Pathways from Heroin Addiction: Recovery Without Treatment, Part 4

The research conducted by Patrick Biernacki, with 101 former heroin addicts, showed some of the courses that people take in their lives when they give up using the drug without the aid of treatment. This is the last part of this series of blog posts.

When people resolve to stop using heroin, they face a variety of problems that go beyond the cravings for the drug and the temptation to use again. These additional problems are related to their attempts to fashion new identities and social involvements in worlds that are not associated with drug use.

As Biernacki pointed out, ‘The manner of termination and the course [or courses] that follow withdrawal from opiates are closely related to the degree that the addicts were involved in the world of addiction, to the exclusion of activities in other, more ordinary worlds, and to the extent that they had ruined conventional social relationships and spoiled the identities situated in them.’

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‘Our Recovery Stories’ Update

I just wanted to let you know that the eBook Our Recovery Stories: Journeys from Drug and Alcohol Addiction will be available from 9th April 2021. It will be available via Apple, Amazon or Kobo (price: £4.99, A$8.99, US$6.99, €5.99). I will provide links and any other relevant information shortly.

I have chosen this date for release, as it is my youngest son Sam’s birthday and is a day before Michael Scott’s, of Michael’s Story, 43rd Sober Anniversary. And I then learn that the 9th April is the 60th birthday of Kevan Martin, of Kevan’s Story. Couldn’t have chosen a better date.

Please note that the book will have to be read on a phone, tablet or a computer. I hope to publish a hard copy version at a later date. Here is what I have said in the publicity material:

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I Am Not Anonymous: Ellie, ‘Come With Me’

EllieTextBlog-1024x682A Story from the excellent I Am Not Anonymous website is long overdue. Here is Ellie’s Story“:

‘When I was drinking, my life was ruled by shame.  It’s exhausting, living a double life. On the outside I was a put-together, active, intelligent woman.  I made sure my outside always looked okay, so nobody would look too closely at what was really going on, at my dirty secret.

Inside, I was a crumbling mess.  I felt less-than, unworthy and insecure.  I strove for perfection in all things, which of course is unattainable, and this left me feeling empty and ashamed.

I drank to fill the cracks, the emptiness.  I drank to numb out, escape.  I drank to feel okay with myself.  I found myself in my late thirties, a shell of a person, hollow and feeling desperately alone, even though I had a beautiful family, a job, and people who loved me. 

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‘Is Depression Who I Am or What I Have?’ by Douglas Bloch

In this video, author and depression counselor Douglas Bloch talks about separating your feelings about being depressed from your sense of self worth.

I Am Not Anonymous: Lauren’s Story, ‘Will To Bear Discomfort’

LaurenText-1024x682(pp_w1000_h666)I’m starting 2015 with some powerful writing from the I Am Not Anonymous website.

‘When I walked into the door to rehab in early 2008 at the age of 29, I was given a lengthy input questionnaire. I decided it was time to be honest for once.

There was just one question I had to leave blank. I pondered it for the better part of a day and kept returning to it with no decent answer.

What is spirituality? I didn’t have a clue. I reluctantly left it blank. By the time I left rehab almost three months later to return to the life I had left, I had a much better understanding of what spirituality was and how it could help me.

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‘A Discussion of Labels, Part One: Disability’ by Melissa Bond

mbondI’m very wary of labels in health. Here’s a great blog and beautiful writing from Melissa Bond on the Mad in America website on labels.

‘When my son was born six years ago, the word “disabled” was suddenly all around me. It came from everywhere – the nurses, the doctors, the physical and occupational therapists, friends and family.

I remember looking into his ice blue eyes and so marveling at the lines of white that extended so symmetrically from his irises that I began calling him Star Boy. I felt a new mother’s sense of protection. The label surrounding my Star Boy was a smoke so thick I felt I could barely breathe.

Disabled. My boy with an extra chromosome was disabled. He wore a label that expressed negation, a subtraction. He was defined by the world at large by the Latin prefix denoting “apart,” “away,” or “having a privative and reversing force.”

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‘Stigma Reduction Through Recovery Contact’ by Bill White, Tom Hill and Greg Williams

Silence PosterMore insightful writing from Bill White and colleagues.

‘Debates continue on whether the stigma attached to persons experiencing alcohol and other drug (AOD)-related problems has a positive or negative social effect on the nature and magnitude of these problems.  Stigma promoters argue that public castigation of excessive AOD users prevents such use at a cultural level and exerts pressure for AOD deceleration/cessation among those with AOD problems.

Stigma detractors argue that such castigation inhibits help-seeking, forces excessive AOD users into subterranean drug cultures, promotes their sequestration through mass incarceration, poses barriers for the reentry of people seeking recovery into mainstream society, and places undue blame on individuals and groups while ignoring the ecology of addiction – the environmental conditions in which alcohol and other drug problems flourish.   

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Russell Brand: my life without drugs

26th Annual ARIA Awards 2012 - Award Winner PortraitsA great article in the Guardian by Russell Brand. He’s doing some great work.

Russell Brand has not used drugs for 10 years. He has a job, a house, a cat, good friends. But temptation is never far away. He wants to help other addicts, but first he wants us to feel compassion for those affected.

The last time I thought about taking heroin was yesterday. I had received “an inconvenient truth” from a beautiful woman. It wasn’t about climate change – I’m not that ecologically switched on – she told me she was pregnant and it wasn’t mine.

I had to take immediate action. I put Morrissey on in my car as an external conduit for the surging melancholy, and as I wound my way through the neurotic Hollywood hills, the narrow lanes and tight bends were a material echo of the synaptic tangle where my thoughts stalled and jammed.

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Elyn Saks: A tale of mental illness — from the inside

“Is it okay if I totally trash your office?” It’s a question Elyn Saks once asked her doctor, and it wasn’t a joke.

A legal scholar, in 2007 Saks came forward with her own story of schizophrenia, controlled by drugs and therapy but ever-present. In this powerful talk, she asks us to see people with mental illness clearly, honestly and compassionately.

‘Stigma and Service Integration’ by Bill White

Stigma and Service Integration ImageIn his latest blog, Bill White emphasises the importance of Recovery Stories and their value in tackling stigma.

‘One of the emerging trends of U.S. health care reform is the tri-directional integration of addiction treatment, mental health services, and primary health care.  This is evident in the growing integration of addiction and psychiatric treatment under the rubric of “behavioral health care,” efforts to integrate primary health care within addiction treatment settings, and increased delivery of addiction-related services within primary health care settings, e.g., physician offices, health clinics, and hospitals.

Considerable resources have been invested in creating policy frameworks for such integration (e.g., provisions for office-based treatment of opioid dependence) and developing technological innovations (e.g., screening, assessment, and treatment protocol) to facilitate such integration, but history would suggest a far greater obstacle to service integration:  social and professional stigma.

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‘Patient Centred-Care Doesn’t Go Far Enough: We Need Patient-Perspective Care’ by Tim Carey

timAn excellent article by Tim Carey on Mad in America.

‘A growing appreciation of the importance of involving people in their own health care has seen the development of initiatives such as “patient-centred care.” Patient-centred care has been defined as “providing care that is respectful of and responsive to individual patient preferences, needs, and values, and ensuring that patient values guide all clinical decisions.” (Institute of Medicine, 2014)

While this definition seems reasonable enough, it appears to be very difficult to translate into practice; particularly in the area of mental health.

It is not always clear in mental health, for instance, that it is patients’ values that guide all clinical decisions. I experienced some of this when I began to develop a system of mental health service delivery which I came to call “patient-led” treatment.

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‘Newsflash – Heroin Addicts CAN Be Good Mothers!’ by Robin Sherwood

9e84425a-905c-44d9-a250-d4307755d13a-620x372Thanks to Mike Scott for finding  this great article in the Huffington Post.

‘I was eight years old when I accidentally walked in on my mum injecting heroin in the kitchen. I’ll never forget the confused look on her face – the warm embrace of the opiates blunted any acute feelings shame and panic, leaving her with an ugly, dumbfounded grimace.

Luckily, this episode was the turning point in both our lives; she knew that she needed to find help and enter rehab, otherwise she’d either OD or I’d be taken away from her. Sadly, not everyone is blessed with the same foresight.

Without knowing what kind of parent Peaches Geldof was it’s really hard to comment on the latest revelations about her death without sounding like a sanctimonious hack, but in my experience of growing up with a junkie for a mother, I’d like to make two points: 1: Being addicted to heroin does not necessarily mean you’re a bad mother and 2: They fuck you up your mum and dad (to paraphrase Philip Larkin).

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‘Benzodiazepine Guidance’ by djmac

Diazepam-3‘SMMGP has published guidance for using benzodiazepines and benzo-like drugs in primary care. It’s a comprehensive 60+ page document which covers most (but not all) of the bases and reinforces the need for caution when prescribing the drugs.

The guidance is so long in coming because consensus could not be reached. Benzo prescribing is an issue where people have strong views.

The guidance sets out a major problem: that current prescribing guidance is that these drugs should not be used for more than 2-4 weeks, but in practice this is widely flouted with over one million people on these in the long term.

As I say the document is comprehensive, so I’ve just picked out a few nuggets here.

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Stamp Out Stigma: “It Can Get Better” by Kelly

A wonderful film clip from an excellent website, StampOutStigma.

“Whatever happened to the sense of community where you actually cared about your neighbour?”

Being brave enough to seek help led Kelly to recovery.

“I get so much satisfaction because I see that when I share my story with others it empowers them.”

‘Experiencing Recovery – Part 5′ by William L. White: Recovery Identity & Cultural Affiliation

This part of Bill’s excellent talk focuses on identity, social stigma and recovery styles. He describes how some people hide behind anonymity because they are ashamed of themselves.

Your Recovered Life: Tim Harrington, Intervention Specialist & Recovery Advocate

‘Tim Harrington is fiercely committed to the world of recovery. He helps people get and stay sober – in whatever way works best for them AND takes daily actions aimed at reducing the shame and stigma of addiction.

The first time I saw Tim in action was at a big conference on addiction treatment. It was during a panel discussion that he raised his hand and asked a simple question.

He referenced how we, who understood addiction and treatment, were all there to learn more…but what about all the people ‘out there’ who weren’t in the know? Especially those whose lives addiction crashed into and who hadn’t a clue about the disease and even LESS about recovery. What if we had a conference for THOSE people?

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‘Is Recovery the Right Word?’ by Dolly Sen

omeka-net-4762-archive-fullsize-757b9035f7beee79de9361dc5997f5bfExcellent reflections by Dolly Sen from an Archive of Mental Health Recovery Stories.

‘The problem with the Recovery Model is that it is a medical term, and is expected to sit safely and warmly in the medical world. The recovery model says you need to look beyond the symptoms and see the person. But the whole relationship between service user and professional is regulated by the symptoms, depending if your symptoms go up or down, decides what treatment you get, if any at all.

It is also assuming that there is an illness to recover from. That the mental and emotional pain is not a very human and very appropriate response to trauma, that it has to be pathological, a sickness.

If that wasn’t enough, it then puts you in a system where people blow out your candle and then ask you to get better, or it takes your candle away and then asks ‘where is your light?’ You won’t find a better example of catch 22 than in psychiatry.

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Stamp Out Stigma

Stigma and prejudice in society are key barriers to recovery. Here is a new campaign against stigma.

‘1 in 4 of us is living with a mental illness. It’s time we stopped whispering and starting talking. Learn more at  http://www.stampoutstigma.com

‘The Language of Recovery Advocacy’ by Bill White

Language“Words are important.  If you want to care for something, you call it a “flower”; if you want to kill something, you call it a “weed”.  Don Coyhis”

Some will question why we as recovery advocates should invest valuable time debating the words used to convey alcohol and other drug (AOD) problems and their solutions when there are suffering individuals and families that need to be engaged, recovery support resources that need to be created, communities that need to be educated, and regressive, discriminatory policies that need to be changed.

We must invest this time because achieving our broader goals depends on our ability to forge a recovery-oriented vocabulary.

Words have immense power to wound or heal.  The wrong words shame people with AOD problems and drive them into the shadows of subterranean cultures.  The wrong words, by conveying that people are not worthy of recovery and not capable of recovery, fuel self-destruction and prevent or postpone help-seeking.

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Tatiana’s Story: ‘On with Forever , Backwards Never’

TatianaText(pp_w1000_h666)Here is another of those beautiful Stories from the I Am Not Anonymous website.

‘My name is Tatiana and I am person in long-term recovery. My sobriety date is April 19th 2011.

What does it mean to be an addict? Some people may shrug with a look of disgust on their face when you ask this question. Those who do actually understand are riveted with compassion and love for the addict. Its funny how a complete misconception can create such a divide amongst people.

Many people still believe that addiction is a behavioral issue and that addicts are just “bad” people with a weak will. Although it may appear this way to the naked eye, this is so far from the truth.

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