I am finally finished the tapering period, finished getting off the oxycodone I was on pre- and post-surgery. It took about four weeks to go from 100 mg/day to zero. Nice and gradual, and I suffered nothing worse than a runny nose, some diarrhea, some insomnia, and a few twitches. Oh, and that sense of impending loss, depression, and despair. Did I mention that? The old circuits carrying that old message, because that’s what old circuits do.
So there I was, flickering into my “addict self,” as people like to call it, and thinking, I like this stuff and I’m not eager to stop…
I don’t remember who gave me this line — one of you, I’m sure: Quitting drugs is like going to the funeral of your best friend. Funny how it still feels like that. That’s what I anticipated. Not as intense as in the old days. But qualitatively pretty much the same.
What I wasn’t anticipating, what I’d forgotten about, was the relief I’m feeling now. An unexpected flush of freedom, breathing in lungfuls of fresh air. And feeling strong again. I feel centered, and focused, and strong. I feel like me again. It’s been awhile.
But…freedom from what? That is the big question, don’t you think? Freedom from the sense of impending loss, the sort of cowering that goes with ingesting something you imagine is enhancing your sense of okayness, knowing it’s not going to last, and putting 
off the inevitable. Freedom from the compulsion, the greedy hording (mentally, at any rate) of the crumbs of wellbeing that I was still getting from these pills — even on a medically supervised, perfectly legal, moral, and even necessary detox regime. I was still getting the crumbs. And the freedom I feel now is from the anxiety — pure and simple: anxiety — about losing those crumbs.
My last post addressed how it might be possible to make the future seem as good or better than the present, by adjusting the subjective value, the sense of value, of the immediate reward (drugs, booze, whatever) versus the long-term reward (that list of seeming 
abstractions) and/or changing their timing. And then you guys asked, and I asked myself, how exactly do you do that? How do you do it for yourself (if you’re the addict) and how do you do it for someone else (if you’re the helper, sponsor, therapist, partner)? If we’re not in some artificial experimental setting, and it’s not just a matter of changing the numerals on a computer screen (e.g., from 10 to 45 euros in the “next week” column), how do you get the future to feel like it’s worth it?! Worth whatever you have to go through to “just say NO.”
And here, ladies and gentlemen, is the answer. At least one answer.
Remind yourself or your addicted friend, lover, client or patient about this sense of relief! This feeling of being a whole person. Of being strong. Make it palpable. Get it back on the radar. Bring it to mind (hint: that’s the first half of the word “mindfulness”). This is what it feels like to finally be free of this shit! Remember? Do you get it? There is peace here.
Certainly there are twinges of wistfulness. Yes, some kind of magical sheen, winking on and off like an old neon sign, has gone missing. Craving still bunches up in your throat like a reflex, a need to swallow — or cough. But the place you land in, after these dust devils have passed…that place feels like home.
Now, as to the details, how exactly to do that, I’m going to turn the floor over to someone in the treatment world. First up is my friend (through this blog) and long-time contributor (to this blog), Matt. And if anyone else would like to help us out here — anyone, but especially those of you in the treatment community — please do: get in touch about writing a guest post. Soon! I think we could all use some concrete ideas about manipulating awareness, about expanding awareness beyond the upcoming delivery of today’s lollipop, about shifting your focus…away from the siren call of the moment and back to the main voyage.
Informed by unparalleled neuroscientific insight and written with his usual flare, Marc Lewis’s The Biology of Desire effectively refutes the medical view of addiction as a brain disease. A bracing and informative corrective to the muddle that now characterizes public and professional discourse on this topic.” —Gabor Maté, M.D., author of In The Realm of Hungry Ghosts: Close Encounters With Addiction
Mark, what a wonderful way of making sense of this perceived loss. Sur I miss heroin, but knowing I can go to sleep with five buck and wake up not worried about where to get the minimum I needed is truly freedom from anxiety. I really think I suffered more from actual worry. My freedom to sleep without it is great. You articulate so well what I think we are really bonded to: worry. As always, thanks
Thanks, Stephen. Good to hear that it resonated so well with your experience. And good to hear that you are sleeping well and waking up with the 5 bucks still in your pocket. Take care. Be good.
Are you still working on your book? Perhaps this recent experience will be useful fodder for it!
I’ve written enough about me. It’s time to write other people’s stories, which is what I’m doing. But my own life is the bridge for understanding theirs.
Does it help knowing and understanding the neurophysiology of anxiety? That, it’s not you, it’s your hypothalmus, your pituitary and your adrenals?
Not exactly. It’s still me. But it does help to know I have a body and brain that have certain rules, and I am bound by them.
Beautifully written and described Marc
what would you like to hear from those of us in the ” treatment” world??
BillA
Thanks, Bill. Check out Shaun Shelly’s comment, last post, from May 27. That’s the sort of thing. I know I’m flying in the dark a bit on how these ideas fit with tried-and-true (or at least tried) treatment orientations. I’d like you guys to help fill in the blanks.
Revaluing the future is very hard. The costs of the next hit seem so low, and the future? Eh, it’s uncertain. One (more) hit won’t really change anything, will it?
So, one can cognitively go at lists of pros and cons. One can try to use motivational interviewing to help with revaluing choices. But my sense is these things don’t usually work on their own. The automatic, emotional drive to use will wear down the cognitive intention and revaluing due to ego fatigue. The key, in my own experience and in working with others, is substitution and distraction. In response to the urge to use, of course it makes sense to revalue the future if one can. My sponsor would call it “playing the tape forward” to remind myself of all the things I could lose if I went back to my addiction. I made a list of 10 reasons to stay sober that I carried with me. But, when I was tempted to go back out, it was also crucial to ACT to 1) get away from the triggering/unsafe stimulus and 2) do some form of healthy self-care behavior (call a friend, exercise, get to a meeting if in 12-step). So, I think revaluing the future is part of the solution, but I think distraction and substitution are equally important.
Tried and true logic. The best way to “break” a bad habit is to substitute a good one (which takes time and practice), coupled with distraction (it’s harder to hit a moving target). That until the potency of the primal drives and urges fade, and one’s intention, motivation, resolution are robust and internally driven. Then it’s a piece of cake, right? 🙂
Fred, I totally agree. Your last sentence really says it all. These two strategies must go hand in hand. But you’re right: cognitive focus on a more positive future is a fragile thing, and it can easily get swamped by delay discounting with the help of ego fatigue.
I had one big advantage over addicts to street drugs and alcohol. My drug was medically prescribed, and even a tsunami of craving wasn’t going to procure me more unless I went to a lot of trouble. That helps take care of THE PRESENT.
Thanks for this excellent formula. Would you care to put it in a guest post?
I’d be honored to be a guest poster. Can you email me privately regarding next steps?
Marc, I was moved by how well you put into words the unbearable feeling of loss and anxiety we feel coming down. I have quit drugs so many times in my life that it has begun to feel like a joke. But each time it is harder than the last. Each time I am more convinced that this feeling of being vaguely terrified will never leave- that I’ve finally hit the point of feeling like this for the rest of my life. It is unreasonable to think this way, I know, but nothing feels more real, and reason never played a big role in my life anyway. The last time I quit, I was alone, scared, and ashamed because I refuse to ask for help ( because of the shame). I needed my mom; meaning that I needed unconditional love and support from someone. But my own mom never has been that person for me. Because I was desperate to get through this, and I had little else to lose, I decided to be my own loving mom and got out a pen and paper. I wrote “I’m so scared”. And my ‘mom’ asked “why are you scared? Can you tell me? I love you and I’m here for you and we are going to get through this together. Talk to me.”
I journaled for an hour, and barfed up everything out of my head on to the paper. It diffused so much of my anxiety, seeing it all in words. My “mom” reminded me that: this too shall pass. You are strong. I love you. For the next few days we checked in together in my head.
Writing this all sounds like I’m corny and crazy and I suppose I am both of those things. But it worked. I made the choice not to refill my drug of choice this month, and told my doc that I don’t want it anymore, sabotaging future indulgences.
The feeling of freedom that you mentioned, Marc, is now something I experience on a daily basis. I treasure this and hope that it’s enough to change my mind the next time I want to use. We will see…
Jennifer, I love this creative thing that you did for yourself. It’s amazing that you knew what you needed and found a way to provide that out of your own being. This is something that I believe could work with others if, as you were, they have the willingness and insight to allow themselves to parent themselves. Thank you for your story.
Fred, thanks for commenting. This blog is the only place where I’ve ever shared my thoughts and experiences about using and recovery. I find it immeasurably helpful to read others’ posts about this stuff. As I mentioned, addiction can be so lonely and the self loathing so extreme; reading smart, reflective and personal posts from other folks going through the same thing makes me feel like I’m part of a larger group and this is new to me. I find solace in being a part of a group of people who are articulate and by appearances anyway, have their shit together, but who also happen to share my “fatal flaw”. I’m not certain where I was going with this, but I guess it’s just to thank you and Marc and others who post here for the thoughtful exchange of ideas.
Jennifer, That is so good to hear.
jennifer it was wonderful what you wrote and so creative
Drug addiction in a lonely endeavor– just think you are “isolating” your self by ” insulating” with a drug induced buzz
And lonelimess is huge ” trigger” to use again. another vicious cycle to deal with . This is why a group like this as well as other mutual help and support efforts are so effective if you can buy into them .
Thank you, Jennifer
An amazing journey, so beautifully put. And it so beautifully encapsulates recovery: the brutal unflinching honesty to oneself. And the two key ingredients: refuge and renunciation. A port in the storm, and an avowed promise to oneself to eschew everything that keeps you from staring dead center at who you are, and the change needed to make that happen. Funny how this is the foundation of most spiritual traditions, as well.
To Jennifer – I share your feelings about this blog exactly, I think
it’s something about being scientifically investigative without
positing that objective rational information ALONE can get into those
gritty abysses of the self and make everything ok, there’ll always be
that third self or whatever you want to call it, either lingering on
the peripheries or stabbing into the heart of our consciousness – But
that sorting out the stuff that CAN be sorted, should somehow make a
clearer path to whatever else we need to get to, instead of hijacking
the journey 🙂
Can I hire you for PR? That is exactly where I want to be going with this.
By the way, you write like an angel.
Hi Rachel
I agree with Marc about your writing (I am jealous actually) but I keep sifting it down to the “Serenity Prayer” by Reinhold Niebuhr.
Particularly the part about “God grant me the serenity to accept the things I cannot do and the courage to accept the things I can”
JLK
Your idiosyncratic rendering of the serenity prayer ….speaks to a wonderful energy and pride that you still use to stay ahead of the wave of depression. Keep it up, man. It serves you well. And you’ve got us — hundreds of kindred spirits reading these comments — to cheer you on.
Thanks for the kind words Marc I think?
I am going to try to use some of the things I am hearing to help me with the biggie….stop smoking. I quit for 15 years then the shit of all kinds hit the fan.
First I was getting divorced (my idea) then I became alcoholic and as I was commuting to Europe and Asia 4-5 times/year I was constantly surrounded by drinking, smoking etc people. I also was starting a new company where I was expected to go from zero to $5mil gross sales/month in 2 years. Faster than a Ferrari.
I did it but at the same time, thinking I was bullet proof, I added smoking to my alcoholism. Now I have not had a drink in 11 years but am STILL F…ING SMOKING. I want/need to quit as I am very sensitive to inflammatory disease. But every time I try (3 months is my record) I will get hit with a Major Depression and not caring if I lived or died I would start again,
Any further advice anyone?
JLK
Hi JLK… This is a real punt but ok…yesterday I was speaking to my Dad and he reminded me of an email I’d sent -it was
An idea that had helped me, I was trying to get a mastery of something, a basic but elusive kind of thing
– and it had lit up in my brain, it all made sense, I had to share it, it would help everyone!!!… but when he mentioned it I’d totally forgotten about it.
It had all clicked at the time, and helped me for about a day, then I just managed to forget and swing back into old patterns… and it got me thinking about, where do I find help that STICKS!!! – It seems I rationalise out a new plan or strategy for success every couple of days about something – but they never last! A moment of “throw it to the wind” takes over and the greatly promising bubble is burst!! And doesn’t reform. I mean, I don’t give up, but I rarely feel like I win, treading, treading water.
Actually the thing which came out of that discussion was a bit of a side-ball, and it was, being around people who have faith is the single greatest thing which has provided that ‘activation energy’ to overcome obstacles in my life. And to be clear, I don’t mean faith in any other context than, that sense that some people seem to have, that anything is possible! That there is some beauty, a source, which can’t be destroyed – not even by me – like that feeling when you look up at the sky and realise outside your mind the world is still turning, birds fly, seals swim and twirl and blow bubbles and I’ve got nothing to do with it – just that – and that peace of mind must possible – like the Lauryn Hill song , I Gotta Find Peace of Mind – “he says it’s impossible… but I know it’s possible..” ( MTV Unplugged). I truly believe you wouldn’t have made it this far without that necessary spark of death-defiance, think about that for a minute – you’ve overcome so much already, you’re somehow still here.
-Ok this seems off track… BUT I thought, I need to surround myself with people, it’s like they’re seeing a possibility others don’t see, they’re stepping out on it, and they make you feel like you can too-these people say all the same things you’ve heard before – but somehow it feels real, seems somehow possible now…there have only been a few in my lifetime.. And not that I know where to find these people for you!!! – but maybe you’ve known one or two over the years, read a memoir, heard a song…
But what I also mean is – maybe there is an indescribable point we reach, when we are finally ready to change. Those epiphanies. I don’t know how to make them happen. But AT this point, nearly ANY way you try will work, and until this point, nearly NOTHING will seem to. I don’t know how to explain that further, and don’t want to get mystical. But it’s one reason I never totally disregard the seemingly cliche or corny inspirations – if you’re ready for change, one of them may be the perfect word for you to step out on into a new way of being. Reading through this blog, there are many gems, try them as you said, one may work for you finally, even if it didn’t before!
This is one that’s been rattling me around lately-
DESTROY WHAT DESTROYS YOU.
With you -R
I don’t mean to sound unrealistic with the whole ‘possibilities’ trip. It can be something as simple as someone else’s recovery/quitting experience- but one you relate to. If you connect the dots by means of reproducible results. I think often if we can grasp something is universal, biological, neurological – then we are willing to apply it to ourselves, we have a sense faith in it’s outcome. Or it can be something way more abstract. I am not writing as one-size-fits-all – only to share what has helped me :-).
-R
Hi Rachel
Your Dad must be smart if only to understand the abstract nature of your thinking.
My problem is and always has been the change from dark to darker in my mood. I have tried to use “triggers” to get me through them the darkest times (when the “Big ONE” hits from time to time. So far I have not discovered the magic bullet,
.Ex: yesterday I was meeting with a subcontractor to get started on a”pocket neighborhood” I am building. (That is my new retirement hobby….. building and renting or selling houses). The location where I do 100% of my work is a really cool resort town on the Columbia Gorge Has it all….low unemployment growth housing shortage, and a good size company right across the river whose employees and want to live where I am.
But,as usual I digress. On the way back, in front of me on the freeway was the worst wreck 2 car wreck (interms of damage) I have ever seen. We all sat for 2 hours not moving out in the middle of nowhere. I was able to hold it together but even a triviality like that becomes a huge burden in a world as dark as the one in which Iive. I must have smoked 3-4 cigs before it was over. Of course that’s not a good example since if wasn’t “carrying” I couldn’t have smoked anyway unless I could have bummed one from the people surrounding me.
If you live on the “dark side of the moon” (kudos to Pink Floyd) and it suddenly becomes much darker the brain looks for the nearest relief. Even though cigs are NOT much of a relief you use anything you can just to break out of the horrendous psychic pain with which you have been attacked.
Now maybe a word or gesture could help and I will mentally roam the possibilities. I have tried it before.
But as my wife told my sister when she (my sister) was complaining about my smoking “John quitting smoking is like rearranging the deck chairs on the Titanic” in consideration of all the other mental and physical health issues I deal with.
Thanks for caring
JLK
Haha abstract … I think I know what you mean with ‘psychic pain attacks’ though… lying in foetal position groaning, crying out but it HURTS!!!! it HURTSSS!!! why does it hurt so MUCH!!!! … just trying to resist the compulsion to escape the present pain of consciousness or dull it just a little, trying to stay in the game of facing reality… when it feels like it takes more strength than you have just to maintain, to stand, not even to take a single step forward…|
Hilarious deck chair analogy, can you imagine yourself as the Titanic floating up the Columbia Gorge?? With all the little creatures running about on top of you? Some even on deckchairs? Probably smoking on the deckchairs!! Or to continue my previous thread I would have said – Till now you’ve been like the Titanic, tragically protesting your fate in the sea of life, but now, this is your iceberg moment – you’ve got to think like the iceberg, feel the power of the iceberg… BECOME the iceberg!! 🙂
Hi Rach
Don’t wanna be the ‘berg. Reminds me of a serial killer. Granted, ice is a natural phenomenon, but then so is Ted Bundy. (Met him once….seemed like a pretty good guy)
As far as the fetal position: I have never spent time wiling and crying “why me, dear God, why me”?
That kind of behavior seems to be reserved for wussies with periodic Dysthymic depression crying out for more Zoloft.
Hate to say it but I have no sympathy, empathy or any other emotional connection to these people except disgust.
I try to see life as one big poker game (although I hate gambling) Even though some of us get more than one’s share of “fruit packs”, every once in a while I will get pair of deuces. When I throw in 3 I usually get 7’s,Queens, etc leaving me again with 2 deuces.
BUT once in a blue moon I will pick up 2 more deuces. This creates an ephemeral brass ring which I am intelligent and aware enough (at least back then) to grab and hang onto.
That is also why I am able to pick either my Bimmer, Lexus or Porsche (no more motorcycles) to drive to the 200 Dr appointments a year. (I take Xmas & other holidays off.) I have become a car fanatic because I can’t do much else.
Regds
JLK
JLK, You express “disgust” for people who are in a lot of pain and talk about it, or even cry about it….. But are they so different from you? You talk about your pain a lot on this blog. And that’s not only ok, it’s often productive, for you and for others. And you get a lot of empathy and some wise and heartfelt advice in return. You don’t get disgust.
My guess is that your disgust comes back at you from the mirror, and that may lock you into these repeated cycles of frustration and failure more than anything else. Give people-in -pain a bit of a break — yourself included. Try empathy…it can be quite magical. As a dear friend of mine used to say: You’ve got a right to complain! You didn’t ask to be here!
JLK. Thanks for taking the time to
write anyway. I see that maybe there is a difference :
either believing that on the other side of pain there is freedom and strength, a way forward and onward – but that our fear of being destroyed in the process often keeps us from going there:
or accepting that life must only be an eternal loop from pain to escape and back again.
at some point I decided freedom was not the absence of pain or despair, but the trust that joy and love could run just as deep – and that made it worth it.
I hope one day you catch a glimpse of your own freedom and peace of mind- though you seem to claim resignation to your suffering, yet you show a healthy dose of spite for it, an unwillingness to let it win completely – seem determined to go down with two middle fingers in the air. You must have got that from somewhere 🙂
I don’t mind being disgusted at don’t worry. When you get caught eating from the workplace bin by your partner and your boss, when you’ve spent collective hours hugging public toilets with your fingers down your throat, when you lose who you love because you thought to be vulnerable was to be weak and to be weak was a death sentence … as Bob Dylan said, when you’ve got nothing, you’ve got nothing to lose 🙂
But I reclaim a bit more of my dignity every day that I don’t complain, binge, smoke, get wasted or give up, I don’t feel sorry for myself, I accept pain and weakness along with strength and love, and I feel alive.
Rachel, There’s a lot to this. This is why people blog, and why people read blogs. This is why we listen to John Lennon and read poetry. There happen to be a lot of us here on this planet, and very few of us do not suffer. So there are memes and themes and ways of putting things flying around this impossibly complex intersection of lives….that just hit home, like a ligand (e.g., dopamine) bonding to its receptor. And that reduce suffering, perhaps by releasing strategies of peace and strength. This occurs all the time in the world of ideas and feelings, not just the world of chemistry.
Jennifer, I’m very moved by your story. You’re right: there is a hole that grows wider and wider in our capacity for self-trust, each time we go through the cycle. I talk about this when I give talks. I think that’s another way to think about the creeping anxiety and sense of doom. I know what you mean.
Your solution was marvelous. When I give these talks, I often mention “intertemporal dialogue” — simply a dialogue between the present “I” and the sense of a “future” caregiving self. It’s not really in the future, but it seems that way, because it incorporates the future in its vision of you and your life. The slide I show with that pictures a fatherly type with his arm on the shoulder of a small boy. That intimate contact between these voices is so very important.
And writing is fantastic. Several psychological researchers (see esp. James Pennebaker: http://homepage.psy.utexas.edu/HomePage/Faculty/Pennebaker/Home2000/JWPhome.htm) have found it to be a very potent form of therapy, just in itself. But the main thing is finding that internal parent. He/she is warm and loving….and there you are.
Bravo Jennifer. Your post is most courageous. Thank you for sharing 😉
Hi Marc
I don’t think you want me to write any pieces on this as I don’t speak your language like Matt.But. unfortunately (for me), I do have a different experience with Oxy and the rest.
As most of you know I have brain damage from a bout of MRSA Staph at 11. The only reason I know it was MRSA and not plain vanilla sepsis besides the hole in my gut and my infection history,is that my Doctor gave me an exhaustive series of symptoms my Doctor gave me a test on every known symptom and gues what I had them all.
Two reasons for the non-sequitar digression
1) MRSA was not isolated until 2 years later in 1960
2) It makes me my relationship with drugs so different.than almost anybody else
3)My strong belief in inherited tendencies (mu guess would be 9 out of 10 of hundreds/thousands people I have met or listened to or personally in AA meetings.having alcoholic parents or even grandparents showing recessive tendencies although alcoholic households are the biggest contributor.
Now back to your experience. I went through the same thing a couple years ago as I was taking Oxy for a few months as an experiment. Since Dopamine and the 2 or 3 others receptors affected by Oxy were among those damaged by the brain lesions that accompany MRSA. Mine also seem to center on the Limbic system as mood and fatigue are the most obvious symptoms (besides physical anorexia).
Now keeping your piece in mind how does this connect with the topic.Vey simple
1) There is no “relief” of any kind even though I was in bed like a goddam heroin addict (sweats fever etc) for 3-4 days.
2) I never get addicted to pills , at the most just a habit Only alcohol the addiction to which which I am convinced came from the concomitant use of Lexapro as my SSRI.
And since I have been through both I can guarantee there is a BIG f…ing difference!!
#3)) I used Virpassna (mindfulness in Hindu) Buddhist studies but it didn’t help even with a Guru and a church because when I meditated I would move into a Hypnogogic state which means I might as well shoot heroin to get the same effect.
To sum up this forever piece not everyone can use that method because there is no end, no satisfaction,relief etc.
JLK .
Hi, JLK
An unimaginably horrific story, as we discussed and commiserated over before. But you are here, blogging about it and helping others. What do you think it is that has gotten you through it all?
Hi Matt
Thanks so much for the empathy it takes to even ask that question of a stranger. I will try to be brief on the story as it began.
Unfortunately my father died a month after I recovered so all the shrinks of the time thought that was the cause of my difficulties….wrong by 2/3..
In the last ten year the human genome project has sped up the ability of researchers to discover that most mental illness is physical.
AS a result a discovery was made that related to me.It is called AIBS or Acute Inflammatory body sickness (dumb name but what the hell)
It is caused by lesions left over by any kind of brain fever or infection.What is left over are scarring from the brain lesions. At one time I has 27 internal infections; 3 in the brain. This in turn causes a whacky BBB where things are going from body to brain and vice versa (things that are not supposed to).
In my case it was evolutionary…. the symptoms changing with age.
The worst period were the year after grad school and the failure to finish. I was not qualified for a job so I started painting and building besides trying every drug I could get my hands on as a self medication
I call these my “dark years”.. prox 23-28. I have been asked many times by close friends “how did you become successful in business and it’s a mystery even to me. All I can think of is the following
1) Embarassment at being a loser in a successful family.
2) Putting one foot in front of the other when my brain/body rebelled..
3) Native intelligence
4) New drugs invented that actually helped (a little.
5) No choice as I had a family to feed and educate.
I know these points are a bit obtuse but it’s the best I have been able to do. I have never experienced joy,no satisfaction from a job well done. You get used to it I guess.
Thks again for caring enough to ask
JLK
.
You forgot one. –Never giving up.
Good luck and god bless.
Wow, that is so dark. But my guess is that you are depressed and so the “good stuff” is simply invisible. Like wearing a pair of sun glasses that only admits certain frequencies of light. I have seen you and heard you blustering, even laughing, about the absurdities we endure. You sent me those pictures of you with your daughters. Remember? You were smiling.
The brain is a lot bigger than you think. The damage you endured is not total, and the brain regrows many damaged synapses. If the brain damage you suffered was as severe as you imagine, you could never have accomplished the many things you accomplished. I hope things look brighter soon!
One more thing: I apologize if my answer is a bit less clear than normal. It is 12.30 my time (PDT) and I have a whole day’s worth of scrip drugs on board.
I have been listening Allison Krause’s version of “Down to the River” at least 25 times while I write. For some reason that song calms me,.
Best Rgds
JLK
Don’t have to be sorry. I’m glad that song calms you. Also try to find the “crack where the light gets in” — Leonard Cohen
Hi Marc
Great to hear your continued recovery told in such honest and candid detail. Your detox kind of confirms a piece of a puzzle about OST that I’m currently working on. As I’ve mentioned before, probably because of misguided and/or misinterpreted harm reduction policies, we have literally thousands of people who have become very dependent on the treatment system and stuck therein. Sadly quite a few of the workers have also followed suit, losing their drive, becoming institutionalised and having real difficulties with maintaining boundaries. Within this it has become really difficult to follow through on any motivation to change because the people managing the system think that ever more rigid targets and inflexible policies and protocols will somehow make things happen.
Detox is a very good example and very rarely ends in a wholly positive outcome. It has developed into a mythological process that needs to be undertaken following a very strict suitability assessment and carried out under rigid clinical supervision as per very inflexible policies and protocols. If you don’t follow all this to the letter the myth is that people will die and/or have a serious seizure. Psychosocial interventions, family involvement and mutual aid type support lose their validity as biomedical becomes king. Trouble being that not many medics really know how to undertake a detox, keep it safe, develop social networks and maximise the chances of positive outcome by, not unlike yourself, doing it over a reasonable timeframe. The system has created it’s own language that often flies in the face of common sense and has become part of the mythology of treatment, for example detox, if you are on Methadone, will be 1ml a month. Now if your in receipt of the therapeutic dose 60-120, this could take up to 10 years! Personally I have managed an inpatient detox and helped hundreds of people detox in the community and firmly believe that anybody can detox from anything within 12 weeks maximum. I also believe that the key is to help people to create a new none using social network and begin to develop resilience and a new identity prior to starting to detox, making the process much simpler and easy to manage. In an effort to simplify this process even more and encourage personal responsibility taking, last year I tried to set up a system whereby people could go into the pharmacy and, depending on how they felt that day, could take any amount up to what they were prescribed. This would mean that if I was taking say 60mls and I felt particularly confident I could drop 20mls. The only proviso being that whatever I took would become the ceiling dose for the next day. I felt this would maximise the chances of a positive outcome, really encourage personal responsibility taking and avoid overmedicalising the whole process. I was met with a concrete wall of clinical governance, “we know best” from medics and pharmacists and ridicule from managers. On further investigation I have found out since that this is exactly how most people detox successfully, they just do it without medics and pharmacists.
Man, what an apt description of my own experience and many others’! Do you think it’s a product of the “top-down” process that is woven into society, and the outcomes just noticeably ineffective, or tragic in detox and early recovery? Or is it an altogether different problem…?
This is fascinating, Peter. Would you mind if I have it posted as an actual post rather than a comment? I think it’s hugely important. Only a few people will read this comment, but roughly 2000 will read a new post. Let me know.
This clinging to strict and unrealistic rules is a terrible thing, a real impediment. A good friend of mine went AWOL from the Betty Ford Clinic, after paying untold thousands of dollars. He was detoxing from a habit of roughly 400 mg oxycontin per day. And the bastards wouldn’t even give him a Valium for sleep. He was climbing the walls, and finally just left after only a few days. He came straight back to Toronto and took as many drugs as he could get his hands on. He died about three years ago.
I highly recommend a recently published addiction memoir (alcohol) written by a man who was himself a mental health professional for roughly two decades before his alcoholism overcame him. It is written with wit as well as anguish, and it gives an inside look into the worst travesties of the rehab industry in North America. It’s called: The Couch of Willingness (http://www.amazon.com/Couch-Willingness-Alcoholic-Therapist-Recovery/dp/0993714706/ref=sr_1_1?s=books&ie=UTF8&qid=1396985021&sr=1-1&keywords=the+couch+of+willingness) I think some of the deadness, the infatuation with strict rules, and the boundary confusion you describe, Peter, is beautifully portrayed here, but perhaps in a different coloured ink.
If you wish to read about the deplorable ” treatment” industry situation in the US, I sugges Anne Fletchers recent book. Inside Rehab
What an insightful post Peter, thanks. My experience with the ‘system/s’ has also been very frustrating, albeit in a different way. On the outside, I appear (and can be) rather high functioning. The system does not bother with people like me. Even with my research background, I have yet to be successful in terms of finding (what feels/seems like) effective treatment. Unfortunately, it appears I’m not considered high risk “enough” for treatment unless I steal, break the law, pose a harm to others, or a visible one to myself. Sadly, I even had to help the intake worker fill out my assessment form.
The only “treatment” that was offered to me was to join a group, twice a week, where topics like nutrition are discussed. I really don’t mean to sound self-aggrandizing, but I know enough about that already. Any other form of treatment, fitting or otherwise, had over a two year waiting list.
So, yeah, the ‘system/s’ aren’t quite working in many regards ;(
Hiya Jasmine
Thank you for your response. Marc has asked me to do a guest blog on the back of my post. It’s about treatment and talks very much about some of the problems you raise. Keep your eye out for it, it really shouldn’t be like it is.
In loving kindness
P
Marc, I just love your phrase “crumbs of well being.” Because that’s truly what we crave and what we get, though we wind up believing it’s so much more. I’m sorry to say that craving this is still a big part of my life, but somehow, each and every day, I get past it. I remind myself that what I’m craving is really an illusion anyway, and if I just distract myself, the time will pass and the craving will go… until it returns and I go through the same thing all over again. So, I hang in there by reminding myself that what I’m craving is truly “crumbs” as you put it, and what I have instead is so much better. Denise
Hi Denise. Do I ever know what you mean. Even this brief reminder (this medical sojourn) about being an opiate addict has brought that world back to me, to experience in a personal and compelling way.
Besides the excellent tools you use, I think it’s helpful to remember that craving is a physical phenomenon — a specific brain process. It involves a rapid infusion of dopamine into your nucleus accumbens (ventral striatum). See previous posts or my book for more details, if interested. The thing is: it just is. Like a migraine, it has a time course. It is something your brain learned to do, because brains, contrary to popular belief, are not all that smart. They’re just organs after all.
For some people, just knowing that what they’re feeling is a biological process is very helpful in itself. In other words: it doesn’t really MEAN anything. Crumbs are still crumbs, whatever your brain might be saying at this moment.
Marc, 2 things briefly: 1) your reminder that the craving is a physical phenomenon makes me wonder whether the bupenorphine that I take is part of the reason for the craving, and 2) you should use this elsewhere, that “. . . brains . . . are not all that smart. They’re just organs, after all.”
1. In a way, yes. Your brain attaches great value to whatever muted feeling you get from the bupe. I assume you feel it to some degree. That keeps those particular synapses running like a leaky tap. As Matt often says, stopping altogether is so much easier in the long run. It’s like transporting your character to a different novel. Where she can live in peace, all reminders of the past fading, fading…..
You might not be ready at the moment. I’m sure waves of anxiety come surging with the thought of it. But consider it. Soon? Maybe very soon.
2. Thanks. I quite like it myself.
Hi Marc
First I want to thank you as well for the kind and empathetic words.
But as far as the sunglasses metaphor…it is beautiful up to a point. That is that I have both periodic Major episodes (complete with probably 2-3 full-on psychotic breaks) and continuous Dysthimic which is what really cuts me off emotionally from the world of joy and satisfaction,.
I can’t count the number of times that people have commented on my facial expression be ‘angry” or “tired” when I thought it was normal. If you look closely at the pic of me on my website I appear to be developing hairline cracks in my face from trying to smile.
JLK
Those are NOT the cracks I mean. Maybe don’t try so hard to be cheery. Ulysses accomplished a lot while tied to the mast. He wasn’t smiling. He was just a highly skilled self-programmer.
We accept our helplessness, then we shrug and help ourselves as much as we can. Then we might smile, or we might not.
As always Marc great post.
Many people are misconceived as to ones length of time clean and sober has the greatest bearing on awareness. Awareness meaning what it’s really like to live a clean and sober life. For me it’s not the length of time so much but what you have learned during that time. I know of many that live a clean and sober life but never find that happy place. Until you have found it you can never really enjoy a good life, of peace comfort, contentment, its a joy of total understanding. For me the greatest gift in being clean is “Happy Thoughts” It’s like breaking free from all your issues and problems, growing down as a child. I find it helpful to write down times of joy in my life and when getting off track, it gives me something to read that brings me back to that happy place. It’s the things we think about that get bigger, takes up more space in the mind. When I think of something that brought a smile to my face or joy to my heart I write it down, cus when your in a state of mind that is above these thoughts it’s hard to find it outside of all the bull that life sometimes throws at us…
Happy Thoughts, Happy Heat, happy Life…
Happy Thoughts, Happy Heart, Happy Life…
That simple wisdom is very helpful, Richard. Thank you for sharing it with us.
A great post Marc and an illustration of strength. I think, with anything in life really, we tend to always focus on the negative. We remember all the bad things because all the good and happy moments tend to be fleeting. It is good however, to remember those feelings of relief and renewal because it is often what gets you back. It’s also a coping technique.
Thanks. Yes, we have to broadcast the “good stuff” to ourselves and to others…. Otherwise the “bad stuff” gets a tremendously unfair advantage.
Hi Rach and Marc
Rach you hit it right on the button with your “double third finger salute” comment. That is how I live my life.
The point I was trying to make was this, and this includes Marc’s comment: Life is tough for many but taking to your bed and crying out for Zoloft is what I find disgusting.Unless you have a physical illness that forces you in and out of hospitals etc I have a close friend who,like me almost worked himself to death whose life matches that description…him I have empathy for…but you know what ? He still heads to work as much as he is physically able. That takes guts and that is what I admire.
My problem That psychologically dovetails with my manifest physical difficulties is something my wife discovered a couple years ago. It is a voice ( or echo) from the past. The voice is that of my mother (I had no father after 11) telling me over and over ad nauseum how lazy I was. I now know I was always tired because of the condition.. She convinced me, so I reacted at first with total rebellion. She would try to “ground” me.But I had a window that lead to a front door overhead..easy peasy.
Got arrested the first time at 15. She had to pick me up at the drunk tank (cops tried to teach me a lesson) at 3.00 AM. My reaction? Was it guilt, fear nawwww it was when can I do it again. She finally admitted, only to my ex-wife at the end of her life what a shitty job she did with me (as opposed to my sisters).
This phase lasted until I was 28 then I got my first “real” job.At first I was terrible because of fear of failure but I kept at it. Finally found my niche after 10 years of floundering.
People asked me how I went from total bum and family black sheep.to multi millionaire I have to say I am clueless on that one.I guess I turned all that rebellious anger into something positive (got that second pair of deuces).
The point of this boring story is I never gave up.
JLK
PS: Now that I have gained trust in this group if anyone is curious as to who and what I am……google http://www.jlkglobal.com. My photo is there (I am incredibly handsome) along with my bio and some of my favorite articles that I wrote until I became too busy with real estate..(click on blog for those… all but 1 or 2 in published form I believe). First one is 31 pages so stay with the 4 page exec summary as it is a piece of possible legislation which Toomey(R) from Pennsylvania asked me to write expanding on a 2008 article I wrote that he liked. He took credit of course.
The rest are 1500 word jobs.
To JLK,
That’s so fascinating and great that you felt you could share your more personal background here. Like Kafka’s character (again, different story this time) whose life question was to investigate the supposed sighting of the giant rat, I feel my life’s question (or one of them) is to investigate motivation and energy – it dovetails, to steal your expression, with all the physical sciences, laws of physics (heat energy), chemistry (electrical energy) and biology (systems energy), music (maths meets emotion), even advertising and consumer culture – my two key interests are
1. recognising lowest common denominators.
2. finding peaks of intensity, in space/ time or in anecdote – what are their sources and limitations.
Any way. When you say about the crying Zoloft people – I’ve never taken Zoloft (my single experience with any prescription drug was trying to distill a whole packet of codeine based stuff from a wisdom tooth operation -hooray, why get a mild impact over a week when I can get a major impact for a day!- and I just got super aggressive for that day, not very fun!) but something’s obviously have left a bad taste in your mouth- that’s an interesting thing because I believe the only reason we hate things is to try to protect what we see as good, or avoid what we see to be injurious – in your case defending things like hard work and ‘toughing it out’, avoiding fruitless wallowing, avoiding drugs which promise to help but don’t. Your values have got you this far at least. You ask for advice -but you don’t want bad advice – so you’ll attack anything that even faintly smells like bad advice just in case – I’m like that too and it’s not because I think I already know the answer, it’s because I want to find a real answer not a cheap fob off! Though sometimes I’ve realised I do end up shooting myself in the foot.
To get back to the point of this addiction blog – and quitting smoking – maybe you’ve could focus your aim a little sharper, find and intensify why you hate it, why you hate being beaten by it – more than you hate being stuck in traffic – because behind that are probably the things you love, the things you want to protect from its impact, your tolerance and strength, your health, and the people who’ll probably care more than you will if you develop inflammatory disease.
No, John, I don’t know the type. Everyone deals with their pain in the best way they can. And nobody likes being miserable. Of that I’m sure.