Guinevere Gets Sober

Recovery news, reviews and stories, by Jennifer Matesa.

Tag: addiction (page 1 of 18)

Tom Petty OD’d On Fentanyl. And Other Drugs.


Some people think fatal ODs have nothing to do with pain management—they think virtually all people who OD either bought street drugs or stole from other people’s prescriptions (“Medical use surely increased access to the drugs—but the people who got hooked tended to do so while using medication that was either prescribed for someone else or otherwise distributed illegally”). But damn, we keep hearing stories that show this is not true.

For every prominent person whose opioid abuse started with real pain, you can bet there are hundreds or thousands of people whose names have not been on marquees who started abusing drugs while seeking relief from what has increasingly become known, in coverage of the opioid problem, as “legitimate pain.”

The Los Angeles medical examiner today announced autopsy results for Tom Petty, who was found dead last fall:

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Who Do You Miss?

In four days it will be my birthday. I’ll be 47, sober for almost two years, in recovery from addiction for three, and in Al-Anon for almost 13. A list of “birthdays.” 

My mother died of lung cancer 12 years ago at 58. I rarely miss her, but there are three days of the year on which I predictably, and sometimes rather desperately, wish she were still alive: her birthday (April 19); my son’s birthday (September 19); and my birthday. Who remembers your birth better than your own mother?

It makes me sad that my son doesn’t get to have a grandma nearby, that my mother never got to see how well my son’s turning out.

(“He’s a good kid,” my father told me before he died. “He’ll be OK. You’re doing a good job.” These words are like the chair in which I put my feet up at the end of the day. I don’t often sit in that chair because when I do, I fall asleep—it’s so comforting.)

The rose window of Nôtre Dame de Paris.

My son used to crawl on her lap and play with her necklace, a gold replica of the rose window in Nôtre Dame cathedral. Dad brought the pendant back from a Paris business trip in 1983. My mother wore it always, and after my mother died Daddy gave it to me. … My son would crawl up onto her lap and stick the disk in his mouth, and she’d let him do it. In the brief time they knew each other, she let him do stuff she’d never have let us do. The grandkids would have mellowed her out.

For our birthdays we got to ask for our favorite dinners and whatever we wanted for dessert. Except for my birthday Mom would make pumpkin pie. And every year I would have preferred to have something chocolate but I could never tell her this, because she somehow got this idea that pumpkin pie was my favorite, or else it was because I was born the day before Halloween. She needed to be the perfect mom who baked the perfect birthday dessert. There was something in me that couldn’t dispel her illusions. That something is the obsessive caretaking thing about me, the thing that’s overly influenced by what other people think, the alcoholic-child-thing. She obsessively took care of me, and I obsessively cared for her right back.

Today I’d be able to find a way to let her know that I like chocolate better than pumpkin. Not so I could have the chocolate, but so we could know each other better. So we could be honest.

I grew up in a family rife with addiction. I lost both parents to it. All my cousins who are still alive have lost people close to them to addiction. Many of us have lost people to addiction—not just family members but also friends, fellows in the rooms, sponsors. The Subversive Librarian wrote a remarkable post about this recently—about how suicides and deaths due to addiction tempt her to relapse, make her desperate with the idea that she might after all have to follow them.

So she takes action to insure that she doesn’t.

Who do you miss? What’s your experience with loss?

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.”


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.


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.


Charlie Sheen, Addiction, Interviews, And Twitter

Charlie Sheen

Charlie Sheen on ABC’s “20-20.





So, the self-immolation of Charlie Sheen.

From the 20-20 interview:

Q: When was the last time you used?

A: I don’t know.

Bullshit. Every addict knows when he last used.

Then, in a burst of recollection, he remembers WHAT he used (though not precisely when).

Q: What are we talking about? How much?

A: I dunno, man, I was banging 7-gram rocks and finishing them, because that’s how I roll. I have one speed, I have one gear: GO.

Q: How DO you survive that?

A: Because I’m me. I’m different. I have a different brain, a different constitution, I have a different heart, I have a different—you know, I got Tiger Blood, man.

They film his workout (bad curls, crappy form, flinging barbells around, not real lifting), flash a closeup of his skinny-ass abs, creep through his house, photograph his cigars, and look for drugs but can’t find any, though they do turn up a porn star and a model. He submits to a urine drop and apparently comes out clean (more bullshit).

He says his brain fires like “something not of this terrestrial realm.” “Judgment” is a word he uses a lot. “I don’t have time for their judgment,” he says of CBS execs who shut down his show, “Two-and-a-Half Men.”

Charlie Sheen joined Twitter two days ago and already has nearly 1 million followers. Not “friends,” followers. Watchers. Oglers. People just waiting to get notice in their feeds that he’s fucked the next thing up. So they can feel better about their own lives? Entertainment?

Meanwhile to the active addict this feels like adulation. He logs in and 48 hours later, instant audience! Viral! Power! “Winning!”

Charlie SheenI tried to find an image of Charlie Sheen from ages ago in which he looks healthy, but I couldn’t dig one up. There are photos of him looking younger, certainly, but he always looks pale, and his eyes are defended. (In contrast to Robert Downey Jr.’s eyes, which always looked sad and empty when he was younger—as if he were staring into blank space, an abyss.) Even when smiling, Charlie Sheen’s face always seems to bark: Get The Fuck Back Or I’ll Rip Your Fuckin Head Off. The Today Show’s Jeff Rossen remarks in yesterday’s interview, “You’re angry!”

Q: You say you’ve cured yourself of addiction. How have you done that?

A: I closed my eyes and made it so. With the power of my mind.

Jesus wept. His advice to other addicts? Fix yourself, close your eyes, change your brain, quit believing all this ancient, plagiarized nonsense.

A friend of mine with some sober years calls this not just ordinary bullshit, but Transcendental Bullshit.

And then there’s this gem: He reads from page 417 of AA’s Big Book. The famous Page Four-Seventeen. The passage on Acceptance Is The Answer To All My Problems Today. You just KNOW what’s coming.

He stares into the camera and tells his boss (his EX-boss):

You gotta accept me.

Lots of people watching all this and saying, “What a fuckin asshole.” From one perspective, they’re right. Addiction, persistently and willfully untreated, makes us into assholes. Plus the experts are right: he probably has some kind of mental illness. In any case, he’s a sick man.

Embarrassingly sad. I feel for him. I feel for his family, especially his kids. I can’t imagine how it is these days to be Martin Sheen. I mean yes I can: I’ve lived with addicted people who refuse to quit or get help; I’ve read blogs of friends who write about how to relate to their family members who are still active or in very early recovery after terrifying histories. But none of these people are watching their kid blow himself up in public.

The masses love to watch a guy set fire to himself, or piss his pants. It can turn us into voyeurs, into nasty seventh-graders whose expertise is finger-pointing and heckling. “Yesterday and very early this morning,” TIME Magazine wrote, “Charlie Sheen continued not going away.” As though they really expected him to. Or even wanted him to.

Why are we so interested in fucked-up celebrities? Is it fair to look at celebrity stories as allegories for our collective experience? … I reckon yeah, with limits. Charlie Sheen is not interesting because he’s an asshole. He’s interesting because he’s got addiction and probably other problems and is refusing to get help. Like many others of us have, and still are. And he has so many resources, including wealth and a concerned parent—unlike many of us.

Celebrities choose to live outside, on the Common, in the public square, instead of behind closed walls like everybody else. The magnifying glass trained on them shows up strengths and weaknesses shared by all of humanity.

“What is called for here is prayer—and plenty of it,” a friend of mine said. “For ourselves as well as Charlie.” I mean I’m not sure I’ve ever known how to pray, exactly, but setting some kind of intention other than being a Gawker helps me put the magnifying glass down. Those damn things can burn.


Jack LaLanne On Alcoholism, Sugar, and Mind-Body Connection

He’s saying: “Get rid of these foods!” 1950s.

Fitness master Jack LaLanne died two days ago at age 96.

Funny, I was just thinking about him, because I’ve been exercising so much. I remember being a kid in the 1960s watching my mother watch Jack LaLanne on TV. Or hearing her talk about Jack LaLanne. I don’t remember her actually doing his exercises. What I remember is my mother shouting epithets at the TV, or about him. I remember one instance in particular. Apparently LaLanne had said something about how, if “housewives” did all the housework they were “supposed” to do (i.e., washing walls, washing floors, washing windows—scrub scrub scrub), then they wouldn’t need to watch his show because all that cleaning would make them physically fit.

My mother had a number of choice names for LaLanne (I was maybe 5?). Then she grunted, crossed her legs and took another drag on her cigarette. Probably tempted to crush it out on his forehead.

My mum died of lung cancer at 58 in 1999, and LaLanne died just the other day of old age. Proof in the pudding, imo.

LaLanne INVENTED modern fitness. He pioneered weightlifting, and he invented some of the weight machines that are still used in gyms today. He’d been a depressed kid eating tons of sugar before he turned his life around by lifting weights and cleaning up his diet. He used the nascent technology of television to bring the idea of fitness and nutrition into American homes. He wanted Americans to recover from their “soft” post-war lives.

And he was already into pretty radical ideas: wealth making people take the easy way out; the increasing urge toward wanting to “buy health”; the “mind-body connection”; and calling overindulgence in sugar and processed foods an addiction equal with alcoholism. Basically calling sugar a drug.

Here are a couple of amazing blasts from the past I came across. (Remember when TV graphics meant chalk boards?) …

I can’t recover just spiritually. Recovery also includes a physical aspect.

Reminds me to keep it simple.

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