Calling bullshit on addiction treatment bullies

About three years ago, I was attending a national conference on public health (American Public Health Association) and presenting my posters on the relationship between drug use and violence, and sexually transmitted infections and injecting drugs. As I walked the aisles I ran into a woman who runs a Florida addiction “treatment” facility. We talked for a bit about my work, her facility, and then we shared some of our personal stories. Mine included meth addiction, jail, recovery, and now graduate school studying addictions. Everything was great until I mentioned that I now drink alcohol socially… “We’ll save a seat for you” she told me as she handed me her business card. Idiot.

Recovery bullies and addiction treatment

Dr. Adi Jaffe Lecturing in Los AngelesAs soon as my version of recovery from addiction didn’t match her expectations, it was an immediate failure. Forget the 6 years I’d spent free from crystal meth use, the excellent graduate school career that was producing real results I was there to present. Forget the fact that my family, my bosses, and my girlfriend at the time thought I was doing amazingly well – As far as this woman was concerned it was her way, or her way. Well I call bullshit on that thinking once and for all.

Unfortunately for her, the research evidence, as well as the actual human evidence that I’ve seen, shows that recovery from addiction comes in many colors and flavors, like pretty much everything else in life. We’ve covered research on all about addiction before showing that the best evidence to date actually calls into question the idea that relapse is the necessary disaster so many paint it as. The fact that the majority of those who meet criteria for drug dependence at some point in their life actually recover on their won is also there, and although this does nothing to reduce the impact of addiction on all those who have an incredibly difficult time quitting, it’s there and can’t be ignored. Drug dependence is almost certainly not a one size problem and the solution is probably far from a one-size-fits-all, no matter how much you like your own solution.

So there’s cognitive behavioral therapy, peer support solutions (like SMART Recovery, Rational Recovery, Life Ring, 12 Step groups like Alcoholics Anonymous, and more), medication-supported recovery (like Suboxone, Methadone, Vivitrol and more), Motivational interviewing and other Motivational Enhancement techniques, as well as a whole host of psychotheraputic approaches that are more eclectic. No research we have to date indicates that any of these approaches is necessarily more effective than others, which means that they are all essentially equally effective. We’ve already talked about some combinations that work very well together, like PHP programs for physicians, but there is absolutely nothing to indicate that the 12-steps (for examples) are somehow superior to CBT, or Rational Recovery, when it comes to treating addiction.

If you get better, you’re a success in my book

When it comes down to it, whether this Florida 12-stepper likes it or not, I am still a social drinker and I still don’t believe that this nullifies any of my other achievements or my successful recovery. More importantly, it doesn’t nullify the success of millions of others, no matter how poorly it fits with some people’s notions. When a life gets overrun by drug use or another addiction, a successful outcome to me means recapturing a functional life that is no longer dictated by the pursuit of that addictive behavior. Anything more or less is a personal preference sort of thing. The problem with these idiots who will absolutely ignore success because it doesn’t conform to their expectations is that they drive people out of treatment and away from success and that is not okay. I’ll continue to call them out for their narrow mindedness and hopefully eventually, their voice will be far from the dominant one.

One day at a time, but not forever!!!

If you’ve ever gone to a 12-step meeting, you’ve heard the phrase “one day at a time,” so often as to make it a mantra. Personally, it always left me wanting more.

Is “one day at a time” enough?!

I think the notion is a correct one… when it comes to early recovery. However, once the initial excitement of staying sober has worn off and life without the crutch of drugs, alcohol, or any other addiction, begins, I believe that there is great value in planning.

Thinking ahead is exactly the sort of thing that addicts don’t do well. As far as I know, there’s only one way to improve a lacking skill – practice.

If a recovering addict truly takes things “one day at a time,” never making plans that take the not-so-near-future into account, where does that leave him except for being sober for one more day? As far as I’m concerned, that’s simply not enough.

I had a lot of learning to do when it came to living a normal life after I cleaned up. I barely knew how to function in the simplest ways without the crutch I’d become so comfortable with. I’ll never forget the single sentence lesson my dad gave me over the phone regarding handling my mail.

“Most people pick up their mail, open it up on the spot, throw away what they don’t need, and handle the rest immediately” he told me.

To me, that was more than a foreign concept; it just sounded strange. You see, I would let mail pile up for weeks, eventually throwing it away when it simply seemed overwhelming. The notion of taking care of my mail, or anything else for that matter, on the spot, sounded so simple as to be impossible. But guess what – it works!!!

Fortunately for me, by the time my dad had shared those pearls of wisdom, I’d been clean for six months and ready to put the lesson into action.

Making plans the right way

Recently, my fiance introduced me to an exercise that requires you to write down your plans for next week, next month, next year, and five years from now. I liked it because it made me think concretely about where it is I’m going in life both in the very short, and relatively long, future. By writing down how I saw different aspects of my life play out in the next five years, I got to think about them more directly than I ever had before.

I’ve adapted the exercise for addicts in recovery. I think that you should try it as early as you feel comfortable with it. The trick early on is to just complete it. Once the first draft is finished, you should go back and change it every once in a while.

Given how quickly things change in early recovery, the second draft should be completed after a week. Since you’ll be getting better, and more realistic, every time, the third draft should probably be done about a month later. From that point on, further edits can be done whenever life calls for it.

I think you’ll find that simply going through the exercise will tell you a lot about where you are in your recovery.

The exercise itself

The first thing you’ll need is a piece of paper. Divide the paper (you can use one side or both depending on how much you like to write) into five sections and title them as follows: “Tomorrow”, “Next week”, “Next month”, “Next year”, and “Five years from now.”

Under each one of the headings, answer the following questions for each of the time periods. Be as specific as possible. Feel free to add, or replace, any of these questions with ones you see as more relevant to your life.

  1. Where will you be living?
  2. What will your job be?
  3. Will you be in a relationship? If so, with who?
  4. How much money will you be making?
  5. What car (or other mode of transportation) will you have?
  6. List your five most important relationships – Describe the quality of each.
  7. What special trips, events, or occasions, will you be taking part in or planning?

That’s it. You’re done. Take a deep breath and read over the list.

Though it seems simple enough, you’ll see that answering these questions can be quite difficult at first. This is especially true the more specific you try to be (answers like “I’ll be living in a 3 bedroom house in Mar Vista with hardwood floors and a home office that faces east” might take some time for some of you).

Again, the point is simply to complete the exercise that first time. I promise you that it gets easier with time. Since you’ll be repeating it relatively often initially, you’ll be able to adjust your plans according to the changing circumstances of your life. Feel free to go back and redo the list any time.

Having goals, both short and long term ones, will help focus your mind. It will also plant the seed of the direction in which you want to take your life. Without this direction, things can seem chaotic, especially when one has recently given up their best friend (cocaine, marijuana, porn, and chocolate fudge ice-cream can easily be thought of as best friends when one is in the throws of addiction or recently out of it).

One day at a time is great, but when you want more out of life, planning is the only way to go.

Recovery from addiction: Stigma and many obstacles, but no excuses!

Many of the people in my life nowadays forget that I’m an ex-convict. Still, I get daily reminders that the “ex” part of convict doesn’t carry much weight. I also know that I have it easy because I have a Ph.D. after my name. For many others in recovery, things are even harder.

Still, when filling out job applications, considering possibilities for the future, or trying to start anything new, my past convictions are ready to jump out as the first hurdles.

Stigmatization after recovery from addiction

My first encounter with this sort of stigmatization came at my first job search after I got out of jail in 2003. I was applying for an Apple Store job and did well. Even though I told them that I’d been arrested on the job application, I got a second interview. Then the coveted email letting me know I was to report for training next week. Only the background check remained. But that final email never came. I never heard from Apple again and none of my emails and phone calls were ever returned. I can only assume that they found out that my arrest resulted in 9 felony convictions and decide to “pass.”

When I started at UCLA (no questions about felonies on school applications), I tried to volunteer at the Los Angeles Big Brothers and Sisters organization. I was rejected as soon as the background check was completed. People wouldn’t even let me volunteer and I had been drug free for over 3 years and attending a doctoral program at UCLA… It was frustrating to say the least

Being licensed is probably also going to be an issue if I want to become a clinical psychologist in the future. It was one of the reasons I didn’t try to go to medical school or law school. The hassle of having to fight for the right to work in my chosen field wasn’t something I was looking forward to. Apparently though while I wasn’t quite ready for the fight then, fighting addiction stigma is something I feel strongly about now. Between our “Anonymous No More” campaign and my efforts on and off the website, I think we’re going to be able to slowly move public opinion away from either the notion that drug use in itself is a terrible thing or that addicts are lepers and should be kept at a distance.

Recovery success, there is a life after addiction

Still, I am constantly reminded that success follows perseverance. When I’m told “No”, I feel disappointed, but I pick my head up as soon as possible (my great fiance often helps) and try to figure out another way in. That was true when I first set on my path and its true today. I’m proud of my achievements and by now, more than eight years after the last time I used crystal meth, they are many.

I know my worth, I believe in my purpose, and I’m not going to let anyone else hold me back. Yes I have nine felonies and I used to sell drugs for a living. But I’m done with that and I’m trying to do the best that I can.

I think my recovery is pretty damn good – I’ve got All About Addiction that is visited by thousands of people a week, more than a dozen publications and articles about addiction in professional and popular journals, and I’ve spoken at literally hundreds of sessions, classes, and conferences about addiction and the problems associated with it. If you believe in yourself, you need to think the same of your own work. Stay on the right path. Don’t let anyone stop you.

About Addiction: Drug Information, alcohol safety, and Addiction recovery resources

You guessed it, another great piece detailing some interesting information about addiction from the corners of the world (wide web?). Enjoy, and remember to let us know if we’re missing some topics you’d like to see here!

Drug Information and alcohol safety

Drug.ie– Educating teens about drugs during the time of adolescence may be too late according to this piece. which claims that parents are very ignorant about the whole drug culture (many do not even know that their teens are using drugs or alcohol). In order to try to combat the drug problem parents should be educated and the whole community should work together to help alleviate the drug problem.   

Irish medical news– A new street drug has emerged in Ireland and is selling for €2 (something like $3). The drug has said to be as dangerous as methylenedioxypyrovalerone (MDPV). The drug is currently being analyzed for its properties but is thought to be as potent as mephedrone, BZP and MDPV.

Examiner– This article examines the history of Amy Winehouse and how she used to be deeply involved in the world of drugs.  The good thing that emerges from this article is the fact that Amy Winehouse has been sober for over 3 years – If Amy can do it, I’m sure many other addicts can!

Breaking the cycles- This article examines the proper ways to deal with individuals when they are drunk.  Alcohol works by depressing the central nervous system by slowing down the heart rate, lowering blood pressure and slowing a person’s breathing rate. If a friend passes out and they have consumed a lot of alcohol you should turn them on their side in order to prevent them from choking on their vomit. This is important, however it cannot stop the depressant action of alcohol as it keeps working on the central nervous system.

Addiction recovery resources

Bloomsburg Buisnessweek– Mental illness stigma is very difficult to shake when it comes to addiction recovery. In order to compact this issue individuals need to be educated about mental illness. In order to reduce stigma people should be urged to focus on the person rather than the disease.

5min Life Videopedia– This video gives a great perspective on how to help individuals who are recovering from drug addiction and alcohol abuse. It is worth watching, Enjoy!

Drug abuse and teens – The adolescent addiction challenge.

Guest author: Clint Stonebraker

teen-smokingRecovery from any addiction is a difficult process. It involves an individual’s willingness to take responsibility for his or her actions, a concrete decision to make significant lifestyle changes, and the courage to repair damaged relationships. The level of emotional maturity involved in taking these steps is usually somewhat foreign to an addict.

What about a person who is suffering from addiction and is, developmentally speaking, still a child? How does this person muster the emotional maturity needed to begin the recovery process?

I had the opportunity to work with a seventeen year old whose father had recently been treated for alcoholism. The father had suffered numerous consequences related to his alcohol problem including multiple D.U.I.’s and a divorce. By the time he sought treatment, the father was motivated to make a life change. He understood the root of his life problems revolved around alcohol abuse and had a desire to take responsibility for his actions.

When it came to the son, things weren’t that simple…

The seventeen year old had also suffered numerous consequences related to his drug abuse. He had already been arrested twice and had left home four months prior to seeing me. In fact, he clearly stated the only reason he agreed to the appointment was because his father had made it a part of the criteria for the boy to come home. He still believed the problems in his life were due to others not “leaving him alone.”

teensFor decades the adolescent substance abuse problem has gotten progressively worse. There have been prevention programs which have had some success, but adolescents continue to abuse drugs and alcohol at an alarming rate.

Because of this, it is important for anyone who works with adolescents to understand this unique population:

  • The conscious motivation for most adolescents to abuse drugs and alcohol is different than that of an adult. An adolescent who engages in substance abuse is seeking fun and peer acceptance, whereas the adult is seeking pain relief.
  • In most cases adolescents have yet to face the same level of physical or emotional consequences most adult addicts have faced
  • The adult addict is responsible for all aspects of his or her life, the adolescent isn’t

These are just a few of the differences between adults and adolescents with substance abuse issues. Some of the challenges in treatment include:

  • Creating an environment in which the adolescent has fun and gains peer acceptance. Developmentally these are needs which must be addressed
  • Helping an emotionally immature child take enough internal responsibility for his or her actions to be motivated to change
  • Showing an adolescent how to maintain healthy balance in his or her emotional life, in other words, limiting the emotional extremes

The biggest mistake clinicians make in treating adolescent substance abuse is assuming the adolescent is capable of dealing with life like an adult. In most cases, an adolescent must be able to see recovery as an attractive lifestyle. An adolescent substance abuser already has a general lack of trust with adults or any other “authority” figures. It is critical to maintain patience in order to gain the trust of an adolescent. Once trust is established, it is possible to reach an adolescent at their level.

When it came to this seventeen-year-old son, I knew that in order for this young man to begin the recovery process, he would need to see sobriety as an attractive lifestyle choice. I was aware of a group that held regular support group meetings specifically for young people. They also facilitated social events on the weekend.

As a part of the therapeutic process, I included his involvement with this group. The combination of counseling and a peer support system gave this young man a comprehensive plan of action.

As a result of beginning to associate sobriety with feeling good, he became more responsive to counseling. Over time he began to take more responsibility for his actions. He had a group of peers with whom he was accountable, could have fun, and network.

His father was involved in this process through his own counseling and involvement in a parent support group. Over time this young man was able to stay sober and reacclimatize himself into society.


This story illustrates key components of a process of recovery for adolescents. Over time an adolescent can begin to see the consequences of his or her actions. It is important to keep in mind what adolescents respond to. It is not one element that provides the key to adolescent recovery. It is the combination of therapy, peer support, and family involvement which provides the best opportunity for an adolescent to recover from addiction.

If we want to weaken the connection between teens and drugs, we have to start using what works.

Releasing the motivation bottleneck – Helping addicts by making recovery easier

My friend Patrick as SpiritualRiver reminded me of an issue that I think is somewhat obvious to many drug addiction researchers but may not be to others.

The way I see it, there is a specific reason behind much of the research into medications, or other interventions, that will help drug addicts in their transition to recovery:

If we can figure out a way to reduce the extreme hold that drugs have over addicts, we may just make it possible for a much larger proportion of them to get their life back and succeed in addiction treatment.

Long term drug use causes some serious alterations in the neurological functioning, and therefore the behavior, of substance abusers. As it stands, it requires a great deal of motivation, support, and perseverance to overcome a serious drug habit.

Still, if we can somehow make it easier, either by intervening earlier, or by somehow speeding up the brain’s recovery, or by creating the kind of functioning needed for the person to be able to make deliberate, informed decisions, we could just even the playing field a little. Right now, there are some medications out there that do just that, and as far as i’m concerned, regardless of what people say about substituting one addiction for another (which they do for methadone and buprenorphine), if we can get addiction back on the road to a functioning, contributing, life – that’s recovery too. Harm reduction is just that, a way to make people’s lives easier even if they can’t, or aren’t ready, to completely give up drugs. I for one don’t understand why so many people are insisting that it’s all or nothing. In case you haven’t figured it out, that’s not how life normally works, in recovery or anywhere else.

And by the way, that’s definitely not the only way to intervene – medication like modafinil and other pharmacotherapies that help addicts make better, less impulsive choices, also work; add to that bupropion (an antidepressant and a nicotine addiction medication that has a low abuse potential), as well naltrexone (good for opiate overdose but also for alcoholism treatment) and you begin to see that this area of treatment is getting better at providing solutions that are meant to supplement, not replace, traditional treatment modalities.

The end goal is to help the addict and as I’ve said before, I think we should use all our tools.

Believing in Recovery: Addiction treatment and faith

Faith Hill seems to believeSarah Henderson return with another article about addiction treatment and recovery. This time, Sarah gets all philosophical with us and discusses the concept of faith in recovery. Personally, my faith is and always has been very logic-based. I’m not a very spiritual person, and the things that are most important to me are usually right around me – my family, my work, and my new baby boy Kai. I’m not against the concept of a higher power, I just don’t feel a deep need for it and it’s probably the one concept that doesn’t keep me up at night (which is weird now that I think about it). But in the addiction treatment and recovery field, faith is a common word that can take on different connotations so I think it’s important to talk about.

Believing in Recovery: Articles of faith

I have a friend who is researching the history of the Bible. He’s on a bit of a mission, searching for some verifiable proof of certain articles of faith. He and I have lengthy discussions on this, going back and forth on the nature of faith, on whether or not one needs proof to believe. His position is, wouldn’t it completely change everything if we COULD verify the existence of God? My position is, yes it would; proof would make faith irrelevant.

Think about it. If you have proof of the existence of something, then believing in it is no longer faith, is it? It’s not even belief. It’s just actuality. I believe there’s a reason that we as a species have never been given proof of the existence of a higher being. (From here on out, I’m going to refer to this being as God.) I don’t believe that we, with our tiny human brains, have the capacity to understand or conceive of God. I also think part of the wisdom in perpetuating the mystery is that it keeps us engaged, keeps us seeking, keeps us wondering.

Faith is a very common word around addiction treatment and recoveryThe character House, MD (who is an atheist) said on one episode, “I love how people are always so proud of believing in something that isn’t there, like that’s some sort of accomplishment.” Well, actually is IS an accomplishment. Believing in nothing doesn’t take a whole lot of work. But believing in God without any verifiable evidence? That takes effort, takes devotion, takes love. Faith is a difficult path, no matter what you believe in. I also think that in believing in something outside of ourselves teaches us to believe in each other. For instance, when falling in love; you have to hold out your heart with no certainty that this person will not crush it. When forgiving someone; you are risking that they will hurt you again, but trusting that they won’t. When learning something new; you may fall flat on your face, but you have to believe that you can do it. If people never took a chance on each other, no one would ever get married, move away, try a new career, or have kids. Eventually, we all have to have faith in something, even if it’s just our own capabilities.Can you imagine a world without faith? I can’t. It’s what helps us believe in the future, surrender to the moment, look up when the world is falling apart and trust that things will right themselves soon.

When it comes to recovery, faith is essential- and I’m not just talking about God or religion. While attempting to recover from an addiction or other self-destructive behavior, you must have belief. First, you need to believe in yourself. You have to have confidence in your own ability to fight, to know that you have it in you to make it. And when that belief falters, as it inevitably does, you need to have faith in something outside of yourself too. You’ve got to hold on to something- God, a friend, the stars, the color blue- some entity to turn to when your confidence in yourself is flagging. And of course, there will be times when you are overwhelmed and feel like the pain of the transition is going to last forever. You have to be loyal to the concept that if you continue on the path of recovery, eventually you will find peace; that’s the “fake it ’til you make it” part. But it doesn’t happen without faith.

The word “faith” in itself has become so loaded that I think we often lose sight of what it really means; though truthfully, I think we each have to create our own personal definitions. To me, faith mean taking chances. And in recovery, that meant everything from eating when I wasn’t sure if it wold make me gain weight to reaching out to a friend without being sure I would get a response. All of those little risks built on each other until I developed some true self-confidence. With that in hand, I was able to make more proactive choices that have helped me get to the place I am now.

No matter what you believe in or how you define faith, I think we can all agree that recovery is something that cannot be done alone. It requires both external AND internal resources. At some point we all are faced with the fact that it will probably feel worse before it feels better; and in most cases, the only thing that keep us walking across that painful bridge is having faith that we’ll reach the other side.

A final word from Adi about  faith and believing in recovery

As I mentioned above, my faith is centered the things close to me and I don’t dedicate too much time to wondering about the existence of that god everyone is fighting about. Unlike Sarah, I see belief as something different than religious faith. As a scientist, I can believe information and data about addiction without having to make any leap other than in the objectivity of science and the honesty of scientists (which has certainly proven to be wrong at times). However, while I can see why people believe in a god, from the beautiful shafts of light that bounce off an ocean after a storm to the notion that there must be a master plan to make sense of all the pain and suffering in the world, I sometimes wish that I believed in a real higher power.

That’s not to say that I can’t see any power out there as greater than my own – Nature, humanity, my family, and the love I feel for my son are all ideas who’s incredible power is easy for me to grasp. Personally, that’s enough. When it comes to addiction treatment and recovery, I’ve seen the information, I’ve read the research, and I’ve personally experienced and viewed many success stories so belief doesn’t take a leap for me. That’s why I think education is so important and anonymity can be dangerous – By making successful recovery a point-of-fact, we make it easier for active addicts, and their loved ones, to believe that a different life is possible.