Category: Connect

We had a bit of a blow-out in the comment section two posts ago. John (JLK) wrote a comment in which he made several claims about what addiction “really” is and provided a very specific recipe for how it should be treated. He also said he didn’t think I qualified as a “true” addict:

Your method of quitting has always sounded too good to be true for me. You also are able to drink on a regular basis. While it is true it takes all kinds there are also a lot of similarities in the stories I have heard… and I must admit I have not heard one remotely like yours…

To put it plainly I am still not convinced you were a true addict but possibly driven by other psychological problems. First you were a “binger” and second you were able to quit the hard stuff too easily.

Two commenters, Alese and Nik, took John to task on these and other points. I stayed out of it, though it’s true his comment did piss me off, and I had to decide to hold my tongue.

Now, in retrospect, I have a few points to add:

First, I don’t think John meant to offend. His very recent comment, about walking on eggshells, suggests that he has his own style of what to express and what NOT to hold back. I feel badly that you may have been stung by some of these replies, John, but I also think that they expressed important and valid counter-arguments to your claims. I also think you walked right into this, by challenging just about everything on your radar, without much thought about how readers, including me, would react.

Nik disputed some of your claims very convincingly. I won’t reiterate that here. But the upshot is that many of us feel there are many ways to BE addicted and many ways to recover….So, maybe, counter to the theme of my last post, there IS a fair bit of diversity in people’s experiences during addiction and recovery. But I guess what inflamed most was how you took experiences such as mine and passed judgement on them without seeming to care how I interpreted my own experiences. Most people, but (ex?) addicts especially, are pretty sensitive to that sort of thing: if you’re going to try to understand what I’ve been through, ask me, don’t tell me.

The funny part is: why should I  be so proud of the “addict” label that I resent you for challenging it — as if you’ve ripped away my favourite shirt or something. But here are a few more concrete issues:

–many addicts are involved in “binge” style using. It’s really pretty common, among alcoholics too. I was talking to some addiction specialists last night who report that binge drinking among teens is rapidly on the rise in many Western countries, leading to increasing reports of death and brain damage. The main issues are: how often, how much harm, and how much control does one have? Call it binging or not, but I was very close to killing myself. When you alternately shoot Demerol and coke, every 20 minutes or so, a minor miscalculation can kill you easily, because you are balancing a massive dose of an opiate with a massive dose of a psychostimulant. This was one of the last episodes of using I report in my book — and I think it was one of my last times ever. Anyway, don’t imagine that this was child’s play, a point that’s not so much insulting as it is inaccurate.

-although my story has some unique features, it’s not all that unique. I did not quit easily. I had tried to quit many many times, and by now I was completely desperate. On this particular day, it worked. But that’s just a small part of the story. I’ve recently talked in depth with two heroin addicts, both of whom can point to a last day: the last day they used — after which they just stopped. So much desperation, disgust, and horror had built up, they just couldn’t keep going. So we shouldn’t confuse the “ease” of “just saying No” with the long, grinding build-up that makes that moment possible. And by the way, “spontaneous recovery” is much more common than recovery through any particular form of treatment, including certainly the 12-step approach. That’s a fact.

-John and I may agree on one thing: that compulsivity is a huge part of addiction. Different parts of the striatum are responsible for different aspect of addiction. The ventral striatum becomes highly sensitive to addictive cues and shifts attention to the drug/booze target. That’s impulsivity. The dorsal striatum is in charge of directing a stream of behaviour, step by step, toward that target. Compulsivity is the inability to turn off that stream of behaviour, as exemplified in OCD and compulsive gambling. Dopamine fuels both striatal functions — wanting and doing. And guess what: when Parkinson’s patients are given  dopamine-enhancing drugs, their tendency toward compulsive gambling goes way up! A central issue in understanding addiction is: how and when does the impulsive aspect give way to or get replaced by the compulsive aspect? We need to learn more about this.

-and finally, yes, I’m able to drink alcohol without a massive landslide in self-control. So are a lot of other ex-addicts. This issue is not definitional — it’s a matter of individual diversity. Many ex-alcoholics can smoke, some can’t, some ex-junkies can drink, some can’t. For some former addicts, smoking pot is a minor diversion after giving up more toxic substances, for others it’s the top of the slippery slope. What bothers me is the tendency to set up these formulas and imagine that they apply to everyone: if you drink then you either never were or still are an addict. All these “formulas” have millions of exceptions. And something that hit-and-miss isn’t really a formula at all.

Okay, let’s bury the hatchet and keep on talking. We really can learn a lot from listening to each other — and that’s not just a warm-and-fuzzy motto: it’s a reality.

As mentioned, I’ve started interviewing a subset of the people who responded to my request for biographical material. These people offered to share the stories of their lives as addicts. Most have recovered. Some are still in process. The point is that this is a rare gift. It gives me a unique and potent data set for my next book – intimate accounts of what it’s like to be addicted and then to try, and fail, and try, and eventually (hopefully) succeed in getting on with one’s life. I haven’t gotten all that far with the book. The proposal has been blessed by my agent. My sample chapter is sitting in his inbox. I’ll discover its fate soon enough.

Meanwhile, I want to tell you what I’m starting to learn from these interviews – even this early in the game.

First, you should know that they take place by Skype or phone – sometimes I see the person I’m talking to and sometimes I have to use my imagination. They seem to last an hour to an hour and a half, and they are full of painful memories – usually memories that have been rehashed many times over, while people try to make sense of them. Now they’ve got someone else rehashing them with them. Sometimes I feel like a dentist, drilling until I strike a new vein of distress or at least discomfort, and I know it must hurt, but we’ve got to get to these details if the book is to be as compelling as I want it to be. I know it hurts partly because I’ve been to similar places, and my memories of the bad times don’t seem to fade much. And I know it because I can get goose-bumps up and down my arms or tears in my eyes. So much suffering! It bowls me over. And so much loneliness – the isolation of being locked in your addiction with everyone you care about eyeing you from the outside.

But I often come away from these interviews uplifted and optimistic, rather than depressed. Because just about everyone I’ve talked to – no, everyone I’ve talked to – has mounted a campaign against his or her addiction and eventually won, or at least formed a truce. And that takes the best of a person: courage, dedication, forebearance, creativity, and plain common sense. I’ve said it before: addicts (ex or still struggling) are some of my favourite people.

I’m learning a lot from the interviews. But here I want to share just one thing that’s struck me repeatedly.

The lives of the people I’m interviewing – and probably the lives of most addicts – have an hourglass shape to them. They start out unique: each person begins with his or her own specific culture, family environment, level of education, personality, social network, personal secrets, and all the rest. But then, when addiction takes hold, these lives start to look exactly the same. Regardless of whether it’s cocaine, opiates, alcohol, or even food, that wide range of individual differences shrinks to a narrow tube – the middle of the hourglass. What I mean is that people’s addictions have this fundamental commonality: the initial discovery that whatever it is helps with anxiety or depression, it feels golden, and then with time it becomes irresistible, then it’s no longer much fun, and then it becomes the source of new anxieties and more depression, as the desperation, the cover-up, the way we turn our back on other people, the way we turn our back on our own selves…. seem to be the main ingredients of everyone’s addiction. Then people make whatever attempts they make to get better, to get past it. (I’m not fond of the term “recovery” because that implies going backward, to something you once were.) And usually, eventually, after ten or a hundred tries, they make it. Then they start to live their own lives once more, and here’s where the hourglass starts to bulge out again, in its bottom half. Now individuality, creativity, and uniqueness get relaunched, without that yoke restricting them, and the hollow tube of mindless repetition fans out to a million possible ways to live your life.

That’s what I’ve learned so far. Tell me your thoughts. Have you also experienced the commonality of addiction, or do you see it another way? There may be massive exceptions to the pattern I seem to be noticing. And stay tuned. I plan to share a lot more as the book proceeds and I get caught up in trying to match these life profiles to the brain events going on below the surface. That will require me to go back to the neuroscience of addiction and do more homework, to try to figure out how it is that the features of the brain are necessary for understanding the features of addiction.

Hi people.

I’m sorry I’ve been so out of touch. There isn’t one particular reason, but several things have conspired to keep me busy. The last actual post was a cut-and-paste from Arne, a reader, on August 25^th, and the last one I wrote myself was on August 17^th. Both posts got a LOT of comments: each became a real dialogue among readers, and that was a delight in itself. Not only that, but new people stumbling on this blog have complimented us on the depth and diversity of our perspectives. So, congratulations to us! Anyway, I got caught up in this sea of comments, followed leads, bought books, etc, and all that kept me busy for a while.

I also finally started my interviews. I’ve been talking with a subset of the people who responded to my request (on this blog) to use their life stories of addiction and (mostly) recovery, for my next book. I must have gotten between 100 and 150 responses to that request, and if you were among them, I’m very thankful to you. I tried to get back to everyone who offered a peak into their private lives – not something I take for granted. If I somehow missed you, please accept my apology: My inbox was completely flooded for a few months.

Everyone who responded shared some aspect of their life with me, all by email, and some also with a follow-up phone call. People shared anything from a rough sketch to a cluster of searing details. Some were almost novella-length. Others were teasers, eliciting curiosity or enchantment. Some struck me as warnings to anyone listening. Others were more like cries for help. I found these accounts to be moving, inspiring, and/or agonizing, each in its own way. So here’s the problem: For my book I can only use four or five of these stories, fleshed out as biographies. More than that and the book would lose its coherence. Now what do I do with the rest? It would be such a waste to ignore them.

Here’s a solution: A memoir repository.

I want to invite everyone who has shared some aspect of your life as an addict, recovered or not, to post your story on this website. And anyone else who wants to join in would be welcome as well. It doesn’t matter whether you’ve contacted me personally or not. My web-designer and I will create a unique page where people can post their stories directly. They will not be edited by me or anyone else. My only demand is that you think before you post. Don’t post details that you might not want to be public. (But if you change your mind later, you can ask me to delete your post and perhaps make up a new one.) What I envision is a repository of addiction memoirs, anywhere from a paragraph to several chapters in length, sitting in their own special place on the Internet. They will be available for anyone who might be looking for inspiration, wisdom, or warning, or parallels with their own troubling experiences, or maybe a few moments of recognition, a sense of commonality, or a spot of hope in an ominous future.

Please don’t send your stories to me now. I’ll let you know when the posting page is ready, and I’ll make sure and announce the details on how to post your story directly. Also, if you have comments about this new feature, or other ideas to share, please send them as comments on this post rather than as emails.

Next post, I’m going to share what I’m getting from the in-depth interviews I’ve already conducted. I’m learning so much more about addiction than I thought I knew, from the astounding details of other people’s lives. You’ll see what’s been keeping me busy.

Marc,

I’ve been working on a drug education video series for a client who works mostly with classrooms of 5th-8th graders, and stumbled on your blog while doing research. It’s been extremely valuable to me in getting my head around addiction and the action of drugs in the brain. The challenge has been how to translate that into information that might help insulate a kid from going down that path when drugs are encountered.

Do we focus on kids never trying drugs, or on preparing them to stay away from “abuse” rather than “use”?

My question about addiction is perhaps most what I see as a non-drug-addict (as you rightly elucidate, there are plenty of my behaviors that mirror those of addicts, but I don’t have any addictions to drugs) who is working in the space between kids and drugs. One thing I haven’t read here in your blog or the resulting comments is a sort of social prism. Thinking of myself as a youngster, the feeling of getting out of my body or being in some ecstatic space was extremely important. I dabbled in various hallucingens mostly, but I think because I had enough other experiences of joy that I saw them as interesting but not essential. If anything, I feared drugs because the resultant come-down deprived me temporarily of access to the more natural experiences of authenticity I treasured.

I think of Ben in the video you link to up there. Sure, he had no overt trauma, but he grew up in what seemed one of those imprisoning and somewhat dulling strata of UK society…loving family, but perhaps not much room for connection to anything other than a row house and a job? Isn’t there a trauma in culture? In growing up in a civilization or particular society that requires a certain kind of adaptation — an adaptation that many of us are unable to make, whether biologically or, if you bend that way, spiritually? I think of the kid in Into the Wild…it wasn’t drugs for him, but he needed something out of his life that his sweet upbringing couldn’t provide.

Drugs for many might provide the only experience of ecstasy they’re likely to have…and who are we to ask them to prefer a long life of frustration and being an upstanding citizen to a few fleeting moments of feeling truly alive? What are we alive for, exactly? To execute our biological and social functions? I think these discussions of being and the brain are extremely fascinating, and I think a lot of work is being done lately to understand how brain networks affect behavior and health, but I feel like there’s a big gap here as we individualize and anatomize too much around addiction and think less of the more philosophical question of our purpose here.

For non-traumatized kids, what do we offer them as a culture that makes resisting drugs an appealing choice? Fear of ending up like Ben obviously isn’t enough. What’s the positive path we give them to choose? If we value euphoria, or even just wellbeing, as a culture, does our current system work?  How available is the state of wellbeing in ordinary life? Or are drugs the best way to get there; and that’s how they get so deeply into our brains?

I started reading your book and couldn’t help feeling that there was more to your drug use than the obvious trauma. Not only were people mean to you and you felt loss leaving home, but it seemed that drugs gave you a path to the sublime that was missing in your surroundings. Your lyrical writing in those passages certainly attests to a sense of doors being opened…maybe the lack of major psychic pain you allude to was also the lack of venues in your social situation to access joy or hope?

I often think about this when working with kids at risk. Are we really telling youth to work at McDonald’s (if they can even get a job there) and be upright citizens for the minimal sense of satisfaction and safety that comes with that choice — rather than choosing either the visceral thrill and sense of joyful community of being in a gang, or the (temporary) euphoria and wellbeing that come with drug use?

I am finally caught up! My inbox is clear for the first time since October. I have no classes to teach until after January. I just completed a draft outline for my next book (at 4:30 AM, somewhat hungover). And I’m now starting to communicate with the many people who sent me amazing stories.

There is actually nothing I’d rather be doing than this “research” into others’ addiction stories. I’m pretty much certain that addicts are the most interesting people on the planet.

Oh yeah, and I finished that disease/choice/self-medication set of posts I promised. Phew.

So, now, on to other things.

…………………………….

People often ask me how I quit drugs (roughly 30 years ago, with only minor blips since). So here’s a recent email exchange (lightly edited) in which I try to spell it out. Like others, this reader thought that the passage describing how I quit was too fast and loose. Maybe it was.

> From: “Donna” [not her real name]
> To: marc@memoirsofanaddictedbrain.com
> Sent: Tuesday, 24 July, 2012 2:53:06 PM

> Message: Hi Marc,
…….

> I just finished your book last night–I could hardly put it down. I
> was fascinated with the subjective descriptions of your experiences
> with drugs and how they manifested biologically in the brain. As I
> read I became rather depressed, however–learning about the brain’s
> loss of plasticity, and the feedback loops created by addiction made me
> feel rather hopeless. I was eager to get to the part where you talked
> about how you finally stopped doing drugs, despite having “hit
> bottom” many times.
>
> I have to say that your “NO” mandala was a big letdown. I’m sure I’m
> not the first nor the last to say that. It made me think of Nancy
> Reagan and the whole 1980s Just Say No campaign and here’s your brain
> on drugs–a fried egg. I really don’t understand. How did this work
> for you? How was it “different” from the other times you were filled
> with self-loathing, got your shit together, and ended up clean for a
> period of years? I wasn’t really looking at your memoir as a
> self-help book–I wanted to learn about the neuroscience of addiction,
> and I did learn a lot. But I also couldn’t help thinking about how
> you escaped, and what I could learn from that and how I could apply it
> to my own life. Sadly, I just don’t get it. Given the changes to your
> brain, what happened to enable you to overcome what was essentially a
> biological process?
>

> Best,
>

Hi Donna,

I’m happy to reply to this kind of mail…especially when your question is so clear and credible. Yes, others have expressed similar disappointment in the ending of my book. Let me try to explain how I quit.

First, there were never any periods of more than a few months, more often a few days or at best a few weeks, of being clean in the previous three or four years. So this time was obviously hugely different. How did it work? I’m really not sure. Basically, I reported what happened. The details are accurate. I didn’t have an instruction manual, so I can’t really say what was going on or precisely what I did that time that unlocked a new door.

But here, I’ll try. I had recently endured two particularly shitty events. My girlfriend left me, which broke my heart, and my friends found me, semi-comatose,  on a toilet seat in a public building with a needle sticking out of my arm, which was intensely shame-inducing. I think by then I had built up a lot of rage, not just self-contempt and all that but real rage — toward drugs, I could say, or toward what seemed to be a force or a malevolent spirit, or maybe something like the Greek Orchestra idea of a “fate” that keeps fucking up the protagonist’s chance of getting out of hell. Something pivoted on that particular day, the day I wrote “NO” on a piece of paper, decorated it with the trimmings of a mandala, and stuck it up on my wall. The rage seemed to pivot around and focus on this external entity, rather than on me for a change. And that was a big change. I remember feeling: you have no right! I deserve to live! You can’t do this to me!

That was how it started. There was also the small matter of saying to myself “never again” — rather than never again for at least 2 years, or never again injecting, or other half-assed self-promises. I truly at that moment didn’t want to EVER do it again.

And I just kept going on like that, day after day, telling myself NO fifty times a day….then less and less as the days went by. By the second or third week, I thought it might be really working, but I didn’t know for sure until about two months had gone by. And during all that time, the horror of my recent life kept returning to me in vivid images, and I kept telling myself: I don’t WANT to go there again. This is ME speaking: I DON’T WANT TO. Of course the withdrawal symptoms and the depression and all that were shitty for a week or two, but even within a few days, there were rays of light. Maybe even that first day.

Things like that happen. Big life changes can turn on a dime. How can that be, you may ask, given all the “wiring” that’s already taken place? For one thing, the brain hasn’t lost all its plasticity from addiction. Not at all. It’s just that addiction takes hold through several really fierce feedback loops that continue to gobble up plasticity on a day-to-day basis. I mean the loop of wanting-getting-losing-craving, and also the loop of using/lying/sneaking and shame, which greatly increases psychic pain and makes you want relief at any price. In both cases, there is a massive interaction between dopamine uptake, cue salience, and the potency of desire……that just cuts through the available options — the plasticity — as if there WERE no other options.

I guess another idea is that, while I was building up this elaborate addict network (I mean synaptically), I was also building up an elaborate non-addict network. I never stopped trying. I still wanted to be a regular person with a good life. I went to see a variety of therapists. I remember one who wouldn’t even talk to me (a psychologist, in fact) because he said I was too far gone. In fact, none of them helped much, but it meant (at least to me) that I was trying. Meanwhile, I was applying to jobs in mental health agencies, and getting some, and I was still aiming to get back into school. All that equals a whole OTHER synaptic network. Maybe the pivot point for me had to do with connecting a day-to-day/hour-to-hour sense of self with that second network, long enough for it to “take”…and start sucking up its own helpings of dopamine (I WANT this).

Also, I have no idea if I’d have stayed clean IF I didn’t get accepted into grad school a few months later. I’d like to think so, but I just don’t know.

Since then, I’ve had a number of flirtations with drugs, I sometimes drink too much, but I have never gone back to the hell I lived in before that day.

So there you have it.

And don’t be depressed. Loss of plasticity is relative. There’s plenty left over. Read Norman Doidge’s book if you want to think more about the immense degree of plasticity that’s available, even well into our later years.

Cheers,
Marc