Recovery

Bipolar Behind the Glass

I’m standing at the oversized glass window, overlooking the city of New Haven, and I’m trapped inside. Freedom, up until this point in my life, is something I’ve taken for granted. I don’t have my computer, I don’t have my phone, but I do have some coloring books and a plastic wrist band that says my name and birthdate. I don’t have a razor to shave my legs unless I’m being supervised and I cannot use my hair straightener. The only door to the outside has big, red, angry letters on it that state that anyone who exits this door without permission is considered AWOL. I’m fifteen years old and I’m locked in the adolescent psychiatric ward at Yale New Haven Hospital.

The weeks and months leading up to my stay at YPI were a blur. I was completely out of control and had no idea. I was misdiagnosed with depression sometime prior in my early teens, and that was a big mistake. They put me on antidepressants, which was an even bigger mistake. Because what nobody took the time to figure out back then was that I was Bipolar, textbook Bipolar, and how my team missed that is still a mystery to me and my family. Maybe it’s because I was a teenager and the mood swings were attributed to hormones. Maybe it’s because I was only spending an hour a week in therapy and as a young teen I was unable to communicate my feelings properly. Regardless, I was Bipolar and on antidepressants with no mood stabilizer. And that, if you didn’t know, is a recipe for disaster.

There’s a fine balancing act that has to be done when medicating a Bipolar individual. There has to be some kind of mood stabilizer or even an antipsychotic acting as a mood stabilizer on board in order to safely utilize antidepressants. Without a mood stabilizing medication, the antidepressants can almost work “too well”, taking someone so far out of depression that it swings them the other way into a full blown manic episode. And that, my friends, is exactly what happened to fifteen year old me on that brisk spring day during my sophomore year of high school.

I had what amounted to a psychotic break, totally disconnected from reality. I lost track of space and time. I no longer understood the difference between right and wrong. I couldn’t properly weigh consequences. I had no fear. Ultimately, I called myself out of school pretending to be my mother, and stole her car while she was away on a business trip. Ultimately, I got in a car accident and someone crashed into me, bringing my joyride and mental health high to an abrupt stop.

My parents were at a loss. They didn’t know what to do with me, but simply grounding me and screaming at me just didn’t seem like the right course of action, thankfully. I was already in therapy, and I was already medicated. I was presenting as delusional, detached, and my behavior was extremely risky.

I’ll never forget when they admitted me, and came to take my clothes and personal belongings. It was the first time I was ever admitted to the psych ward, but it wouldn’t be the last. Managing Bipolar I is like riding a bucking bull that you never know when someone is going to put a quarter in it and when it’s going to stop or start flailing you around. You’ve got to hold on as tight as you can, but sometimes, no matter how hard you hold on, you still get bucked off. And that’s okay. You find yourself on a high, the world in your hands, everything going great until suddenly everything is moving too fast and you can’t keep up and the world keeps spinning and you just need it to slow down. Then it all gets really slow. So slow that it might even be moving backwards. You’re moving backwards. The only place you’re going is nowhere.

Living with Bipolar I throughout my addiction has made a challenging situation even more difficult, but I wouldn’t change it. My mind is my best asset, my most defining characteristic, my best friend in this world. I take the good with the bad, the highs with the lows, because there is no other option.

A few years ago, the medication that saved my life from the day I got admitted to YPI, lithium, started to destroy my kidneys. A small percentage of people who take lithium develop Chronic Kidney Disease, and that’s what happened to me. It brought me back to that day in the psych ward, standing behind that glass window, looking out at the world. Do I want to be in it? Absolutely. So we try something new.

For the past few years, I’ve been juggling different medications trying to replace the lithium that I loved so dearly and that saved my life all those years ago. It’s been going surprisingly well, and I’ve been able to stay out of the hospital and haven’t had any major episodes despite the medication changes.

Taking good care of my mental health is freedom for me. When I don’t do that, I become a prisoner again. I may not be locked in the hospital, but I’m locked inside a place in my head that feels just as tight, just as constricted, and just as unpleasant. I’m standing behind that same glass window, looking out at the world that I’m not participating in. That’s why self care is so important, especially for those of us who have a substance use disorder on top of a mental health condition.

Today, on National Bipolar Awareness Day, I’m here to remind you that we exist.

We walk among you. We are your brothers and sisters, sons and daughters. Please be gentle with us and handle us with a little bit of care. While I may not be trapped behind that glass window today, it’s still there in a way. Society kind of represents that window where I can see the rest of the world out there, functioning, and I just desperately want to be a part of it but I don’t always know how or have the tools to participate in life the way I wish I could.

Standing at that glass window, I see my mom’s car park in the lot and I know I’m going home today. It’s Easter Sunday. I’m not religious, but I understand the symbolism. Rebirth, renewal, starting over. I walk out of the hospital into the crisp, spring air and feel the sun peeking out behind the clouds. I knew in that moment that I would be okay. And today, I’m okay. Just for today.

©Copyright 2019 In Angel’s Arms and Lauren Goodkin

Recovering Slow Turkey

I was watching tv the other day when I saw a commercial for a medication used to help people quit smoking. The ad was a play on the old “cold turkey” method, and advocated instead for the use of their medication to quit “slow turkey” instead.

We often hear it takes 29 days to make a habit, or that change doesn’t happen overnight. So, it got me thinking, why do we expect substance users to change their behavior in an instant?

We expect those with substance use disorder (SUD), which is the appropriate terminology in today’s language, to enter treatment and stop using substances on the same day. This thinking is asinine, and it makes no practical sense for the average substance user.

Using is not just part of our day, it’s the entirety of our lives.

Using and finding ways and means to get more encompasses every minute of our waking hours, and even some of our sleeping hours, too. I can’t tell you how many times I went to sleep with no plan for the next day’s use, and woke up the next morning with a plan in my head that my brain worked on while I was asleep. Using is everything to us, and it takes up the vast majority of our time. For most of us, we can’t just stop using on a dime and jump into recovery with both feet.

Why is it that when it comes to smoking, people understand medication assisted treatment? People understand that ANYTHING is better than smoking. If someone wanted to wear the nicotine patch, or take that medication from that commercial to quit smoking, no one would hold that against them. Even if they had to use those methods for YEARS, maybe even the rest of their life, nobody could possibly say that they would rather see their loved one still smoking. We want someone who smokes to do anything in their power to quit and stay quit, even if it means using a nicotine replacement therapy like the patch or gum.

Medication Assisted Treatment (MAT) for opioid use is the same principle. It’s a medication that assists the person with substance use disorder in finding a way to let go of their illicit use. These therapies use opioid and partial opioid agonists to bind to the receptors in the brain where heroin used to bind. It tricks the brain into thinking it has what it wants, so the brain and body no longer crave the drug with such severity and frequency. It allows the brain to repair slowly over a very long period of time. For some people, they are able to continually lower that dose and eventually get off of MAT. For others, the cravings are too severe because their use was too severe. They may need to stay on MAT for the rest of their lives.

The question is, why does anyone care?

If someone is no longer waking up every day with their entire existence focused on using, then who cares if they’re on MAT? If they can hold down a job, pay their rent, raise their family, then who cares if they’re on MAT? If they have changed their lives so completely and become a productive member of society, then who cares if they’re on MAT?

I see people saying they don’t agree with MAT and I ask myself the same question every time: Why is it any of your business how someone else chooses to recover? Why are you judging someone else’s path?

I have no shame about being on methadone and if you are too, then you shouldn’t either. My addiction was so severe that there were no other options for me. I didn’t have time to keep trying the natural way, the twelve step way, the inpatient way. I was going to die if I kept trying to treat my medical brain disease without a medical treatment.

My recovery is as slow turkey as it gets. I’m not in any rush to get off medication assisted treatment. Why? Because IT WORKS. Methadone is the most effective treatment for opioid use disorder by leaps and bounds over any other method. I don’t know about you, but I’m betting on the winning horse. I’m betting on science. I’m betting on what has worked for me and millions of others. Actually, forget the winning horse. I’m betting on the slow turkey.

©Copyright 2019 In Angel’s Arms and Lauren Goodkin

January is for Homecomings & Anniversaries

Seven years ago, I was boarding a flight in Fort Lauderdale, Florida bound for Bradley Airport in Hartford, Connecticut. Bound for home. I had been in Florida for five months, two weeks and four days. I was about three months sober after a one time use in Florida, and I was more than ready to come home. What I wasn’t ready for, was to be sober, at home.

I had a connection in Charlotte and I waited anxiously for my next flight to board. Of course, it was delayed. It wasn’t the first time I made this round trip, and I remember distinctly sitting in my seat, stretched out across the empty row, thinking to myself that this would be the last time I would make this flight for this reason.

So far, I’ve been right.

What I wasn’t right about was that I could stay sober on my own. I arrived in Hartford to snow on the ground, which I could not have been more thrilled about. I love the snow, and I had missed several good storms while I was in Delray. We stopped home briefly for me to switch out my bathing suits and tank tops for snow boots and hoodies, and left again for my new home.

I arrived at the sober house in New Haven, which was inside of an old, partially restored mansion. My room was on the third floor, of course, and I never quite got used to those old, creaky, narrow stairs. I made it a few days in the sober house before I realized how to get what I really wanted, which was to use. I had started taking the bus in Florida, but had never ridden it here at home.

The system was completely different, but it didn’t take long for me to figure out that I could ride the bus for an hour and wind up right in the center of my universe, which at that time was Brooklyn, deep in the sick cesspool that is Waterbury, CT.

I knocked on my drug dealer’s door and there she was, right where I left her. She had a new phone number which I didn’t have since I had been gone, and there was no way for her to contact me because my mother had changed my phone number while I was in rehab. Phone numbers aside, I happened to know where she lived, which I guess no one accounted for. I was back in business.

Even though I had suffered a near fatal overdose before I left for Florida, that didn’t stop me from jumping back in with both feet. I made an early habit in the sober house of using in the bathroom prior to taking a shower, so no one was likely to bother me or see me nodding out. It wasn’t long before I hit my first speed bump and got arrested for possession.

When I got kicked out of the sober house for all of my many indiscretions, I went back home. My mother didn’t know what to do. Another failed attempt at rehab, and I was back to actively using. It was as a last resort that I agreed to get on the methadone program and give recovery another try.

I didn’t want to live that way, and I didn’t want to die that way either.

I was court ordered into an Intensive Outpatient Program (IOP), and I chose to complete it at the closest facility to home which was the APT Foundation on State Street. That’s where I became exposed to the methadone program and chose to get on board. It was the best decision I believe I have ever made in my entire life.

Within a few months, I had completed IOP and I started to give clean urines. Not everytime, mind you, but some of the time. I had made a friend, who turned out to become my best friend to this day. Years later, I would meet my partner and love of my life in those very same group rooms.

I kept coming, and let the methadone do it’s job, while the program supported me and gave me the time to get my head screwed on straight. They didn’t expect me to get sober overnight, and I didn’t. It would be two whole years from the day that plane touched down to the day I got truly sober. I’m not even sure what day that was, I just know it was sometime in mid January.

This month, I will celebrate four years in long term recovery from heroin.

I still work hard at it every single day. I still think about using all the time, but today I am strong enough to resist that urge. My addiction doesn’t run my life anymore, it inspires it.

It inspires me to speak to students and share my story to help them make better choices. It inspires me to sit on the Substance Abuse Action Council in my town and inform policy and procedure as it relates to substance abuse. It inspires me to work hard at my job and continue to take on new projects and responsibilities.

Today I am dependable, I am collected, and I am sober. I walk through the world as a woman who has faced her own death and come out the other side. I am strong, I am powerful, and I am capable. There is nothing I can’t do or figure out today.

If it wasn’t for my family, none of this would be possible. If someone you love is in active addiction, I implore you not to give up. I implore you to support them each and every attempt they make at sobriety, because you never know when it’s going to be the attempt that actually works. We don’t recover easily, but we do recover.

I am literal living proof.

©Copyright 2019 In Angel’s Arms and Lauren Goodkin

An Open Letter to the Parents of Addicts

From the very first moment you found out that you would be parents, you imagined the life your child would lead. You painted a nursery and assembled a crib and you dreamed of the milestones to come. You stood behind your fearless kindergartener on the first day of school, barely holding it together as they ran off into the world, for the first time, without you.

You sat in the cold ice rink at five in the morning, watching your little one take on the hard, cold ice, covered head to toe in so many pads that they could barely move their little feet. You stood in the blistering heat on the soccer field, trying not to laugh as your four year old tripped over the ball that would eventually become an extension of their foot. You put bandaids on skinned knees which gave way to broken hearts. You laced up ballet slippers which gave way to high heels. You painted cartoon characters on their bedroom wall which gave way to black pleather curtains and posters for bands with names that you couldn’t even pronounce.

You got through the terrible twos which gave way to terrible teens. You watched that fearless kindergartener give way to an anxious adolescent, and maybe you thought the worst was over. You looked at colleges and helped them get their first car. You raised a happy, competent, capable young adult and then you watched in horror as your child became lost.

You didn’t know what was wrong at first, just that something was wrong. You find out your child is doing drugs, and you think maybe they’re just experimenting. You think it’s a phase and it will pass. They’re out partying until all hours and you think they’re just kids being kids.

Then the partying gives way to solitude. Good friends from childhood are replaced by shady characters you don’t recognize, whose parents you’ve never met. The upward trajectory of your child’s life is suddenly stalled out, and like a standard car stopped at the top of a very intimidating hill, your child starts slowly rolling backward.

They roll and they roll and they pick up speed and suddenly they’re flying at 100 miles per hour, backward, in the wrong direction.

They’ve lost control of the car and no matter how badly you want to intervene and grab that steering wheel, or stomp as hard as you possibly can on the brakes, there’s nothing you can do because you’re not the one driving the car.

You watch in horror as your little fearless kindergartener becomes a fearful, dulled down version of themselves. You watch them fight and you watch them stumble and you watch them fall. You do your best to pick them back up, only to become exasperated as they fall again. You get tired and you get angry and you get upset but most of all you get hurt.

You wage war beside them and try your best to help them, but you don’t know how. You would give your own life to see them live theirs, but it just doesn’t work that way. You have small victories and big setbacks. You spend a lot of time praying, a lot of time crying, a lot of time remembering those days when the most danger your fearless kindergartner was in was from a pair of safety scissors.

You pray and you make devil’s bargains, willing to give up anything or pay any price to save your child’s life.

You take a second mortgage on your home to send them to a world renowned treatment center. You lock your purse in your car and wear the keys around your neck. You start checking your child’s breathing in their sleep.

If your child gets sober, you wait with baited breath for the other shoe to drop. Maybe your child is in jail, and you are surprised to find yourself relieved because at least you know where they are and that they’ll likely still be alive tomorrow morning. Maybe you’re living the very real nightmare in which you’ve buried your child.

No matter what chapter of the story you’re currently living in, it’s likely the hardest thing you’ve ever done in your life. You’re watching your child die of a chronic, progressive, often fatal disease while the world scoffs at you and tells you it’s your fault. People ask “Where were the parents?” like you haven’t been standing beside your child this whole time, since the day they were born, fighting for them.

Addiction is a family disease, and for every active addict out there, countless others are affected. For every addict out there, there is a mother, a father, a sister, a brother, a husband, a wife, a son, a daughter, a friend. Every single addict was once a fearless kindergartner, taking their first steps into the world.

Nobody could ever imagine the pain and anguish that an addict goes through, except maybe their parents. Because they watch it, helplessly. They feel it in their bones. There’s nothing in this world more painful than loving an addict, except losing one.

As the dialogue shifts and the world begins to display a little compassion for those afflicted with this deadly disease, it’s important that we remember that none of us can win this war alone. It’s important that we acknowledge those who have walked beside us in our struggles, who have wiped our brow when we were tired and when we were truly broken, they carried us.

Our parents carry us as infants, and they don’t expect to be carrying us as adults. But they do it without hesitation, over and over again, until we learn to walk again or until our battle ends. They carry us through the hardest times of our lives, and though they may get weary, they are stronger than any of us could ever imagine.

They are the parents of addicts, and they deserve our respect, admiration, and compassion.

They are the parents of addicts, and they are the unsung heroes of this epidemic.

©Copyright 2018 In Angel’s Arms and Lauren Goodkin

Dear Addiction: I See You.

I saw you yesterday.

I saw you in the eyes of a young girl. She was frail and her skin was red and erupting in anger. It’s easy to spot you inside of people when you know what to look for. I saw you under her fingernails, tangled into her dull, matted hair. I saw you in the hollows around her collarbones. I saw you trying to hide under the long sleeve shirt she wore despite the ninety degree heat that hung like heavy, wet laundry on an already overburdened line.

I saw you last week.

I saw you in the parking lot of the grocery store as I pulled into my parking space. There you were, hanging in the air between a car window and a pale, shaking hand. I saw you folded up in between the three crumpled twenty dollar bills. You didn’t even care that everyone could see you right there in the open, you weren’t even trying to hide. I saw you last week in that parking lot, but nobody else could see you creeping further into our community, seeping into every open space and into every vulnerable soul. Of course, people know you’re around. But they didn’t see you. I did.

I saw you last month.

I saw you hanging around outside the clinic where people go to get help. You’re just so insidious, sitting there waiting for the next person who isn’t quite ready yet, who is still a little vulnerable, who still listens when you call. I saw you there when the checkout girl from the gas station down the street approached my partner to ask for her clean urine. I saw you when a fist full of Xanax were passed from one shaking hand into another. I saw you as nurses and staff came sprinting outside with Narcan in hand to the car parked against the fence where a father of three was slumped over his steering wheel. I saw you too many times last month.

I saw you a few months ago.

I saw you in the long, snaking line outside the funeral home. I saw you in the eyes of mourners, offering their best sympathies to the parents who are burying their child, at the same time knowing they brought you as their guest to the service. I saw you in the burn hole in the pants of a former classmate, struggling to keep his eyes open, as he wonders to himself if he could be next. I saw you in the casket, in the dead body laying in front of me. That body used to be alive with purpose and promise. Now it’s just the two of you, tied together forever into eternity.

I see you everywhere, every day.

Not a moment passes without you trying to sneak your way in, lurking somewhere in the background, always watching and waiting for your chance to get back into my life. I see you in those texts that still come every once in a while when an old dealer gets a new phone number. They don’t care that they haven’t seen me in three years, because they know you will always be there and today might be the day I let you win. I see you in the scars on my skin from where you got inside me, those black and red splotches and blotches that just never seem to fully fade.

I see you in the clients I meet at my job, where I put my armor on and get ready to wage war against you. I use every weapon in my arsenal to try to fight you off, push you back, cast you out. There’s medicine and there’s therapy and there’s twelve step meetings and there’s friends and family who support us and all the while you hang in the air around us. Because our weapons are only enough to subdue you, enough for a daily reprieve, enough just for today. Because tomorrow you will be back, ready to fight another day, back to your ultimate mission.

Because I saw you yesterday.

I know what you want. You want me to come back to you. You want me to be your slave again, your partner, your lover, you want to be my only friend. You want to take everything from me that I love. You want me to remember the good times, the happy days, the warm blanket, the arms of the angel. You want to possess me, own me, control me, and then kill me.

I saw you yesterday, just like every other day.

But you didn’t see me.

©Copyright 2018 In Angel’s Arms and Lauren Goodkin

No Day But Today

Yesterday was March 3rd. 3/3. The anniversary of my first sober date.

It was quite a few years ago now that I checked into detox at Stonington Institute on the Connecticut/Rhode Island border. I was shuttled around in dirty vans from our old, dilapidated house that we stayed in, back and forth to the program facility where we spent the bulk of our days. It was on one of those vans that I learned from a friend who had just come into the program that my classmate and friend, Ryan, had overdosed and died while I had been in treatment. He was the first loss from my graduating class from an overdose. I was devastated.

That day I decided to take my treatment seriously. I did what I was told. I became the “house rep”, of course, and became a beacon of recovery overnight. I committed to getting the Vivitrol injection before returning home, even though I had not been properly detoxed from Suboxone yet, and suffered through the worst withdrawal of my life in a strange place with no medications, alligator rolling across the squeaky twin mattress in my recently earned private room.

3/3, or as I simplified it to simply 3 or III, became the sign of my life. It became my lucky number. I ordered a silver ring with the serenity prayer engraved on the inside, the number III engraved on the outside. A few years later, I would put that ring on my friend Taryn’s finger at another rehab in South Florida, as she clasped a silver elephant bracelet around my wrist. Symbols are big for many of us in recovery. 3 had become invalid long before I found myself in the beautiful garden housing at the Orchid Recovery Center for Women in Palm Springs, a very long way from Stonington Institute, and not just in terms of miles.

Letting go of that sober date, of the recovery time I had painstakingly earned, was a tremendous challenge for me. I felt that I had lost that time. That I had let it slip through my fingers because my hands were too busy juggling the life I fancied for myself as a “normal person”, letting my recovery fall into the past.

So last night I find myself somewhere that I never would have been when 3 was my sober date, which is an AA meeting. In the early days, I found meetings to be nothing but one giant trigger. I frequently left meetings and drove directly to my dealer in those early attempts at sobriety. I just couldn’t find serenity in those crowded basement rooms. But ten years later, here I am, in the most unlikely of places: The rooms of Alcoholics Anonymous.

Though the vast majority of my current stretch of recovery has been spent keeping the rooms at an arm’s length, recovery can sometimes surprise us. Finding myself in a relationship with another addict was the biggest surprise of all, I thought. Until I agreed to come to her regular meetings and meet her network of women. I found a much more agreeable group, particularly the Saturday night meeting, where open-mindedness flourished and the “old timers” and their rhetoric were quiet, with a few notable exceptions.

As time wears on, I find that despite my unorthodox recovery program, my unique philosophies, my anti-AA attitude, I am not only welcomed but slowly came to be respected in these rooms. I am even asked to speak, despite my story having little to do with alcohol. Though AA knows many of our stories are intersected with substances other than alcohol, the group conscious often asks us that we keep our discussions focused on issues as they relate to alcoholism. Yet here I am, a heroin addict, who only identifies as an alcoholic out of respect for the rooms, being asked to share my story. I made Saturday night my home group that night, two seconds before the meeting opened.

My partner now chairs that meeting and I make the coffee. Last night, the anniversary of my first sober date, my partner wasn’t feeling well and I offered to chair in her place as we sometimes pick up the other’s commitments if one of us is not feeling well or can’t make the meeting for whatever reason. So here I am, chairing a meeting in Alcoholics Anonymous on the anniversary of my first sober date, and I welcome the speaker named S.

S had 16 years of sobriety before she relapsed. She went back out for ten long years before she finally found her way back in. With five years of new, good sobriety under her belt, she talked about the struggles of trying to present as a normal person in the world while being so very far from it.

I instantly identified with her story.

Being sober before your 21st birthday is an interesting phenomenon. It would’ve been quite the story, had it lasted it, however my story today has a few more chapters which I think makes for a better read anyway. But going back out after being truly in, is one of the hardest things for an addict and for those who love them.

Knowing that you had it, you were doing it, and now you are suddenly incapable of what you had done so well for so long, is very difficult to explain to your friends and family. They saw you do it. They know you can do it. But suddenly you can’t do it anymore.

The guilt and shame of that is part of what keeps us out for so long when we have a relapse like that. I was back out for longer than I had previously been in. The expression that it’s a lot easier to stay sober than it is to get sober is one of the truest that we have in recovery. Coming back was the hardest thing I’ve ever done in my life. Adding those chapters to a story I thought was already finished absolutely destroyed me.

I got sober the first time at 19. Relapsed at 22. I didn’t truly make it back in until I was 26. I am at the point now where I have slightly more recovery time than active time. It’s funny though, that depending on the day, it can feel like I’ve lived a whole lifetime in active addiction and it feels like that is who I truly am on the inside. Yet on other days, that part of my life feels so far away that it almost feels like a scene from a movie I’ve watched way too many times. That one movie that feels like it’s your real life, that you know every word, every dramatic pause, every exchange of dialogue.

When I relapsed after those first three years, I was so devastated at the loss of time. I couldn’t stomach telling anyone that 3 was dead and gone, that I had thrown it all away, that the time had been lost. It kept me from coming clean about my relapse, which kept me from getting clean, for much longer than it needed to. It took me a long time to figure out that I didn’t actually lose that time. I still had three beautiful, amazing years of active recovery. I still had a meaningful impact on countless parents, other addicts, and millions of people who saw my features on Good Morning America and Nightline in 2007. I spoke to addicts as far away as Australia, encouraging them to keep fighting. I put down the roots of the advocacy career I’m still building today. If it hadn’t been for those first three years, there are so many lessons I would never have learned. I didn’t lose them. They are just as real, and just as valid today as they were back then.

Today I no longer fear losing time. I no longer worry about sober dates. Today I know that I came back in some time in January of 2015. I picked up a three year coin a few weeks ago, for the second time. I have reclaimed those three years, I have done what I thought I could never repeat, that I could never put those three years back together again. Counting days became something bigger than me, and time, the quantity of my sobriety, became more important than the quality of my sobriety. Today the time doesn’t matter. I finally understand what they mean when they say I only have today.

My favorite musical of all time, Rent, helps me to remember how important today is for my recovery. How important it is that I don’t let the fear of losing time prevent me from moving forward. How important it is that I never have to start counting days again.

“The heart may freeze, or it can burn… The pain will ease, if I can learn… There is no future, there is no past, I live each moment as my last. There’s only us, there’s only this. Forget regret, or life is yours to miss. No other road, no other way… No day, but today.”

Harm Reduction: The Answer to Community Drug Issues

There has been a lot of talk lately about the effects addicts have on the community. Especially when it comes to addicts using in cars parked in neighborhoods, syringes and other paraphernalia being found around our communities, and theft of personal belongings especially from cars. People in the community are up in arms about it. They want it dealt with, they don’t want to see it, they don’t want their children to see it.

The problem here is not that we don’t have solutions to these problems. We absolutely do. Progressive societies, especially the Nordic ones, have come up with some great alternative solutions to these exact problems. So why don’t we implement them? The answer is that people who have absolutely nothing to do with addiction, are not addicts themselves, do not work in the field, but live in the community, feel that they know what’s best for us and are so vocal to town administrations that it prevents these solutions from being utilized.

The issue is that these progressive solutions are not understood by the community at large. Harm reduction strategies seem “soft” or “counterproductive” or “enabling” to people on the outside, and even to some people on the inside. They are not ultimately fixing the problem, they are reducing the harm associated with the problem, which is why we call it harm REDUCTION.

If you don’t want to see active addiction in your community, you have to give it a place to go.

There are three big harm reduction strategies that address the problems our communities are facing.

1. Needle Exchanges

Needle exchanges are the easiest to implement, and the less invasive of all the harm reduction strategies I’ll be addressing. They can be mobile or stationary and there are advantages to both. Mobile exchanges are great because they can go to high traffic areas for drug users and meet them where they are, which makes it easier for many addicts to access their services. This works best in larger cities. In smaller communities, especially those that are more upward socioeconomic areas, a stationary facility can be a good option as well. Being stationary can provide more space for more services, so that the facility can possibly employ other agents who can assist addicts in other ways.

This directly deals with the issue of drug paraphernalia being left in streets, parks, parking lots, and other areas of the community. This is becoming an issue in a lot of towns, so why not confront it head on by creating a safe place to dispose of dirty works? Most towns have no place where people can safely dispose of syringes, even for diabetics! These facilities typically give one syringe for every one that is turned in. Even in the instance that they do provide syringes without exchanging them, people need to understand that syringes are not hard to come by. They can be purchased in bulk on the internet, and can be picked up in quantities under ten at many pharmacies. It’s not that these facilities are giving out contraband that cannot be obtained any other way. Addicts have always, and will always, find what they need when they need it. Needle exchanges are the answer to used and dirty paraphernalia in our communities.

2. Safe Injection Sites

Another big problem we are seeing in our communities is people parked in cars on neighborhood streets, people in public restrooms, parking lots, and other public places using drugs. Many addicts cannot go home to use because they are hiding from their families or the people they live with. I know many addicts who unfortunately have children in the home, whether the children are theirs or a relatives, and they don’t want to bring drugs into the home. Worst of all, many addicts are homeless and don’t have a safe place to use.

Providing these facilities gives addicts that safe place they need to take care of their business. It keeps addicts out of public places where they can be seen by residents, especially children. This also contributes to the work of needle exchanges in that it keeps works off the streets.

The best and most useful part of these facilities is that they virtually eliminate overdose deaths. They are typically staffed with medical professionals who can intervene in the event of an overdose and administer Narcan and life saving measures. Furthermore, they typically have counseling staff on hand to help those who are ready to get clean. They can fast track addicts into treatment and eliminate many of the barriers to getting clean.

Of course, no one wants one of these facilities in their neighborhood.

We have enough trouble opening methadone clinics in our communities. People seem to believe that these facilities bring addicts to the area, not understanding that addicts are ALREADY THERE. These facilities help addicts to stay alive long enough to hopefully get clean when they are ready.

3. Heroin Assisted Treatment

The most controversial of all the harm reduction strategies that exist in the world is heroin maintenance, or Heroin Assisted Treatment (HAT). Many countries utilize this program in a similar way to how the United States utilizes methadone maintenance programs. The clients are provided with a safe, synthetic heroin several times throughout the day and must use it at the facility. These programs are sometimes used in conjunction with methadone.

While this seems contradictory, it has had incredible success in Europe. Statistics show a decrease in illicit drug use overall, a lack of appeal of heroin to young people, and of course a virtual elimination of overdose deaths. Many people reduce their dose over time, just as with methadone, and eventually get their lives together. The idea is to taper addicts off over a long term, while providing counseling and other resources to help them eventually get off the drug all together.

While methadone works perfectly well for millions of people, some do have an aversion to the medication. Many people continue to use heroin in the early stages of methadone therapy, so these programs are basically providing addicts with a safer way to do what they’re already doing anyway. That’s what harm reduction is all about: Making addicts’ lives safer until they are ready to get clean.

Programs like HAT, while controversial, solve the problem of neighborhood crime. Our communities are seeing more and more petty theft such as car break ins, theft of landscaping equipment off trucks in neighborhood streets, and the theft of building materials from construction sites. This petty theft is how many addicts support their habits. HAT programs provide the narcotics that addicts need to prevent dope sickness, and are a reliable alternative to tainted street heroin. These programs keep people alive, period, and that should be enough in and of itself.

 

People hate the idea of harm reduction strategies because they see it as enabling. However, these strategies exist to help people be safer while engaging in behaviors that they are already going to engage in, regardless of whether the harm reduction strategy is implemented or not.

Something to consider while you’re rolling your eyes at these life saving strategies is that what the United States does and has done to deal with drugs has not and will not ever work. Incarceration doesn’t work. Making an addict a felon will not help them to live in sobriety. Prohibition has never worked. Police crack downs have never worked.

We really need to look at other progressive countries who have the actual science and statistics to back up their policies. Our insistence as a country of doing things our own way, despite plenty of evidence that illustrates that our way is not working, is allowing people to die in record numbers. Eventually, these programs will be proposed in your town. When that time comes, please ask yourself if you want to be part of the problem, or part of the solution. Trust science. Trust statistics. Be willing to open your heart and change your mind.

©Copyright 2017 In Angel’s Arms and Lauren Goodkin

Theft In Addiction: We’re ALL Guilty

Theft is a huge piece of the puzzle that is addiction. The vast majority of addicts, especially opiate addicts, have stolen something from someone or somewhere at some point in their active addiction. Whether it’s a few dollars from a parent or spouse’s wallet, a pawned piece of jewelry, or an old laptop, most of us are guilty of stealing at one point or another. When we think about theft in addiction, we typically think about the taking of a physical object that does not belong to us. However, that isn’t the only kind of stealing that we do in our addictions.

I recently had an experience with an addict who felt that she was better than the rest of us because as she put it, “I don’t steal”. Apparently she was independently wealthy, or able to maintain employment during her addiction and somehow was able to support her own habit. This is extremely rare, as even the wealthiest of celebrity addicts have used themselves broke in very short order. So this particular addict felt above those of us who have stolen during our addiction.

My father, who generally doesn’t have much to do with the deep and dirty details of my addiction and recovery, is the one who actually put the true nature of theft during addiction into perspective for me some years ago. Even though I never “stole” any money from my dad, unlike the countless dollar taken from my mother’s wallet and endless amounts of her jewelry that I pawned, my dad still felt violated and that he had been stolen from.

He explained that any money he had given me for spending money, bills, or other expenses that I in turn spent on drugs, was money stolen from him. He gave me that money for a specific purpose, and that purpose was NOT to buy drugs. To him, every dollar that I spent on drugs that came from his wallet, even though he had willingly given it to me, was money stolen.

But what about the things that money cannot buy? What about the time that is lost while using? I bet my mom would say that I stole what adds up to years worth of time that we could’ve spent together. She would say that I stole many nights of peaceful sleep from her. I stole her peace of mind. I stole her sanity.

These are all intangible things, things that can’t be measured in dollars and cents, but they are just as real and just as valuable, if not more, than any amount of money that I stole.

Worse still, I stole something more valuable than all of that from not only my mom and dad, but my brother, my aunts and uncles, my cousins, my friends, and anyone who knew me. I stole their TRUST. Trust can be easy to gain, and even implied among family members. However, once it is gone, it can be impossible to regain it.

I was banned from the homes of family members for years, because I stole that trust from them. I was not allowed to carry cash by my parents for years, because I stole that trust from them. Everywhere I went, everything I did, every word I said, had to be questioned. Even months into sobriety, I couldn’t be trusted to do something as simple as drive to pick up the Chinese food from around the corner. The theft of that trust is the most valuable thing I ever stole, and I took it from more people than I can count.

We steal so much in our addictions that can’t be measured.

Time, friendship, relationships, and trust are just a few of the non-monetary things we steal during our addictions. Money, electronics, cars, jewelry, all of those physical things can be replaced, and in some cases quite easily. The real theft is the emotional toll we put on those around us. There isn’t a single one of us who lived through an addiction that didn’t steal some sanity from the people who love and care about us.

So to any addict out there who feels “better than” because they’ve never been in a pawn shop or lifted a few bills from someone else’s wallet, just remember that the things you stole are just as real, and just as valuable. And until you understand and own that, you’ll never be able to repair the damage and you’ll never truly live life in recovery.

©Copyright 2017 In Angel’s Arms and Lauren Goodkin

Unpopular Opinions: Marijuana For Good

When it comes to the fight against substance abuse, especially geared towards students and young people, many communities are still wasting precious time and resources trying to fight against the inevitable legalization of medical, and eventually recreational, marijuana. While hundreds of people die every day due to heroin and other opioid related overdoses, we know that no one has ever, in the history of the world, died from an overdose of marijuana.

That doesn’t mean like with every single drug and/or medication out there that there are not risks. True that driving under the influence of any substance, marijuana included, is dangerous and can cause serious injury and death to not only the driver and passengers, but other innocent people on the road. It is true that we don’t fully understand the impact marijuana has on the growing and developing brain and body, so keeping individuals under the age of 18 from using this substance isn’t a bad idea. I certainly don’t object to efforts to keep kids from experimenting with marijuana until they are of legal age, just like we do with alcohol.

Fighting to keep marijuana illegal, whether it’s medical or recreational, is a complete waste of resources and it is a fight that will not be won by opponents of legalization.

Marijuana is one of the oldest, if not the oldest, mood and mind altering substances in the world. It has been used by humans for thousands of years for both medical and recreational purposes. We know that it is not a drug that causes fatalities. We know that less than ten percent of users develop an addiction to the drug, which is characterized not by regular use but by any negative consequences associated with that use. Smoking weed everyday, just like drinking a glass of wine everyday, does not make one an addict. Being unable to go to work or school because of the consumption of the substance, or financial issues resulting from money spent on the substance, or the ability to live a functional life due to the substance would indicate a possible addiction. This is extremely rare when we talk about marijuana, just like with alcoholic beverages. Many people consume alcohol on a regular basis, with about 70% of Americans reporting drinking within the past year.

However, just like with marijuana, less than 10% of individuals who drink have a problem with alcohol consumption.

So why is marijuana illegal while alcohol is not? Many people believe that it goes back to industries that lobbied to make hemp illegal because it would be a more cost effective alternative to their products. Hemp is an incredible resource that can be made into paper, textiles, and hundreds of other everyday products, so other industries vilified the drug itself to prevent it from harming their business and bottom lines. Other reasons trace back to early immigrants who used the drug, so just as we do today, the white people vilified the drug because it was linked to brown immigrants who they considered dirty, lazy, and undesirable. We are all familiar with the prohibition of alcohol, and the propaganda used against it. It has been much the same with the prohibition of marijuana.

Many people in the treatment industry believe that if one is sober, that they need to abstain from every mind altering substance out there. This is the way promoted by Twelve Step fellowships, and consequentially this is the philosophy held by the majority of those who work or live in recovery. Just like each person gets recovery in their own way, the parameters of what recovery means can be different for different people. Many people in recovery from drug use are able to drink alcohol without consequence, and the same is true of casual use of marijuana. It is up to each of us as individuals to decide what recovery means to us.

When it comes to opiates, marijuana has been used for decades, probably even longer, to help with the withdrawal effects. Historically, people who couldn’t afford to get on methadone or receive other kinds of treatment have turned to marijuana to help with both acute and post acute withdrawal. Many people use it just like methadone or Suboxone, as an unofficial maintenance program to help them cope with the long, years long process, of staying off opiates. If we can treat opiate dependence with marijuana instead of other opiates, then why shouldn’t we? Isn’t it a better alternative than staying dependent on methadone or Suboxone for years on end? Some states get this, and are trying to move forward with “marijuana maintenance” programs for those addicted to opiates.

In the same vein, isn’t it better to prescribe marijuana for various medical conditions than the alternative of prescribing dangerous opiates and benzodiazepines? The dependence and side effects of these drugs are so dangerous and even deadly, while the alternative of using marijuana is much safer. I’d rather see a chronic pain patient smoking weed or using CBD’s to treat their condition that spending their life dependent on an ever increasing dose of oxycodone.

We’ve all seen the videos online of people having seizures, or episodes of indescribable pain, and using marijuana almost instantly reverses the symptoms. It is inhumane to allow people, especially children, to suffer from pain, discomfort, or crippling anxiety when we have a drug that can be used to treat it with little to no side effects. There are countless strains of marijuana that can be used for all kinds of issues. Each strain has a unique set of traits that can be applied to almost any illness or condition.

Legalization would provide an incredible amount of tax revenue to our communities. It could solve a great deal of budget issues. Furthermore, it would drastically reduce the number of people that are incarcerated for possession or sale of marijuana. It would put a significant dent in our prison overcrowding problems. It would significantly lessen the traffic through our courts and drastically reduce the number of people who participate in diversion programs and who are on probation. It would lower the number of children who are placed into foster care, and parents who are trapped in DCF programs, simply because they use marijuana. This is basically the equivalent of taking the children of parents who drink alcohol, and since most adults in this country drink, everyone should be able to see how ridiculous this policy is.

When opponents of marijuana are asked to explain their argument, they have nothing but junk science and skewed studies to support their position. Marijuana is no more dangerous than alcohol, and in all honestly probably less so. We are spending copious amounts of money to keep this drug illegal. We have to pay police, prosecutors, public defenders, advocates, court employees, treatment centers who run diversion programs, and an endless list of people and agencies. It costs a lot of money to keep this drug illegal, while legalizing it would actually GENERATE money. Dispensaries could bring jobs to our communities. Imagine the research that could get done on so many different diseases and medical conditions once we work to eliminate the stigma associated with marijuana.

Marijuana is just as valid of a medication as pain killing opioids, with a fraction of the risks associated with them. It is also just as safe of a recreational drug as alcohol, if not more so. The health risks are really in the ingestion method, which is typically smoking. However, using cannabinoids and marijuana itself in other ingestion methods would eliminate this one potential danger. We can do better when it comes to the ways we treat many different diseases and conditions, including the terrible issue we have with opioid dependent individuals. We need to focus our energies on the prevention of dangerous drug use, like that of opiates, and stop wasting our time and other resources fighting something that just isn’t worth the battle.

Rather than a danger to those in recovery, marijuana could be, and to many people already is and has always been, a blessing.

©Copyright 2017 In Angel’s Arms and Lauren Goodkin

I’m Still Here: Treatment for Long Term Sobriety

I often talk about changes on this blog. Changes that are happening, and changes that need to happen. There is an endless list of things wrong in the sphere of addiction. From the problems with the way the police and justice system deal with addicts, to the stigma we deal with in the general population, and even on the front lines in the treatment world.

There are many different kinds of treatment out there. There is a lot of treatment available to someone who is in the very beginning stages of sobriety. We have the highest levels of care in detoxes, which then typically lead to an inpatient or Partial Hospitalization Program (referred to as PHPs). The level of care after that is generally Intensive Outpatient Programs (referred to as IOPs). There are no rules to the order in which someone engages in treatment, except that most programs do require someone who is actively using to have completed a supervised medical detox before enrolling them in treatment. Some people jump right into an IOP without having gone through an inpatient program.

The problem with any kind of outpatient treatment is that is allows the client to still engage in addict behavior while enrolled in treatment. Whether it is actively using, or other shady behaviors, it can be challenging to break those habits and that lifestyle while only engaged in treatment a few hours a week.

This is a problem that not only outpatient treatment programs deal with, but that is common in the rooms of twelve step programs as well. Everyone who has ever been in treatment or in the rooms has been told to “stick with the winners”, meaning that you shouldn’t hang around with people who are struggling to live a clean and sober life.

This philosophy can be difficult to adhere to, however, when those with good clean time are mixed into a group session at the treatment center with those who are still struggling to stay clean.

This issue basically stems from the major problem with treatment in general, which is that there is little treatment available for those in long term sobriety.

Once you have over a year of good clean time, your life generally changes in very significant ways. For most of us, our legal problems have been resolved. We are no longer on probation, and if we are on a long term probation that has extended multiple years, we are no longer worried about violating our probation in our daily lives. We don’t worry about giving dirty urines. We don’t have open cases with DCF and we don’t worry about losing custody of our children. If we have lost custody in the past, we have regained it or are in the process of regaining it. We don’t associate with people who are actively using, even if it’s only occasional slipping. We no longer frequent places like pawn shops, or spend time hanging out in the streets. We have realized major changes in the three areas I talk about that indicate true recovery: Behavior, Mindset, and Intent.

For these reasons, I generally avoid attending groups or twelve step meetings. I don’t want to spend time talking about those early recovery issues, because for me personally, it puts me in a negative mindset.

It is extremely triggering for me, personally, to be put back into a room full of people who have a totally different set of behaviors, a completely different mindset, and a dangerous intent.

Keep in mind, AS ALWAYS, we are all unique in our experience. For some people, they call it “keeping it green”, which means being reminded of those bad times so that they remember not to fall back into those old routines. For those people who find that kind of group experience to be beneficial, they should continue to utilize it as part of their program of recovery. However, for myself and many others, we prefer to stay moving forwards.

Yesterday I made the mistake of attending a group at my treatment center. I typically only attend one group, which is an aftercare group for those of us who have completed IOP and are succeeding in recovery. There is only one of these groups available, and all the rest are open to everyone, regardless of their level of recovery. Don’t get me wrong, these people need groups, and they should be welcome to attend them. The problem for someone like me, with multiple years, is that we need a different level of group care.

This group was completely out of control from the minute it started, which was ten minutes late. The topics of discussion were all things that are typical problems for people who are still using. Custody issues, probation violations, arrests from pawning stolen items, you name it. The individuals who were talking dominated the entire group, and became agitated every time the counselor tried to reign them in. The topic of the group was supposed to be “Coping Skills”, which is something we all need to work on. No one on this earth has perfect coping skills. However, there is a big difference between coping with the early days of sobriety and coping with the problems that arise for us later on.

The treatment industry needs to take steps to address the needs of those who are living in recovery long term. I am proud that my treatment center does offer the one aftercare group that I truly benefit from, but we need more. We need to make it a common practice in treatment centers to offer groups to those who have a history of clean urines and whose counselors can approve them to attend based on their time in recovery and what they have accomplished during that time.

The problems that generally arise stem from trying to ascertain what qualifies someone to attend what we might call an “advanced” group. For me it always comes down to the three qualifiers of Behavior, Mindset, and Intent. Is this person engaging in any negative behavior? Is their mindset focused on living life in recovery? What are their intentions in their daily life? These are observations that a counselor should be able to make regarding each of their clients, and determine who has come to a point in their recovery where their daily challenges have changed from those faced by someone who has less progress.

My daily challenges have drastically changed from the ones I dealt with three years ago, or even one year ago. This is why I struggle to sit through a group with people who are still navigating those early struggles.

We need to break down the recovery process further than simply clean vs. dirty.

Progressive treatment centers need to find ways to cater to clients in every stage of recovery. Someone who has been in recovery for ten years probably has much different challenges from someone who has been clean for three years. Someone who has been clean for six months is in a totally different place for someone who is still counting their first thirty days.

Everyone who desires a life in recovery deserves to have their unique needs addressed by their treatment center. When we talk about opiate withdrawal, the Post Acute Withdrawal process can last up to two years, but the average treatment center provides no more than eight weeks of care to clients enrolled in an IOP. What happens after that? Where is the follow up care? We need to do a better job with the follow through process when it comes to continued care.

A diabetic doesn’t get prescribed insulin, spend a few weeks getting monitored, and then get sent on their way. They continue to report to their doctor and talk about what is working and what is not working for as long as necessary to keep their condition under control. A cancer patient doesn’t go into remission and then never see their doctor again. They go back for testing for years to ensure that the cancer doesn’t return, and if it does, it is caught early BECAUSE of the continued regular monitoring.

Addiction is an all consuming disease that totally alters every single facet of our lives, and it typically goes on for months or years. When we talk about weight loss, we always hear that it took so long to put the weight on, so it’s going to take just as long to lose it. We need to treat addiction and recovery the same way. Changing your behavior, mindset, and intent amounts to changing your entire perspective on life. These changes cannot be made overnight. We spent years building these negative habits, and it can take years to fully break them and replace them with our new way of life.

This is just one of many changes we need to see moving forward in the treatment of addiction. The list of steps towards progress is endless, and it’s going to take time to implement new strategies of care as we change the way we look at and treat this deadly disease. The good news is that there ARE progressive treatment centers who are looking beyond the twelve step model to see what else is out there and what other ways people can get into and stay in recovery. What changes would you like to see in the treatment of addiction? Let me know in the comments!

©Copyright 2017 In Angel’s Arms and Lauren Goodkin