Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: recovery from addiction (page 2 of 10)

New Mexico Dad Busted for Injecting Heroin Into Nine-Year-Old Son’s Neck

Came across this on, of all places, Gawker yesterday.

“Good Christ, that one’s grisly, eh?” my friend Dirk, who runs the news desk at The Fix, said.

Jose Velasquez Jr., who allegedly injected his son with heroin.

Here’s what happened: Jose Paul Velasquez Jr. was alleged to have been injecting his son with heroin through, one presumes, the little boy’s jugular vein. The Gawker story said the 9-year-old boy’s mom noticed “unusual track marks” (as opposed to the “usual” ones? hm) on her son’s neck and took him to hospital. The little boy tested positive for weed and opiates.

 

The cops arrested Velasquez and charged him with child abuse. And here’s what I found interesting about this story: the dad was also charged with contributing to the delinquency of a minor.

The dad is pretty obviously an addict, right? And it’s correct to arrest him for abusing his kid, because if he did this, it qualifies as abuse: he will have harmed his son’s body (and psyche). But the charge of “contributing to delinquency” puts addiction back into the sphere of moral degeneracy.

If the guy injected his son with drugs, how is that turning the kid into a degenerate? In my mind, it’s exposing him to sick behavior. Here is how my logic runs: If the kid grows up to do what Daddy did, he’ll grow up to be an addict first—somebody who is sick and needs help—and then, possibly, because of his addiction, a criminal, a “degenerate.”

Most of all, he’ll grow up first to hate himself. He’ll carry on abusing himself the way Daddy abused him.

So let’s hope Velasquez goes to jail. Lots of people have kicked in jail; Steve Earle has a great passage about it in Chris Lawford’s book, Moments of Clarity. And Earle and others have STAYED clean not through the actions of law-enforcement but through programs of recovery, usually involving a component of spiritual development.

Saying the guy’s sick doesn’t absolve him of having to pay for what he did. Part of the payment is accepting help from society—which ought to provide opportunities for people to heal, instead of just punishing them.

Sick is an ancient word with roots all over the North Sea and Teutonic lands. It comes from Old English, Old Frisian, Middle Dutch, Old High German, Old Norse, Icelandic, and Gothic words, and their origins can’t be traced—the condition of sickness in humanity is so old and pervasive. But their meanings are all the same: suffering from illness. People who are suffering need compassion. (See Maté’s video again.)

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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New York Times Addiction Story—Is Addiction Really Like Diabetes?

Yesterday the New York Times ran a story called “Rethinking Addiction’s Roots, and Its Treatment,” about how medical schools are starting to establish accredited residencies in addiction medicine. This would allow med students who have completed such residencies to enter the field of addiction medicine right out of med school, rather than go through additional training.

So glad to see the NYT covering addiction issues. Something that needs to continue, in order to bring addiction into the national public health discourse. But:

Lots of complaints in the comments section about how problematic this story is.

Here are a few I found.

Problem 1: The Diabetes Analogy

Man, what a tired analogy. Let’s either get rid of it, or take it all the way. Right now, people only take it up to the point where diabetics inject insulin—implying “real” addiction treatment should be about drugs. Then they miss a critical part: most cases of diabetes these days are Type 2, which indeed has a genetic component but is largely influenced by poor “lifestyle” factors: smoking, drinking, and obesity. These problems are all related to addiction, and they all have underlying psychological drivers about alleviating stress.

Another critical part missed: in the vast majority of cases of diabetes, the pancreas never recovers its function, whereas in the vast majority of cases of opioid addiction, the opioid receptors do recover their normal functioning—if, at some point, when the recovering person is ready, they’re allowed to remain abstinent for a while.

Both addiction and Type 2 diabetes can be considered the result of unfortunate genetics and poor lifestyle choices. As for treatment: insulin doesn’t “cure” diabetes. While no drug or treatment could restore the function of the pancreas to normal, treating the cause of diabetes would address the underlying compulsions—the addictions—so people wouldn’t continue to smoke, drink, and eat compulsively.

The diabetes/insulin analogy drives the ending of the NYT story, where Suboxone comes in to save the day for a 53-year-old patient on bupe maintenance. This sets up Suboxone (and, implicitly, other future Miracle Drugs), as the magic bullet that can “cure” addiction simply by “blocking cravings.”

Hmmm.

Problem 2: Unexamined Conflicts of Interest

Is it really news that “the medical establishment is putting its weight behind the physical diagnosis”? The medical establishment, in the U.S. at least, is largely funded by Big Pharma—through government institutions such as NIDA. The most recent study on extended-release buprenorphine, the opioid drug in Suboxone and other preparations, was funded by NIDA to the tune of $7.6 million. The government did not hire the researchers of this study independently; the grant went to Titan Pharmaceuticals, the maker of the proprietary buprenorphine formulation being studied, who then turned around and picked the UCLA researchers—who were already being paid speakers’ fees and research funds from both Titan and Reckitt Benckiser, the makers of Suboxone.

Hmmm.

Problem 3: The Split Between Medicine and Psychology in Recovery

It’s important that med schools are starting addiction-medicine residencies—this helps to educate more doctors about addiction. Nora Volkow makes a good point when she says it’s a “very serious problem” that general practitioners lack knowledge about addiction—this is true, and leads to the corollary thought that it might actually be best to spend the money training primary-care physicians in addiction, rather than create more specialists. PCPs are on the front lines; they’re the ones prescribing, for example, the most Oxycontin and Vicodin. They could do with more education about addiction.

And it’s important to think of recovery from addiction as the management of a chronic problem, the way high blood pressure and diabetes are managed. (Addicts have been thinking of the problem this way for a long time. 🙂 )

But why should we automatically think about addiction as EITHER a medical OR a psychological problem? Why can’t its treatment involve both disciplines, as well as others? Most active and recovering addicts and alcoholics are able to articulate the experience that addiction involves not only their physical response to the substance or behavior, but also a psychological component—we use/drink/eat/gamble/have compulsive sex to alleviate “stress.”

“Bringing Respectability to Addiction Medicine”?

In the third graf the writer mentions a guy named David Withers from a rehab called Marworth (a physician? addiction specialist? the writer does not tell us… aha! quick Google search reveals he’s an M.D. and associate medical director at Marworth). Withers says that the establishment of residencies in addiction medicine is “the first step toward bringing . . . respectability and rigor to addiction medicine.” What a slap in the face for the many doctors in America already dedicating their practices to addiction medicine. Be interesting to hear what, for example, Dr. Drew thinks of this (as of this morning he hasn’t yet tweeted on it). I intend to call my local, renowned rehab and speak to the well-known medical director about this statement.

 

Book Review: Jeffrey Schwartz’s “You Are Not Your Brain.”

Leo DiCaprio as the obsession-driven Howard Hughes.

So here’s an interesting story about the work of Jeffrey Schwartz, M.D., a psychiatrist who studies neuroplasticity and mindfulness, and who specializes in treating obsessive-compulsive disorder (OCD) with cognitive-behavioral techniques. Schwartz was apparently a consultant to Leonardo DiCaprio when Leo was studying to play Howard Hughes in Martin Scorsese’s 2004 film, The Aviator. Hughes was notoriously debilitated by severe OCD, which eventually rendered him a recluse in later life. And to play the part, DiCaprio made the choice to “let his own mild OCD get worse,” Schwartz has said.

Schwartz also said,

By playing Hughes and giving into his own compulsions, Leo induced a more severe form of OCD in himself. There is strong experimental evidence this kind of switch can happen to actors who concentrate so hard on playing OCD sufferers.

It apparently took DiCaprio three or four months to recover from his self-induced OCD.

When actors play a role, Schwartz has said, they can alter the functioning of their brain-chemistry—it’s been documented in the lab. Schwartz has taken that idea and turned it on its head: if people can successfully choose to induce illness in themselves, then people should also be able to induce healing.

Which is really good news for addicts. Because we adopted a bunch of behaviors and choices that led us into our illness; and it would seem Schwartz is saying we can get back out the same way we came—by making a bunch of different choices.

Schwartz’s new book, written with his colleague, Rebecca Gladding, M.D., is You Are Not Your Brain: The 4-Step Solution for Changing Bad Habits. It’s a kind of sequel to Brain Lock, his popular manual for controlling OCD. In You Are Not Your Brain he aims to show how people with any kind of debilitating compulsion or habit can change their neurochemistry by changing their actions and thoughts—thoughts being a kind of action, according to the practices of mindfulness which Schwartz espouses.

I LOVE the idea of neuroplasticity—which is essentially says the body’s neurology is not set in stone. When I was a kid, I was taught that we were born with a certain number of brain cells, and that if they somehow got damaged or broken, we’d be shit-out-of-luck—those cells would never grow back, and those electrical connections would be forever severed. Scientists like Schwartz are proving that, in fact, the human neurological system is smarter and more resilient than we thought it was, and that it can not only carve out new pathways but that we exert a certain amount of control over our own neurology through the “force of will” or, as I prefer to understand it, through “mind.”

Schwartz makes the critical distinction that “mind” and “brain” are not one and the same:

The brain receives inputs and generates the passive side of experience, whereas the mind is active, focusing attention, and making decisions. … In other words, the brain does not incorporate your true self or Wise Advocate into its processes, but merely reacts to its environment in habitual, automatic ways.

Schwartz introduces the idea of the “Wise Advocate” (another way of thinking of higher power) very early in the book. He talks about “sculpting” the brain you want to have by using your will, but it becomes clear that in practice he advocates tapping into the wisdom of a power greater (wiser, smarter, more dependable, less selfish, however you want to say it) than self-will. So following his program becomes a process more of self-discovery than self-creation. I guess the latter would be more selfish and self-serving, unless healing and service are the primary motivations.

How can this book help people with addiction?

I’m a relative newcomer to sobriety, but I’ve experienced recovery as a process of finding out who I really am after a lifetime (or half a lifetime) of spending much of my time and energy pretending to be someone in order to make other people happy, which never worked anyway. Schwartz writes,

Deceptive brain messages get stronger the more you ignore, deny, and neglect your true self.

This is just another way of saying that the more I persist in insane behavior (which does not always have to include drinking, using drugs, gambling, overeating, or starving ourselves—it can include, for example, compulsively taking responsibility for other people’s feelings, otherwise known as “people-pleasing”), the more I lose any chance of finding out who I really am—and the more disconnected from my higher power I become. The more I foster spiritual weakness. The sicker I remain.

Schwartz and Gladding say recovery is all about taking “contrary action,” including changing our thoughts about ourselves. It’s not rocket-science, and it seems to me that, having been in and out of therapy since my mid-20s, I’ve heard his four steps before (Relabel, Reframe, Refocus, and Revalue). Which is just to say that his book offers commonsensical and reliable stuff. It’s also to say that it harmonizes with the ways I’ve seen countless people recover from addictions just as debilitating as Howard Hughes’s OCD, perhaps more so. We take action—“contrary action,” as they say in the rooms. Action that counters what we’d feeeel like doing, but that we believe (based upon the experience of trusted others) will benefit us.

Schwartz’s practices also rely a great deal on mindfulness, which is arrived at through meditation (Step 11). I’m all for any practice that gets me to live more inside the present moment. My experience is, meditation is a tool to counter any kind of obsession, addictive or otherwise. Studies also show that meditation and prayer, if practiced diligently and long enough, can PERMANENTLY decrease fear and sadness, and make us smarter and more compassionate. The practice of it has radically changed my own life, and I hope to run some more posts and maybe even some video about how to meditate.

Dreaming About Drugs Or Drinking—What To Do About It?

I’ve had a couple drug dreams lately. It’s been a stressful time—school let out, my kid is home all day, I’ve had to negotiate lots of scheduling issues with my partner. Transitioning into summer is always hard—in fact, any transition is hard for me. Addicts, in general, do not like transitions. I’m the kind of person who likes to eat the same things at the same time of day; I order the same menu items from the few restaurants I go to; I wear the same clothes—dependable ones that look good on me—until they wear out.

The other night I dreamed I had a bunch of fentanyl patches. Part of me doesn’t want to describe what I tried to do with them, because I don’t want to give anybody ideas about how to abuse medication (especially fentanyl, because abusing it can kill you), and I also don’t want to send anybody into euphoric recall. … But another part of me wants to tell you how my senses responded in the dream. Because it helps to be honest with people about what I used to do, and how it used to feel.

When I first detoxed off fentanyl, back in November 2008, I had drug dreams pretty often. It seems to me they happened almost every night, but I don’t think they were actually that frequent—it just SEEMED like they were. My using dreams back then were frantic: in the dream, I’d be searching through stuff in the house, looking for something to make me feel better, and when I found it, my whole body would yearn toward the drugs. (I tried thinking of a better and less corny word than “yearn,” but this is what it felt like. “Yearn” comes from an old Germanic word meaning “eager.”) My whole body bent itself toward the stuff it knew would make it feel better.

It was partly a chemical thing: withdrawal just takes time to get through, and during withdrawal it’s very hard to sleep. Sleep-deprivation is one of the things that prevents a lot of people from making it through to the other side of withdrawal—it’s hard to function during the day if you can’t sleep at night, and when your body knows what will make it easier, it naturally gravitates toward that.

But it was also partly a psychological thing. Pavlovian. I’d trained myself to cope with problems (and also joyful situations) by using drugs. I’d managed the way I felt with chemicals, instead of allowing the feelings to pass. I didn’t want the painful feelings to persist, so I used chemicals to get rid of them; I didn’t want the joyful feelings to leave me, so I used chemicals to try to prolong them—or else to get rid of the fear of the joy leaving me. Of course, in the end, the drugs stopped working, but I clung to the hope that they would work again someday—which is the delusion of addiction, and the insanity, the breakdown of health and wholeness.

And when I’d wake up from the dream, I’d feel mortally disappointed that I hadn’t actually found drugs, that I was on my own again, trying to manage life by myself. (This was before I learned to depend on another power than my own will.) Sometimes I’d cry.

I hadn’t had a dream about using drugs for a long time before I had one a couple weeks ago. In the dream I found these fentanyl patches. Brand-new, shiny-clean, pure drugs. But somehow in the dream I couldn’t touch them. I’d try to touch them and they’d dissolve from view, disappear. Then I’d pull my hand away and they’d reappear. Ephemeral.

So this dream wasn’t actually about USING drugs… it was about the temptation, and the presence of drugs in my mind and consciousness. The fact that my addiction is always with me. The aliveness of it. I don’t exactly imagine it, as they say, “doing push-ups in the parking lot” while I’m at meetings. But as Eminem raps,

This f*cking black cloud still follows me around
But it’s time to exorcise these demons
These motherf*ckers are doing jumpin-jacks now

It’s around. It’s not Gone.

I was sick for a long time, and it takes a lot of discipline to recover from a chronic sickness. People who undergo treatment for cancer, diabetes, hypertension, and other illnesses have to organize their lives around managing their problems. And I don’t buy the argument that people with addiction caused their own problems and people with other illnesses didn’t. Many people with obesity and diabetes today have made a hefty contribution to their problems through their reluctance or refusal to face the fact that they eat too much and they eat foods that cause ill-health. It’s being shown that cancer and hypertension are caused by the disastrous ways Americans eat and drink and use their bodies—or don’t use them.

Blaming is useless, but figuring out the cause-effect relationship leads to the ability to strategize about solutions.

So what do I do when I dream about drugs? Today I first of all wake up and send up a statement of thanks to the Higher Power Of The Day (today my HP is Time) that I didn’t actually use. And then I let it go. My friend Arlene in L.A. used to tell me all the time, when I was newly detoxed, “This Too Shall Pass.”

Life is not about what you feeeel, baby girl,

she’d say, and she was right.

When I was newly detoxed and dreaming about drugs, I used to cling to those feelings of maybe Finding Something Someday. Today I try to let it all slide off me. I hand it over to Time, which will eventually make me forget. I hand it over to Love, which will help me take care of my body and spirit. I hand it over to Common Sense, which tells me:

It’s just a dream.

What do you do when you dream about drugs or drinking?

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