Tag: Tessa Torgeson

  • Finding Recovery and Support for Opioid Addiction on Social Media

    Finding Recovery and Support for Opioid Addiction on Social Media

    The rules state: We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.

    Four years ago, Dorothy had no support for her opioid addiction. As a mother and stepmother, she was afraid to be open about her struggle; if her children’s father or stepchildren’s mother found out, they might question her ability to be a good parent. She thought about attending recovery meetings but was worried they would shun her for being in active addiction or, some years later, for taking Suboxone, a partial opioid agonist, to manage her chronic pain. Luckily, she discovered a private Facebook group that supported people like her with opiate addiction.

    For the sake of full disclosure, I’m also a member of this group. While I enjoy my social media fill of cats dressed in dinosaur costumes, babies getting slices of Kraft singles thrown at their heads, and I love dad jokes just as much as the next person, I value this group the most.

    Addiction Support…on Facebook?

    The group quickly became a refuge for Dorothy and me, a digital safe haven where we could share our pains and joys behind the privacy of a screen.

    “I have made friends that I’m sure I’ll have for the rest of my life. I feel supported and secure here. What I love the most is how diverse we are. We run the gamut from people who are using to people who are totally abstinent and everything in between… All we ask is that people respect each other and everyone’s path to recovery,” Dorothy said.

    After participating in another group where members were shamed for taking Suboxone or methadone to manage their opioid addiction, I found Dorothy and the group’s perspective on harm reduction refreshing. In order to join the group, members must agree that they will not bash medication-assisted treatment (MAT). According to the official group guideline: “We support everyone’s path to recovery, including Suboxone, Subutex, Methadone, Vivitrol, cannabis and kratom. We do not allow any debate as to whether or not being on maintenance meds means you are or aren’t clean.”

    Another administrator added, “If you hate the fact there are active addicts in this group, if you don’t support MAT or [you] want to be a douche canoe to everyone you meet who doesn’t live up to your standards, LEAVE.”

    After nine months of participating in this group, Dorothy became a volunteer staff member, then administrator. On an average day, she spends six hours involved in the various tasks that keep the group running. Dorothy, along with eight other administrators and nine moderators, approves each post before it hits the page, ensuring that the posts follow group guidelines. The guidelines mirror that of an in-person support group: members must maintain each other’s confidentiality and privacy, be respectful, and refrain from giving medical advice, selling or seeking drugs, asking for money, or posting links to treatment centers.

    Sarah Burbank has also been a volunteer group administrator for four years and spends four to eight hours on the group each day. Sarah considers the members of the group to be family. “The group is a touchstone and an inspiration. I have watched some group members pass away and have to announce to the group a loved one or cherished member has passed away from the disease. Those are the darkest of days. But there are little milestones that we share that make it so special. Day 1! 30 days! Years clean! Getting children back and jobs and lives back. Those are the truly beautiful things that keep me here.”

    Dorothy and Sarah are not alone. This particular Facebook group has blossomed to 22,000 members. Members are hungry to share their stories, to be supported, validated, and encouraged. Posts reveal a complex tapestry of emotions: of recovery, struggle, pain, joy, heartbreak, victory and defeat, often all in a single post.

    Using Social Media to Forge Connections in Marginalized Groups

    It may seem contradictory to turn to social media for support for addiction. According to a 2018 Fix article based on research from Penn State, social media use is correlated with increased rates of depression and loneliness. Similarly, in 2011, Researchers Daria J. Kuss and Mark D. Griffiths systematically reviewed psychological literature and found that social media can be used for connection, but also that it may negatively impact relationships, work, and academic achievement. This and other evidence suggest social media can be an addiction just like alcohol and drugs.

    While it’s important to acknowledge this research and the potential negative impacts of social media, this critique fails to recognize the power of online social networks, especially for marginalized people. Toronto-based mental health professional Krystal Kavita Jagoo says, “For some, authentic human connection may only come online. Sometimes you don’t have those options in person.” Jagoo pointed out that social media or internet forums can feel safer for people of color, queer, trans, and non-binary folks, and people of differing abilities.

    Jagoo continued, “If you’ve had a traumatic experience and are able to hear from others about things someone has struggled with, you don’t feel as alone. Sometimes it’s just knowing that others understand what you’re going through; they can offer strategies or things that have worked for them that you might be more inclined [to try] than a professional who doesn’t have lived experience.”

    Jagoo herself has found valuable support online. “I think of how healing it has been to connect with folks of color around the world with respect to surviving oppression.” In order to maintain balance in our lives and avoid social media burnout, Jagoo recommends finding a group that is anti-oppressive, accepting, and feels rewarding. Setting and maintaining boundaries is important, as is making sure that you only check notifications when you have time and energy to engage, and unfollowing or leaving groups if they are feeling more draining than helpful.

    Both Dorothy and Sarah mentioned that it is difficult to be a group administrator while balancing their work and home lives. But by far, they feel the benefits outweigh the challenges of spending hours volunteering in the group. “The online community is really important because it allows people to connect in the safety of their own homes, anonymously if they choose. It gives us the ability to reach so many more people, people that we wouldn’t have otherwise had any contact with.”

    View the original article at thefix.com

  • When Treatment Professionals Relapse: Shattering the Stigma

    When Treatment Professionals Relapse: Shattering the Stigma

    We are treatment professionals: we are trained to help our clients navigate addiction and mental health crises. We aren’t supposed to relapse and have crises ourselves.

    In my last article about helping professionals who struggle with addiction and relapse, I wrote about how 37 to 57% of addiction treatment professionals are in recovery and 14.7% relapse over their career lifespan. After readers inquired about my story, I decided to write a follow-up.

    “The Blind Leading the Blind”

    It was a sunny July day when I started dual diagnosis inpatient treatment for alcoholism and mental health issues at a psychiatric hospital in Fargo, North Dakota. If there was a What Not to Wear: Rehab Edition, I would’ve been a damn good makeover candidate. I was clad in yellow scrubs and those dreaded teal slipper socks, the glass slippers of the mad. My chin-length blonde hair was matted, my wrists bandaged, my face puffy from drinking and binge eating. Shuffling to the pop machine, I ran into a colleague.

    I tried to avoid eye contact, but he saw me. I was mortified, ashamed. I had just resigned from my social work job at a drop-in center for at-risk youth. Later, I kept replaying the incident in my head like a ticker tape and longed for Harry Potter’s invisibility cloak. Unfortunately, I encountered something even more awkward two days later.

    The scene of this awkwardness was “nursing group,” which sounded to me like a class for breastfeeding mothers. Instead, we learned about the health consequences of drinking, using, and addiction. During the group, I spotted a former client from the YWCA domestic violence shelter. As soon as the group ended, I rushed off to the bathroom, hoping she wouldn’t see me.

    I smelled her before I saw her: a familiar alchemy of Estée Lauder perfume and menthol cigarettes. We met while washing our hands.

    “I’m surprised to see you here,” she said, applying a coat of peach lipstick.

    I wanted to tell her that I was also surprised I landed here, that at only 24 years old I hadn’t yet worked through my trauma and struggle with mental illness. Instead, I said: “I know, it’s probably weird for you, too. I won’t tell anyone how I know you. I ask that you do the same, please.”

    They don’t teach you how to handle this sort of situation in social work school. We are helping professionals: we are trained to help our clients navigate addiction and mental health crises. We aren’t supposed to have crises ourselves.

    When I told my last supervisor that I was struggling with alcoholism and needed time off to go to treatment, he said, “I support you, but I really need my social workers stable, or else it’s like the blind leading the blind, right?”

    After feeling ashamed for days, I imagined a role reversal to have more compassion for myself. What if I saw my former therapists in rehab? Would I really think they were less qualified to do their jobs because they were getting help? After all, I’d rather run into a therapist in rehab or 12-step meetings than drunk at a bar.

    Second Chances

    Even though I resigned from my social work position, I didn’t want to completely leave the profession. I was still deeply committed to helping others and working towards a more compassionate, equitable society. I was also idealistic, thinking that I would be an even better social worker once I worked through my demons. I imagined myself returning to the profession with renewed passion and vigor.

    As a licensed social worker, it was my ethical duty to report my substance abuse and time in rehab to the Board of Social Work. I admit, I was tempted to hide it; I didn’t want to send my addiction and psychological evaluations to complete strangers on the Board of Social Work. After an anxious month of awaiting their consensus, I eagerly ripped open the letter with the state seal. Since I had completed treatment and had an addiction counselor vouch for my sobriety, I was approved to continue practicing as a social worker, so long as I maintain my sobriety and attend 12-step meetings.

    While I was grateful for getting a second chance at the profession, I still felt humiliated that I had to turn in all of my psychological records, not just my successful completion certificate. I also wished for some sort of formal support system for people in my situation. I felt so alone in this battle, although I knew there had to be other professionals who had experienced relapse.

    You’re Not Alone

    A 2013 New York Times article called “Addiction Treatment with a Dark Side” featured the stories of social worker Melissa Iverson and addiction counselor Travis Norton. Both professionals relapsed while working in the addiction field.

    According to the article, “Iverson first requested anonymity, like most other professionals interviewed, some of whom have never acknowledged their problem to their families, primary care physicians or even insurers.” Later Iverson contacted the New York Times to “come out of the closet,” saying, “The stigma needs to be tackled by real people with real names, or else it will haunt us forever.”

    Back in 2014, I interviewed Norton, who was open about recovering from heroin addiction and owned his own practice adjacent to a Suboxone clinic in a suburb of Minneapolis-St. Paul.

    Norton said, “I was on methadone successfully for many years, then switched to buprenorphine (Suboxone). I’ve been on it for almost three years now. For ten years off and on, I have worked in a variety of settings that incorporate harm-reduction and have used the resources personally as a using addict. Because of relapses while working in the field, I am being monitored by my licensing board and am subject to random drug screens.”

    Sadly, three months after I interviewed Norton, he died of a heroin overdose. His mother Michelle Norton gave me permission to share his story because she knows that her son wanted to fight the stigma of addiction. He also deserves to be honored for the all the people he helped and inspired. Norton’s death is part of the national opioid crisis. At least two-thirds of the 72,000 overdose deaths in 2016 and 2017 were linked to opioids.

    Hope after Relapse

    There is hope for those of us who are helping professionals who also struggle with addiction and recovery. Norton and others who wrote to me shared that social work and counseling licensing boards are typically supportive of those who relapse, so long as they follow through with treatment, counseling, or medication assisted treatment like Suboxone or Naltrexone (a medication used for opioid addiction and alcoholism). An increasing number of treatment centers are offering specialized tracks for medical and helping professionals.

    Each one of us can work to support this societal shift from stigma to acceptance of our friends, colleagues, and loved ones who work in the addiction field. If you have relapsed, you are not alone. We are not the blind leading the blind, we are strong people who have a special understanding of our clients because we know what it’s like to go through hell and come out the other side. We’ve had a more valuable education than what can be taught in textbooks. We can help clients precisely because we have done the hard work of tunneling from the trenches of addiction to the light of recovery.

    View the original article at thefix.com

  • "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    "Dopesick Nation" Shows Reality of Treatment Professionals Who Struggle with Addiction

    Dopesick Nation explores addiction treatment and the thin line between interventionist and client, recovery and relapse.

    Note: This piece contains spoilers for Dopesick Nation

    As a former social worker in recovery from addiction, I was initially skeptical of the VICELAND Series Dopesick Nation because I thought it would follow the familiar formula of A&E’s Intervention and TLC’s Addicted. I was wrong. Dopesick Nation is different from these other shows for many reasons, but it’s especially good at illuminating the unique difficulties of being a recovering addict while also working with and helping other people struggling with addiction. Dopesick Nation explores the thin line between interventionist and client, recovery and relapse. This is a common struggle, as 37 to 57% of professionals in the addiction field are in recovery themselves. Due to stigma, there is sparse data on how often people working in this field relapse, but I found a preliminary study that found 14.7% of addiction treatment professionals relapse over their career lifespan. I can relate: I’ve relapsed twice while working in the field.

    Let me start by saying that I commend all people working in addiction and recovery treatment. While I have mixed feelings about Intervention and Addicted, I have deep respect for the interventionists who have made it their mission to help people with addiction while also navigating the daily struggles of their own recovery. The traditional interventionists of Addicted and Intervention appear so stable; each of their stories follow a typical trajectory from drug addict to helper. On the opening montage of Addicted, interventionist Kristina Wandzilak says: “By the time I was 15, I was addicted to drugs and alcohol. I robbed homes, I sold my body, I dug in dumpsters to pay for my habit. Today I am an interventionist…”

    Yes, Wandzilak and the other interventionists’ stories are all inspiring to people like me in recovery, but the reality is that many of us relate more to Dopesick Nation’s leads, Allie and Frankie. Both are candid about the difficulty of working in the field and later Frankie is open about his relapse. But we’ll come back to that.

    Addiction Treatment on TV: Intervention, Addicted, and Dopesick Nation

    One of the first stark differences between these shows is the more relatable, down-to-earth way that Allie and Frankie approach their clients. From my experience as a social worker with eight years of experience in the field, I know that the first step is building rapport and earning the trust of vulnerable people who are skeptical of helping professionals. Allie wears yoga pants and hoop earrings, Frankie is covered in tattoos and wears a backwards black hat and a t-shirt with the logo of his nonprofit, “FUCK HEROIN FOUNDATION.”

    This may seem surface level, but first impressions matter. Trust should be earned, not expected. I had a client who refused to open the door to staff for weeks, in part because she felt social workers were elitist and unrelatable. When she finally let me in, she said, “You’re not one of those preppy ass bitches.” My boss joked that all the staff should get tattoos, a lip ring, and blue hair like me even though technically it was against dress code policy.

    In Addicted and Intervention, the interventions are staged in the carefully controlled environments of beige hotel conference rooms. Wearing business casual clothes, neatly ironed polos and chinos, the interventionists sit on comfy chairs in a U-shaped circle, then conduct a carefully orchestrated, seemingly scripted intervention.

    In Dopesick Nation, Allie and Frankie meet their clients where they are, which is a foundation for building a helping relationship. The show takes place in sunny, touristy Florida, where glimmering sandy beaches are dotted with tourists in Hawaiian shirts playing shuffleboard next to the swirling tides of the turquoise ocean. But Allie and Frankie don’t meet on the beach. Instead, they talk to clients on park benches, and curbsides in bad neighborhoods, braving torrential downpours and scorching heat. This method of “meeting people where they are at” is supported by years of social science research and was a cornerstone of my work as part of an outreach team to help people with severe mental illness and addiction. We left our office bubble, braving blizzards and arctic cold, because we knew clients were more likely to go to detox or another facility after a course of meetings in their homes.

    Fast forward to Frankie admitting he’s relapsed and is taking Suboxone, a medication to deal with opioid cravings. Wringing his hands, itching his sweat-glazed skin, Frankie tells his sponsor Gary: “90 to 95% of my day helping other people find their recovery. Sometimes I’m not taking care of my own recovery. And how am I gonna help other people get something that I don’t have? A lot of people rely on me, that pressure weighs on me.”

    Gary encourages Frankie to go to detox. “When you’re working in treatment, you’re around sickness all day long and you’re absorbing it… You need to work a righteous program.”

    Treatment Professionals Who Relapse

    I want to tell Gary that even though Suboxone is sometimes shunned by the recovery community, many studies support its efficacy. Suboxone is a valid form of recovery. I want to reach across the screen, hug Frankie and tell him he deserves the same care and compassion that he gives to clients, that it’s okay to take a break from the field to take care of himself. I want to tell him that I admire him even more because he let his guard down and was honest. I want to tell him that more of us relapse than he may realize and assure him that he is not a hypocrite for relapsing and taking Suboxone. I want to tell him my story.

    Three years ago, I was working at a day center with people who had struggled with homelessness and addiction. I remember one day when a client who was an IV heroin and meth user told me about his struggles to get clean. My years of experience taught me the art of self-disclosure, specifically if and when it was appropriate to disclose to clients that I too was in recovery. Since I’d known him seven months and even been trusted to store his dead cat’s ashes (a story for another day), I told him about my addiction as though it was in the past tense, although it was very much in the present tense. Steeped in denial, I told myself that my nighttime and weekend benders wouldn’t bleed into daytime. Looking back, I feel ashamed, but I know that denial is also a powerful drug. For a while, I thought I juggled my work life and secret life well. I thrived at my job, until, surprise— the benders bled into my work days.

    One day this client told me he was worried about me. He’d noticed my weight loss, blue circles under my darkened eyes, and change in personality. That’s when I knew I needed help. It was time to take a break from being a social worker. I went to detox for five days, then resigned and decided to move home. Like Frankie in Dopesick Nation, I realized that I couldn’t take care of others until I took care of myself.

    Eighteen months later, I miss social work and helping people. I hope to one day return to the profession, but in the meantime I’m using writing as a means to fight the stigma of addiction and shame of relapse. The reality is that relapse rates vary between 50 to 90%, and even treatment professionals are not immune to the realities of addiction. My hope is that one day more helping professionals like me can come out about their relapses and be commended for our honesty.

    What are your thoughts on Dopesick Nation and Frankie and Allie? How should people who work in addiction treatment make sure they’re taking care of their own recovery? Let us know in the comments.

    View the original article at thefix.com

  • How to Taper Off Suboxone: A Survival Guide

    How to Taper Off Suboxone: A Survival Guide

    “Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient.”

    Note: This article is not intended as a replacement for medical advice. This is merely the experience of 21 people interviewed by the author who have successfully tapered off buprenorphine-based medications (Suboxone, Zubsolv, Bunavail, Subutex, etc.) or significantly reduced their dose. Please consult your doctor before beginning a taper. 

    After two and a half years of taking Suboxone, I’ve decided that it’s time to start the tapering process. I don’t like having to rely on this little orange film strip each morning to get out of bed, the tidal wave of nausea, being constantly hot, the restless legs, and the constipation. This is an incredibly difficult decision because Suboxone has saved my life. Additionally, studies have demonstrated the effectiveness of Suboxone and found it’s reduced overdose death rates by 40 percent. 

    Some people decide that it is best for them to take Suboxone for life. Shannon has been taking 16 milligrams of Suboxone for 17 years and has no intention of tapering. She said: “I’m never getting off, why fix something that isn’t broken? I love life now. I’m a great mother, wife, daughter, sister, aunt, and trustworthy friend to all those that know and love me. I have absolutely no shame being a lifer. I’ve been to the depths of hell and now I’m in heaven. I believe without subs, I would be dead.”

    Like Shannon, fear of relapse and withdrawals makes me terrified of coming off Suboxone. I imagine waking up panicked and glazed in sweat, running to the bathroom to puke and worst of all, the black hole of depression and existential dread that is common with opioid withdrawal. These are common fears for people coming off opioid addiction treatment medications. In order to help others like me who are interested in tapering, I researched this topic and surveyed 21 people: 13 have successfully tapered off Suboxone and eight have significantly lowered their doses and are currently at or under six milligrams per day.

    Slow Taper

    Sixteen of 21 people I surveyed reported using a slow taper to come off or lower their dose. Dr. Jeffrey Junig of the Suboxone Talk Zone Blog suggests that the optimal dose to “jump” or quit taking Suboxone is .3 mg (about 1/3 of 1 mg).

    Junig writes: “I have had many patients taper successfully off buprenorphine. Fear is common and normal for a number of reasons, but the fear usually gives way to a sense of confidence and optimism when a taper is done correctly…Be patient. Tapering by too much, or too quickly, causes withdrawal symptoms that lead to ‘yo-yos’ in dose.”

    Amanda* agrees with Junig’s advice not to try to jump from too high of a dose. She said that when she jumped from 2 mg cold turkey it was “40 days of hell.”

    To avoid a hellish experience like Amanda’s, Junig advises reducing your dose by 5% or less every two weeks or 10% every month. Sound confusing? Junig simplifies: Use scissors to cut half of an 8 mg film. Then cut half of that, then half again. Put the doses in a pill organizer so they don’t get lost or accidentally consumed by children or pets.

    Holistic Remedies

    There are a handful of holistic remedies that can help with the tapering process. Folks I surveyed said that yoga, meditation, and healthy eating are pillars of their recovery. Studies have confirmed the benefit of yoga for improving quality of life in those withdrawing from opioids as it alleviates anxiety, restless legs, insomnia, and even nausea.

    Sarah said: “I tapered with a clean diet with digestible nutrient-dense food and smoothies and stayed hydrated. I got plenty of sun, used yoga and exercise too.”

    Others recommended vitamins and other supplements including: L-Tyrosine, DLPA, Vitamin C, Omega 3 Fish Oil, and ashwagandha. They used melatonin for sleep and Kava tea for relaxation. (Consult your physician before taking any supplements. Even benign substances may interact with other medications or have unintended side effects.)

    Marijuana

    Four out of 21 people polled used marijuana to deal with the difficult side effects of tapering off Suboxone. Barry said: “I know that some people may not see marijuana as a way that should be used to taper, but for me I was desperate to try anything that worked. I consider marijuana a lesser of evils. It helped with restless legs, nausea, pain, and anxiety.”

    Marijuana may now be a viable option for those who wish to try it, because it’s now legal for medical use in 29 states and for recreational use in nine states plus Washington DC. Unlike opioids, marijuana provides pain relief with a lower risk of addiction and nearly no risk of overdose. Plus, comprehensive studies like this one from the American Pain Society found that medical cannabis use is associated with a 64 percent decrease in opiate medication use.

    While studies have supported the use of marijuana to reduce opioid use, further research needs to be done as reported in the The Daily Beast. Dr. Junig also advises that patients should not start new mood-altering, addictive substances in order to taper off Suboxone.

    CBD Oil

    Three of the Suboxone patients polled were able to taper with the help of cannabidiol, also known as CBD oil. Experts emphasize the distinction between marijuana and CBD oil: CBD oil is not psychoactive, meaning that it doesn’t make patients feel “high” like the THC in marijuana. CBD oil may be a more viable option for people in states where marijuana has not been legalized and also for those who do not want mood altering affects, but strictly relief from physical symptoms. “I used CBD oil during the taper because pot isn’t legal in my state and it helped with restless legs, sleep, and anxiety,” Pablo said.

    A 2015 study in Neurotherapeutics examined the therapeutic benefits of cannabidiol as a treatment for opioid addiction. They found that CBD oil is effective in reducing the addictive properties of opioids, mitigating withdrawals, and lessening heroin-related cravings. Specifically, it relieved physical symptoms such as: nausea, vomiting, diarrhea, runny nose, sweating, cramping, muscle spasm. Additionally, it treats mental symptoms like anxiety, agitation, insomnia, and restlessness. The study states CBD oil is effective with minimal side effects and toxicity.

    Kratom

    In our survey, the people who tried kratom claim that the herb is a controversial yet effective way for tapering from Suboxone. Some experts agree. According to the Mayo Clinic: “In Asia, people have used kratom in small amounts to reduce fatigue or treat opium addiction. In other parts of the world, people take kratom to ease withdrawal, feel more energetic, relieve pain, or reduce anxiety or depression.”

    Four of the individuals surveyed used kratom for tapering off Suboxone. Christine said, “I was very tired when coming off Suboxone, so kratom helped give me the energy to work, clean my house, and take care of my kids.”

    Cristopher R. McCurdy, PhD, a professor of medicinal chemistry at University of Florida’s College of Pharmacy in Gainesville, studies kratom. McCurdy told WebMD: “I definitely believe there is legitimacy to using kratom to self-treat an opiate addiction.”

    Despite these positive reviews, the Mayo Clinic and Web MD caution that kratom can also lead to addiction and withdrawal. According to an article on WebMD, “There’s little research on the herb’s effects on people, and some experts say it also can be addictive. The herb is illegal in six states and the District of Columbia, and the Drug Enforcement Administration is considering labeling it as a Schedule I drug…For now, the agency calls it a ‘drug of concern.’”

    Pharmaceutical Remedies

    Five of the people surveyed said that they tapered with the support of medications prescribed by their doctors to treat individual withdrawal symptoms. It is best that patients talk with their doctors and addiction professionals to see if a particular medication is right for their situation.

    Happy tapering! I plan on writing more in the future about my experience and progress tapering off Suboxone. If you’re embarking on this journey, I wish you luck!

    The names of some individuals have been changed to respect their privacy.

    Have you successfully tapered off Suboxone or methadone? Or are you a “lifer” like Shannon? We’d love to hear your thoughts, experiences, and tips in the comment section.

    View the original article at thefix.com

  • In Praise of the Geographical Cure

    In Praise of the Geographical Cure

    For me, leaving was about survival and going back to supportive friends and family who had known me my whole life and who would give me a temporary place to stay.

    When I moved to the city of my dreams, I drove my Navy Subaru Impreza stuffed so full that I couldn’t see out of the rearview mirror the entire 1300-mile trek. My backseat was packed with my white cat Toby, my maple-bass guitar Helga, a vintage amp, a typewriter, a case of angsty journals, and a ridiculous amount of polka-dot and striped clothes. All things that I deemed too valuable for the moving truck. A month later, my serious boyfriend finished welding school back home and joined me. After finally leaving our sleepy home state of North Dakota, we were excited to start our new life together.

    Fast forward a few chaotic years to a plot that is achingly familiar for those of us who struggle with addiction; a plot almost sad and pathetic enough to make me a country song — if only I drove a pick-up truck and was a dog person rather than a cat lady. When the city of my dreams became the city of my nightmares, I decided to leave. My addiction counselor warned me that running away from my problems wouldn’t fix me, but I didn’t care. My drug hook-ups practically lived outside the Whole Foods across the street from my apartment, the same store that I had been kicked out of for stealing. My rent check bounced so I was on the verge of eviction. I needed to get the hell out.

    When I left the nightmare city, my cat Toby had died, my car had died, my identity had been stolen, and worst of all, I had broken up with that boyfriend who was supposed to be my forever mate. Then I fell in love again and that passionate, drug-fueled love also didn’t work out. Since I had sold or given away most of my possessions, pawned my bass and amp, there was no need for a moving truck this time around. I left, feeling broken.

    I sobbed as I said goodbye to the stunning Pacific Northwest wonderland with its gleaming snow-topped mountains and volcanoes, waterfalls, rainforest. As I drove east, I felt as flattened and empty as the prairies of my home state.

    I knew that just because I was moving home, it didn’t mean that I’d be magically fixed. I tried not to fall under the spell of what folks in the program call the “geographical cure.” Kerry Neville recently wrote a beautiful, lyrical, and illuminating piece on the geographical cure in which she says: “a change in external position on the map doesn’t reset the compass and point us to true north, because we always meet up with the self we are, no matter where we are.”

    I agree with some of Neville’s points, namely that taking vacations to topical locales will not get rid of our problems and provide us with a healthy, extended recovery. Yes, I knew that changing my zip code wouldn’t necessarily change my soul. I knew that I’d have to really dig down and do the hard, gritty work of recovery. But for me, leaving wasn’t about a vacation. I couldn’t afford vacation, I couldn’t even afford my rent. For me, leaving was about survival and going back to supportive friends and family who had known me my whole life and who would give me a temporary place to stay.

    Now that I mention it, the geographical cure warning is ironic because it contradicts other 12-step platitudes. These platitudes are like currency in the rooms, exchanged as freely as the collection basket for money and meeting lists: If you go to the barbershop enough times, eventually you’re going to get a cut, and: The only thing you have to change is everything. Change people, places, and things.

    Why are those of us who do decide to change our location criticized? Why do certain meetings and rehabs keep using their one-size-fits-all mottos rather than listen and embrace the many winding paths that lead us to recovery? In the few meetings I attended and the online recovery groups I participated in, people reacted negatively when I told them what I was doing. The consensus was that I was making a mistake. Even my counselor was quick to remind me that I wasn’t “special and unique,” and if this plan didn’t work for others, then why should it work for me? But I chose to do the thing that I knew would help me and my recovery. It wasn’t a mistake; it saved my life.

    Surely I wasn’t the only one who felt that perhaps the geographical cure may have been successful, so I decided to research the power of environmental cues, aka triggers, for addiction, relapse, and recovery. It’s likely you’re familiar with Pavlov’s classic dog study and the mechanics of classical conditioning, but I want to review it because it’s the foundation of every study that I read on this topic. Russian physiologist Ivan Pavlov was studying salivation in dogs when he noticed that the dogs salivated every time a door was opened, even when researchers didn’t have food. This was because the dogs began associating a neutral stimulus like opening a door (or, later, ringing a bell or flashing a light), with food. Researchers later used this model to study people with addictions.

    Studies found that people who develop alcoholism and addictions develop strong associations with drug-associated cues and environmental stimuli like Pavlov’s dogs. In other words, after repeated experiences, drug users relate the rewarding effects of a drug (like euphoria and relaxation) with the people, places, and things that are present when we are using. For example, one study found that smokers who received IV nicotine still reported cravings, whereas smokers who received IV nicotine and nicotine-free cigarettes didn’t. Why? Because of the power of environmental cues, including the feeling of holding a cigarette in one’s hand, the smell of smoke, and even packaging of a cigarette box.

    I mention these study results not just because they confirm what I already knew in my heart to be true and I love being right, but because they are vital for understanding recovery and relapse prevention. We must acknowledge the power of our environment and triggers. Although most of us won’t take the extreme step of moving across the country, we all can minimize our exposure to triggers until we feel strong enough to deal with them. We can also bring a friend or family member to face triggers and create new associations, as the studies I read suggested.

    Above all, we should all learn to embrace our own unique path to find what works best for us, even if it goes against the current of AA axioms. I will always be grateful that I listened to the fluttering in my chest. Wisdom means knowing when to keep your feet firmly planted in place or when to take flight. Sometimes leaving is the thing that saves you after all.

    View the original article at thefix.com

  • A Practical and Comprehensive Guide to Finding a Suboxone Clinic

    A Practical and Comprehensive Guide to Finding a Suboxone Clinic

    It took me 10 hours of phone calls, 20 voicemails, 3 chewed fingernails, and many packs of cigarettes before I found a Suboxone provider in my new town. This is the list I wish I had then.

    When I pulled a “geographic” a few years ago, leaving Portland for my home state of North Dakota, I underestimated the stress of starting over. In fact, stress isn’t a strong enough word to describe driving 1,300 miles with my recent ex-boyfriend in the passenger seat and the fear of restarting life without heroin; not to mention I had no full-time job prospect, no health insurance, no apartment, and very few of my possessions. I also had a unique fear that loomed over me like an ominous storm cloud: trying to find a new Suboxone* provider in a rural state. 

    It took me almost ten hours of phone calls, twenty voicemails, ten games of phone tag, three chewed fingernails, and many packs of cigarettes to find a clinic that would dispense the medicine I take to maintain my recovery. 

    Unfortunately, my situation is a common one. Despite our nation being in the throes of an opioid epidemic, finding a Suboxone provider is a widespread problem; only about one-third of addiction rehabilitation programs offer long-term use of methadone or buprenorphine (the active ingredient in Suboxone). And according to the National Alliance of Advocates for Buprenorphine Treatment (NAABT), only about half of all Suboxone providers are accepting new patients.

    Finding this life-saving medication shouldn’t be so hard. When you are committed to getting better, you shouldn’t have to worry about whether or not you’ll be able to find a clinic to dispense your medicine. A person with diabetes wouldn’t have to search hard to find insulin. So I’ve compiled a round-up of tips and suggestions. 

    This is the list I wish I’d had in early recovery:

    1. Find friends and family who are supportive of your Suboxone journey.

    2. Remember that your form of treatment is just as valid as all other types of treatment and recovery.

    Although Suboxone is a widely stigmatized and divisive medication in the recovery community, it has been shown to reduce opioid overdose death rates by 40 percent.

    3. Join online support groups and forums for people on Suboxone.

    Since I lived in a rural area, I couldn’t find any in person groups. So I joined secret social media Suboxone support groups on Facebook, recovery Reddit threads, and peer-support forums such as the Addiction Survivors website and Suboxone Talk Zone.

    4. Allow Plenty of Time to Research, Call, and Locate Providers.

    This was the most daunting and lengthy part of finding a new provider. Dr. Bruce Seligsohn has been a board-certified internist in Southern California for 30 years and practicing addiction medicine for 10 years. Dr. Seligsohn advises: “Patients really need to be very careful selecting a doctor if they have a choice. I would suggest that a patient looking for a new doctor do their due diligence and see what comes up online about the doctor.”

    I have compiled the most current resources available as of August 2018. See the sidebar for a sample phone script for calling providers.  

    Pros: Convenience, ease of navigation. You will be able to easily search for a provider based upon zip code, state, and the distance that you’re able to travel for a clinic.

    Cons: Out of date, inaccurate, not comprehensive. Be prepared for hours of phone calls depending on your location and financial situation. Not all providers are listed on the site. I also found that some of the clinics listed were not accepting new patients, had been closed, or had their numbers disconnected.

    Pros: Ease of navigation, instant results. Similar to the Suboxone manufacturer’s website, this is a good launching point for starting your search based upon zip code, state, and the distance that you’re able to travel. 

    Cons:  Not comprehensive and despite being a government resource, it is not up-to-date.

    Pros: Easy to use, more accurate. Treatment Match only connects you with providers in your area who are accepting new patients, reducing dead ends and calls to providers who aren’t accepting new patients or insurance. 

    Cons: Wait time/ lack of timeliness, not as many provider connections. This is not a straightforward directory and while it’s easy to sign up, you have to wait for a provider to respond to your email. The site claims that doctors respond 24/7, including weekends and holidays, but I only heard from them during normal business hours.

    • Yelp Reviews of Clinics

    Pros: Hearing directly from other patients about their experiences, easy to use, instantaneous, accessible.

    Cons: Questionable trustworthiness. Dr Seligsohn said: “Patient reviews can sometimes be very misleading.”

    • Calling Your Insurance Company

    Note: Insurance companies vary widely, so I can only speak from my experience. For example, in Oregon I was easily able to locate a Suboxone provider through my insurance company, but my North Dakota insurance did not provide referrals. They stated that their preferred addiction treatment was therapy and 12-step based treatment programs rather than medication.  

    Pros: Possible thorough list of doctors certified to prescribe Suboxone. Those Suboxone providers who accept your insurance are required to keep their information listed and up-to-date.

    Cons: Time-consuming and you have to deal with the hurdles of bureaucracy. Plus, some studies have found that only about 50% of eligible Suboxone doctors accept insurance. Some insurance companies like mine will allow you to submit an appeal asking them to cover part of your Suboxone visit or prescription, especially in rural areas. I saved all of my receipts and had my psychiatrist and Suboxone doctors write letters of support. After months of appeals, the insurance company agreed to cover part of each appointment. Each month I sent in a claim and receipt, and then I received a reimbursement check about a month later. 

    • Asking for a referral from your primary care provider, psychiatrist, or hospital.

    Another note: This is also difficult to give specific advice on because they vary depending according to location and providers, among many other factors.

    Pros: In-person support and assistance, more direct medical guidance and advice. 

    Cons: Stigma, lack of education about Suboxone, judgement, lack of timeliness. 

    5. Be Persistent!  

    6. Moving? Set Up an Appointment Months in Advance.

    Dr. Seligsohn advises finding a doctor and setting up an appointment prior to moving. “Patients need to find out as much information about how their perspective new doctor runs his practice…They also need to find out what the doctor’s philosophy is about long-term vs short-term Suboxone. If I was a patient I’d be reluctant to move to an area where there’s a shortage of Suboxone doctors.”


    Sidebar: Sample Phone Script for Calling Suboxone Providers

    I remember being so nervous, overwhelmed, and frustrated while also dealing with the symptoms of opioid withdrawal. Make sure you set aside a few hours for making calls in a quiet, safe place. I know some of these tips might seem like common sense, but when you’re in crisis and everything feels overwhelming, it can be a relief to have a guide.

    1. Introduce yourself and tell them that you’re looking for a suboxone provider.

    2. Where are you located?

    3. Are you accepting new patients?

    • If yes- when is your earliest available appointment?
    • If no- don’t hang up just yet! Ask: do you have a waiting list? Can you give me an estimate for how long it would take me to get an appointment? 
    • Do you have a cancellation list and if so, can you please add me to it?

    4. How often do I need to come to the clinic or office? 

    • Most clinics and offices require monthly or bi-monthly visits, but some require daily visits and dispense suboxone in a similar manner to methadone.

    4. Do you accept my insurance? 

    5. If the clinic does not accept insurance, how much does each appointment cost?

    • How much does the intake appointment/ first visit cost? This is an important question to ask because initial intake appointments can cost anywhere from $100 – $200 more than a regular visit.
    • Some clinics require pre-payment to reserve your appointment and prevent cancellation. Do you require a down payment before the appointment?
    • What forms of payment do you accept? (cash, credit, check?) Note that most clinics do not accept checks.
    • Do you allow payment plans or is payment due on the day of the appointment? A majority of clinics will not allow patients to do a payment plan and payment is due on the day of the appointment.
    • Are there any additional costs or required fees? Some charge additional fees for mandatory counseling, drug screens, etc.

    6. What are the counseling requirements?

    • You may be required to do weekly or monthly therapy groups with others at the clinic, and/or meet with an addiction counselor. This varies depending on how long you’ve been clean and your insurance coverage. (For example, one of my previous clinics had no counseling requirement, but my new clinic requires me to meet with an addiction counselor for one hour each month. Other clinics require weekly or bi-monthly group support meetings.)

    Quick Resource List:

    The Substance Abuse and Mental Health Administration (SAMHSA)’s Buprenorphine Treatment Practitioner Locator

    Suboxone Website’s Treatment Provider Directory

    Buprenorphine Matching System on Treatment Match on The National Alliance of Advocates for Buprenorphine Treatment (NAABT)

    Addiction Survivors

    Suboxone Talk Zone

      

    *(Writer’s Note: Suboxone is the most common brand-name buprenorphine medication, but this article is also applicable for patients seeking any form of buprenorphine treatment including: Subutex, Zubsolv, Bunavail, and Probuphine).  

    View the original article at thefix.com

  • Let’s Get Real: How To Handle the Tough Stuff in Recovery Without Using

    Let’s Get Real: How To Handle the Tough Stuff in Recovery Without Using

    Of course, people had good reason to think that I couldn’t handle upsetting news. Every time a hardship, breakup, or something unsettling happened, I wound up in the psych ward, detox, ER, or a bloody, tear-filled mess.

    When I was drinking, I was the girl who took pulls of rail vodka right from the bottle. I took it straight, no chaser. Others looked at me with a mixture of surprise and disgust. Girls were supposed to mix their vodka with fruit juice or soda. Girls weren’t supposed to out-drink the men or keep straight razors in their wallet for chopping up fat lines. Fellow drunks patted me on the back. I was one of them. I embraced my heavy drinking as a point of pride, wore it like a badge of honor.

    But the point of this isn’t to share my war stories or act like I was the most bad ass alcoholic or junkie to ever haunt the planet. Rather, I want to share how I still prefer to apply the “straight, no chaser” motto to other areas of my life. I prefer when loved ones are straightforward, blunt, and honest with me about tough stuff and hardship rather than trying to gloss over the truth or protect me from pain. Even though I have been in recovery for years, some of my loved ones have continued to worry that I will relapse upon hearing bad or heartbreaking news, as though I was some sort of wounded dove with the word “fragile” stamped on my forehead.

    Of course, they had good reason to think that I couldn’t handle upsetting news. Every time a hardship, breakup, or something unsettling in my life happened, I wound up in the psych ward, detox, ER, or a bloody, tear-filled mess. I categorized people as either “normies” or “addicts and crazies” because it was easier than embracing the messy complexity of human beings. In my mind I was broken. Normal people went to the gym, spa, or the mall when they were troubled. But those options didn’t work quickly enough to soothe my mercurial temperament and smooth my edges. I labeled myself as a crazy addict, so I went straight to the liquor store or to the organic grocery store (ironically this was where my dealers were, standing outside with signs reading: “needs money, anything helps”).

    If you’re someone who struggles with addiction, you understand this self-destructive pattern. It’s hard to deal with “life on life’s terms,” as they say in the program. When stressful life events happen, we often turn to our familiar coping mechanisms. In fact, the National Institute of Drug Abuse found that up to 60 percent of people relapse within their first year of recovery. 

    There is a constellation of reasons that people relapse. Studies have found that being exposed to stresses that originally caused someone to excessively drink or use drugs is a major trigger for relapse. Another study found that patients with alcohol and opioid dependence were most likely to relapse when they had a family history of substance use and high number of relapses, used maladaptive coping strategies, and also had “undesirable life events.”

    I can relate as I had my share of undesirable life events this past year. Even though I’ve been clean for a few years, I still felt a massive urge to use after hearing about the death of my god-daughter and, on a less serious note, a heartbreaking romantic let-down.

    These events were handled very differently. The morning after my god-daughter died, my mom called and told me the tragic news. She wanted to make sure I heard it from her directly rather than passively finding out about the death on social media. Although this was devastating news, I appreciated that she was direct and real with me.

    What really triggered my cravings was ambiguity and a romantic disappointment. Although we broke up a few years ago after I relapsed, I still consider my ex one of my best friends. We text every single day and I even stayed with him for five days when I was visiting Portland in December. He let me sleep in his bed while he slept on the couch. Wrapping myself in his blankets, I was comforted by his familiar smell of Camel cigarettes and Old Spice. Although the visit was platonic, there were moments when I felt a possible rekindling of our romantic relationship.

    He paid for all my meals, opened doors to restaurants, and even took me to the Oregon Museum of Mental Health in Salem where I researched an essay. Okay, maybe going to a museum of mental health isn’t exactly a hot date, but the fact that he was willing to take me felt positive. He also talked about taking a road trip together in his new BMW coupe, laughing at how when we had been together he drove a Buick and we barely made ends meet. I reminded myself that my intention for this visit was to make amends in person for spinning him in my addictive chaotic orbit and leaving him in the wreckage of our relationship. Yet I still got my hopes up that we would get back together and I wrote him a long letter proclaiming my feelings for him.

    He never responded. He faded away from me, and his texts became infrequent and vague. He said that he was busy and stressed with work. Finally, he admitted to our mutual friend that he had a girlfriend but was afraid to tell me because I was “constantly on the verge of suicide” and he was worried about relapse.

    I was crushed, but at the same time I sort of understood his perspective. He knew the story of my old self. I had shown him in the past that I couldn’t handle such rejection or disappointment.

    So how do we deal with the tough stuff in recovery? Amanda Decker, a Licensed Addiction Counselor (LAC) and Licensed Professional Counselor (LPC) in Fargo, North Dakota, explained: “There will be growing pains throughout the ebb and flow of recovery. It’s hard knowing how to deal with life without drugs or alcohol but it’s helpful to remember that perspective shifts over time. It also helps to develop hobbies and interests. When people in recovery can embrace these things, drugs and alcohol become white noise in the background.”

    Decker suggested developing a “pre-emptive” relapse prevention plan by thinking about how to handle life stressors without alcohol or drugs. If we are in the position of telling difficult or uncomfortable news to a family member or friend who is in recovery, Decker advises: “As an addiction counselor, I’ve had to tell my group about a fellow group member who has overdosed. The first thing I did was to be direct and be present with my group members who were struggling in that moment. There will be a lot of grief and sadness that we have to learn to cope with.”

    The truth is that hardship, tragedy, and disappointment are parts of life that we have to learn how to come to terms with in recovery. We have to start embracing and seeing the shades of wellness and addiction rather than labeling things “normal” or “crazy.” It’s hard to tell a different story about ourselves, it’s even harder to break the story that others have about us. But I have faith in myself and I have faith in you, my fellow humans in recovery. For we are resilient, brave survivors, not fragile wounded doves.

    View the original article at thefix.com

  • Embracing Pride and the LGBT+ Community in Recovery

    Embracing Pride and the LGBT+ Community in Recovery

    “The sense of having two selves was the root of my addiction, especially in the beginning. It was exhausting to play a role I didn’t want.”

    Ten years ago, I was both terrified and ecstatic to go to my first ever LGBT Pride Parade. I knew that I was attracted to both men and women, but I had always kept this hidden. Being raised in the Catholic Church and in a conservative town, I was told it was a sin to act upon “homosexual desires.” To smooth out the edges of my mental tug of war, I took pulls of vodka and chased it with cherry Sprite.

    Broadway was bursting with vibrant seas of color and glitter. Rainbow flags replaced American flags, much to the dismay of the town bigots. A float rolled by with drag queens dressed like Beyoncé and Dolly Parton, hair teased as big as their ta-tas. Then I heard the roar of Harley Davidsons as a throng of denim-clad lesbians cruised by with signs that said, “DYKES ON BIKES.” Next, another group chanted: “hey-hey, ho-ho, homophobia has got to go!”

    I know this all sounds like a stereotypical version of Pride, but this was truly how it appeared to me as a newbie. Over time, I began to peel apart the layers and examine the nuances within the community. Pride showed me the power of embracing and celebrating your identity, even when it is associated with stigma, discrimination, and stereotypes. I realized that Pride gave me kindling for my desire to fight stigma, even long before I was in recovery.

    *

    As author of My Fair Junkie and Fix Contributor Amy Dresner wrote in (Re) Claiming Language: “I think the addiction/recovery movement needs to model itself on the gay rights movement and be vocal, out there, shameless and visible: parades, glitter, boas. Bring it all on.”

    After admiring Dresner’s writing for years on The Fix, then her memoir, I finally had the courage to message her. She sent me a kind response and we had an amazing actual phone conversation! Okay, I swear that my fan-girling has a point. She also spoke with me in more depth about the parallels between our communities: the stigma, the struggle with health issues like HIV, Hepatitis C, and losing friends to overdoses or suicides. Amy can speak to these similarities since she has experience with the LGBT+ community in L.A. “Even though I’m straight, I often attend and speak at LBGT meetings. I like the vibe there. They feel more real and more celebratory. They get my humor and irreverence. I feel like I can be more open about my crystal meth use and being promiscuous without them judging me, because they’ve been there too,” she said. We also share an immediate kinship with each other over burrowing our way from the trenches to light.

    *

    My first small-town Pride parade only lasted fifteen glorious minutes. After all, my city, Fargo, was famous for the Coen brother’s cult classic film and being the highest binge drinking city in the country, not LGBT rights. I wandered to a beer garden for another Pride event. A girl with hot pink hair asked for my signature for a human rights petition. I signed and wanted to flirt with her, but I realized that I didn’t know how. At the line in the bathroom, a woman noticed that I was shaking with anxiety and offered me a little blue pill she said was Xanax.

    “This will help chill you out,” She said. It worked. She led me down the street to the only gay bar, where scantily clad men grinded to Katy Perry under pulsing neon lights. Later that night, I drunkenly wrote in my journal: “we’re here, we’re queer. We’re junkies and drunkies.” I also realized that alcohol and pills were the easiest way for me to “break bread,” in the LGBT community. They were magical potions that could teleport me from being an outsider to an insider, give me the courage to flirt with women, to numb the shame. I’m not alone. For many, Pride and being part of the queer community is synonymous with drinking and drug use.

    Charlie* is a 24-year-old graduate student who is bisexual and is ambiguously trans. They are from a school district in Minnesota with the one of the highest suicide rates in the country. At their high-school, gay and “gay-coded” students were bullied, peed on, and called faggots. Charlie said, “For myself, the intersections of addiction and LGBT identity are so complex. It’s so ingrained in our daily lives, in our community lives. Our history. We weren’t given the social or political power to have public space. So, bars and underground clubs were our space…so addiction can sometimes become a learned behavior. For me, it was alcohol. I used it to suppress my identity.”

    According to a 2015 study by the Substance Abuse and Mental Health Service Administration (SAMHSA), 30 percent of LGBT people struggle with some form of addiction compared to 9 percent of the heterosexual population. Bisexual women and trans people face the highest risk of drug use and abuse.

    I spoke with a 30 something freelance writer from the Midwest named Morgan, who said she had known she was “next-level” gay long before she even knew the word. “The sense of having two selves was the root of my addiction, especially in the beginning. It was exhausting to play a role I didn’t want. I think it was originally a combination of easing the pain of not being able to love the people I loved openly and resentment toward the society I felt excluded me. There was an ease and confidence about being my true self when I was drunk though.”

    Charlie said they have managed their drinking without the help of outside groups, but if they did need one they would prefer an LGBT-oriented recovery group. Meanwhile, Morgan lives in an area that does not have LGBT meetings. Morgan said she felt very uncomfortable at her first 12-step meeting and definitely didn’t feel comfortable disclosing that she is lesbian, because her home is near the birthplace of the notoriously bigoted Westboro Baptist Church. Her first meeting “was full of a Confederate-flag wearing, chain smoking old school crowd that didn’t have much experience with LGBTQI people.”

    What about people who want to connect with other queer folks in recovery, but live in a rural area or don’t connect with 12-step meetings? I spoke with Tracy Murphy, who is lesbian and founded a blog called LGBTeetotaler, which aims to “create community and visibility for queer and trans people in all forms of recovery.” Murphy is an inspiring example of the power of connection through the internet, which she said is “life-changing.”

    “Many times, when I’m dealing with cis hetero members of my recovery community, I end up feeling like I’m doing education while I’m also just trying to process an experience I’ve had… Having a group of queers to reach out to takes away that layer of education and emotional labor. We’re free to discuss and process without having to also explain why or how an experience is difficult,” Murphy said.

    *

    Talking to Murphy and Dresner inspired me to reflect upon my nearly ten years in and out of the recovery community- as an alcoholic/ addict in recovery and then as a social worker. Throughout those years, I’ve noticed a universal theme that weaves us addicts together. We all felt like misfits, outsiders. Like many others, I first went to meetings flashing my outsider identity like a badge of honor. I was surprised to discover the very thing that made us feel like misfits and lone wolves is often what connects us most in recovery. There’s a glorious alchemy that happens when a bunch of misfits unite for a shared goal of recovery.

    But sometimes, the alchemy doesn’t happen. I’ve heard this to be true especially among people in the LGBT community.

    Since Morgan didn’t feel comfortable in the AA group, she stopped going and eventually relapsed. Desperate to get sober and with no other options in her small-town, she decided to give it another try. She was happy to befriend another lesbian in the group, but surprised when the woman advised Morgan to keep the “personal information under wraps.” By that, she meant not to come out to the group.

    Morgan said, “It felt like going backwards to be in the closet after 15 years of being openly gay everywhere and that contributed to the feeling that maybe this program wasn’t going to work for me. It feels strange to do that and to fear judgement in a group that is all about acceptance and guidance and love… I have a feeling that I will eventually come out at least in the women’s group…My gut tells me I can’t have true recovery if I’m not being my true self.”

    How can mainstream 12-step meetings and groups be more inclusive of LGBT people? While this could be an entire book in and of itself, I wanted to ask others to see what they thought.

    Murphy said: “I think that some of the easiest and most effective ways for the recovery community to be more inclusive of LGBTQ+ folks are to really be aware of language and not make assumptions about the people they are addressing. For me, personally, I immediately get the message that I am not someone’s intended audience when the message being presented assumes that all women are feminine and attracted to men. Heteronormativity is ingrained in every part of mainstream society and, for people who want to make sure they are being inclusive of queer and trans folks, making sure that they’re not assuming people are heterosexual or cisgender is a huge step in the right direction.”

    While I think that Murphy has valuable advice, she has had very different experiences; she has not been interested in attending AA and was able to get sober with the support of an online community called Hip Sobriety.

    Josh* is a trans man from the Midwest who has gone to several rehabs, jails, and attended AA off and on for 20 years. He said that it’s hard to change an old institution like AA, but pointed out that they released the brochure: “AA and the Gay and Lesbian Alcoholic” in 1989. This omits others on the LGBT spectrum, but he said: “As for being included as an LGBT person, I don’t want to be treated any differently, just respected. Greeting goes a long way for me. Having people smile, shake hands, introduce themselves. Sounds simple but that’s where it all starts.”

    *

    I won’t be able to attend Pride this year. Ironically, I will be in a Catholic Church at my godson’s baptism. I will be thinking of my friends in Minneapolis and across the country as they march through the streets on floats, gathering signatures, and celebrating. But most of all, I will be thinking of the invisible misfits of the LGBT community- the ones struggling with addiction, the ones passed out before the dance even starts, the ones who are in rehab or detox.

    I will be sending the brightest beams your way, knowing that one day you will finally be seen and embraced the way that I have been.

    View the original article at thefix.com

  • So You Want to Write About Addicts

    So You Want to Write About Addicts

    At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    We started each morning of residential treatment with burned muffins, a house meeting, and introductions.

    “My name is Tom and I’m a junkie here on vacation. My goal today is to lay in the sun and sample the delicious food in this all-inclusive resort.”

    Tom’s sarcasm made orange juice squirt out of my nose. Humor was an elixir for the boredom of early sobriety and monotony of the rehab center’s strict daily schedule.

    Our addiction counselor corrected Tom: “You need to take this more seriously. I need you to redo that and tell us your real goal for today.”

    The story that society tells about addiction is one of tragedy. When we talk about addicts, we talk about pain, drama, and heartbreak. Of course, addiction is all of these things, but it’s also a rich, multi-faceted story with humor and joy. When we let addiction define the entirety of a human being’s existence, we flatten people to one-dimensional caricatures.

    The story that society tells about my favorite tragic hero Kurt Cobain is a prime example; his sense of humor gets buried beneath his pain. The media glosses over parts of his personality, like how he wore pajamas on his wedding day and a puffy-sleeved, yellow dress to a heavy metal show on MTV. “The show is called Head Banger’s Ball, so I thought I’d wear a gown,” Cobain deadpanned. “But nobody got me a corsage.”

    Two weeks after Nirvana released Nevermind, they pranked the famous British show Top of the Pops. Wearing sunglasses and a smirk, Cobain infuriated producers and the audience when he dramatically sang “Smells Like Teen Spirit,” in a mopey style that evoked Morrissey from The Smiths.

    If you want to write about addiction, remember that two seemingly contradictory things can be true at the same time. Addicts can be both funny and tragic. Another example: Cobain’s original name for In Utero was I Hate Myself and Want To Die, but the record company opposed the title, fearing that fans wouldn’t understand the dark humor.

    While I love satire, I also understand why we don’t want to minimize the seriousness of addiction. Addicts suffer. Addicts bleed. Addicts, like Cobain, die too young.

    *

    I know a thing or two about almost dying.

    I recently discovered an old home movie of my ex Sam* and me. In the video, we were strung out like Christmas lights. Watching it made me feel like a voyeur in my own life.

    Thick tongued, I slur, “Let’s jaaammmm,” to my musician boyfriend. He pushes a tuft of blonde hair out of my face. My unruly David Bowie mullet always gets in the way.

    Sam’s strumming his acoustic guitar and singing “Needle and The Hay” by Elliot Smith, a classic junkie song.

    I’m taking the cure/ So I can be quiet whenever I want.

    He hands me a bass guitar, but I can’t hold it. My limbs go limp. Thunk. The maple-neck, cherry wood bass crashes to the floor.

    So leave me alone/ You ought to be proud that I’m getting good marks.

    The bass doesn’t break, but I do. I try to pick it up, but my body slumps into a question mark. I look like a bobble head doll, with glassy blue-green eyes. Doll eyes blinking open and shut. Opiate eyes. Open and shut. Haunting thing.

    Sam stops singing. “Are you okay? Tessa, did you take Klonopin this morning?”

    Shut. When my eyes roll in the back of my head, he grabs my shoulders and commands, “Wake up! Wake up!”

    “I’m fiiiinnnneeee,” I mumble as my pale skin turns blue.

    I wouldn’t be fine for years.

    *

    When I heard there was going to be an opioid overdose memorial, I was skeptical. When I saw that Showtime was releasing a new docuseries about the epidemic called The Trade, I was skeptical. When Andrew Sullivan christened a non-addict “Poet Laurette of the opioid epidemic,” in a New York Magazine essay, I was skeptical. But not surprised. Never surprised.

    I’m skeptical because I’ve been devouring books, essays, documentaries, and movies about the opioid epidemic for years, charting their predictable rhetoric, cliché story arcs, and stigmatizing portrayal of addicts: addicts as cautionary tales, signal fires, propellers for drama. We’re afraid to color outside these lines, to show the ways in which addicts contain multitudes.

    I wear skepticism like a shell. It feels safer than being vulnerable. My skepticism asks questions like: who has the right to tell the addict’s story? How can a writer dip their plume into the well of an addict’s pain without having been there herself? How can we do justice to addicts and the addiction story?

    If you want to write about addicts, you first need to familiarize yourself with the formula and conventions of the “addict lit” genre. The territory has been well-charted in recent books like Leslie Jamison’s The Recovering.

    Human beings are intrigued by conflict and drama. We are all complicit. I am, too. Even though I’ve been clean for multiple years and know that I shouldn’t be gawking, I do. Even though I feel like they exploit people’s pain for entertainment, I still watch shows like Intervention and Celebrity Rehab with Doctor Drew. These shows jolt us out of the doldrums of our own lives or, if we are addicts ourselves, they reassure us that we are not alone.

    We watch from a safe distance, with the luxury of returning to the comfort of our own cocoons. At its best, addict lit satiates our quintessential human yearning for stories that may lead to salvation. We want warm fuzzies. We want sweet, sweet, redemption.

    *

    If you want to write a story about the opioid epidemic, you must imagine how addicts hunger for stories that represent us, encourage empathy, and feel believable. We long for stories to be our anchors and buoys to keep us afloat. Unfortunately, some stories sink. We must study those too, as a lesson of what not to do.

    The Prescribed to Death Memorial is a dehumanizing failure. It features a wall of 22,000 faces carved on pills to pay tribute to those who overdosed in 2017. If I died of an overdose, I wouldn’t want my face carved on a pill.

    I’ve spent my whole life being carved out. Instead, I’d like to know what it feels like to be whole.

    When I heard about the docuseries The Trade, I quickly signed up for a free trial of Showtime and checked its Metacritic score: 84.

    Steve Greene of Indie Wire praises the series. The Trade “doesn’t purport to be a corrective or some magic key to unlocking the problem. But as a means for empathy and a way to understanding the human cost at each step of an international heroin trade, it does far more than hollow words and shallow promises.”

    Each episode shifts between three main story arcs: a Mexican drug cartel, law enforcement, and addicts and their families. It is technically well-made, with sharp cinematography and juxtapositions like masked members of the cartel guarding poppy fields in Mexico as children play in the street; a grieving mother and father at a memorial rally in Ohio flying signs that say, “Hope Not Dope.”

    But the series was predictable and flat. The addict’s story arc of The Trade is a simple five-part dramatic structure. In the exposition, we see white middle-class young adults are prescribed painkillers for a sports injury or surgery. As their physical dependence grows, they need more and more to manage their pain. At the climax, they switch to heroin because it’s cheaper and sometimes easier to find than painkillers. They fall deep into the well of addiction.

    Then they go to rehab or they don’t. Cut. End scene.

    Paste film critic Amy Glynn says it was “dangerous from a watchability perspective…Junkies don’t make good television because they are really, really damned boring. They are painfully uninteresting, because heroin turns most people into zombie reptiles who are deeply depressed and deeply depressing.”

    At first, I was taken aback by this quote. But Glynn has a point. If you want to write about the opioid epidemic, you might want to do more than rely on pain porn. The poetry of a needle plunging into the crook of a junkie’s arm, crimson swirling into the plunger. Junkies drifting through public streets like zombies.

    Glynn redeems herself: “Someone needs to start telling the rest of the story. Like now.”

    *

    If you want to write a story about addicts, you need to realize that it’s still a stigmatized condition. My friend had to leave a grief group because other parents said her son’s overdose death was his fault and not as sad as a child who died of cancer. It’s as though grief was some sort of competition of suffering and pain. But an entire super bowl stadium could be filled with dead bodies like her son. There were 64,000 overdose deaths in the US in 2016.

    If you want to write a story about addicts, you need to know that life-saving medication-assisted-treatments like Suboxone and methadone are still expensive and difficult to access. Unfortunately, many treatment centers are “abstinence-only,” meaning they don’t allow their patients to take Suboxone or methadone. For a more in-depth plunge into the world of harm reduction, read Tracey Helton, Tessie Castillo, or Maia Szalavitz.

    *

    In addition to these dire facts, we have to deal with our stories being appropriated and exploited. Enter the poet William Brewer, who has never used opioids or struggled with addiction himself. Brewer inhabits the voice of addicts in his poetry book, I Know Your Kind. The title derives from a Cormac McCarthy quote, but it’s very clear to me that Brewer doesn’t “know my kind.”

    I don’t want to be harsh on Brewer. Being from the polite Midwest where we’re supposed to avoid confrontation, I almost deleted this part. But Brewer’s words feel like a chisel mining people’s pain. I also feel it’s my responsibility as a recovering addict and writer to call it like I see it.

    Brewer writes lines like: “Tom’s hand on the table looked like warm bread. I crushed it with a hammer, then walked him to the E.R. to score pills” and “Who can stand another night stealing fistfuls of pills from our cancer-sick neighbors?”

    In a world where artists and writers are constantly being called out for cultural appropriation, I was surprised that nobody called Brewer out for appropriating the addict’s story for his own artistic gain. Brewer’s sole connection to the epidemic is that he was born and raised in Virginia, the state with the highest overdose death rate in the nation. In an interview with Virginia Public Radio, Brewer said when he visited over the holidays, he inquired about whereabouts of former classmates. “People replied, ‘They’re on the pills. We don’t really see them anymore.’”

    If you want to write about an addict, you should avoid infantilizing and dehumanizing addicts, along with the trope that addicts are all “lost and forsaken.” Some of the strongest, most courageous people I know are addicts. Active drug users like The People’s Harm Reduction Alliance in Seattle established needle exchanges, distributed the overdose reversal drug, naloxone, and are fighting to open supervised safe injection sites.

    *

    If you want to write a story about addiction, realize that most addicts struggle with whether or not they should publicly share this part of their identity. For a long time, I didn’t think I’d ever write about my addictions to alcohol, opiates, and benzos. I didn’t have the courage. Here in the Midwest, we keep the laundry to ourselves. We don’t air it out. When I wrote about my first struggle with alcoholism in 2011, my family warned me that it could impact my future job opportunities and dating. I knew they were just looking out for my “best interests.” But I insisted: my privacy, my mistakes, my choice. I hoped that sharing my addiction and vulnerability might be therapeutic for me and maybe even help others.

    If you ‘re going to write a story about addiction, realize how it’s affected by different identities. For example, I’m extremely lucky, because I have supportive friends and family. When I was broke and had nothing, they offered me food, shelter, and support. Also related to my privilege as a white, middle-class woman is that I don’t have a criminal record. Yes, my hospital records bother me, but they are protected by confidentiality laws.

    In a way, writing about my addiction felt like making these private records a public matter. I was hesitant. Brewer was also reluctant to write about the opioid epidemic, for different reasons. He said, “West Virginia is very rarely looked at in a positive light. And so here again is a situation where something really quite terrible is going on, but it became so clear that this thing wasn’t going to go away and was starting to seep into my daily life.”

    *

    Heroin doesn’t seep into most people’s daily lives. Heroin is a tsunami. Heroin drowns.

    *

    There may be value in writing beyond our own experience, as Brewer did. Representation is important and if we all followed the advice to only “write what we know,” things could get bland and boring. Artistic expression would suffer. But it’s a tightrope. It’s a practice in tremendous empathy, wanting to diversify representation, while also being respectful and staying in your lane.

    *

    If you want to write about addicts, you’d benefit from also depicting the humor of early recovery, a story that often falls outside the margins. When I was digging through my own videos and journals, I was of course humiliated by some of my own narcissism and self pity. But I was also surprised and heartened by the unexpected joys like my friendship with Tom at my first rehab.

    On my first day, I noticed him in the smoking tent, wearing bright red Converse, a beret, and long sleeves to hide his track marks. I noticed the way his brown eyes brimmed with both kindness and sadness as he deadpanned in meetings.

    “You guys are like The Wonder Twins of rehab,” staff said. Despite our 20-year age difference, we were inseparable.

    Tom bummed me Parliament menthols and lent me one of his ear buds, so we could listen to The Replacements, The Pixies or The Velvet Underground together. On weekends, we went to record stores, ate pizza, and he read my shitty poetry. We made beaded lizards and built crooked birdhouses bedazzled with feathers and glitter.

    One day in group, we had to watch a 1987 film called, The Cat Who Drank and Used Too Much.

    “Was I just daydreaming, or did you just say we are watching a movie starring a cat?” Tom asked.

    “Yes, it’s made for kids. Lost and Found Ministries recommended it as a good way for parents to explain addiction to their kids.”

    “Drunken cats, who knew?” I said.

    I later learned that the film was praised as an “audience favorite about a beer drinking, drug addicted cat,” when it was screened at the Oddball Film Festival in San Francisco.

    Our story begins in any town USA, a sleepy suburban neighborhood lined with rosebushes and plush green lawns. Cue sappy flute and piano elevator music with too much treble.

    The film opens as Pat the Cat is getting into a red car for his morning commute. We see Pat drinking alcohol from a pitcher and beginning to experiment with other things. A cigarette here, some prescription pills, a bit of coke there (powdered sugar).

    “He’d try anything, it was never enough. Then it was too much.” Pat crashes his car and almost loses everything, but then decides to go to rehab!

    “I’m not trying to be catty, but Pat seems to be pretty well-off to me,” Tom said.

    At the end of the movie, Pat has a cupcake to celebrate his sobriety. Ah, it seemed like only a few weeks!

    “If only it were that easy!” I said.

    “Sure, his life isn’t purr-fect, but it’s pretty close!”

    *

    What I’m trying to say is: If you want to write a story about an addict, we might not be perfect, but we can do better. Starting now.

    If you want to read stories about heroin or the opioid epidemic, I recommend starting with nonfiction. There is power in reading about people’s lived experiences.

    Of course there are also excellent and illuminating fictional books about the opioid/ heroin addiction. Check out this list by Kevin Pickard.

    View the original article at thefix.com