A Far Cry From “Just Say NO”

Hard to imagine where we would be today had the blinders-on policy of the Reagan administration actually been something based on science, research, and statistics. Just say ‘no’ was a failure of epic proportions.  Like all those who died of AIDS under the Reagan watch, thousands lost their battle with addiction either through death or incarceration.  It’s about time we made up for lost time and got with the program.

Obama: Addiction is a preventable disease

“Regardless how individuals get into theses situations. We don’t know everything. There may be genetic components. Addictions may be different for different people. What we do know is there are steps that can be taken to get through addiction and get to the other side, and that is under-resourced.”

Science Report: Why Risky Rats

I am currently loving the place I find myself in recovery, safely cocooned between two beliefs:  faith and science.  Of course science, by definition, is supposed to be more than faith, but time and time again we find research that negates other research, so how are we supposed to believe that?  Well, faith, I guess.  I know my issues are far more than behavioral, social flaws.  But even when ‘the program’ allows for the disease model of addiction, some people insist it’s all a matter of faith.  Or of just not picking up that drink.  I’ve come to believe that.  But only because I have removed my ability to get high or drunk.  Literally.  No cash, no credit cards, full transparency with my loved one.  Otherwise, until my brain reprograms itself with the help of time, behavior modification, and chemistry (medication), I would likely still be taking risks even when I desperately don’t want to.  A great read.

Risky Rats Help Shine Light on Brain Circuitry Behind Taking a Chance

When people make risky decisions, like doubling down in blackjack or investing in volatile stocks, what happens in the brain? Scientists have long tried to understand what makes some people risk-averse and others risk-taking. Answers could have implications for how to treat, curb or prevent destructively risky behavior, like pathological gambling or drug addiction.

In Love with Lithium

Here’s what gets me upset:  regardless of the program, therapy, rehabilitation program, or self-help book off the shelf at B&N, attempting to tame an addiction without a thorough investigation into one’s mental health by a professional (not a therapist, not a sponsor, not a general practitioner, but someone with the specific credentials to understand mental health “disorders” and the drugs that can possibly help), is like teaching braille to someone with complete hearing loss.  It might open up a new world of sensory exploration for your fingers, offer an insight and language with which to communicate with a specific group of people who share a different physical problem than your own, but it does not address the bigger issue of not being able to hear.  And lumping all mental health disorders into one massive category and allowing non-professionals to diagnose and prescribe, even via a casual personal story, is no less harmful than saying addiction to alcohol is the same as every other addiction whether it be sex, bath salts, binging/purging, meth, heroin, and on and on.

Too often, addiction is a symptom, not the problem, but in the hands of the wrong people, that claim can be turned on its head and used as some form of sick proof one is “in denial” or that their ego is fighting against the fact they are really just a ‘bozo on the bus’ and not being honest with themselves about their true condition, a condition through which adherence to a few simple steps can bring freedom, serenity, and joy.

Somewhere along the way, it became cool to be a part of a larger program of recovery;  that’s great.  Actors step forward and claim their seat.  Writers do the same.  Politicians even.  But it seems that with this new esteem has come the bashing of psych-meds, medications that not only save lives but that treat the problem, not the symptom.  I could run through the list of diagnoses I have been given by various professionals throughout my adult life, could tell story after story of how I fooled some professionals into giving me the exact diagnosis I wanted to hear at the time, and more tales of unsolicited advice from people who insisted they knew what I was going through because they, too, shared the label, “Addict.”  Or they were a family member of an addict or a whole family of addicts.  Often, these people are the ones out there shouting the loudest in a well-intentioned attempt to bring relief to others.  Often their shouts just confuse the issue for those of us suffering from something other than our addictions.

Lithium.  What does that word bring to mind?  To me it’s looney-bins, ‘One Flew Over the Cuckoo’s Nest,” Francis Farmer (or rather Jessica Lang), and on and on.  So unfair, so off-target, such a stereotype from an old generation of labeling.  I don’t know a thing about Lithium outside of what I just read in the below article.  Not a thing.

[‘I Don’t Believe in God, but I Believe in Lithium’]

 

But I do know about Wellbutrin, Effexor, Zoloft, and Prozac.  In the first three, up until last December, I held my hopes for some relief along with a heavy dose of therapy and 12-step.  Why the first three and not Prozac?  Because of magazine ads, commercials on TV, suggestions from friends, and stories in ‘the rooms.’  These were the newer, cooler, if you will, medications that could and would bring relief.

A week before the end of a 90-stay in my first rehab, 90 days after having tried to shoot an 8-ball of meth into my arms with a 4 year-old rusty veterinarian’s needle previously used on our cat, 11 weeks after telling one of my rehab counselors I wanted to die to which she replied, “Oh Spencer, leave the drama for the stage,” 5 days before leaving that rehab, my other counselor said, “You don’t need that Effexor.  Just stop taking it.”  Literally.  I was advised to go cold turkey days before heading home.  What happened after isn’t the point; the point is this person wasn’t qualified to discuss psych meds, a psych med that had been prescribed by a physicians assistant the previous year.

I stayed off that med and all others until 5 years later Wellbutrin and Zoloft were prescribed by that Harvard trained psychiatric nurse.  They worked as well as they could while I secretly kept my truth:  I was raiding the needle-exchange closet of all the used needles dropped off by the meth users in town, sometimes scraping the residue out of those needles and using the clean needles on the shelf above, but at other times, just filling the used needle up with water, shaking the left over crystals together with the client’s blood and shooting it into my veins.  At work.  Yes, I hit a major bottom, nearly killed myself by going septic, and eventually went away to the PRIDE institute.  There, the doctor, a pediatrician, gave me her diagnosis and psychiatric recommendation.  A pediatrician.

A few more years later, last fall, when I finally accepted I couldn’t stop thinking about killing myself, I finally admitted to my therapist these fears (they had become not just ideations but a fear I would succeed), and I saw a psychiatrist for the first time in my life.  There was an initial diagnosis, multiple visits to ensure ‘bi-polar’ was not appropriate, and a thorough discussion of my med history and my current two meds (Wellbutrin and Zoloft).  We eventually landed on my needing to stop Zoloft and to add Prozac.  Prozac?  Isn’t that so 80’s?  Wasn’t that the catch-all drug of a generation of self diagnosed depressives?  Wasn’t it a joke?  I had to check my biases, my baggage, my history in order to hear what he was saying and to realize he was the one with the expertise who could possibly give me my life back.

He did.  As did Prozac.  You see, I’m on the obsessive compulsive spectrum which I never really knew.  My binging, purging, love of sticking needles into my arm, self-mutilation, and addictions were as much a part of obsessive compulsion and they were in what I thought was an inability to stop (addiction.)  Suddenly (weeks later), instead of a tiny unexpected thought creeping into my head creating a chorus that would scream, “DO IT (‘it’ being whatever desire was hitting me at the moment), I heard the initial voice and could stop other voices from joining it.  Instead of crying on the way to get drugs, hating myself because I couldn’t stop, I could now see my thought process. Where before I had no control over where those thoughts went, now my thinking was under my own reigns.  My obsession wasn’t in control  That is a big difference in the mind of a depressed, self-destructive addict.

I write this because I cannot emphasis enough how important it is to seek professional help, to question the baggage of all those non-professionals offering help, and to make sure you cover all your bases.  If you were recovering from a car crash, you wouldn’t just have your bones reset; your medical team (TEAM) would cover all the basis.  Putting all our eggs in one basket only makes for a big helping of raw, scrabbled eggs.

Connection? The Opposite of Addiction?

Johann Hari has been getting a lot of attention recently, a lot of traction out of a premise he hopes will help the world understand addiction a little better, namely:

‘The Opposite Of Addiction Is Not Sobriety. The Opposite Of Addiction Is Connection.’

This attention long overdue, desperately needed, and essential to the world of recovery.  It makes sense, is founded on a bit of research, and is likely welcome to so many who have struggled with conventional treatment programs.  He’s also a journalist, so he knows how to write, how to offer evidence, to logically explain his premise.  Whether he’s hit a bull’s eye or not isn’t really the issue; if he’s hit on THE truth or a partial truth, the continued discourse and need to look beyond what we currently have in place to help those suffering is the only way we can hope to help that one person who hasn’t been served by that current, somewhat sparse, menu of treatments.

Personally, I believe what he is saying makes sense in a very over simplified way. The evidence and research he offers regarding rats and Vietnam have been used to support his point, but it wouldn’t take much to throw a wrench in his argument.  If it was all so simple, AA and other 12-step programs would have a 100% success rate because they are founded on community and connection. Problem is, current data shows the success rate is about 10%.  Of course just writing that could spark the ire of 12-step supporters (and I again have to say I consider myself ‘in the program’ precisely because I get that connection from the rooms.)

I think the most important thing in watching and keeping an open mind here is that he’s onto something. Something, not everything. It just happens to be a small piece of the puzzle.  I am still more convinced that addiction is multifaceted, having different pieces which if you are unfortunate enough to have all of them makes treatment very difficult.  If I went back to Pleasure Unwoven, that documentary on addiction which points out 5 different levels of addiction

1. Genes
2. Reward
3. Memory
4. Stress
5. Choice

I could easily go through the various forms of treatment program and explain how each level either ‘fits’ into a specific treatment or not.

For example:  someone who has suffered trauma as a child is not going to be saved by the 12-step program.  Period.  Those who think that are doing severe damage to those people who have trauma and who come into the program as their sole treatment plan.  Without professional therapeutic help, trauma simply gets locked away to emerge later.

Another example: there are some people who don’t believe in psycho-pharmacology as a legitimate form of treatment.  Perhaps psych-meds are over prescribed by too many general practitioners who don’t hold an expertise in the field.  I personally have spent decades fighting an issue with my brain chemistry which until recently wasn’t successfully dealt with until I saw a professional psychiatrist. Because I self-medicated heavily on an over-the-counter cold medicine (DXM) for 15 years, monthly for a week at a time, nearly 1/4 of those 15 years I spent tripping….yeah, like LSD tripping.  I learned how to curb my behavior to mask being high, and successful taught my brain that it no longer needed to create happy chemicals.  Just like in the researched effects of long-term ecstasy use, there can be irreparable damage.  ‘Connection’ isn’t going to cut it for me.  Considering the early age at which kids are starting to use heavy drugs, there will be significant damage done to brain chemistry.  All the connection in the world, all the meetings in the world are not going to fix that sort of neurological damage.

I happen to have all 5 levels listed above making me a quintuple threat.  Treating all five of these levels is the best form of treatment so a one-size-fit-all philosophy, approach, program, belief is likely to fall short.

Again, the more information out there the better.  What I am so happy about is that these sorts of articles are being offered via social media—making that connection which tells us we are not alone and it’s actually okay to step away from the pack and to create our own program of recovery.  That’s what I am calling, “Re(DIS)covery!”

What’s Your Fitness Age?

I was born in 1967.  I am currently 47 years old.  At least that’s what my birth certificate claims.

Clearly I can turn anything into an addiction or an unhealthy pattern of behavior.  Ask my family who, after I left a second stint at rehab, asked if my need to ‘go all out’ when biking was yet another form of taking a healthy behavior and intensifying it to a point of compulsion.  My tendency toward perfectionism adds to the mix and creates a behavioral formula often leaving me on an exercise endorphin rush one day and a flat-out exhaustion the next.  During long periods of sobriety, I have always sought out the comfort of exercise, tapping into a primal need to expend energy, to sweat, to feel my heart pumping to levels of rush intensity.  Beside the natural endorphins exercise releases, when I am engaged in cardiovascular activity (I am making the distinction here between weight training/interval training and a steady period of cardio that consistently challenges the heart over an extended period of time) my synapses make new connections, my lymph clears out the crap, my mind goes into a meditative state, and, apparently, I get younger.

If you are not a fitness freak, I get how hard it is to start exercising.  If you don’t have all the underlying reasons (often called ‘baggage’) to exercise, starting to do so can be as daunting and difficult as starting a program of recovery.  I might even go so far as to say it is actually harder.  In a recovery program, we take action because on one hand we have no choice (we try to recover or stay forever stuck in the same place) and on the other hand our desire to exorcise the pain of our life forces us into action.  Then there are the people telling us we need to change or else, that loving ultimatum offered to rescue us from the fight between ‘good and evil.’  Somehow with exercise, even though we know the benefits, we watch how healthy and happy other people are, we covet their bodies, their sexual energy, their high spirits, we don’t have the same need to engage in that healthy behavioral way.  There isn’t a meeting which encourages daily exercise (as in a daily reprieve), there is no public counting days to a healthier life, there is no family member whose innocent question (How are you doing?) is actually loaded with specific need to know (are you still sober, or rather, did you get your cardio today?)  There is very little accountability.  The person next to you, unless you’re at the gym, is just as likely as you to have skipped any form of exercise the day before.

Sweeping generalization, I know, but if I went to my regular meeting and gave out a survey of the 60+ people who attend with questions regarding their cardiovascular activity for the week including knowing what their maximum heart rate is, for how long did they raise their resting heart beat when engaged in physical activity, or simply, how many days did they get their heart beat above it’s resting state, I am confident 75% wouldn’t even fill out the survey.  They would avoid the survey like they avoid exercise because somehow adding something to one’s life is even harder than taking something away.  And the benefits could actually be as great if not greater.  (I’m hearing some groans.)

In a recent New York Times article about Fitness Age describing the researched benefits of being an older competitive athlete, the outcome was clear: you can change your age, your fitness age.  I dare say that while recovery from an addiction is the act of saving one’s life, being in recovery does not decrease your fitness age.  It conceivably stops the damage already done, perhaps helps the body to heal, and saves one from the hell into which they have descended.  But this isn’t always the case.  Removing the drug to which one is addicted may save a life; but too many stop right there.  That’s it.  Life is based on counting how many days the drug has remained out of one’s life.  And yet, if the research is true, we could be doing so much more.  And most of us don’t.

I am a man who has lived with HIV for ten years now.  5 years ago I received an AIDS diagnosis because I was doing all sorts of things to hurt myself in my addiction.  I’ve injected the worst forms of drugs, bath-salts, the purest forms of research chemicals you can find on the planet, used dirty syringes in the hopes of contracting something deadly (little did I know that when I contracted HIV it was no longer a death sentence).  When I stopped, my body restored it’s order; I am a relatively healthy person when I allow my body to be in a natural state.  I’m 47 years old.  But I exercise.

My fitness age:  26.

How is that possible?  The calculator measures resting heart beat against maximum heart beat with amount of cardio to body fat index.  And that’s that.  It’s really quite simple and is nothing new.  The reality of exercise is that it not only keeps you healthy, it can reduce your fitness age.  Personally, I’m not in recovery to live a life based solely on my not doing an unhealthy behavior.  Living a life trying to hold something at bay is exhausting.  Just look at the faces of those around you in recovery.  But living a life holding something at bay while adding something that actually changes your age, your spirit, your energy, your cellular make up, you outlook, your looks is something I want to do.  I see so much potential in people, so much more than they likely see in themselves.  That could be the chronic human condition.  We have to try to rediscovery our potential which includes adding behaviors which can alter our physical, mental, and emotional being.  Nothing, not even abstinence from your drug of choice, can do that as dramatically as cardiovascular exercise.

 

 

Pleasure Unwoven: a must see DVD

SCIENCE and 12-Step NEED NOT BE MUTUALLY EXCLUSIVE.  There.  I said it.

I often end up separated from the pack, “the pack” being any group of people who share a recovery experience, or in this case a program, who readily throw out the, “hey, whatever works for you, man,” quip when someone suggests alternatives to their chosen path of recovery but who also tends to be blatantly one-sided in their own convictions as to what is actually ‘THE WAY” (I picture Saturday Night Live, Dana Carvey doing The Church Lady, saying….’Well, isn’t that special…..” to anyone not sharing her dogma )

I believe a holistic approach is the only approach.  Some 12-step here, some CBT there, therapy, exercise, medication if necessary, diet, and on and on.  Just like most people I can be easily swayed by a well-founded argument or by a touching, emotional story.  I can go from a blog post sharing an article which says addiction isn’t a disease to this blog post sharing a video which states convincingly the opposite.  And that’s the point.  Unless you are willing to open up to other possibilities, you will be limited in life.  That’s a simple concept that has reaches far beyond the recovery community.

We must, as people trying to heal, stop closing the door to science when science steps forward with empirical evidence.  And we also can’t let hope and faith (I am quickly taken to the anti-vaccination movement) say that we can heal without science.  At least look at the data.  Look at the research.  Listen to the people who have spent their lives trying to find answers instead of blindly holding faith that your journey to recovery rests in 12 simple, albeit painful and exhausting, steps written in the 30’s, to the exclusion of everything else.

Got you mad yet?

At my last rehab (the Pride Institute--a twelve step program), we watched a DVD called “Pleasure Unwoven.” (Abridged clips here)

It’s a beautifully produced piece using the new science of addiction (by a doctor who did the research.)  It was a life changing experience for me because it helped validate what I have always known–there is not just one answer to this problem.  It says there are 5 levels to addiction:

1. Genes
2. Reward
3. Memory
4. Stress
5. Choice

You’ll need to explore yourself what these levels actually mean via the DVD, but even with a quick glance you might understand how each level works in you.  At the end, he talks about the benefit of 12-step programs.  Watching was life changing because I could assimilate the content of the DVD with what I was experiencing at that time for the first time:  intense 12-step.  But the 12-step also had me in creative therapy, individual mental health therapy, group therapy, exercise, etc. etc.

Do you ever wonder why we feel so good upon leaving a treatment center?  It’s because, no matter what the treatment is, it’s likely surrounded by a holistic mandatory menu of alternative treatments.  When we leave treatment and get back to life, we’re often left alone and isolated within one channel of recovery.  And it’s not enough.  Or maybe it is.  If so, there’s no real reason you’d be reading this.  Otherwise, if you are reading it, you may be questioning and asking yourself if there isn’t actually more you can do.

Watch the clips, buy the video (if you are the person I loaned my copy to, please return it!).  Here’s a review by Cold Creek Behavioral Health—a NON-12 Step program based on CBT.  If the DVD gets both 12-step and Non-12 step treatment center approval, it might be good enough for you.

Read Cold Creek Behavioral Health’s review of Pleasure Unwoven