Addiction Q&A
Someone recently listened to my interview with Josh Eccleston on his “Jobcast” podcast, bought a copy of my book, read it, and reached out to me with some questions. I did my best to answer them, and I also tried my hardest to avoid letting this get to my head. Oh what the hell? Someone I’ve never met listened to my interview, bought a copy of my book, and e-mailed me! HOLY SHIT! Time to assemble an entourage!
Seriously, though, I was happy to take a few minutes to answer questions from someone who already made a huge time investment in me by reading my book. I also got his permission to publish the Q&A because I figured a lot of other people have the same questions. Below I’ve posted his questions and my answers to them. I cut out the personal conversation portion of our correspondence, but I need to let everyone know that he expressed the same disdain for the Dallas Cowboys that I have voiced in my book and my personal life. You’ll see why I shared that tidbit once you read my e-mail farewell at the bottom of this post.
Here goes the Q&A:
1. I know this is a very broad question, but can you kind of elaborate on how addiction is a disease as opposed I guess the societal stereotype of a selfish moral failing?
In short, the medical model views addiction as an allergy to alcohol and/or drugs. A “normal” person, or “normie” as we addicts call them, can have a drink, smoke, etc. without it turning into a mental obsession and a physical compulsion. Once it has developed into an addiction – in other words it has gone from substance use to abuse to dependence – the body and the brain needs the drug. This is tricky for a lot of reasons, but for two in particular:
A) There aren’t cotton swabs or blood tests that reveal addiction the same way there are those for other diseases. This is true for all mental illness.
B) It sounds like an excuse for bad behavior. The medical model that views addiction as a disease does not absolve people of wrongdoing. Once people have been exposed to recovery and have been taught what to do to stay clean, they are responsible for the poor choices they make.
2. What are your thoughts on how our society views addiction, the stereotypes and portrayals in media and such?
Like I said before about addiction and other mental illnesses, they can’t be “proven” through blood tests and whatnot, so some people are skeptical. Most of this comes from a lack of education. I’ll admit that some people “play crazy” or use addiction as a crutch, but there are far more legitimate cases. As for movies/TV shows that portray addiction, some are more authentic than others. Just like a doctor or a nurse might pick apart an episode of Grey’s Anatomy, I can’t help but do the same for portrayals of addiction.
3. Do you believe that addiction is similar to depression in that it is a condition caused by a chemical imbalance in the brain? If so, do you believe that this chemical imbalance is something preexisting, brought about by drugs altering brain chemistry, or a combination of both?
Sometimes mental illness is directly caused by or at least exacerbated by drug abuse, and sometimes it is a means of self-medicating for a pre-existing condition. I definitely used because of my depression, but my drug use also made it worse. I went to rehab with a guy who literally became schizophrenic because of meth abuse.
As for the chemical imbalance theory, I read a book a few years ago that rocked my world. “Anatomy of an Epidemic” by Robert Whitaker, uses research to poke a lot of holes in the traditional thinking of serotonin deficiencies leading to depression. I don’t want to get too neuroscience-y, so I’ll just say that I’ve learned to keep an open mind.
4. In general what kind of backgrounds (upbringing, class, etc.) would you say those with addiction that have counseled and those you went to rehab with came from? Do you notice similarities or are their stories and experiences pretty varied?
The backgrounds are EXTREMELY varied. I went to rehab with a woman who worked at the local college, wore Christmas sweaters, baked cookies, and was a closet meth abuser. Age, gender, and socioeconomic status don’t matter.
5. Do you believe that being addicted to some drugs, particularly heroin, are more difficult to recover from than others?
That’s on a case-by-case basis. In general, heroin is regarded as the hardest to kick, but it is NOT one of the two drugs that kill people going through detox. At abstinent facilities, only two drugs require medical detox because patients die from the withdrawals: alcohol and benzodiazepines (Xanax, Klonopin, etc.). Most people don’t know that. I was also extremely addicted to weed, and a lot of people think that’s ridiculous.
6. What are some things that have helped you to maintain your sobriety? Are there things that helped you that didn’t work for others and are there things that have helped others but didn’t help you?
People have to find what works best for them. I’m honest with everyone about this, and some people have a problem with my “program” for this reason: I’ve been clean for more than 11 years now and I stopped going to 12-step groups almost 10 years ago. I don’t want to bash those groups because they saved my life and I still live by the principles I learned in the literature and in the meetings. Without getting too personal (funny I should stop now, right?), I’ll just say the group thing stopped working for me.
From the beginning I had to lose some friends and stop going to certain places. Some of the principles of 12-step recovery I referred to earlier include taking a moral inventory, promptly admitting my mistakes, and taking care of issues before they become festering resentments. When it comes to losing friends, I don’t just mean people who use. Over the years I’ve had to let go of “toxic people,” meaning those who bring nothing to a friendship but drama and negativity, with or without drugs.
Some aspects of the way I maintain my recovery has changed over time. Over the last handful of years I got serious about eating right and exercising, I quit smoking cigarettes, and I lost 50 pounds. When I don’t have a healthy balance of work and play and I don’t take care of myself physically through proper nutrition and exercise, I start to go off the rails a little bit. I never want to use, but my depression rears its ugly head. About four and a half years ago I went back to individual counseling for the first time since I got clean. The cornerstone of my program is vigilant self-awareness.
7. What do you think is effective about traditional rehab programs? 8. What are some shortcomings of traditional rehab programs?
I don’t even really know what traditional means anymore, so I’ll just say what I think is effective and what isn’t. I went to a 14-day intensive inpatient program, and it obviously stuck. But I was also a highly motivated “student” of recovery, and I attended 8 weeks of intensive outpatient groups following my inpatient stay. Generally speaking, I think people should stay in rehab for at least the standard 28 days through any means they can find to pay for it.
I’m honestly a little conflicted on the “resort” style rehab. I don’t think people should be punished by staying in a shithole, and they already have enough to worry about without issues of bad food, bad service, and cleanliness. On the other hand, if rehab is too much like a vacation, then what kind of message are we sending about the consequences of our actions? Ideally, people should have nice surroundings where they are free to focus on the HARD WORK of getting clean and learning how to stay clean.
It might sound like a new-age fad, but I’m a huge fan of the holistic approach to recovery that so many facilities are advertising these days. That simply means focusing on all aspects of the individual: mental, emotional, physical, and spiritual. In my opinion, by treating all of these maladies, people will be much better equipped to cope with life without drugs once they leave rehab. There also needs to be some kind of aftercare plan in place, and I’m a huge proponent of exposure to 12-step groups. Even though I don’t go anymore, I wouldn’t be here without them, and a lot of people are lifelong members who genuinely enjoy the fellowship.
9. Do you believe that a person is more likely to be successful in recovery if they choose to seek help themselves as opposed to say court ordered rehab or family members putting them in rehab?
Not necessarily. Even if people get help because of legal troubles or to save a job or a marriage, they can have lifelong recovery if they start to do it for themselves at some point. However, if a person never finds any intrinsic motivation to stay clean, the chances of sustained recovery aren’t good.
10. Lastly could you recommend some further reading to help understand addiction?
Nikki Sixx’s The Heroin Diaries was a lot of rock star excess, but it really captured the heart of addiction. In my opinion, there’s nothing better than The Basic Text of Alcoholics Anonymous, in particular the section of personal stories. The Basic Text of Narcotics Anonymous is also good.
Hope that made sense. Thanks again for reading.
Fuck the Cowboys.
Adam
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