Drug hell memoirs often make for self-indulgent, voyeuristic vic-lit (victim literature). And that includes A Million Little Pieces by James Frey, although the artistically embroidered bits were entertaining enough.
So why then more about addiction?
Well, because I need to tell you about the “hideous Four Horsemen - Terror, Bewilderment, Frustration, Despair,” as the Alcoholics Anonymous Big Book terms them. And how, after battling them for a decade or more, they trotted away for a bit. Then came thundering back with a diabolical fury that saw me go on to autopilot and, in a moment of utter insanity in mid-2009, pick up a bottle of vodka and shamble down the Via Dolorosa.
Within 12 hours the teetering house of cards that was my life was showing major structural damage. Within 72 hours, to the whop-whop-whop of a medical helicopter, following a coma induced by a fall, the entire edifice imploded.
Once I reached rock bottom, I just kept on digging. For months I was numb with suicidal self-hatred and shame. But I’ll go light on the tawdry autobiographical bits, other than to add that Careline Crisis and Trauma Centre - a facility in Hillcrest, KZN - became home to not just the half-dead wraith I was, but to my dogs, too.
And under the indefatigable Joey du Plessis, its founder and director, it provided a moral and material support system, and de facto family.
What I do want to do is lash out at some of the myths, old wives’ tales and sheer rubbish surrounding addiction.
MYTH 1: If it’s legal, it can’t be that bad
This one would be hilarious if it wasn’t so sad.
Drugs, according to William L White, author of the book Pathways From the Culture of Addiction to the Culture of Recovery: A Travel Guide for Addiction Professionals, fall into four categories:
l. Celebrated: that’s chiefly alcohol.
2. Tolerated: think nicotine
3. Instrumental: that’s prescription and over-the-counter medication, and while distribution of these is tightly controlled, addicts are very good at finding dodgy doctors and pharmacists to source them from.
4. Prohibited: these encompass everything illegal from marijuana to methamphetamine.
What separates legal from illegal substances is, to a huge degree, society’s perception.
Anyone using prohibited drugs is painted as bad and worse. Alcohol, on the other hand, is part of the warp and weft of Western society. Never mind that, more than any other drug, it attacks every single organ and tissue in the body and has incalculable social cost.
Along with benzodiazepines - an instrumental drug, encompassing Valium and other sedatives and hypnotics - alcohol is one substance whose withdrawal can kill. Not even heroin shares that dubious quality.
MYTH 2: It could never happen to me
When I was a boy I wanted to be an astronaut, a fireman - or an alcoholic and prescription pill addict. Well, not really.
The point is when it comes to addiction there’s a Titanic mentality at work. No one believes that the unsinkable ship will go down.
In my younger, bulletproof days, I certainly subscribed to this. And it led to incidents of episodic hubris, even though I was already an addiction timebomb with the fuse lit.
As Joey du Plessis puts it, and this is based not only on her own encyclopedic knowledge of addiction, but on a new wave of research, it’s a question of numbers. Addiction is up to 60 percent genetic, 20 percent environmental and 20 percent stress and trauma related.
Up to one in 10 people taking a psychoactive substance - anything mind-altering, from cabernet to crack - will plunge from being a user, or even an abuser, to being dependent on their drug of choice. It might take months. It might take years. But it will happen.
Du Plessis uses a bee-sting analogy, saying 10 percent of people might be allergic to them, and 90 percent not.
Addiction, she adds, is full of “unsung heroes”. But addicts simply don’t warrant sympathy. In one book I read, a woman lying in an alcohol detoxification ward cries out, “God, why couldn’t you have given me cancer instead? Then at least my family would have visited.”
This isn’t a plea for pity, however, nor is it a medical textbook. To grossly simplify things, addiction makes the leap from the frontal cortex - which governs reason - to the mid-brain - which governs short-term survival, and the fight-or-flight instinct, among other functions. So using the drink or drug becomes as essential to survival as breathing. Or so it seems to the addict, as eating, hygiene and working become distant memories in the late-stage throes of addiction.
MYTH 3: Addicts and alcoholics lack self control, strength and willpower
Once you’re locked into active addiction, trying to break out of the whirlpool of destruction, desolation and dysphoria by yourself is utterly futile.
“Willpower,” says Carlton K Erickson, PhD, in The Neurobiology of Addiction, “cannot change the dependence on drugs any more than it can control the tremors of Parkinson’s.”
Any recovering addict or alcoholic will tell you that when they were using they weren’t being willful, spiteful or just plain bad. They simply could not stop.
It’s bad timing, really. Addiction awareness is increasing and improving exponentially. Mine is possibly the last generation that will ever be vilified for having a disease. Remember, epileptics were once thought to be possessed and Aids victims to be suffering the wrath of a vengeful God.
MYTH 4: Alcoholics and drug addicts are lazy and shiftless
Anyone subscribing to this little chestnut has quite patently never experienced the full fury of active addiction.
“The popular notion of addiction for the past century has portrayed the addict as one who lives a withdrawn, passive lifestyle, escaping reality and responsibilities through the experience of intoxication,” writes White.
The hard work comes with the over-riding need to answer a ticking body clock and to consume drugs, as well as dodge the inevitable consequences related to that all-consuming call. And, of course, the addict or alcoholic will require a never-ending income stream.
Adds White: “The fact that the businessperson works for money and the addict for drugs does not diminish the rigours of the latter’s lifestyle.”
MYTH 5: There’s nothing wrong that 28 days in a rehab won’t fix
The movie 28 Days with Sandra Bullock is hilarious. She does something quite bad - the consequences of her drinking start biting - so she’s packed off to a rehab centre.
The place looks rather like an idealised American summer camp. After an initial bit of truculence, she learns the error of her ways and becomes all sober and serious, and leaves looking resolutely fixed.
If only it worked like that.
The addiction culture is replete with individuals who’ve done three or four weeks in a rehab. And then rapidly relapsed. I was one of them.
Thing is, after a month, the addict is only just past the Withdrawal Stage and into the Honeymoon Stage, as it’s dubbed. This lasts up to 45 or so days and is characterised by over-confidence, complacency and high energy. All seems idyllic.
Next comes the Wall Stage. This goes on for up to four months, and you can expect to feel sluggishness, depression, periodic paranoia and anhedonia, which is pretty much the inability to experience pleasure.
Then comes the Adjustment Stage, and even so the addict is not propelled into a sun-dappled Disney world, with the Resolution Stage coming next.
And there’s ample empirical, medical and anecdotal evidence to suggest that it takes anywhere from six months to two years for the cerebral pathways to return to normal.
MYTH 6: Alcohol companies want you to drink reponsibly
Maybe the South African ones do - I mean, their adverts carry riders along the lines of: “Not for sale to under 18s. Use responsibly.” Surely only the uncharitable would suggest that it’s anything but social concern that engendered this.
But in the US, at least, 70 percent of alcohol sales go to 15 percent of drinkers - and that’s obviously the hard core, who are alcoholic or borderline. The figure comes from White, quoting a group called Science in the Study of Public Interest that published an analysis of alcohol advertising.
“While the alcohol industry regularly proclaims that it supports responsible drinking and that alcoholics give the industry a bad name, there is evidence to suggest that the industry’s financial interests would clearly not be served by this position,” writes White.
MYTH 7: Cocaine, not alcohol is my problem, so a few drinks won’t hurt
This little myth would be amusing - if it wasn’t about as funny as Ebola.
Yes, welcome to the world of cross-addiction. This is essentially where you start using another drug other than the one you’re addicted to, in the process often leading back to your primary substance.
If you’re a cocaine addict, for instance, drinking might seem innocuous enough. But it increases your chances of relapsing on cocaine by an estimated 800 percent, according to some figures.
As a full-blown alcoholic I was prescribed vast quantities of benzodiazepines. But the medical profession neglected to mention that they act on the same brain receptors as alcohol, a fact that I only learnt at Careline. Guess what? I relapsed on alcohol. With catastrophic consequences.
A handy rule of thumb, reinforced by virtually every known recovery programme, is that if you’re addicted to one psychoactive substance, you’re addicted to all - even those you’ve never tried.
MYTH 8: I haven’t drunk or drugged for a year - I’m cured!
Like a sleeping lion, addiction lies in wait, ready to awake with primeval fury.
In the DVD Relapse: The Illusion of Immunity, Dr Claudia Black cites a man who was sober for 30 years. Three days after starting drinking again, he was hospitalised.
So, no, addiction isn’t a curable disease. Just a manageable one. The symptoms might go into remission, but the disease never disappears.
What terrifies even more is the dark, satanic fury of addiction when reactivated. When you pick up drinking again after a break - presuming that alcohol is your drug of choice - you don’t restart where you left off. You restart at the same point as if you had never given up drinking in the first place.
MYTH 9: Calling addiction a disease is a cop-out
If I wasn’t an addict - and I use the terms alcoholic and addict interchangeably - I’d probably also think calling addiction a disease was the ultimate abrogation of responsibility.
Some say addicts can stop any time. They represent the choice model, and I tend to think of them as flat-Earthers. In the other corner, you have the disease model, subscribed to by a vast armada of addiction experts, neurobiologists, addicts and, increasingly, laymen.
Kevin McCauley, one of many proponents of this argument, explains in eloquent detail just how addiction fits the model. It is, in short, a brain disease.
McCauley says: “If addiction is proven to meet the criteria of other treatable medical conditions like diabetes or a broken leg, then instead of putting alcoholics and addicts in jail, we should put them in treatment…”
Carlton Erickson puts it even more unambiguously: “Chemical dependence - like diabetes, cancer, and Parkinson’s - fully meets the requirements imposed by any reasonable definition of the term disease.
“Why is calling dependence a disease so controversial? It appears that labelling a person with chemical dependence as ‘being diseased’ is the same (in some people’s minds) as releasing the person from the responsibility for his or her behaviour,” adds Erickson.
MYTH 10: A piece like this is not only self-indulgent, it’s irrelevant
It has been estimated that every individual’s addiction impacts around 17 people. About 76 million people are affected by “alcohol use disorders,” according to the World Health Organisation. Either way, the maths is terrifying.
The cost of psychoactive substances runs into billions, from lost productivity to strains on the health system to car crashes. The trauma and human suffering attached to this all isn’t easily quantified.
So even if you’re not cursed with an addiction, statistics alone suggest that somewhere, somehow along the line it’s going to impact on your life. - Independent on Saturday