Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: nicotine addiction

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.

Surgeon General’s New Report: No Safe Level of Smoking

Secondhand smokeSurgeon General Regina M. Benjamin released a report yesterday declaring there is absolutely no safe level of exposure to tobacco smoke, whether from smoking or from secondhand smoke.

The 700-page report, “How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Diseases,” is the thirtieth surgeon general’s report on tobacco since the first landmark report linking smoking with lung cancer in 1964. This week’s report details the specific pathways by which tobacco smoke damages the body and lays out the scientific evidence for a number of conclusions I hadn’t heard before:

  • The toxins in tobacco smoke quickly damage blood vessels throughout the body and make blood more likely to clot, causing heart attacks, strokes and even sudden death
  • Tobacco’s toxins interfere with the functioning of the fallopian tubes—the little tubes that carry the woman’s egg from her ovary to her uterus—increasing the risk for poor pregnancy outcomes such as ectopic pregnancy (when the egg implants inside the fallopian tube), miscarriage and low birth-weight. Toxins also damage the DNA in sperm, which can reduce fertility or harm fetal development
  • Tobacco’s chemicals screw up the body’s blood-sugar regulation. Those with diabetes who smoke have a higher risk of heart and kidney disease, amputation, eye disease resulting in blindness, nerve damage and poor circulation

Obviously I haven’t had time to read the entire report! 🙂 so relying on the fact sheet from yesterday’s National Press Club event. But the sheet also said that adolescents’ bodies are “more sensitive to nicotine.” I wish they’d given details about this “sensitivity” that causes them to be “more easily addicted than adults.”

The fact sheet said about 1,000 teenagers become daily smokers each day. Hard to believe—that’s more than one-third of a million each year.

Friday Roundup: Scanning Smokers for Lung Cancer; How Smoking Wrecks the Body (In Pictures)

Finally, a national agency is coming out with study results that seem to suggest it might be good to screen smokers and former smokers for lung cancer.

The National Cancer Institute yesterday announced that conducting regular low-dose computed tomography (CT) scans to screen for lung cancer on heavy smokers and former smokers resulted in 20 percent fewer deaths from lung cancer than those who received conventional chest X-ray.

Bonus result: deaths from all causes (such as emphysema, chronic obstructive pulmonary disease, cardiovascular disease, etc.—but including lung cancer) were 7 percent lower than those who were X-rayed.

The study, called the National Lung Screening Trial, was designed to compare CT screening with chest X-ray (which has long been thought not to be an effective way to screen for lung cancer).

The data still have to be examined further and put through peer-review; some researchers are concerned about the negative effects of the CT scans themselves.

Lung cancer is the leading cause of cancer death in the U.S. by a long shot for both men and women. Many folks believe more women die of breast cancer. More women are diagnosed with breast cancer: while 255,000 women were estimated to have been diagnosed last year with breast cancer, 40,000 of those cases were fatal. With lung cancer, about 106,000 women are expected to be diagnosed this year, while 71,000 women will die. Lung cancer has one of the lowest cure-rates in cancer treatment because it’s difficult to diagnose early—which is the reason scientists have been looking for a good screening tool.

And yet lung cancer is the single most preventable form of cancer death. The addiction to nicotine has to be stopped. What that takes is asking for help.

(You know that little pink ribbon for breast cancer? My dream is to have one for addiction. Awareness helps people to get help.)

I’ve written about this before, about my old friend the longtime alcoholic and drug addict who saved quitting smoking for last. He had an active 12-step program in place, which has since morphed into a Buddhist recovery program. Within six weeks, his physician’s nurse had tapered him off his nicotine program and he was entirely drug-free.

In case anyone needs an extra bit of motivation, or is curious: Came across this interesting slide-show called “Surprising Ways Smoking Affects Your Looks and Life.” The split photos of twins are especially cool—they so clearly show the effects of the myriad chemicals in cigarettes on the skin, eyes, teeth, and hair. They also illustrate how dangerous smoking is for nonsmokers exposed to smoke.

Twin smokers

Which one do you think is the smoker?

Smoking wrinkles and darkens the skin.

Also found these statistics appealing: I’d always known there are at least 80 million smokers and former smokers in the U.S. They broke it down: 45 million Americans smoke, and 48 million have quit.

Finally: A maximum of only 7 percent could do it without help.

Get help. And check out the excellent resources from Bobby Venicchio’s Stop Smoking Now Aids.

Friday Roundup: Tobacco Trial; L.A. Pill Doc; “To Be Of Use”

Florida Tobacco Trial: Can Addiction Cause Lung Cancer?

Good question. What do you think? … A 77-year-old grandma who started smoking in 1948 is suing R.J. Reynolds for causing the lung cancer that, so far, she is surviving. She’s now being treated for chronic obstructive pulmonary disease.

Tobacco company lawyers are arguing that the best proof that Grandma isn’t an addict is that she quit smoking her two packs a day. (This is akin to the medieval water-trial, in which they’d throw the “witch” into the pond and, if she sank, she’d be innocent. If she floated, she’d be declared a witch and they’d get to burn her. Only possible proof that Grandma WAS an addict: that she couldn’t quit smoking and died. So, either way, she loses.)

To win, Grandma’s lawyers have to prove that Grandma was a nicotine addict, and that her addiction caused her cancer and COPD. Very interesting: I think as a juror I could vote that addiction could have LED TO cancer, but not that it caused it. I mean, I haven’t heard the evidence yet. I’m watching this one.

About 8,000 such cases are pending in Florida. Of those tried, 19 were decided in favor of plaintiffs and six in favor of Big Tobacco.

DEA Arrests Los Angeles Physician for Running Huge Pill Mill

I don’t usually run stories like this, because I don’t really care about the doctors who run pill mills, but this guy was allegedly making $100K IN CASH per month for dispensing illegal scripts to addicts and dealers out of his medical practice, where people were said to line up far into the night waiting for their re-ups. Agents took $80,000 from his home in Newport Beach.

The doctor is 71 years old; his employees are also in their 70s, and they all could face up to 20 years in prison. In other words, they’re screwed.

Apparently the DEA is hard at work in L.A. The L.A. Times ran a string of events from just this year with physicians prescribing painkillers to patients who did not need drugs, including a Valley Village doctor who killed himself after being investigated by county drug people.

She Wanted Only “To Be of Use”

Elizabeth L. Sturz

Elizabeth L. Sturz / Argus Community

Now for the good story. I didn’t know about Elizabeth L. Sturz, who according to the NYT obit died yesterday in New York City at 93. Interesting woman who did many kinds of work: wrote poetry and novels, and also soap opera scripts (a job she apparently said made her sick); worked as an acrobat; ghost-wrote for Madame Chiang Kai-shek (how itinerant can you get).

And then decided that she wanted “to leave a footprint somewhere, perhaps even a wingbeat,” and founded Argus Learning Center in the Bronx, a program for “youths considered unteachable and incorrigible.” Eventually Argus morphed into Argus Community and started a program in 1989 called Harbor House that served homeless people with both mental illness and drug addiction. Because at the time the twain could not meet (they still can’t meet very effectively)—if you had mental illness, you couldn’t get drug treatment, or the other way around.

The program worked so well that the National Institutes on Drug Abuse gave $4.5 million (equivalent to about $7.5 million today—about as much as they’re giving big drug companies to study, say, buprenorphine implants) to study the way Sturz’s NON-DRUG program combined rigorous instruction and “affection.” And how it actually worked.

It doesn’t get called Step 12, but that’s what it is. Step 12. It works.

But it can’t be patented, so it won’t earn anybody big bucks, so the incentive isn’t there for people with resources to invest in it or promote it. Unless they have the kinds of motivation that Elizabeth L. Sturz had.

What she said about the addicted people she worked with:

They are wonderfully, exquisitely sensitive people. They take care of each other.

The obit also said:

Mrs. Sturz above all wanted her charges to feel safe, psychologically as well as physically. She looked at people who had only recently been wandering the streets in rags as troubled people, not difficult problems.

This speaks to me in so many ways. Those of us who are recovering from addiction—even if we don’t have a mental illness too, and even if we aren’t literally homeless—often feel as if we’re wandering the streets in rags for a while before we figure out where we fit in. Especially if we have trouble staying sober. If we see ourselves as “difficult problems” to be fixed (or worse, to be “maintained” in some kind of pharmaceutical limbo), recovery is only complicated, or even made impossible.

Here’s a woman who wanted to offer compassion. She wanted to use her resources (obviously, a gift for organization, and for fronting organizations) to give to people who had less than she did. People like this often give money, but she gave a great deal more.

It makes me ask, How can I give today?

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