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Posted by on in Drug Addiction

If you want to tell the truth, it's best to do so in a story. 

I think that's what I've done here with my short story "The Damage Done." It is a grim, horrific tale, but one that demonstrates the lengths addicts will go to when under the throes of cravings. The manipulations. The obsession. The desperation. It is also a tale of how a family legacy of addiction can be so haunting.  Enjoy this short, quick read. The title is based on the Neil Young Song, "The Needle and The Damage Done" and it's a precursor to the heroin addiction story MILK-BLOOD

  

The Damage Done

Jervis Samsa lay awake on his bed, twitching in and out of detox dreams. Poison sweat ran from his pores and dampened the sheets. He wanted to scratch and itch away at the flesh that covered him and then rip out the muscles that cramped in pain. The lifeblood was gone from his veins. No dope for a day now. Not since yesterday when he popped a vein with Tara, and he hoped she’d return with some cash but never did. Now he had nothing.

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Posted by on in Alcoholism

 Nine Candid Thoughts About Substance Abuse Treatment and the 12 Steps

I am 24 years sober today, and of those years, 20 of them have been working in the substance abuse/behavioral health field. I’ve gathered a random sampling of thoughts on treatment and AA. If you agree with all of them, then I have either bored or failed you. Check them out:


1. Cliche to say, but treatment works. It saves lives and ripples to save families. You will hear all sorts of stats, sometimes as low as only 1 in 10 who participate in substance abuse treatment will stay sober for a whole year after discharge, but there are other stats that state almost 50% of those in treatment at any given time will be sober ten years later. It just may take a few attempts for it to stick into long lasting recovery.

Also, ‘treatment’ is such a broad term describing such different levels of interventions. The question is what type of treatment works best, and when. I’ve always felt that inpatient or residential treatment squeezes folks a bit harder to get to some necessary truths and insight. (For when you squeeze an Orange, you get Orange Juice, because that's what’s inside. Well, when you squeeze an addict, you get what’s inside as well.) Inpatient treatment can do this squeezing best in a safe situation and stop a relapse in the early days so that long term recovery can take roots.  Yet less restrictive modalities such as day treatment programs and intensive outpatient give the therapist and client real life scenarios to process and do not offer the fantasy scenario of living 24 hours in a therapeutic environment. In general, the world out there wants you go get high, so go fight it, (with friends at your side) and come back to report.

2. Treatment doesn't work, for some folks, at least in a traditional 12-step model. I believe that substance abuse treatment has cast too wide a net, and that there are many patients in substance abuse specific treatment who are actually primarily personality disorder or other diagnoses that are ill-served by giving them traditional CD treatment. For these folks, using drugs or drinking is just one of many symptoms that often include other anti-social traits.

I am not talking about the bipolar or depression diagnosed client where the two disorders feed off of each other and make both set of symptoms worse. I am referring to some axis 2 personality disorders or affective disorders. We throw them into the mix and treat them the same, and it’s a set up for failure for both client and clinician. Asking a client with narcissistic personality disorder to get humble and ask for help is cruel and unusual punishment for all involved. An untreated borderline personality diagnosed patient with acute symptoms sits at a first step table and nobody gains. What happens is, many of the social arenas provided in treatment, including groups and 12 step support meetings, are actually just another stage for the narcissist or anti-social personality disorder member to practice their pathology. This is especially prevalent as cluster B personality disorder traits, who end up in the criminal justice system, are mandated chemical dependency treatment.

3. There are too many recovering addicts treating other addicts. Okay, maybe I contributed to the problem, but I find that when folks become ‘experts’ and well-versed at AA or NA, they tend to expect others to work a program or get sober exactly as they did. These are the folks who do way too much self-disclosure, and every moment is an aa/na meeting, and they have a slogan for every situation. Treatment center staff who gain a masters degree only as an excuse to further their own personal agenda, which is pushing their own way of treatment onto others. Ironically, these therapists are often the most popular and heralded at treatment centers, but maybe not the most effective. They often have a fervent desire to spread their recovery gains to others, and you can’t deny the enthusiasm, but many times it could stay at the tables rather than inside facilities.

4. AA and NA itself is not treatment
Let me explain. The focus of treatment needs to be on clinical issues such as negative, self-destructive thoughts, inability to manage emotions or self-soothe without substances. (just as an example, for there are tons others.) Treatment is facing cognitive distortions, behavioral patterns, and cognitive reframing to find hope amidst despair, as well as identifying concrete and tangible behavioral changes and skills. Treatment should not be a boiler plate of writing out ones first step, listing 3 examples of powerlessness, writing an autobiography, getting a sponsor, identifying a higher power, watching a Father Martin video, etc... These things are essential, I believe, but they are a supplemental. Too often, the steps are seen as the only form of therapy.

5. AA and NA saves lives and understands addicts better than any Counseling theory.

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Posted by on in Alcoholism

Nine Reasons Recovering Addicts Run

In order to stay sober, the alcoholic and addict need to learn natural ways to get high. It's a crucial part of recovery. Running seems to be a great fit for those who are trying to enjoy live free from alcohol and other drugs.  Here are nine reasons. (adapted from Chasing the Dragon: Running to Get High)

1. You Only Get What You Give

Distance running by its nature lends itself to the addictive personality, if there is such a thing, of rewarding those who blast past barriers. It not only rewards but demands the obsessive brain, the kind who goes to a $5 all-you-can-drink keg party and asks for $10 worth. It's the metaphorical potato chip that, once it's on your taste buds, lights up something deeper within you that craves more.

Yes, addicts can be cowards, immature, fragile, obnoxious, and so on (it's an `in' group thing, so I can get away with saying that) but lazy is one thing we are not. Maybe lazy when it comes to responsibilities, sure, but not lazy when it comes to getting what we want. 

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Posted by on in Drug Addiction

First off, I am honored to be featured as the Addictionlands “June Expert”. Then again, my inclination is that anyone who calls themselves an expert has too much certitude for me to trust. Instead, think of these as observations from numerous perspectives and years of experience.  

Here goes:

We live in a world that wants you to get high. In fact, companies need you to get high in order to exist. Their job depends on it.

Right now, pharmaceutical companies are churning out addicts in record numbers. The pain management industry is lucrative. To live in chronic pain is to truly be sick and suffering, so it is an essential, and even compassionate service, but the spin-off is, pills in so many cabinets are creating an incredible number of heroin addicts. The curious teen no longer steals a Bud Lite from their dad’s supply, they take some Vicodin. They learn to chew the pill rather than swallow for a quicker high. They learn how to snort. Soon enough, they learn what it means to be dopesick: the need to do more for the same high, and to maintain a supply.

 An opiate addict is a massive consumer for big pharm. (A pain management client times ten.) But instead of managing their pain, the prescription use causes intense suffering and sickness.

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