The young man, Ryan, looked stressed.
He couldn’t sit still and left the Alcoholics Anonymous meeting repeatedly only to return, pacing and lighting one cigarette after another.
The older man watched as his grandson, 29, fidgeted and paced, obviously in distress. He knew the feeling. He’d been there, struggling to overcome the acute discomfort of being wired, his body craving the alcohol that had possessed him. His grandson, he knew, was desperate and longed to hit the streets where he would find the heroin that had possessed him for over a year.
The young man, Ryan, knew of his grandfathers addiction and recovery almost 40 years ago, and he dreaded the lunch they had planned for after the meeting. He just wanted to get away and find a dealer, but the hard reality was that he was broke and in debt. He hoped that his grandfather would sympathize with how he felt and maybe give him money to tide him over.
At lunch, the grandfather said he knew how Ryan felt and would do his best to help him get well, but he wouldn’t give him money to buy drugs. He would, however, work with him and the boy’s father in getting the young man back into a suboxone program and develop a plan leading to freedom from all drugs including suboxone.
Suboxone is a drug that produces an effect similar to heroin but less intense. It’ll buy some time, but the addict must plan to get off it by tapering off with medical help. Ryan had been in a program but failed to follow the protocol that would gradually allow him to get off suboxone and other drugs. Ultimately, the addict has to get off the suboxone and that’s where it breaks down as an effective answer to an addiction problem.
Sadly, we as a nation have failed to invest sufficiently in research and in developing systems of recovery that respond to the need.
Almost a decade ago, the University of Arkansas Medical Sciences (UAMS), in Little Rock, made an investment in finding out more about addiction and staff member Dr. Warren Bickel joined a group focusing on the study of addiction and recovery. It’s purpose was to develop answers to questions associated with why people use illegal drugs and what to do about it. Many of its initial findings produced information of significant value.
One of the obstacles to recovery for addicts, researchers found, is that they operate on a short time line. The non addict looks well into the future. Years, actually. The heroin addict, on the other hand, has a timeline of nine days. Nine Days! Doesn’t leave much time for making good decisions. The time horizon for the general population is four and a half to seven years!
“If you are only thinking a day or two ahead,” Bickel concluded, “it allows you to make choices that completely ignore the consequences of some of your decisions.”
Studies of the brain, Bickel went on to say, also show that the cerebral cortex, which provides the capacity to plan and think abstractly, among other things, “goes offline with addicts, and they go back to the more primitive part of the brain dealing mostly with emotions—the limbic.”
The findings seemed to confirm what the average citizen believes about the behavior of alcoholics and other drug users. They also suggest that getting the cortex back on line and toning down the limbic are worthy goals in substance abuse treatment.
Regrettably, the UAMS investment in research and other aspects of addiction and recovery was soon after curtailed by budget considerations, a factor in many potentially valuable discoveries.
For comment on what’s needed in addressing the drug problem, I turned to an old friend, psychiatrist Dr. Harley Harbor. Harley has been retired for a while now, but I still recall our conversation on the state of substance abuse treatment. Here are some bullet points:
- Increasing numbers of medical discoveries will help us treat the physiological aspects of addictions (brain disease itself), but they do not address our character defects and lack of spirituality. That is up to God and us.
2. A deep and wide chasm exists between what we do and what we believe. The 12 Steps and recovery bring the differences into closer alignment.
3. Impaired physicians and airline pilots have the best recovery rates of any groups—85 to 90 percent for physicians and 90 to 95 percent for pilots. That’s because there are huge financial and professional incentives (they get to keep their jobs if they recover), and they are given adequate time for long-term treatment as well as significant professional support and post-treatment monitoring.
4. Twelve-Step programs are excellent predictors of long-term sobriety. If you can stay clean and sober for a year, the chance of a “slip” drops dramatically. In the short term—less than a year—only one in ten 12-Step newcomers is there and still sober one year later.
5. Even if you go to a meeting every day, it isn’t enough in the initial stages of recovery. Remember, the founders of Alcoholics Anonymous (Bill Wilson and Dr. Bob Smith) spent a lot of time together. An hour a day is just a beginning.
6. You have to get rid of the substance abuse problem before you can treat the whole person.
7. There’s currently not enough money to fund nationwide treatment programs that will produce recovery rates comparable to pilots and physicians.
8. Today, treatment can give you a place where you feel safe and can help you get clean and sober while you are going through the Steps and other aspects of recovery. I just wish it could be longer term.
To this I would add that as we contemplate the efforts we are making to build a giant wall to help keep illegal drugs out of the country, I wish we would put more emphasis on reducing the demand for drugs than to try to curtail the supply.
And let’s give our local hospitals and other care giving institutions the funds they need to develop systems of recovery for drug addicts.
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