(2013) by David Sheff
reading the end first:
understand that drugs don’t cause addiction, life does (#2 of 12 steps).. t
(gabor in acknowledgments)
tom mclellan, a preeminent addiction researcher, knows as much about addiction as anyone in the world.. yet despite that, his two sons became addicts.. ‘i was the addiction expert.. ‘ founder of treatment research institute and former *deputy director of the office of national drug control policy in the obama admin
wow.. i would say *that would keep him from being an addiction expert..
‘.. but i didn’t know what to do. i asked my colleagues – they’re experts – and they didn’t know what to do’… he had access to the best care possible, but it wasn’t good enough. one son is now in recovery, but his younger son died of an overdoes..
sometimes i gleaned the greatest wisdom from addicts themselves..
every day drugs kill over 365 americans, more than any other preventable health problem.. 135 000 a year .. but doesn’t take into account the more than 100 000 additional fatalities that are cause by drugs but counted as suicides, homicides, auto and other accidents, heart attacks, pulmonary disorders, strokes, and cerebral hemorrhage, hepatitis and other infections, hiv/aids, liver disease, kidney disease, septicemia an don an don..
approx 1 in 12 americans over the age of 12 is addicted to drugs..
drug abuse/addiction overwhelm america’s health care system..drugs are linked to more er visits and hospital admissions than any other single cause.. 4.6 million of them in 2009.. the most recent figure available. that was an 81% increase over 2004
drugs are also the number one cause of crime.. more than half of america’s fed prison inmates are in on drug convictions.. in 2010 .. 85%.. 80% of kids involved in juvenile justice system… 50-75% abuse.. 60% of homeless..
total cost in us.. exceeds $400 billion..
american teens use drugs at higher rate than teens in any other country.. competition isn’t even close..
1 – america on drugs
1 – this is your brain on drugs
2 – this is our nation on drugs
joanna jacobs .. explains one reason teenagers are so susceptible to using and abusing drugs, and why it’s esp dangerous for them.. the go system – more primitive – in brain develops early.. the stop system – decision making/judgment – takes longer to mature.. ‘brain isn’t ready to do its job inhibition the reward system.. there’s discrepancy between development of adolescents’ reward system and impulse control system, so the reward system is overactive’..
joseph frascella: ‘kids have a double whammy .. the go system rages, the foot’s on the gas pedal and the stop system has a hard time keeping up..
it’s actually trip whammy we kids begin using drugs.. brain chem more susceptible to using and drugs impede maturation of prefrontal.. further slowing development of brain’s braking system.. teens known for impulsivity and reckless behavior.. turns out they’re *wired that way.. add drugs to mix and impulsivity and recklessness remain unregulated for longer ‘..
we’ve failed at prevention.. parents no idea.. school tries to scare.. mandatory drug prevention tactics.. visits from police.. tv campaigns.. egg.. this is your brain
we’ve failed at treatment.. 90% of people who need help never receive it.. those who do get treatment enter a broken system that’s almost impossible to navigate .. all sorts of rehab.. what is rehab.. multi billion dollar industry
in and outside of treatment.. no? ie: get better.. go back to the same messed up world..
because the addition treatment system is so ineffective, people assume addicts can’t get will.. because of the failure of prevention strategies, people assume that no matter what anyone does, kids are going to use.. but both prevention/treatment fail for the same reason: the stigma of addiction that is based on the widely held but archaic view that good people don’t use drugs; bad people do
we’re offended when drug users don’t follow the rules that apply to everyone else. whether they’re working or in school, their performance usually suffers..
huge case of crazywise ness
there have always been these opposing factions in human culture.. one group demonizing drugs and one glamorizing them.. many of the most revered writers of every age were drinkers/drug users.. and you’d be hard pressed to name a jazz, rock and roll, or hip hop great who abstained
we tell your children to talk to us, but we often unwittingly motivate them to lie or keep quiet.. as a result, kids often nod when they’re warned about drugs, and they’re unlikely to admit if they’re tempted. their fantasies and fears go underground. they conduct their experiments in secret..
drug abuse is seen as a character flaw (in finding jobs/promotions).. so it’s not wonder that both adults/children keep their worsening problems hidden..
legislators and govt agencies are unlikely to focus on people they perceive as making selfish choices.. .. families often too ashamed to take on what appears to be a problem caused by their loved ones’ moral deficiencies.. as a result.. there’s little money for research.. which reduces potential for finding effective treatment options
that’s a sham/e as well.. we already have enough research.. we just need to offer a nother way to live..
this stigma associate w drug use – that bad kids used, good kids don’t, those w full blown addiction are weak/degenerate/pathetic – has contributed to the escalation of use and has hampered treatment more than any single other factor
2 – why we use
3 – everybody does it
teens’ primary motivations to use were to ‘forget their troubles’… their parents were clueless.. in the study only 7% connected drug use w stress.. most parents assumed ‘drugs are fun’ was #1..
drugs can make like easier to navigate. for some people, drugs may make life possible to navigate..
chuck palahniuk in the novel choke: ‘when you’re an addict, you can go w/o feeling anything except drunk or stoned or hungry.. still, when you compare this to other feelings to sadness, anger, fear, worry, despair, and depressions, well, an addiction no longer looks so bad. it looks like a very viable option’
sounds like gabor
people in pain are desperate for relief.. far more of them turn to drugs than to therapy.. many have no access to therapy, and drugs are a quicker fix.. people get to feel high.. and the pleasure is in sharp contrast to the pain they feel.. for a sublime moment to two, the rats stop gnawing..
‘addiction is always an attempt to soothe severe emotional suffering which is often rooted in childhood emotional loss/trauma.. t.. such loss or trauma is imprinted when the child’s ability to cope is overwhelmed by adversity – physical/sexual/emotional abuse, extreme parental stress, violence in family.. whether addiction is to alcohol/heroin/anything.. it is an attempt to change one’s mind state form negative to positive in the short term.. adverse early experiences not only induce the pain the addict was wanting to escape.. they also shape developing brain circuits in ways that predispose to addiction’ – gabor
about 20% of school age children in the us.. about 11 million – have learning disabilities.. t
who’s defining disorder..? big part of our problem/illness.. whatever you want to call it.. we need to quit labeling everyone.. and start listening to daily curiosity (let those be our only label.. in order to help us find our people)
and these have been show to increase the risk of drug abuse.. academic failure and peer rejection.. common risk factors.. adhd associated w earl onset of substance abuse and greater difficulty of treating it
various drugs including marijuana and alcohol can ‘treat’ depression.. at least temporarily, before it floods back in (alcohol is itself a depressant).. some meth addicts w bipolar disorder or depression have reported that when they tried the drug, they didn’t feel high; they felt normal..
my son nic, who ultimately was diagnosed s bipolar and depression, told me that when he first tried meth he thought, if only i’d been breastfed on this.. ‘it was the feeling i’d been looking for my whole life..
although drugs can make mentally ill fell better temporarily, they worsen conditions over the long term ad they further damage already malfunction ing neurological systems..
dang.. so wrong.. perhaps ‘mentally ill’ are the sane ones.. and it’s like we’re forcing them to take drugs in order to not truly go mad in our broken system/world.. ie: supposed to’s.. of school/work
and then yeah.. the amount they have to take wrecks their brain
a high can be a respite from hell or a net that prevent s a person from falling into hell
add to all that.. the man other reasons people use: temp treat physical pain, lessen inhibitions; help cope w loneliness, insecurity, stress.. rather than being surprised that some people use drugs, we should be surprised that some don’t
(on keeping drug use at bay till kids are older) matthew large: ‘that extra time could allow a young person to *finish school and gain other skills that might reduce th elifelong disability ta toften accompaines mental illness’
in spite of parents’ frustration, they can influence their kids, and so can schools and communities. effective prevention requires a multifaceted approach it involves protecting children by untangling and addressing the roots of their problem and offsetting their risks..
we have to go deeper
eve reider: ‘our goal is to change the balance between them, so protective factors outweigh risk factors’..t
so what if these ‘protective’ factors are the risk/perpetuation/problem/cause
rather than fight the teenage brian, we can work w it. we can help kids become immersed in positive rather than negative experiences that can sate their curiosity, engage their passion and harness their impulsively
right idea.. but not happening at school man.. nor work..
we can try to help lessen the *stress.. guide succumbing to **peer pressure.. informed ***decisions.. transition thru each ****phase of life..
mothers and fathers who aren’t prepared to be parents require support and education
rather.. support.. as in spaces of permission/freedom with nothing to prove.. so they can listen to their heart everyday.. how to be w kids .. is already in us.. we just need time/space to listen to that
a model that’s been show to protect children .. the nurse family partnership.. nnfp.. nurse helps w prenatal.. post birth.. nurse also works w mother to get her back to school so she can pursue a career …
exercise and engagement help, but research has shown that computer time can hurt
dang.. go deeper.. exercise can hurt/help as much as computer can hurt/help.. all depends on what you’re looking for.. getting out of it.. ie: your son saying if he didn’t run he didn’t feel like he was worth/doing anything .. other side.. some people finally find their people online
indeed, one segment of american’s ed system operates as if its job is to funnel kids into college and careers instead of to make them as healthy as possible
we don’t need to train kids in schools (anti drug et al).. we need to let them.. all of us.. out of schooling ness..
3 – when drug use escalates
5 – use becomes abuse, and abuse becomes addiction
research has indicated that one of the most importan factors is the age of first use.. because brains not fully developed.. so impact on their extremely plastic nervous system is dramatic.. it’s one reason it’s so difficult for dr’s to detoxify babies born addiction.. (every year, more than 13 000 babies are born addicted ).. drugs become an integral par of nervous system.. also.. may cause permanent deficit of naturally circulating dopamine making the pleasure caused by drugs particularly potent
‘why would you stop if you were going to?’ – never judge answers..
6 – addicts aren’t weak, selfish, or amoral – they’re ill..t
it’s their coping mech in sick society..
we should worry about the people not taking.. acting like everything’s ok..
people must understand that addiction is a disease.. it’s critical if we’re going to effectively prevent/treat addiction.. accepting that addiction is an illness will transform our approach to public policy, research, insurance, and criminality; it will change who we feel about addicts and how they feel about themselves.. there’s another essential reason .. we punish bad behavior.. we treat illness
maté addiction law – saying.. not a disease
a disease is ‘an interruption, cessation, or disorder of a body, system, or organ structure or function’.. according to stedman’s medical dictionary..
even most common drugs, marijuana and alcohol, considered by many to be less harmful..change structure of brain
while drugs do cause structural changes in the brain, the most pronounced changes are functional.. ‘the brain is hijacked.. connections impaired’.. baler says
all drugs change the flow of dopamine.. that’s how they work
like people w a range of mental illnesses, addicts can become confused, irascible, and irrational, because their illness is rooted in the very brain center that normally would tell them that they’re in trouble and need help
there are two way s people become addicted. anyone who takes enough of a drug to cause severe structural and functional changes in the brain can become addicted. but most people who become addicted do so because their brains are diff before they use drugs.. not because they use them.. in fact, there’s evidence that addicts’ brains are diff from birth.. they have various neurological and genetic anomalies that, when combined w environ influences, may cause them to respond differently to drugs than nonaddicts do.. genetic predisposition
7 – don’t deny addiction, don’t enable it, and don’t wait for an addict to hit bottom – he could die
8 – intervention
4 – getting clean
9 – finding treatment
no matter which of these treatments are recommended.. there’ san essential first step.. they must get drugs out of their system and become physically stable.. they must go thru detox.. the initial stage of evidence based treatment
10 – detox
the addict’s nervous system adapts to the presence of drugs.. when drugs are withheld.. the addicted brain goes into a kind of shock.. it’ not quite as serious as oxygen deprivation, but it can feel like it.. in distress, the entire body system now has one purpose: to return to equilibrium by finding more drugs to stimulate dopamine flow..
there’s no easy way to detox.. heart rate can rise dangerously and the addict has a high risk of seizures..
the science based approach rejects cold turkey detox.. toughing it out is archaic, ineffective, and dangerous.. medical detox.. more humane and safer.. based on fact that getting sober isn’t about character but about chemistry.. the removal of a toxic chemical from a compromised system that has become dependent on it..
a sad fact of addiction: getting clean is traumatic, and the reward can be the very hell the addict was running away from in the first place..
5 – staying clean
11- beginning treatment
12 – primary treatment
13 – treating drug problems w drugs
14 – where does aa fit in
6 – treating a chronic illness
15 – treating dual diagnosis
16 – relapse prevention
it’s often noted that relapse can be part of recovery, because addiction isa chronic disease w relapse as a symptom.. but just as a recurrence of cancer can be fatal, so ca a relapse w drugs..
7 – ending addiction
17 – the future of prevention and treatment
on experimenting w fruit flies
of course a main component to tackling america’s drug problem is preventing use and abuse in the first place..t
yeah.. let’s just go there.. ie: cure ios city
because people use drugs *for so many reasons, it’s tremendously challenging.. finding ways to prevent addiction may be even harder than finding way to treat it..t
*maybe not.. maybe just two (ie: missing pieces)
imagine if we treated young kids’ depression before they treated it themselves w marijuana.. t
imagine if we helped kids w learning disabilities before they checked out and found solace in drinking..
imagine the suffering that could be prevented..t
18 – fighting the right war
half a decade ago i called for the formation of he american addiction society, modeled after the american cancer society.. tom mclellan chairman .. i’m on advisory board.. i’m hoping mclellan’s new org will make addiction become the squeaky wheel..
the clean paradigm in 12 steps
1\ reject the view that america’s drug problem is unsolvable..
2\ understand that drugs don’t cause addiction, life does
3\ help children navigate challenges
4\ get help as soon as problem
5\ understand that addicts aren’t bad people – they’r eill
6\ try all.. but remember just one of many treatments
7\ go to a dr.. trained in addiction meds
8\ choose evidence/science based treatments
9\ addicts’ bodies must be detoxed, but that’ snot all it takes
treat dual diagnosis (duel.. addict and psych disorder)
11\ do all can to prevent relapse.. but don’t consider it a sign of defeat
12\ end war on drugs and treat addiction as health crisis not criminal problem
a little frustrating reading about suggestions/measures – seeing a nother way