Eileen Flanagan’s book about the Serenity Prayer, The Wisdom to Know the Difference: When to Make a Change—and When to Let Go, was reissued in paperback yesterday. In preparing the book for reissue, she combed through her archives looking at outtakes… Since one of my favorite interviewees of hers was Park Dong-Sun, a Korean Buddhist monk and recovering alcoholic, Eileen gave an outtake from her interview with Park for the readers of Guinevere Gets Sober.
Eileen brings an honest and deeply thought Quaker perspective to the Serenity Prayer, but not necessarily a perspective from recovery—the community that, from a cultural perspective at least, perhaps gives this prayer the most sky-miles. No one can “own” a prayer… but for hundreds of thousands of people on the planet, the Serenity Prayer brings to mind “the rooms.” Eileen relies on her subjects to provide the personal perspective she herself lacks… and Park Dong-Sun, a longtime Buddhist practitioner, is an entertaining and wise subject. It’s brilliant that she found him.
If you’re looking for a book to teach the principles of discernment between the time to change and the time to accept things as they are, then this book is worth the price. In my review I recommended the chapter about “seeking divine assistance” for people who have trouble with “the God thing” in 12-step programs… But I also recommend the chapter on “letting go of outcomes.” Eileen’s Quaker practice of stillness gives her prose a calm and steady tone and provides the lubricant that helps the medicine go down… Especially when she’s telling me, for example, that I need to let go of my image of what I assume I should be doing, because it may close my mind to divine guidance that contradicts that picture. Something I need to hear right now…
Thanks to Eileen for the text below.
Happy Labor Day weekend.
***
Park Dong-Sun, a Buddhist monk and recovering alcoholic, on the 12-step path
Park Dong-Sun came to the United States decades ago to establish business contacts as an exporter/importer. Now in his late 60s, he notes that it was very common for people to drink socially in his native Korea, but not to get drunk. In the United States, however, he started getting drunk, especially when his business failed, and his drinking accelerated. “I used alcohol as a lubricant for socializing,” he explains, though he did not like the effects.
A turning point came when he watched a friend’s son struggle with addiction and then get sober with help from the recovery community. Park was inspired to go himself, first to Al-Anon and then AA, where he observed people who had successfully stopped drinking, something he had been unable to do on his own. “I wanted to be part of it and use their program to quit drinking, and that’s what I did the last 25 years, and I haven’t had a drink since,” he explains.
As Park studied the Twelve Step Program, he had to translate some of the language from the Judeo-Christian tradition into Zen Buddhist concepts. “It was a struggle,” he recalls, but it rekindled his desire to study and practice his own tradition, which he has done for more than 20 years now, along with working the AA program. He does walking meditation about two hours every day. “I haven’t made much progress,” he says laughing. “But I did spend lots of time studying the teachings, over and over and over.”
He takes the saying Let go and let God and relates it to the Zen teaching Let go of all your concepts of life, explaining that this is a powerful teaching, though difficult to practice. “Ultimately the Zen training and practice is to stop conceptualizing. As soon as we conceptualize we limit ourselves, and with that limitation, we cannot see the whole.” For example, you can’t become enlightened by effort. It only comes when you’ve let go of any ambition to be enlightened, which is why so few do it. Park notes that it is difficult to let go completely, especially all of a sudden, “so we move progressively one step after another.” He compares it to doing the Twelve Steps. “There is no beginning, and no end,” he says, like the Serenity Prayer, which he says helps people to get to a higher level.
Park explains that Buddhism recognizes that there are different levels of spiritual practice. A typical church or temple service only requires an elementary level, but the Twelve Steps require an intermediate or even advanced level of spiritual practice, which is why he says they are so difficult for newcomers. One thing that helps in both Buddhism and recovery is community, which Park compares to a nurse that administers the medicine we need. He expresses gratitude for his own communities and thanks all his teachers, including the Buddha.—Eileen Flanagan
Surprise, surprise. A new study by some researchers at the State University of New York at Buffalo (UB) has shown that increasing numbers of heroin users became addicted after being given legal painkillers for pain.
The study appears in June’s issue of Journal of Addiction Medicine.
The researchers found that many pain patients first got hooked by using legal prescription drugs, and then they progressed to buying illegal opioids off the street. “Later, they purchased heroin, which they would come to prefer,” the study states, “because it was less expensive and more effective than prescription drugs.”
More effective, you ask?
OxyContin 80mg tablets
If you look at the study results: more than 90 percent of the participants had purchased street-drugs at some point, and not just tidy little pills—almost two-thirds preferred heroin to anything else “and more than half had used drugs intravenously.” Any drug used intravenously is going to be “more effective.”
It also depends on the “effect” you’re looking for. But in terms of either pain- or mood-control, IV is the most bioavailable route (meaning there’s less drug lost to metabolism—it all goes into the bloodstream), and it’s going to give the strongest “effect.”
As to why they’d choose heroin over pills—I’ve never shot up or bought anything off the street, but I understand from friends who have that it’s more difficult to shoot pills, especially pills with non-opioid agents such as Tylenol and especially fillers that clog up the works.
Another troubling fact reported in this study that all the other digests have missed: 74 percent of these pain patients said the physicians who prescribed them opioid painkillers for extended periods never asked them about any personal or family history of addiction before giving them the drugs.
One of the authors, Richard D. Blondell, M.D., a family medicine doc at UB, made a comment in the UB press release that kind of stuck under my skin:
I tell patients that addiction can be an unintended side-effect that occurs occasionally with the use of these medications. . . . Doctors need to be able to help them if this occurs, so doctors will need to monitor the use of these medications closely.
Those are my bolds. I wanted to know what he meant by addiction being “an unintended side-effect.” I mean, when I think of a “side-effect,” I think of those annoying flies-in-the-ointment that disappear when you stop treatment—nausea, insomnia, even sexual dysfunction. But addiction?—it’s permanent, man.
If you took a pill that caused permanent erectile dysfunction, would you call that a “side-effect”? … And ED isn’t even life-threatening. (Although I guess some folks might feel it that way…)
So I asked the good doctor: This seems a rather diminutive way of looking at addiction. Is this really the way you conceive of it? Many physicians do not understand the nature of addiction, they’re afraid of it, and this is why they miss the signs of it in their offices. … I also wanted to know how he proposed to “help” patients with chronic pain who develop addiction, since the solution for many a physician is to kick the addicted patient out of the practice.
I got a reply a few days later, via his PR flak:
Here’s the sensitive issue: many patients are afraid that physicians will shy away from treating “legitimate” pain if doctors are too worried about the risk for addiction. Many patients take these medications long-term without problems. We don’t want to stop that. On the other hand, some patients do develop an addiction which neither the doctor nor the patient ever intended to happen. The use of the word “unintended” is meant to be a non-judgmental term for this. It means that there’s no blame for the patient or the doctor; sometimes it just happens. When it does occur the doctor must recognize it and manage it with care and compassion. Blaming the patient, blaming the doctor, or “kicking the patient out” are not answers that accomplish anything constructive.
He didn’t quite get it. He was focusing on the word “unintended.” I wanted him to talk about the word “side-effect.”
But it’s great that he’s getting physicians to talk about being non-judgmental and compassionate, and helping patients manage addiction. Blondell has another paper out in this month’s Journal of Addiction Medicine about how chronic pain patients who are addicted do better on steady doses of buprenorphine (Suboxone) rather than tapering doses to become opioid-free. It seems this guy’s orientation is to help some people with chronic non-cancer pain and addiction help manage their pain with some sort of opioids…
Looking forward to seeing how he thinks he can help pain patients with addiction “monitor” their use of painkillers so that they don’t abuse them. That’s one of life’s $64,000 questions.
And since Reckitt Benckiser has just been given the FDA go-ahead for their fancy new Suboxone film, it also seems like it’s time for me to get on the Suboxone story… a whole nother can of worms. Anybody out there with experience with Suboxone??
More about fentanyl… In gratitude for two years of freedom from it.
A 33-year-old upstate New York man is facing two years in state prison after pleading guilty Tuesday to selling the fentanyl patches that caused a teenager to overdose fatally when he sucked on them.
This guy, James Slingerland, apparently stole his father’s supply of patches after his father, who was being treated at home for end-stage cancer pain, was taken to the hospital. Of course when you’re taken to the hospital, you don’t bring your drugs with you because they give you drugs from the hospital pharmacy.
So Slingerland had this brainwave: he would nick his dad’s drugs and sell them for a bit of extra pocket change. Except the middle-man sold them to a teenager who then chewed one and died.
This is what a brand-name Duragesic fentanyl patch looks like.
Brand-name Duragesic fentanyl patch, 75 micrograms.
Fentanyl is so strong it’s measured in micrograms, not milligrams. (A microgram is one-onethousandth of a milligram. Very small amount.)
Can you see the gel inside there? People squeeze the gel out and suck on it. I have a friend from Opiate Detox Recovery who used to call brand-name Duragesic patches his “ketchup packets.” Because he said as soon as he tore the envelope off the first one and saw how squishy it was, he knew what he’d do with it. He couldn’t stop himself. (It’s part of addiction, the not-being-able-to-stop-yourself.)
Aside from increasing the risk of overdose by sucking the gel, the other agents in the gel are also toxic to organ systems. The gel is NOT GOOD FOR YOUR LIVER when it is eaten. Please do not eat it.
I used to buy the generic Mylan fentanyl patches.
Generic Mylan fentanyl patch, 100 micrograms.
This is exactly what my fentanyl patches looked like. 100mcg. Boy does this bring back memories…
In the news stories about the upstate New York overdose, the cops were saying fentanyl is “about 80 times more powerful than morphine.” Morphine is the gold standard against which other opioids are compared, and I’ve heard lots of different estimates bandied about. Truth is, they don’t really know how to measure how much more powerful than morphine fentanyl is, because of the varying rates of absorption. If you have not a lot of body fat, fentanyl will metabolize more quickly than if you have more body fat. If you have more body fat, fentanyl will hang around in your body longer and take longer to excrete, because it’s fat-soluble. If you work out, or if your temperature runs even a degree high, and you put a patch on your skin, fentanyl will be absorbed more quickly.
People have found all kinds of ways to warm up the patches so they’ll be absorbed more quickly—so the blood levels will “spike” and they’ll feel some kind of high.
And if you stick it in your mouth, where it’s the warmest in the body—where does the nurse take your temperature?—the fentanyl will be absorbed the fastest of all. If you don’t watch out, or if you’re unlucky or uneducated—if you fall asleep (“nod”) with it in your mouth—it can kill you.
Fentanyl is, if you’ll excuse my French, nothing to fuck with. It is only for opioid-tolerant patients with high levels of pain who are being overseen regularly by a physician.
Extra fentanyl worked wonders when I had an appendectomy and when I broke my elbow. For pain in the tissues, opioids do a crack job (to use a pun). For neurological conditions, not so much. Fentanyl suckers (“Actiq” lollipops) are marketed for neurological problems such as headaches. In my experience all Actiq did for my migraines was make me not-care about them. They didn’t take away much pain—they just made me not-care about it.
Fentanyl was my ball-and-chain for three years, until I hired a detox physician to help me get free. And two years ago this week I woke up free of fentanyl. I was on Suboxone for two more months—which is another story for another day soon—but I was free of fentanyl. Thank god.
Found this tool that calculates how much smoking will reduce your lifespan.
A smoker getting his dose.
I love interactive tools. They’re like toys. I tested it out on my mother’s smoking history and it was accurate… She lost about 20 years, and that’s about right.
See below for a set of facts about the benefits that immediately start accuring when you stop smoking.
For all the drugs I’ve bought legally over counters and ingested, I’m glad I’ve somehow escaped nicotine. The consequences are just so damaging.
An interesting read for those who want to quit: Glassbottom’s quit-smoking journal on Opiate Detox Recovery, one of my favorite recovery sites. On the first page of this journal the author, Glassbottom, says of a previous time having quit,
For me, quitting cigs changed my entire perception of time. This was frankly the most enjoyable byproduct of quitting. I hadn’t realized that every activity, every commitment, every damn thing that I did during my day was some how couched in the thought of “when is my next cigarette” If I was writing a paper for school, “How many pages till I go smoke a cigarette.” If I was watching a movie that I enjoyed, “When will this movie be over so I can go smoke a cigarette.” When it was time to eat, “I can’t wait till I’m done so I can smoke a cigarette.” … When we smoke a pack a day, that’s 20 cigarettes. Essentially we don’t go for much longer than a half an hour without a smoke. If two packs, then 15 minutes. Now consider how much of that half hour/fifteen minutes of non smoking time that the thought of the next cigarette crosses our minds. Yep, it’s an obsession.
This gave me insight into my mother’s addiction. Glassbottom wrote that the pride of quitting smoking was “just as great as dope in many ways,” though he said that, for him, opioids were “way harder to deal with” than nicotine. But knowing my mother, I don’t think it was that way for her, and I think it may not be for some others. Nicotine can truly be a “drug of choice”—or, as some on ODR might say, a “drug of no-choice.”
What happens when you quit smoking
After 20 minutes
You stop polluting the air
Your blood pressure and pulse decrease
The temperature of your hands and feet increases
After 8 hours
The carbon monoxide level in your blood returns to normal
Oxygen levels in your blood increase
After 24 hours
Your risk of heart attack decreases
After 48 hours
Nerve endings adjust to the absence of nicotine
Your ability to taste and smell begins to return
After 2 weeks to 3 months
Your circulation improves
Your exercise tolerance improves
After 1 to 9 months
Coughing, sinus congestion, fatigue, and shortness of breath decrease
Your overall energy level increases
After 1 year
Your risk of heart disease decreases to half that of a current smoker
After 5 to 15 years
Your risk of stroke is reduced to that of people who have never smoked
After 10 years
Your risk of dying from lung cancer drops to almost the same rate as a lifelong NON-smoker.
You decrease the incidence of other cancers – of the mouth, larynx, esophagus, bladder, kidney and pancreas
After 15 years
Your risk of heart disease is reduced to that of people who have never smoked
Played tennis early this morning. I love tennis; hadn’t played in a few weeks; felt a bit rusty. Let the other person break me in the first game. Started to lose it… saw myself sliding down that spiral, that funnel of “why do anything if I’m just gonna fuckin lose. I suck; might as well just quit.”
REALLY shitty attitude. (Sorry. I’m talking like Mom again. Except she never said the F-word… but she said everything else and then some.)
Then I remembered that I could play better if I “took a few simple steps.”
1. Get outta my own head. Stop thinking and just let myself play. I don’t have to place every single shot perfectly; in the end, my goal is to do my best, and to get the ball over the net one more time than the other person. Which I knew I could do.
2. Stop running myself down Start building myself up. I thought about what my therapist would say. He’s also a coach. He’d say: “You talk so negatively to yourself. When you’re healing, you protect the wound from dirt. Why don’t you try that with your self-talk?” I started encouraging myself. “You can do this.” And I did. I won every game from there on out. More importantly: I played better, and I had fun.
3. Have fun. Part of recovery is enjoying life. I woke up this morning wanting to stay in bed. Bad sign. I thought back: what am I doing wrong? What have I not been doing?—I realized, I haven’t been exercising. My body NEEDS to exercise. It’s like a dog that needs to get out regularly and run around. It can sit for a long time and wait patiently, but after a while, it gets squirrelly. What do dogs do when they need exercise and don’t get it?—they start chewing stuff up. They get destructive. I need to get out and have fun. So I called my friend and we played first thing this morning. … I didn’t enjoy life for so long that sometimes I have to give myself actual permission to enjoy life.
Last day of vacation before school. Gonna take three almost-teenage-guys kayaking, then fishing on a creek, in the 92-degree weather. Wish me luck. I may even enjoy it. –G
I’ve heard this one before and I heard it again today at the 7 a.m. meeting…
They say:
It’s not alcohol-wasm;
it’s alcohol-ism.
I also heard this one this morning, which I thought was great…
They say:
The only meeting you’re late to
is your first meeting.
Two years ago was my last day of daily active addiction. August 28, 2008. The next day,
I committed to detox…
The Suboxone threw me into precipitated withdrawal
and I kicked superhard, in my bedroom, for two days, until
on the third day I could drag myself out and start eating again.
Precipitated withdrawal isn’t like “normal” kicking. It’s like
all 10-15 days of normal kicking packed into two.
I need to remember these facts.
It took me three weeks before I made it to my first meeting…
Two days after my son’s 11th birthday.
Late, but much better late than never.
They say:
I’m either moving
toward a drink or a drug
or away from a drink or a drug.
It can feel like a tug of war.
They also say:
Drop the rope.
It’s important for me to remember
that any thought that makes me want to use
is a lethal thought.
If I find myself thinking something
that makes me want to use, drink,
or behave compulsively,
I have choices today.
I have tools:
prayer
meditation
inventory
meetings
telephone
exercise
self-care
surrender.
Gratitude.
(Did you know that scientific studies have shown
that practicing gratitude actually reduces health problems?
Aside from just making us happier.)
G is having a hard day and trying to do the next right thing, not always successfully.
Dunno why I feel so sad today.
Just back from a weekend in the mountains. Ought to feel refreshed and happy.
Expectations… To put it in perspective, however, I have a high-school friend with a husband and four children and who is dying of leukemia; and another friend both of whose parents have been diagnosed with cancer. And I’m sitting here feeling “sad.”
Where I sat the first day.
This weekend I was in a remote place. No phone reception; hardly any internet. It was healthy to be disconnected. … All the while, though, I kept wondering how it would be when I got back. How I would transition back into connection.
We walked dark trails that crossed waterfalls.
The waterfall we saw on Saturday.
We drove deep into forests, along high ridges and down, and the road gave out onto broad fields with rolls of hay and black cows. We were told to park by the shore, near the campers. And there was the swimming hole.
It was cooler on Saturday; a screen of cloud covered the sky but the sun bored through bit by bit and heated the flat rocks by the river. The water had carved a deep channel at that spot. And on the other shore, an old brown rope with five knots, hanging from a tree. Much too high for my son, who simply jumped from the cliff.
I lay on the rocks and listened to the river making its music, and my son’s laughter and screams.
We ate grapes and cheese and crackers.
My guys sat in the “natural jacuzzi,” a place in the shallow falls where the water cascaded over their shoulders. Still I didn’t get wet. One of my recurrent nightmares is diving under, being unable to get to the surface in time, and being forced to inhale the water just before I wake up.
I took photographs. I watched the yellow Swallowtails sail up the shoulder of the hill on the opposite shore and thought about the many times I used to get drunk in this state when I’d worked there 20-odd years ago… How I’d always meant to visit this section but never thought I could do it on my own. How I was always afraid of the good ole boys I’d inevitably meet out on the road. (Just digging the towels out of the car that afternoon, in those two minutes, I’d had to deal as one of them pulled up and stopped the truck: “How’s the water, darlin?” “It’s nice,” I said, shortly. For godsake.) How my accent said I wasn’t local. I couldn’t take care of myself. I was afraid of everything, the water, the roads, the wildlife, the men, everything.
The meeting last night was about “people, places and things.” People talked about how they’d changed their lives when they got sober—hauled up stakes and moved; changed partners and friends or lived alone for a long time. “Hibernated,” one woman said. I thought back to two years ago when I got sober. I couldn’t do that. I had a husband and a child, a house, a garden.
A husband and child I was afraid of; a house and garden I’d ignored for a long time.
My addiction made me leave people, places and things. I was afraid of almost everything and everyone I loved, and I either avoided or left them.
People that I loved—not just my husband and son, but friends, colleagues, and family.
Places that I loved: despite having the resources to travel, I’d refuse to plan vacations with my husband. Having fun and being happy threatened me.
It still does.
I left things. The number of valuable things I’ve lost—or “forgotten,” left behind—I’m ashamed to say. Even if it’s just a special stone that I used to carry in my pocket. My carelessness with things I love comes from my belief that I don’t deserve them. It’s a kind of reverse-arrogance. I’m super-specially-low.
As my husband and son were taking their last swim in the river before leaving, my husband asked me if I were finally going to get wet, and as I shrugged, he called, quietly, “Wimp.”
“What did you say?”
He laughed softly and turned his back.
“Hey!”
I jumped in and swam the channel to the other shore. The depth of the hole stole my breath—whenever I swim and my feet can’t touch the bottom, my diaphragm seizes, and I had to turn my mind to my breathing so I didn’t panic. Once I’d recovered, I could see the beauty of the valley from the surface of the water. The ridge bent a curved reptilian backbone against the sky. I grew up in a place on a river. Everything looks different once you get out on the water… if you can bring yourself to get out there.
My son was ecstatic. He’d already scrambled up the cliff and was waiting for me, shivering, lips tinged cyanotically.
“Mom!”
I pulled myself up the slick boulders.
Once up I could see a natural set of steps to the top, decorated with pale-green lichens.
It was perhaps 12 feet. At the top, it looked so high… And the mesas of limestone beneath the water shone through in the pale sunlight. We’d have to jump far out. If we slipped…
There are so many things I want to do with my life. Why is danger always the first thing I see?
“OK, Mom . . . one—two—three!”
How do the Swallowtails manage to fly so high with such light wings?
***
I jumped four times. HP leading me to take risks and have faith, I guess.
Then swam upstream and put my hands against the old boulders and let the current wash over me.
Slept well…
I wish I could feel that clean and relaxed all the time. But life is not about what I “feeeel.” It is what it is.
They say:
While I’m in a meeting
my addiction is out there
in the parking lot
doing push-ups
and waiting for me.
I need to be fit, strong and vigilant
I thought this story was pretty amazing: According to the Casper Journal, there’s going to be a new high school in Casper, Wyo., where kids with addiction can work on getting their diplomas and their sobriety at the same time.
The high school’s name is REACH—which stands for Recovery, Education, Accountability, Community, and Hope. The treatment program, facilitated by an addictions specialist that’s a member of the school’s faculty, is part of the regular curriculum.
The district founded Reach High after determining that fully 7 percent of high-school age kids in the district demonstrated addiction problems. Which is pretty much par for the course—I’ve read varying reports that say addiction shows up in, what, 7-10 percent of the general population? The program is designed to offer a limited number of kids a social setting that supports their recovery and prepares them to return to the regular high school so more kids can enroll behind them and benefit from the program.
An amazing thing about this high school is that it’s smack dab in the middle of nowhere. I have a friend in recovery who used to live in rural Wyoming, near Casper, who I met from the forum Opiate Detox Recovery, and she says it can be damned hard to get to meetings out there. She used to drive two hours one way to get to a meeting. So this program meets the kids where they are.
And then—which reminded me of the parents of addicted kids who read this blog—I found out: there are other sober high schools across the country, with names like Central Freedom Recovery School and Serenity High (a name I particularly like, playing as it does on both words—”serenity” and “high”), according to the Association of Recovery Schools. And the same website gives details of recovery-support services at colleges and universities across the country.
Though one must say, now that the kids are arriving in my own back yard in droves and ready to knock themselves out playing Beer Pong and sniffing Adderall, that with only 15 such programs listed, that’s not enough by a long shot.
The sober high school that’s about 30 minutes away from me will take, apparently on the home district’s bill, any kid who’s referred by their public high school—though the website says “private tuition is also available,” so if you can’t get a referral you can pay on your own. Kids usually have to stay sober for certain length of time and demonstrate they’re committed to recovery before they’re admitted.
There are also Sober Dorms at various universities…
What a great option for the kids. Has anyone had experience with any of these?
