Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: cigarettes (page 1 of 2)

Are Cigarette Smokers “Really” Addicts?

SmokingWhile I was in the UK for my father-in-law’s funeral last week, I had an interesting talk with someone who has tried and failed for some years to quit smoking.

This guy has been smoking for half his life. He started at about 16, and he’s 32. (Studies show that when people start smoking as teens—or using any drug, including alcohol—it’s much harder to quit later.) When he was 18 or 20, back when nicotine patches were prescription-only, his father paid for patches. And the patches worked to help him stop. But then he started smoking again. Since then he’s quit “a bunch of times,” as he said, but has never been able to stay quit.

I remember asking him after the first time, when he was maybe 21, why he found it so hard to stop smoking. This was around the time my mother died of lung cancer, and before my own addiction became entrenched—before I understood the ways addiction becomes woven throughout the fabric of life, the ways it changes the neurological system.

He had given me simple answers: He was always desperate for the first morning cigarette with his coffee. He missed having a cigarette with his friends when he went for a beer. He wanted a cigarette when he smelled other people having cigarettes. Smoking helped him deal with stress.

So, as the author of an addiction blog I was thinking to myself, here’s some reasons he found it hard to quit:

  • the morning hit of nicotine potentiating the caffeine—people have always used drugs together; addicts get used to using them together; think Speedball, think alcohol and Valium (a combination that has killed many people), think ecstasy and speed. Hell, think Four Loko, the crazy-ass combination of caffeine and booze that has landed college kids in the hospital in the past year.
  • the social aspect of using—he missed smoking with the people he drank and smoked with. When he went out drinking, it was natural also to smoke. He couldn’t do one without the other. (In fact, he might not have been able to socialize without drinking. I mean holy God, I understand this.)
  • simple sensory triggers—cigarette smoke creating what we addicts call “euphoric recall.” He sniffed the smoke, he suddenly remembered the burn at the back of his throat, his mouth watered, he just needed a cigarette. Alcoholics feel the fire down their throats when they see someone drinking; opiate addicts feel the spreading warmth in the bottom of their bellies when they come across “paraphernalia” or actual drugs.

And then, of course, the all-time biggest “trigger” of them all: stress. (When I was using, getting up in the morning was stress enough to make me use. Vikes with morning coffee, anyone?)

We were on a walk in a park with a group of family and I heard a particular, very familiar loose bronchial cough come out of his mouth.

“You’re not STILL smoking?” I said.

He unzipped a jacket pocket and showed me a packet of Marlboros. UK law dictates one entire side of the package be printed with the warning, “SMOKING KILLS.”

“Dude,” I said, “you have to stop.” He knows all about my mother, blah blah blah. And there we were, standing with some of his closest family.

“I know,” he said.

I asked him what was making it hard for him. He said he found it impossible not to smoke when he goes out drinking with his buddies, “and also smoking spliff makes it hard. I mean, smoking anything would make it hard,” he said. Bingo. Using other drugs. Alcohol and weed.

What’s necessary? Well, how about total abstinence and a program of spiritual fitness… But most smokers don’t see themselves as “real addicts” so they don’t think going that far is necessary.

“I’m gearing up to create the Master Plan for quitting for good,” he said. “But I don’t know what it’ll be yet.”

We talked about Chantix, which he hadn’t heard about. I told him Chantix had worked for friends of mine for whom all else had failed.

Chantix might get him clean, but staying clean is another matter. As every recovering addict knows.

He was speaking really laconically, as though he had all the time in the world to quit, as though the warning printed on the packet in his pocket were just an ad he didn’t have to pay attention to. Addicts have very selective attention. And most smokers don’t consider themselves addicts.

In fact: in trawling through some research today, I found this astonishing paper published in the journal Addiction. In this paper, “Believing in Nicotine Addiction: Does It Really Make Quitting More Likely?”* the researchers suggest that it’s counterproductive for smokers to think of themselves as “addicts” because, in some studies, those who did “expressed weaker intentions to stop smoking and had much lower expectations regarding their perceived ability to do so.”

I was amazed. They’re paying these guys to sit in a room and tell people who can’t quit a lethal substance to deny they have a real addiction. I mean, take the logic a step further: if smokers should not “believe” in their addictions, why shouldn’t alcoholics and heroin users also take the same strategy? Why don’t they just do away with rehabs and tell us all, “You’re not really addicted—believing you’ve got an addiction just takes away your power and responsibility to quit.” Unbelievable.

Nicotine addiction is real. I’ve seen it. It killed my mother. She was a prodigiously intelligent and beautiful woman who died at 58, after having lost her hair (three times), her balance, her hearing, the use of the muscles on one side of her face, and eventually her speech and her mind. She should be here today, 70 years old, playing with her grandchild. But she’s not. Because of nicotine addiction.

No one told her she had an addiction. Her physicians told her to quit but never told her she was an addict. She herself would have been mortified at the term and would have rejected it.

But in my experience, the truth sets free.

Of course, this is just “anecdotal.” 🙂

*Addiction, 106:3, 678-679, March 2011.

Recovery and sexuality, part 2: Sex as a drug.

This was a story I ignored last month, because I was like, Oh god, not another Teen Story about being Addicted To Love with Robert Palmer wearing his bad mullet-cut and droning his boring 1986 ditty in the background. It was in almost every headline or lead: “Might as Well Face It…”

Except the media bent the story out of shape. They said, “Romantic Rejection Is Just Like Cocaine Addiction!” (The New York Daily News also got it wrong on a number of other counts: It was not 15 hetero men, it was 10 women and five men, but who’s counting?) Wrong.

The real story, when you read it in the July 2010 edition of the Journal of Neurophysiology, turns out to be this: Romantic obsession is just like any other addiction.


Guinevere and Lancelot

Queen Guinevere and Sir Lancelot, obsessed with each other behind Arthur’s back…

The operative word here is “obsession.”

The researchers interviewed 10 women and five men who had been rejected by romantic partners. And the ad the researchers placed on the Stony Brook campus asked, “Have you just been rejected in love but can’t let go?

I think I hear Lucinda gearing up here…

The difference between these subjects and the ones who didn’t respond to the ad isn’t that the ones who didn’t respond hadn’t been rejected. It’s that maybe they were able to let go. Move on.

The ones who responded to the ad told the researchers things like,

  • I think about him constantly.
  • We try to be friends but it doesn’t work; I’m too attracted to him.
  • What’s the point, without her.

Substitute “alcohol” or “drugs” for “him” or “her,” and you’ve got what addicts say about their substances.

The findings were not just about cocaine, either. The researchers noted that “craving for drugs is associated with a significant increase of dopamine in the striatum,” a part of the brain where they found activation; that they found activation in another area associated with cigarette craving; and that

These previous findings suggest that the experience of romantic rejection involves the same neural systems that underlie various addictions.

When we get sober, it’s easy to substitute one addiction for another. I’ve heard people talk about it all the time. We get rid of the chemicals and start in on the behaviors: shopping, television, eating, Internet surfing, cutting . . . sex.

After the whole Tiger Woods Thing, my Gmail inbox was stuffed with notices: “Does Sex Addiction Really Exist?” Who knows? It’s all obsession. Obsession is obsession is obsession. The monkey’s inability to let go of, as it were, the banana.

When I first got sober, and the chemicals leached out of my cells and tissues, my body woke up. A cloud passed over the lioness who had been sleeping, forever it seemed, in the sun, and the lioness roused for the first time in many years.

And all around her were lions.

I’ve written elsewhere about how I drank and used drugs (and came down with headaches and a great deal of physical pain) because I felt like I didn’t deserve to be sexual. It was a challenge, seeing all those lions—for the first time, really—and knowing I was married to only one.

For a while my striatum (or whatever) must have been flooded with dopamine, because I spent some months pretty distracted by all the activity that was crossing my field of vision. My radar hadn’t been so jazzed since I was maybe in my 20s. And since I was a lot more mature and experienced than a 24-year-old, I had more ideas about what to do with all that jazz.

It confused the hell out of me and I lost sleep over it, and I cried over lost time and opportunity and youth and being 44 and on the downhill slope, and like the students in the study I’d stand in front of the mirror and poke at my face and wonder “What’s the point?” and in general feel terribly sorry for myself that I’d “gotten sober too late.” As though I should have kept using, just because.

And then because all my negative feelings were too much for me, I’d make up whole scenarios in my head to get out of myself. I’d waste yet more time. And then beat myself up for wasting it. I didn’t know what to do to get out of this loop of tape.

This DOESN’T only happen to people newly sober. I’ve heard people with upwards of 25 years talk about using sexuality—whether real or imagined—to get out of themselves.

I was directed to write inventory about my sexuality and my resentments—against my mother for being the Thought Police and Sex Gestapo in my adolescence and early adulthood (the time of life when you’re supposed to experiment with sexuality and identity); mostly against myself for making “stupid” decisions, for “allowing” myself to become an addict, for being a Terrible Writer, a Failed Artist, a Bad Mother, a Weak and Compliant Daughter, an Exceptional Wreck of a Human Being. I am such a star at being bad. Ego, ego ego ego.

I even wrote inventory about my resentments against God, for making me an addict. For making addicts of so many of my family members, and “letting” them die.

(I still don’t know why God would make anyone an addict, btw. I don’t know why God would give my father-in-law dementia, or my niece Down Syndrome, or my uncle multiple sclerosis. One of my sponsors told me point-blank that God made me an addict . . . My ideas about God are still under revision and I don’t know if I buy that God made me an addict. If I stay with that thought for too long, I get pissed off at higher power, and getting pissed off at higher power isn’t good for me.)

But anyhow, writing inventory helped. My part became clear. My part—or part of my part—is to use my gifts productively and in service to higher power’s will.

And then I started meditating and praying. I’ve been meditating every day for the past six weeks, under direction of someone who has a strong meditation practice. I was directed to pray after I meditate… my own version of the seventh step prayer, asking higher power to relieve me of the bondage of self (helping me to LET GO) and build with me throughout the day. I’m still working on that version of the prayer… so I pray a half-assed spontaneous made-up version every morning, and it seems to be OK for now…

In terms of sexuality, I see mine as strong and beautiful and as a gift from higher power. I’ve relinquished the Catholic vestiges of shame that would make me view my sexuality or my body as “bad” or “wrong,” as long as I don’t hurt myself or anyone else with it. So … with all the soccer-dad lions that prowl across my radar these days … I allow myself to appreciate them. I let the saliva flow. And then I let them slink off into the desert and I get my roar out with the one I married.

Next I think these researchers should put addicts into functional magnetic resonance imaging and ask us to meditate on a gratitude list. I’ll be first in line. I want to see where all that dopamine goes when gratitude is applied to it…

Secondhand smoke may cause mental illness

Remember how the other day we saw a story about how cigarette smoking might cause depression? Now it turns out that researchers in London have figured out that “exposure to secondhand smoke is associated with psychological distress and risk of future psychiatric illness in healthy adults.”

Their study appears in this month’s Archives of General Psychiatry.

I find this fascinating, as the child of two smokers, one a chain-smoker who refused to roll the windows down when she smoked in the car. … Little story here: There’s a whole bunch of data to suggest that babies born to women who smoke throughout pregnancy are at risk of low birthweight. I was born at just over six pounds, six-two to be exact, and as all babies drop weight, I dropped below that after birth. At eight weeks old, tiny little baby, I came down with pneumonia, and I nearly died.

My mother always attributed the pneumonia to “someone with a virus who wanted to hold the baby.”

It only recently dawned on me that the secondhand smoke in a house with the windows closed (I was born at Halloween) could have been the bigger problem, huh? Or at least a complication. Denial—dayam.

If you smoke, please quit!

Nicotine addiction kills 5 million worldwide per year

Many people don’t think of smoking tobacco as a “real” addiction.

Take a look at these stats from the United Nations Office on Drugs and Crime’s World Drug Report executive summary:

[T]he consumption of tobacco, an addictive, psychoactive drug that is sold widely in open, albeit regulated markets, affects as much as 25% of the world adult population. . . . [M]ortality statistics show that illicit drugs take a small fraction of the lives claimed by tobacco (about 200,000 a year for illicit drugs versus about 5 million a year for tobacco).

Amazing. Tobacco kills 5 million people worldwide per year. How can anyone think of it as not a “real” addiction?

I don’t agree with the War On Drugs… But if we’re going to have a war on drugs, why don’t we pick the right drug to fight?

If you smoke, please save your life and quit.

Cigarette smoking may cause depression

Can’t wait to read the rest of this paper about cigarettes actually causing poor mental health in The British Journal of Psychiatry. The abstract cites the researchers’ results:

Adjustment for confounding factors revealed persistent significant . . . associations between nicotine-dependence symptoms and depressive symptoms. … [T]he best-fitting causal model was one in which nicotine dependence led to increased risk of depression. The findings suggest that the comorbidity between smoking and depression arises from two routes; the first involving common or correlated risk factors and the second a direct path in which smoking increases the risk of depression.

In other words:

1. The symptoms of nicotine addiction and depression are strongly connected, even when you control for variables.

2. After looking at a bunch of different ways of figuring out what causes what, the way that made the most sense was that nicotine addiction increases the risk of depression.

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