A River of Rage and Redemption

An interview with writer James Brown.

“Who could blame a reader, after James Frey's discredited 'A Million Little Pieces,' for being skeptical of the pyrotechnic literature of addiction?” asks Susan Salter Reynolds in her review of James Brown's “This River” in the March 20 Los Angeles Times. Besides, it’s a cliché to assert that former addicts always know more about drug addiction than the so-called “experts.” But Los Angeles writer James Brown, a professor of creative writing at Cal State San Bernardino, is a special case. Brown has a sharp, restless mind, a hair-raising background, and has read just about everything worth reading on the subject of addiction. In “This River,” James Brown has come not to bury us in bullshit, but to praise the ineffable mysteries of the human condition. The author writes of the time when, battered and baffled, he clung to the notion of sheer will, of having total mastery over his own destiny—even as the devastating deconstruction of everyday life that drug addiction produces was proceeding apace all around him.

What saved him from dying of drug-related misadventures, like his brother and his sister and a shocking number of his childhood friends? “This River” is no ordinary tale of redemption, but rather a dogged, unadorned, very human description of one man’s attempts to understand his disorder, and to find some way to control it.

 I asked Brown if he would submit to a brief Q and A by email to be published here at Addiction Inbox, and he graciously agreed.

Q. Recent surveys suggest that kids who had their first drink at 12 or 13 are far more likely to experience alcohol dependence as adults. Did you have any early formative experiences with alcohol or other drugs that in hindsight seem significant to you?

James Brown: I’ve heard about this survey, along with another statistic cited in Under the Influence: A Guide to the Myths and Realities of Alcoholism by Milam and Ketcham that children born to an alcoholic mother or father have a four times greater chance of becoming alcoholic themselves than if they’d come from teetotaler parents. 

 Given both studies, if there’s truth to them, and I believe there is, I got off to a great start. I took my first hit of marijuana when I was nine, by twelve I’d begun drinking, and by fourteen I had my first taste of heroin. Alcohol and drugs were a way of life in the neighborhoods I grew up in, poor neighborhoods in poor apartment complexes, where nearly all of the kids were raised by single parents, typically mothers.  

All the kids I knew and hung out with drank and used. I lost contact with nearly all of my childhood friends over the years, but one became a heroin addict and bank robber (and a good one, if there is such a thing, with over 40 robberies before he got caught), and is currently in San Quentin; another shot one too many loads of meth and died of a heart attack in his 40’s; and a good friend, one of my best friends, is still hanging in there. He always loved his marijuana and now gets it prescribed, but he’s quit drinking.

So if I’m any example, and if my childhood friends are any example, I’d have to say, based on personal experience, that I believe there is a strong connection between addiction and getting off to an early start at it.

Q. Tom McGuane once referred to alcoholism as "the writer's black lung disease." Why do you think so many prominent writers have been addicted to alcohol or other drugs?

James Brown: The list of alcoholic writers is long: Hemingway, Kerouac, Eugene O’Neil, Dorothy Parker, Fitzgerald, Jean Rhys, Poe, Faulkner, and on and on. The only rationalization I can come up with, at least in regard to my own addiction, is spending long, long hours alone in a room, trapped in my own head, imagination, feelings, memories and thoughts, and when it’s time to resurface, to leave that room and return to the world that exists outside the sheltered perimeters of my mind, I’d want a drink to ease myself back into it. Without that drink, and the many that followed it, because not even from the beginning could I or did I want to stop after just one or two, it was stimuli overload.  Lights seemed brighter.  Noises louder. I was expected by my wife and children to just return to earth and join their lives when a big part of me was still locked up in that room.

But these are rationalizations. As the years passed, and the alcohol and drugs took greater hold of me, using and drinking was no longer about easing back into the world but eluding it altogether, where I didn’t have to feel or think.   Did booze or drugs help me creatively? No. That’s myth, a lie, this notion of the tragic artist. Outside of Kerouac’s On The Road, which he wrote on speed, and Stevenson’s Dr. Jekyll and Mr. Hyde, which he purportedly completed in 21 days spun on coke, and maybe a few other writers, maybe a dozen other exceptions, generally speaking writing under the influence typically produces work that reflects an insensible, messed-up consciousness.  That’s scribbling, not writing. Good writing requires clarity of mind and vision. 

Q. Can you describe your experience with the controversial drug Seroquel?

James Brown: For me Seroquel has been something of a miracle drug and helpful in maintaining my sobriety. As I’m sure you already know it’s categorized as an antipsychotic and classified as a “major tranquilizer,” as opposed to the “minor tranquilizers,” typically members of the benzodiazepine family. Why Seroquel has become a drug of abuse, I have no idea, because it doesn’t get you high, at least not for me, and there’s no sense of the euphoria associated with Valium and Xanax. Why there’s this big push (all the TV ads) to prescribe it for those suffering from depression, I also have no idea, other than the obvious, which is to make the pharmaceutical companies more money. Seroquel is potent stuff, and was prescribed to me for manic-depression (I prefer this term because it more aptly describes the nature of the illness than the euphemistic “bipolar”), post-traumatic stress syndrome and mild schizophrenia.

It took my nervous system about a week or better to adjust, with side effects of blurred vision and garbled speech, but once the sides passed the drug made a major difference in my ability to sleep without the nightmares that have plagued me for many, many years. Also, it made a big difference with the mania aspect of my mental illness, keeping my system at a relatively even keel, but I can only take it at night. If I use it during the day, I can’t function well, I can’t think clearly or quickly, and I have to be focused when I teach and write.  For depression, I use Wellbutrin, which is effective for me.  Again, I don’t understand, or agree, with the aggressive marketing of Seroquel.  It’s nothing to mess around with and should only be taken if absolutely necessary for ones mental stability.

Is Post-Traumatic Stress Medication a Danger to Veterans?

I have not run any guest posts lately, but some months ago the AllTreatment site was kind enough to feature a guest post of my own, so I've arranged to return the favor with an article by Brandon Yu. He is a Managing Editor of Alltreatment.com. AllTreatment is an online rehab center directory and substance abuse information resource.‬

Opinions expressed in guest posts are not necessarily those of Addiction Inbox.
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By Brandon Yu

After spending weeks, months, or years on the battlefield, veterans often experience Post-Traumatic Stress Disorder (PTSD) when returning to civilian life. The Department of Veteran Affairs reports that 60% of men and 50% of women, not just veterans, experience some sort of trauma in their lifetimes. PTSD has been known to cause insomnia, depression, and a sense of detachment, making it difficult for veterans to readjust to society, and throwing their personal and professional lives into disarray.

While there may not be a cure for Post-Traumatic Stress Disorder, there are treatments, and certainly medication, to sooth its side-effects. The most popular medication for PTSD is the pharmaceutical Quetiapine, marketed as Seroquel by the biologics company AstraZeneca. A potent antipsychotic, Seroquel is often prescribed to treat symptoms of psychoses including schizophrenia, bipolar disorder, and acute manic episodes; numerous physicians claim that it is one of the few treatments that curbs the nightmares, insomnia and anxiety that come with PTSD. It is not considered a controlled substance, and not deemed addictive like other sleeping pills.

However, several families of veterans are calling for a Congressional investigation of Seroquel after reports of mistreatment over the drug have arisen. After some complaints that the treatment was not working, some doctors prescribed progressively larger doses for given patients, with certain ones receiving more than double the maximum recommended. Though only six similar deaths have been noted, there is a belief that there have been others. The New England Journal of Medicine recently published a report linking Seroquel use to heart failure, noting that 3 of 1,000 patients who suffered from cardiac arrest were noted to be on Seroquel at the time of death.

Seroquel is one of the more common medications in America, as it is one of the Department of Veterans Affairs’ most prescribed drugs and the fifth best-selling drug in the nation. It has been reported to help schizophrenia and PTSD, but some of its side effects, such as diabetes, weight gain, and uncontrollable muscle spasms, have caused AstraZeneca to receive multiple trips to court, with an estimated 10,000 product liability lawsuits. It is noted that although it is commonly prescribed for those suffering PTSD, Seroquel has not received FDA approval as proper treatment for insomnia. Families of veterans who are attempting a Congressional investigation on Seroquel are hoping for a clearer guideline of the side effects as well as the risk to one’s health.

The Black Market for Seroquel

Speed freaks, coke heads, and antipsychotics.

Last week, writing on the Daily Beast web site, reporter Jeff Deeney profiled a startling underground market for the antipsychotic medication Seroquel (quetiapine). Deeney described street transactions in North Philadelphia for Quells or Suzie-Qs, as the drug is sometimes called. Seroquel, a drug developed for the treatment of schizophrenia and bipolar disorder, has developed an additional reputation as a “comedown” drug for stimulant abusers.

Seroquel, a so-called atypical antipsychotic, works by altering levels of dopamine. While some addicts have claimed that the drug is perfect for a cocaine or speed comedown, Seroquel has also been studied for its anti-craving properties when used for cocaine abstinence.

Why would a speed freak or a coke addict want to take a drug that might decrease their desire for their stimulant of choice? For the same reason that ecstasy users often take a morning-after dose of Prozac in a misguided attempt to compensate for possible damage to serotonin receptor arrays. Or because the drug is mildly sedating for some users. However, there may be more to it. Perhaps Seroquel is an effective anti-craving medication for cocaine and methamphetamine addicts, who misuse it as a drug to ease them through enforced periods of detox or lack of availability.

One high-traffic drug discussion site has shut down a long-standing thread on Seroquel with the warning: “Do not use Seroquel for a cocaine comedown.”

The fact that prescription Seroquel is available as a street drug, at least in some parts of the country, demonstrates the likelihood that physicians and psychiatrists are increasingly using it for off-prescription purposes—like drug detox. Deeney strongly suggests that this is the case: “Drug dealers, mandated to treatment as a condition of their probation or parole, are given off-label prescriptions for Seroquel, then sent right back to the street, where the pills can be sold for cash to users and other dealers.”

Increasing its appeal is Seroquel’s reputation for combining well with cocaine in a mixture known as a Q-Ball, or Rosemary’s Dolly—a variation on the heroin/cocaine mix known as a Speedball, to which Seroquel can also be added. An anonymous med student on a medical blog noted that “certain people say they love Seroquel when doing a speed-ball. Makes sense, think about it. It heightens the high of the heroin, it eases the crash of the cocaine.”

Seroquel’s ability to modulate the effect of illegal drugs means that the medication can possibly find a market both as a detox drug for stimulant abusers, and as an ingredient in the very stimulants they abuse.

By itself, Seroquel is not considered addictive. Some addicts told Deeney that the drug simply put them to sleep more quickly after a long meth run. Indeed, Seroquel is considered to be more sedating than similar antipsychotics such as Olanzapine and Aripiprazole. The larger issue, as the Daily Beast post makes clear, is that “Seroquel can have serious side effects including diabetes, a permanent Parkinson’s-like palsy called tardive dyskinesia, and sudden cardiac death.”

All of this confusing and sometimes contradictory input is coming well ahead of the clinical data, although a study in 2001, presented at the 4th International Conference on Bipolar disorder, found that quetiapine caused a significant reduction in cocaine use among a small group of cocaine-dependent subjects who also suffered from bipolar disorder. A report last year in the Journal of Clinical Psychopharmacology also showed positive results with cocaine users. Studies of quetiapine for the reduction of cocaine use are currently being undertaken by the Seattle Institute for Biomedical and Clinical Research.

drugs dopamine