Have you heard: “a drug is a drug is a drug” sometimes mentioned in the halls of NA? Or have you heard, that taking pills is like chewing your booze? Maybe you believe the propaganda that having an addiction disorder means any and all addictive substances are taboo? Don’t feel bad, most all of our medical doctors ascribe to this script too. Oh boy, better poor that coffee down the drain; and, that cigarette you’re smoking is like inhaling forbidden wine. Alcoholics Anonymous (2018) publishes a pamphlet about medicinal drugs and doctors suggesting that: “No A.A. member should play doctor.” Virtu Services Network agrees whole heartedly! We also advocate the following from the same pamphlet: “If you feel that your doctor does not understand your problems, consider making an appointment with a physician who has experience in the treatment of alcoholism.” For us, changing the word alcoholism to addiction works a bit better, as we deal with all addictions. Well, the advice is commendable and worthwhile; except, the only physicians we’ve found credible, for our client base anyway, are psychiatrists.
Addiction Disorders are both psychological and physiological in nature, each exacerbating the other. Understanding the placebo effect helps inform this dynamic of physiological and psychological interactions. As neuroscience develops its take on Addiction, we are rapidly learning how molecules like dopamine, serotonin, and epinephrine are the real target drugs of addictions. Folks are chasing and obsessing over these cocktails made of neurotransmitter molecules. Street drugs or addictive behaviors are merely the syringes or cocktail shakers used for establishing the true internal elixir of addiction. These drugs are produced inherently by our bodies and manipulated by our thoughts, feelings, and behaviors, as understood by SMART Recovery’s third point (www.smartrecovery.org). In fact, there is really only one addictive molecule not produced by our bodies which isn’t even considered a drug by many, it’s called alcohol. Well, news flash, it’s the worst drug (addictive molecule) out there. Doc LaBranche claims it to King of the addictions. Designing a remission process is excruciating and treatment resistance horrendous. “I have a much easier time getting folks off heroin than I do off booze.”
Furthermore, alcohol causes irreversible brain damage, in some cases. Wernicke-Korsakoff can soon lead to Korsakoff psychosis, which is not the case for opioids. And here comes the take-home-message of today’s news brief: a drug is not a drug is not a drug. The degree of debilitation from the various effects of different addictions and from different associated substances and/or behaviors need to factor into a proper Harm-Reduction approach for addiction remission treatment protocols. Over the past decade there appear to be two main factors contributing to today’s inability to curb our opioid overdosing crisis. First is decerning various drug interactions within an individual’s internal chemistry (physiology) and worldview (psychology). The second relates to addressing the intermediate remission phase, where sufficient neural plasticity has been established to allow for higher order cognition and comprehension. It appears that this intermediate learning and development phase is imperative to sustainable remission and yet not well known in treatment circles. Those who neglect treatment during this phase seem to be prone to lapse and relapse months and even years later. As expressed often by 12-steppers, they relapsed because they stopped going to meetings. Within our circles, the intermediate phase involves changing core beliefs and learning new perspectives that eventually sustain remission.
In closing, Doc’s personal remission protocol included returning to academics, under the guidance of his spiritual director. At that time, Jack Kerouac’s “On the Road” had recently appeared in full Russian print in 1995 and his work was rapidly gaining international fame. Needing to fulfill an English Lit. core requirement, Doc thought: why not go for some Jack, and no not Jack Daniels! How enlightening the endeavor turned out to be, over the next 25 years of sobriety! The Beat Generation was Doc’s introduction to the enigma Herbert Huncke, who incited some friction during class. Still in early or intermediate remission, Doc expressed how offering studies exploring a heroin addict’s lifestyle is extremely dangerous (triggering) for addicts. Of course, at the time, Doc was thinking a drug is a drug. Today that education of the Beat Generation has become vital to decerning various elements of various addictions in their context of lethality. In hindsight, thank you once again UMass Lowell faculty, for offering a wonderful curriculum. Now, before reading some final research data related to alcohol use, please watch Mr. Huncke, at age 80, taking a short ride to the clinic.
“People hospitalized with alcohol use disorder have an average life expectancy of age 47–53 years (men) and age 50–58 years (women) and die ages 24–28 years earlier than people in the general population. Alcohol use disorder is a major public health problem that causes many years of lost life, even in countries with restrictive alcohol consumption policies.” (Westman, J. et. al, 2015). So, why the inclusion of our character who’s name rhymes with junkie? It is because of his integrity. It was well known that he would not simply pan handle money for his drugs, he was known to trade you a story he’d create on the spot for your spare change. According to The New York Times he was the hipster who gave definition to Kerouac’s Beat Generation, along with giving Burroughs his first fix (injection of heroin). And most importantly, his life of addiction presents very differently from the presentation of an alcohol use disorder.
References
Alcoholics Anonymous (2018). The A.A. Member—Medications and Other Drugs | Alcoholics Anonymous (aa.org)
Kerouac, J (1960) Na doroge // Inostrannaya literatura. https://www.bookvica.com/pages/books/100/j-kerouac/first-russian-kerouac-na-doroge-i-e-on-the-road
Westman, J. et. al. (2015, April). Mortality and life expectancy of people with alcohol use disorder in Denmark, Finland and Sweden. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4402015/
I can see why AA uses the oversimplification approach that states “all addictive substances are bad”. AA’s mission is to stop people alcoholics from drinking. The addiction remission community; however, has matured. As specialists study addiction more closely, they are finding better ways to focus on an individual’s specific needs for accomplishing remission. These techniques may include using methods that include medication that could be addicting if used improperly. AA has started to address this situation. (Please read the AA pamphlet “The AA Member-Medications and Other Drugs | Alcoholics Anonymous (aa.org)).