First Responders Need Help, Too

20 hours 7 minutes ago
The tumultuous events of the last year – political unrest, the coronavirus, and even the 20th anniversary of the terrorist attacks on September 11, 2001 – have put our first responders and public health workers in sharp focus. Federal, state, and local law enforcement, as well as firefighters, and emergency medical services (EMS) face extraordinary challenges on a daily basis: they are regularly the first on the scene during or after a crisis, and the first to offer support and protection to the injured, survivors, and onlookers. Though first responders are trained to work efficiently under the most challenging conditions, the constant exposure to life-threatening or traumatizing events will eventually take its toll.A 2018 report from the Substance Abuse and Mental Health Services Administration (SAMHSA) noted that an estimate 30 percent of first responders develop mental health conditions, including depression and posttraumatic stress disorder (PTSD). For civilians, the rate is 20 percent. The report cited another study that found that the suicide rate among law enforcement is an estimated 125 to 300 police officers per year. The suicide rate among firefighter and EMS is equally troubling: a study of more than 1,000 current and retired fire personnel found that 15.5 percent attempted suicide (the civilian rate is 4.6), while another report found that 6.6 percent of EMS professionals reported attempting suicide (the report's civilian rate was 0.5 percent).Substance abuse, including alcohol and narcotics use, can also be high among career first responders. Fifty percent of male firefighters and 39.5 percent of female firefighters reported heavy or binge alcohol drinking in a single month. A study looking into alcohol use among police officers following the events of Hurricane Katrina in 2005 found a "significant association" between relief efforts for that natural disaster and hazardous alcohol drinking. Another study of police officers after Katrina found that their average number of drinks per day after the hurricane increased from two to seven per day.First responders also face a host of factors that impact them in ways that differ from how the general population experiences traumatic events. Additionally, they face collateral behavioral health damage before, during, and after disasters. First responders may have their hands full with mental or physical issues before they arrive at a traumatic scene; according to the SAMHSA report, these may include on-the-job problems, such as inadequate training, excessive expectations from superiors, issues of favoritism, fatigue, and lack of time off. When combined with issues outside of the workplace – depression, anxiety, physical health problems, family problems, personal loss – and those particular to their line of work, such as regular exposure to death and severe injuries, all contributed to increases in PTSD, substance issue problems, anxiety, and depression.So how can first responders gain the support they need in the face of such challenges? The SAMHSA report had a number of suggestions: leaders can assist by developing clear strategies for dealing with disasters that include all team members and foster cooperation within the organization. They can also inform team members that the situation they are facing has the potential to generate stress, and encourage them to speak candidly about their ability to perform under such conditions. They can also take notice of team members that appear to be fatigued or suffering from psychological issues, and make plans for all team members to take part in self-care during the actual disaster situation.Unfortunately, many first responders feel that asking for help is not part of their emotional makeup. In an interview with the Reno, Nevada-based television station KOLO, James Brumfield, president of the Truckee Meadows Firefighter Foundation, underscored the reluctance that many first responders feel in regard to their emotions. "By nature, we want to be there to help people," he noted. "And we're going to be the last to speak up when something is bothering us."For clinician Steve Nicholas, who is embedded with Truckee Meadows Fire and Rescue, that belief is not only outdated, but also dangerous. "The [idea] of the warrior never hurts, well, that's silly," he said. Problems arise for many first responders when they leave the disaster situation. "It's when they go home," said Nicholas. "And they're not necessarily in that mindset – the stack of three cereal bowls in the sink will be the tip-over moment."Brumfield agreed. "It's the quiet, self-reflection time where it seems like some of the darkest moments get re-lived again."When those darkest moments prove too overwhelming for first responders, there are mental health options that are available to them that specifically focus on their needs. Wish Recovery – luxury rehab & detox, a private dual diagnosis residential detox and alcohol/drug treatment center located in Northridge, California, has addiction treatments and therapies tailored specifically to first responders, who recover alongside members of their peer group.The facility's team includes both current and former first responders with extensive, first-hand experience with and clinical knowledge of the mental, emotional and physical stressors faced by first responders on the job. Through group, family, and individual therapies, clients learn new, healthy ways to cope with depression, anxiety, grief, fear and work-related trauma. They also have access to an array of modalities, including cognitive behavioral therapy (CBT), dialectical behavior therapy (DBT), experiential therapy, EMDR and trauma-based therapy, and relapse-prevention therapy.
The Fix staff

When Places Are Tainted by Memories

2 days 19 hours ago
"When I walked in there my eyes went straight to that table in the corner where they were sitting. I remembered that stupid candle and the way they were looking at each other so intently--it was like they were eye fucking.”Passenger Melody* was referring to a once beloved Silverlake bar at which she'd seen her ex on a date with another girl two years prior (after two of them had only been broken up for a week).Since then, every time she entered her body would tense up and she’d go into shut-down mode. She remembers how alone she felt afterwards--unable to make conversation, disconnected from the group she was with."The laughs and shouts of everyone around me felt maniacal, and the bro spilling beer on my shirt as he passed by felt intentional. I tried going back to the bar again after that but my body just steeled itself. I can’t for now.”Talking to Melody reminded me of the powerful associations that certain places can carry. Memories get stored inside our unconscious, sometimes forgotten by our conscious minds. Years later, the slightest smell, sound, or touch can convoke them.I’m reminded of this each time I climb Magnolia Avenue, the curvy street I used to ascend to get to school as a teen. All of a sudden fuzzy headphones are covering my ears, my disc-man jostles around in my gym bag (the track sometimes skipping), Megan Frock’s* cat shimmies around overturned cleats on the front porch of her tangerine colored house. I'm back in my high school body.These conjured memories aren’t always so welcome or benign. As you could tell from the opening quote, Melody’s were more negative and prevented her from wanting to re-enter the place. I definitely related, as for a while I too had to avoid certain places in my college town that carried too many painful associations.Driving past a freeway exit that bore the same name as my college ex’s new “friends with benefits” on the way back to Davis from my parents’ house in Oakland, for example, always evoked the same visceral reaction that overtakes me when my cars' tires pass over a dead animal.For a while I also didn't want to go back to the brewery where another ex girlfriend and I had our first heated conflict.Bad things don’t even need to have happened inside the triggering place. Even having been merely thinking of something negative, or going through a rough time when you were last there, can be enough to resurrect those same feelings the next time you step foot into the place.When I walked in to certain spaces, I’d instantly feel depressed. I always tried to CBT my way out of it, but these undeniable black drapes hung from every wall. Negative emotional energy left by memories still circulated the air.A former client of mine once said: “I studied in a specific cafe—usually my happy place, filled with plants and murals and LA sun streaming through— every day when my mom was fighting cancer. I tried to take in information about organic compounds and hydrogen bonds, but instead what filled my mind were images of her in bed, the pain on my dad’s and sister’s faces, thoughts of life without her. I can’t go back there anymore. The place is tainted. It will always be filled with memories of memories that are just too painful to revisit.”It’s not even necessary to have spent time with a person who triggers painful emotions while inside the place in question. Even just thinking about them the last time you were there is enough to summon memories and unlock old painful feelings."Your memory of a thought is married to the place in which it first occurred to you," writes Jennifer Ackerman, author of The Bird Way.~~What I’ve found helps is that if I’ve been experiencing a hard time at the same time that I’ve been going to a certain store, or taking a particular road, I will sometimes avoid that place--not for forever, but at least until the wounds are less fresh. Or until enough time has passed for the negative associations to clear out.Passenger Trey* stayed away from a Hollywood Hills hiking trail that he used to run at often when his dad was dying. If he were to keep going back to it before he had healed, the negative feelings and associations would just continue to compound upon one another. His mind might permanently categorize it as a negative place—“and I don’t want that to happen because it’s a kickass place and I love it; the hills are rad and I can get a really amazing workout, am always sweating by the time I’m done.”In Melody’s case, after she stayed out of the bar for a year, when she finally did go back, it no longer had power over her. You might think of it as temporary avoidance— a strategic and proactive (rather than reactive) move. I want this place to go back to doing what it once did for me, so I’m gonna give it some space. What's more, putting yourself in new surroundings gives your mind novel details to pay attention to, which is great for preventing rumination.There’s catharsis in breaking free from negative past associations. And once we take that temporary break, we can watch as positive associations repopulate once fraught places, breathing new life into them. *Names changed to protect confidentiality
Eleni Stephanides

How Dangerous Is One Day Detox?

5 days 19 hours ago
For individuals struggling with opiate dependence, detox and, subsequently, withdrawal symptoms can be the first step in gaining freedom. Successful opioid detoxification can help accomplish this goal. Rapid detox allows for a complete detoxification from opiates while the patient is under sedation. The process is also beneficial because it enables the patient to immediately start Naltrexone or Vivitrol therapy, both non-addictive drugs that significantly help reduce physical cravings after detox. Controlled studies have found that this form of detoxification is both practical and cost-effective.However, it's important to note that not all forms of detoxification under sedation are the same. Since anesthesia detox was developed in 1988, centers have adopted various protocols; some might even promise complete treatment after one day. While the idea of immediate relief from opioid dependency and the withdrawals accompanying detoxification efforts may appeal to those in the grip of addiction, such promises are not fair, accurate, and sadly enough, often not safe.The continued use of opioid drugs causes the body to become dependent. Opioid dependence leads to withdrawal symptoms, which makes it difficult to discontinue use. Once a user stops using opioids, the body goes through tremendous physical and emotional distress associated with withdrawal. Symptoms can include muscle pain and spasms, gastrointestinal distress like nausea or vomiting, depression and anxiety, fatigue, and sleeplessness. Dependence is often followed by addiction. Addiction occurs when opioid dependence interferes with daily life. Symptoms of addiction include uncontrollable cravings and the inability to control drug use regardless of the adverse effects on every aspect of one's life. Although rapid detox, sedation-assisted detox, or any other form of detoxification under anesthesia might be extremely appealing, it is not a cure for addiction and should not be described as one. Withdrawal symptoms may be too challenging and physically unsafe for a person already physically and emotionally in a fragile state, making medically supervised detoxification a more viable option. Instead, when performed responsibly, at a proper facility, by an experienced anesthesiologist, sedation-assisted detox is an excellent option for complete opioid detoxification and for reducing physical cravings. That's why Waismann Method® Opioid Treatment Specialists and Rapid Detox Center do not support one-day detox protocols. The Waismann Method team believes that patients deserve comprehensive and responsible medical care. Furthermore, opioid use leads to significant physiological changes that affect the individual on many levels. Having enough inpatient time before detox for stabilization, evaluation, and tailoring of an individualized protocol is as essential for the safety and comfort of the patient as providing inpatient recovery care for a few days after detox.In 1998, Clare Waismann RAS/SUDCC founded Waismann Method, located in Southern California. After a few years, Mrs. Waismann understood that patients deserved more. Sending them to a hotel room or home immediately after detoxification under sedation was no longer an option. In 2005, Domus Retreat was created: a safe environment where patients can start adapting to this new opioid-free state while receiving professional assistance, care, and guidance around the clock.For the last 23 years, patients have traveled from all over the world to California, where they receive treatment from a quadruple-board certified medical doctor in their private room of a full-service accredited hospital.Although most patients come for detoxification under sedation, there are several medically assisted detox options. From a clinical standpoint, opioid withdrawal is one of the most influential factors driving opioid dependence and addictive behaviors. Waismann Detox™ tailors every treatment based on the understanding of each individual's specific health needs. However, not all opioid detox treatment facilities follow the same stringent protocols as Waismann Method. To that end, Waismann and her associates suggest the following criteria when considering a rapid detox or treatment center that offers detoxification under sedation:The treating physician should be a board-certified doctor with a degree from a reputable educational institution. Board certifications are rigorous programs that require doctors to continually assess and enhance medical knowledge, professional judgment, and clinical techniques.Detox should occur at a full-service accredited hospital. A hospital allows access to medical specialists and immediate medical support with no time constraints for inpatients. This requirement is one of the most frequently overlooked by potential patients, especially those seeking lower-cost options.Patients should receive their own private ICU hospital room and individual attention from medical professionals. These are common oversights for patients, and while shared rooms and medical attention may reduce costs, they also carry the potential for greater risk during the procedure and personal discomfort.One-day and overnight detox centers can be dangerous for several reasons. Though the potential for instant cures can be appealing, it is usually not the safest option. Doctors must have the time to give patients a comprehensive inpatient evaluation and stabilization care for at least a day before the sedation-assisted detox. Before the procedure, they must also have enough information on the patient's intake – food, medication, and other substances – to avoid adverse reactions when the detox drugs are introduced to the patient's system.Post-detox patients should have access to FDA-approved medication like naltrexone and Vivitrol. They should also stay in a specialized recovery center for a few days where their mental and physical stabilization can be observed and attended to. The additional few days of care allows the patient to become more stable while reducing the risks of immediate relapse.Waismann advises that individuals considering any form of rapid detoxification conduct comprehensive research into a facility's protocols, promises, and, more importantly, physician’s credentials, experience, and affiliation with reputable organizations. It is important to know that although medically assisted detoxification can be a life-saving procedure, there are no overnight miracles; nor is there one exclusive treatment that fits every patient's unique health needs.Opioid use disorder is a multifaceted condition that needs to be treated by a team of specialists with a tailored protocol for each person. No single approach to opioid detoxification is guaranteed to work well for all patients. Therefore, detox centers should offer several options, so no patient is pushed into a procedure that does not meet their specific health needs. 
The Fix staff

Rejection Sensitive Dysphoria: What You Should Know About ‘Emotional Sunburn’

1 week ago
Almost everyone is familiar with the sensation of sunburn. After a day of splashing and fun at the beach, you’re overexposed. Your skin is red and any tiny touch can feel overwhelming.Now, let’s consider the idea of emotional sunburn. This is how some professionals characterize Rejection Sensitive Dysphoria (RSD), a condition that often appears in people with ADD and ADHD. After years of being criticized and critiqued for their behaviors, people with these conditions often feel raw and vulnerable. Because of that, they can react strongly to any real or perceived criticism, critique or failure.What is RSD?Usually, RSD is characterized as an outsized reaction to an incident, says Mandy Schneider, alumni coordinator at Sunshine Coast Health Centre, a non 12-step drug and alcohol rehabilitation center in British Columbia. Someone with RSD might show emotional outbursts, which are sometimes confused with rapid-cycling bipolar disorder or other mental health conditions.RSD can manifest in two ways. Some people become angry. These people are prone to outbursts, and may become aggressive to themselves or others. In other cases, RSD manifests as anxiety. People with this form of RSD are likely to become withdrawn and isolated. They may become perfectionists in hopes of avoiding failure.RSD might present as aggression toward others, but the condition is even more dangerous when it is internalized. In the most severe form, this can lead to suicidal ideation.ADD/ADHD and RSD: The ConnectionUnderstanding the connection between ADD, ADHD and RSD can help people get the treatment that they need. Some estimates say that children with ADD or ADHD receive 20,000 more negative interactions during their school years than their neuro-typical peers. Constantly being told to sit down, calm down, and work differently can grate on people, particularly if they have not been diagnosed and thus don’t have a clear understanding of the root cause of their behaviors.Overtime, these people can become particularly vulnerable to having outside emotional reactions when they experience criticism. This compounds the emotional dysregulation that is a feature of ADD and ADHD in children and adults. Up to 70% of adults with ADD or ADHD have trouble controlling their emotions. RSD is an even more pronounced and severe form of this.Treatment of RSDRSD is not a well-known condition, so it can be difficult to get a diagnosis. Still, many people feel relief when they are diagnosed, in part because they learn that there is an explanation for their behaviors.Once RSD is diagnosed, providers can use medication to help alleviate the symptoms. A class of medications known as alpha agonists can provide relief to about one-third of people with RSD. MAOI inhibitors can also help control the symptoms of ADD/ADHD and RSD. Some people find that controlling the symptoms of their ADD or ADHD can make them less prone to mistakes. That might reduce the frequency of criticism that can lead to outbursts.Medications alone can’t fully control the condition, however. Cognitive behavioral therapy might allow people to better understand their triggers, and equip them with healthier coping mechanisms when they feel an RSD episode coming on. However, CBT and other therapies are considered less effective for RSD than they are for other mental health conditions, in part because of how quickly an episode of RSD can be triggered. Although therapy may be helpful, mindfulness can also help people with RSD control their emotional reactions.Spotting and Treating ADD/ADHD and RSD in AdultsIn order to get treatment for RSD, you’ll need to identify the condition as the cause of your emotional dysregulation. Getting a diagnosis of ADD or ADHD can be an important first step. Although ADD and ADHD are more common in children, an estimated 2-5% of American adults also have the conditions. Although diagnosis of ADD/ADHD in adults is on the rise, it remains relatively rare. Oftentimes, a patient must raise the issue with their provider in order to get a diagnosis.In adults, the symptoms of ADD/ADHD can include:ImpulsivenessForgetfulnessRestlessnessExtreme emotionsAdults who have RSD might:Become “people pleasers” to reduce the risk of criticismFocus on perfection to lessen the chances of failureExperience emotional reactions as physical symptomsHave intense emotional reactionsBe their own worst criticIf the symptoms above look familiar to you, you should talk with your doctor about whether you might have ADD, ADHD or RSD. It’s never too late to get a diagnosis for these conditions, and start on the path to better mental, emotional and physical health.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.
The Fix staff

A Letter to Friends in Recovery

1 week 2 days ago
I am writing in the dark, by hand, hoping my words make sense tomorrow morning. The light of the screen hurts my head because I have a concussion.Two weeks ago, I was hit by a drunk driver while heading out to pick up my CSA box on a Thursday morning. I saw him coming toward me on the wrong side of the road at about 50 mph on my neighborhood street. I screamed “Nooo!” and waved in a desperate jazz-hands gesture just before impact, hoping he’d see me and swerve away at the last moment. He didn’t. In a split second, our cars were connected in a sickening crunch. I didn’t hit my head. No glass was broken. I was just shaken—hard. He stared into me, wild eyed, threw his car into reverse, then drove away.I exited the vehicle in an adrenaline-fueled rage, yelling expletives as I tried memorizing his license plate. A Good Samaritan came to my side and asked if I was ok. Just as she did, we heard a crash from around the corner. He had hit someone else.By the time I turned my car around and drove the block to where he was, his vehicle sat wedged into the side of a gigantic hauling & demo truck. I saw several men holding a man of about 60 who was bleeding from his head, belly distended from the bottom of his white tank top. He fought them in slow-motion until first responders arrived. “He threw a tequila bottle from the car” one neighbor told me. “He smells like alcohol” another said as he was taken away in an ambulance. I kept my distance, took my police report and drove my leaking car home, thanking the Universe the crash wasn’t any worse.After a trip to urgent care, I found the seatbelt left a bruise and I had a pinched nerve causing a tingling arm. A few days later when the right side of my head felt strange, I saw a neurologist who performed some tests. One was the Romberg test, where I was asked to stand with my feet apart, arms out and eyes closed. I found myself frustrated, normally a yogi still doing handstands into my 50s, yet here I was swaying to the right, unable to balance on my own two feet in a doctor’s office, right side up. Later research revealed that the Romberg used to diagnose my concussion is the same one sometimes used by law enforcement to determine DUI.I have my issues but have never been addicted to anything, nor had a problem with alcohol. It just never agreed with me. I am one of those annoying people who could drink occasionally in college, then not do it again for months or years. I also grew up in Washington, DC, very involved in the punk scene and heavily influenced by the idea of “straight edge.” My partner doesn’t drink and by my 30s I eventually just quit altogether, no big deal.But I have loved many addicts. Some who have left this earthly plane in the most cliche of ways. Some of whom I’ve had to let go. Some who have turned their lives around. I have benefitted from Al-Anon.This accident brought all of that to the surface. Why did this happen to me? Why was I repeatedly the one on the other end of the “making amends” step, dammit? As my anger with the driver subsided, I recognized that his drunken state at 11:30 on a Thursday morning was evidence of his own pain. I thought about all of my friends who have worked so hard in recovery to become better versions of themselves.To anyone who has done or is doing the work, I want to say thank you. Please know that the sharing of your stories over the years helps me to have compassion for this man who has wreaked havoc on my life, his own, and undoubtedly others.Maybe you have been the drunk driver, but most likely now you are the woman who came to my aid after I was hit, the neighbor who held onto his fellow man in the name of justice, the EMS who treated the offender, the nurse who later took my vitals, the friend who sent me flowers in the aftermath, the client who sent me groceries, the yoga teacher who offered healing words of support.Whether this will be this man’s rock bottom before getting help is not for me to say. I don’t believe in silver linings—you get what you get and deal with it. I am getting better every day. Yes, this incident sucks… and I am lucky to be alive and to know you. I wrote this thinking maybe someone reading it might recognize themselves and decide who they want to be in their own narrative.
Shawna Kenney

Chapter 6: The Thrush’s Song

1 week 5 days ago
After a man in my small Vermont town who had a heroin addiction committed suicide, I began asking questions about addiction. Numerous people shared their experiences with me — from medical workers to the local police to people in recovery. Shauna Shepard, who works as a receptionist in the local health clinic, visited with me on my back porch. She shared why she drifted into substance abuse, and how she struggled to get — and remain — sober.“Drugs,” Shauna finally said after a long silence, tapping her cigarette on the ashtray. “Drugs are really good. That’s the problem. When you’re using, it’s hard to imagine a life without them. For a long time, I didn’t know how to deal with my feelings any other way. It’s still hard for me to understand that getting high isn’t an option anymore.”I nodded; I knew all too well how using could be a carapace, a place to tuck in and hide, where you could pretend your life wasn’t unraveling.“You can go weeks, months, even years without using, and then you smell something or hear a certain song on the radio, or you see somebody, and — bam! — the cravings come right back. If you don’t keep your eye on that shit, it’ll get you.”“It? You mean cravings for drugs? Or your past?”“Both,” she said emphatically. “I mean, fuck. Emotions don’t go away. If you bury them, everything comes crashing out when someone asks you for a fucking pen, and they get the last six months of shit because they walked in at the wrong time.”I laughed. “So much shit can happen in six months.”She nodded, but she wasn’t smiling.I rubbed a fingertip around the edge of the saucer, staring at the ashes sprinkled over its center. “What’s it like for you to be sober?”“It’s harder. But it’s better. My job is good, and I want to keep it. I have money the day after I get paid. I’ve got my therapist and my doctor on speed dial. I have Vivitrol. But I still crave drugs. I don’t talk to anyone who uses. It’s easy for that shit to happen. You gotta be on your game.”“At least to me, you seem impressively aware of your game.”With one hand, she waved away my words. “I have terrible days, too. Just awful days. But if my mom can bury two kids and not have a drug issue, I should be able to do it. When my brother shot himself, his girlfriend was right there. She’s now married and has two kids. That’s just freaking amazing. If she can stay clean, then I should be able to stay sober, too.”“Can I reiterate my admiration again? So many people are just talk.”Shauna laughed. “Sometimes I downplay my trauma, but it made me who I am. I change my own oil, take out the garbage. I run the Weedwacker and stack firewood. I’ve repaired both mufflers on my car, just because I could.” Her jaw tightened. “But I don’t want to be taken advantage of.” She told me how one night, she left her house key in the outside lock. “When I woke up next morning and realized what I had done, I was so relieved to have survived. I told myself, See, you’re not going to fucking die.”“You’re afraid here? In small town Vermont?”“I always lock up at night. Always have, always will.” Cupping her hands around the lighter to shield the flame from the wind, she bent her head sideways and lit another cigarette.“I lock up, too. I have a restraining order against my ex.”She tapped her lighter on the table. “So you know.”“I do. I get it.”*As the dusk drifted in and the warm afternoon gave way to a crisp fall evening, our conversation wound down.Shauna continued, “I still feel like I have a long way to go. But I feel lucky. I mean, in my addiction I never had sex for money or drugs. I never had to pick out of the dumpster. My rock bottom wasn’t as low as others. I’m thankful for that.”I thought of my own gratitude for how well things had worked out for me, despite my drinking problem; I had my daughters and house, my work and my health.Our tabby cat Acer pushed his small pink nose against the window screen and meowed for his dinner. My daughter Gabriela usually fed him and his brother around this time.“It’s getting cold,” Shauna said, zipping up her jacket.“Just one more question. What advice would you give someone struggling with addiction?”Shauna stared up at the porch ceiling painted the pale blue of forget-me-not blossoms, a New England tradition. She paused for so long that I was about to thank her and cut off our talk when she looked back at me.“Recovery,” she offered, “is possible. That’s all.”“Oh . . .” I shivered. “It’s warm in the house. Come in, please. I’ll make tea.”She shook her head. “Thanks, but I should go. I’ve got to feed the dogs.” She glanced at Acer sitting on the windowsill. “Looks like your cat is hungry, too.”“Thank you again.”We walked to the edge of the driveway. Then, after an awkward pause, we stepped forward and embraced. She was so much taller than me that I barely reached her shoulders.When Shauna left, I gathered my two balls of yarn and my half-knit sweater and went inside the kitchen. I fed the cats who rubbed against my ankles, mewling with hunger. From the refrigerator, I pulled out the red enamel pan of leftover lentil and carrot soup I’d made earlier that week and set it on the stove to warm.Then I stepped out on the front steps to watch for my daughters to return home. Last summer, I had painted these steps dandelion yellow, a hardware store deal for a can of paint mistakenly mixed. Standing there, my bare feet pressed together, I wrapped my cardigan around my torso. Shauna and I had much more in common than locking doors at night. Why had I revealed nothing about my own struggle with addiction?*I wandered into the garden and snapped a few cucumbers from the prickly vines. Finally, I saw my daughters running on the other side of the cemetery, racing each other home, ponytails bobbing. As they rushed up the path, I unlatched the garden gate and held up the cucumbers.“Cukes. Yum. Did you put the soup on?” Molly asked, panting.“Ten minutes ago.” Together we walked up the steps. The girls untied their shoes on the back porch.“We saw the bald eagles by the reservoir again,” Gabriela said.“What luck. I wonder if they’re nesting there.”Molly opened the kitchen door, and the girls walked into our house. Before I headed in, too, I lined up my family’s shoes beneath the overhang. Through the glass door, I saw Molly cradling Acer against her chest, his hind paws in Gabriela’s hands as the two of them cooed over their beloved cat.Hidden in the thicket behind our house, the hermit thrush — a plain brown bird, small enough to fit in the palm of my hand — trilled its rippling melody, those unseen pearls of sound.In the center of the table where Shauna and I had sat that afternoon, the saucer was empty, save for crumbles of common garden dirt and a scattering of ashes. When I wasn’t looking, Shauna must have gathered her crushed cigarette butts. I grasped the saucer to dump the ashes and dirt over the railing then abruptly paused, wondering: If I had lived Shauna’s life, would I have had the strength to get sober? And if I had, would I have risked that sobriety for a stranger?In the kitchen, my daughters joked with each other, setting the table, the bowls and spoons clattering. The refrigerator opened and closed; the faucet ran. I stood in the dusk, my breath stirring that dusty ash.Excerpted from Unstitched: My Journey to Understand Opioid Addiction and How People and Communities Can Heal, available at Amazon and elsewhere.
Brett Ann Stanciu

Havana syndrome fits the pattern of psychosomatic illness – but that doesn’t mean the symptoms aren’t real

2 weeks 1 day ago
In early September 2021, a CIA agent was evacuated from Serbia in the latest case of what the world now knows as “Havana syndrome.”Like most people, I first heard about Havana syndrome in the summer of 2017. Cuba was allegedly attacking employees of the U.S. Embassy in Havana in their homes and hotel rooms using a mysterious weapon. The victims reported a variety of symptoms, including headaches, dizziness, hearing loss, fatigue, mental fog and difficulty concentrating after hearing an eerie sound.Over the next year and a half, many theories were put forward regarding the symptoms and how a weapon may have caused them. Despite the lack of hard evidence, many experts suggested that a weapon of some sort was causing the symptoms.I am an emeritus professor of neurology who studies the inner ear, and my clinical focus is on dizziness and hearing loss. When news of these events broke, I was baffled. But after reading descriptions of the patients’ symptoms and test results, I began to doubt that some mysterious weapon was the cause.I have seen patients with the same symptoms as the embassy employees on a regular basis in my Dizziness Clinic at the University of California, Los Angeles. Most have psychosomatic symptoms – meaning the symptoms are real but arise from stress or emotional causes, not external ones. With a little reassurance and some treatments to lessen their symptoms, they get better.The available data on Havana syndrome matches closely with mass psychogenic illness – more commonly known as mass hysteria. So what is really happening with so–called Havana syndrome?A mysterious illnessIn late December 2016, an otherwise healthy undercover agent in his 30s arrived at the clinic of the U.S. Embassy in Cuba complaining of headaches, difficulty hearing and acute pain in his ear. The symptoms themselves were not alarming, but the agent reported that they developed after he heard “a beam of sound” that “seemed to have been directed at his home”.As word of the presumed attack spread, other people in the embassy community reported similar experiences. A former CIA officer who was in Cuba at the time later noted that the first patient “was lobbying, if not coercing, people to report symptoms and to connect the dots.”Patients from the U.S. Embassy were first sent to ear, nose and throat doctors at the University of Miami and then to brain specialists in Philadelphia. Physicians examined the embassy patients using a range of tests to measure hearing, balance and cognition. They also took MRIs of the patients’ brains. In the 21 patients examined, 15 to 18 experienced sleep disturbances and headaches as well as cognitive, auditory, balance and visual dysfunction. Despite these symptoms, brain MRIs and hearing tests were normal.A flurry of articles appeared in the media, many accepting the notion of an attack.From Cuba, Havana syndrome began to spread around the globe to embassies in China, Russia, Germany and Austria, and even to the streets of Washington.The Associated Press released a recording of the sound in Cuba, and biologists identified it as the call of a species of Cuban cricket.A sonic or microwave weapon?Initially, many experts and some of the physicians suggested that some sort of sonic weapon was to blame. The Miami team’s study in 2018 reported that 19 patients had dizziness caused by damage to the inner ear from some type of sonic weapon.This hypothesis has for the most part been discredited due to flaws in the studies, the fact there is no evidence that any sonic weapon could selectively damage the brain and nothing else, and because biologists identified the sounds in recordings of the supposed weapon to be a Cuban species of cricket.Some people have also proposed an alternative idea: a microwave radiation weapon.This hypothesis gained credibility when in December 2020, the National Academy of Science released a report concluding that “pulsed radiofrequency energy” was a likely cause for symptoms in at least some of the patients.If someone is exposed to high energy microwaves, they may sometimes briefly hear sounds. There is no actual sound, but in what is called the Frey effect, neurons in a person’s ear or brain are directly stimulated by microwaves and the person may “hear” a noise. These effects, though, are nothing like the sounds the victims described, and the simple fact that the sounds were recorded by several victims eliminates microwaves as the source. While directed energy weapons do exist, none that I know of could explain the symptoms or sounds reported by the embassy patients.Despite all these stories and theories, there is a problem: No physician has found a medical cause for the symptoms. And after five years of extensive searching, no evidence of a weapon has been found.Mass psychogenic illness – more commonly known as mass hysteria – is a well-documented phenomenon throughout history, as seen in this painting of an outbreak of dancing mania in the Middle Ages. Pieter Brueghel the Younger/WikimediaCommonsMass psychogenic illnessMass psychogenic illness is a condition whereby people in a group feel sick because they think they have been exposed to something dangerous – even though there has been no actual exposure. For example, as telephones became widely available at the turn of the 20th century, numerous telephone operators became sick with concussion-like symptoms attributed to “acoustic shock.” But despite decades of reports, no research has ever confirmed the existence of acoustic shock.I believe it is much more likely that mass psychogenic illness – not an energy weapon – is behind Havana syndrome.Mass psychogenic illness typically begins in a stressful environment. Sometimes it starts when an individual with an unrelated illness believes something mysterious caused their symptoms. This person then spreads the idea to the people around them and even to other groups, and it is often amplified by overzealous health workers and the mass media. Well-documented cases of mass psychogenic illness – like the dancing plagues of the Middle Ages – have occurred for centuries and continue to occur on a regular basis around the world. The symptoms are real, the result of changes in brain connections and chemistry. They can also last for years.The story of Havana syndrome looks to me like a textbook case of mass psychogenic illness. It started from a single undercover agent in Cuba – a person in what I imagine is a very stressful situation. This person had real symptoms, but blamed them on something mysterious – the strange sound he heard. He then told his colleagues at the embassy, and the idea spread. With the help of the media and medical community, the idea solidified and spread around the world. It checks all the boxes.Interestingly, the December 2020 National Academy of Science report concluded that mass psychogenic illness was a reasonable explanation for the patients’ symptoms, particularly the chronic symptoms, but that it lacked “patient-level data” to make such a diagnosis.The Cuban government itself has been investigating the supposed attacks over the years as well. The most detailed report, released on Sept. 13, 2021, concludes that there is no evidence of directed energy weapons and says that psychological causes are the only ones that cannot be dismissed.While not as sensational as the idea of a new secret weapon, mass psychogenic illness has historical precedents and can explain the wide variety of symptoms, lack of brain or ear damage and the subsequent spread around the world.[Understand new developments in science, health and technology, each week.Subscribe to The Conversation’s science newsletter.]Robert Baloh, Professor of Neurology, University of California, Los AngelesThis article is republished from The Conversation under a Creative Commons license. Read the original article.
Robert Baloh University of California Los Angeles

Dear William: A Father's Memoir of Addiction, Recovery, Love, and Loss

1 month ago
The officer standing in the doorway raised his arm when I stepped forward, blocking my entrance to my son’s apartment. I tried to peer over his blue-uniformed shoulder to gaze around the corner to where the body of my son sat on the couch. My precious William—I saw him take his first breaths at birth, and I’d cried as I looked down at him and pledged to keep him safe forever. Now, within a day of his final breath, I wanted to see him again.“Please,” I said to the officer.“Listen,” he said, and I dragged my eyes from straining to see William to the officer’s face. His brown eyes were stern but not unkind. “You don’t want to see this.”“I do,” I said. “It’s my son.”He glanced over his shoulder, then back at me. “Death isn’t pretty,” he said. “He’s bloated. His bowels turned loose. That’s what happens when people die and are left alone for a day or more.”I didn’t say anything. I couldn’t.“And there’s something else,” he said.“What?”“He’s still got a $20 bill rolled up in his hand used for whatever he was snorting.”I felt the pavement beneath my feet seem to tilt. I reached to steady myself on the splintered doorjamb one of the officers had forced open with a crowbar just minutes before.At his hip, the officer’s radio squawked. I knew the ambulance would be here soon. “Your son—we found him with his iPad in his lap. It looks like he was checking his email to see what time he was due at work in the morning.”Yes, William was proud of holding down that job at the Apple Store. He was trying to turn things around.“It’s typical, really,” the officer continued. “That’s how addicts are. Snorting a fix while hoping to do right and get to work the next day. It’s always about the moment.”This past year, William had been the chief trainer at the Apple Store, and he’d been talking again about heading to law school, the old dream seeming possible once more now that he was sober. He seemed to have put the troubles of the previous year, with his fits and starts in treatment, behind him. They’d kicked William out of one center in Colorado because he drank a bottle of cough syrup. Another center tossed him out because he and a fellow rehabber successfully schemed over two weeks to purchase one fentanyl pill each from someone in the community with a dental appointment. They swallowed their pills in secret, but glassy eyes ratted them out to other patients, who alerted counselors. When asked, William confessed, hoping the admission might move the counselors to give him a second chance. But they sent him packing back to Nashville, where his rehab treatment had begun. One counselor advised us to let William go homeless. “We’ll drop him off at the Salvation Army with his clothing and $10,” he said. “Often, that’s what it takes.”We knew that kind of tough-love, hit-rock-bottom stance might be right, but our parental training couldn’t stomach abandoning our son to sleep at the Salvation Army. Instead, my wife and I drove five hours from our home in Mississippi to Nashville to pick him up. He was fidgety but he hugged us firmly, looking into our eyes. We took him to dinner at Ruth’s Chris Steak House, and, Lord, it felt good to see his broad smile, our twenty-two-year-old son adoring us with warm, brown eyes. We told stories and laughed and smiled and swore the bites of rib eye drenched in hot butter were the best we’d ever had.The next morning, after deep sleep at a Hampton Inn under a thick white comforter with the air conditioner turned down so low William chuckled that he could see his breath, we found a substance treatment program willing to give him another chance.“This dance from one treatment center to another isn’t unusual,” a counselor explained at intake. “Parents drop their child off for a thirty-day treatment and assume it’s going to be thirty days. But that’s just the tip of the iceberg.” My wife and I exchanged a look; that’s exactly what we’d thought the first time we got William treatment. Thirty days and we’d have our boy home, safe and healthy.The counselor continued, “If opiates and benzos are involved, it often takes eight or nine thirty-day stays before they find the rhythm of sobriety and self-assuredness. The hard part for them is staying alive that long.”When we left William in Nashville for that first thirty-day treatment, weeks before Thanksgiving, we imagined we’d have him home for Christmas. In early December, we bought presents that we expected to share, sitting around the tree with our family of five blissfully together. But William needed more treatment. Thanksgiving turned into Christmas, and Christmas turned into the new year, and the new year turned into spring. We missed William so much, but finally, the treatment was beginning to stick. We saw progress in William’s eyes during rare visits, the hollowness carved by substances slowly refilling with remnants of his soul.Now, when parents ask me how they can tell if their kid is on drugs, I say, “Look into their eyes.” Eyes reveal the truth, and eyes cannot hide lies and pain. In William’s eyes, we saw hopeful glimmers that matched improved posture and demeanor. Progress, however, can become the addict’s worst enemy since renewed strength signals opportunity. Addicts go to rehab because substances knocked them down, yet once they are out of treatment and are feeling more confident, they forget just how quickly they can be knocked down again.Yet we, too, were feeling confident about William’s prospects. He’d always been scrappy, a hard worker. In college, he ran the four-hundred-meter hurdles in the Southeastern Conference Outdoor Track and Field Championships, despite the fact that he had short legs for a college hurdler. He overcame that by being determined, confident, and quick. And all the time he was competing at the Division 1 level, he was an A student in the Honors College. He’d set his mind on law school and people had told us that with his resumé he could get into most any law school in America.During that year after his graduation, in 2012, when William was in and out of treatment, I decided to quit my job as a newspaper editor to spend more time with him. I wanted to keep an eye on his progress and be there if he started to slide, so I visited him in Nashville every other week. He worried I was throwing my career away, but I would throw away anything to help him. Also, I had a plan. Instead of the daily grind of editing a newspaper, I thought quitting might provide the opportunity to return to a book project I’d abandoned. The Greatest Fight Ever was my take on the John L. Sullivan versus Jake Kilrain bare-knuckle boxing match of the late 1800s. The Sullivan-Kilrain fight was an epic heavyweight championship held in South Mississippi, lasting seventy-five rounds in sultry July heat, part showmanship theater and part brute brawl. I had researched the story for years and was once excited about explaining its role in the playing—and hyping—of sports today. I enjoyed sharing anecdotes over the years, like how the mayor of New Orleans served as a referee. Or that the notorious Midwestern gunslinger Bat Masterson took bets ringside on the fight, which set the standard for sports’ bigger-than-life culture that continues today.I had written other books by then, including some that found commercial success, but looking back at them from a distance, I judged none to be as excellent and useful as they could have been. I wanted the Sullivan-Kilrain fight story to change that. But William noticed as we visited that my enthusiasm for the story had evaporated. I wasn’t spending time crafting the manuscript.“You need to finish your book,” William said that April when I visited him in Nashville. We were eating breakfast at a café known for pancakes, but I was devouring bacon and eggs as William wrestled with a waffle doused with jelly.“I’m trying,” I said between sips of coffee. “It’s easy to tell a story, but it’s more difficult to tell a good story. That’s what I’m working at.”“You are a good writer. You can do it if you get focused.”“It’s hard to immerse yourself in a championship boxing match from the 1800s when you and your family are in the fight of a lifetime,” I said.William looked at me over his jelly-slathered waffle. He knew I wasn’t just referring to his struggles. I was referring to my own as well. Two years earlier, I’d almost destroyed our family completely through a string of spectacularly bad decisions, and we, individually and collectively, were fragile.“William,” I said. “I’m worried about you. I’m worried about me. I’m worried about all of us.”We hadn’t talked so much about my own self-immolation. But now William turned to me. “I’m sorry if the mistakes I’ve made were what made it worse for you. I mean—” he looked off and took a breath. “For so long, I thought drugs were for fun, and I didn’t realize how deep I was in. And then it was too late. I needed them. I’m sorry for making it harder on you and Mom.”“No, William, don’t put that on yourself. I caused my own problems. And I want to apologize to you too. I’m sorry for when you struggled in college and I was so caught up in my own life or career that I wasn’t there when you needed me. I failed you.”We went on that way for a while, saying the things that had burdened us, the things we’d needed to say for a long time. That weekend was our best, most direct connection in years. I was glad to sit beside my son over coffee and a breakfast we could live without for conversation we’d been dying for, glad I’d quit a decent editing job, glad even to stop pretending I was writing a book that no longer held my interest.“Maybe there’s another book you should be writing, Dad,” he said.“About sports?”“About us.”I looked at his plate, the waffle barely eaten. I looked at his eyes, shining with encouragement.“Do you ever think maybe other people could learn something from hearing about our story? I mean, when we were growing up, no one would have looked at our family, this all-American family that pretty much lacked for nothing, and predict how bad we’d crash. But maybe hearing what happened to us could help people. Maybe that’s the story you should tell.”“Maybe we should tell it together,” I said after a bite.“I’m not ready yet,” he said. “But one day, we’ll do it.”“Yes,” I said, clutching his hand in mine. “One day, we’ll do it.”We said goodbye then and told each other we loved each other, and I walked to my car.“Dad,” William called out.“Yeah?” I turned over my shoulder.“Make sure you finish that book,” he said.I stopped. “What book? The Greatest Fight Ever?”He smiled and waved goodbye.I wiped tears away, then drove home.That was the last time I ever saw my firstborn child.Five sleeps later, William died. He didn’t plan on dying. But the early days of sobriety can be the loneliest days. And it’s never hard for an addict to find an excuse. Excerpted from Dear William: A Father's Memoir of Addiction, Recovery, Love, and Loss by David Magee, available November 2, 2021 at Amazon and elsewhere.
David Magee

Individual dietary choices can add – or take away – minutes, hours and years of life

1 month ago
Vegetarian and vegan options have become standard fare in the American diet, from upscale restaurants to fast-food chains. And many people know that the food choices they make affect their own health as well as that of the planet.But on a daily basis, it’s hard to know how much individual choices, such as buying mixed greens at the grocery store or ordering chicken wings at a sports bar, might translate to overall personal and environmental health. That’s the gap we hope to fill with our research.We are part of a team of researchers with expertise in food sustainability and environmental life cycle assessment, epidemiology and environmental health and nutrition. We are working to gain a deeper understanding beyond the often overly simplistic animal-versus-plant diet debate and to identify environmentally sustainable foods that also promote human health.Building on this multi-disciplinary expertise, we combined 15 nutritional health-based dietary risk factors with 18 environmental indicators to evaluate, classify and prioritize more than 5,800 individual foods.Ultimately, we wanted to know: Are drastic dietary changes required to improve our individual health and reduce environmental impacts? And does the entire population need to become vegan to make a meaningful difference for human health and that of the planet?Putting hard numbers on food choicesIn our new study in the research journal Nature Food, we provide some of the first concrete numbers for the health burden of various food choices. We analyzed the individual foods based on their composition to calculate each food item’s net benefits or impacts.The Health Nutritional Index that we developed turns this information into minutes of life lost or gained per serving size of each food item consumed. For instance, we found that eating one hot dog costs a person 36 minutes of “healthy” life. In comparison, we found that eating a serving size of 30 grams of nuts and seeds provides a gain of 25 minutes of healthy life – that is, an increase in good-quality and disease-free life expectancy.Our study also showed that substituting only 10% of daily caloric intake of beef and processed meats for a diverse mix of whole grains, fruits, vegetables, nuts, legumes and select seafood could reduce, on average, the dietary carbon footprint of a U.S. consumer by one-third and add 48 healthy minutes of life per day. This is a substantial improvement for such a limited dietary change.Relative positions of select foods, from apples to hot dogs, are shown on a carbon footprint versus nutritional health map. Foods scoring well, shown in green, have beneficial effects on human health and a low environmental footprint. (Austin Thomason/Michigan Photography and University of Michigan, CC BY-ND)How did we crunch the numbers?We based our Health Nutritional Index on a large epidemiological study called the Global Burden of Disease, a comprehensive global study and database that was developed with the help of more than 7,000 researchers around the world. The Global Burden of Disease determines the risks and benefits associated with multiple environmental, metabolic and behavioral factors – including 15 dietary risk factors.Our team took that population-level epidemiological data and adapted it down to the level of individual foods. Taking into account more than 6,000 risk estimates specific to each age, gender, disease and risk, and the fact that there are about a half-million minutes in a year, we calculated the health burden that comes with consuming one gram’s worth of food for each of the dietary risk factors.For example, we found that, on average, 0.45 minutes are lost per gram of any processed meat that a person eats in the U.S. We then multiplied this number by the corresponding food profiles that we previously developed. Going back to the example of a hot dog, the 61 grams of processed meat in a hot dog sandwich results in 27 minutes of healthy life lost due to this amount of processed meat alone. Then, when considering the other risk factors, like the sodium and trans fatty acids inside the hot dog – counterbalanced by the benefit of its polyunsaturated fat and fibers – we arrived at the final value of 36 minutes of healthy life lost per hot dog.We repeated this calculation for more than 5,800 foods and mixed dishes. We then compared scores from the health indices with 18 different environmental metrics, including carbon footprint, water use and air pollution-induced human health impacts. Finally, using this health and environmental nexus, we color-coded each food item as green, yellow or red. Like a traffic light, green foods have beneficial effects on health and a low environmental impact and should be increased in the diet, while red foods should be reduced.Where do we go from here?Our study allowed us to identify certain priority actions that people can take to both improve their health and reduce their environmental footprint.When it comes to environmental sustainability, we found striking variations both within and between animal-based and plant-based foods. For the “red” foods, beef has the largest carbon footprint across its entire life cycle – twice as high as pork or lamb and four times that of poultry and dairy. From a health standpoint, eliminating processed meat and reducing overall sodium consumption provides the largest gain in healthy life compared with all other food types.Beef consumption had the highest negative environmental impacts, and processed meat had the most important overall adverse health effects. (ID 35528731 © Ikonoklastfotografie |, people might consider eating less of foods that are high in processed meat and beef, followed by pork and lamb. And notably, among plant-based foods, greenhouse-grown vegetables scored poorly on environmental impacts due to the combustion emissions from heating.Foods that people might consider increasing are those that have high beneficial effects on health and low environmental impacts. We observed a lot of flexibility among these “green” choices, including whole grains, fruits, vegetables, nuts, legumes and low-environmental impact fish and seafood. These items also offer options for all income levels, tastes and cultures.Our study also shows that when it comes to food sustainability, it is not sufficient to only consider the amount of greenhouse gases emitted – the so-called carbon footprint. Water-saving techniques, such as drip irrigation and the reuse of gray water – or domestic wastewater such as that from sinks and showers – can also make important steps toward lowering the water footprint of food production.A limitation of our study is that the epidemiological data does not enable us to differentiate within the same food group, such as the health benefits of a watermelon versus an apple. In addition, individual foods always need to be considered within the context of one’s individual diet, considering the maximum level above which foods are not any more beneficial – one cannot live forever by just increasing fruit consumption.At the same time, our Health Nutrient Index has the potential to be regularly adapted, incorporating new knowledge and data as they become available. And it can be customized worldwide, as has already been done in Switzerland.It was encouraging to see how small, targeted changes could make such a meaningful difference for both health and environmental sustainability – one meal at a time.[You’re smart and curious about the world. So are The Conversation’s authors and editors. You can get our highlights each weekend.]Olivier Jolliet, Professor of Environmental Health Sciences, University of Michigan and Katerina S. Stylianou, Research Associate in Environmental Health Sciences, University of MichiganThis article is republished from The Conversation under a Creative Commons license. Read the original article.
Olivier Jolliet

Tarzana Recovery Center

1 month 1 week ago
Tarzana Recovery Center (TRC) is a residential treatment center based in the San Fernando Valley neighborhood of Tarzana that provides treatment for substance use disorder, alcohol use disorder, dual diagnosis, and more. The facility offers an accredited sub-acute detox program certified by Integrated Management Systems. Treatment at Tarzana Recovery Center also features an array of in-residence plans and case management, as well as a partial hospitalization program (PHP) as part of their program aftercare. As their website notes, their inpatient treatment seeks to assist clients in achieving and sustaining long-term sobriety, and to guide clients on "a path of physical, mental, and spiritual health."Surveyed alumni gave a number of reasons for choosing TRC for treatment. The most frequently cited factors were the quality of treatment and accommodations, privacy, price, and location, with quality of treatment ranking highest among respondents. One alum noted that the staff and fellow clients "felt like family, [and] I will remain in touch and some will remain lifelong friends, I hope." Accommodations, which were the second most frequently cited reason, range from shared rooms with roommates to single room options; roommates were "very respectful" and even "awesome." Clients are expected to keep their rooms clean but are not assigned chores. Alumni described their fellow residents as a "refreshingly wide range of people." Clients were a mix of men and women of all ages and ethnicities, and many were described as professional, but there were "college student age people" as well. Alumni considered their fellow clients "regular people looking to address what was holding them back in life." The average length of stay was 30 days, and the most common issue driving respondents to seek treatment at TRC was substance use disorder. Others sought help for alcoholism or "dual addiction(s)," "gender-identity issues," "relationship issues," and "compulsive behaviors."The food served at TRC was described as "very gourmet" but also with a "home meal feeling." Meals were frequently described as "healthy" and clients were allowed to "have choices and input" on the menu selections. Clients with vegan diets were pleased with the range of options available to them, while fresh fish and seafood and Italian food were cited as favorite meals, as was the cookout that is offered as part of TRC's many activities. Coffee was made several times a day, and snacks were both plentiful and healthy. One alum felt the food was "too healthy," while another was "grateful to have a meal."Alumni described their days at TRC as "busy," with frequent involvement in a number of different activities. A couple former residents noted that staying busy is "part of the deal at Tarzana," with an emphasis on "getting and staying involved in your life." The program was "well-structured" and "with an emphasis on recovery through recreation and learning to have fun sober." TRC's treatment includes a "custom treatment plan" developed with the client, as well as one-on-one meetings with a residential treatment case manager – typically, a certified alcohol and drug counselor and a personal therapist. Evidence-based therapies such as cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT) and eye movement desensitization and reprocessing (EMDR) are also offered, as is meditation, equine therapy, pet therapy, music therapy, yoga, and professional massage therapy.While TRC's program does include a 12-step element, alumni viewed it as just one part of their treatment plan. "I think the foundation is somewhat 12-step, but they were really trying to provide me with something I wouldn't find in meetings alone," wrote one alum. Others appreciated the fact that the emphasis seemed to be more on "learning to actually live one's life sober and have fun." Most cited the groups and interaction with the staff as the most memorable element of their stay at TRC. Staff was regarded as "very caring and engaged" and "very understanding," but also with an element of tough love, which many considered "out of love and care."During non-treatment hours, clients had a number of activities and amenities available to them. The latter includes a pool, gym facilities, and fitness classes, while volleyball, cooking classes, bike riding were among the many activities. Clients could also take advantage of numerous off-site activities, including trips to the beach, surfing, bowling, virtual reality gaming, go-kart racing, and other weekend options, which were "super enjoyable."Access to a phone was described by alumni as "liberal" but also restricted while in detox, during group sessions, as well as after 10 p.m. (phones were returned at 10 a.m.). Access to television, Internet, media, and work obligations were "frequent" and the staff was "accommodating" in that regard.TRC's treatment includes 24/7 care from a diverse array of medical professionals, from doctors and nurse practitioners to therapists, mental health counselors, and alcohol and drug rehab technicians. The staff was described as "very helpful" and "always on call." Doctors were even available upon request via Facetime and Zoom, which was "helpful," while counselors at TRC were described as "exceptional."When asked about how they've fared since treatment at TRC, all respondents answered that they had been successful in maintaining sobriety for months, with some approaching their first year without substances. Some found it more challenging that others; as one alumni noted, "It is a daily reprieve. However, the tools they provided me have helped me stay clean for nine months now." Another reported feeling "far better equipped to handle things in my life" and one summed up: "I have never been this proud of myself."When asked to summarize their time in treatment at TRC, many alumni expressed gratitude for the center's staff. "I feel VERY fortunate to have found this treatment center," wrote one alum. Another noted that the staff made them feel "at home," and praised the staff for being "here to help me with whatever I needed." One cited an example of the staff's willingness to help by noting that transportation was arranged for a homeless client to come to Tarzana and stay for free, adding that the client "turned his life around."Another seemed to encompass their fellow alum's feelings by "highly recommend[ing] it to the next addict." They added that "the program helped me become the person I am right now, and I can't thank them enough."
The Fix staff

7 Ways 'Back To School' Can Help You Create a Better Routine

1 month 1 week ago
January may be the time for New Year’s resolutions, but for many people September presents another opportunity for a fresh start. Kids return to school, the chaotic summer schedules quiet down, and many people transition into their fall and winter routines. That makes September a perfect time to check in on your routines, evaluate what’s working and what’s not, and make the changes you need to live your healthiest life.Here’s how to get started.Check in with yourselfBefore you make any big changes, take some time to check in with yourself. Journaling can be helpful, but you can also just take yourself on a walk or find another way to have an internal conversation, uninterrupted. Ask yourself what feels good in your life right now? What changes are just screaming to be made? Use these as directions to evaluate what you should do next.Make a listAfter you’ve taken some time to think about what you’d like to keep and change in your life, get out your pen and paper and make a list. The staff at Sunshine Coast Health Centre, a non 12-step drug and alcohol rehabilitation center in British Columbia, recommend making three lists to evaluate different areas of your life. First, start with a list of things you’re grateful for. Next, list your preferred activities, or the ways that you enjoy spending time. This can guide you in deciding how to prioritize and schedule your time. Finally, list the resources that are available to you if needed.Update your routineSummer can be a tough time to keep on schedule. The free and easy living is nice, but can become overwhelming after a while. Think about what you let slip from your routine, and what you would like to reincorporate. This is especially important as society begins opening up again. You might have the opportunity to volunteer, participate in alumni programs or take in-person classes for the first time in more than a year. Look back on your list of preferred activities and determine how you can incorporate more of those into your days.Get organized. Cooler weather means that most people will be spending more time inside during the coming months. To keep yourself happy and healthy, you should start with a clean slate in the house. Removing unnecessary clutter can help you keep a clear head, and knowing that all of your belongings have a physical space where they belong can help you stay organized. If you feel overwhelmed, start with one room at a time, donating things you no longer use and finding systems that work for the things you have left.Reach out for help.Think back to that last list you made: the resources that are available to you. These might be community programs, alumni supports or people you have close relationships with. Now, think about the areas in your life where you could use a bit of extra support. How can you use your resources to build your strengths in those areas? Maybe you’re looking to get more physical activity, and could recruit a friend to be your gym or walking buddy. Perhaps you can utilize a free community credit resources to help get your finances back in order. Remember: we all need support sometimes, and reaching out for help is a strength, not a weakness.Set a sleep routine. What’s the key to good mental, physical and emotional health? For many people, it’s getting a solid night’s sleep. Tweek your routine so that you get the recommended 8 hours of shut-eye. If you are a parent, try to get the kids in bed earlier so that you can have some time to yourself, but still get to bed at a recent hour. If you have trouble sleeping, remember to shut down the screens and turn to an old-fashioned book or bath in the hour before bed.Decide to say no.Sometimes, what you say no to is just as important as the things you decide to do. Especially after a year at home, there’s a temptation to take every opportunity, but that can leave you overstimulated and overtired. Instead of diving back into everything all at once, choose a few meaningful (or preferred) activities to focus on. Set boundaries on things that stress you out, whether it’s joining the PTA or helping with carpooling. Remember, your time is one of your most valuable resources, and you get to decide how to spend it.It’s not a new year, but it is a new start in many areas of North America. At this junction you can decide what you want your fall and winter to be like, and what you would like to leave behind.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.
The Fix staff

What Is the Difference Between Street Fentanyl and Pharmaceutical Fentanyl?

1 month 2 weeks ago
Statistics regarding the number of overdoses and fatalities involving the synthetic opioid fentanyl continue to paint a grim picture in the United States. The Centers for Disease Control and Prevention released preliminary data showing that overdose deaths in the United States rose 29.4% in 2020 to an estimated 93,331, including 69,710 involving opioid drugs, mainly fentanyl. Every state has reported a spike or rise in fatal overdoses during the COVID pandemic. One prevalent issue is that the COVID crisis is now getting worse due to the abundance of illicit fentanyl and fentanyl analogues on our streets.Furthermore, the Centers for Disease Control and Prevention noted that drugs like fentanyl are the primary reason for a 38% increase in overdose deaths between May 2019 and May 2020. During that same time period, 18 U.S. jurisdictions with available data on synthetic opioids saw increases of more than 50%, while 10 Western states reported a 98% increase. Adding to mounting concerns is the reduced availability of treatment options due to the COVID-19 pandemic.Fentanyl continues to be at the heart of the overdose epidemic, mainly illicit but also in prescription form. Fentanyl analogues are made from raw materials originating primarily in China and manufactured and sold to the United States by Mexican drug cartels. Though both forms are extremely powerful and possibly lethal, variants found in illicit mixtures are far more dangerous and affect users differently.The prescription form of fentanyl is a Schedule II controlled substance, which means that the medication is considered a drug "with a high potential for abuse, with use potentially leading to severe psychological or physical dependence," as noted in the Controlled Substances Act, which is overseen by the U.S. Drug Enforcement Administration (DEA) and Food and Drug Administration (FDA). Prescription fentanyl is used primarily to treat patients enduring severe pain from surgery, cancer, or significant traumatic injuries.Illicit fentanyl comes from two sources: it is diverted from prescription medication and sold on the street, or manufactured from other chemical sources, and then sold. Diverted fentanyl can be obtained by extracting the drug from the patch and then converted to injectable form, or by prescriptions obtained illegally from a medical professional or a person with a valid prescription. While diverted fentanyl poses serious dangers to illicit users, the illegally manufactured form fentanyl has a myriad of ways to harm individuals. The raw materials produced in China are made without quality controls imposed on the pharmaceutical variety; two milligrams of the drug can be enough to cause a fatal overdose, depending on the individual's tolerance and other health factors. The DEA has reported seizing counterfeit medication containing 5.1 milligrams of fentanyl per tablet – twice the lethal amount and more than capable of killing multiple users.Even users who seek to avoid using fentanyl may inadvertently ingest the drug. Numerous state and federal investigations have found fentanyl used as a cheap additive to boost the potency of drugs like heroin, cocaine, MDMA (also known as ecstasy or molly), or methamphetamine. It has also been found in counterfeit analogues of prescription opioids such as oxycodone. Combining such potent narcotics in a single dose has caused fatal interactions in increasingly high and frequent numbers.Symptoms of fentanyl overdose are similar to those experienced with other narcotics: chest pain, labored breathing, vomiting, pale or bluish color to the face, fingernails, and lips. Seizure or unconsciousness frequently follows, and unless treatment is immediately sought and revival is attempted with the opioid overdose reversal drug Naloxone (Narcan), the afflicted individual can lapse into a coma or possibly even suffer a fatal overdose. Additionally, recent scientific data suggests that the toxic effects of fentanyl and its analogues may include compromised pulmonary function due to mechanisms not reversible by naloxone alone. Immediate comprehensive medical care is needed for every suspected drug overdose situation.How to combat this rising tide of fentanyl overdose? Although addiction is a multi-facet condition, Clare Waismann, a substance use disorder counselor, addiction specialist, and the founder of Waismann Method, an opioid treatment program and rapid detox center, believes that mental health care and medically assisted detox should be accessible not just to those who can afford it but also to those who are in need. In today's world, we are living through such an unsettling reality. Additionally, so many people have to deal with the trauma and consequences caused by COVID and its attendant restrictions— medical treatment for opioid dependence must be available in public hospitals along with necessary psychological support, says Mrs. Waismann. Additionally, we need a more substantial commitment to combating the rise of opioids, especially the influx of fentanyl to every corner of our country."We have the medical science and resources to help those suffering from fentanyl addiction. Now we need the right priorities." - Clare Waismann.
The Fix staff

The Gold Cure for Alcoholism

1 month 3 weeks ago
One of the most interesting aspects of the study of early addiction treatment is seeing that so many concepts which are believed to have been originated by AA and the modern disease theory were actually fully developed by the end of the 19th century. Another is that the battle between those who promote pharmaceutical treatments for addiction and those who promote spiritual solutions also dates back to the 19th century.The story of addiction treatment in the late 19th and early 20th centuries is a fascinating story of a battle between medical dogmatism, pragmatism, and profiteering. Orthodox medicine of the 19th century promoted the dogma that the only possible treatment for alcoholism or other addictions was confinement in inebriate asylums for years at a time, where inmates could be remade through moral therapy. The inebriate asylum movement got its start in the mid-19th century with the founding of the Binghamton, New York Inebriate Asylum (opened 1864) and the Washingtonian Home in Boston (opened 1857). The inebriate asylum movement, led by orthodox doctors specializing in mental disease, held that pharmaceutical treatments for inebriety were an impossibility and that inebriates could only be treated by moral means such as work and religion. Their stance was that pharmaceuticals were only to be used during detoxification, and sparingly even then.Then, in 1886, a Russian doctor named Nikolai M. Popoff published an article stating that when alcoholics were given injections of strychnine nitrate, they spontaneously stopped drinking in two to three days. The use of strychnine as a medicine may sound strange to 21st century ears; however, strychnine was an extremely commonly used medicine in the 19th century, one of its most common uses was as a cardiac stimulant.An English-language summary of Popoff's article was published in the May 1, 1886 issue of the British Medical Journal, and this summary was reprinted in countless English-language medical journals. Numerous other Russian doctors replicated Popoff's experimental treatment, and these were also translated and published in many English-language medical journals. However, the Quarterly Journal of Inebriety, America's only specialty addiction treatment journal during this era, pointedly ignored the Russian discovery and did not print a single word about it.However, a railroad surgeon and patent medicine salesman named Leslie E. Keeley, who lived in the dusty little prairie town of Dwight, Illinois, heard about the Russian cure, and decided to give it a try. Keeley had already been selling a patent medicine which he called the Double Chloride of Gold Cure for alcoholism since 1880. The main ingredient in Keeley's Gold Cure appears to have been tincture of red cinchona, and it is questionable how efficacious it was. It contained no gold. But when Keeley added the strychnine injections to his treatment regimen in 1886, he found that he had a miracle cure on his hands. Keeley found that calling his treatment the Gold Cure was a great marketing strategy, so he retained the name, although the treatment still contained no gold.Keeley, of course, never gave any credit to the Russians for the discovery of the cure. Instead, Keeley marketed the cure as a secret formula which he had discovered through years of painstaking research and experimentation. It was a motif which Americans ate up: the simple country doctor who solved a medical problem which had baffled the great and learned doctors on the east coast. The stories of Thomas Edison and the Wright brothers are examples of this same motif.At first, the news of Keeley's miraculous Gold Cure spread by word of mouth, then, in February of 1891, Joseph Medill, editor of the Chicago Tribune, published an endorsement of the Keeley Cure in his newspaper, giving it national publicity. Medill had initially been skeptical of the Keeley Cure; therefore, he had sent several of the worst drunkards in Chicago to Dwight for treatment in order to test the efficacy of the cure. All had returned to Chicago unable to drink whiskey. The floodgates broke, and by the end of 1891, Keeley was treating nearly 1,000 patients a day at Dwight. Subsequently, 126 Keeley Institutes opened worldwide, and at least 300 imitators popped up, running institutes which claimed to offer a gold cure which was as good as or better than Keeley's. By the time the Keeley Institute closed in 1966, half a million people had taken the Keeley Cure.The members of the inebriate asylum movement hated the Keeley Cure. The inebriate asylum movement had never been a success, only a few were ever opened. Moreover, their cure rate was only about 20% to 30%. Dr. Keeley bragged that his success rate was 95%. Although Keeley was clearly exaggerating, it is quite clear that those who completed a 28-day course of injections at a Keeley Institute were unable to drink whiskey when they left the institute, although some made an effort to overcome their aversion and eventually resumed their drinking careers. Many others used the initial treatment as a springboard to permanent abstinence from alcohol. Keeley graduates also banded together to form a mutual support group called the Keeley League, which had over 30,000 members at the height of its popularity. The members of the inebriate asylum movement mounted vicious attacks on the Keeley Cure in medical journals and the popular press; these attacks were, however, filled with specious arguments and logical fallacies. Rather than engage in debate, Dr. Keeley simply ignored them and laughed all the way to the bank.The Keeley Institutes began encountering some stiff competition when the Neal Institutes were opened in 1909. The Neal Institutes offered an early form of conditioned taste aversion therapy which paired an emetic with a drink of whiskey, causing the person to immediately vomit up the whiskey. Although vomiting when intoxicated does not create an aversion, vomiting while sober does. Later research at the Shadel Sanitarium in Seattle Washington in the 1940s would produce statistics which proved that this form of aversion therapy was highly effective for alcoholics. However, Dr. Benjamin Neal and the Neal institutes were satisfied in finding the treatment highly profitable. Whereas the Keeley Treatment took 28 days and required hypodermic injections four times a day, the Neal Treatment only took three days, and no injections were used. About 80 Neal Institutes were opened worldwide.Treatment demand fell precipitously around the time the US became involved in World War One (1917 - 1918), and most of the proprietary cure institutes had closed by the advent of national alcohol prohibition in 1920, although a few managed to survive. After the repeal of prohibition in 1933, many new proprietary treatment facilities such as the Samaritan Institutions and the HALCO institutes sprung up; however, these new institutes all relied on aversion therapy with emetics, which was simpler and faster than the strychnine cure. The Gold Cure was available in only a few surviving Keeley Institutes and by the late 1940s, the Keeley Institute in Dwight had abandoned the Gold Cure in favor of 12-step treatment.When I began researching the early proprietary cure institutes of the late 19th and early 20th centuries, I found that there were no detailed accounts of their history in existence. Most articles written about them had simply and uncritically repeated the diatribes attacking these institutes which had been published in the medical journals of the late 19th and early 20th centuries. Therefore, I felt compelled to write a detailed history of these immensely popular treatments. This required going back to primary sources, i.e., the newspaper stories, medical journals, pamphlets, etc. published during this era. A fascinating and previously untold story emerged which I have published in two books, Strychnine and Gold (Part 1) and Strychnine and Gold (Part 2). Each is over 400 pages in length, and they are available at Amazon.  
Kenneth Anderson

Why using fear to promote COVID-19 vaccination and mask wearing could backfire

1 month 3 weeks ago
You probably still remember public service ads that scared you: The cigarette smoker with throat cancer. The victims of a drunk driver. The guy who neglected his cholesterol lying in a morgue with a toe tag.With new, highly transmissible variants of SARS-CoV-2 now spreading, some health professionals have started calling for the use of similar fear-based strategies to persuade people to follow social distancing rules and get vaccinated.There is compelling evidence that fear can change behavior, and there have been ethical arguments that using fear can be justified, particularly when threats are severe. As public health professors with expertise in history and ethics, we have been open in some situations to using fear in ways that help individuals understand the gravity of a crisis without creating stigma.But while the pandemic stakes might justify using hard-hitting strategies, the nation’s social and political context right now might cause it to backfire.Fear as a strategy has waxed and wanedFear can be a powerful motivator, and it can create strong, lasting memories. Public health officials’ willingness to use it to help change behavior in public health campaigns has waxed and waned for more than a century.From the late 19th century into the early 1920s, public health campaigns commonly sought to stir fear. Common tropes included flies menacing babies, immigrants represented as a microbial pestilence at the gates of the country, voluptuous female bodies with barely concealed skeletal faces who threatened to weaken a generation of troops with syphilis. The key theme was using fear to control harm from others.Library of CongressFollowing World War II, epidemiological data emerged as the foundation of public health, and use of fear fell out of favor. The primary focus at the time was the rise of chronic “lifestyle” diseases, such as heart disease. Early behavioral research concluded fear backfired. An early, influential study, for example, suggested that when people became anxious about behavior, they might tune out or even engage more in dangerous behaviors, like smoking or drinking, to cope with the anxiety stimulated by fear-based messaging.But by the 1960s, health officials were trying to change behaviors related to smoking, eating and exercise, and they grappled with the limits of data and logic as tools to help the public. They turned again to scare tactics to try to deliver a gut punch. It was not enough to know that some behaviors were deadly. We had to react emotionally.Although there were concerns about using fear to manipulate people, leading ethicists began to argue that it could help people understand what was in their self-interest. A bit of a scare could help cut through the noise created by industries that made fat, sugar and tobacco alluring. It could help make population-level statistics personal.NYC HealthAnti-tobacco campaigns were the first to show the devastating toll of smoking. They used graphic images of diseased lungs, of smokers gasping for breath through tracheotomies and eating through tubes, of clogged arteries and failing hearts. Those campaigns worked.And then came AIDS. Fear of the disease was hard to untangle from fear of those who suffered the most: gay men, sex workers, drug users, and the black and brown communities. The challenge was to destigmatize, to promote the human rights of those who only stood to be further marginalized if shunned and shamed. When it came to public health campaigns, human rights advocates argued, fear stigmatized and undermined the effort.When obesity became a public health crisis, and youth smoking rates and vaping experimentation were sounding alarm bells, public health campaigns once again adopted fear to try to shatter complacency. Obesity campaigns sought to stir parental dread about youth obesity. Evidence of the effectiveness of this fear-based approach mounted.Evidence, ethics and politicsSo, why not use fear to drive up vaccination rates and the use of masks, lockdowns and distancing now, at this moment of national fatigue? Why not sear into the national imagination images of makeshift morgues or of people dying alone, intubated in overwhelmed hospitals?Before we can answer these questions, we must first ask two others: Would fear be ethically acceptable in the context of COVID-19, and would it work?For people in high-risk groups – those who are older or have underlying conditions that put them at high risk for severe illness or death – the evidence on fear-based appeals suggests that hard-hitting campaigns can work. The strongest case for the efficacy of fear-based appeals comes from smoking: Emotional PSAs put out by organizations like the American Cancer Society beginning in the 1960s proved to be a powerful antidote to tobacco sales ads. Anti-tobacco crusaders found in fear a way to appeal to individuals’ self-interests.At this political moment, however, there are other considerations.Health officials have faced armed protesters outside their offices and homes. Many people seem to have lost the capacity to distinguish truth from falsehood.By instilling fear that government will go too far and erode civil liberties, some groups developed an effective political tool for overriding rationality in the face of science, even the evidence-based recommendations supporting face masks as protection against the coronavirus.Reliance on fear for public health messaging now could further erode trust in public health officials and scientists at a critical juncture.The nation desperately needs a strategy that can help break through pandemic denialism and through the politically charged environment, with its threatening and at times hysterical rhetoric that has created opposition to sound public health measures.Even if ethically warranted, fear-based tactics may be dismissed as just one more example of political manipulation and could carry as much risk as benefit.Instead, public health officials should boldly urge and, as they have during other crisis periods in the past, emphasize what has been sorely lacking: consistent, credible communication of the science at the national level.Amy Lauren Fairchild, Dean and Professor, College of Public Health, The Ohio State University and Ronald Bayer, Professor Sociomedical Sciences, Columbia UniversityThis article is republished from The Conversation under a Creative Commons license. Read the original article.
Amy Lauren Fairchild

Substance Use Disorder Can Complicate Grief

2 months ago
In the past eighteen months, more than four million people around the globe have died from COVID-19. This massive loss has shined a spotlight on a normal, but painful, part of daily life — grief. Grief can occur for a variety of reasons: you can grieve the loss of a relationship, or the end of a career. However, the most acute and deep grief often comes around death.Although there’s no prescriptive way to move through grief, there are healthy ways to process loss. If grief begins interfering with your daily functioning and keeps you from healing, you may be experiencing complicated grief. This condition can have a big impact on your life, and often requires medical treatment.Here’s what you should know about grief, especially if there is a history of substance use disorder in your family.Substance Use Disorder and Grief: Risk for ComplicationsGrieving can be incredibly painful. That often leads people to look for coping mechanisms to get through. This can be problematic for people who have a history of substance use disorder. Research has shown that people who have a history of addiction are more likely to experience complicated grief, the type that keeps you from moving on and healing. In addition, when people with a history of substance use disorder experience complicated grief, they’re more likely to turn toward maladaptive coping strategies, like using drugs or alcohol.If you experience a loss, you should try to be proactive about maintaining your sobriety while you are grieving. Talk to trusted loved ones and medical professionals about how to cope with the pain of grieving if you are struggling. Have an emergency plan so that you know what to do if you’re very close to relapse, or if you have used.The Stages of GriefMost people have heard of the five stages of grief. Although people don’t move through the stages in a predictable manner, the stages can help normalize how you feel when you’re grieving. This alone can be helpful, reminding you that many other people have been through what you’re experiencing.The five stages of grief, as explained by researcher Elisabeth Kübler-Ross, are:Denial: When you first experience a shocking loss, you might not be able to comprehend it. The denial phase is characterized by feeling numb, and focusing on just getting through each day.Anger: As you begin to understand the depth of your loss, you may become angry about it. You might feel abandoned by God or the universe, or that the loss is unfair. Although anger might feel like a surprising emotion while grieving, it’s important to feel your anger and move through it.Bargaining: During the bargaining phase, you try to exert control and change the outcome of the loss. You might find yourself saying things like, “I’ll stay sober, as long as I get my mom back.”Depression: At this stage, the reality of loss has settled in. You’ve realized that you can’t bargain a solution or rail against the injustice of the loss. You settle into depression, which may put you at increased risk for relapse.Acceptance: Finally, after moving through the pain of grief, you might find yourself coming out the other side. You may notice that you’re remembering your loved one with joy and gratitude, rather than just focusing on the pain of losing them.The New, Sixth Stage of GriefRecently, David Kessler, a grief expert who worked with Kübler-Ross, introduced a sixth stage of grief: finding meaning. To truly heal from a loss, you must find a way to create a meaningful life, living in a way that honors the person you loved and the meaning of their life.This sixth stage is especially important for people who have a history of substance use disorder. In healing from addiction, it’s important to create a meaningful life. This can give you the impetus that you need to stay sober. Focusing on the components of a meaningful life — self-awareness, positive relationships, and intrinsic motivations — can support you in overcoming grief in a healthy way.A Hand to Hold: When to Get HelpGrief can become overwhelming. Communicating with your healthcare providers and your recovery community can help you navigate the grieving process. However, if you experience any of the following, you should reach out for more immediate help:An inability to recall good, happy memories about your loved one.Being unable to acknowledge or accept a lossHaving thoughts of self-harm or suicideThinking frequently about drug or alcohol use or relapse.Grief never goes away entirely. However, you can learn to incorporate grief and memories into your life in an emotionally healthy way, remembering what was, while continuing to live your life in the present and future.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.
The Fix staff

How the media may be making the COVID-19 mental health epidemic worse

2 months ago
Since the pandemic began, anxiety rates in the U.S. have tripled; the rate of depression has quadrupled. Now research is suggesting the media is part of the problem. Constantly watching and reading news about COVID-19 may be hazardous for your mental health.We are professors who study the psychological effects on people caught up in crisis, violence and natural disasters. COVID-19 surely qualifies as a crisis, and our survey of more than 1,500 U.S. adults clearly showed that those experiencing the most media exposure about the pandemic had more stress and depression.It’s understandable. The intimations of death and suffering, and the images of overwhelmed hospitals and intubated patients can be terrifying. COVID-19 has created an infodemic; members of the public are overwhelmed with more information than they can manage. And much of that information, especially online, includes disturbing rumors, conspiracy theories and unsubstantiated statements that confuse, mislead and frighten.Stress worse for some than othersA June 2020 study of 5,412 U.S. adults says 40% of respondents reported struggling with mental health or substance use issues. This finding did not address whether respondents had COVID-19. Since then, some people who had COVID-19 are now reporting mental health issues that appeared within 90 days after their illness subsided.Taking care of a relative or friend with the virus might result in mental health problems, and even just knowing someone with COVID-19 can be stressful. And if a family member or friend dies from it, anxiety and depression often follow the grief. This is even more likely if the individual dies alone – or if a memorial isn’t possible because of the pandemic.Essential workers, from hospitals to grocery stores, have a higher risk for COVID-related mental health problems. This is particularly true for health care workers caring for patients who ultimately died from the virus.[Get facts about coronavirus and the latest research. Sign up for The Conversation’s newsletter.]Black and Hispanic adults also report more mental health issues, including substance abuse and thoughts of suicide. Having access to fewer resources and experiencing the systemic racism running through much of U.S. health care may be two of the factors. The COVID-19 pandemic also intersected with episodes of police violence toward Black Americans. This alone may have exacerbated mental health problems.Children, young adults and college students also show comparatively worse mental health reactions. This could be due to the disconnect they feel, brought on by the isolation from peers, the loss of support from teachers and the disappearance of daily structure.Setting limits essentialStaying informed is critical, of course. But monitor how much media you’re consuming, and assess how it affects you. If you are constantly worrying, feeling overwhelmed, or having difficulty sleeping, you may be taking in too much COVID media. If this is happening to you, take a break from the news and do other things to help calm your mind.Parents should frequently check in with children to see how they are affected. Listening to and validating their concerns – and then providing honest responses to their questions – can be enormously helpful. If a child is having difficulty talking about it, the adult can start with open-ended questions (“How do you feel about what is happening?”). Reassure children that everything is being done to protect them and discuss ways to stay safe: Wear a mask, socially distance, wash hands.Finally, you can model and encourage good coping skills for your children. Remind young people that good things are still happening in the world. Work together to list healthy ways to cope with COVID-19 stress. Then do them. These activities will help your children cope – and it will be good for you too.J. Brian Houston, Associate Professor of Communication and Public Health, University of Missouri-Columbia and Jennifer M. First, University of Tennessee, College of Social Work, University of TennesseeThis article is republished from The Conversation under a Creative Commons license. Read the original article.
J. Brian Houston


2 months 1 week ago
Tara had the body of a runway model with thick blond hair that cascaded down her shoulders to the middle of her back. We had become good friends, pulled together like magnets by our mutual brokenness.It was the late sixties, I was sixteen when Tara and I were sitting on the bleachers together at school. I was etching my initials into the soft, splintery wooden bench with a paperclip. I knew better than to leave my entire name amongst the other scattered names, initials and drawings of hearts or it could be used against me later on.“Look at those stupid girls,” Tara said, glaring off into the distance.“Which ones?” I followed her gaze.“All of them. Those snobby bitches make me want to puke.”She was referring to the loud, happy teenagers sitting on the grass eating their lunches. Some had their hair piled up in beehives, held together by copious amounts of hairspray, while others had short bobs that flipped at the ends. I didn’t think any of the girls were intentionally trying to arouse our envy, but that’s exactly what they did.“Fucking clueless bitches,” I said.I was trying my best to stay out of trouble when Tara made this announcement: “I’m going to run away.”“Really? Why?” “I hate my step dad.” I knew Tara’s mother had recently remarried and the new hubby was strict.“That bad, huh?”“He’s trying to tell me what I can, and can’t do, and he’s not even my dad.”Silence. Then I said, “I’ll go with you if you run away.”“Really? You would do that?”I wanted to show her what real friendship looked like, but I also wanted to get away from the constant drama and craziness going on at home. “Of course,” I said, like it was a no brainer.“Where would we go?”Staring off in the distance I spotted a girl with two long braids, dressed in a bright orange tie-dyed, t-shirt. “We can see where the open road takes us.”Tara and I met by the flagpole in front of school the next day. I was dressed in bell-bottom jeans and a sweatshirt. I’d also brought a back pack stuffed with a toothbrush, a change of clothing and a dozen Twinkies in case we got hungry. Tara was wearing a cool brown rawhide jacket with fringe that hung from the back of her arms like wings. “You sure you want to do this?” Tara’s forehead was crinkled up.“Totally.”That was it. An hour later we were standing on the Pacific Coast Highway with our thumbs out. It took less than five minutes before a green and white Volkswagen van with flowers and a peace sign pulled over. Tara climbed in the back and I got in the front. Instantly I was hit with the smell of stale cigarette smoke and Patchouli oil. Strands of beads hung from the rear-view mirror. The driver was a guy with long brown hair, a straggly beard, and a rawhide vest worn over a linen shirt.“Where you girls headed?” he asked.“That way.” I pointed in front of me.“Well, what a coincidence. I’m going that way too,” he smiled.“Groovy.”“My name is Jeff by the way.”We told him our names.“We just ran away from home,” Tara blurted out.Jeff tilted his head sideways. “Oh really? Runaways?”“Our parents suck,” I said, as if no other explanation was needed.“I dig it man. I left home when I was seventeen.”“Wow. That’s really cool,” Tara said.As we drove up the coast, I watched the waves reaching up like fingers on the shore. I loved everything about the ocean. The mere sight of it could put me at ease. When we came to a red-light Jeff hit the brakes causing empty bottles and beer cans to roll forward from underneath the seat.“Looks like you had a party,” I said.“Oh yeah, sorry about that.”“No problem.”The salty wind was whipping my hair in my face.“What do you do Jeff?” Tara said, leaning forward.“I’m a singer-songwriter.”I liked the sound of that. He seemed like a free spirit.“Right now I happen to be living in the caves.”“What caves?” Tara asked.“In the canyon.”“I’ve never met a cave man before,” I smiled.“You chicks are welcome to come check it out.”Looking around Tara gave an enthusiastic nod.“Yeah. Okay,” I said.A few minutes later the bottles and cans crashed again as we were made a sharp right turn. Topanga Canyon Boulevard was a narrow, windy road, curling through the burnt orange Santa Monica Mountains. As we drove deeper into the canyon, I stuck my head out the window, causing my hair to windmill in my face. The chaparral-covered hills with steep rock out-cropping’s were breathtaking. I gazed down at the creek that rushed over massive boulders and rocks below. The raw beauty and energy of it all caused my blood pressure to drop a good ten points.Pulling my head in, I asked Jeff. “Are we still in L.A?”“Yup.”“I never even knew this place existed.”“Topanga is a well-kept secret,” Jeff smiled.“Well, I’ve had plenty of practice keeping secrets in my life,” I said.“Haven’t we all,” Jeff said, in a matter of fact tone.The van pulled onto a sliver of dirt by the side of the road. “Here we go ladies.” Jeff reached over and picked up his bag.Tara and I grabbed our backpacks and crawled out of the van.“So, where are the caves?” I asked.Jeff pointed. “Down there.”“Looks sort of dangerous.” Tara’s face was all scrunched up.“I climb it every day.” Jeff swung his long leg over the guardrail.Tara and I followed, dropping down onto a narrow clearing that was being strangled off by a thick layer of prickly underbrush and plants. Beyond the ledge was a dramatic drop into what seemed like a dark abyss.“Oh shit,” I said.“I know. I know,” Tara said.“If you start to lose your balance grab onto something,” Jeff said.“Have you ever fallen before?” I cupped my hands over my mouth.“Just once….” he said, without stopping.As we made our way down the loose dirt started to slip beneath us.“Watch out for poison ivy,” Jeff yelled.“What’s it looks like?”“Red and orange with almond shaped leaves.”All of a sudden I lost my balance and fell. I grabbed a handful of shrubbery to keep myself from going further down the hill. I pushed myself up and dusted the dirt off my butt. We see-sawed down the embankment. In some places it was so steep I had to sit down and scoot along on my butt.Out of breath we finally made it to the bottom. I noticed how everything was super quiet except for the water gushing in the nearby creek. The smell of sage and pine hung in the air. “Wow. It’s so quiet here,” I said to no one in particular.“This way, girls.” Jeff wanted us to keep moving.Dry leaves and twigs crunched beneath our feet. I turned to Tara and said, “How the hell are we going to get back up?”“Can’t go up when it’s dark that’s for sure,” she said.As we followed the creek downstream, Jeff abruptly stopped in front of a huge gray boulder. “Camp is on the other side of this,” he said, patting the rock with his hand. My neck craned as I gazed upward. The boulder was the size of a small house.“But how do we get over?” Tara asked.“Just watch me, and do the same thing.” Jeff started to climb with a surprising agility for a man who had to be over thirty. He used the tips of his fingers and toes to shimmy up the side. He made it look so easy, and seconds later he was at the top, cupping his hands over his mouth, he yelled, “Okay, girls, come on up. One at a time.”Tara went first. I bit my lip as she snaked her way up the side. I was afraid she would fall and break a bone. Then what? But Tara didn’t fall and when she made it to the top, I let out a long sigh of relief.“It’s not as hard as it looks,” Tara said, cheering me on.My heart was pounding as I inserted the tips of my fingers into the same dusty crevices that they had both used. I felt the hard, unrelenting rock beneath the front of my body. The toes of my sneakers found a small ledge as I reached my right arm overhead, searching for the next crack. When I found something to hold onto, my thigh and calf muscles tightened as I pushed myself up a few more feet. Reaching with my left arm to a crevice, I pulled myself up again. Twenty pounds over my ideal weight, and a half-pack-a day-smoker, I quickly became out of breath. When I made it the top, I felt a great sense of satisfaction.Standing next to Tara and Jeff, I gazed down at a waterfall with dark water gushing out from between two rocks. I was surprised to see a bunch of naked hippies standing waist high in a swimming hole with a crescent slice of sand encircling a private beach. It was the first time I had seen so much exposed flesh in one place. Embarrassment rippled up my spine. I had to look away.A guy with his dick dangling between his thighs yelled, “Who are your friends, Jeff?”“They’re runaways,” he said.“Well, come on in girls,” Dick man said. “The water is refreshing.”“Ah… No. I’m good, but thanks,” I replied, holding up my hand.We kept descending the boulder, but getting down was much easier than going up. Toward the bottom, I pushed off and landed with a thud on the crunchy gravel. I noticed the shallow caves Jeff was talking about at the base of the jagged mountain. Each opening was stuffed with a sleeping bag and scattered articles of clothing. I could see why all the hippies would want to stay there. It was the ideal place to live off the grid.A big-breasted girl with hair the color of chocolate fondue was stirring a pot over an open fire as smoke drifted toward the sky.“Do you girls want some of my special brewed cowboy coffee?” she asked.“Sure.” I shrugged.Tara and I sat on a log in front of the fire.“How did you guys meet Jeff?” she asked.“We were thumbing it on PCH.”“Groovy.” She stirred the simmering liquid in the pot. “They call me Sunshine around here.”“Do you have parents Sunshine?” Tara asked. “I mean, how do you live down here?”“My parents were always up my ass, so I ran away.”“Yeah, my parents were up my ass too,” Tara said, nodding.A few minutes later Dick man came and sat on a rock, his flaccid penis nearly touching the ground. I averted my eyes as Tara dug her elbow deep into my ribs.“Hello ladies.” He smiled.Making sure to avoid the penis I gazed just over his head.“Welcome to our casa,” he said, smiling directly at Tara.Minutes later Sunshine pulled out a fat joint. It was getting late and the sky had an orange, pinkish glow. By then all the other hippies were joining us. When the pot came around to me I took a hit. The smoke was harsh and burned the back of my throat. Coughing, I passed it on to Tara.As we got buzzed, we listened to stories while the sound of water fell over rocks a few feet away. Smiles emerged in the blurry orange light from the flames. A half-gallon of Red Mountain wine got passed around and everyone took swigs directly from the bottle.I had a good buzz going on when one of the younger guys started playing his guitar and singing, Heart of Gold, by Neil Young. My shoulders swayed to the sound. The sweetness of his voice coaxed everyone else to join in. We all knew the song and it sounded like a chorus bouncing off the canyon walls and reverberating into the ethers.I want to live.I want to give.I’ve been a miner for a heart of gold. …The words never felt truer to me than they did in that moment.We stayed up until the fire started going out. Some of the people said goodnight before drifting off into the blackness. I watched in horror when Dick man took Tara by the hand and guided her to his cave.Suddenly, I was struck with fear. Where am I going to sleep? As if reading my mind Jeff said, “You’re welcome to share my sleeping bag.”I put my palms closer to the fire and took a deep breath. “Okay. Cool,” was all I managed to say.Jeff stood up and I watched him walk away.A jittery feeling took over my entire body.I was trapped. While I had let plenty of guys feel me up or put their fingers inside me I hadn’t actually gone all the way with anyone yet. I was afraid Jeff might want to have sex. After all, weren’t the hippies all about having free love?A few minutes later I found myself fully clothed worming my way into Jeff’s sleeping bag. And while I might have had sex with him had he tried, Jeff only went as far as holding me in his arms. What I remember mostly was how the moon shone like a bleached oyster shell and the zillion silvery stars, flashing like sequins on a black velvet cocktail dress in the sky.“Gorgeous right?” Jeff said.“It’s, it’s so beautiful.” Jeff may not have noticed, but tears had welled up in my eyes. With a mind like a finely-tuned torture-device, it was rare for me to notice such beauty. As I drifted off to sleep, I wondered if my Dad was looking for me, but eventually my entire body merged with the blackness of the night. Excerpted from Incorrigible: A Coming-of-Age Memoir of Loss, Addiction & Incarceration by Wendy Adamson, available now at Amazon and elsewhere.
Wendy Adamson

Did You Fail Treatment, or Did Treatment Fail You?

2 months 1 week ago
The inability to complete treatment for addiction or remain sober after treatment can have a damaging impact on the individual seeking recovery. Failure, for whatever reason, in recovery can leave those struggling with addiction with a host of negative emotions and thoughts (also known as "stinking thinking" ): people might think that because they failed drug treatment, they are also incapable of succeeding in other areas of their life. They might also start believing that recovery programs are not a solution to addiction and there's no point in trying other treatment programs. Such thoughts can place an individual fresh from recovery in a precarious position that, in many cases, can lead to relapse and further danger to their physical, mental, and emotional wellbeing.One significant component of the unsuccessful result of those in treatment is the overinflated promises attached to it. When those struggling with addiction or their loved ones call treatment centers, they are often oversold by the treatment professional or facility. Patients may believe that treatment is a "golden ticket" to instant sobriety, mental health healing, social rehabilitation, and more, without further work on their end once they leave the facility. Usually, this inaccurate message is not delivered with malicious intent on the part of the treatment provider, but more often than not, due to a lack of complete information and a need to affect positive change in a manner that may not be immediately available to both provider and patient."I believe it's really important for us as treatment providers to be realistic about what we can and cannot offer," says Clare Waismann, RAS/SUDCC and founder of WAISMANN METHOD®, an opioid treatment program and rapid detox center, and Domus Retreat on a recent episode of the Waismann Method podcast. "When patients say, 'I failed treatment so many times,' more often [than not], the treatment failed them. They failed the treatment because they and their families were promised that their personalities would change, their lives and their realities would change, and their mental health issues would be solved. So I think it's really important [for] treatment providers to tell [patients] exactly what you will be provided, exactly what your ability is as a provider, and what their responsibility [will be] not only during treatment, but after treatment."What creates these inaccurate narratives between patient and treatment professional? The issue is often due to a lack of clarity regarding each individual's unique needs and the scope of what a recovery treatment can actually provide. Outlining the limits of a program and managing realistic expectations can be vital to connecting a patient with subsequent success. "My goal is to give people real, personal insight into some of the specific things that are causing [the] compulsivity," says David Livingston, LMFT and psychotherapist at Waismann Method, who joined Clare on the podcast. "And then we try to put together a plan that will address that. That often includes continued therapy, and we go through the positives and negatives­­­ of that. I'll even talk about the 12-step [programs]. I try to give them a realistic understanding of what treatments, the difficulties [that are inherent] in them, and what [they] need to look for in terms of finding and sustaining a successful treatment."Another stumbling block for treatment professionals is the "one-size-fits-all" theory regarding recovery. For Waismann, this idea that one single recovery track applies to all patients is a "red flag." As she notes, "You're not treating the condition, you are treating a patient. Not every treatment is effective for everybody. People tend to push patients to receive what they have to offer. That's a mistake. It's really important to hear the patient's history and needs, and make sure that they – and you – know that there are different options."Hand-in-hand with this peg-and-hole approach is the idea that treatment will completely "cure" the patient. "That's impossible," says Waismann, who notes that this particular perspective will always lead to unrealistic expectations that prove disastrous for patients and professionals. "Individuals often feel unseen, when professionals focus on a certain (addiction) diagnosis." she says.As patients and families search for a solution in the face of an often challenging and intense situation, they lack an understanding of their condition, which causes them to lose the ability to distinguish credible from unreliable sources. Additionally, vulnerable situations lead people to seek hope or the impossible-to-guarantee promise of a positive treatment outcome, however unlikely those outcomes may be. "If you're just getting pushed into things that don't make sense to you, that don't feel helpful to you, and that you're resenting, that will drive up your frustration," adds Livingston. "I don't see that as productive treatment."Livingston also suggests that the failure to provide a complete picture of recovery expectations – which sometimes involves challenges after treatment – can also lead to inflated expectations. "Compared to most [facilities], we have a shorter program, because we get people detoxed quicker, and they feel better faster," he says. "That is really the strength of our program. We do it to try and minimize the length of suffering involved – a suffering that I see as neurotic suffering because it does not help you grow. It's just suffering to get something done that needs to get done."After the detox, the next level of work begins, and it's here that Livingston notes that attention and flexibility can produce actual results. "We go a step at a time addressing the most relevant needs as they surface," he says. "If you understand what those needs are, and you're not loading them up on your own program, and you're talking about the limitations [of the program], it's a great comfort – it actually aids in the treatment. "What's therapeutic for them is that patients actually feel what it means to have their needs met and to have a handle on their lives. But [as a therapist], you have to do your part and delineate and specify what exactly [needs to be done], and then make sure it's getting done."
The Fix staff

Oh No, Is He Talking About God Again?

2 months 2 weeks ago
One of the bigger issues in the recovery community is the idea of god. Is a belief in one necessary to getting clean and sober? If so, does that god have to be one spelled with a capital “G,” as it is in The Big Book, or a lower-case “g” that allows for a more open dialogue? The following is excerpted from Writing Your Way to Recovery: How Stories Can Save Our Lives.Chapter SixOh No, Is He Talking About God Again?My sponsor hates it when I talk about feeling like an agnostic, or an atheist, or just conflicted and confused. He definitely believes in God, capital “G” and all. But you know I’m not so sure about god. In truth I had, and sometimes still do have, a lot of trouble with the concept of a higher power.For a lot of us the god part of A.A. was a roadblock we had to navigate around if we wanted to remain in the fellowship and stay sober. Unfortunately quite a few of us had religion shoved down our throats as children, typically of the sort that damned you for being who you were. Then we showed up at our first meeting, and boom, it’s god all over again. Not so oddly the statistics say A.A. loses a large percentage of newcomers due to its thinly veiled Christianity.I grew up in a very conflicted household, especially when it came to religion. My mother was a quasi-Catholic-sometime-Protestant that would force us kids to go to church on a not so regular basis. My father was a Marxist. On Sunday, he’d say, “you can go to church if you want, but I’m going out to hike in the woods and then eat doughnuts and drink hot chocolate. You want to go, too?”I’m laying odds you could easily guess what a six-year-old wanted to do more than go to Sunday school. So every time I read “God” in the Big Book I’d think of my dad. Which brought up all those old conflicting feelings of wanting to please an authority figure as opposed to rebelling.In the beginning I had a sponsor I would later learn was what they called a “Big Book Thumper,” and he didn’t really care or understand my issues with religion and god. Anytime I expressed doubt and a lack of faith he would tell me to read, “We the Agnostics” because he said, “A.A. is a spiritual, not a religious program.” But then two seconds later he was telling me I had to pray.As a newcomer it seemed impossible to separate religion and spirituality.So what does all this talk of a higher power and spirituality have to do with writing your way to recovery? Well if you read a lot of addiction memoirs, or just memoirs in general, you’ll notice there’s a connecting tissue that most of them have. Memoir often embraces seemingly un-embraceable subjects such as death, loss, illnesses, catastrophes, squandered opportunities, horrific events, addiction, broken dreams, and then chronicle the protagonist’s ability to overcome adversity and persevere.But the memoirs that really resonate are when the authors reflect on their “journey” and use their story as an opportunity to look inside themselves. It’s not just everything that they have experienced, but how everything has helped change them into who they are today — the person that is writing the memoir. That “internal change” is by definition spirituality, “the quality of being concerned with the human spirit or soul.”Whew, that took a long way to get here, right? Okay so again, you may be wondering, what the hell is he talking about now? And if I haven’t lost you yet, here it is. Spirituality is not just what we need in a memoir; it’s also what we need for our program of recovery.Yet for me the concept of spirituality was a bit too ambiguous. Okay, so it’s not god. It’s not religion. It’s... oh shit, I don’t know what the hell it is.Then one sunny afternoon I was driving on the freeway in Los Angeles and I passed a broken down and very overloaded station wagon on the side of the road. The hood was up, gray smoke billowing out, and a family huddled together on the shoulder. For a nanosecond I locked eyes with the mother as she hugged her child and I swear I could feel her sadness and absolute despair.I was hemmed in between two lanes of speeding traffic and I couldn’t stop to help. Yet the fear in that woman’s eyes haunted me and I remember thinking, let those people be all right. Let that woman get her kids home safely.Now that might not seem like a big deal to you, and I understand. But for someone that used to drive by similar situations and think, better you than me, sucker, it was a huge departure. And in that moment I came that much closer to understanding spirituality. It wasn’t that I had to attain nirvana, or make some magnanimous gesture, or even perform a miracle. I just had to give a shit about someone other than myself.Chapter SevenGod? Not God?Like Patrick, I had trouble with God. Since the ripe old age of seven, when my mother was arrested and thrown in jail, I sat on the lawn outside our apartment complex, looked up at the sky, and cursed Him. Or Her. Or It. I think I actually said “fuck you,” fully expecting to be struck dead by lightening. It didn’t happen. And in the mind of a child this was only further proof that He didn’t exist. And if He did, as my older sister firmly believed and tried her best to make me believe, then what sort of God was He to allow our mother to be taken from us?So began my life as an atheist, or, at best, an agnostic.Believing or not believing in God didn’t seem to present any problems for me until my forties. I got by just fine on my own, or so I thought, because by then I was a total mess. Nevertheless, when I first walked into the rooms of Alcoholics Anonymous, the “God thing” almost sent me running. By now I’d come to accept that I was “powerless over alcohol,” and when push came to shove, though I resisted it for as long as I could, I also eventually had to admit that my life had “become unmanageable.” Of course this is the First Step in A.A. and there’s no point in attempting the next if you honestly don’t think that you’ve fucked up just about everything in your life because you couldn’t stop drinking and drugging.But that Second Step?It says that we have to believe in a “Power greater than ourselves,” and it capitalizes the P in power, which is a dead giveaway that it’s referring to God, thereby assuming that God exists. And that, as I said earlier, was a problem for me. Actually it’s a problem for a lot of people, and I’m not just talking about A.A.Patrick wrestles with this same issue, empathizing with those who had “religion shoved down [their] throats as children,” predisposing them to later reject god. Especially the one spelled with a capital G. Even today, with 20 years of sobriety, his definition of spirituality continues to evolve.I understand that. I respect that.In time, however, I changed, but this doesn’t mean that I don’t or can’t still identify with those who either downright don’t believe in a God or are struggling to embrace one. For me the change occurred slowly, over a period of a couple years, when my sponsor kept after me to pray, to whom or what didn’t matter, just pray, even if I only saw it as a one-sided conversation with myself.“Open your mind to the possibility of a God,” he said. “That’s all I’m asking. And when you pray, keep it simple. At night, if you got through the day sober, hit your knees and say ‘thank you.’ And in the morning, when you wake up, hit your knees and ask for ‘the strength’ to do it again. What’s that take out of your day? Thirty seconds? A minute? Don’t tell me you can’t do that.”Allowing for the possibility of a God involves an openness toward faith, and as the sober days began to accumulate, the simple act of prayer combined with a little faith eventually turned into a belief in God. Once that happened, the conversation was no longer one-sided. Obviously it’s more complicated than this, requiring much soul-searching and willingness, confronting looming questions and doubt, but it’s how the process began for me.But that’s just me.What about you?Is there a God, and, if so, who is He or She or It?***In two-to-three pages, describe the God of your own understanding. Do you picture Him as Christians picture Jesus? Is He or She or It different than the God of traditional world religions? Do you see this Power in terms of Mother Nature? The Great Spirit? The Collective Consciousness of Human- kind? Does It defy personification? What strengths, virtues and qualities does your God possess? Kind- ness? Love? Is He forgiving or punishing or both?For the non-believers, for the sake of argument, if you were to have a God, what would you like Him or Her or It to be? Again, you don’t have to believe in a God, but you do have to pretend that if by some chance there was one, what might He or She or It mean to you? What would be Its strengths, virtues and qualities?What we’re after with this exercise is nothing more than a better grasp of a God of our own understanding. And we do it by articulating and describing who and what He or She or It means to each of us. Writing Your Way To Recovery: How Stories Can Change Our Lives, by James Brown and Patrick O’Neil, is now available on Amazon and elsewhere.
James Brown

How to Change Your Life with 3 Daily Habits

2 months 3 weeks ago
“If you are someone who has struggled with addiction, you are excellent at forming habits.”The first time my friend Dr. Darlene Mayo said that sentence to me, I was a little taken aback, and very intrigued. She was right: addicts are great at forming habits, and that propensity, when applied for good, can be life-changing.During our conversation on The Recovered On Purpose Show, I shared with Dr. Mayo the story of my past as a homeless heroin addict, and my present as someone seeking to change other people’s lives through the power of the lessons I’ve learned on my journey to recovery.I wanted to know if building solid habits was one of the keys to unlocking the kind of life I had always dreamed –– the kind of life I built for myself, and wanted to help others build as well.And Dr. Mayo, neuroscientist and neurosurgeon who has spent decades studying the brain and how it’s wired, was absolutely right.Don’t get me wrong, this isn’t my way of glamorizing addiction. My addiction ruined my life, and it was only when I realized I had nothing left to give but my life that I resolved to turn my life around. However, if Dr. Mayo’s wise words, and the habits I’ve built on my path to recovery, can ring true for even one person, it will have made my journey worth it.My StoryWhen I was 26, I had it all: a 2,400-square-foot ranch home 10 minutes from the Central California beach, a girlfriend, a motorcycle, two cars, and a dog. My sales job working for DirecTV provided me with a comfortable living on about 25 hours a week, so I had plenty of time to do what I loved, like taking my girlfriend out on dates, swimming in the ocean, riding that motorcycle…And shooting up with heroin.At this point, my habit of shooting up before going to work and then shooting up when I got home hadn’t taken over my life. In fact, no one noticed anything was off. I was able to maintain my lifestyle, my home, and my relationships, and I thought I was truly capable of having it all.A year later, when I was 27, I had lost that job, my house, all my vehicles, my girlfriend, and the dog. I was living on the streets – I had been kicked out of homeless shelters – and was severely underweight. Three years ago, I realized I had nothing left to give my addiction and resolved to get clean.But, as I’m sure you know, that’s much easier said than done.I got clean and sober in November 2017, and stopped smoking cigarettes a month later. Since then, I’ve built an online following of over 40,000 people, run a mile in under six minutes, published a best-selling autobiography, and created a seven-figure company.But between 2017 and now, and between the lowest low of my addiction and the height of my success (so far), there was one key component that shaped my future:My habits.The Habits that Changed My LifeWhether you want to recover from an addiction, a breakup, a psychological or spiritual upset, or just want to re-set your life, cultivating new habits to replace the old, negative cycles you’re used to is a lifelong practice. These three habits changed my life – and they’ll change yours too.Prioritize LearningWhat are you interested in? What are you passionate about? Where in your life do you feel you’re lacking? Once you answer those questions, you’re well on your way to understanding what you should be learning about in your free time. Not only is lifelong learning a great practice for your mental health and agility, it also ensures you stay humble. No one can possibly know everything about everything, after all.If you don’t have time to read, or know you take in information better through other means, that’s okay. We all learn and grow differently; the important thing is that you intentionally set aside time – at least 10 minutes – every day to invest in your growth.Invest in Your MorningsThere’s a reason why morning routines are hailed by successful people all over the world as the key to unlocking your potential: you can spend your morning hours taking control of your day and investing in yourself before even starting to serve other people.There’s no right or wrong way to craft your perfect morning routine; it all depends on your priorities and what you know is healthy for your mind, body and spirit. These are a few of the things I’ve incorporated into my morning routine:Brushing my teethMaking my bedDrinking lemon-flavored salt waterTaking vitamins and supplementsReading my BibleJournalingGoing to the gymI also practice what I call the “list of six” every night. Before bed, I write down six things I want to do in the morning before my work day starts. My brain will work on them while I sleep and I’ll be ready to go the moment my eyes pop open the next morning.Invest in YourselfYou’re no good to anything or anyone if you don’t take care of yourself first. And, while mastering yourself through self-discipline, healthy eating, exercise and more are all important, taking an hour a day to have fun and unwind is equally so.I think we overestimate how much one hour will take away from our schedules, and underestimate what one hour can do for our lives. Setting aside time dedicated to enriching your spirit and bringing you joy is a great habit to establish, not only because it staves off burnout, but because everyone needs fun in their lives.
Adam Vibe Gunton