Take It Easy

One day at a time.

From Failure to Enthusiasm

Guest Post

By Andy

"Success is walking from failure to failure with no loss of enthusiasm." —Winston Churchill

One of the reasons I love this quote, is because for many of us, being able to keep our enthusiasm up in the midst of trying times can be very difficult to achieve. But once you figure out how to never lose it, no matter how hard life can get, it will mark the difference between giving up and succeeding. I love this quote and remind myself every time that sobriety success is shaped by my attitude. In this post I’m going to take you through my personal sobriety journey.

The Addict/Alcoholic

When I was 4 years old my parents made the life changing decision of moving from Colombia to California. It was 1986 and the situation in my country was scary and very violent. Upon arrival in California my parents took on many jobs to be able to provide for me and my siblings; they worked really hard to make sure we would have a life full of opportunities.

The great thing about latinos is that culturally not only are we very hard working people, but we are also very happy people who love to party. And of course, no Colombian party is ever complete without that anise-flavored drink called Aguardiente. Not that all Colombian’s are drunks, it’s just simply something they enjoy once in awhile, when there’s a good excuse to celebrate.
The first time I got drunk was at a family friend’s house party when I was nine years old. I was always a pretty mischievous kid, therefore at the party my cousin and I played a game to see who could steal more shots of aguardiente without getting caught.

After a few shots I was feeling very different inside. I felt comfortable, more secure, I danced salsa with my sister and all my cousins, I felt great. From that night on I drank every time I had the chance.
At 15 a friend introduced me to marijuana. Although today teen drug use is declining, back when I was a teenager the statistic was increasing and at 19 I attended a party and some guys introduced me to meth and so began the downward spiral. At 23 I found myself incarcerated in Idaho on drug related charges for two years.

You might be wondering why I left so many parts of the story untold. Well, I’m not writing this to reminisce on war stories, being eight years sober now I believe myself to be a bit wiser and truth be told, a little tired of recounting my crazy times. Jail in Idaho was the starting point of my recovery, and that is the part of THIS story I really want share.

AA and NA

When you are in prison, any activity that can take you out of your cell is welcomed with open arms. So when I was told that I could attend the Alcoholics Anonymous meetings I did not hesitate. At the time I was not interested in recovery, in fact, I thought I didn't have a drinking problem or substance abuse problem. I just needed to do something else than read in bed. So I attended meetings without participating. It took three months of going to these meetings to realize that I might have a slight drinking and drug problem.

One day, a fellow inmate told the story of how he hit rock bottom. He was a high level accountant abusing drugs in order to deal with the insane amount of work and stress at his job, until one day, having suicidal thoughts, he got drunk and drove his car into a local store. He lost his job, his wife filed for divorce, his family had lost hope (this wasn’t his first run in with the law). He shared that apart from coming to terms with his drug and alcohol problems he had also realized that he also had an anger management problem, he concluded that “rage spawns from anger, anger spawns from hurt, hurt spawns from getting your feelings hurt.”

Like I said before, I thought I didn't have a problem. I was convinced that I was fine, that I wasn’t hurting anyone. But thanks to that inmate sharing his story and his realization my eyes were opened: I had hurt the only person I had to live with for the rest of my life and the damage I had done to myself needed to be repaired. I had a drinking problem, a drug problem, a personality problem...a life problem.

The Workaholic

Prison was everything but easy, but attending the AA and NA meetings and the friendships I built helped me get through it. Once I was released I had a new sense of responsibility, I knew I needed to find a job, and be able to provide for myself. But it wasn't easy. Having a criminal record made it a challenge to find a good job, so I struggled for months. And when I finally found one, I was unmotivated and feeling trapped in a routine. Despite attending my AA and NA meetings on a regular basis, I relapsed. I lost my job and life seemed unbearable, hence my voluntary check in to a rehab center in Idaho.

After 3 months in rehab I moved back to California where I landed a job selling knock-off cologne. Being closer to my family helped me immensely, therefore my motivation was higher than ever. I would wake up at 5:00 am to pick-up my co-workers and go to gas stations, shopping center parking lots, flea markets, etc. to sell perfume out of the trunk of my car. After a few months I had become very good at selling. I had learned how to approach strangers, how to pitch my product, make people feel comfortable and how to overcome rejection. The job was purely commission based, thus if I didn’t sell, I didn’t make money. There is a great feeling about making cash on a sale that I cannot really describe. It is a feeling of accomplishment, it is a feeling that I wanted to replicate time and time again. I was determined to keep working harder and harder.

Months went by and next thing I knew I was training more than 10 people to sell perfumes and other beauty products on the street. I had my own office, had ads running in the paper, had a secretary taking calls, etc. In that year I had lost ten pounds, I had zero friends, and I barely saw my family.

After a long conversation with a friend he presented me with a book by Jeffery Combs called Psychologically Unemployable (Jeffery is also a recovering addict). One of the most important things said is that you should never confuse obsession with passion. After reading it and studying it for a few weeks, I understood that I had simply traded drugs and alcohol for work. It was an addiction and it wasn't any better. I was getting physically sick and emotionally unstable from the pressure I was putting on myself.

The Entrepreneur

I sold my perfume business and moved into my parents house. It was really important in my road to recovery to have their support. After a month I got a job at Target, so I could help my parents pay the bills and have some sort of income. I had no passion for that job whatsoever, and I was completely unmotivated in that point of my life. I couldn't find balance between success and a healthy, happy life. Being afraid of relapsing I started attending weekly AA/NA meetings. I acquired a really good sponsor that I am very grateful for. He gave me the task of taking a class at the local community college.

At the time I was not very happy to do the task. I felt old and I thought there was no point in taking a measly course. I just wanted to go to work, do my job and pay my bills, that was it. Nevertheless, I forced myself to take a class. The class I took was called Introduction to Website Development (HTML). I liked computers and websites, so I thought, why not give it a shot?

You should have seen my bedroom after three months in the class. I had stacks of books and papers about HTML and website design. I found myself at the computer for hours, coding, creating, learning. Finally, one day I thought to myself that it would be great if I could make a business out of my new acquired skill.

Nine years later I co-own a successful digital marketing agency. I have a great team that I feel are like my family, in fact, my brother is part of it. We are based in Medellin, Colombia, which means my life has taken a 180 degree turn. 30 years ago my parents left Colombia to give my siblings and I a better life, now I am back with that better life.

I still go to meeting and try to keep in touch with some of the good friends I made on my way to recovery. We always give each other support during rough times. Being sober has become a part of my life now. My attitude defines me and I do not let anything take control of my emotions, it only gets easier with time. I have learned to attend dinner parties and skip the wine; to dance with my colombian friends and kindly decline those beers and still enjoy myself. In regards to my business, I didn't let myself get lost while pursuing success. I have learned that balance is what makes you successful. Being able to work hard for months enjoying what you do, but also taking a weekend off to recharge has proven to be a critical part of my work-life balance. I feel very fortunate because I went out and found something I was passionate about, put my skills and knowledge to work and built a business. Sobriety, just like building a business, does not happen overnight, one has to commit to it and work hard.

It’s Not All About You

When you are in the process of recovering, every single thing you do to maintain your sobriety seems to be about you. Every one of the 12 steps you complete, every single task or piece of homework your sponsor gives you, every book or article you read is all about you and your recovery. But after a while you realize, there's a bigger picture. And going back to that Winston Churchill quote, "Success is walking from failure to failure with no loss of enthusiasm," learning that failing is just a part of the process. Behind the most successful people are years of failure, even if it's on their way to sobriety or on their way to being a successful entrepreneur. The issue is not failing, since we all will go through it, it's to never lose enthusiasm. Good luck and thank you for reading my story.

Graphics: https://pocketperspectives.com

Tips For Dating a Person in 12 Step Recovery

Would you let your daughter go out with an addict?

In the title of her book, Girlfriend of Bill, author Karen Nagy riffs on the time-honored public code for mutual AA recognition: “Are you a friend of [AA co-founder] Bill?” Nagy says she was unable to find any material written “specifically for someone who is new to such a relationship or who is thinking about dating someone in recovery.” So she wrote one, and the publishing arm of Hazelden brought it out. People in Hazelden-style recovery (Nagy calls them “PIRs”) can present challenges, since, as Nagy learned by dating several of them, stopping drinking or using is not necessarily the end of the matter.

Readers should know that the book is written from the perspective of a member of Al-Anon, who is also a firm believer in the 12 Steps. But if dating people who participate in AA or NA is not your thing, than Nagy suggests dating people from SMART recovery, Secular Organizations for Sobriety, church, mental health peer support programs, therapy groups, and so on. Her own experience, however, appears mainly limited to men in and out of 12-Step recovery programs.

While the controversial disease model of addiction continues to provoke heated debate, Nagy discovered that “knowing addiction is a disease has helped me to confront and get over my past prejudices about alcoholics and drug addicts, and to better understand why they might think, act, and react the way they do.”

“Change is tough for all of us,” says Nagy, “but it can be especially hard for an addict” because of the strong tendency to rationalize and resist needed change. Addicts, she adds, “are also known for ‘wanting it now,’ a trait that could be related to their brain chemistry and addictive cravings.” (Or, as non-practicing addict Carrie Fisher memorably put it, “instant gratification takes too long.”)

Her summation of the notion behind the AA/NA concept of a higher power is a common one these days: “Some might call their Higher Power God; others might define it as nature, the positive energy of their group, or an unnamed sense of spirit.” While that may sound naïve to some, what the addict must grasp is that white-knuckle notions of triumph through personal will may have to be abandoned along the way, if we are talking about chronic, active addiction. And she correctly points out that the AA Big Book is “written in an old-fashioned style that hearkens back to the 1930s,” when the amateur self-help group known as AA was founded.

It’s easy to forget that there are common experiences that most recovering addicts are heir to. “We who care about a Person in Recovery are also powerless over alcohol and drugs,” Nagy writes. “Try as we might—we can’t control whether or not the PIR uses them.” And non-addicts who are dating them might usefully be forewarned about such things, Nagy believes. In addition, “It can take months for an addict’s body to adjust to abstinence,” she writes. “Aches and pains are common in withdrawal, and so are digestive problems that can include constipation, diarrhea, and loss of appetite… sleep disorders can be a huge problem….”

Nagy also tips boyfriends and girlfriends to the widening and primarily generational dispute over the use of medications for craving or associated mental health disorders. “Believing ‘a drug is a drug is a drug,’ many old-timers in recovery resist taking medications, whereas younger People in Recovery are more open to taking them if they need them.”

Addicts new to recovery may be coming off a period of social isolation, and a sense of being cut off from others. Nagy advises that a summary knowledge of the 12 Steps can be helpful, in particular the business about “making amends” to people one has harmed. Forgiveness is a touchy and ongoing bit of business. It never hurts to say you’re sorry, if in fact you are. Or to say it again.

Perhaps the single most common complaint takes the form of jealousy or irritation: Why is the Person in Recovery spending so much time with those other people, rather than with me? Aren’t I “supportive” enough? Nagy views the essence of AA/NA as a “spirituality of companionship—friends accompanying friends, helping, sharing, daring, celebrating, or grieving.” In the end, Nagy believes, “it’s not about religion; it’s about connection.”

Hazelden Offers Companion to the “Big Book”

New guide attempts a modest AA update.

The founders of AA published their book, Alcoholics Anonymous (The Big Book) back in 1939. The world has changed a great deal since then, so it’s not surprising that there have been periodic calls for an update. Barring an official revision, which is unlikely, Hazelden, the Minnesota treatment organization, has published an updated companion volume to the Big Book. (Narcotics Anonymous published their version of the basic text in 1962). “The core principles and practices offered in these basic texts hold strong today,” says Hazelden, “but addiction science and societal norms have changed dramatically since these books were first published decades ago.”

Hazelden’s book, Recovery Now, billed as an easy-to-follow guide to the teachings of Alcoholics Anonymous and Narcotics Anonymous, dispenses with the divisive question of medications for withdrawal straightaway. In a foreword by Dr. Marvin D. Seppala, chief medical officer at Hazelden, the doctor makes it clear: “I agree with the majority of treatment professionals who support using these meds to help with cravings when it is appropriate to do so. Addiction is a disease that calls for the best that science has to offer.” The unnamed authors of the “little green book” agree, stating that “for some mental health disorders, medications such as antidepressants are needed. These aren’t addictive chemicals and so professionals, as well as AA and NA, accept that we can take them and still be considered clean and sober (abstinent).” There are now, as well, specific Twelve Step groups for those with both addiction disorders and mental health disorders: Dual Diagnosis Anonymous and Dual Recovery Anonymous among them.

As Seppala points out in the foreword, when some alcoholics and other drug addicts hear about the research showing that addiction is similar to many other mental and physical disorders we call diseases, it reorients their thinking amid the shame, stigma, and negative emotional states associated with active addiction. For some, it opens the door to treatment.

Okay. Hazelden, Betty Ford, and many other major treatment providers are no longer fighting a rear-guard action against a host of medications, from buprenorphine to Zoloft. But two-thirds of the Big Book consists of stories of how people recognized and dealt with their sundry addictions. That’s really about it, which tracks well with AA’s core operating principle: one drunk helping another. AA believes that much of its success stems from the fact that the program is run by the members, without direct rule setting and intervention from organizations, including their own. (All statements hold for NA as well).

What else? Recovery Now takes on another sticking point for many: the fact that “the AA Big Book and other writings include traditional male-focused and religious language, like discussing God as a ‘he.’” And there is the matter of “the realities and stereotypes of the 1930s, which is why it contains a chapter titled ‘To the Wives.’” Hazelden continues the recent tradition of broadening acceptable interpretations of “higher power.” One example given is from Samantha, a young cocaine and alcohol addict: “My higher power is the energy of this group. I call her Zelda.”

The book presents some of the psychological aspects of the AA program as a sort of reverse cognitive behavioral therapy. CBT attempts to teach people how to unkink their thinking and turn harmful thoughts into helpful ones. AA attempts to convince people to first change their behavior—“fake it until you make it”—and helpful thoughts will follow.

Perhaps the genuine sea change lies in this passage, which can be contrasted with the faith and certainty with which the Big Book proclaims that AA will work for all but the most stubbornly self-centered. Even with the myriad of choices of AA groups now available, Hazelden acknowledges that “a group based on the Twelve Steps doesn’t work for all of us. Some of us have found help in recovery groups that offer alternatives to the Twelve Steps, such as SMART Recovery, Women for Sobriety, and Secular Organizations for Sobriety.”  This is a change of heart, given that groups like SMART Recovery don’t necessarily buy the idea of total abstinence, and often structure recovery as an exercise in controlled drinking. Hazelden also suggests that many of “us” have found the necessary ongoing support for recovery at churches, mental health centers, and nonreligious peer support groups.

As for anonymity, Recovery Now states: “While Twelve Step members do not reveal anything about another member of the group, any one of us may choose to go public with our own story.” Another promising development is the proliferation of Twelve Step meetings catering to specific populations—AA meetings for African Americans, Latinos, Native Americans, women, seniors, gays, and drug-specific (Cocaine Anonymous).

In the end, one of the best arguments for attendance at the AA program (free of charge) is that many addicts have “worn out our welcome” with families and friends, “and they have a hard time putting all that behind them and supporting us completely. But at most Twelve Step recovery meetings we can find the support we need.”

How to Kick Everything

Christopher Kennedy Lawford on recovery.

Christopher Kennedy Lawford’s ambitious, one-size-fits-all undertaking is titled Recover to Live: Kick Any Habit, Manage Any Addiction: Your Self-Treatment Guide to Alcohol, Drugs, Eating Disorders, Gambling, Hoarding, Smoking, Sex, and Porn. That pretty much covers the waterfront, and represents both the strengths and the weaknesses of the book.

There’s no doubting Lawford’s sincerity, or his experiential understanding of addiction, or the fact that the raw ingredients were present in his case: bad genes and a traumatic early environment. He is related to Ted Kennedy, two of his uncles were publically murdered, and he started using drugs at age 12. But this book doesn’t dwell on his personal narrative. Lawford is a tireless supporter of the addiction recovery community, and Recover to Live is meant to be a one-stop consumer handbook for dealing with, as the title makes clear, any addiction.

To his credit, Lawford starts out by accurately pegging the addiction basics: A chronic brain disorder with strong neurological underpinnings. He cites a lot of relevant studies, and some questionable ones as well, but ultimately lands on an appropriate spot: “You can’t control which genes you inherited or the circumstances of your life that contributed to your disease. But once you know that you have the disease of addiction, you are responsible for doing something about it. And if you don’t address your problem, you can’t blame society or anyone in your life for the consequences. Sorry. That’s the way it works.”

Once you know, you have to treat it. “It can turn the most loving and nurturing home into a prison of anger and fear,” Lawford writes, “because there is no easy fix for the problem, and that infuriates many people.”

 Lawford includes good interviews with the right people—Nora Volkow, Herb Kleber, and Charles O’Brien among them. And he makes a distinction frequently lost in drug debates: “Nondependent drug use is a preventable behavior, whereas addiction is a treatable disease of the brain.” Due to our penchant for jailing co-morbid addicts, “our prisons and jails are the largest mental health institution in the world.” He also knows that hidden alcoholism and multiple addictions mean “rates of remission from single substances may not accurately reflect remission when viewed broadly in terms of all substances used.”

One nice thing about Lawford’s approach is that he highlights comorbidity, the elephant in the room when it comes to addiction treatment. Addiction is so often intertwined with mental health issues of various kinds, and so frequently left out of the treatment equation. The author is correct to focus on “co-occurring disorders,” even though he prefers the term “toxic compulsions,” meaning the overlapping addictions that can often be found in the same person: the alcoholic, chain-smoking, compulsive gambler being the most obvious example.

The curious inclusion of hoarding in Lawford’s list of 7 toxic compulsions (the 7 Deadly Sins?) is best explained by viewing it as the flipside of compulsive shoplifting, a disorder which is likely to follow gambling into the list of behavioral dependencies similar to substance addictions. In sum, writes Lawford, “If we are smoking, overeating, gambling problematically, or spending inordinate amounts of time on porn, we will have a shallower recovery from our primary toxic compulsion.” Lawford sees the exorcising of childhood trauma as the essential element of recovery—a theory that has regained popularity in the wake of findings in the burgeoning field of epigenetics, where scientists have documented changes in genetic expression beyond the womb.

But in order to cover everything, using the widest possible net, Lawford is forced to conflate an overload of information about substance and behavioral dependencies, and sometimes it doesn’t work. He quotes approvingly from a doctor who tells him, “If you’re having five or more drinks—you have a problem with alcohol.” A good deal of evidence suggests that this may be true. But then the doctor continues: “If you use illicit drugs at all, you have a problem with drugs.” Well, no, not necessarily, unless by “problem” the doctor means legal troubles. There are recreational users of every addictive substance that exists—users with the right genes and developmental background to control their use of various drugs. And patients who avail themselves of medical marijuana for chronic illnesses might also beg to differ with the doctor’s opinion.

Lawford attempts to rank every addiction treatment under the sun in terms of effectiveness (“Let a thousand flowers bloom”), an operation fraught with pitfalls since no two people experience addictive drugs in exactly the same way. Is motivational enhancement better than Acamprosate for treatment of alcoholism, worse than cognitive therapy, or about as good as exercise? Lawford makes his picks, but it’s a horse race, so outcomes are uncertain. Moderation management, web-based personalized feedback, mindfulness meditation, acupuncture—it’s all here, the evidence-based and the not-so-evidence based. Whatever it is, Lawford seems to think, it can’t hurt to give it a try, and even the flimsiest treatment modalities might have a calming effect or elicit some sort of placebo response. So what could it hurt.

Lawford’s “Seven Self-Care Tools” with which to combat the Seven Toxic Compulsions vary widely in usefulness. The evidence is controversial for Tool 1, Cognitive Behavioral Therapy. Tool 2, 12-Step Programs, is controversial and not to everybody’s taste, but used as a free tool by many. Tool 3 is Mindfulness, which is basically another form of cognitive therapy, and Tool 4 is Meditation, which invokes a relaxation response and is generally recognized as safe. Tool 5, Nutrition and Exercise, is solid, but Tool 6, Body Work, is not. Treatments like acupuncture, Reichian therapy, and other forms of “body work” are not proven aids to addicts. Tool 7, Journaling, is up to you.

One of the more useful lists is NIDA director Nora Volkow’s “four biggest addiction myths."

First: “The notion that addiction is the result of a personal choice, a sign of a character flaw, or moral weakness.”

Second: “In order for treatment to be effective, a person must hit ‘rock bottom.’”

Third: “The fact that addicted individuals often and repeatedly fail in their efforts to remain abstinent for a significant period of time demonstrates that addiction treatment doesn’t work.”

Fourth: “The brain is a static, fully formed entity, at least in adults.”

Finally, Lawford puts a strong emphasis on an important but rarely emphasized treatment modality: brief intervention. Why? Because traditional, confrontational interventions don’t work. The associate director of a UCLA substance abuse program tells Lawford: “I haven’t had a drink now in 25 years, and this doctor did it without beating me over the head with a big book, without chastising me, or doing an intervention. What he did was a brief intervention. Health professionals who give clear information and feedback about risks and about possible benefits can make a huge difference. A brief intervention might not work the first time. It might take a couple of visits. But we need more doctors who know what the symptoms of alcohol dependence are and know what questions to ask.”

If your knowledge of addiction is limited, this is a reasonable, middle-of-the-road starting point for a general audience.

What It Means to Say Alcoholism is Genetic

One woman’s journal.

From Insanity to Serenity, by Tommi Lloyd

Excerpts:

"I was born in 1963 in Toronto, Canada, to a family struggling long before I arrived. My dad was an alcoholic, born in Wales in 1921. His father and namesake was also an alcoholic who died at age 28…. My oldest sibling and only brother, Harry, entered a treatment centre at age 36 and has been sober for more than 20 years…. My Uncle Griff died from alcoholism when I was 10 years old…. There were no reprieves by which we spent a day or two in a sober environment. Dad drank from morning until night…. Christmas, Thanksgiving, and Easter—these were some of the worst days of the year…. Santa started leaving a carton of cigarettes next to my stocking at Christmas and I thought it was great.

"I yearned for some quality time before his drinking took center stage for the day… he drank from the minute he got up to the minute he passed out. At the height of his addiction, he was drinking more than 40 ounces of vodka a day…. There were many times when I would walk into the bedroom and see him guzzling the vodka straight from the bottle. It made me feel physical ill and utterly helpless.

"I too, am an alcoholic. In addition to alcohol, my teenage love of marijuana turned into a 30-year affair…. I have two nephews who are addicted to marijuana…. Rather than being sloppy drunks, my nephews opted for the mellow alternative that’s not addictive, (so we like to think) and you can pay for your habit by selling it to your friends.

"By age 11 I tried drinking for the first time…. I recall Susie telling us we could try drinking, but it had to be done quickly so as not to get caught. We poured some very strong rum and cokes and I guzzled mine down by holding my nose with my free hand…. As soon as I lay down on my bed the room started spinning and it wasn’t long before I was throwing up. Mom fussed over me, concluding I had the flu and I recall feeling both happy and guilty at the same time. I loved the attention but felt badly for the cause of my illness. I didn’t drink again for a few years….

"There is nothing more validating for me as a mother than to know I’m an inspiration to my children. I could not have asked for a better gift. This is what sobriety and a renewed spiritual life has brought my children and me…. Intellectually, I recognize how my childhood experiences and the disease of alcoholism molded a lot of my behavior and have been the root of much of my struggle with self-esteem. But self-knowledge does not change our circumstances, action does."

Book Review: Writers On The Edge

A compendium of tough prose and poetry about addiction.

Here’s a book I’m delighted to promote unabashedly. I even wrote a jacket blurb for it. I called it an “honest, unflinching book about addiction from a tough group of talented writers. These hard-hitters know whereof they speak, and the language in which they speak can be shocking to the uninitiated—naked prose and poetry about potentially fatal cravings the flesh is heir to—drugs, booze, cutting, overeating, depression, suicide. Not everybody makes it through. Writers On The Edge is about dependency, and the toll it takes, on the guilty and the innocent alike.”

I am happy to stand by that statement, content to note that this collection of prose and poetry on the subject of addiction and dependency by 22 talented writers, with an introduction by Jerry Stahl of “Permanent Midnight” junky fame, includes a number of names familiar to me. That makes it all the easier to recommend this book—I know some of the talent. Take James Brown, a professor in the M.F.A program at Cal State San Bernardino, the book’s co-editor, who offers an excerpt from his excellent memoir, This River.  James is no stranger to the subject, having pulled out of a drug and alcohol-fueled nosedive that would have felled lesser mortals for good. “Even though you’ll always be struggling with your addiction, and may wind up back in rehab,” Brown writes, “at least for now, if only for this day, you are free of the miracle potions, powders and pills. If only for this day, you are not among the walking dead.” Or my friend Anna David, who is an editor at The Fix, an online addiction and recovery magazine to which I frequently contribute, and author of several books, including Party Girl and Falling for Me. Anna poignantly recalls “my shock over the power than booze had… it was the greatest discovery of my life.” And Ruth Fowler, another Fix contributor and author of Girl Undressed, delivers up a brilliantly detached story of her life as an addict on both coasts and just about everywhere else, which begins with the line, “I gravitated to the fucked up writers.”

Then there are the contributors I don’t know but wish I did, like co-editor Diana Raab, a registered nurse and award-winning poet, as well as co-author of Writers and Their Notebooks, who offers a poem to her grandmother: “Your ashen face and blond bob/disheveled upon white sheets/on the stretcher held by paramedics/lightly grasping each end, and tiptoeing.” Or another poet, B. H. Fairchild, author of the marvelous collection, Early Occult Memory Systems of the Lower Midwest: “When I would go into bars in those days/the hard round faces would turn/to speak something like loneliness/but deeper, the rain spilling into gutters/or the sound of a car pulling away/in a moment of sleeplessness just before dawn.”

And more: Frederick Barthelme, author of Double Down: Reflections on Gambling and Loss. Stephen Jay Schwartz, best-selling crime novelist  and former director of development for filmmaker Wolfgang Petersen. Writers Rachel Yoder, Victoria Patterson, David Huddle, and Scott Russell Sanders. Etc. This collection is a rich brew of essay, poetry, and memoir. A tough book, a brutal book, a real heartbreaker with grit. Some people get stronger and rise; some don’t. It is a thoughtful and creative compendium of addiction stories, and some of them will surprise you. All of them are solidly written, laid out with an unrelenting realism.

Here it is, these authors are saying. This is how it plays out. Unforgettable stuff.

Mike Doughty Talks About “The Book of Drugs”

Former Soul Coughing front man on sobriety and life as a solo artist.

Over the phone, Mike Doughty doesn’t have much to say about his former band, Soul Coughing. When I mention it, he gives out a low growl as a warning. He said it all in The Book of Drugs, and it doesn’t sound like he had much fun. Although the avant-garde rock band created music that was spiky and sneaky and immensely popular, topped off by Doughty’s monotonic but strangely penetrating vocal delivery on such classics as “Super Bon Bon,” “True Dreams of Wichita,” and “Circles,” Doughty was drug-dependent and miserable. Musician pitted against musician, egos battered and bruised, credit taken and not taken—and Doughty busily running the gamut of addictions from Jack Daniels to heroin, with a ton of marijuana in the bargain. 

But that was the 90s. Since then, Doughty has done two things of note—three, if you count teaching himself German. He has crafted an innovative solo career, and he has escaped from a cornucopia of addictions that had almost buried him alive.

It seems almost unfair that a talented singer/songwriter like Doughty should also turn out to be a good writer, but there you have it. The Book of Drugs is informative but not confessional, rock-snarky but tempered with a round of amends. It is also whip-smart and bitterly funny:

--“Lars would go out and get drunk every night, then stumble in, sounding for all the world like he was going around moving absolutely everything in the room a foot to the left.”

--“Currently, in the studio next door, guitar overdubs were being recorded for a Meatloaf record. Meatloaf was not in attendance.”

--“I smoked three packs a day. Ridiculous. It was like a job. I woke up, and began the work of the first pack. It was a repetitive, manly task, like getting up early every day to chop down pine trees.”

--“Weed addicts are along among drug users in that they think their shit is cute.”

--“The unsingable girl yelled at me, ‘You don’t get HIGH, you just get FUCKED UP!”

Told in an episodic, chapter-free style, the book lays the foundations for Doughty’s future by page 3. “My dad’s dad,” he writes, “was the town drunk in Tullos, Louisiana.” Doughty's father was an alcoholic as well. From the outside, the process is unfathomable: Doughty relates what is known as the parable of the jaywalker: “Guy’s really into jaywalking, his friends are all like, ha ha funny, then he gets hit, they figure he’s done, he does it again, this time gets both legs broke, the friends are like, whoa that’s weird, and then he does it again and they’re bewildered, and he does it again, and they abandon him, and he does it again, and he does it again.”

Here's what Doughty had to say last week in our interview:

--You got sober after embarking on your solo career. Did you hit bottom, in the classic AA sense?

The thing that really made me think was when I was actually addicted to alcohol, and I started waking up in the morning with the shakes, and I just had this very logical reaction, which was like, oh, I’m addicted, this is horrible, so I’ll just start drinking first thing in the morning. And that’s when it was like, holy shit, I’m an alcoholic, there’s alcoholism in my family, and it’s not just a "drug thing." It was kind of acceptable to be a heroin addict for me, but it was not acceptable for me to be a morning drunk.

--Was alcohol your drug of choice, or heroin?

Well, I went through about thirty-five different drugs. I was always good at finding drugs. My struggle was to manage it. If I had to call something my drug of choice, it would be heroin, in terms of the thing that killed the most pain effectively. Eventually, when it stopped working, I’d say, okay, well, I’ll just do it on the weekends, or detox for a couple of days, and I’ll smoke a lot of weed and I’ll drink and I’ll do some coke or ecstasy, and then I can be back on the heroin on weekends.”

--What’s your opinion of addiction as a biological disorder—the disease model approach to it?

I don’t really know any addicts that don’t have trauma in their backgrounds. I think, to activate this thing, there is generally pain that needs to be numbed, or trauma that needs to be gotten away from. One of the things about the disease model is that so many people of the non-alky variety are just so indignant about it. I think we should just give it up. It’s maybe not worth the fight over the semantics of it. It’s like, addicts are killing themselves, they’re unable to stop using drugs, I would think that would be more important than what to call it.

--Did you use any anti-craving drugs, or do any medication-assisted recovery?

I was on naltrexone for a while, but I was getting high on everything but opiates at the time, so it was just a way of not using opiates. I was shit-faced drunk, and stoned, so I don’t know what eliminating one specific drug—I don’t what the ultimate effect of that was, because for me, I would just go out and find something else.

--Did you do any formal detox or treatment before you went into the rooms, as AA is often called?

No. I had a couple of prescribing shrinks and they suggested treatment, because I had insurance, but I was like, fuck that, no way. It’s funny, they cover detoxes and rehabs but they don’t cover talk therapy. Most of my struggle to get into the path of non-self destruction was because of a shrink who just nailed me as an addict the moment I met her. Within probably twenty minutes she was like, "you know, there are AA meetings above St. Mark’s Place." And I was so angry, like, "what are you talking about?" So a lot of the struggle, of, you know, am I an addict, or do I just have a problem with a single drug, or are the rooms just a cult, it’s a religion—somehow she got me to keep showing up. I don’t know what kind of hook she put in me, but I was showing up, strung out, falling asleep in the chair, and she kept me coming back week after week. I don’t know what kind of Jedi mind trick she used.

--You’re one of the few performers who have been willing to admit that for a minority of people, marijuana is addictive and has its own characteristic set of withdrawal effects.

Yeah, my basic line is, if you know a thirty-six year-old wake-and-bake guy, that guy is probably a marijuana addict. I don’t know the science, I don’t know shit about withdrawal, the mentality of addiction, but I know plenty of people that were stoned all day. And they kept doing it. But I definitely believe weed should be legal. First of all, it doesn’t make any sense if alcohol is legal. Second, it’s such a dirty weapon in the drug war. And the drug war is a war on the poor.

-- You’re "co-morbid." You're an addict, and you’re diagnosed as bipolar.

I do know that there was a part of it that was relieved tremendously by meds—a very careful construction of a cocktail of meds by a super-smart prescribing shrink. Really being very cautious and gradual about it. But if I’m really messed up about something emotionally, talk therapy has the most immediate effect. Just being in touch with dudes from the rooms, a sponsor, friends, I’m on a gratitude list with a bunch of guys, we email each other every day—that stuff is a lot more effective in the short term.

--As a polydrug addict and an artist who has seen his way through to sobriety, what message what you like to send to people working in the treatment and recovery fields?

You know, advice is not my scene. I lucked into the right kind of treatment. Something I hear over and over again from people is that they end up with the wrong therapist. It’s like a relationship, essentially. I think it would be great if therapists were very upfront about saying, "If I’m not the right person, then let’s find you the right person.”

--“Don’t push against your own weight,” you sing in “Diane.” It got me thinking about how hard it is for addicts to lift themselves by their own bootstraps through sheer willpower.

If you let go, if you just get out of your own damn way, it will be so much easier. David Mamet wrote a book about the theater, and he has this thing about how directors overmanage plays when they direct them. And his metaphor was that when the airplane was being developed, they had this terrible problem with spinouts. All the time, the pilot would lose control of the plane; it would start spinning and spinning, and crash and hit the ground. So they invented the ejector seat, so if you’re having a spinout, you just hit the button and zoom out into the air with a parachute. And they discovered that pretty much immediately when the pilot was out of the plane, the airplane straightened out and righted itself. That’s how it is, you try to control too much shit, you’re more likely to fuck it up.

--So, things are good?

-- I’m stoked to be sober. I’ve got eleven years now. Things are really good, even when they’re bad, like a bad year financially or whatever, it’s like, oh my god, I’m doing really good. As long as I’m loving the work I’m making, and I have an audience, and I can make a living, those are pretty much the only things I really have any control over.

Nothing Organic About Rodale’s New Book on Addiction

Raw carrots won’t cut it.

How times have changed. You’ve heard of Rodale, the outfit that kicked off organic gardening in America, and publishes Prevention Magazine and Organic Gardening? Founded in 1947, the Rodale Institute’s mandate was to publicize J.I. Rodale’s personal vision of healthy soil and healthy food. So it was with great astonishment that I picked up The Addiction Solution: Unraveling the Mysteries of Addiction Through Cutting-Edge Brain Science, published by Rodale Books, heretofore famous for such perennials best sellers as The Rodale Book of Composting, The Rodale Whole Foods Cookbook, Diabetes Without Drugs, and The Organic Manifesto.

So what is the approach taken in this new paperback about addiction? Herbal treatments for alcoholism? Fresh air and sunshine for meth addiction? No. The “brain science” in the subtitle is really just that. Written by Dr. David Kipper, a Beverly Hills physician, and Steven Whitney, a former addict, the book states that addiction is… er… a brain disease, and not primarily a behavioral issue. It seems that Big Science has gotten its murderous dissecting hands around the Rodale organization at last. In neuroscience, not organic carrots, lies the future of addiction treatment, the book asserts. Is old man Rodale turning over in his grave? It gets worse. The Rodale organization is now saying, through this book, that if you are an addict, you might want to consider taking… more drugs.

Here it is, in a nutshell: “An inherited genetic flaw causes specific imbalances in brain chemistry, that, when impacted by stress, create biochemical ‘wantings,’ or needs, that show themselves as bad feelings, uncharacteristic behaviors, and/or addiction, which is medically treated by a new family of pharmaceutical medications that first regain and then stabilize the biochemical balance. During the rehabilitation of the brain chemistry, the patient enters a personalized recovery program featuring behavioral and other therapies.”

You can argue with certain specifics in that definition—“brain imbalance,” for example, is falling out of favor as a descriptor—but there is no denying that it represents an attempt at a strictly neurophysical definition of the condition.

Traditional addiction treatment, the book argues, hasn’t included any of this. The authors maintain that “traditional 28-day inpatient programs at treatment centers are now largely unnecessary. This is good news, since that kind of treatment costs from $50,000 to $100,000 per month.” [Editor’s note: perhaps in Beverly Hills.]

“In contrast,” the authors write, “the new medical paradigm is grounded in outpatient treatment, making it more affordable, especially with insurance and government benefits that define addiction as a medical disease. Thanks to the Mental Health Parity and Addiction Equity Act of 2008, insurers that offer substance abuse coverage must provide the same lifetime limits on payment as they provide for other medical diseases like diabetes, heart disease, and cancer.”

And what does all this accomplish? “More subtly, the new approach replaces the expectation of failure attached to the old, traditional treatment with a tangible opportunity for success, including raising an addict’s self-esteem.” Away with your old and traditional ways, says this Rodale title. If you are looking for an organic alternative to what is becoming the mainstream view of addiction, you will have to look elsewhere. Perhaps Prevention magazine might have something more in your line.

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Is Addiction Deductible?

You're free to write off the cost of addiction treatment—if you can afford to.

The cost of addiction treatment is a legitimate medical expense, as long as you are talking about drug and alcohol addiction, which the IRS recognizes as a genuine medical disease. If you go to Betty Ford on the advice of your doctor for alcoholism, it’s deductible. If you go to Passages for cocaine addiction, it’s deductible. If you buy nicotine gum and patches and fill a prescription for Chantix, in a stop-smoking effort, it’s deductible. But if you want to write off the cost of a weight-loss clinic, or a gambling cessation program, or treatment for compulsive sexual activity, you’re a bit ahead of the curve.

According to Dave Hutchison, Planned Giving Officer at the Betty Ford Center Foundation: “Generally, medical expenses, including amounts paid for medical treatment, drugs and medicines, nursing care and certain transportation and travel required for medical care, are deductible as an itemized deduction.  Amounts paid for inpatient treatment of alcoholism or drug addiction at a therapeutic center and for meals and lodging furnished as a necessary incident to the treatment are deductible.”

Officially, IRS Topic 502 says that “payments for acupuncture treatments or inpatient treatment at a center for alcohol or drug addiction are also deductible medical expenses.” So just about any loopy treatment is covered, as long as the official diagnosis is alcoholism or drug addiction, including cigarettes.

And while theoretically the IRS is open to the idea of allowing deductions for the “cost of participating in a weight-loss program for a specific disease or diseases, including obesity, diagnosed by a physician,” the tax people aren’t yet persuaded that obesity, per se, is an addictive disease. They don’t allow most deductions for the cost of health food diet items or health club dues, for example, even if health food and gym workouts are doctor’s orders.

So, in theory, the cost of drug and alcohol rehab is a legitimate medical expense. Or at least those expenses over and above 7.5% of your income that haven’t been paid for by medical insurance. In practice, whether you can deduct the cost of drug rehab depends entirely on your total amount of itemized medical expenses. You can write off the cost of addiction treatment—if you can afford to.
Kelly Phillips Erb, who blogs at Forbes as Tax Girl, explains it all:

As a general rule, the costs of rehabilitation for drug and alcohol abuse and addictions are deductible as medical expenses, assuming that you itemize your deductions on Schedule A. Like other medical and dental expenses, rehab and addiction treatment expenses are only deductible to the extent that they exceed 7.5% of your adjusted gross income (AGI). So, for example, if your AGI was $40,000, you can only deduct expenses which exceed $3,000 (7.5% of $40,000). If the total of your expenses, including treatment costs $5,000, then you can deduct $2,000 ($5,000 expenses less the $3,000 threshold).

And that’s after you’ve parsed the IRS definition of qualifying medical care: “The diagnosis, cure, mitigation, treatment, or prevention of disease.” According to Tax Girl, that’s it. Other than throwing out a few examples—nursing services, x-rays, ambulance expenses—there is precious little help in defining what counts as a disease. Tax Girl says that the “IRS allows deductions for expenses related to the treatment of alcoholism and drug addiction because it agrees that those behaviors are a disease—even if many taxpayers think differently.” But the IRS won’t allow deductions for the cost of treatment with illegal drugs, thereby making the likelihood of write-offs for medical marijuana and marijuana addiction treatment unlikely, as long as marijuana remains illegal at the federal level. Furthermore, certain promising treatment options are not deductible for the same reason. Tax Girl writes that “despite evidence in Europe that “prescription” heroin taken together with methadone might lessen heroin dependence in addicts, the treatment remains illegal in the U.S. and is, therefore, not be deductible for federal income tax purposes. Methadone on its own, however, is a legal treatment for drug addiction in the U.S.” and is therefore deductible for federal income tax purposes.

Furthermore: “The IRS does not necessarily agree that all behaviors considered to be ‘addictions’ qualify as a disease.” Given the broad net cast across the medical waters in the name of addiction—everything from Internet addiction to cornstarch addiction—it’s probably just as well that the IRS is taking a jaundiced view of the so-called behavioral addictions. But they have taken some heat for being hard-nosed about obesity, while at the same time allowing write-offs for medical expenses associated with sex change operations.

Okay. But what if you’re Charlie Sheen, living on the other end of the income scale, until recently pulling down $2 million dollars per TV episode, starring in a mildly amusing sitcom? He’ll make maybe $40 million this year. How much would Charlie have to spend on rehab to make it tax-deductible? As it happens, there are tax geeks like Kay Bell at MSN Money who wonder about such things. Remember, Charlie can only deduct the amount of qualifying medical expenses that exceed 7.5% of his adjusted gross income. Bell says that Sheen “would have to spend lots of time at a pretty swanky rehab center to run up the more than $3 million required for him to claim the medical expenses deduction. He’s in Los Angeles, so it’s possible, but still, that’s a big recovery bill.”

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NIDA on Drugs, Brain, and Behavior

How Science Has Revolutionized the Understanding of Drug Addiction.

Addiction to alcohol, nicotine, and other drugs costs Americans as much as half a trillion dollars a year, according to the National Institute on Drug Abuse. Since the 1930s, when the science of addiction got its start, scientists have consistently battled against a prevailing view of addicted individuals as morally flawed and lacking in willpower. In an effort to dispel myths and keep drug arguments on track, NIDA has released an updated 2010 version of its valuable publication, “The Science of Addiction.” The report is available as a PDF for download.

As a disease that affects both brain and behavior, addiction is indeed the “cunning, baffling and powerful” disease described by Bill W., the founder of AA. Dr. Nora Volkow, director of NIDA, said that despite the plethora of scientific advances being made in addiction medicine, “many people today do not understand why individuals become addicted to drugs or how drugs change the brain to foster compulsive drug abuse. This booklet aims to fill that knowledge gap by providing scientific information about the disease of drug addiction, including the many harmful consequences of drug abuse and the basic approaches that have been developed to prevent and treat the disease.”

Dr. Volkow exhorted Americans to “adopt science-based policies and programs that reduce drug abuse and addiction in their communities, and support scientific research that improves the Nation's well-being.”

Today, "thanks to science,” writes Volkow, “our views and our responses to drug abuse have changed dramatically. Groundbreaking discoveries about the brain have revolutionized our understanding of drug addiction, enabling us to respond effectively to the problem.”