the Jersey shore and Niagara Falls at night. To me this is no coincidence: this postcard, lost then miraculously recovered, does parallel my own recovery, lost for twenty-two years, then found again in a new group, above an Italian fishmonger.

    And so, my dear friend Delphine, here is the full story, the real letter I promised you, delivered now, almost thirty years later. You are not an alcoholic, but maybe some of this makes sense. I hope so. We must talk soon.
     

     

    This piece originally appeared on Medium on September 13, 2020.

    View the original article at thefix.com

  • What Happened When I Spent Christmas Eve in a Basement with a Crazy Cat

    I didn’t exactly catch the holiday spirit, but I took a suggestion that kept me hanging on by my claws through the Next 12 Days of Christmas…

    It was Christmas Eve, 2013, and I was scooping poop from a litter box in my neighbors’ basement. Leticia and Dana had rescued a feral kitten whose new habitat extended from the hot water heater to the washer/dryer. Although it was icy outdoors and toasty within, this foster feline wasn’t buying into her rehabilitation. But I was. I was three months sober.

    Kitty was ambivalent towards humans. She darted about the boiler room, kicking up supermarket circulars that had been neatly layered for her comfort. As I shook Friskies into the bowl, she shouldered up to me, twitching her tail against my forearm, her throat vibrating under a flea collar. As I reached to pet her, she caught my wrist between her paws and bit down hard on the hand that fed her.

    I was tempted to punt the little ingrate into the sewer trap, but instead I dialed a sober friend. Darlyne listened as I droned on about what I was sure would be my worst holiday ever, the bluest Blue Christmas imaginable. After fourteen years of marriage, my husband and I had agreed to call it quits in September. Here we were now in December, Yuletide upon us, and that sparkling snow globe of a mental construct—the family Christmas—was shattering. There would be two trees this year instead of one, two piles of hastily-wrapped presents, and even two plates of sugar cookies, left for two Santas, because our younger son was only six, and very much still a believer.

    I never doubted my decision to divorce, but I had misgivings when it came to the kids. I feared the emotional fall-out from all those times when mom’s temper met dad’s radioactive passive-aggression. I saw an acid cloud of neuroses raining down upon my sons from their parents’ split, a psychic soaker that would take them years of therapy before they’d start to dry out.

    I watched two lines of red dots on my forearms swell and connect where the beast had scratched me. Then I lost it. I broke down bawling on the basement floor. After a while, Darlyne interrupted me. “Viv I get it. I do. it’s a rough time. A really rough time. And it’s good you’re letting it all out. But we’ve been on the phone thirty minutes now and I’m gonna pee my pants.”

    “Ok,” I said as I blew my nose into the deli section.

    “But listen,” Darlyne said before signing off, “I want you to do something.”

    Change or Die

    I had no idea what she was going to say, but I already knew I didn’t want to do it. The default of my defiant alcoholic mind—then and now, drinking or sober— is “NO.” But recovery, I have learned, is about change. And change often means saying “YES” instead of “NO.” It means being willing to take suggestions—often awkward, tedious or unsexy actions that force me to sit with feelings and stretch my tolerance for discomfort.

    “It’s just going to be so weird for the kids to wake up Christmas morning and not see two parents!” I wailed, ignoring my friend’s bladder. I wasn’t done catastrophizing.

    “Just listen,” Darlyne was louder now. “I want you to do something, and I promise it will help.”

    At that moment, I had a choice: take in what my friend was telling me, or tune her out. Sobriety is about making choices, and I’ve made some doozies in my fifty-five years of frolicking between a few zip codes in New York City, with or without a Bacardi and Coke in hand. And the takeaways from all my choices—good and bad—have always been there too. Only now I’m actually able to take these takeaways. Free of mind and mood-altering substances, I’m present for each new experience, and I can see my part in it. Sometimes I repeat the same mistakes, but these successive ones occur less often, and feel less calamitous. It’s getting better. And that feels good.

    But I wasn’t feeling good that morning. I was cold and panicky.

    “What is it?” I choked.

    “Make a list of ten things you’re grateful for,” said Darlyne, “and save it in your phone. Then read it back to yourself, over and over again, for the next two weeks. Got it?”

    “I got it,” I sniffled.

    “You’ll feel better. Trust me.” Then she hung up.

    I was skeptical, and I didn’t feel better yet, but I did it. I squatted on that cellar floor, my tailbone pressed against the cold cement, and I took that sober woman’s suggestion. It was one of the better moves I’ve ever made.

    …

    Ten things I’m grateful for:

    1. My sobriety
    2. My sons
    3. My family (most of the time)
    4. My soon-to-be ex (He’s a good dad after all.)
    5. All my friends (from 4th grade to the present)

    What else?

    1. My first cup of coffee in the morning
    2. A good mattress
    3. Food in my stomach
    4. The sun rising over the rooftops

    I don’t remember the tenth. So I’ll just add something now, something that could have been on that first list.

    1. Pannetone

    Yes, the fluffy bread, loaded with raisins, that you only see in supermarkets at the holidays. To go with number 6. For me, the small things on my list have come to matter too. Even when the big ticket items are absent—like the job with benefits, or the boyfriend—the small, quiet things are always there, if I look for them. Like the neighbor with the beehive in his backyard, who feeds my Poohish habit with a steady supply of golden honey nine months of the year out of twelve.

    There! I read the list in my cupped palm. Then I reread it. Well, I wasn’t jolly yet, but I was functional. Mrs. Santa Clause dried her tears in an ad for holiday ham, then stood up and got on with the business of making magic for her kids that Christmas Eve. And she muttered that merry mantra over and over for the next twelve days and arrived at the new year, clean, sober, and—to her surprise—not absolutely miserable for every second of it.

    Flash forward to 2020, amicably-divorced and effectively co-parenting, I feel far-removed from that bleak midwinter morning spent bawling in a basement with a bipolar cat. I still have days where I forget that I’m wildly blessed, days where I watch my teen on the tennis court and forget the shattered ankle, the surgery, the cast, and the flawless recovery. I still have sour days where I see only another wet towel on the bathroom floor and pistachio shells on the pillow case.

    But on these days, thankfully, I remember what will slap me back into gratitude. I know that if I just jot ten things I’ve got going for me, it’ll make me feel better. I also know that when I neglect to count my blessings, I’m more likely to cry over every glass of spilt milk or busted garbage bag.

    When my twelve-year-old quips: “Quit trying to make your own disgusting chicken fingers and just take me to McDonald’s,” I don’t collapse in tears on the linoleum anymore; instead, I rattle off my list. My sobriety is always on top, and my sons still take the number two spot (except today, the younger slides down to number eight). My good health follows, then my elderly parents and my brother, who mows their lawn and drives them to doctors’ appointments. I acknowledge my good neighbors, my shrink, my deep pre-war apartment bathtub, fat dogs with short legs, and my self-respect.

    Then I turn to Liam and say: “Put on your hoodie, we’re going to McDonald’s.”

    View the original article at thefix.com

  • Helping Your Child Through Difficult Times

    All too often when we look beyond a child’s drinking or drug use we discover their struggle to manage intolerable thoughts, feelings or memories is a core issue that needs treatment.

    I have been a mental health and addictions counselor for over two decades. I’ve treated adults and adolescents diagnosed with serious psychiatric and substance abuse issues at one of the nation’s premier psychiatric hospitals. After informing parents of their child’s substance abuse history the most frequent response I heard from them was “I had no idea this was going on.” Or if they suspected their child was using a substance, they were shocked at how extensive it was.

    Adolescent substance abuse continues to invade too many of our families, leaving parents confused and without a roadmap to guide them in finding help for their child. Today, more than 40 percent of seniors and one-third of tenth graders are vaping a substance like marijuana. Twenty percent of teens report abusing prescription drugs like Xanax, Ritalin and Adderall.

    As the parent of an addicted child, feelings of helplessness, blame and fear can drown out any sense of hope. But in the pages of my book The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse they receive the information and resources needed to help their child through assessment, treatment and recovery.

    Alcohol and drugs have the power to change a child’s brain and influence behaviors so I include a chapter on the neuroscience of substance abuse. In non-technical language parents learn how substances work in the adolescent brain.

    Because the best treatment starts with a comprehensive assessment there’s a chapter explaining which assessments are critical for a proper diagnosis. These assessments go beyond looking just at a child’s history of using substances. All too often when we look beyond a child’s drinking or drug use we discover their struggle to manage intolerable thoughts, feelings or memories is a core issue that needs treatment. While not every child using alcohol or drugs has an underlying psychological issue, for those that do, treating the alcohol or drug problem without treating the mental health issue can be a treatment plan doomed to fail.

    Other chapters in The Addicted Child address issues such as eating disorders, self-injury, gaming and cell phone use which often accompany a child’s use of substances. Parents learn the warning signs for these disorders and the warning signs that often accompany alcohol and drug use. Parents also learn which drugs are invading today’s adolescent population and how to recognize them.

    Parents often need guidance when looking for treatment options. There is no “one size fits all” treatment approach to addiction. For this reason, I have included chapters explaining the important principles of adolescent substance abuse treatment and various treatment options available for families. There is also a chapter listing helpful resources for parents.

    Very few things are more destructive to a family than having someone, especially a child, addicted to alcohol or drugs. While working on an adolescent treatment unit I met parents struggling to understand and accept their child’s psychiatric and substance use issues. For most of these families it was a heart-breaking experience. Sadly, many families do not have the financial resources to send their child to a nationally acclaimed hospital like the Menninger Clinic in Houston. Their desperate search for help often leaves them feeling alone and without a roadmap to guide them through the process of their child’s assessment and treatment. It’s for these families that I wrote my book, The Addicted Child: A Parent’s Guide to Adolescent Substance Abuse. You can find The Addicted Child on Amazon and at the following website: https://www.helptheaddictedchild.com

    View the original article at thefix.com

  • Double or Nothing: The Two Diseases That Want Me Dead

    My depression didn’t entirely cause my alcoholism, but it certainly played a key role.

    I have two diseases that want me dead.

    One is addiction, a progressive, incurable and potentially fatal disease that presents as a physical compulsion and mental obsession. I am addicted to alcohol and, as an alcoholic, can never successfully drink again.

    There is no cure, only ways of arresting the vicious cycle of binge, remorse and repeat that leads to ever-deeper bottoms. My alcoholism took me not only to unemployment but unemployability; not only selfishness but self-destruction; not only deteriorating health and heartache but abject desperation and insanity.

    My other deadly illness is depression. By this, I mean clinical depression – a necessary distinction considering the widespread, ill-informed use of the phrase “I’m depressed” to describe mere sadness. The difference is that sadness is rational while depression decidedly is not. Depression is not an emotion; it is a chemical imbalance that leads to hopelessness and self-loathing and, for that reason, is the leading cause of suicide.

    Mourning a loved one is understandable and altogether appropriate; that is sadness. Climbing to the roof of a six-story building and nearly jumping because I considered myself toxic and worthless, as I did in my mid-20s, is not normal and certainly not healthy; that is depression.

    I will be an alcoholic and depressive for as long as I am alive. But while neither is curable, both are certainly treatable. And increasingly, I’m finding that my progress in recovering from one disease is paying substantial dividends in combatting the other.

    Weller Than Well

    I took my final drink on October 10, 2011, the last in a long line of cheap beer cans littering my car. Wherever I was going, I never got there; instead, I crashed into a taxi and kept driving. Police frown upon that. I spent the night in jail and the next six months sans license. I was in trouble physically, spiritually, and now legally, and I had finally experienced enough pain to seek salvation.

    I got sober through Alcoholics Anonymous. There are several programs effective in arresting addiction; AA just happens to be the most prolific, and embodied the sort of group-centric empathy I needed during the precarious early stages of recovery. There are few things more alienating than being unable to stop doing something that you damn well know is destroying your life. Meeting consistently with others who’ve experienced this tragic uniqueness made me realize I wasn’t alone, and provided a glimmer of something that had long been extinguished: hope.

    Unlike traditional ailments, addiction is largely a “takes one to help one” disease. I needed to know that others had drank like me and gone on to recover by following certain suggestions. AA provided both the road to recovery and, through those that had walked the path before me, the trail guides. 

    It isn’t rocket science. AA and other forms of group-centric recovery thrive on a few basic tenets. I admitted I had a problem, and saw that others had solved that problem by adhering to certain instructions. I accepted that my addiction had been driven by certain personality flaws, and that active addiction had only exacerbated these shortcomings. I made concerted efforts to begin not only amending my actions through face-to-face apologies, but also diminishing the underlying character defects that had fueled my alcoholism.

    In the process, I did not recover so much as reinvent myself. Nine years into my recovery, I am not the same person I was before becoming an alcoholic. I am better than that catastrophically damaged person.

    Like no other illnesses, recovery from addiction can make sufferers weller than well. I am not 2005 Chris – pre-problem drinker Chris. I am Chris 2.0. Stronger, smarter, wiser.

    And that brings me to my other incurable illness.

    So Low I Might Get High

    My battle with depression predates my alcoholism. In fact, the aforementioned rooftop suicidal gesture came before I was a heavy drinker. Like many people with concurrent diseases that impact mental health, one malady helped lead to another. My depression didn’t entirely cause my alcoholism, but it certainly played a key role.

    For me, bouts of depression descend like a dense, befuddling fog. At its worst, I have been struck suddenly dumb, unable to complete coherent sentences or comprehend dialogue. My wife once likened my slow, confused aura to talking with an astronaut on the moon; there was a five-second delay in transmission, and my response was garbled even when it finally arrived.

    My depression is clinical, meaning it is officially diagnosed. I am medicated for it and see a psychiatrist regularly. Upon getting sober, the first cross-disease benefit was that the anti-depressants I took daily were no longer being drowned in a sea of booze. The result of this newfound “as directed” prescription regimen was the depression tamping down from chronic to episodic. For the first time in nearly a decade, there were significant stretches where I was depression-free.

    Still, come the depression did, in random waves that enveloped me out of nowhere, zapping the hopeful vibes and purposeful momentum of early recovery. The sudden shift in mood and motivation was stark, striking and scary. Above all else, I was frightened that an episode of depression would trigger a relapse of alcoholism.

    In recovery from addiction we are taught, for good reason, that sobriety is the most important thing in our lives, because we are patently unable to do anything truly worthwhile without it. If we drink or drug, the blessings of recovery will disappear, and fast.

    Ironically, and perhaps tragicomically, by far the most formidable threat to my sobriety was my depression. One of the diseases trying to kill me was persistently attempting to get its partner in crime back. Inject some hopelessness and self-loathing into a recently sober addict’s tenuous optimism and self-esteem, and there’s a good chance he’ll piss away the best shot he’s ever had at a happy, content existence.

    For months and even years into recovery, my only defense against depression episodes was intentional inactivity. Upon recognizing the syrupy sludge of depression draining my energy – a quicksand that made everything more strenuous and, mentally, seem not worth the extra effort – I would do my best to detach from as much as possible. My routine would dwindle to a questionably effective workday and, if any energy was left, what little exercise I could muster, an attempt to dislodge some depression with some natural dopamine – a stopgap measure that rarely bought more than half an hour of relief.

    Most alarmingly, during bouts of depression I would disconnect from my recovery from alcoholism, often going weeks without attending meetings or reaching out to sober companions. In depressive episodes, the hopeful messages of group-centric recovery rang hollow, and at times even felt offensive. How dare these people be joyous, grateful and free while I was miserable, bitter and stuck.

    Over an extended timeline, though, life had improved dramatically. As a direct result of sobriety and its teachings, my status as a husband and an executive improved drastically. In rapid succession I bought a house, rescued a dog and became a father. My depressive episodes grew fewer and further between.

    But when they came, I was playing a dangerous game. I now had a lot more to lose than my physical sobriety and, despite being rarer, my depressive episodes were almost more intimidating for what they represented: irrational hopelessness amid a life that, when compared to many others, was fortunate and blessed. So when depression descended, I did the only thing that seemed logical: I whittled life down to its barest minimum, and waited the disease out. I put life on pause while the blackness slowly receded to varying shades of gray and, finally, clearheaded lucidity returned.

    Essentially, I became depression’s willing hostage. I didn’t want it to derail me, and didn’t have a healthier means of dealing with it.

    And then suddenly, I did.

    Beating Back a Bully

    For the second time in my life, I have hope against an incurable disease where before there was hopelessness. And though I can’t place into precise words exactly how it happened, I’m hoping my experience can benefit others. For the countless battling mental illness while recovering from addiction, my hope is to give you hope.

    Last fall, just as I was celebrating eight years sober, I hit a wall of depression the likes of which I hadn’t encountered in a while. Like most depressive episodes, its origin was indistinct. It had indeed been a tough year – I had lost a close relative and had an unrelated health scare, among other challenges – but trying to pinpoint depression triggers is generally guesswork.

    Anyway, there it was. A big, fat funk, deeper and darker than I’d experienced in years. But for whatever reason, this time my reaction was different. Always, my routine was to place mental roadblocks in front of my depression. I justified this by telling myself, understandably, that depression’s feelings were irrational and, therefore, not worth confronting.

    This time, for whatever reason, I took a different tack. For the first time, I leaned in rather than leaning out. I stood there and felt the harsh feelings brought on by depression rather than running from them. Whether it was sober muscle memory or simple fed-upedness, I had had enough of cowering in a corner while depression pressed pause on my life.

    The result? It hurt. A lot. But if battling depression is a prize fight, I won by majority decision. And having stood up to my most menacing bully, I fear the inevitable rematch far less.

    This would not have been possible – and is not recommended – earlier in recovery. In hindsight, I’m realizing that at least part of the reason I finally confronted my depression was that, after eight years of recovery work and a vastly improved life, I had placed enough positives around me that depression’s irrational pessimism couldn’t fully penetrate them. I had built up just enough self-esteem through just enough estimable acts that the self-loathing pull of depression couldn’t drag me down as far. I stumbled and wobbled, but I did not fall.

    Depression also prompted a highly unexpected reaction: gratitude. Its wistful sadness made me pause, sigh, even tear up. It made me look around longingly and grasp the blessings that, during my typically time-impoverished existence, I often take for granted. It made me feel guilty for not fully appreciating the positives in my life… but this guilt was laced with vows to cherish life more once depression invariably lifted, as it always did. There’s a difference between hopeless shame and hopeful guilt; the former yields self-hatred, the latter self-improvement.

    In this way, the tools acquired in recovery from addiction were wielded effectively against depression. There is a retail recovery element at play here: Though not as simple as a “buy one get one free” scenario, I’ve learned that fully buying into continued recovery from alcoholism can lead to significant savings on the pain depression can cause me. I have a craziness-combating coupon, and it’s not expiring anytime soon.

    To be clear: This is by no means a “totally solved” happy ending. Confronting my depression meant facing some demons that have been stalking me for decades. You don’t slay dragons that large in one sitting. I have, however, made a promising start. I have discovered that progress against complicated chronic afflictions is indeed possible, and can sometimes flow unexpectedly from sources one wouldn’t expect.

    View the original article at thefix.com

  • No Map or Compass

    The feeling of that first sip changed me into everything I was not: confident, brave, careless, fearless and most importantly, accepted by all the people I looked up to.

    There is nothing unique about my beginnings with alcoholism. The first time I got drunk it was exactly what every other alcoholic says, something inside of me changed. At the ripe age of 13 I took my first sip of alcohol outside the parameters of my own home.

    My parents always had empties lying around when I was a kid, mostly my dad in those years, and I found it to be both dangerous and exhilarating to take the few last bottom drips for myself. This started when I was four. Even then, the rush of being defiant felt warm and cozy — a feeling that later in life would fuel my every move.

    That same feeling hit me harder than ever before when I was sitting on a garage roof with an older boy from the neighborhood. He handed me a 26 of vodka and a one-liter carton of orange juice. Vodka, orange, vodka was how I was trained to drink. Made sense to me. The feeling of that first sip changed me into everything I was not: confident, brave, careless, fearless and most importantly, accepted by all the people I looked up to.

    Everyone drank where I came from and there were never really any parents around. Even if they were around, they didn’t seem to mind that we were stealing liquor and hiding in the basement to drink it or that they were the ones supplying it for us.

    My parents were not this way. My dad was an alcoholic drug addict and my mom was the same except she was a sober dry-drunk who eventually became an addiction counselor. So, I made sure to stay away from there as much as possible. This is how I ended up on that garage roof, eager to fit in and be like everyone else.

    I was not like everyone else. These nights became more frequent and the invites got more regular. The older boys loved getting me and my best friend as drunk as possible and seeing what they could make us do. There wasn’t much we wouldn’t do and there wasn’t much we wouldn’t drink. I had a knack for it. I could drink whatever was given to me and drink twice as much as I was expected to hold. The drunker I got, the better I felt — a dangerous cycle that my grandma, a recovered alcoholic, always warned me about. As a matter of fact, all my family warned me about the addiction gene we had but I always thought I was better than that. I would never end up a drunk.

    I kept this attitude for the next 13 years of my life. I had sobered up a few times, or tried to at least, but I always ended up coming back to the warm bath of alcohol and sinking right in.

    I started playing in bands in basements and garages when I was 16. We would play shows at community centers around Saskatoon and we would spend hours jamming, smoking weed and sipping Jägermeister. This is what all the greats did, so why would we do it any different? As I became bar age (or old enough to pass for bar age), I wanted to start playing shows to an older, more sophisticated crowd. The bar owners loved a guy that would play for free; as long as people were there drinking they didn’t mind.

    I remember the first time I got offered an “exposure” show to open for a touring band on a Thursday night on Broadway in Saskatoon. The offer was one set, 20 minutes, 50% off food and drink tickets. Drink Tickets! They were really going to pay me with booze! I had never heard of such an amazingly lavish thing. My band and I, 18 years old, playing on Broadway and being fed alcohol by the establishment. I truly felt like I was making it right then and there.

    But as all good things do, the band came to an end when my partner and I decided to pack up and move to my hometown of Calgary, Alberta. She got accepted to a school there and I could pursue my music dreams in a much bigger market.

    When I returned home all of my old drinking buddies were there right where I left them and our first night in Calgary was spent in a blackout at a karaoke bar in the same neighborhood I grew up in. It felt so good to be home. Things were not easy out in Calgary, though. I had more on my plate at 22 than anyone else I knew. I spent my days giving all of my time to others and by the time evening hit I just needed a beer. A beer would usually turn into a few more, followed by a few shots, some weed, more beers until the bar was closed and I ended up at someone’s house drinking until the booze ran out or I passed out, whichever came first.

    For a few years this was an everyday occurrence: a perpetual cycle of hangovers and morning bongs rips to get me through until it was time for a drink. The worst part is I was happy with this. Sure, I would get a little too rowdy sometimes and get into a fight with a stranger. And I mean, sure, on occasion I would end up needing to be removed by the police from the place I was at. And, okay, I once in a while got a little too drunk and liked to beat up my friends. Isn’t that what everyone did?

    2015 was the worst year of my life. My grandmother, after many years of battling heart and liver problems, passed away on April 30th. She was my rock, the only safe place I knew. Before she passed, she told me that I needed to stop drinking. She told me that the way I drank worried her and she wanted me to have a good life. She sobered up for me so I figured I could do the same for her.

    I could not. My drunks became sad, tear-filled nights that I barely remember. I don’t remember much from that year at all. November 14, 2015 is when my drinking took a hard turn for the worse. I was playing a show the night before at a bar in Calgary. Before I went on I called my dad which was a ritual we had established since I left the family acreage back in Saskatoon and he and mom split. He didn’t answer which I didn’t find to be that unusual and I figured he would call me back when he saw the missed call.

    My dad in a drunken state of desperation and sadness ended his life that night alone in our family home. I could not handle the pain of losing the two of them in the same year. It was like I was walking through the woods with no map or compass. I quit working to stay home and drink and my drunks were angry and violent. I would lash out one moment and the next be pouring shots for me and all my friends.

    The next few years are really all a big blur that I can’t seem to figure out. I was suppressing every emotion that would come up and hiding behind an image I had created with my music. No one knew what was going on inside of me unless I was in a manic, drunken state. I seemed to find a new rock bottom every few months but never seemed to hit my head hard enough.

    I am happy to say that as I write this down I have successfully stayed sober for two years’ worth of one day at a times, I have two beautiful daughters that I am actually able to be there for, and my partner and I have a stronger relationship than ever before. Life has not gotten easier since I put down the bottle, but it has gotten a whole lot better.
     

    Forrest Eaglespeaker’s band, The North Sound, has just released their second full-length roots-rock album, As The Stars Explode. The album is an autobiography written from places of pain, realization, and healing. It weaves together themes of addiction and sobriety, mental health, and intergenerational trauma. Some of the songs were written while Eaglespeaker was in the chaos of active alcohol addiction (such as “My Happiness”), some in the more grounded and “new” life of sobriety. “Better Days” was the first song Forrest wrote in sobriety and was released as a single during the beginning of the COVID-19 pandemic.

    Listen on Spotify. Watch the video for Heavy Heart.

    View the original article at thefix.com

  • A Temporary Suicide

    How do you square that madness of loving what alcohol does to you for a few hours while suspecting that it’s killing you?

    “Men intoxicated are sometimes stunned into sobriety.”
    – Lord Mansfield (1769)

    Today marks five years since I had my last drink. Or maybe yesterday marks that anniversary; I’m not sure. It was that kind of last drink. The kind of last drink that ends with the memory of concrete coming up to meet your head like a pillow, of red and blue lights reflected off the early morning pavement on the bridge near your house, the only sound cricket buzz in the dewy August hours before dawn. The kind of last drink that isn’t necessarily so different from the drink before it, but made only truly exemplary by the fact that there was never a drink after it (at least so far, God willing). My sobriety – as a choice, an identity, a life-raft – is something that those closest to me are aware of, and certainly any reader of my essays will note references to having quit drinking, especially if they’re similarly afflicted and are able to discern the liquor-soaked bread-crumbs that I sprinkle throughout my prose. But I’ve consciously avoided personalizing sobriety too much, out of fear of being a recovery writer, or of having to speak on behalf of a shockingly misunderstood group of people (there is cowardice in that position). Mostly, however, my relative silence is because we tribe of reformed dipsomaniacs are a superstitious lot, and if anything, that’s what keeps me from emphatically declaring my sobriety as such.

    There are, for sure, certain concerns about propriety that have a tendency to gag these kinds of confessions – I’ve pissed in enough alleyways in three continents that you’d think the having done it would embarrass me more than the declaring of it, but here we are. There’s also, and this took some time to evolve, issues of humility. When I put together strings of sober time in the past, and over a decade and a half I tried to quit drinking thirteen times, with the longest tenure a mere five months, I was loudly and performatively on the wagon. In my experience that’s the sort of sobriety that serves the role of being antechamber to relapse, a pantomime of recovery posited around the sexy question of “Will he or won’t he drink again?” I remember sitting in bars during this time period – I still sat the bar drinking Diet Coke during that stretch – and having the bartender scatter half-empty scotch tumblers filled with iced tea around the bar so that when friends arrive, they’d think I’d started drinking again. Get it?! So, this time around I wanted to avoid the practical jokes, since in the back of my mind I’d already decided that the next visit to the bar wouldn’t necessarily have ice tea in those glasses. Which is only tangentially related to my code of relative silence for the last half-decade – I was scared that the declaration would negate itself, and I’d find myself passed out on my back on that sidewalk again. So, at the risk of challenging those forces that control that wheel of fate, let me introduce myself – my name is Ed and I’m an alcoholic.

    Here’s the thing though: for many addiction specialists, five years marks long-term recovery. Very few who try get here, and not everyone who does stays here, but by some strange combination of luck, contemplation, and white knuckles I’ve strung together one day after another and if not exactly proud (well, a little) I’m more than anything amazed. Because had you asked me even a weekend before my last drink, when I purchased an old-fashioned cocktail shaker for myself as a gift marking the start of a new semester, if I could have conceived of a month without drinking, much less five years, it would have been unimaginable. During a previous attempt to dry out I contemplated the idea of having a designated wet weekend each month when I’d lock myself away without computer or cell phone and get shit-faced black out drunk because the idea of a life without alcohol seemed so impossible, and now I’m the sort of person who wakes up every day at dawn (and not on the sidewalk this time). I can count the days before my sober anniversary each year like part of the liturgical calendar, often made possible by social media’s annoying tic of reminding you of every bad decision you’ve ever committed, so that I can chart the last time I drank with this or that drinking buddy, the last time I went to the bar after work, the last time I drank on the patio of my apartment complex. What always strikes me is how that morning of the last drink, when I got up, I was looking forward, as I always did, to go to the bar. My quitting, thank God, was never planned. Had it been I doubt it would have taken.

    If you detect a hint of nostalgia like the tannins in a glass of chianti, you’re not amiss. They call it euphoric recall, the way a brain the consistency of Swiss cheese can edit out all of the bad things, the embarrassments, the traumas, the pain, but only remember the conviviality, the solidarity, the ecstasy. The way in which you recall the electric hum in the skull when sitting like a god with your broken shoes on the brass rail, staring at a neon sign and feeling infinite; but not the pile of vomit on your chest, surprised that you haven’t choked to death. The memory of all of the friends you made at dives around the world, but not that nothing either of you said was worth remembering. The feeling of instant, almost supernatural, relief the moment a lager, a shiraz, a scotch hits your tongue, but not the shaking hand that brought the glass to your lips. The sense that accompanies drunkenness which holds that within the next fifteen minutes the most amazing things were going to happen, that limitless potential always was about to occur, but not that it never did. Sobriety becomes possible when you begin to remember the bad that outweighed the good – when you continually force yourself to understand that.

    Now some people may wonder why you don’t just avoid all of that stuff, why you can’t just moderate. As the dark joke goes, if I could moderate my drinking, I’d get drunk every day. I used to make a big deal about how angry I was that I couldn’t just have a drink or two, that there was such privilege in being able to wax poetic about the vagaries of hopiness levels in India Pale Ales without publicly shitting yourself, of being able to savor the peatiness in a single malt Laphroaig without stumbling back home unremembered to yourself and the world, but I never really wanted those things. Anger was performative for the counterfeit stints in sobriety, when the real thing happens and you know it’s dryness or death, then different emotions emerge. And the truth is that because I have no interest in drinking that way, in moderation, I begrudge nobody who wants to do it, who can do it. I suspect that moderate drinkers have never concocted baroque rules of order around drinking based in how much of which thing you can drink in what location for what amount of time (which you still break anyhow). I suspect that moderate drinkers never fear that the moment alcohol hits their lips that they’re ceding part of their sovereignty, not the part of their soul which keeps them from stumbling out into traffic so much as the part of their soul that cares. I suspect that moderate drinkers always know for sure that, barring the regular kind of calamity, they’re certain to come home safely at the end of the evening (probably before the nightly news).

    I’m not angry – at all – over the existence of the moderate drinker. What I am is confused. I don’t understand that aspect of them, I can’t grasp their reality. Once you started drinking how could you not want to keep doing it? How could you not pursue oblivion or extinction unto joy, or at least the pretending of it? For me, the thought of half a pint is anathema, the idea of not sucking the ice cubes clean of whisky is confusing. This is not to say that I was completely incapable of putting the glass down, of leaving the bar at four in the afternoon and being able to twitchily abstain until dinner drinks. This is not to say that responsibility, or duty, or love couldn’t compel me to stave off a binge, nor is it to say that all drinks (or, honestly, even most) would result in a mad spree of boozing. You don’t necessarily pour the bottle down your throat every time. What it says is that once the cork comes out, there’s always a sense of being not-quite-right unless you’re chasing your chaser with a chaser, playing the drinking game of taking a shot for every time you take a shot. You can force yourself to not take that next drink (except of course for those times when you can’t), but you’re forever itchy, at least until the djinn is out of your system.

    There has always been a sense, as I think Carl Jung (or somebody similarly evocative) put it, that alcoholism is a physical solution to a spiritual problem. While I’m loathe to romance the affliction that much, for it simply exonerates too many assholes, I doubt that anyone who is an addict doesn’t at least share in some sense of incompleteness, that liquor plugs a hole in the spirit which of course comes rushing out all over the floor. For most people, I’ve heard, alcohol is something that accompanies food, or celebration, or unwinding, that occasionally there’s a bit of giddiness at having imbibed a bit too much – that some of these folks even have stories about that time, or even a dozen, when they had a bit too much in college, or at a birthday party, or a wedding. Alcoholics have a different relationship to liquor, an understanding of why spirits are called such. “I had found the elixir of life,” Alcoholics Anonymous founder Bill W. wrote in recounting the first time he got high from some Bronx Cocktails served at a party in 1916. Later, in the “Big Book,” which constitutes the scripture of AA, he writes that “Gradually things got worse.” Same as it ever was.

    Every drunk is in an abusive relationship with this thing they think they love, and which they dangerously hope loves them back. A lot of fantasizing, mythologizing, and philosophizing can surround justifications of drunkenness (or then again, not); a lot of denial, and the assumption that you have any agency in this thing tend to be even more universal to the disease. But the result is all the same. I’ve heard a lot of people in recovery say that they hated drinking, but that was never exactly my experience. I hated what it resulted in, the ruined friendships, the uncertainty, the physical ailments, the strange fear at 25 that 30 might not come, the knowledge at 30 that 35 definitely won’t. But here’s what I loved – the fraternity of talking, talking, talking (even if it’s nonsense), the courage to belt out the lyrics to “Thunder Road” at inopportune moments, feeling the almost mystical materiality of the bar’s surface (every warp and swirl imbued with infinity), the sense of adventure and limitlessness, even while doing nothing. Here’s what I hated – shaking, shaking, shaking (never nonsense), being surprised that you’ve woken up again, laying hungover in bed and pretending to be a corpse, the delirium tremens for when you try and dry up a bit and you see those flickers of blackness in the corner of your eye, checking your shoes for evidence of what route took you home, checking your email outbox to make sure you didn’t send the wrong message to the wrong person (or the wrong message to the right one), the shame at having gone out for one or two and having imbibed twenty. The dangerous situations, the emergency rooms, the police. How do you square that madness of loving what it does to you for a few hours while suspecting that it’s killing you? I’ll have another round. The best description I know comes from my fellow Pittsburgher Brian Broome in an essay from The Root: “I miss getting drunk, but I don’t miss being a drunk.”

    I’ve put that into my arsenal of magic incantations which I carry around in my skull and as of yet have prevented me from picking up a drink in 1,827 days: “Play the tape forward,” “I’m sick and tired of being sick and tired,” “If drinking caused you problems then you have a drinking problem,” “A pickle can never become a cucumber,” “One drink is too many because all of them is never enough,” “Lord grant me the serenity…” If recovery is built out of anything, then it’s built with the bricks of cliché and the mortar of triteness. That’s not a bug, it’s the feature, and it’s why it works. I’m obviously not the first person to notice this; David Foster Wallace says as much in Infinite Jest when he observes that the “vapider the AA cliché, the sharper the canniness of the real truth it covers.” Recovery slogans are like axioms from some ancient wisdom gospel, they’re a jingle-jangly hard-boiled poetry written in a noir vernacular, and as dumb as some of them are the knowledge that “Nobody wakes up wishing that they’d drunk more” has miraculously kept me from picking up that first bottle.

    When I drank, and had that resentment of recovery language that only an alcoholic with a bit too much self-knowledge can have; those sayings seemed like the bars of a cage to me. Now I know that they’re the ribs in the belly of a life-boat. That’s not to say that I’m endorsing any program of recovery, or admitting to being in any myself, other than acknowledging that I’ve read wide and long on the subject, and I try to approach it with some humility, take what works for me and leave the rest. What I’ve found is that intentionality is crucial, for it’s the cavalier, the laid-back, the lackadaisical that caused me such grief. Again, I tried to “quit” thirteen times before it seemed to stick a little; I tried to moderate almost every time I drank (except when I didn’t try). There is a tendency towards amnesia, a valorization of the good times, and the bracketing out of the awfulness was a wet brain’s survival strategy. Everything was an exception, an extenuating circumstance, an anomaly. The obviousness that drinking was at the core of virtually every awful, dangerous, or depressing thing in my life since I started drinking at the age of 17 was easily overlooked in favor of the idea of a beer (beers) at a ballgame or a shot (shots) after last call.

    Because the idea of choice is so complicated in alcoholism, I’ve long interrogated at what point the desire to drink became a compulsion. In every evening there is the drink that saturates you, the hinge point when you’re already strategizing which bar you’ll grab another six pack from on your perambulation home from the first bar (the third one, maybe), but I wonder if there is one cosmic drink in life that shifts you from the weekend warrior into the sort of person that people wouldn’t be surprised to hear had choked to death on their own puke. Was it the first Bloody Mary that I had after that time an ex-girlfriend passed out face down on a Pittsburgh sidewalk, a crowd of our best friends whom we’d met for the first time just that night standing around a half-remembered house somewhere in Shadyside, an ambulance spiriting us both through the summer night? Perhaps it was the Yuengling I had a few days after I nearly broke my ankle on a slick of Pennsylvania ice, forced to walk on crutches for two weeks because I chose to protect the six pack that I was walking home with rather than bracing my own fall. Or maybe it was that Guinness that I drank in about a minute in a Greenwich Village pub, after nearly five months of sobriety, convinced that I was all better, even though that summer a liver sonogram had indicated that there were fatty deposits surrounding that beleaguered organ like a ring of gristle around a raw steak. You’d think that the indignity of sitting in that waiting room, in the presence of joyful expectant mothers and framed pictures of new born infants on the office wall, to learn that my dangerously high liver enzyme levels were a sign of exactly what my doctor was worried about, would have staved the need to drink. And it did, for a bit, for around twenty weeks, until a New York bar convinced me otherwise. I drank for three more years after that.

     Poet Denise Duhamel writes about the sort of spirit that animates that madness in her appropriately named lyric “The Bottom.” She recounts a drunken late-night stumble to a liquor store for (another) handle of Smirnoff, when two men in a truck try and abduct her off the street. The narrator is able to dodge the men, running up the hill (and away from El Prado Spirits), suffering at worst some trash thrown at her and screamed obscenities. When she makes it to the store, the clerk at the counter asks if she is alright, and the narrator lies, since the possibility of having to file a police report will only stall the entrance of ethanol into her blood stream. “I stopped drinking,” Duhamel writes, “when I realized I was fighting/for the vodka at the bottom of the hill/more than I was fighting against the terrible/things that could have happened to me.”

    That’s the most succinct and truthful encapsulation of the disease which I’ve ever read. There is finally that very unsweet spot of fearing that you can’t live without alcohol while also knowing that it will eventually kill you. Sobriety is the strange inverse of drunkenness, and as every person in recovery is haunted by the ever-present threat of relapse, so I remember that while an active drunk I always wondered what was going to be the drink that finally brought it all to a close (in any sense of that phrasing). My last summer of active drinking certainly felt more extreme to me – I’d seen my father die of cancer only a few months before I quit, I was mired into the sort of depression that doesn’t even allow its own philosophizing (or indeed recognizes its own face in the mirror, mistaking falling for flying) and even the general mood of the country seemed to shift towards something darker (that same something that we’re all still in). In that apocalyptic summer of receipts found in my pockets from bars that I didn’t remember having gone to, and of scraps and scabs from falls barely considered, there was a sense of rushing towards something – and so I was. As Duhamel writes, “I stopped drinking even before I had that last sip, /as I ran back up the hill squeezing a bottle by its neck.”

    Rock bottoms are a personal thing, but the stories, in an archetypal way, are strangely similar. That’s one of the things you learn to appreciate in recovery; a respect for narrative’s elemental basicness. In various Midtown church basements I’ve heard stories of last drinks that were precipitated by things as dramatic as manslaughter and DUIs, to one Upper East Side socialite who admitted that she had to quit after she forgot to feed her beloved Yorkshire Terrier (I understand this, innately). The nadir of your drinking is, as they say, when you quit digging, and there’s a final freedom in that defeat. What distinguished that final drink, the one that I can’t remember (it was either a G&T or a beer, based on that summer)? Certainly, it was the consequences, the being shepherded to the hospital. But worse things had happened to me. When I called a friend to pick me up at the ER an hour or so before dawn, I can still remember keying into my building and thinking about what a great bar story this would make for all of my drinking buddies next time we went out.

    The morning was like a thousand other ones; my mouth dry and my head pounding, I would lay in bed and cinematically pretend to be dead, mildly surprised to still be alive. I was in the early stages of dating a woman who would become my wife, and I knew that continuing in this way would kill the relationship; I had been languishing for the better part of a decade in a doctoral program, and I knew that continuing in this way would kill my career; I had been harboring moleskin fantasies of being a writer, and I knew that continuing in this way would keep those dreams forever embryonic. Because the drinking itself was worse than normal, I called a friend of mine from back home who was never one for knocking them back, and I recounted the usual litany. How my intestines were embroiled and my hands shaky; my memory incomplete, and my guilt unthinkable. Of how I was greeted every hungover morning by “The Fear,” that omnipresent specter of shame, fear, and uncertainty. This friend (he knows who he is) was used to these phone calls, having fielded dozens of them over the decades, and he was always uniformly supportive and sweet, listening with concern and seemingly devoid of judgment. On this day he said something that if he’d mentioned it before, had never stuck – “You know, you never actually have to feel this way again.”

    I’m not big on Road to Damascus moments, but that simple observation clarified, explained, and encompassed everything. I haven’t had a drink since. When you’re an active alcoholic, you always expect that something great is going to happen in the next 15 minutes, but that that moment is forever deferred. It’s also true that sobriety delivers what drunkenness promises. There are things bigger than me, more important than me. My relationship with my wife (who has made this possible); now my relationship to my son. Sobriety isn’t always easy, but it’s always simple. My life is such that I could have scarcely imagined it that shaky day in 2015. My life isn’t just different because of sobriety – it’s possible because of it. There are certain conventions to this form, what people in recovery sometimes lovingly (or not so lovingly) call the drunkalogue. It’s a venerable genre, the redemption narrative, the recounting of how it was, what happened, and how you changed. Your experience, strength, and hope, etc. The didacticism is precisely the point, but the broad interchangeability of the form is also crucial. Because in all the ways that I’m different, I share something with all of these other people, with the people who got clean, but crucially also with the ones who didn’t. It’s that ultimately this beast inside you is so thirsty, that soon it’ll devour you as well. For those of you reading – the drunks, the junkies, the addicts, the alcoholics, the dipsos, the losers, the hopeless cases; to the ones who can’t quite remember coming home or who need an eye opener, to the ones who’ve alienated everyone they know and most of the people that they don’t, to the ones the ones who scarcely know a sober night, to the ones who need a drink to turn the volume down and are scared of putting the glass on the counter forever – I understand you. What you need to know is that you never need to feel that way again. Be well.

    View the original article at thefix.com

  • The Stigma of Addiction

    Repeated addiction treatment is prevalent because rehabs do not adequately address each patient’s medical and emotional needs.

    Stigma creates harmful misconceptions surrounding people suffering with substance use disorder. A term that in the dictionary is defined as “a mark of disgrace or infamy,” one that has detrimental consequences to those struggling with harmful substance use or mental health issues. Although substance misuse often causes erratic behavior and impaired judgment, research shows that most of these adverse effects stem from chemical changes to the brain. Yet, those suffering from addiction continue to be stigmatized by society.

    Understandably, stigma causes embarrassment and shame among those suffering from addiction. The combination of personal shame and public stigma is considered one of the primary barriers to effective prevention and addiction treatment. This fear and shame prevent too many individuals from getting the help they need.

    Studies show that only one in ten Americans suffering from substance use disorder receives professional care for addiction. Furthermore, society’s stigma, negative attitude, and perceptions towards addiction keep people under-diagnosed and under-treated. Also, research and treatment programs are under-funded, especially compared to other primary health conditions currently affecting our nation. While substance abuse continues to be one of our nation’s most prominent public health issues, there is a lack of effective treatment and mental health resources.

    Substance Use Disorder is a Treatable Condition

    Sadly enough, most people see addiction as a moral or criminal issue rather than a health one, despite scientific findings establishing the condition as physiological. Understanding the physical effects of addiction remains mostly misunderstood and widely marginalized by mainstream medical professionals. Consequently, our country continues to suffer from the devastating effects of the deadly opioid crisis. We continue to pay the high price for years of neglecting the effective and adequate healthcare resources required to confront highly stigmatized addiction issues.

    Time for Change

    It is time we stop seeing and treating those suffering from addiction as immoral or dangerous. No one wants to feel lesser than, especially those struggling emotionally. Drug and alcohol abuse have only increased over the last decade, and overdose rates have skyrocketed. Individuals often lose their family, friends, and careers. They continue to use drugs despite the physical and emotional consequences. Sadly, many end up losing their life to an overdose. However, this condition is not only preventable in many cases, but also treatable.

    Stigma in Healthcare

    The addiction and mental health crisis continues to worsen without much change in the healthcare system. It takes a great deal of courage to ask for help and admit there’s a problem. It is our job as healthcare providers to respond with compassion and understanding. It is all too common for a patient admitting their substance use problem to be met with criticism and even let go by the provider due to being considered a risk. This type of medical rejection often leaves patients feeling hopeless and without the courage to seek further resources or support.

    Emergency Rooms and Drug Addiction

    Hospital emergency rooms receive an influx of patients suffering from opioid withdrawal. ER staff are often busy, overworked, and have to operate with limited resources, especially now during COVID-19. These facts, along with a lack of education about drug addiction, often leads to them dismissing patients –who desperately need immediate medical help–as ‘drug-seeking.’ Rather than turning their backs on patients, ER should have specialized staff to direct these patients into medically assisted detoxification, followed by providing mental healthcare resources. Instead, addicted people go back to the streets and continue using drugs. 

    Sadly, this fault in our healthcare system perpetuates the cycle of addiction. Each time a healthcare worker misses the chance to provide the appropriate level of care, a life may be lost.

    The Need for Change in Addiction Treatment

    Rehab centers across the nation are overcrowded because there is not enough access to addiction treatment, let alone adequate care. Repeated treatment is also prevalent because rehabs do not adequately address each patient’s medical and emotional needs. Consequently, the real issues that led to addiction go untreated, and immediate relapse is inevitable. 

    To ensure those suffering from addiction or mental health conditions receive the help they need, we must fix the broken system. We need to educate the public about how different substances can affect the sympathetic nervous system and how most people affected by substance use do not have enough control over their actions and behavior.

    All levels of healthcare professionals must receive training on the intersection of drug abuse and mental health, as well as how to provide adequate care for those patients. Then they can begin the healing process by treating patients compassionately and with the right level of care.

    The Benefits of Medically Assisted Detox

    There are many types of drug treatment centers, but medically assisted detox should be available as the standard of care. Medically assisted detox is the most effective way to help a person withdraw from opioids safely and comfortably. The chance of completing detox is almost certain, yet the healthcare system does not recognize this treatment.

    As it is now, only those who have the resources to seek private treatment can receive this level of care. There is no reason why everyone in need should not receive the best form of treatment for opioid withdrawal.

    Knowledge and understanding breeds empathy, an excellent tool against stigma. The sooner we educate the public, the more lives will be saved. We must change public views on substance abuse and treatment so that this crisis ends.

    View the original article at thefix.com

  • The Role of Trauma in Treating Addiction

    People who have suffered trauma often need to address its lasting effects before they can get a handle on their substance use.

    The word trauma is used today more than it ever was ten years ago. While some people might feel like the word is overused, many mental health professionals would say that we’ve just become better at recognizing the lasting impact that events — from losses to abuse — can have on our psyches.

    Many people with substance use disorder have trauma in their backgrounds. Trauma causes residual lasting mental pain. If you don’t address the trauma, you might find yourself self-medicating to escape the mental pain. Although that might work for a moment, using drugs or alcohol to cover your mental pain will just cause more difficulties in the long run. That’s why it’s so important to find a treatment center that understands the interplay of trauma and addiction.

    Understanding Trauma

    The American Psychological Association (APA) defines trauma as an emotional response to a terrible event. What constitutes a terrible event varies from person-to-person. An event that is traumatic for one individual might not cause trauma for other people, even if they experience the very same event. Anything from abuse to a natural disaster to an accident can cause trauma.

    It’s normal to experience some psychological distress after a major event. Consider the stress that we all experienced early on during the pandemic. But, for most people, the stress gets better with time. If you find that your stress continues to interfere with your life, you might have trauma. Symptoms of trauma can include flashbacks, headaches and nausea.

    Sometimes, trauma can evolve into post-traumatic stress disorder (PTSD). PTSD is characterized by lasting effects of trauma that impacts life. People with PTSD might have flashbacks or nightmares; they might avoid certain situations that remind them of the traumatic event.

    The Connection Between Trauma and Addiction

    There’s a close connection between trauma and addiction. A 2019 study compared people who were getting treatment for opioid abuse disorder with healthy individuals. It found that the people in treatment reported more severe traumas and more instances of trauma in their lives. The study found that the more trauma people experienced, the more likely they were to experience addiction.

    The connection can be particularly strong for people who experience trauma as teens or children. Among teens who needed addiction treatment, 70% reported trauma in their backgrounds. In addition, 59% of teens with PTSD go on to develop a substance abuse problem.

    Research like the ACEs study — which looked at adverse childhood experiences — have solidified the connection between trauma and addiction. Even seemingly minor ACEs, like growing up with divorced parents, can increase the risk for substance use disorder later in life.

    Treatment for Trauma

    If you have experienced trauma or ACEs, and particularly if you believe you may have PTSD, you need to access a recovery center that is trauma-informed. Trauma-informed treatment centers have knowledge about the ways that trauma impacts the brain. They are able to help you address your substance abuse disorder, while also helping to control your trauma.

    Of course, it is also a great idea to get specific treatment to help you overcome PTSD, if you are experiencing that condition. EMDR — Eye Movement Desensitization and Reprocessing — is a type of therapy that is particularly effective for treating PTSD. During EMDR, you recall your traumatic event while doing to back-and-forth eye movements. Scientists don’t understand exactly why this is so effective at reprocessing the traumatic event, but research shows that people make huge improvements in just a few sessions.

    The Takeaway

    Trauma is extremely common: up to 70% of American adults have experienced a traumatic event in their lives. Some people recover on their own, while the trauma lingers for others. Too often, people use drugs or alcohol to try to numb or escape the trauma.

    Oftentimes, people need help to overcome trauma in their lives. Finding and utilizing a treatment center that has a trauma-informed approach to treating substance use disorder can help you understand the role that trauma plays in your addiction. Then, by addressing the underlying cause of your addiction, you’re better able to stay sober long-term.

    Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

    View the original article at thefix.com

  • Understanding Dependence Versus Addiction

    Opioid dependence and opioid addiction are closely related, but two distinct conditions.

    Opioids are powerful substances, whether they’re being used in a medically-sanctioned way or abused. Any opioid is likely to have an impact on your health and wellness, but how that plays out will vary greatly. Most people who use opioids regularly will experience some level of physical dependence, and others will develop opioid addiction.

    Understanding the difference between physical dependence and opioid addiction can help you find the treatment that you need.

    What is opioid dependence?

    To understand physical dependence, you need to understand a bit about how opioids work in the body. Opioids attach to opioid receptors. Normally, these receptors can be used to send pain signals; having opioids bound to them prevents pain signals from being sent. That’s why opioids are commonly prescribed for pain.

    However, over time your brain adjusts to the opioids that you’re taking — even if you’re following doctor’s orders. You might need more opioids to experience the same pain relief.

    The brain changes that happen as a result of taking opioids can lead to opioid dependence. The Centers for Disease Control and Prevention defines dependence as experiencing withdrawal symptoms when you stop taking an opioid medication or using illicit opioids. Symptoms of opioid withdrawal can include anxiety, nausea, diarrhea and sweating.

    Over time, if you continue to take opioids — whether prescribed or illicit — you’ll likely need more and more opioids to feel normal and avoid the symptoms of withdrawal. This is because your opioid tolerance has increased. That can lead to addictive behaviors.

    What is opioid addiction?

    Opioid dependence is a physical condition brought about by brain changes, whereas opioid addiction is a condition that can happen as your physical dependence becomes more acute, according to Waismann Method® Opioid Treatment Specialists.

    Addiction to opioids is a pattern of physical and emotional responses that stem from your physical dependence on opioids. As you try to avoid withdrawal symptoms, your behaviors can change. This can have a devastating impact on your life and impact your career, friendships and family relationships.

    People who are experiencing opioid addiction can display uncharacteristic behaviors, like:

    • Ignoring responsibilities to family or work because you are focused on obtaining opioids.
    • Having trouble controlling your emotions or behaviors.
    • Fixating on how and when you will next be able to obtain opioids.

    With time, these symptoms of addiction can erode the bedrock of your life.

    Treatment for opioid dependence and addiction

    Whether you are struggling with opioid dependence or full-blown opioid addiction, the first step toward treatment is detoxing from opioids. Detox is the process of removing opioids from your body, so that you no longer need opioids to function at a normal level.

    Detox can be painful, because it brings about the symptoms of withdrawal. However, there is a medical detox option that provides the highest level of comfort available. Rapid detox allows your body to be flushed of opioids while you are under anesthesia in a fully-accredited hospital. Because you’re sedated, you don’t feel the acute symptoms of withdrawal. Using a combination of medications, detox can happen much more quickly than it would under normal circumstances if you tried to detox on your own.

    Addressing physical dependence is only one step toward recovering from opioid addiction. After you have detoxed from opioids, you can address the pain — whether physical or emotional — that drove you to use opioids in the first place.

    At Waismann Method®, people who undergo detox receive continued care at Domus Retreat, where they can make a plan for an individualized approach to life in recovery. There are no set schedules or required meetings, but there is space to rejuvenate and recover, and guidance toward the next steps that are right for you.

    A dignified approach to treating opioid dependence and addiction

    Waismann Method® understands that opioid addiction is rooted in the physical brain changes that take place when opioids enter your body. Furthermore, addiction often results from using drugs to cope with underlying physical, emotional or mental health issues. There is no shame or blame in treating opioid addiction — just an understanding that no matter your past, you can have a new opioid-free beginning.

    View the original article at thefix.com