A Disgrace

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"The national data released today confirms that untreated alcohol and drug addiction remains at pandemic levels, with 23 million Americans suffering from the disease, approximately the same number that suffers from type 2 diabetes," said Victor Capoccia, director of the Closing the Addiction Treatment Gap initiative. "But you wouldn't know it from the way our country responds to the problem. Only one in ten Americans affected by addiction is treated, as opposed to four out of five people with diabetes." --Substance Abuse and Mental Health Services Administration (SAMHSA)

This can't be okay.

We have had "wars on drugs"; we have had "just say no"; we have had boot camps; we have had zero tolerance policies.

Not one of them, frankly, has been worth a damn. Like the man said, doing the same thing over and over and expecting a different result is a definition of insanity.

Let's try a little common sense.

1. Get serious about the fact that we are talking about a disease. Not bad habits or behavior. Not a lack of "will power". Note some personal weakness, but a disease. An illness. A malady. Like cancer. Like heart disease. Like schizophrenia. A disease.
2. Make treatment available on demand. No crap, no managed care nonsense, no nothing. If you ask for treatment you get it. Plus, let's look at some of the highly successful ways of getting someone into treatment, like intervention.
   
3. Let's redefine the role of the Criminal Justice System. Is there any other illness in which the courts take such an active interest? Criminal Behavior should be where the courts come in, and rightly so. We are all responsible for our actions, and have to face the consequences. But, let's not criminalize the fact of the illness itself. It does nothing more than to force the addict further underground into a subculture promoting ever more anti-social and deviant behavior. Someone commits a crime--robs a store, shoots someone over a drug deal or during a theft, then they deal with the law and accept fair punishment. But regardless, if drugs are at the heart of the crime, then treatment has to be a part of their rehabilitation. Somewhere along the line, we forgot that most of the people in jail are not hardened criminals, they are excellent candidates for a second chance.
4. Listen to families, they want help and they want to help. Families need education in addiction and help to deal with the devastating consequences of addiction. Substance Abuse Treatment, unfortunately, is not family friendly. Not that there are not exceptions, but where I live, there is exactly one (1) family education program run at no cost. In case nobody noticed, that's not enough.

Addiction is an individual's nightmare, a family tragedy, and national health emergency. The limitation of treatment to the point were less than 10% of individuals impacted by the illness are receiving treatment, is a national disgrace.

We are so much better than that.

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The Sacred And The Profane: Spirituality in Recovery

I was having a cup of coffee the other day with Grateful John. He said that he was angry with his daughter over her arrest for drunk driving, and described what options he had. It went something like this:

"I wanted to bust her blanking face in and slap some blanking sense into her but my blanking conscience kicked in and told me to call my blanking sponsor. I did, and he said to pray on it. blanking pray? I'll blank pray, I said. But I did, and I asked my Higher Power to take the whole thing over because I couldn't blanking deal with it. I had to turn it the blank# over to God as I understand Him and get out of the blanking way. I'm not ready to deal with that, I look at her and see myself, my own blanked up excuses and I get angry, not at her. At me for being a blanked up father because of this blanking illness. Thank God I called my Sponsor"

Only he didn't really say blank

I am not thinking that Grateful John is likely to be helping the Pope draft his Christmas Encyclical this year, but I do believe that his faith and trust in God, and his willingness to do God's will, are as strong and valid and true as any more pious, and less profane individual's.

This is a good example of the way that the sacred and the profane co-exist in the 12 Step Programs. As my Uncle Jerry the Bartender, sober over 30 years in AA, once said, "a lot of us aren't exactly Choirboys when we come in."

It's true. It's also true that very few addicts and alcoholics seek out the 12 Step programs because they feel a sudden need for spiritual growth. Addicted people go to meetings out of fear and desperation. Sometimes desperation for something that will work and fear that they have found it. The illness of addiction so utterly takes over an addict's life that in a pathetically perverse paradox, the thing destroying them (the addiction) feels like the only thing that makes life bearable. To threaten the addiction with recovery is like threatening life itself, and every corrupted survival mechanism kicks in. Addicts come to their first 12 Step meetings in fight or flight mode.

And yet, there they are, usually hanging right on the wall, or in case someone missed them, read out loud at the beginning of the meeting:

The Twelve Steps of Narcotics Anonymous
1. We admitted we were powerless over our addiction, that our lives had become unmanageable.
2. We came to believe that a Power greater than ourselves could restore us to sanity.
3. We made a decision to turn our will and our lives over to the care of God as we understood Him.
4. We made a searching and fearless moral inventory of ourselves.
5. We admitted to God, to ourselves, and to another human being the exact nature of our wrongs.
6. We were entirely ready to have God remove all these defects of character.
7. We humbly asked Him to remove our shortcomings.
8. We made a list of all persons we had harmed, and became willing to make amends to them all.
9. We made direct amends to such people wherever possible, except when to do so would injure them or others.
10. We continued to take personal inventory and when we were wrong promptly admitted it.
11. We sought through prayer and meditation to improve our conscious contact with God as we understood Him, praying only for knowledge of His will for us and the power to carry that out.
12. Having had a spiritual awakening as a result of these steps, we tried to carry this message to addicts, and to practice these principles in all our affairs.

It doesn't leave a lot of room for doubt that this is a spiritual program with a Higher Power at the heart of it.

So, how does the world of the active addict and the world of the spirit co-exist?

Pretty Good, actually. Ask Grateful John why he's grateful?

(More to come)

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Do The Right Thing.

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Sometimes, you just have to do what's right.

A couple of years ago a friend of mine, Stacey Gill, approached me with an idea for a group for kids from families with substance abuse issues. I was skeptical at first, but eventually realized the importance of doing something to help some kids before they got into trouble.

Also, as anyone who knows Stacey would agree, she can be very persistent.

Anyway, with the help of a grant through the Healthy Communities Initiative and the County Office of Behavioral Health, we got this little group off the ground, and for over a year some kids were able to come to a safe place to talk about whatever was on their minds without fear of retribution or resentment. They laughed, cried, played games, learned meditation and stress management techniques, and got a snack. They learned about addiction, family roles, skills to help survive in an addicted family. It became a very rewarding group to do.

Until I got the news last week that because of the budget crisis in Pennsylvania, no one knew when or if the grant would be renewed.

Now, I know that there are more inportant cutbacks and shutoffs than Stacey and my little group. I have talked to out of work fathers and mothers whose unemployment has been held up, families who are waiting for some relief in the areas of health care and fearful of cuts in school programs and vital public services like fire departments and police stations.

Against that backdrop, how important can one little group for Children of Substance Abusing Families be?

Well, considering that kids from families with drug and alcohol problems are more likely to become addicts themselves, to get arrested, to have unplanned pregnancies, to contract STD's, HIV/AIDS, Hepatitis and the variety of illnesses related to cigarette smoking, not to mention the fact that their kids are at higher risk of addiction and alcoholism, maybe more important than one would think.

At any rate, Stacey and I have decided that it's too important to shut down. So, we aren't shutting it down.

Grant or no grant, funding or no funding, this group is going to continue. Every Thursday, 4:00 to 5:30 PM, Stacey and I will be doing the group at Ken Williams' Recovery, 300 W. State St., Media PA 19063.

We won't charge for it, and we won't get paid. It's not that we don't care about that, neither of us are independently wealthy, but as we are faced with hard choices these days, sometimes the choice is, simply, to do the right thing. And the right thing is to stand by our words. We told these kids from families of chaos that we would be there for them, so there we will be.

And the snacks are on us.

Recovery In Action

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On September 12th, 2009, Philadelphia will be invaded by addicts and alcoholics.

They will not be hiding in alleys or committing petty crimes. They will not fill the bars, or the crack houses, or shooting galleries. They will not hide. They will be in plain sight, walking en masse down the streets and boulevards of Philadelphia.

And they will bring their parents, their children, their spouses and their loved ones. They will be of all races and colors and faiths, as well as atheists and agnostics.

They will be walking to celebrate recovery.

This will be PRO-ACT's Annual Recovery Walk.

We walk to let Philadelphia see that the face of Recovery is as diverse as the city itself. That individuals and families from every walk of life recover from the ravages of the disease of addiction.

We walk to show that, as it says in the Basic Text of Narcotics Anonymous, We Do Recover. Last year there were almost 5000 of us. Let's make it more this year. Check out http://www.recoverywalks.org/ and http://proact.org/ to find out more.

The Art of the Intervention Part III

What's a Professional Interventionist?

As of this writing, that's a tough question to answer. There is no one certification or license; no one specific training process, graduate school of Intervention. So here are some things to look for. Don't be shy, ask questions. Ask a lot of questions, if you need to. And ask for references. Any of us who have been around for a while should have no problem furnishing you with several family members who have participated in past interventions and are willing to share their experiences.

1. Experience: If anyone can hang out a shingle and say that they are an interventionist, then you have to ask a lot of the hard questions. How many interventions have you done? What was the outcome?
   
2. Education: What specific training have you had in addiction? Remember, training or education as a counselor does not automatically qualify someone to do addiction intervention. Any good Interventionist will be able to identify a specific course, training or other educational process directed toward competency in Intervention.
3. Cost: Do not be squeamish about cost. There is a broad divergence in the cost of Intervention. My personal belief is that Interventions can be made available to any family at an affordable price. Talk about the cost with an interventionist and if it seems excessive, move on. In Pennsylvania PRO-ACT can recommend Interventionists who charge reasonably, and locally, in my little corner of the world, The Delaware County Interventionist Network is committed to finding affordable ways to help families in need of Intervention.

Why do you need a professional?
Family loyalties, problems, tensions and arguments are extreme. Feelings run deep, resentments, too. Trying to organize all of this into a focused and specific intervention can be like trying to nail jelly to a tree. What begins as a well-intentioned talk about a loved one's problems turns into a free-for-all.

A professional Interventionist will:

• Help the family to understand addiction as an illness.
• Work with the family to master the art of effective confrontation.
• Plan an effective post-intervention strategy for both the subject of the intervention and the family.

Interventions are not events, but processes. An Interventionist is someone who knows the process, and can help the family to negotiate it.

The Art of Intervention Part II

The Drama Triangle, as Karpman described it, is an ongoing, series of rigidly patterned behaviors, driven by unfulfilled needs. See http://www.karpmandramatriangle.com/ for more information on the Drama Triangle, including an excellent piece relating the triangle to classic alcoholic and addicted family roles.

At any rate, if we use the Drama Triangle as a starting point, we see the roles to which we are relegated in the disease of addiction. We become reactive; our actions dictated by the behaviors of the sick addict. We can scold, extravagantly rescue, feel abandoned and guilty. We can experience mood swings based on someone else's drug use or drinking.

We get sick. Literally.

In The Medical Aspects of Codependency Dr. Max Schneider identifies a variety of medical issues that develop as someone becomes enmeshed in a codependent relationship with an addict. http://www.fmsproductions.com/substance-abuse-videos/MedAsp/CoDep.php

Most importantly, we lose the ability to act. We can only react. We cannot act in the best interests of the addict. We cannot even act in our own best interests. We either continue in the downward spiral of emotional addiction or we run away, filled with anger and shame and traumatized by the experience.

Is it any wonder why a family member or other loved one of an addict gets butterflies and sweaty palms at the thought of confronting the addiction? Not at all. Because when we do, we are not only intervening in the person whom we love's addiction, we are also intervening in our own codependency. We are reclaiming our ability to act, with all of the risk and responsibility that implies, in our own self-interest, and the interest of the addict.

Enough to make anyone nervous!

Next--why you need a professional interventionist.

The Art of Intervention

"Let me talk to you for a minute...."

We all know the feeling, speaker or spoken to, the rise in the anxiety level, the catch in the voice. We know what we want to say, we know what we don't want to hear.

Why is it so difficult? I mean, we're adults. We should be able to talk about anything. (Unless we are adolescents, in which case we can't talk about a lot of things, but we sure can text, message, facebook and twitter about them!)

It's anxiety-producing to venture into any area that is emotionally unpredictable. The old fears about abandonment come to the surface itching poison ivy. What if he can't handle it? What if he kills himself? What if it just makes her drink more? What if I'm wrong?

And on the receiving end: oh, man, this is it. I'm getting thrown out! They're putting me away. I'm done for!

We take care of each other out of love and become co-dependent out of fear. The fear spurs resentment, then guilt, then more fear. Stephen Karpman postulated years ago that each of us us capable of only one of three existential roles when dealing with an addict.

Rescuer, Persecutor or Victim.

The Rescuer feels bad because of the physically or emotionally impoverishment of the addict and tries to help, maybe with a loan. Sure, people have warned him not to give money to an alcoholic or addict, but he seems like such a good guy and only needs something to help him get back on his feet. A Rescuer is born.

What?? Oh no, he couldn't have done this to me! He used the money for drugs? How could that be? What have I ever done to him to deserve this? Victim.

That lousy rat....just wait, I'll show him, trying to put one over on me! I'll just wait until I get a good chance to take a shot at him and..... Persecutor.

Rescuer, Victim, Persecutor.

More to follow