Thursday, February 6, 2014

Addiction, part deux

First of all, let me just say thank you from the bottom of my heart for the response to the original post I wrote earlier this week about addiction.

I wanted to clear up a few things, answer a few questions and address a few issues in the wake of it. I wrote it initially because the words just needed to get out of my head. I've told quite a few people that I really don't even feel like I wrote it, I was just the person attached to the fingers that typed it out. It came from my soul.

The difficulty in writing something like this is that I wrote it for my own reasons, which are related to my own personal experiences with addiction in many different forms. I never wrote it thinking for even one second that it would go viral. It was not done to capitalize on the moment, it was not even a celebration of PSH as an actor, though I will miss his contributions to the industry. It was a response to the way people reacted. The assumptions made about him. The assumptions made not just about him, but about everyone out there struggling the same way he did.

It wasn't about him at all, really. It was about the addicts I have known and loved. It was about the people I have known, the struggles I have witnessed. The demons in my own head.

His death just forced all that to the surface for me.

There are a few things that I wanted to clarify, that I probably should have written more in depth about at the time but didn't either because I didn't think about it at the time, or I did and chose to try and condense my words.

The greatest of which is the issue of what causes addiction, something we may not ever have clear and convincing scientific evidence of. We see what we see, though. We observe what we observe. I did not state in the post that every case of addiction has mental illness as a precursor, though I believe many of them do. There will certainly be people who don't relate to it at all. It's not intended to be all-inclusive, nor would I ever presume that it could be.

There most certainly appears to be an element of genetics involved when it comes to addiction. Some people are just more inclined to be drawn toward drugs, alcohol, food, whatever it is. Some families seem to have clusters of addiction. Whether it is an actual issue of genes or just the force of habits and learned behaviors from a lifetime of living with and around other addicts, I can't say. I just know that some people have a predisposition to it.

I know this because I am one of them.

I walk the line.

I have been forthcoming about my personal issues in the past.

There are people who may not have that predisposition, who can use drugs socially, who can drink without hesitation, and it never causes a problem. For some of them, though, these people without the predisposition, they may find themselves addicted anyway simply because the item they use creates its own physical addiction.

Nicotine, heroin and cocaine are the ones that come to mind immediately. These drugs are inherently addictive and create dependence in people who might otherwise be able to fight it off, purely because of the chemical compounds involved and their effect on the body.

Along with all that, there is the underlying issue quite often of mental illness. I say this only because it has been the case in every single addict I have ever known, most commonly depression. In many cases, because of the stigma about mental illness in general, people are resistant to believe they have a problem, resistant to seek help, and in turn seek out ways to self medicate...which can lead them down the path of addiction.

Some of the comments left indicate that people misread my words. I never intended for anything in the post to be an absolution of responsibility on the part of the addict. Quite the opposite, in fact. Attempting to understand why people become addicts and why it is so hard for them to get clean doesn't equal helplessness at all. They are without a doubt the most essential piece of the puzzle. Without a desire to get better, without the determination to get up and fight the fight every single day, no amount of resources, no amount of support will ever make a difference.

Those of us who have been there understand that. Those of you out there who haven't been there should consider yourselves lucky. Honestly.

Do addicts choose to use? Yes, of course they do, at least initially. Once they are in it, though, the issue of choice isn't clear cut anymore, it's not cut and dried, it's not black and white. Some drugs mess with the messages in your head. Some drugs force your body to get more. It's not as simple as just deciding to stop, particularly for people with severe addictions that can only quit safely with the help of detox.

The physical aspect of addiction is only one piece, and most would argue, one of the most inconsequential, at least in the long run. The reason people relapse is precisely because addiction isn't just physical. It's bigger than that. It's more complicated than that.

Our mental health system isn't equipped to help addicts. Even where there are services available, the resources are usually lacking to help pay for it. Not all insurance covers rehab, for those people who even have insurance. One of the lesser discussed aspects of the Affordable Care Act is that all plans sold on the exchanges are required to include coverage for substance abuse.

This is huge, and might finally be a step in the right direction.

We need to do a better job for addicts in this country. We need to do a better job for all mental health conditions in general. We need to have a better understanding of the co-morbidity often present between them. We need to stop believing that drug use is simply a criminal issue.

Mostly, though, we need to remember what it's like to care about people.

We need empathy and compassion.

They, the addicts, need it maybe more than anyone else does.

Does that mean that I am claiming you should always be there, be subjected to abuse, throw money at treatment centers for people who refuse to try? Of course not. In all of this, you have to understand that all the help in the world won't help someone who doesn't want it, someone who isn't ready, someone who won't get up and fight every day.

You can't love them enough to fix them.

You can't love them enough to keep them clean.

You can't love them enough to make it all better unless they want it to be better.

It's a painful realization, one that I've had to come to before. It sucks backwards and forwards. You can only do what you can do until you can't do it anymore. Then you have to do what you have to do to protect yourself.

No one will fault you for that if they understand what it is like. Those who would can't possibly know.

Another of the topics I wanted to clarify a little here is the subject of religion, which is something mentioned quite often in the comments. I didn't talk about it because I am not a religious person. I am spiritual, but not within the confines of a religion per se. I have known addicts to get clean even without a belief in God. I have known people with all the faith in the world who didn't make it. My opinion is a simple one - whatever works for you, cling to it, but don't think that it will necessarily work for someone else. Each person has a different path, a different inspiration, a different reason.

I honor them all. I respect them all.

I think that is all the issues I wanted to clear up. I think. I'm probably missing something, but I can count on you all to let me know.

Again, thank you for sharing this important message.

Peace and strength to you all.


  1. The mental health system is for the most part nonexistent especially for addiction issues. HIPPA does not help the situation if someone is not forthcoming to family and friends etc. Everything is confidential. I agree that there has to be more empathy and compassion for people struggling with addiction.

  2. Great posts, ma'am. It may not appear on your statistics, but I've shared your blog on Facebook.

  3. I understand the need to clarify, but I do not think you need to defend. Research suggests that 60-70% of addicts have co-occurring disorders (COD), that is a combination of mental health issues and substance abuse. Research suggests that 9.2 million Americans meet the clinical diagnosis for COD. My own personal experience with my son Harris who died on October 23, 2013 at the age of 19, having been discharged from a program and sober living environment about 36 hours before, is that the system, as it currently exists, fails to properly address COD. Harris had a history, from early childhood of anxiety, and later ADHD. In the year and a half before he died, Harris attended: 2 outpatient, 1 short term mental health in-patient, 4 primarily substance abuse (but promoted themselves as experts in COD) in-patient. The treatment model was ultimately virtually the same, regardless of what the program touted itself as: abstinence from drugs; group therapy; minimal face time with psychiatrists and psychologists; often a removal of medication designed to aid with mental health issues or a failure to augment or change medications that weren’t working; and, ultimately, discharge from the program, when the mental health issues surfaced (even when there was no relapse in drug use). Harris never received services that were integrated and comprehensive to address the anxiety (and later ADHD) that he had been suffering with since early childhood together with the addiction. In fact, one in-patient program in particular, relied almost exclusively on shame, blame and breaking apart the family unit, even though a large portion of the young adults in the program presented with a mental health condition that certainly required specific care and attention. It’s important to know that Harris attended these programs with the same hope for recovery as we had.

    In addition, after Harris was released from the first in-patient program he saw a psychiatrist/psychologist team that were supposedly experts in COD. Sadly, they were not. Harris relapsed under their care almost immediately after he was discharged from that first in-patient program, and, even though they were “experts” in COD, they didn’t have a recommendation for our next in-patient program.

    Since Harris’s death, we have called many programs around the country to see if we had somehow missed something. While initially promoting themselves as experts in COD, most (well all actually), when pressed, admitted that the ability to address the mental piece was extremely limited.

    Why do I post now? Because my biggest fear is that the rehabilitation models that currently exist will become eligible to be covered by insurance. Why is that my fear? Because in our experience with Harris the programs he attended boasted 12% success rates! I am afraid that those with COD will continue to fail unless the treatment models become integrated and comprehensive addressing both sides of the disease at the same time. That is the goal of "the harris project" to be the voice of those with COD and to advocate on behalf of 9.2 million Americans who for the most part live in the shadows!

    Keep doing what you're doing! And thank you so much for your support!
    stephanie marquesano

  4. I've never seen more comprehensive discussions on the complexity of the "disease of addiction", which ran my life into the ground in my younger days. During the last 32 years of abstinence, I've observed that the disease is societal as much as it is personal. Given the substrate of polarization, hate talk, bullying, poverty, environmental devastation, pharmaceutical dominance, etc., all increasing moment-by-moment, the attraction of a temporary respite must seem overwhelming to a child (or to the parent or school system attempting to cope with a child's justifiable terrors).

    The hospitals and rehabs I've visited over the years in an attempt to help those who want a life without drugs are dedicated to a single focus. For example, one treats addiction as a lack of self-esteem; another treats it as a neurochemical deficit to be addressed with the latest model pharmacology.

    What recovery I have is a community effort, and the community is eroding under the pressure of the society at large.

  5. Thank you, from a prescription meds addict, just taking the first baby steps towards recovery.

    As for choice, well those of us on prescription meds chose to start our drugs for very good reasons. I think a great deal of responsibility must fall on to the doctors who prescribe these things like sweeties

  6. Wondering if any of your thoughts could be shared by high school students during a speech event? I am a speech coach who is constantly trying to find material that can speak to a wide audience and your work does just that.

    1. Amanda hi, the foundation we created in my son's memory has sparked wide spread discussion on high school and college campuses as his peers want to join us as we advocate for awareness of co-occurring disorders (COD) and integrated and comprehensive treatment models. I would be honored if you look at what is being done, and I am confident that it would provide high school students with the opportunity to introduce our country to COD and the 9.2 million Americans who meet the clinical diagnosis for it.

  7. I have found your posts very refreshing and SPOT ON when it comes to MH issues and addiction. Thank you for your thoughtful commentary on these issues. Many of us out here really appreciate. I did share your blog with our NAMI group too. thanks.!

  8. Please stick to what you know and avoid diagnosing people or the health care system. You write that you "Fucking hate cigarettes" and have been "Adjacent to pot many times" Huh?
    The boldest statement was:
    "Rehab doesn't fix addicts. It primarily treats the physical symptoms of withdrawal."
    Again, stick to what you know.
    You write about compassion very well, stick to that.
    You writing/opinions/solutions of addictions are predominately co-dependent.
    "I have never tried hard drugs and I hope I never do..." Wow. Red flag there.
    Limit yourself to what you know: be available as a strong independent source of support the next time you are adjacent to a person 'strung out' on (insert your peer group's addiction here)


    1. As most other people are writing I think the author is right on. Its too bad one needs to be a junky to be allowed to write about people who need more support. She is literally speaking for many that have no voice. We could go on without yours.

    2. M IL Tecnico, I absolutely encouraged her being supportive of others. But. She doesn't stick to that. DeBeeHive diagnoses the problem of prescribes cures for addiction without any experience beyond her social sphere nor any investigation or training.
      Addiction has been around as long as there have been beating hearts (animal and human) and its not the health care system that is going to solve this condition. its the addict talking with another addict. one by one. day by day. month by month. in church basements, on sidewalks, under bridges..not in universities and colleges, congress, and certainly not in internet essays. The people who 'have no voice' is not the addict. rather it is the reason for al-anon, COA, and all the other splinter groups from the first step groups started by bill and bob in the 30's.

      DeBeeHive takes hoffman's overdose as a means to a platform of what I don't know- Social commentary...self flagellation. She diagnoses Hoffman's heroin use as a consequence of reckless pain management by doctor(s), but yet didn't know him personally.
      From the addicts POV, she naively removes an addicts' empowerment and puts them (with her) in the category of victim and its irresponsible.

      Throughout her essays on addition De Bee Hive sticks in self-obsessive mini rants about how hard "other" people's addictions were on "her" and vomits up the oh-so-trite group think blame game. (When one points a finger at a "problem", there are three fingers pointing back at the likely problem)
      and fwiw... Junkie, alcoholic, military medic, DDX psych tech, rehab customer, inmate... clean and sober.

  9. this was very timely for our famiy thank you for recognizing the complexity of this issue as well as the pain our family is going through as we struggle help, not enable someone we love, the struggle is continuous. depression robs the soul and drugs grab one by the throat and it is difficult to break the stranglehold . with grace and wisdom we strive to regain the person we know is lost inside this struggle MG

  10. Hi, I just wanted to let you know I read a few of your posts and you are an inspiration to me...keep up the GREAT work.

  11. I just want to say thank you, We lost our son to an OD two years ago this June. He was in and out of rehab and I always said that if Love could save him he would be with us today. I do feel we did not loss him in vain, my dearest friends son says that the thing that helps keep him clean, is the memory of our Stephen. And that brings a smile to my face, our loss is helping someone else survive. Thank you again for your words, they put to words feelings that I never could. I don't know you, but I love you!!

  12. You are brave and I appreciate you sharing your experiences and your feelings. I think it gives us all a better insight into the people we may know who are addicts. xoxo

  13. The author is on point, here it shows by all the other praise she is getting. Don't need to be a junky to advocate for people who have no voice, many need more support, that is the point. Our system needs to do better.


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