Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: Gabor Maté

Sex in Recovery: Advance Praise

Sex In Recovery revised 2c

The people who know their stuff are liking my new book.

Sex In Recovery is a work long overdue. In a frank, personal and highly personable way Jennifer Matesa opens a topic usually only whispered about: the essential role of sexual healing in sobriety. Many readers will be grateful to her.”—Gabor Maté M.D., author, In The Realm of Hungry Ghosts: Close Encounters With Addiction

“In this beautifully written work, Jennifer Matesa accomplishes a herculean task. For decades, clinicians have struggled to assist patients to integrate healthy sex lives into robust recovery programs. At the same time, traditional 12 Step programs have promulgated rules that shamed and denied their members’ sexuality. Sex in Recovery resolves this disconnect. Through compelling narrative descriptions, it gives its readers a map to navigate, resolve and embrace their sexuality in its most rewarding expression.”Dr. Paul Hokemeyer, Senior clinical fellow at Caron Treatment Centers

Release date: Oct. 4. Preorder here.

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The Narcan Is Working, But The Dealers Aren’t.

So it’s not clear exactly how many have died, but one report says “several” Western Pennsylvania people have died of overdoses of heroin in bags stamped “Piece of Mind.”

Narcan has saved at least another 15. Which, it’s about time Narcan is out there. It should be as easily available as condoms, IMO.

As in any story, I like to read the social media comments sections. One woman wrote,

Any person that could hand over these drugs to make a dollar should be dead themselves.

I’m pretty open about the fact that I’m recovering from addiction. What I talk less often about, because it’s not my life, is the fact that I come from a family pretty full of people with addiction. A few of us are in recovery. But a bunch of us are dead.

Here are the Pennsylvania people arrested so far.

heroindealers

They remind me of some of my cousins. When those cousins were still alive, of course. When they were alive, they were tricking, stealing, and also selling drugs.

You think people start out at 8 or 10 dreaming of looking like these dealers by 28 or 30—unhealthy, hard, haunted?

The reader writes,

Too many kids losing their lives. Too many kids losing their parents. How can we put a stop to this… I don’t care.. You get caught putting this on the street you need to be in jail for the rest of your life. Period.

Interesting.

You think all drug dealers aren’t parents?

You read the word “drug-dealer” and you think “kingpin”? As a friend pointed out to me, these are not the Drug Dealers who the DEA ought to be going after. These are the street-level folks who are basically heroin users selling a few bags on the side. Their main problem is addiction. “They are tortured souls,” my friend said. And they need treatment and a hell of a lot of support.

You think there are no people with addiction who are so sick they shoot up in front of their kids, teaching them how to do the same?

Putting a drug dealer away for life is depriving another kid of his or her parent. You may argue that the drug-dealer deserves it, but does the kid? Research shows that kids who grow up with incarcerated parents are more likely to become just like those parents, and/or to develop other serious health and social problems. These people in the mug shots probably grew up with parents who were mentally ill, addicted, incarcerated. The cycle repeats, unless we a a society stop it. We need to figure out a better solution than just killing them or sticking them in prison.

She writes,

I can’t believe what society has came too

Well, hon, I can’t believe what society has came too, neither. What it has come to, according to you, is this: we should imprison for life people who straight-up sell heroin, but we should let off scott-free people who trick others into signing bad mortgages and deprive them of their life savings and blow the bottom out of the economy and cause the largest recession since 1929.

Also, what it has come to is this: we are finally admitting addiction is not just a low-class black-folks and white-trash problem. It’s not just in Washington and Johnstown. It’s in Pittsburgh. And in Pittsburgh it’s not just in Homewood and the Hill anymore. Although when it was, not too many people cared: another reader wrote,

They don’t make a big deal when it happen in North Philly. Y do they care when it happen in West Pa?

It’s in white upper-middle-class Upper St. Clair, too.

And even if you grow up white and “privileged” and go to college, you’re looking at a shitload of debt and a shrinking job-market for anyone not doing software or drone development. SUPER good times, this economy. It SUCKS, and the 1 percent is overjoyed because a lot of the 99 percent is so hoodwinked about the situation that they either don’t bother to vote or, if they vote, they actually support the people who are enacting policies that enable the yawning class gap.

The Narcan is working, but a lot of people in this society are not. And as Gabor Maté, Johann Hari, and a number of other people writing about addiction have pointed out, we don’t just need to detox “junkies” and send them on their ways—or even to put them on maintenance drugs—to solve the problem. We need to create a society where they actually have a chance of doing productive work for a living wage that pays for both their student loans and a place where they can keep their heads out of the rain.

Otherwise, cutting, bagging, stamping, and selling dope looks like a pretty damn good way of making a buck.

//

Richard Pryor: “They call it a ‘epidemic’ now. That means white folks are doin it.”

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Book Review: Gabor Maté’s In the Realm of Hungry Ghosts

In the Realm of Hungry GhostsIn the Realm of Hungry Ghosts

Close Encounters with Addiction

Gabor Maté, M.D.

North Atlantic Books, 2010

Hungry Ghosts is a brilliantly conceived, richly researched and eloquently written account of a decade of encounters with addicts and addiction. Maté offers a deeply insightful understanding of how addiction arises in ordinary people’s lives and how to open ways toward transformation and healing.

Maté is the staff physician for the Portland Hotel, which provides housing and medical care to addicts in “the drug ghetto” (as he calls it) of the Downtown Eastside of Vancouver, B.C. Portland Hotel residents often have mental illness, HIV, sexually transmitted diseases, and other life-threatening problems besides drug addiction. This book not only tells the stories of his patients and his work treating addiction, but he also models the kind of compassion toward addicts that he’d like to see happening in society. “Facing the harmful compulsions of my patients,” he writes, “I have had to encounter my own.”

Gabor Maté, M.D.

The “hungry ghost” image in the title comes from a Buddhist story about the “denizens of hell”: the inhabitants of this realm have small mouths and large, empty bellies, representing the “aching emptiness” that the active addict feels and seeks to fill with things outside the self.

Not “Why the Addiction,” but “Why the Pain”?

Maté is a Hungarian Jew born in Budapest in 1944, two months before the Nazis occupied Hungary. While he was still a baby, his grandparents died in the genocide. He believes his early life was deeply scarred by the horror of that time: though the Jewish kids were dearly loved by their parents, “they inhaled fear, ingested sorrow. . . . What they knew—or, rather, absorbed—was their parents’ anxiety.”

One of Maté’s central messages is: The question is never, “why the addiction?” but “why the pain?” The addict, he says, has usually sustained similar traumas in childhood that result in certain traits that are common to addicts: poor self-regulation, lack of boundaries between self and other, a sense of deficient emptiness, impaired impulse control, and an inability to self-regulate under stress.

Maté sees himself as a workaholic and compulsive shopper—he once dropped $8,000 in one week on classical-music CDs—and he identifies these compulsions as true addictions, though of a less life-threatening sort than the drug and alcohol addictions of his patients.  He attributes his addictions to his compulsive need to anesthetize the deep terror he “absorbed” as a child, growing up in decimated post-war Europe, before his family emigrated to Vancouver. His examination of his own history not only gives him compassion for the suffering of the addicts he treats, but it also provides his readers with a unique understanding of the origins of addiction and possibilities for its treatment—and for addicts’ ultimate transformation.

Genetics: Are We Doomed to Become Addicted?

Maté debunks the popular idea that we “inherit” addiction or alcoholism. He quotes several addiction specialists as determining that “there is no gene for alcoholism” and that “the liability trait for alcoholism is not static”—in other words, becoming an addict or alcoholic depends at least as much upon ever-changing environmental factors as it does upon genetics. He uncovers the weaknesses in addiction-research based on studies of twins. He argues that genes influence temperament and sensitivity, which go on to influence the way we experience the environment.

Maté is not interested in blaming anyone for the phenomenon of addiction—genes, parents, God, the weather. He is only interested in assigning responsibility (including to the self, so he does not see addicts as victims) and changing what can be changed.

Even if, against all available evidence, it were demonstrated conclusively that 70 percent of addiction is programmed by our DNA, I would still be more interested in the remaining 30 percent. After all, we cannot change our genetic makeup, and at this point, ideas of gene therapies to change human behaviors are fantasies at best. It makes sense to focus on what we can immediately affect: how children are raised, what social support parenting receives, how we handle adolescent drug users, and how we treat addicted adults.

No Single Way to Heal

One thing I love about this guy is that he doesn’t think there’s One Right Way to recover. He argues that the 12 steps and 12-step communities have extraordinary healing potential for addicts (an appendix includes one of the most thoughtful and helpful meditations on the steps that I’ve ever read); he offers an interpretation of Dr. Jeffrey Schwartz’s Four Step program (to which Maté adds one step). He presents research about other ways recovery can happen, and he argues that part of the healing is on a cultural level. He defends harm-reduction and methadone maintenance. I would like to hear what he has to say about Suboxone.

A valuable book for anyone seeking to understand her own addiction—and for those who love an alcoholic or addict.

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The Dutch Begin Studying Baclofen For Addiction

So here we are again, back at the baclofen question. My Dutch friend sends me a link to a news story (in Dutch!) about the University of Amsterdam starting a study of baclofen as a treatment for alcoholism and drug addiction. Managed to cobble some sense out of the story, which begins:

Is this the wonder pill which will bring rescue to, among others, alcoholics, junkies and smoke-drug addicts?

“Smoke-drug addicts”—very much like that one. My mother, a die-hard smoker for 30 years before she died at 58 of lung cancer, was definitely a “smoke-drug addict.”

(Another interesting tidbit: the Dutch word for “addiction” is “verslaving”—which, my friend says, means “a slave to a substance.”)

Baclofen is a derivative of gamma-aminobutyric acid (GABA) and is a GABA-receptor agonist—just like, as it happens, alcohol. Surprise, surprise! they work in the same way. … Baclofen is prescribed as a muscle-relaxant for spasticity in conditions such as multiple sclerosis. It is also prescribed off-label to reduce addictive cravings. And it’s dependency-producing. You can’t just quit baclofen—it must be tapered up and down when getting on or off it; stopping use suddenly leads to the same kind of (prolonged, painful) detox that benzos induce.

So they’re gonna study us alcoholics, junkies and smokers, BUT: not gamblers, because apparently there’s no medical evidence that gambling addiction actually exists. The researchers are, according to the story, somehow really hoping it works for drug-addicts. Leading us to believe “junkies” are maybe worse than the other types?

The story quotes a guy from a drug-rehab who has administered baclofen to 100 patients addicted to alcohol, cocaine, cannabis, GHB and benzos, and, apparently, about half of them no longer use their (other) drugs.

The best part of the story: the researchers are speculating that baclofen works better on addicts who use out of “angst.” The story reads (according to my Dutch friend–thanks P):

“With people who use substances from a more positive emotion we do not believe baclofen to be very effective,” according to [Professor Reinout] Wiers [of Amsterdam University]. One assumption of the researchers is that the muscle relaxer also has a calming effect on addicts who try to mask and conquer their fear.

Which would make sense. I mean, what real alcoholic doesn’t drink out of conscious or unconscious “angst”?

Also: I was not fully aware of this, but angst is the Germanic word for fear. So, take a pill, and my fear is relieved. … This brought back the words of my first sponsor, a deeply spiritual woman and former “junkie” who once advised me, as I detoxed off fentanyl and started work on my Fourth Step only to discover that I had a few bits of “angst” going on:

DON’T call it “anxiety.” It’s plain old fuckin fear, OK? If you call it “anxiety,” you can go to the doctor and get a pill for it. It’s OK to medicate “anxiety.” But nobody goes to the doctor and says, “I’m having some FEAR, I need a pill.”

I took her point.

But maybe now, with baclofen, you’ll be able to do that.

Olivier Amiesen, M.D., who controls his alcoholic cravings with Baclofen

The whole baclofen business started with Olivier Ameisen, a French cardiologist who for 15 years practiced in New York and taught medicine at Cornell’s Weill Medical College. Unable to stay sober despite following up on all his practitioners’ recommendations, going to rehab, and sitting in two AA meetings per day for seven years, Ameisen experimented on himself: he started taking high doses of baclofen, which, he wrote in his 2008 book The End of My Addiction, eradicated his cravings and allowed him to become a social drinker. Ameisen called for randomized studies of baclofen’s effectiveness—of which, presumably, the Amsterdam study is one.

One wonders if it would even be OK to become a social drinker while taking high-dose baclofen. Though not classified as a benzo, baclofen basically has a benzo profile and the same kinds of OD risks. In addition, though it seems not to have any tolerance effect (unlike alcohol), dosages have to be closely monitored, because over 80mg/day baclofen can interfere with functioning and cause drowsiness. Ameisen uses baclofen at doses of 200mg+.

I once brought my questions about baclofen up at a meeting early in my sobriety. I got a number of very interesting responses. One was from a young man, maybe 28 or 29, who had been clean for about a year or so. Smart guy and very physically fit. His face lit up like a torch when I mentioned baclofen. After the meeting he said:

It’s funny when people talk about using baclofen to get rid of cravings. My experience was, when I used baclofen WITH alcohol, the combination was juuuuust right. If you know what I mean.

I knew what he meant.

For me, using a chemical to fight chemical addiction is like using water to avert a flood.

Ameisen’s statistic sounds so disappointing: 5,000 meetings over seven years failed to keep him sober. Another friend, a former heroin addict who got sober the way I did, bristled when I mentioned this statistic:

For an addict like me, sitting in two AA meetings per day for seven years ISN’T the solution.

What this person meant was, for an addict like her, the solution = taking the steps. Meetings alone don’t keep her sober.

I can buy, along with Gabor Maté (one of my true addiction-treatment heroes), that some people just can’t get sober with the steps and may need to take “maintenance” drugs to escape the “junkie” lifestyle. That’s cool. In Stephen King’s words, there’s more than one way to de-fur a feline. But if they want to research the addiction-treatment possibilities of baclofen, on which the patent has expired and from which ain’t nobody gonna make no big bucks, why don’t they also research the effectiveness of other cheap and non-patentable “solutions” that have worked for millions of people for much longer?

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