Archive for the ‘Alcoholism and Addiction’ Category.

Pill Heads in the Waiting Room

I am by nature a quiet man who avoids conflict except in the most unavoidable of circumstances, and as a recovering drunk with going on 14 years of sobriety under my belt I tend to cut people in recovery more slack than perhaps I should. But I have zero sympathy for junkies or addicts who refuse to admit they have a problem, and thanks to prescription drug abuse in this country there are millions of people staggering around who fit both profiles.

I just heard from Dr. Wife that there was a young woman screaming in her waiting room because she would not refill a prescription for 90 Xanax, along with others for pain killers, muscle relaxants and Ambien she somehow got from a variety of other doctors. Dr. Wife examined her and  found there was no medical reason for her to be on those medications and she was not going to prescribe them. Dr. Wife tried counseling the woman about the dangers of prescription drug abuse, how it’s easy to kill yourself and usually makes pain worse, and offered to help her get off the meds, but the junky started screaming obscenities at her and the staff.

I recommended punching her in the head but Dr. Wife and her staff got her out of the office without resorting to violence. I still think a punch in the head is warranted, perhaps two, but then again I’m not a doctor so I don’t know what the dosages are for punches to the head. Perhaps I should check with the LAPD.

There’s a special circle in hell reserved for the doctors and nurse practitioners who supply these junkies. It’s a lot more difficult to try to help these people than throw drugs at them. Helping them takes longer; it takes seconds to print out a script for OxyContin, sometimes 30-60 minutes to talk a junkie down, and what’s the billing code for that? Dispensing pills like some white-coated Santa Claus throwing candy off a firetruck will make you popular with your patients too, but at a price.

A few years ago in a nearby county one of my wife’s patients, an 11 year old boy, died in a car accident. His parents were pill-heads and high when they made an illegal turn in front of a tractor trailer. All three were killed instantly. I spoke to one of the first responders on the scene. He told me how the car had rolled over and how he found the boy hanging lifeless in the backseat. Empty pill bottles littered the scene. The accident happened in front of a popular restaurant in the county and every time I drive by it I can’t help but think of that little boy. I never met him, and it’s hard for me to explain, but I can’t help but sense there’s a hole in the fabric of spacetime where an innocent child died because of the mistakes made by his parents abetted by their health care providers.

Whenever Dr. Wife tells me about the grief she gets in the office from demanding pill heads, I think of that accident. There were the names of many doctors on those bottles, but not my wife’s. She cares too much for her patients to help them kill themselves – and others as they so often do. But other health care providers don’t give a crap, or worse, think they are helping these junkies by giving them the pills they request. These pill dispensing Florence Nightingales are just as delusional as their addict patients.  They wouldn’t think of handing car keys and a case of scotch to their teenage patients even if they begged for them, yet they can’t say know to adults asking for medications that are much more dangerous than alcohol. And it’s left to responsible health care providers like my wife to clean up their messes.

With Obamacare, falling reimbursement rates, unpaid paperwork and non-compliant patients doctors don’t need another burden in their professional lives, yet everyday they deal with addicts, and sadly, it’s a burden that the profession is partly responsible for creating.

On the Death of Robin Williams

We all have our demons, the voices that seek to confuse us, ruin us, then laugh at our own destruction. For some people these demons are mere shadows, rarely seen and easily ignored, but for others these demons are as real as anything else in the world. Their voices ring in our ears, their touch as cold and painful as plunging a hand in ice water. They are a constant presence, inescapable and a burden carried through life.

To deal with these demons we often medicate ourselves, seeking oblivion to silence their voices, to dull their touch. Whether it’s cocaine, alcohol or gambling the addictions are an irrational attempt to deal with an irrational situation. These vices provide momentary comfort but only make the demons heavier, stronger, perpetuating a cycle that so often leads to the grave.

Those of us who have managed to escape the cycle, usually only temporarily, understand our fate. We see the demons, every horn and wart, smell their fetid breaths with each gasp of our own, but are too damned stubborn to let them beat us at the moment. Each day, each hour, each second when we don’t succumb to the false cures weakens the demons ever so slightly, making the next day, hour or second slightly easier than the last. But we don’t kid ourselves; no matter how long we’ve been sober the demon is still there. Its voice may be weaker, its stench just a little less pungent, but it will never disappear. It will always be with us.

When we witness one of our own overwhelmed by his demons, it saddens us. Rich or poor, famous or not, we are all united through our struggle against powers we never asked to fight in wars we never asked to be part of, and we are left embittered by the fact that so often those overwhelmed by his or demon are the least deserving of the fate. Why do they fall while so many others who have become real demons tormenting real people draw breath? Where are the inner demons of the men executing women and children in ISIS controlled Iraq? Why aren’t the savages launching rockets as they cower behind children in Gaza immobilized by doubt and fear?

It isn’t fair and yes I’m old enough to recognize that Life isn’t fair. But it sure does suck.

13 Years of Sobriety Today

To any addict that finds this post: It gets easier the longer you stay with it.

To anyone else: Don’t let the addicts in your life destroy it.

Maybe in another 13 years I’ll have something important to say, but that’s all I’ve got for today.

Bullying Has Far Reaching Consequences

In seventh grade, I got quite sick with a rather serious case of strep throat leaving me bedridden for about two weeks. I had lost my father two years before, my mother’s sister was killed crossing the street near her home a few months after that, my sister’s fiancee died in a car accident, my favorite sister lost a child during birth, and two months later my niece with Down’s Syndrome, so special to me in ways that bring a tear to the eye just thinking about her now, would die on the operating table. Needless to say I wasn’t the most emotionally stable 13 year old. When I returned to school, I noticed immediately something was wrong. As I climbed the stairs kids were looking away from me, not catching my eye. As I reached the top of the stairs and opened the double doors several boys met me. “Welcome back Kirwin,” one said, then sucker punched me in the face. I fell backward through the doors onto my back.

Before I had gotten sick I had written a list of 10 people I didn’t like called my “Sh*t List”. This list contained the names of popular boys, jocks who called me names during recess and boys who pushed me around in gym – guys I didn’t like. I remember I added the last name, a boy I didn’t have any trouble with but who hung with the guys I didn’t like, simply because I needed to round up the list to 10. I don’t know why I did it, and it wasn’t the last time my writing would lead to trouble. I made the mistake of telling my best friends about this list that I kept in my desk (another mistake), and one of them, a transfer from another Catholic school, decided to take it out of my desk and betray me to those on the list in order to score points with the popular kids.

The last two years at that school were hell for me because of that list and the betrayal. I lost all my friends at school and was shunned by everyone. I remember standing alone in the corner of the playground playing a mental game with the digital clock at a bank across the street, seeing if I could judge when the minutes would change simply through feel without counting, desperate for recess to be over. Outside school my best friends including my personal Judas would hang out with me, but at school I was alone. For the rest of my tenure there I was at the bottom of the social ladder. Those wishing to climb it would push me around to appear tough, boosting their appeal with those at the top. To the girls of the class I was a non-entity, a weakling of no consequence.

My mother was devastated by the same losses I was going through, and she tried everything. We spoke to my teachers, the principal and the pastor. None could offer much help. The principal suggested I could transfer to another school, but then followed up the suggestion with the observation that the bullying and ostracism would follow me there. When my Judas gave me the nickname of the Italian slang word for “penis”, and all the kids in the class started calling me that, my mother suggested I call him the Gaelic word for outhouse. Nice try mom.

The only thing she didn’t try and which I was too scared to do at the time was encourage me to fight back.

Being bullied changed my life. It pushed me onto a deeply destructive path throughout my teens and twenties that finally culminated 13 years ago in the choice of sobriety or a life alone in the gutter. Before the bullying I was a stellar student taking advanced math classes dreaming of a life in Academia. Afterward all I cared about was Oblivion, doing almost anything to achieve it. My grades cratered. I sought the extremes of subcultures and the solace of artists and the drugs and alcohol they called their muses.  I suffered flashbacks, waking up with the faces of my 13 year old tormentors in my twenty-something year old mind. It took years of bitter experience, counseling and therapy to finally let go of the anger, the hatred of my tormentors, and the loss of my childhood brought about through Fate and the brutality of children.

With the birth of my son I put my personal experience to work. When he came crying to me about being bullied, I comforted him but I also told him, “Next time, fight back.” As he progressed through school I realized that fighting back against bullies was being discouraged. Teachers and school administrators would punish both children for fighting, refusing to make the effort to determine who was right and wrong, who was the victim and who was the victimizer. I learned an important lesson about public school systems: they always follow the path of least resistance and especially the path of least effort. If a fight broke out they had to have authorities who were nearby and paying attention to what the kids were doing. It’s far easier to not expend the effort to be vigilant and be alerted to a fight after one has started then simply punish both sides.

Imagine cops being called to a domestic violence situation and arresting both aggressor and victim because they didn’t want to take the time to investigate what happened, deciding it’s easier to throw both in jail. Will this deter the batterer next time? No but it will deter the victim from screaming too loud and alerting the authorities.

This is a terrible lesson to teach kids.

What prompted this little bit of soul exposure on the Internet? Bookworm Room’s post, Schools and parents who teach children to become chum for bullies. Bookworm writes, “I cannot believe that a mother told her child to be a punching bag for bullies.  Moreover, I cannot believe that a mother told this to her girl child. One of the primary lessons women learn in every self-defense class is this:  if you fight back against someone who is assaulting you, you are likely to suffer physical injuries, but you are also much less likely than the passive victim to be raped or killed.”

In adolescence I told my son, “Don’t worry about the School. I’ll take care of them. You just make sure that if you can’t avoid a fight, you inflict as much pain on your tormentor as possible.” I knew this from experience. A busted lip will disappear in days; shame lasts a lifetime.

Bookworm agrees:

 

Ever since my kids hit school, I’ve given them a single message: Never be the one to start a fight but, if someone else starts the fight, you make sure to end it. And don’t worry about the school’s subsequent response. If you had to use physical force to defend yourself, and if the school attempts to punish you, I will take the school on if I have to go all the way to the Supreme Court. I’ve never had to make good on this promise, since no one has ever physically attacked my kids. I suspect that, with my instruction ringing in their ears, they don’t walk around like shark bait.

 

I made the Kid a promise. If he gets in trouble for defending himself he has nothing to fear. I would hire lawyers to turn his principal into a Cinco de Mayo pinata in court. I would own the trailers his bullies called “home,”  have them moved to our property, set them on fire and roast s’mores in the flames. I’ve backed this up with personal appearances at the principal’s office whenever there was a whiff of trouble. He knows I have his back even when I’m not there, and that confidence itself has deterred trouble. Bullies smell weakness like sharks smell chum. The personal losses I suffered between 1977-1980 weakened me. Had Fate been kinder I suspect I would not have become a target and suffered such life-changing torment.

But the lessons of standing up to bullies go far beyond the school yard. My experience has made me extremely suspicious of authority, whether small town cops, multi-national companies or the Federal Government. It has driven me to stand up to bad bosses and quit jobs rather than suffer torment in the workplace. When a company pisses me off I will fire off letters or even go to court. Neighbors have tried bullying me and received letters from attorneys then been forced to reimburse me for my trouble.

Bookworm Room writes, “I always back up this instruction to my kids by telling them that, had Jews not been conditioned by centuries of oppression to avoid arms, put their heads down, and try to appease authorities, its likely that the Holocaust wouldn’t have happened.  Please understand that I’m not blaming those victims.  First, no one could ever have imagined what the Germans intended to do.  Second, the Jews’ behavior wasn’t a conscious decision.  It was the result of a thousand years of conditioning.  Israel, thankfully, while not blaming the victims, nevertheless learned the lesson.  Like my children, Israel won’t start a fight, but she will finish it.”

We should be teaching our children to fight back and not be victims. Bullies don’t disappear at age 20; they will always be with us so learning how to confront them should be taught as a life skill in our schools.

Help for Tobacco Addicts: Electronic Cigarettes

When I was a kid I used to steal cigarettes from my sisters, and lit cigarette butts I found in the street, so I guess addiction to tobacco was only a matter of time. I inhaled my first cigarette at the age of 12, and still remember when, where, and how it made me feel. For the next 17 years I smoked anywhere from a pack to two packs a day. From Marlboros in Missouri to Mild Sevens in Japan and Sportsmans in Tanzania, I smoked wherever and whenever I could. I even remember smoking on airplanes within the USA, something that no one under the age of 25 could remember.

After a few years of being hooked I got tired of being a servant to addiction and tried to quit. Sometimes I lasted for months, but other times I lasted just a few days before the urge would overwhelm me. I probably tried seriously quitting cigarettes over twenty times, but all ended in failure until one night in Kyoto, Japan. It was a cold night in the western part of the city, and the Wife and I were eating at a noodle joint near where we were staying. She was nagging about smoking, and I finally got tired of hearing about it. “Fine,” I said, stamping out the Mild Seven in my hand, “I quit.”

And I did. It’s been 17 years since I smoked a cigarette.

The reason I mention this little anecdote is because I’ve just tried an electronic cigarette for the first time. It looked like a movie prop, and I put it to my mouth and drew on it. The tip sprang to life with a nice reddish-orange glow, and my mouth filled up with smoke. More surprised than anything I didn’t inhale it and blew it out. It was steam, and it tasted similar to what I recall an ultra light cigarette tasting like. I didn’t light it and the electronic cigarette is completely inert until you suck on it, then it provides you a mouthful of vapor mixed with nicotine and flavor.

Does it taste like a Marlboro? Absolutely not. But if you are a smoker and are simply tired of being ruled by your addiction, an electronic cigarette is a way to help your body heal itself while you try to quit. There is no second hand smoke so it is safe to use indoors, and there are no harmful carcinogens like tar and formaldehyde found in normal cigarettes so your lungs will thank you. Your clothes will not smell of rank smoke, and your car will stop stinking like an ashtray. Would it be better if you quit completely? Yes, but the electronic cigarette is much better than the patch or nicotine gum because it keeps some of the ritual that plays an important part in making smoking psychologically addictive.

If you want to try it, one of the brands offer a free sample. Just pay for shipping and handling.

Man, looking at this post makes me think I should be paid by the electronic cigarette company to write this. But I’m doing it for free, simply because beating cigarettes was a victory that 17 years later I am still proud of. Electronic cigarettes may help people to win their own battles starting today, and as an ex-smoker who has literally walked five miles in a snow storm to buy cigarettes, I’ve been there and understand the importance of allies in the fight.

Another Lost Soul

Spoke to a good friend who is mourning the loss of an old friend from addiction. I didn’t know the guy but my friend painted a picture for me showing the arc of his life that started and ended in his mother’s arms. It’s easy to dismiss the death of an addict, forgetting the person beneath the illness, but my friend remembers him and by the sound of things, he was a truly remarkable individual.

Maurice, this one’s for you.

Another Lost Friend

I don’t write that much about alcoholism or addiction but that’s not because it’s not a constant presence in my life. It’s because like most evils it’s banal, dreadfully dull to read let alone write about. While I’ve written this journal for almost 11 years now for my own pleasure, I do care about those who read what I’ve written, making alcoholism and addiction one of the less common topics here.

The last person I shared a drink with nearly 12 years ago died last month. The Wife’s sister was found dead and alone, ending a life that like most started with promise but for addicts ends in tragedy, and I don’t use that word lightly. The Greeks used the term to describe those whose fates were completely out of their hands, subject to the whims of the gods that controlled them. Like the tragic figures of Grecian morality plays, the addict is controlled by his own god, his addiction, and suffers accordingly. Some like Homer’s heroes are able to rise above their addictions, but only through Divine Intervention.

My sister-in-law was not so lucky. The gods never smiled on her, and instead condemned her to a life that ended under a blazing sun above a cloudless sky. At heart she was a wonderful, kind person who deserved much better than the fate she got. Like many families of addicts, we tried to save from the Siren song of addiction, but our entreaties, pleading and efforts were much weaker than the straps that bound Odysseus to the mast, and she stopped hearing us years ago.

Now her suffering is over, and the demons of addiction have claimed another soul. But I will remember her kindly and hope that she is happy wherever she has gone, free at last from the torment that only another addict understands. With love, to a lost friend.

Florida Docs Charged in OD Deaths

In general, if you are hauling around cash in garbage bags, chances are you’re doing something that is going to send you to jail.

From Medscape (free login required):

Prosecutors say the physicians prescribed a standard “cocktail” of controlled substances — specifically, oxycodone and alprazolam — on an assembly-line basis without obtaining prior medical records, ordering alternative treatments such as physical therapy, or referring anyone to specialists. The clinics also dispensed the prescribed pain pills and accepted only cash or credit cards as payment to avoid the scrutiny of third-party payers. The cash was hauled to the bank in garbage bags.

The docs earned more than $1 million a year but now face life in prison. 7 other doctors received prison sentences up to 17 years behind bars.

Rot in hell, boys and girls, rot in hell.

Prescription Abuse and the Legalization of Illicit Drugs

I have advocated the legalization of illicit drugs for a very long time. While my politics and party affiliations changed over the years, the belief that most if not all currently illicit drugs should be legalized has never wavered. Whether taking them decades ago or living the Straight Edge path for going on 12 years, I always believed that America would be a better place as a society if it legalized and regulated marijuana, cocaine and heroin.

Walter Russell Mead challenges that belief by comparing the arguments supporting legalization with the reality of prescription drug abuse. Try as I might I’m finding it difficult to argue with the points he makes. Mead writes, “Legally prescribed drugs are now regulated the way many legalization advocates think illegal drugs should be. The flourishing black market in prescription painkillers and the thousands of deaths associated with their use demonstrate that drug use will not be magically fixed by regulating currently illegal drugs. While legalization advocates argue that putting heroin and similar drugs on a prescription basis would reduce fatalities associated with their use, the high toll from overdoses of legal painkillers suggests that this argument is weaker than often believed.

The statistics about prescription drug abuse, to pardon the pun, are sobering. According to the CDC deaths from legal prescription painkillers now surpass those from heroin and cocaine combined. In 2008, 15,000 died from painkiller overdoses. In 2010 12 million Americans used legal painkillers to get high, and that year enough prescriptions were written to keep every single American stoned for a month. That’s 4x more drugs prescribed than in 1999. Today pain is the most common reason for physician visits in the US.

As with any complex issue, there is no simple solution. Until recently doctors had taken more of a “what we cannot cure we must endure” stoic approach with their patients when it came to pain. It wasn’t until the 1970s that doctors began studying pain and specializing in pain treatment and management. Progress has been slow. The foundation of pain management remains addictive narcotics with broad effects instead of the development of drugs that target specific pain. Worse, when used to treat chronic pain these medications may increase pain sensitivity. Even when pain isn’t chronic it may take months, sometimes even years for the underlying injury to resolve. If narcotics are the main treatment for pain, should we be surprised when a patient becomes addicted to pain medications?

There is a big difference between the perception of prescription pain medications and illicit drugs. Generations have been indoctrinated into viewing crack and heroin as “dirty” and socially unacceptable. It takes years for newer drugs such as methamphetamine and ecstasy to be recognized by society as a threat and subject to a mix of propaganda and truth to stigmatize the drug and curtail its usage. In the 1980s and early 1990s meth was underground and commonly used for all night cram sessions by college students and by long haul truck drivers. Now it has been stigmatized as a cheap high for rednecks a step above huffing paint. Prescription drugs have an aura of acceptability that illicit drugs currently lack but would attain if they were legalized. Legalization presents a legitimacy which in turn implies safety. People may naturally view heroin and cocaine as dangerous and consider Oxycontin as innocuous even though one can overdose on Oxycontin as well as heroin. People believe that because a drug is prescribed by a doctor it is somehow completely safe.

While it is possible that after legalization the negative perceptions of the formerly illegal drugs would remain, it is expected legalization would expand usage and abuse. Those favoring the legalization of illicit drugs need to accept this and modify their arguments to reflect this reality. One way to do this is to focus on the core arguments for legalization such as individual freedom and personal responsibility. In the case of prescription drug abuse, doctors need to recognize the danger of supplying patients with narcotics, including the likelihood that the drugs will fall into the hands of others. It is much easier for a physician to prescribe narcotics than it is to advise patients on non-medication pain management therapies such as deep breathing, meditation and exercise. Those that need more should be sent to pain clinics which specialize in pain therapy (and can be monitored closely by authorities).

People need to be educated about pain. Pain is a reality of life and in most cases such as injury it is an important component of the healing process. Dulling it at every opportunity may feel good in the short term but present long term dangers such as prolonged healing, re-injury or addiction. Similarly people need to learn the truth about pain medications. The narcotics on grandma’s shelves are just as dangerous as those being offered for sale on the street a few blocks down.

The solution for drug abuse, whether illegal or legal, is education along with treatment options offered by for-profit and charities. As far as solutions go it’s a lame one, but the alternatives such as the continued prohibition of illicit drugs and the jailing of addicts is far worse. Far better to increase awareness and encourage personal responsibility.

As a recovering alcoholic with 11 years of sobriety under my belt, personal responsibility is the one key component to wellness that gets ignored in the debate. To those sympathetic to the addict and those who take a hard line against illicit drugs, the addict is powerless to resist the drug so the addict must either be protected from his drug or kept away from it through its illegality. Hardly anyone dares tell the addict “You live in a world with your drug. You can have it and ruin your life, or not and live a decent life without it.” There is proof that addiction has a genetic component. For some it may have an epigenetic basis. But regardless of its origin, whether the addict was born that way or acquired it later in life, one is ultimately responsible for one’s own destiny, not Society.

UPDATE:
A documentary on the Oxy Express. The most chilling documentary I’ve seen in years.
An in-depth series on prescription drug abuse by the Delaware News Journal.

On the Front Lines of America’s Hidden Drug Problem

“I’m going to kill you!” the patient screamed at the doctor after telling him “f*** you!” for his refusal to write a prescription for 270 Oxycontin. The patient had taken the “Oxy Express” but came back to North Carolina to fill her prescription – a stupid move since narcotics prescriptions can’t be filled across state lines – and then visited his office and demanded her family doctor rewrite it. Her doctor explained the situation and offered to refer her to a clinic that specialized in pain management, but she refused. She wanted her “f***ing pills” and threatened to sue him unless he wrote the script. He didn’t budge, and the outburst followed in front of several patients and staff.

Over the years he has seen a rising in prescription drug abuse among his patients making otherwise normal people who have suffered injury into pill-seeking addicts. “Patients will bounce from one doctor to another until they find one who will write the scripts. If they can’t find one locally, there is always the Internet, a friend they know who will sell them a few tablets, or the ‘Oxy Express’.”

What troubles him is that there isn’t the stigma with prescription drug abuse that there is with alcohol or illicit drugs. “People take vicodin and think it’s safe because it’s legal and they got it from their doctor. But then they start finishing their prescriptions early. Like all addicts they slide into addiction.”

The problem, as the doctor explains it, was that we had gone from one extreme to another. “Years ago people were just told to suck it up when they were in pain,” he says. “There wasn’t much pain medication out there beyond morphine and a few benzos. Now we’ve gone to the opposite extreme where we treat every twinge and ache with painkillers.” He believes that people’s understanding of pain had changed, and that the overuse of painkillers was making the treatment of pain worse. “Pain is your body telling you to take it easy,” he says. “By dulling it with drugs you risk making the injury worse.”

The issue is more complex with what people call “chronic pain”. “Not all pain disappears within a few days or weeks,” he says. “But pain rarely lasts forever either. It may take months or even years for the underlying condition causing the pain to resolve.” Because pain is part of a complex feedback system between the mind and body, it is possible that treating it as a chronic condition with drugs may result in a situation where the body has healed completely but the mind still perceives pain. “The pain is real – it’s not in the patient’s imagination,” he says, “but the painkillers disconnected the pain from the event that caused it in the first place. It exists on its own, and therefore becomes a true chronic condition.”

Back pain is real and may never resolve, condemning the patient to a life-time of pain. But pumping him full of narcotics debilitates him just as much as the pain does. “We’re in the Dark Ages when it comes to handling pain,” he says. “We cannot reliably remove pain without impacting a person’s daily activities.” Some pain management clinics are experimenting with hypnosis and bio-feedback as well as acupuncture in order to find pain relief that doesn’t turn people into zombies.

But the doctor wasn’t hopeful. “Treating these patients isn’t easy which is why I don’t like doing it,” he says. He refers as many of his patients to pain management but worries that all he is doing is passing along the problem to someone else. Worse he is developing concerns that some of these clinics are just money-making pill dispensaries, leaving Society to suffer the consequences of a growing legion of addicts.

A few years ago three of his patients were in a car accident. A man, his wife and their 10 year old son were cruising at high speed before the car slammed into a box truck…. All three died instantly. Pill bottles were found on the car’s floor, and toxicology found the dad was high on painkillers. None of the bottles had his doctor’s name on them, which gave him a measure of relief. One of the first respondents on the scene – another one of his patients – was haunted by the sight of the boy’s limp head hanging upside down in the back of the car. He was a strong middle-aged man who had seen a lot over the years as a volunteer firefighter, but what he saw that night still haunts him.

The doctor remembers that boy whenever one of these junkies come seeking drugs, and it makes it much easier for him to keep his prescription pad in his pocket.
——-
The above is a composite based on a series of conversations I’ve held with health care providers over the past two years. Both the addict’s rant and the accident occurred as described. SK

UPDATE:
The Grouch At Right Truth, an ER physician, lists 11 warning signs of a drug seeker. My favorite:


4. They frequently present with illnesses that are hard to objectively diagnose. A couple of favorites are headaches and back pain. Now many people present with legitimate causes of headache and back pain and some of those can in fact be life threatening. Herein lies the problem. Sometimes the bullsh*t train ride can be long and expensive as we run many, sometimes costly tests in an attempt to separate the sheep from the goats as well as protect ourselves from lawyers.

Another reason the Wife should have been a plumber.

Family Guy’s Creator Seth MacFarlane Doesn’t Get Alcoholism and AA

Reading about alcoholism bores almost as much as writing about it so I’ll make this brief. I caught the recent Family Guy episode where Peter and Brian are sentenced to 30 days of AA meetings. Hi-jinks ensue as Peter turns the meetings into booze filled parties. Seth MacFarlane shares my interest in classic musicals, so there was a fun piece called “Mr. Booze” where alcohol is made a scapegoat for everyone’s moral failures. Peter ends up drunk driving and killing himself whereupon the Grim Reaper shows him what his life would be if he continues down the path of alcoholism (not sure how the path continues after dying in a car accident…), and another path in which Peter never touches alcohol in his life. Peter asks whether there isn’t a third way between being an alcoholic asshole and a dry douche – and the Reaper informs him about moderation.

Seth MacFarlane is a raging liberal and Family Guy is spotty, but I have followed it since its beginning and overall like the show. But moderation being the key to alcoholism is just another simple solution for a complex problem that liberals like MacFarlane preach, along with the fiction that Israel’s returning to its 1967 borders will end the Arab-Israeli Conflict, showing terrorists how we respect Islam in America will make them change their minds about killing us, and spending more money on education will make American kids smarter.

Moderation… why didn’t I think of that when my wife was threatening to leave me before I got sober over 10 years ago? Moderation. How many drunks in church basements have failed to turn around their lives with one word? Moderation. If only Jack Kerouac had known about that maybe he wouldn’t have bled to death after decades of pickling his liver.

Or maybe it’s because for most alcoholics moderation doesn’t work. Does MacFarlane seriously think that the answer is that easy? How much time has he spent around drunks? Has he met people who literally cannot stop drinking? I know of an alcoholic on hospice who was dying of liver failure caused by her alcohol consumption, but couldn’t stop. She was relieved to learn that she didn’t qualify for a liver transplant because she didn’t have to stop drinking, and the nurses on hospice actually poured her drinks for her. She only stopped drinking when she died. In my experience my life revolved around my next drink, and moderation wasn’t possible. I had tried it several times from the time I started drinking in high school until the time I began my current ride over 10 years ago. One beer inevitably turned into two which inevitably turned into six which inevitably turned into so much alcohol that it forced me to switch to the metric system so that I could calculate my consumption in liters because the Imperial system was too complex when I was drunk.

The stories I gleaned in church basements were always the same as mine. Moderation simply wasn’t possible for those of us who ended up there.

Moderation? MacFarlane’s knowledge of alcoholism is as shallow as his most of his non-sequitur humor and this episode proved it. In the episode Brian stated something along the lines that all people did was turn their alcohol addiction to an AA addiction. Something tells me that MacFarlane’s knowledge about AA only extends to rehab where the people attending have only days or even hours of sobriety under their belts. They tend to be giddy about their sobriety and in desperation almost as high on it as they were on alcohol. But I’ve been to meetings where the average sobriety was measured in years, and sometimes in decades. The long-timers at those meetings hadn’t substituted one addiction for another: they had achieved a level of calmness that drunks only glimpse in the oblivion they so crave. Every meeting is different, and some have terrible chemistry and are a waste of time. The bottom line remains that when it comes to addiction, AA is the only game in town. While I have not been to a meeting in years and remain sober, I know it is there and carry a number in my pocket – a lifeline that I haven’t had to use but know is there. I’m glad AA is exists.

MacFarlane is a comedian; his cartoons won’t change the world honestly and shouldn’t. But when he preaches as he did in this episode, I’m going to call him out on it – and it’s clear to me that he doesn’t understand what the hell he is talking about.

UPDATE: The Mr. Booze piece isn’t a MacFarlane original: it’s from the Rat Pack classic Robin and the 7 Hoods (1964). Here’s a link to the original.

Michael Vick and Redemption

Those that don’t know me very well are often surprised to learn that I am an avid NFL fan. Of all the things I’ve been, punk rocker, goth, IT nerd, ending with middle-aged parent and Tea Partier, the NFL doesn’t exactly fit the profile. But I’ve paid the rights to my soul to DirecTV for their NFL Sunday package so that I can watch games on an embarrassingly large Panasonic plasma HDTV.

I am also deeply involved in animal rescue and have been for years. I have financially supported several local grass roots organizations: Forgotten Cats of Delaware, Dumpster Cats, the ASPCA, Tri-State Bird Rescue, and the Delaware Humane Association. I have also opened my home to dozens of stray animals over the years, finding homes for those that I could but assuring all that arrived that their suffering was over; they would never again go hungry or sleep alone in the cold. If I could not find them a forever home elsewhere, they would join my pack of misfits and mongrels. I laugh and tell people that I belong to the “Dog of the Month club” but that’s an exaggeration; on average my wife and I rescue a dog about every other month and we’re about due for our next one anytime.

Three years ago I wrote the following about Michael Vick:

I’m no saint, Michael. I’ve done stupid things in my life just like anyone. But I’ve never done anything as bad as what you’ve done. My parents raised me to avoid doing those things – killing for sport and torturing for kicks. I’m no sadist, and seeing a sadist stand there as the camera shutters whirr away really pisses me off.

I hope you turn life around, Mike, but if you don’t I won’t lose any sleep. You can then rot the rest of your life having tasted success while knowing you will never, ever taste it again.

I wasn’t just a Vick hater; I wanted to see him completely and utterly destroyed. I was beside myself with rage at a man who could do what he did to dogs, and a system that limited his punishment to less than two years in jail. There is something unique about animal cruelty that sets it apart from all but a handful of crimes except child molestation or abuse. I believe that it is because the only thing that separates it from cruelty towards children is the fact that the sadists are afraid they’ll get caught if they do to a child what they do to a dog. Both child and dog are innocents and incapable of protecting themselves, and I believe that the line separating an animal torturer from a child abuser is a thin one, and one that she or he will eventually cross if not stopped.

Michael Vick was stopped by the full force of the Law before crossing that line. He was stripped of his fame and his fortune and sent to prison, and even today I stand behind what I wrote 3 years ago. Should he have been punished more severely as some have argued? Should he have been banned from his passion and his livelihood forever?

I understand why people believe so. I sympathize with their fury at seeing his face on the cover of Sports Illustrated and his name hung on banners inside stadiums. Michael Vick had everything that most do not – money, fame, athleticism – yet none of that stopped him from drowning struggling dogs in pails of water. As Isolde of Avalon writes:

People want Vick to be punished more because his crime was not one of passion or bad judgment or desperation. It was one of repeated, cold-blooded, needless cruelty inflicted by a millionaire who had everything against a bunch of innocent animals whose nature is to be loving and faithful companions for human beings. That is why people want “more”.

I understand that, and it would be much easier for me to agree with him (or her – come Isolde, forget the nom de guerre and use your name. It’s 2010.) than to accept the nagging suspicion that the Truth is much more complex than that.

Michael Vick admitted his crime and went to prison. In every interview he has not attempted to dodge the severity of his crime or his responsibility for it. He has followed the letter of his sentence without complaint. He has listened to his mentors like Tony Dungee and his former and current coaches – and by doing so he has forced me to answer this question:

Is it possible for a man to atone for his crime no matter how heinous its nature or how honest his atonement?

As an alcoholic I did terrible things to others. As a recovering alcoholic I have done my best over the years to make amends where possible for these actions. Now nothing that I did was anywhere near the same magnitude of what Michael Vick did, but who are we to judge whether redemption is possible for one man but not another? That sounds like Supreme Diety turf to me.

Over the past three years I have viewed everything Vick has said and done through the lens of suspicion, just as every ex-con or recovering addict understands the games played by other cons and addicts. Everything he says is worthless; only his actions add credibility to them. Vick followed the program laid out to him by the courts and by his mentors. When the Human Society president Wayne Pacelle spoke well of Vick’s efforts to end dogfighting, I took note. I respect the The Humane Society because they don’t get to cherry pick the easily adoptable dogs the way some so-called “no kill” shelters do, and they are often on the front lines of cruelty, working in the inner cities where the affluent are afraid to go to rescue or adopt pets.

How many people haven’t done something that they need redemption for? How many have never experienced the shame and disappointment of finding yourself in a deep well dug with your own hands and struggling to see the light above? How many have never struggled upward against a heaviness that sucks you down as you reach upward towards the light? How easy it must be for them to not feel the icy fear in the pit of your stomach with each loose stone that pulls away at your fingertips.

For Michael Vick the well is deeper and the light dimmer, but does the possibility of redemption exist for Michael Vick? Do the screams of dying dogs echo in his dreams the same way as the sobs of loved ones do in mine? Does redemption exist on a spectrum or as a binary event? Again, these are questions only Michael Vick or theologians can answer.

Before I heard of Vick’s Bad Newz Kennels I had no idea that dog fighting existed in the inner city. In the Midwest where I grew up it was known as a backwoods “sport” practiced in the Ozarks or in “Deliverance territory” in the Deep South. Vick’s case shone light on its prevalence in the inner city, and has helped authorities and animal rights activists to roll it back there.

It pains some people when good things come out of evil actions. Of course the end should not justify the means but shouldn’t we accept that Vick’s case has helped the cause of ending animal cruelty? Vick’s success on the gridiron only furthers that cause by keeping the issue in the public eye and funds flowing to animal rescue and support groups. Would these groups and their cause be doing as well with a broken Michael Vick in prison or in a half-way house somewhere?

When I sobered up there were people who wanted me to pay for my actions as well. I followed the 12 Steps and did the best I could, but for some it wasn’t enough. They never forgot my mistakes or forgave me for them, and that’s something that I will always have to live with. But sitting on the loveseat next to me as I write are a chihuahua mix and a beagle, the former found abandoned as a pup in a box without his mother and the latter running around alone in my field on the coldest day of the last Winter. They are warm, well-fed and loved. Would they prefer that I was ruined to pay for my mistakes?

Over the past 10 years I have helped raise a decent kid, supported a wife through medical school and residency, helped her through the loss of both her parents, and overall built a decent life for my family and dozens of stray animals – knowing throughout it all that one mistake would cause it all to evaporate. Should I have sacrificed those things and worn a hairshirt in payment for my mistakes as some even today want me to do?

What kind of payment is that anyway? What are the goals of people like that? In the case of Vick, what do they want him to do if not electrify the football field every Sunday that he steps on to it? What more must he do to redeem himself in their eyes?

True redemption is one of the most honest and beautiful things around. There are no more lies and clarity in abundance. The humility it grants endows one with a taste of serenity that a junky or criminal will never savor. Redemption replaces chaos with peace, selfishness with selflessness, wrecklessness with caution. It is a force of good in the world that can spread from the redeemed to transform the world around him or her.

I hope that Michael Vick’s redemption is real, but only Michael and his mentors know for sure. In the meantime I will not forgot his crime but I will cheer him on. I want Michael Vick to succeed to be redeemed and transform the world around him. I want to believe in the promise and possibility of Redemption.

UPDATE: Maybe the Eagles should reconsider this after their shellacking at the hands of the Vikings last night.
Eagles Pick Squeaky For Defensive Coordinator

10 Years of Sobriety

I haz it.

My only advice? Addicts are self-centered. Stop thinking about yourselves and start thinking about others.

Why An Alcoholic Supports the Legalization of Illicit Drugs

Anybody who knows me understands that I have traveled a long and tortured road when it comes to substance abuse. The drugs I abused were completely legal – tobacco and alcohol – but at the height of my abuse I was up to two packs a day and well… consumed embarrassing amounts of liquor. On January 28, 1996 I stubbed out my last cigarette in a neighborhood noodle shop in north Kyoto Japan. In the early hours of December 1, 2000 I set down my last drink in Wilmington Delaware. I have been Straight Edge ever since, but the years of sobriety haven’t made me complacent. I realize that the hell I left behind is only a drink away and one is as close as the refrigerator in the kitchen (the Wife keeps beer and wine in the house).

I know what it feels like to crave something so badly that one’s world becomes focused on a single glass or tobacco-filled paper tube. I have trudged a mile through foot deep snow to buy cigarettes and lost my mind from nicotine withdrawal the dozens of times I tried – and failed – to quit. But in the end something more powerful than me pulled me out of my own private addiction hell and left me dumbfounded and humble towards addiction in the real world.

That humility has shown me that I have gotten off much more lightly than most. Search this journal for essays about my old drinking buddy, my sister-in-law, for an example of someone with both feet firmly planted in the pit of hell. Over the years I have seen others ruined by alcohol, tobacco and illicit drug abuse of seemingly a thousand different varieties and come to one conclusion: we as a people have yet to understand and treat addiction effectively.

Even as a recovering addict myself I can’t tell you what the solution is for addiction. What helped me was a swift and hard kick in the pants by the Wife combined with an iron will forged in my childhood by my mother. But I don’t claim to know what works for others.

What I can say beyond a reasonable doubt however is that jailing addicts does not help addiction. If anything it makes the addict’s situation worse while doing nothing to protect Society.

An addict’s first priority feeding the addiction by securing his or her drug. Everything else pales in comparison to this fundamental need. While I was in the African bush I never fell below a carton of Tanzanian Sportsmans and a bottle of scotch. Every six weeks I would take a long trip up Lake Tanganyika to get supplies for the research camp, and rebuild my stash. I ran out of coffee but I never once ran out of cigarettes over the course of an entire year in the isolated outpost.

Since my drugs were legal, they were easily obtained and therefore relatively cheap. I doubt that my annual bar tab and smokes budget ever consumed more than 5% of my income. Some – I’d hazard a guess and suggest that most addicts spend more on their dope than they take in. To make up the difference they lie, cheat and steal – often from their loved ones. Some also deal to make enough money to feed their addiction. These particular sad-sacks usually end up in shallow graves as their addiction forces them to steal from their suppliers.

Outsiders ask how they could do this – yet forget that the addicts first priority is securing her drug. Nothing else matters. It’s hard for non-addicts to understand this, but as Al-Anon teaches you have to accept it nevertheless.

As an addict to legalized drugs I live in a world awash with them. A clove cigarette smells so sweet on the Spring air, and nothing seems to get a man laid faster than a can of beer - if the commercials are to be believed that I see on television. But my personal history has taught me that sweet smelling cloves eventually lead to fetid Marlboros, and nothing  gets a man arrested faster than drinking a 12 pack of beer and smarting-off to a cop.

Addicts can’t live in a protected bubble forever. Eventually they have to leave rehab or the safety of their family to get on with their own lives and become responsible for themselves. Some will fail and die. Others will succeed in living a relatively decent life in spite of their addiction.  Still more will bounce between addiction and sobriety, leading uneasy and restless lives.

Of all the things I can blame for my addiction – my upbringing, my genetics – Society isn’t one of them. Sure I live in a permissive society where alcohol and tobacco are legal, yet the fact that heroin and meth aren’t permissible in our Society hasn’t stopped people from getting addicted to them.  Similarly there are drunks in Riyadh and Tehran – nations where alcohol is banned. The legality of a substance has little impact on its addiction, and to believe otherwise is to fail to understand the nature of addiction and underestimate its power.

Besides, it’s my disease – not Society’s. I own it, and I will not let anyone take away that tiny bit of power from me.

Legalizing illicit drugs is no panacea. It isn’t going to stop addiction, but at the same time it isn’t going to turn normal people into coke whores and junkies. The drugs don’t have that kind of power to the non-addict. It’s only those of us who are open to addiction that can become addicts.  One can even take opiates and not become an addict, as soldiers proved in Vietnam where over half of enlisted men in 1971 had tried opiates and half of those did not become addicted. Similarly there are even some who manage to smoke cigarettes without becoming addicted – something that I personally don’t get after my 17 year smoking “career”.  And most people who have a beer or glass of wine do not become alcoholics. In fact according to the US Dept. of Health and Human Services, approximately 7.4% of the US population meet the criteria for alcohol abuse. That means that at least the Government believes that 92.6% of Americans – around 280,000,000 – aren’t alcoholics.

For forty years America has waged a war on drugs, and all it has to show for it are casualties. But I’m arguing that these casualties exist whether we declare war on drugs or not. People are going to continue to die. Lives will continue to be ruined – whether we declare a war or not, whether we throw addicts into prison or not. The only way forward out of this mess is to take the first step and recognize that the problem of addiction is not a law and order problem, nor solely a medical or mental problem. It is all of these yet more – a spiritual problem that we have yet begun to understand let alone solve.

I’ve been sober for over 8 years now, but I still am terrified of losing the sobriety I have worked so long and hard for. All I can do is continue onward in the hope that someday Society will mature enough to begin to provide solutions for what has to be one of the most insidious problems anyone can face in his or her life.

Another Brilliant Mind Lost to Addiction

A friend of the Wife died on Friday. He was a young doctor with a sharp mind, handsome and athletic, married to another doctor with a child on the way. During his residency he had become hooked on drugs but over the past year had gotten clean with the help of his wife and his boss. On Friday he appeared to be sick but nothing out of the ordinary. His wife went to work and when she came home nine hours later she found him dead in their home.

Had he relapsed? Tests will determine that. In all likelihood what killed him can be traced back to his addiction whether he had relapsed or not. Perhaps it was a blood vessel in his brain that had thinned prematurely over the course of his drug-taking; or perhaps his immune system had been so weakened from addiction that he wasn’t able to fight off an infection.

I met him a couple of times over the years. I didn’t know him well, but his death has saddened me regardless. All of the effort  put into raising him, the hard work of high school, college and medical school. The investment he had put into himself as well as the investments of his family and most especially by his wife. All wasted.

Some deaths are merciful; others justifiable, but his death? A complete and utter waste.