HOOKED

While I was transferring some of my files from my old hard drive onto my new computer, I found a folder with a series of images that I thought some might find kind of entertaining. These images were the individual pages of a comic book that had been distributed throughout New York city during 1966. It’s called HOOKED and its a story about one guy who finds himself unwittingly hooked on heroin. If anyone is interested in reading this 30 page story, click on the image. Once at the link, you’ll see the web page I’ve created and uploaded for this comic. There are individual full pages for each page of the comic so that it is nice and easy to read. Enjoy!!!

TORN APART

The following is a recent story published by Youth Communication, a website where teens are able to tell their true stories with anonymously. It was bloody powerful and absolutely tragic.

torn apart by anonymous

Carried nine months by a drug-addicted mother, I was born into a house where I was only as good as her next fix. I don’t know what neighborhood we lived in. I only remember the reeking smell of piss in the hallway of our project, leaks in the ceiling, cracks in the wall, no heat in the winter and no AC in the summer. My little brother and sister and I slept on the floor because we had no bed to call our own. Our fridge was as empty as a poor man’s pocket. Our mother never cooked for us; we survived on the scraps of food that she left.

Stepping on needles and glass in my mom’s old apartment, the cuts on my feet bled like the scars from my heart. I wanted my mother to love me, but her addiction consumed her. It was more powerful than her love for her own kids.

As a young child I wasn’t aware that my surroundings were unusual. People were getting mugged and beaten in the stairwell, so the cops stayed in our building like it was a police station. And in our home, drugs were an everyday object. There was nothing shocking about it, and when I think back on the other kids in our building, I realize that we weren’t the only ones suffering with a parent’s addiction. But at the time I was unafraid, because this life was all I knew.

My Heart Got Numb

As I got older, the greed of my mother’s addiction grew. When she could not get her fix, or when she was forced to go sober from the lack of cash, she would hit us with a broomstick, extension cord, or anything else that she could get her hands on. She was desperate to find some way to forget about her own problems, something that would give her a rush, a substitute for getting that high.

The only time that our mother was able to show emotion and give attention to her kids was when she was abusing us. Otherwise, she showed us no feelings, no love. Different men would come and go from the apartment. As a child, I didn’t know what was going on. Much later, I realized she was probably resorting to prostitution. But it just added fuel to the fire because once she crashed, she would be right back to abusing me and my brother and sister.

We were like rodents, scrambling around to pick up her scraps of food and trying to stay out of her way. I was hurt and confused. I thought, “How could she do this to her own kids?” After a while my heart got numb. I felt no hate toward her, but I also felt no love.

My brother and sister and I became closer than the average siblings because we had to look out for each other in order to survive. In the beginning there wasn’t much I could do to protect them from my mom’s abuse. I couldn’t even protect myself. But we would do little things to try to comfort each other. Like if my sister was beaten, I would take the leftover food and give it all to her.

Survival Mode

Then, when I was 7, my mother’s addiction got so bad that she could not support her habit and maintain an apartment. She got evicted, and we followed her to a shelter in Brooklyn. The shelter was scary. I remember people stealing from each other.

I don’t know how much time passed, maybe a few weeks. But one warm day, we went out with our mother and she just walked away from us. We didn’t follow her, because we thought that she would be coming back. But she never did. After a while, we started getting hungry. We didn’t know what to do. We didn’t know how to get back to the shelter. That’s when survival mode kicked in.

I’d never been able to depend on my mother, so I didn’t really miss her when she disappeared. My main concern was getting us something to eat. When it got dark, we started walking. When we saw the projects, I thought we were home, but they weren’t the same ones we’d lived in with our mom. We didn’t know were else to go, so we followed someone into the building, cuddled up together on the floor and went to sleep.

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TO READ THE REST OF THIS ARTICLE, CLICK HERE.

Getting Off Right

Lately, I have been noticing that there seems to be an increased amount of chatter regarding injection as the preferred means of administering drugs. While I would in no way attempt to promote or even encourage users to use this method, I do think that it is essential that, if used, it is done safely. For the few additional minutes that it takes one to ensure that proper procedure is followed, these few minutes may end up saving your life in the future, or at the very least, ensuring your continued good health.

For better or worse, my method of choice in administering my drugs was almost always via injection. By doing my best to ensure that I always followed proper protocol, I’ve managed to come through reasonably unscathed with my health more or less intact. While during that all important moment when you finally get your hands on what you’ve anxiously been waiting for, I know just how easy it can be to just dismiss how important it is to use a new needle or to ensure that your injection site is rotated regularly or to never share your works with anyone else, etc. Too many users allow themselves to be careless or really just plain reckless in their haste and impatience. I understand how easy this is to do, especially because any adverse affects on your health are not immediately apparent.

While it may take years for any negative side effects to rear themselves, short term gratification is not worth it in the end. If you have not yet tried this method, why bother? In the end, it’s not really worth it. If there is absolutely no convincing you otherwise, if you must, then at the very least, make sure that you follow proper protocol religiously, without exception. If you’ve already started, it’s still not too late to change for the better.

As a means to this end, I found a fantastic manual on line that absolutely must be read before continuing further. It covers everything that one could possibly need to know. It’s entitled Getting Off Right – A Safety Manual For Injection Drug Users. You can download it HERE. It was put out by the Reduction Coalition. You can get to their site by clicking HERE. The site itself has loads of important and interesting information as well as other literature for downloading.

OXY Part Five

So here is the final installment of the Oxy series from the London Free Press.

I think for a "small" town paper that the series was fine but I think as a whole London needs to start realistically looking at this issue if the stats that they reported are actually accurate.

On a personal note, I don’t really have a lot to report. I am doing well both physically and mentally. Am thinking of dropping my methadone dose by 5ml next week as I’ve been on my current dose of 80ml for close to a year now and am able to go more than a day and a half without feeling badly. I think that it is time.

Part Four of Oxycontin Series

Here is the next part of the London Free Press’s series on oxycodone.

 

This is the clinic that I attend. The male in the photo is Dr Craven who was my first doctor when I initially started. I had to switch to another doctor though when I started my new job this past May as his hours of practice were not working well with my work hours. He was a fantastic doctor none the less, but believe it or not, my current doctor is even better! We’re lucky here in London as most of the doctors associated with the clinic are fantastic.

Part Three of Oxycontin Series

Here is the third part of the series that my local paper is running on oxycontin.

London Free Press – Local News – Oxycodone

Oxycodone

By RANDY RICHMOND

Early morning and a steady path of people make their way to the counter.

Each one stops and takes a sip from a small, plastic medicine cup.

In each cup is methadone, a narcotic you also can buy off the street.

In Clinic 528 on Dundas Street, the methadone is legal.

In here, fire is being used to fight fire, one opioid drug handed out to battle others –plastic cup after plastic cup after plastic cup.

“I remember us thinking maybe we would end up with 350 people here,” says Dr. John Craven, associate director of Clinic 528.

It opened on Dundas Street five years ago, after doctors running a smaller clinic and private methadone treatment practices realized the need was growing. Back then, in 2001, the doctors had 120 patients with 80 on a waiting list.

“About three years after opening, I thought things would plateau,” Craven says.

“But everybody coming in, still to this day, tells us they know half a dozen other people out there.”

About five to seven new people a week come in for treatment, he says. Now there’s about 850 in treatment in London and another 180 at Clinic 461 in Woodstock.

More than 80 per cent of clients are addicted to opiate drugs prescribed through doctor’s offices, Craven says. The most common are the oxycodone-based drugs, Percocet and OxyContin being the most popular brands.

Methadone replaces those drugs, but comes, supporters say, with a much lower price.

Methadone basically fools the brain into thinking it’s getting a far more interesting and powerful opioid than it is, Craven says.

“Methadone is the most boring drug on the face of the earth,” he says. “It is useful because it is a lousy drug. It fills up the brain receptors and doesn’t do much of anything else. It stops people from going into withdrawal.

By all accounts, the physical withdrawal from opioid painkillers is a nightmare.

That physical dependence starts when the brain becomes used to an opioid. The drug changes the brain’s chemistry so it demands more each day to obtain relief or euphoria.

When the drug is taken away, the brain and body rebel. “I would sneeze until I felt like my head would blow off,” one told the Free Press.

“You get the runs. You would be on the toilet forever. You feel nauseous. You feel like you want to throw up. You get achy.”

A factory worker named Steve, 39, says he tried twice to go through counseling at Addictions Services of Thames Valley, the central outpatient service for addicts in the region.

“I just couldn’t do it, cold turkey,” Steve says. “I felt like my feet and my hands were going to pop off my body.”

He has a good family that he neglected more and more during the two years he was addicted to OxyContin. He spent all his savings on the drugs, lost a girlfriend and gave up his social life. Of all things, it was the repo man that turned him around.

“I had bought a new car and they repossessed it. I woke up one day and my car was gone. I thought, what am I doing?”

His elderly mother drove him to his first appointment last year. Imagine, Steve says, making your mom take you to a methadone clinic because you are an addict. He got clean in 12 days. After a year, he has a new girlfriend and is playing sports again.

“I don’t want to say it saved my life. But if I wasn’t here, I don’t know where I’d be.”

Not everyone sees Clinic 528 in such a positive light.

Provincial Conservative Leader John Tory, accompanied by police Chief Murray Faulkner, took a law-and-order tour of London last year and called for the clinic to be moved because it is close to Beal secondary school.

That prompted several London leaders to criticize the clinic’s location and the work it does. But the city itself runs a coffeehouse two doors east at William Street that attracts a rough-edged crowd.

Dozens of dealers, users, those trying to kick and other down-and-outers mill on the sidewalk between the clinic and coffee house.

In the middle of the day, you can get several offers to purchase drugs on the sidewalk.

Homeless people make up about seven per cent of Clinic 528′s patients, Craven says. Another 15 per cent are “one pay cheque away” from homelessness. The rest are working or in school or homemakers.

In the downstairs waiting area, though, a constant flow of rougher-looking patients come in each day for their methadone.

That’s because ‘downstairs’ is where beginners and long-time addicts who can’t get clean get their methadone.

Once someone tests clean for everything but methadone, they move ‘upstairs.’

That means they can get ‘carries’ — several days worth of methadone at once, and get individual counseling from one of three doctors.

“All I do is prescribe methadone, get them in the door, get their feet on ground, then try to educate them on how they got in this mess in the first place and how to get out of it,” Craven says.

A third of his patients are upstairs, a third downstairs trying to get upstairs. “And one third are determined to kill themselves through their addiction,” he says.

————

Upstairs and downstairs patients can meet twice a week in group recovery sessions. Mondays they talk about what they want. Thursdays they listen to a short recording by Craven and mostly stick to that subject.

There are rules here. No interruptions. First names only. A few veterans talk at a recent session about some other rules they’d like to see. No nodding off during session. No opening a bottle of pills for an aspirin.

“How do they know those aren’t my triggers,?” says one in exasperation.

At this session, they talk about honesty. A regular member, a woman in her 30s, fidgets in her chair. She tells the group she feels ashamed because she trusted a friend and the friend lied.

“Why do you feel ashamed? It’s your friend who should feel ashamed,” a group member says.

“I’m embarrassed because I want to help people but I can’t because I am not recovered yet,” the woman says.

“You can’t give what you don’t have,” Craven tells the group. “You have to help yourself first.”

Another group member tells them, “My conscience is working overtime now.”

That’s normal, because during addiction, you can’t get emotional about what you do, Craven tells them.

“Don’t beat yourself up,” a veteran of the clinic says.

————

After the meeting, the veteran says he’s been on methadone for seven years.

There are no deadlines to getting off, Craven says. Only after a year on a regular dosage should anyone even try to taper the amount, he says.

Opioids change the brain chemically and feed a growing hunger of fears, worries, past abuses and guilt.

That is one criticism of methadone treatment: It replaces one addiction with another.

Even those on it worry.

Tom, 34, an out-of-work furniture installer, used to drive by Clinic 528.

Why don’t these people just quit? he wondered.

He signed up in February 2006. Three years earlier he hurt his back at work, then spent years battling an addiction to OxyContin. “I tried to quit on my own. It was debilitating. I looked down on these people until it was me.”

His daughter saved him. Her grades were failing and she was getting into trouble at school. “I had to get the pills out of my life or I was going to lose my daughter. I think I just barely got away.”

It took him six months to move upstairs because he continues to smoke marijuana.

Ironically, the same thing that keeps some people away from the clinic was the thing that made him strong enough to get clean and move up.

“There are some pretty hard tales and some pretty hurting people downstairs,” Tom says. “It inspires me to get better.”

It took him a year to get his energy back and only now has he begun to call up old friends he left during the addiction years. He’s even thinking about going back to work.

“The past year I was content to have not much money. It helped me quit.”

It’s been a while since he had a craving for the drugs.

“I had a lot of dreams about it that are really where you are going and scoring and going home and doing it. Right now, I don’t think I will ever go back. I don’t want to ever go back to where I feel that low about myself.”

There’s just one worry.

“The methadone is a really good painkiller so I wonder how long I am going to be on it. When I am off, I don’t know how much of my pain will return.”

GLOSSARY

Opioid: Drug made from the opium in poppy. Commonly called narcotics or opiates. They are effective painkillers, but can also produce euphoria, making them prone to abuse.

Oxycodone: An opioid and key ingredient in prescription painkillers such as Percocet, Oxycet, Endocet and OxyContin. Oxycodone can create addiction and physical dependence.

Percocet: Contains 5 mg of oxycodone and gives about five hours pain relief. On the street, “percs” refers to both Percocet and generic forms of the drug.

OxyContin: Contains higher levels of oxycodone, usually 10 mg to 80 mg. It has a time-release coating offering pain relief for 12 hours. Chewed, crushed and snorted, or injected, the time release is bypassed and all the oxycodone is released at once.

Addiction: When a drug is so central to thoughts, emotions and activities the need to continue its use becomes a compulsion.

Physical dependence: The body has adapted to the presence of the drug, and withdrawal symptoms occur if use is reduced or stopped.

How they work: Opioids bind to brain receptors, and over time block those receptors. That forces the brain to require more opioid to produce the same euphoria.

What’s The Story, Morning Glory?

Remember in high school whenever you had to study for that all important exam? What was the first thing that you did in order to prepare yourself for this? If you were, and still are, anything like me then the first thing that you tended to do was anything but study. I’ll never, ever forget how suddenly even the most mundane of chores somehow managed to become mythical in proportion, waiting ever so patiently until they had my undivided attention. Over the years not much in regards to my procrastination skills have managed to change.

Now instead of school, I generally have work related projects competing for my ever diminishing attention span. It seems that whenever I sit down to my computer to complete one of the many never ending stream of projects that the Property Manager keeps sending my way, I find myself very easily distracted away from the task at hand. Like some pathetic sort of sycophantic fan, each day I am compelled to check out one of the many entertainment type gossip blogs. My morning simply can’t start until I’ve managed to get a wee taste of celebrity dirt. I mean, I have to be looking good when held up against comparison, say, to Ms Spear’s current foibles, etc

Now, if I may take the time to wonder aloud how it is possible that she has found herself in this recent set of misdeeds and misadventures. I thought that these type of people generally paid good money to certain types of employees to ensure that this type of stuff stayed very much in the background not front and centre of the public stage. And seriously, how badly messed up are you to allow things to reach this point? I mean even Kurt Cobain and Courtney Love, who in a strictly legal sense, lost custody of their newborn for her first three months and technically had to surrender their physical custody of her, all four of them – including Frances’ first nanny – managed to live under the same roof this entire time.

Come on Britney, give your head a very serious shake. If two of the most notorious heroin users were capable of successfully pulling this off, you at the very least could at least make a little bit of an effort to show up for your custody hearings and actually show up on time. My guess would be that this would strengthen your case significantly. Certainly passing a drug test here and there wouldn’t hurt either. Also, what kind of drugs is this chick on anyway that she has allowed herself to become this unglued?

I’ll be the first to admit that the entire drug landscape has most definitely change a lot over the past decade. No where do I find this very apparent then witnessing this change each and every day at my methadone clinic. The general demographic of the typical methadone patient has undergone quite the change here in London, Ontario, Canada from the first time that I started MMT in the summer of 1999 – in fact, in less than a ten year time period.

The number of patients actually at the clinic who are on MMT is 800 compared to the 162 patients back in 1999. Typically, the current wait time to start treatment works out to approx two and a half weeks, whereas the first time, I ended up having to wait almost three months. I ended up lucking out getting in at that time simply because there had been a cancellation on their waitlist. If not for that cancellation, I would have ended up waiting four months before I would have been able to even start MMT. From my experience, when a junkie finally reaches out and starts asking for help, being put on someone’s waitlist is not any kind of solution but rather, an additional problem.

In the years between each MMT, the opiate landscape in this city changed so that what I remember from a decade ago, no longer exists today. While talking to my doctor recently, he mentioned of the 800 patients currently on methadone at the clinic barely a handful had ever seen heroin. Or almost 780 patients – out of 800 – being treated with methadone, were not, by exact definition, heroin addicts. Yes, they were opiate addicts because each and every one of them had issues with narcotic analgesics, but they certainly could not be easily lumped into society’s usual perception of the dirty, disgusting junkie.

Of course, in the end, this is all just semantics. Obviously, the growth of the clinic here in London, Ontario these past tens years is a result of a number of factors occurring simultaneously. Obviously, there is a growing need for this type of facility and from the perspective of a business plan, a need which if operated properly, will also prove to be financially rewarding for any investors i.e. the doctors that decided to expand their much smaller clinic from the previous decade into a clinic requiring considerably more support staff, etc.

Now a clinic of its current size will definitely be much more noticed by John T Public because depending on its location, the influx of nearly 1000 individuals that for the most part walk to the beat of a different drummer would hardly be invisible. Not many would be thrilled to have this particular group doing not much more than loitering near their homes or business each and every day. If it were just the patients of the clinic that the neighborhood had to be concerned about then that would be one thing but inevitably, it is the baggage that accompanies each of these patients that ends up being the biggest concern as generally they have less to lose.

Now if most of the opiate addicts in London, Ontario are not addicted to heroin, what the heck are they doing then? Apparently the majority are hooked hardcore on oxycontin. Or at least so says the five part series that our local paper, the London Free Press, started running in yesterday’s paper. This special report plans on covering all aspects of this addiction and how it is affecting our community as well as what we as a community can and should do to help.

The article from today focused on how oxycontin was doing much more than killing pain for two men while yesterday the series shared the story of one young housewife and mother of two’s battle with this drug.

Following is the introduction article to the series which was written by London Free Press reporter, Randy Richmond, that you should be able to read in its original form here. There was a second article regarding pharmacists and how they feel caught in the middle.

Oxy, part 1
Oxy, Oxygen, M&Ms, 80s, Oxycotton.

Killer.

The drug sweeping London’s downtown streets, workplaces and suburbs goes by many nicknames.

But it has one effect on police, civic officials, social service and health-care workers, users and those dealing in drug subculture — alarm.

And it’s ravaging London like few other cities in the province, police say.

A $3.7-million, five-year plan to combat substance abuse will be unveiled at city hall Monday.

“It is the drug of this city right now,” said Sgt. David MacDonald, head of one of the police’s two street drug units.

The opioid called oxycodone is so powerful, so easy to get and so hard to kick, it’s fueling crime, ravaging the vulnerable, and turning ordinary middle-class citizens into sellers and buyers.

What makes it tough to tackle is the source. It’s not made in makeshift labs, grown in basements or shipped in from other countries. Most comes from London doctors’ offices, then gets ’diverted’ to the underworld.

Signs of its rise are everywhere:

• OxyContin, the most popular oxycodone based painkiller, is the most commonly injected drug among needle users in London, recently surpassing heroin.
• Opioid abuse is rising to one of the top three problems cited by people seeking help at Addiction Services of Thames Valley. In most areas, it is tied with or nearing crack, cocaine and cannabis.
• In Ingersoll, opioid abuse ranks behind only alcohol, traditionally the No. 1 cited problem among people getting outpatient counselling.
• The Children’s Aid Society of Middlesex London is seeing more and more parents hooked on OxyContin and other painkillers.
• In 2004, only 86 police occurrences, such as break-ins and thefts, could be identified as fueled mainly by oxycodone addiction.

By 2006, the number of police occurrences had jumped to 261.

- OxyContin is the drug of choice — supplanting crack –among sex-trade workers in London, police say, and 100 per cent of the about 80 women working in the sex trade use drugs.

The diversion and rising influence of oxycodone-based prescription drugs is one of the forces prompting the city’s community services boss, Ross Fair, to present a plan to politicians to attack substance abuse in London. The five-year plan rests on four foundations — improvements in prevention, harm reduction, treatment and enforcement.

Only a large-scale co-ordinated effort will work, Ross says. “Addiction is a big hairy beast.”

The city would pay a third of the $3.7-million price tag, the rest coming from Ottawa and Queen’s Park.

The plan would target the most vulnerable first: the homeless, sex-trade workers, street youth.

Key points include:

• Create a downtown street outreach initiative, with nurses and addiction workers.
• Expand existing safe haven drop-in programs, such as Mission Services, My Sisters Place, Centre of Hope and AtLohsa, so full day and evening service is available
• Push senior levels of government for more treatment, and wait-time standards.
• Increase London police so the force can focus on illegal activities associated with drug dealing and prostitution.

The strategy also has clear targets:

• Reduce the number of sex- trade workers 50 per cent in three years
• Cut to zero the number of overdose deaths among homeless.
• Increase the number of homeless in addiction programs by 200 over five years

Prohibition: a crippling habit

Nick Davies

December 14, 2006 12:00 PM

Everybody knows, of course, why those women sell themselves out on the streets of Ipswich – because they are heroin addicts. As the front page of the Guardian put it yesterday: “Pock-marked and painfully thin, they all bore the obvious signs of heroin and crack addiction … selling their bodies to feed their crippling habit.”All of that happens to be untrue. Neither of those drugs makes you pock-marked or thin, nor is a drug habit crippling. Nor does it require you to sell your body. All of those things become true only if addicts have the misfortune to live in a society which insists on prohibiting those drugs.

In the case of heroin, all of the side effects which are associated with the drug – all of the disease and death and misery and depravity are the effects not of the drug itself but of the black market on which the government insists that it is sold. So, we have dirty heroin polluted with all kinds of dangerous crap; dirty needles which spread hepatitis and HIV; desperate users who can’t afford to eat or look after themselves; and a never-ending tidal wave of property crime and prostitution.

Pure heroin properly used is a benign drug. It’s worst physical side-effect is constipation. Other drugs, like cannabis and cocaine do have some bad side-effects, but always and everywhere it is true that no drug becomes safer when its production and distribution are handed over to criminals. Water would become dangerous if we banned it and were forced to drink ditch water from black market dealers. Alcohol did become far more dangerous, when it was prohibited in the United States and brewed with methylated spirits which attacks the optical nerve (which is why so many of the old blues singers were blind.)

In Holland and Switzerland, where they have been supplying their most prolific addicts with clean heroin, they have proved the virtues of legalization. The average age of addicts in Holland has been rising for years, because they have taken away the black market which sucks in new users as each user deals to his or friends to find funds for
their own habit. The Swiss have published detailed results about the addicts on their scheme, which show them improving in health, employment, family relations, housing, crime – and abstention.

There are really only two kinds of people who support the prohibition of drugs: those who know the truth and, for some political reason, refuse to admit it; and those who genuinely have no idea what they are talking about. Both of them should look at the lives of those women on the pavements of Ipswich and of every other major town in this country; they should look at the lives of the estimated 300,000 chaotic drug users in this country; they should look at the crime boom around them and consider the misery for the drug users themselves and for the communities around them; and they should get on and support legalization of all black market drugs.

Beth Alvarado – How I Quit Heroin and Other Toxic Substances

Beth Alvarado - How I Quit Heroin and Other Toxic Substances

I found this article while I was surfing the internet the other day. I think that I did a search for “heroin addiction” at LookSmart’s FURL site. This was just one of the many links my search produced. Normally before reprinting an article, especially an article of such personal and sensitive nature, I attempt to contact the website that the article originated from. Unfortunately when I got to the web site that stores this piece of writing, I could not find any sort of contact info. I’m hoping that perhaps someone from sporkpress might stumble across this entry and contact me. Until I am told otherwise, I plan on keeping the link and this portion of her article online for others to read as I think that it is an important one as well as one that many of us most definitely will be able to relate.

Imagine turning your head and holding your arm out, as if for a blood test. You feel a slight prick, you loosen the tie, and then suddenly this warmth floods up, you feel a rush that begins at the base of your spine and surges up until it explodes in your head, like light. Then, for hours, you float in a bubble of warmth and well-being; dreams as vivid as movies drift before your eyes. This is why people like heroin.

Imagine you no longer feel like an ordinary girl, bland and vulnerable, but like a girl who is daring, an outsider, a risk-taker, one of the guys. This is why I tried it in the first place.

But why is a question junkies never ask. They know why. The question for a junkie, is why not? You have to have a very good reason to give up that rush. After all, you’ve come to love the ritual, even the smell of sulfur, the flame beneath the spoon. You love the liquid lightning that fills your veins and blossoms in your head. You love the dreams, more brilliant with color than anything you’ve seen in life: a car so red its edges are silver in the sunlight, poppies exploding into color, again and again and again, orange, purple, vermilion, the dark velvety center. And then the psychic numbness that envelops you for hours, where you have no worries, no fears, no anxieties, no guilt, no other desires.

So why is not the question. You may as well ask why people have sex—which, as we all know, can have as deadly side-effects as heroin.

I was sixteen when I started. Thin, thin, always dressed in jeans and a black t-shirt, hair long and wild, I imagined I was a bohemian. The rules didn’t apply to me. I didn’t have to attend school to get A’s and B’s. The year was 1970. Janis was still alive, I think, maybe even Morrison and Hendrix. The Civil Rights Bill was six years old. Watts had burned, so had Newark. John F. Kennedy, Martin Luther King, and Bobby Kennedy had all been killed. Vietnam was old news. The Cold War was simply a part of the landscape. We wanted out. Sometimes it seemed as if the world were falling apart. The center was not holding. We were kids, living in the borderlands of Arizona, in a town ringed by missiles. We couldn’t imagine a future. Instead, we shot dope. We ran it across the border. We were falling from idealism to despair. I’d fallen. Needle to the vein. My blond boyfriend from West Texas was threatening suicide and planes like dark predators were circling overhead.

By May of my twentieth year, I had not only grown up, I felt old. I had quit using every toxic substance I’d ever tried. This includes pot, hallucinogens, cocaine, speed and alcohol, none of which required any effort at all to quit, as well as the two that caused me difficulty, heroin and tobacco. I could claim that this makes me an expert, not only on addiction but on recovery, but I am ambivalent about everything: what constitutes addiction, whether physical addiction leads to psychological or visa versa, and whether or not people can be “cured.” Whether addiction is a disease—or a symptom. Part of me believes I was never addicted to anything—and that may be true. I started smoking at fourteen, for instance. Can I really say, that at twenty, I was addicted to nicotine? Likewise, even though I started using heroin at sixteen, I abstained for my entire senior year in high school—instead popping several Percodan every few hours. (My boyfriend, true to his Texan roots, was a Cowboy, but of the Drugstore variety.) Since I used opiates daily for only a few years of my life, was I truly an addict? Perhaps I was on the road to addiction and mercifully waylaid.

I have proof, at least, of physical need: I was cranky as hell whenever I tried to give up smoking and felt withdrawals whenever I tried to quit heroin. Yet physical withdrawals are simply the most obvious manifestation. Addiction is the absence of choice. To illustrate, when I was sixteen, I was sitting in a park when I realized I was out of cigarettes. Upon discovering that fact, I really wanted one—which meant I would have to stand up, walk a block home, scrounge for thirty-five cents (yes, thirty-five), walk two blocks to the discount store, and buy the cigarettes. (This not only gives you an idea of how lazy—or stoned—I was but of the oppressiveness of summer heat in Tucson.) At any rate, I realized that if I quit smoking, I could choose not to take the walk. What liberation! Ever since then, addiction, for me, has meant that a substance compels me to consume it. If I feel like I have to have it—even if, physically, I don’t—then I am addicted.

In some fundamental way, then, it makes little difference if the precious amber liquid is scotch in a glass or heroin in a syringe, if escape comes in a vial of cocaine or is provided by little pills in a prescription bottle. The underlying desire is the same. Perhaps each of us, given the right (or wrong) substance and the right (or wrong) set of circumstances, is a potential addict. After all, you don’t have to be an asthmatic to suffer an asthma attack; you simply have to be exposed to something that will trigger the reaction. And you never know what that something might be.

For this reason, I’ve never blamed my family. My parents were as typical of their WWII generation, with its alcohol use and repression, as I am of the Vietnam generation, with our drug use and penchant for openness. To be fair, my father would never have considered a few highballs a “problem” and my mother would insist that a stiff upper lip is an admirable quality. When I was coming of age, we thought psychedelics would liberate our minds. It never occurred to us that cocaine was dangerous; it certainly wasn’t thought to be addictive. And heroin? Well, they had lied to us about the dangers of every other drug, why should we believe them about this one?

But we should have. And perhaps because we didn’t, the Vietnam War helped spawn a heroin epidemic—at least that’s what they called it when use crossed the border from the ghettos and the barrios into the suburbs. Ironically, my husband, who is Mexican-American, didn’t use when he lived in the barrio; it was only later, after his parents moved the family into a white neighborhood, that he hung out with anyone who was doing drugs heavier than marijuana. All the guys we knew coming back from Nam were strung-out on China white. In the four years I was shooting dope, sixteen people I knew died of drug overdoses. Sixteen people just like me. Middle-class, white. Children of doctors, lawyers, and restaurant owners.

Heroin is pernicious, but whether that’s due to inherent properties of the drug or to the black market lifestyle, we may never know. I don’t suppose there are enough independently wealthy junkies for an accurate survey; I do suppose that bootleggers during Prohibition led equally unhealthy lives. At any rate, according to my brother-in-law, who has been in prison on drug charges three times and who is still on methadone maintenance, many of the (mostly white, middle-class) addicts we knew frequent the same clinic he does, still addicted nearly thirty years later. Only four of us, my husband and myself included, were able to quit in time to make “normal” lives for ourselves. Statistics are equally frightening: only one out of thirty-five addicts will stay clean and sober; some relapse after ten or fifteen years; most become alcoholics; in one study, of the 10% who had “recovered,” half were counted as not relapsing only because they had died. Death as a cure—imagine that! I fit the profile of the addict most likely to stay clean: young, female, addicted for under five years.

This suggests that the longer one uses, the more fierce the psychological addiction, yet we also assume that psychological factors—childhood trauma, history of family dependency, unhealthy living situations, poverty, etc.—make some of us more vulnerable in the first place. A chicken or the egg sort of cycle. Some research indicates that people who get addicted to opiates may already have a deficiency of dopamine in their brains, which predisposes them to addiction to substances like heroin. But whether you’re predisposed or not, if you use heroin with any regularity, you will get addicted because heroin takes over a natural function of brain chemistry: it replaces dopamine. When the heroin stops, no dopamine, your nerves are screaming. Physical addiction is simple. If you don’t do it, you experience pain; since you did it in the first place to alleviate or avoid pain, you just do it again. Basic Pavlovian theory. You know what cures you.

On the other hand, people who have abused drugs like metham-phetamine or cocaine, which stimulate the pleasure centers of the brain, are always left with a need to have that center stimulated. (Ecstasy, as I understand it, like Prozac, increases the amounts of serotonin in the brain and thus causes changes in brain chemistry, at least temporarily.) In other words, even when there is no physiological predisposition to addiction and no physical dependency, because the drug itself causes changes in the brain, those changes can create a strong psychological addiction—in the case of cocaine, to anything that will stimulate the pleasure center. Even sex. So far as I know, cocaine is not physically addictive, only psychologically, but, hey, monkeys will give up food, water, and sex for cocaine. Monkeys will die for cocaine.

No big surprise there. People die for cocaine. I once met a real estate developer who had lost everything, and he had quite a bit to lose, to that white powder. He said, “Cocaine is God’s way of telling you you make too much money.”

But back to the monkeys with monkeys on their backs: monkeys who have unlimited access to heroin gradually level out their use. They still eat, they still sleep, they still have sex. They simply do enough heroin to keep from going through withdrawals. This experiment, which I read about in the Stanford Alumna Magazine, was published in the mid-eighties, when cocaine was thought of as nose candy, something one might indulge in at cocktail parties. (Please pause for a moment to consider what that target audience might have been doing in its spare time.) Whatever else the experiment’s purpose, it did prove that there is no “just” to psychological addiction.

Physical addiction, no matter to what substance, seems to be the least of an addict’s problems. There’s methadone for the junkie, Nicorette gum for the smoker. Drunks, speed freaks, crack heads and their brethren coke heads have no choice but to go cold, I guess—although researchers are experimenting with new drugs which affect serotonin levels and seem to reduce the addict’s cravings. But even if you have to take the old-fashioned route and go cold, your body gets over it. People do kick. Some stay clean for years before going back. It’s the psychological pull, the craving, that’s so hard to overcome.

For some people, of course, addiction is a symptom of an underlying disease, clinically known as a dual disorder. For example, many schizophrenics or manic-depressives are addicts; prior to being diagnosed, they used (and became addicted to) illicit drugs in an attempt to balance out a brain chemistry that was naturally out of whack or had been thrown out by trauma. For the rest of us, though, the question is how do you liberate yourself from desire so intense it rules your life? I can answer only for myself.

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The Dragon of Dissociation

Getting off drugs, or learning to stop drinking, is very often easier than staying off them. As Mark Twain remarked about tobacco, quitting was easy-he’d done it dozens of times. Relapse, the biological imperative, will have its way with most of those abstaining for the first time. Addiction is a psychological disorder with strongly cued behavioral components, whatever its dimensions as a biochemically-based disease.

The three-headed dragon is a metaphor first popularized by alternative therapists at the Haight Ashbury Free Medical Clinic in San Francisco. The first head of the dragon is physical. Addiction is a chronic illness requiring a lifetime of attention. The second head is psychological. Addiction is a disorder with mental, emotional, and behavioral components. And the third head of the dragon is spiritual. Addiction is an existential state, experienced in isolation from others.

Addicts speak of “chasing the dragon” in an effort to catch the high that they used to achieve so easily. It is also drug slang for the use of small metal pipes to catch and inhale the wisps of smoke from a pile of burning opium, crack, or speed. We can picture the dragon chasing his own tail, snapping at it with all three hungry mouths, in an endless escalation of tolerance and need.

“Because of the unique reaction that the genetically addiction-prone individual experiences to his drug of choice, he or she programs his or her belief system with the deep conviction that the substance is ‘good,’” writes Richard Seymour of the Haight Ashbury Clinic. “This is where self-help becomes intrinsic to recovery. Unless one deals with the third head, unless one changes the belief system and effects a turning-about in the deepest seat of consciousness, there is no recovery.” The “X” factor in recovery, for many people, turns out to be a form of inner self-awareness; something that includes the attributes of will power and determination yet transcends them through a form of surrender.

And speaking of changing one’s belief system, experience has shown that it is a spectacularly bad idea to sit around and do nothing but stare at the wall during the early phase of recovery. Psychologist Mihaly Csikszentmihalyi argues, in The Evolving Self, that when attention wanders, and goal-directed action wanes, the majority of thoughts that come to mind tend to be depressive or sad. (This does not necessarily apply to formal methods of meditation, which cannot be described as states marked by wandering attention.) The reason that the mind turns to negative thoughts under such conditions, he writes, is that such pessimism may be evolutionarily adaptive. “The mind turns to negative possibilities as a compass needle turns to the magnetic pole, because this is the best way, on the average, to anticipate dangerous situations.” In the case of recovering addicts, this anticipation of dangerous situations is known as craving. The next step is often drug-seeking behavior, followed by relapse.

For a highly motivated addict with a stable social life, a safe and effective medication to combat craving might be all that is needed. For many others, however, attention to the other two heads of the dragon is going to be necessary. An addict’s ability to experience pleasure in the normal way has been biochemically impaired. It takes time for the addict’s disordered pleasure system to begin returning to normal, just as it takes time for the physical damage of cigarette smoking to partially repair itself. Alternative therapists are fond of referring to recovery as a process, with an emphasis on the importance of time. Medication of any disease, even if successful, does not treat the continuing need for healing. It is now well understood that mood and outlook can have an effect on healing. Positive emotional states can be beneficial to the maintenance of good health. Thoughtful physicians make the distinction between a disease and an illness. A disease is a chemically identifiable pathological process. An illness, by contrast, is the disease and all that surrounds it-the sociological environment, and the individual psychology of the patient who experiences the disease.

Dissociation

Where does the everyday self go during active cycles addiction? It is not a simple case of amnesia, or sleepwalking. It is more like a waking trance, or autohypnosis. Psychologically, it is a state of dissociation. For addicts, the three-headed dragon is both a part of them and not a part of them. It is integral to who they are, yet it is estranged from their core selves. When activated, the cycle of addiction lead men and women away from their genuine natures. Their sense of self becomes impaired through the processes of intoxication, denial, neuroadaption, withdrawal, and craving. This impaired sense of self causes behavior that is baldly contradictory to their core beliefs and values. Honest men and women will lie and steal in order to get drugs.

Webster’s Unabridged Dictionary defines dissociation, rather vaguely, as “the splitting off of certain mental processes from the main body of consciousness, with varying degrees of autonomy resulting.” Recall that in the case of state-dependent memory, if you give a rat a mind-altering drug, and teach him to run a maze, the rat will perform this maze task more efficiently in subsequent runs if it is under the influence of the same drug. How autonomous were you, consciousness-wise, the last time you got drunk and parked your car somewhere you couldn’t remember?

Dissociation may be part of the way consciousness itself adapts to chronic drug use. Richard S. Sandor, a thoughtful Los Angeles physician, helped to clarify many of these issues in an excellent essay in Parabola magazine:

…the inability to satisfy a physical craving or psychological compulsion will produce all kinds of unusual behavior, but this is true for natural drives and appetites as well as for created ones. What might one not do to avoid starvation? Such behavior alone cannot be used as evidence for a pathological personality type. The failure to recognize this point has led to a considerable amount of confusing retrospective research–deducing a personality type after the addiction had developed. But in fact, a dependence on a substance or activity condemned by society as illegal or immoral leads the addict to act in antisocial ways; and this is the case far more often than that drug addiction results from an antisocial personality type.

Secondly, Sandor points to the inability of prevailing behavioral models to produce a comprehensive framework for effective treatment. “None of the current treatment methods based upon the positivist scientific paradigm-be it psychodynamics (Freud, et al.) or behavioral (Pavlov, Watson, Skinner)-has demonstrated any particular superiority in the treatment of the ‘addictive disorders,’” he writes. “Many psychoanalysts readily admit the uselessness of that method for treating addicted individuals (the patient is regarded as being ‘unanalyzable’).”

Thirdly, says Sandor, “It appears that the most successful means of overcoming serious physical addiction is abstinence-very often supported by participation in one of the twelve-step groups based on the Alcoholics Anonymous model…. The basis of recovery from addiction in these nonprofessional programs is unashamedly spiritual.”

The problem for the addict, as Sandor realizes, is not so much the matter of quitting, as it is the matter of not starting again. The resolve to quit is often present, but the resolve not to start again can be interfered with in a variety of ways. All addictions, Sandor argues, more closely resemble “the whole host of automatisms that we accept as an entirely normal aspect of human behavior than to some monstrous and inexplicable aberration.” Bicycle riding is a good example of an automatism, because once learned, “…it no longer requires the subjective effort of attention; more importantly, once learned, it cannot be forgotten. It is as though the organism says to itself, ‘Riding this thing could be dangerous! It’s much too important to trust that Sandor will pay close attention to it.’”

So what does the mind do? It creates a new state called bicycle riding:

Number one priority in this state (after breathing and a few other things, of course) will be maintaining balance. In much the same way, the organism recognizes that mind- and mood-altering chemicals disturb the equilibrium of functions and are therefore potentially dangerous. In response, it may form a new state in which the ability to function is restored, but in which a new set of priorities exerts an automatic influence. Just as one’s only hope of not riding the bicycle again (if for some reason that is important) is to never again get on one, once a particular addictive state has developed, there is no longer any such things as “one” (drink, hit, fix, roll, etc.). Addicts begin again when they forget this fact (if indeed they have ever learned it) and/or when they become unable to accept the suffering that life brings and choose to escape it without delay. Addictions can be transcended–not eliminated.

Sandor ultimately concluded that “The only modern Western psychologies that can aid us in our search to become truly human are, like AA, frankly spiritual or transformational in nature (e.g., those of Gurdjieff, Jung, Frankl).”

Sandor compares the addictive state to a form of hypnosis accompanied by posthypnotic amnesia. This automatism, this subsequent amnesia about the drugged “I” on the part of the sober “I,” is highly reminiscent of the consequences produced by state-dependent memory:

A hypnotized subject is instructed to imagine that helium-filled balloons are tied to his wrist; slowly the wrist lifts off the arm of the chair. The subject smiles and says, ‘It’s doing it by itself!’ The ‘I’ that lifts the arm is unrecognized (not remembered) by the ‘I’ that imagines the balloons…. One part denies knowledge of what another part does. A cocaine addict, abstinent for a year, sees a small pile of spilled baking soda on a bathroom counter and experiences an overwhelming desire to use the drug again. Who wishes to get high? Who does not?

“Interestingly,” Sandor says, “this type of amnesia is very similar to that seen in the multiple personality disorder (see Jekyll and Hyde), in which one entire ‘personality’ seems to be unaware of the existence of another. Even more interesting is the fact that confabulation, rationalization, and outright denial are also prominent features of the addictive disorders.” Dissociation, then, can occur without the intervention of anything as dramatic as hypnosis. The common quality is automaticity, the experience of “it doing it by itself.”

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