Dire Mental Health: A Catalyst for Post-Pandemic Drug Addiction

Did you know that loneliness - the sadness we feel when we’re apart or separated from our loved ones, like parents, siblings, partners and friends, or even from society itself - is affecting more and more adults, and actually appears to worsen with each new generation of Americans?In addition, this loneliness, this sad sense of separation, is a prominent precursor to depression and other mental health disorders, and a major contributing factor in substance use and, later, drug addiction, among its other effects.For decades and decades, and long before “coronavirus,” “social distancing” and “quarantine” became commonplace words and phrases in our daily conversations, the U.S. was experiencing an ever-worsening plague - one of simply feeling alone - and it’s still with us.Unsurprisingly, the COVID-19 pandemic has made this “loneliness epidemic” far more pervasive throughout the nation, and far more concerning to mental health experts, especially as many of them are now predicting a wave of post-pandemic mental health and behavioral issues as a result of both the physical and socio-environmental effects of COVID-19, resulting in a new public mental health emergency on the very near-horizon.“We have supply shortages and economic stress, fear of illness, all of our disrupted routines… There's a real grief in all of that. We don't have a vaccine for our mental health like we do for our physical health.”- Lisa Carlson, MPH, MCHES, renowned public health expert (2020)So, should we listen?...Well, these same expert voices were 100% correct in predicting the rapid spike in fatal drug overdoses as the pandemic and its effects really kicked in across the U.S. In fact, record numbers of drug users died by opioid-related overdose in 2020, as recently acknowledged by the U.S. Centers for Disease Control & Prevention (CDC).Furthermore, they correctly predicted the rise in relapse rates as those in addiction recovery were left to look solely online for their support (from treatment and counseling, to their 12-Step meetings), and, lastly, they were more than proved right when it came to the growing influence across the entire U.S. of the synthetic opioid fentanyl in today’s illicit drug trade.Think about it. It’s a succession of undeniable consequences with severe effects on U.S. public health. It’s only prudent to listen to them now.Loneliness, Depression and Self-MedicationIn 2018, the global health service company Cigna, in partnership with market research firm Ipsos, released the results from their national “loneliness” survey, which utilized the “UCLA Loneliness Scale” - a frequently referenced and acknowledged academic measure for loneliness, involving a 20-item questionnaire developed to assess subjective feelings of being lonely and social isolation.The survey revealed that most U.S. adults should be considered as lonely, and that feeling or sense of loneliness has further increased with each subsequent generation. The survey revealed a number of other worrying findings, too:43% of U.S. adults often or always feel that their relationships are not meaningful, and that they are isolated from othersGeneration Z (adults aged 18-22) is the loneliest generation, and appear to be in worse health than older generationsRespondents defined as “very heavy users of social media” had a loneliness score of 43.5%, only marginally higher than those who never use social media (41.7%)Predictive Factors for Substance AddictionAs we now understand from extensive research on the subject, there is no one single factor that determines the likelihood of an addiction developing from substance use. Moreover, it’s a combination of possible factors that can be predictive when assessing an individual’s risk of addiction.However, the more “predictive boxes” that are ticked, the higher the likelihood of substance addiction, as individuals look to “self-medicate” to deal with their struggling mental health. Predictive factors include:Biology: It is believed that about half of an individual's risk for addiction is solely genetic. Additionally, gender, ethnicity, and the presence of mental disorders will further increase risk.Environment: An individual’s personal environment includes many different factors, such as family and friends, economic status, quality of life, peer pressure, physical and sexual abuse, early exposure to drugs, stress, and parental guidance.Development: Furthermore, these genetic and environmental factors will interact with an individual’s development (particularly in teenagers) to affect addiction risk. Using substances at any age can lead to addiction; however, the earlier the drug use begins, the more likely it will progress to addiction.Loneliness, as we’ve discussed above, can act as both an environmental and a biological factor in addiction risk (especially if it leads to a depressive or other disorder), resulting in a much higher risk for the later development of substance addiction, and, as we’ve mentioned previously, the COVID-19 pandemic has only made this “loneliness epidemic” more pervasive and more concerning in the opinion of mental health experts.Unfortunately, it doesn’t end there.Post-Viral Inflammation and Mood Disorder DevelopmentMedical researchers have long known about the direct link between inflammation, a natural biological response to viruses like COVID-19, and the subsequent development of mood disorders, such as depression. Additionally, they have also demonstrated that inflammation and mood are so intrinsically linked that the presence of inflammation may induce or exacerbate a mood disorder.A “Tsunami” of DepressionAn Irish Journal of Psychological Medicine article, published in May, 2020, and entitled “Fallout from the COVID-19 Pandemic - Should We Prepare for a Tsunami of Post Viral Depression?,” highlights this link, and predicts that 2021 will see a tidal wave of depressive disorders and other behavioral issues.“How is this possible?” you may ask.During the period when an individual has a viral infection, they experience decreased cellular immunity, and their body produces neuromodulators and immunomodulating agents to cope with this. However, these agents can then penetrate the brain when the blood-central nervous system (CNS) barrier is compromised - common during time of stress, infection and inflammation.In short, these neuromodulators inhibit our brain’s neurotransmitters, and so create feelings of depression and other negative responses, such as severe fatigue.COVID-19 Survivors and Mental IllnessFurther and more up-to-date research, in the form of an analysis of existing COVID-19 data by the psychiatry department at the University of Oxford, UK, has shown that around 1 in 8 people (13%) who have had Covid-19 are now being diagnosed with their first psychiatric or neurological illness - this occurs within 6 months of testing positive for the virus.This is a major public health concern because, as of the end of January, 2021, the U.S. had already seen nearly 26.5 million confirmed cases of coronavirus. If that wasn’t enough to create a brand new demographic of “self-medicating” individuals susceptible to substance addiction, it gets worse.The research further concluded that those figures rose to an alarming 1 in 3 (33.6%) when patients with a previous history of psychiatric or neurological illnesses were included. Furthermore, it’s worth noting that the Oxford study used, obviously with permission, relevant data from 236,379 U.S. survivors of the COVID-19 virus.Both of these in-depth studies simply add to the robust body of evidence that stresses the coronavirus pandemic and its consequential effects will lead to many more individuals with mental health disorders, such as major depressive disorder (clinical depression), other neuropsychiatric disorders, and a range of behavioral issues, which will undoubtedly include substance use disorders, and will instigate a rise in illicit drug use.Depression, Drug Overdose and The Dark Spectre of SuicideAs we slowly begin to navigate our way through 2021, still with over 100,000 new cases of coronavirus being diagnosed in the U.S. on a daily basis, we can but hope that the vaccine rollout will soon begin to have a positive effect on the nation’s seemingly futile battle with the pandemic, and that one day, possibly in the summer but far more likely in the fall, the CDC and other major U.S. public health bodies will announce a kind of tentative victory.However, by the time it does finally happen, further extensive and severe damage will have already been done to the collective mental health of the nation. It begs another question:How exactly will this new public mental health emergency manifest itself?Sadly, it will be more of the same of what was witnessed in 2020, with similar record numbers of premature deaths either through drug overdose (predominantly, involving fentanyl and other high potency opioids and their analogs) or the dark spectre that pervades any crisis of the mind - suicide, the ultimate self-medication.Like overdose, in the midst of this pandemic, the issue of suicide has never been far from the legitimate concerns of mental health experts.Finally, as this article has demonstrated, one clear feature of the looming public mental health crisis facing the post-pandemic U.S. will be a significant rise in the use and abuse of illicit substances - from opioids to cocaine, and from counterfeit prescriptions to methamphetamine - all of which are now being cut with the far cheaper product of fentanyl, and its analogs, by America’s perpetual dealer - the Mexican drug cartels.And, just like the coronavirus pandemic, exactly as Dr. Fauci stated, it will “get worse, much worse before it gets better.”

In AA, COVID’s Sobriety Inequality Gap

As large-scale lockdowns commenced to blunt the spread of COVID-19, members of Alcoholics Anonymous around the world took swift action. In many cases, the same dedicated folks who regularly serve as meeting chairpersons – the glue that binds local groups together even in the best of times – embarked on self-taught scramble drills to fulfill their duties online, typically via Zoom. In mere days, AA went digital.This expedient, comprehensive cyberization of AA was nothing short of remarkable. Among other pleasant surprises, it showed an adaptability that a program whose keystone literature has barely changed in 85 years might seem incapable of mustering. While AA’s traditions and principles are supported by an understandable stubbornness – the program works, so why fix what isn’t broken? – this success can lead to a dearth of malleability. Considering this, the Zoom rooms that promptly sprouted by the thousands have shown an impressive nimbleness, albeit one born of necessity.Nearly a year later… we’re still Zoomin’ along. It was never meant to last this long. And therein lies a distinctive issue the pandemic has inescapably exacerbated: inequality.The uneven impact of COVID-19 has long been evident. Economically, white collar workers who can earn a living from laptops have fared far better than blue collar and service industry workers, who are more likely to lose both jobs and vital health insurance. Communities of color have seen higher rates of hospitalization and death than whites, and children from lower-income families face obstacles to remote schooling that more affluent students do not.But boardrooms and classrooms aren’t the only mission-critical environments Zoom is struggling to replicate. The rooms of Alcoholics Anonymous are also significantly diminished by digitization. And as with other walks of society, a chasm in AA has emerged between the haves and the have nots.Getting Sober vs. Staying SoberWhile inequality in other landscapes typically involves economics – white collar vs working collar, privileged student vs. disadvantaged one – AA’s COVID-caused gap generally goes like this: those with longstanding sobriety remain sober, while newcomers struggle mightily to achieve and sustain sobriety. And every day that Zoom substitutes for in-person gatherings, that gap yawns ever wider.Some of this has been well publicized. Unsurprisingly the added anxiety, fear and isolation COVID-19 has caused lends itself to increased risks for alcoholism and substance abuse. Hard data shows overdoses increasing, and analysts noticed marked upticks in alcohol consumption from the very first week of stay-at-home restrictions.These are, however, mere figures. While it’s easy to track indicators of substance disorders, more difficult is assessing the challenges COVID poses to those ready to leave the bottles and baggies behind. Here, the growing recovery gap birthed by the pandemic lies in two truths: Getting sober is really hard, while remaining so is comparably easy.I have been a sober member of Alcoholics Anonymous for nine years, and can unequivocally state that, as far as getting and staying sober goes, AA’s Zoom rooms are an unworkably far cry from the in-person meetings that have served as lifelines for countless millions. AA works – I am living proof. But Zoom does not – and I fear it’s costing lives.For most addicts, myself included, getting sober is arguably the most arduous endeavor – and most rewarding accomplishment – of our lives. We come in broken and, with the help of others who’ve walked the path before us, slowly emerge stronger, 2.0 versions of ourselves. We accrue wisdom and develop tools we never possessed prior, even before descending into addiction’s depths. We become weller than well.But we did not – we could not – do it alone. AA thrives on the principle that addiction and alcoholism are “takes one to help one” diseases. Those with longstanding recovery pay their experience forward to the next generation of newcomers.And for those newcomers, including me in 2011, there is something magical about an AA meeting – something whose spirituality is tied to physical symbols and experiences. The 12 Steps posted to show our adherence to principles over personalities. The formality of the introductory readings – reverence to a text written in 1935 that remains penetratingly current today. The Serenity Prayer said in unison by dozens gathered for one primary purpose: arresting addiction.Recovery lives and breathes behind those closed church basement doors. The sing-song “Hi Chris” from scores of fellow alcoholics as I identity myself as one of them, at once humbled and empowered. The hoots, hollers and applause received by a newcomer celebrating another day free of drugs and booze. The enraptured silence of a group listening to someone who once drank or drugged like them explain his downfall and ultimate redemption through the 12 Steps, sober mentors and fellowship. And finally, a circle of sober drunks, hands linked, closing the gathering as they opened it: united. Standing together against a common enemy.The best in-person meetings are instructive, inspiring, fortifying. The best Zoom meetings are… well, a heaping pile of meh. If you think teaching a six-year-old arithmetic is difficult online, try teaching a 26-year-old not to drink himself to death during the other 23 hours in his isolated day.Instead of awed silence there is muted awkwardness. Instead of a room full of engaged sober drunks there is a Brady Bunch screen of stacked, often distracted faces. Instead of hugging and handholding there is, simply, nothing.A Temporary Necessity, Not a Long-term Solution AA has an essence that cannot be digitalized and, because of this, many with substantial recovery time have limited their attendance during the pandemic. Others have undoubtedly abandoned it entirely. We’ve worked the Steps, adopted the principles, and have already proven durable through protracted emergencies, alcohol-related and otherwise, We have the luxury of time, and don’t want Zoom eroding our esteem for AA. With vaccines on the way, we can wait this thing out safely and soberly. Newcomers, though, cannot. And therein lies the inequality COVID has foist upon recovery. It has significantly diminished the effectiveness of the most prolific recovery program in human history – and those most affected by it are the ones most threatened by active alcoholism and addiction.Is it possible to achieve and sustain sobriety via Zoom AA? Of course. But it is exceptionally difficult. Remote rooms have made an exceedingly challenging, existentially important process exponentially harder. To arrest alcoholism for the vast majority of those struggling with substance disorders, we must first arrest COVID.We’ve been living with this pandemic for nearly a full year. Its protracted nature brings with it a concern separate from the nearly half a million dead Americans: the concern that we start seeing these emergency measures as the new normal.Zooms rooms are not normal. They are a stopgap measure – a backup generator in an only-option scenario. This lack of alternatives is especially evident in the wintertime in cold-weather areas. No one is meeting in a park that just got 30 inches of snow, as much of my home state of New Jersey recently did.We all owe a debt of gratitude to the men and women who so quickly and capably pivoted to hosting Zoom meetings during widespread lockdowns. But we must remember that their sterling examples of sober service are merely making lemonade from lemons. They are keeping the AA ship afloat during a 100-year storm.AA will persevere. We will navigate this storm online for as long as necessary. But once the pandemic subsides, online meetings should return to being the exception rather than the rule.

The Stages of Change Model Shines Light on Recovery

In the common dialogue about recovery and substance use, there are a lot of black and white terms. You’re sober or you’re not; you’re in recovery or out of it; you’ve made change, or you haven’t.But most people who have lived with addiction for any amount of time know that there are shades of nuance and progression involved in making a major life change. Sometimes it’s two steps forward, one step back. If you’ve experienced this, you’re not alone.In fact, scientists have documented this phenomenon. To understand how people go about deciding to make a major life change, researchers developed the Stages of Change Model, also known as the Transtheoretical Model of Change.Familiarizing yourself with this model can help you understand your own behavior, or that of a loved one who is trying to get and stay sober. It can also help you accept that relapse is a normal, even expected, part of recovery.The Stages of ChangeAccording to the Stages of Change model, there are six stages that people go through when they are considering making a major change. They are:Precontemplation. People at this stage don’t see any problem with their behavior, and don’t have plans to change. For the person at the precontemplation stage, like a person who is still using drugs or alcohol, the idea of making a change seems to have more drawbacks than the idea of continuing life how they’re currently leading it.Contemplation. At this stage, a person is beginning to see that their behavior is problematic. They plan to change, but aren’t ready to change quite yet. A person who is using might know that their substance abuse is problematic, but they’re ambivalent about making a change.Preparation or Determination. After contemplating change, a person becomes committed to making a change. They know that their substance use is problematic and that they need to get healthier, and they’re starting to explore ways of getting sober, like researching treatment centers.Action. At this point, a person has decided to make the change that they hope will improve their lives. For people with substance use disorder, that might mean getting treatment. They’re learning about life in sobriety and trying their new skills to cope with challenges without using drugs or alcohol.Maintenance. After taking action, people in the maintenance phase know what they have to do to maintain change. That might mean working an aftercare program and engaging in activities like exercise, volunteering or anything else that keeps them sober and responsible.Relapse. We would like to think that after going through the hard work of recovery, change is permanent. However, it’s well-known that most people who get sober will relapse at some point. Accepting that relapse is part of recovery can help reduce shame and stigma, and encourage people to restart the stages of change as soon as they can.What The Stages of Change Say About RelapseIt’s scary to think about relapse, especially when you’re new in recovery. But putting your head in the sand will not help you stay sober. Being frank about the risk of relapse can serve as motivation to adhere to your recovery program. Understanding relapse risk can help you grasp that relapse is not the end of meaningful change.Consider this: most people have to go through the Stages of Change 4 - 7 times before they make lasting change. Knowing that making change is a fluid and dynamic process can normalize the experiences that you’re likely to have during your recovery journey.Processes of ChangeThe same researchers who identified the stages of change also identified ten processes of change that can be used to help motivate people looking to alter their lives. For example, consciousness raising helps you become more aware of an unhealthy behavior. Environmental reevaluation helps you understand how your behavior can impact the people around you. Forming helping relationships can keep you sober and on track.In order to make lasting change, you have to determine which processes of change resonate the most with you. That way, you can tap into these sources of motivation when you’re struggling.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.

Lesson 9: Expect the Unexpected

The following is excerpted from Crushing It: How I Crushed Diet Culture, Addiction & the Patriarchy by Kortney Olson.8/09: "I have been doing sessions for about ten years. Not many, once or twice a year. Pretty much all of them have been scissor sessions with some pretty strong women and some not so strong women. KO is one of the strongest women, and if she continues to work her legs like she is talking about doing, holy crap. Watch out. Usually I don’t tap much, I just like to see what limit the women can scissor. I tapped a lot more often with KO. She put me in a sideways figure-four with me sitting up and her laying sideways on the couch with her leg around my neck and I remember tapping, then she reapplied the pressure, and the next thing I remember is waking up on the floor. She put me out, I was snoring. After that I had some melons I bought for her to crush and she did it with no problem. I also have to say KO is one of the best-looking fitness/bodybuilders I have seen, her look reminded me of "Le Femme Nikita", she has a cute baby face with a killer attitude!!!! What a mix!! I am betting she has the ability to be one of the best out there. " -ClarkI owe a lot to Clark. If it weren’t for Clark, I’m not sure where I’d be today. Sliding Honda car doors, I guess. I sure as shit wouldn’t have a bunch of watermelon tattoos on my arm, and there’s a fair chance I wouldn’t have blue checks on my social media accounts.Clark was a local fan. Pretty basic dude who worked as a graphic designer in the Bay Area. I’ll never forget his email asking for a scissor session. He wanted to see if I “had what it takes” to knock him out. He‘d seen maybe twenty bodybuilders over the last decade, with only one who could successfully knock him out. He ended the email asking if I‘d be open to him bringing some watermelons for me to “try” and crush between my legs at the end of the session. Lastly, could I bring my video camera to film my “attempt”?The words “try”, “attempt” and “if you got what it takes” are a surefire way to get me onboard, dickhead. I don’t see why not. After all, it doesn’t involve an enema of any kind.As usual, I wrote back with my cocky ass attitude, feeling the need to justify my rate, and make some kind of outlandish statement that would wind up having me stressed the fuck out until the session was over.“Hi Clark-In case you needed reminding, my name is KO for a reason. Be forewarned, I’m the best there is. Once you have a session with me, the rest will seem like a waste of money. When and where?”KO always had to be the best.KO had something to prove.But Kortney felt like she had to justify herself, always.We set the session up for the following week. Nothing out of the ordinary, I’d drive down to his office and I’d spend an hour living up to my email claim and name. The time came and I got dressed.I slipped on my cute matching black Bebe thong and bralette, followed by tugging my way into the black, wet-looking pleather leggings that somehow one day appeared in my wardrobe. I pulled on one of my office ‘dress shirts’ which had the capability of sending me to the HR director back in the dealership days. Looking like a personal stewardess for Hugh Heffner on top and something out of the matrix on the bottom, I confidently bee-bopped my way towards takeoff and grabbed my video camera. With a slight pull of anxiety over whether or not I was going to come through and actually be ‘the best he’d ever seen’, I chewed up another few Norcos.Guess I can leave my stun gun. I’ve had enough back and forth to feel comfortable with Clark. Because ya know... people are always who they say they are on the internet. Including myself. At least I don’t feel fat today.No longer a middle classer with a Honda, I painfully strutted my too-tight high heels straight out the front door and into my newly financed Acura. Adorned with a professional decal across the back window, I backed out of the driveway with zero fucks regarding the poor choice of personal branding. Underneath the enlarged words of HARD AS FUK! sat my website, as if some curious passer-by on the highway needed to know who I was.Armed with an adequate stash of pills, I cranked the stereo up and lost myself in the music. After an hour and a half drive, I parked in Clark’s office complex and walked into the building to anxiously find his suite. Feeling like I was in a scene out of Outbreak, I started walking the dimly lit hallway while feeling eerily alone and emptyBit of a shitty rundown complex. I wonder if anyone else even occupies this building, and if so, could they hear me scream?Just like most things that made me anxious when thinking about the ‘what ifs’, I was in front of Clark’s door before I knew it, giving the rhythmic and happy sounding knock I learned from my dad, ’Bom, bom, bom-bom-bom. Bom. Bom.’Shit. I should have been a little more dominating on that knock. I sound like a girl scout trying to sell cookies as opposed to an FBI agent coming to fuck your life up. God I always fuck shit u....Clark opened his office door and interrupted my train of thought as he stood there with an energy of intimidation and nervousness.“Hey KO! Did you find the place ok?””Hi Clark! I did, thank you,” I replied while reaching out to give him a hug.Maybe that’s what made me different. Maybe Rob programmed that hug when opening the door with strange men I’ve just met over the internet. Maybe I needed another pill. In the midst of our embrace, I looked around the five hundred-ish square foot office for any kind of sign he was a serial killer while my irrefutable inner voice butted in as usual. Such a shame I took my real estate appraisal course while high on meth and drinking heavily. I really could have done something with that. “So, what’s with the tarp, Clark?” I said as it caught my eye. As I stared at the four foot by six foot crinkled, bright blue painters tarp, I immediately thought about all the late night interior paint jobs I’d done on Billy’s mom’s house while being high on meth.“That’s for the watermelon, KO! If you can actually break one.”“Oh, right! Guess it threw me off seeing that we’re in your office!” I retorted as I looked around and noticed there were no windows.“Yeah, it’s my name on the lease and I only have one other guy who works with me part time, so why not?” Clark said with his cool guy attitude.As usual, Clark was an average guy. Happily married but missing a piece of excitement in his life that I’m sure his wife could fulfill had they ever talked about ‘it’.After I set my purse down on the ground, I looked Clark up and down.“So only one woman in over a decade, huh?” I said while noticing he didn’t have a thick neck whatsoever. By my calculations, Clark would have only been one hundred and sixty pounds soaking wet.As I sat on the floor and started peeling my skin tight leggings off over my high heels, Clark began rearranging some folding chairs.“Yeah, I don’t know what it is. I have this weird capability to withstand any woman’s scissors with the exception of Yasmine. I’ve managed to really piss a few bodybuilders and wrestlers off!” he said with a little smirk. With his attitude and mannerisms, Clark reminded me of a stoned, hippy surfer bro from Manhattan Beach. But between his looks and the memorabilia sitting around his office, he screamed the NASCAR and Pabst Blue Ribbon type.Feeling solidly high from my steady dose of daily narcotics, I stood up with just my thong, high heels and blouse on. All part of the KO tease, of course.“Wow, KO!” Clark exclaimed from across the room. “Those legs are something else!”I stood and looked down at my twenty seven inch legs and replied, “Yes, they‘re magnificent, aren’t they?” while momentarily forgetting about how much I hated them when I was alone.“Wait till you feel them around your neck, Clark. I’m not so sure you’ll be saying the same words.” I said seductively while tugging at the elastic sleeve around my arm. Pulling it up just enough to sit across the middle of my bicep, I flexed while Clark stood there with his mouth gaping open like some kind of cartoon character. Now completely in my KO headspace, I continued with my shit talking.“In fact, I highly doubt you’ll be able to speak at all by the time I’m done with you.”.. . .Now arranged in a straight row, I pulled my blouse off over the top of my head and instructed Clark to sit on the floor in front of the chairs.Knowing that my ‘figure four’ had a decent amount of crushing force, I thought I’d start there. It wasn’t my strongest scissor hold, but much like playing poker, I wanted to create some assumptions and illusions first. I liked to tease my boys and start out with about sixty percent of full-strength capacity before I started to really bring the pain.On the same outdated low-pile carpet that was in my college dorm, Clark sat cross-legged with his back to the row of chairs as I laid across them on my side, facing towards the back of his head. Like a python, I slithered my bottom leg around the front of his body and gently put his neck in the fold of the back of my knee.Similar to a ‘rear naked choke’, the figure-four was set up and executed in the same way but instead of using arms, I’d use my legs. I had a few years of Jiu Jitsu training under my belt, and was poorly experienced in the art of submissions. If applied effectively, the blood flow from the left and right carotid arteries which supply the head with oxygenated blood, are cut off and render the person unconscious.After strategically placing my bottom leg around Clark’s neck, I took my top leg and placed the back of my knee around the foot that was coming off the leg that was around his neck. I started to lightly apply some pressure by pulling my top leg down which was acting like a lever, and as anticipated, Clark immediately grabbed onto the leg wrapped around his neck with his hands.I knew it took roughly seven seconds to knock someone unconscious once they were in my grip. If I were to keep applying force beyond those seven seconds, the likelihood of creating an increased chance of brain damage and/or death, would start ticking over quickly.After a few seconds, I let up on the pressure for Clark, but never let my legs leave his neck. Like a spider pulling a live fly further into her web, I dragged Clark backwards with my leg to get him closer to the row of chairs. Now that I was warmed up and we were well on our way, I was ready to play ball. I needed to get his neck deeper in my leg grip so I could squeeze tighter.As I felt the side of my crotch make contact with the ice-cold metal of the chair, I wondered who or what had previously been touching the surface. Laying and rolling around on disgusting, potentially disease-infested surfaces never stopped me before, and it certainly wasn’t going to stop me now. The need to be the best, the need to win, and “I needed the money” always won whenever it came time for me to consider my actions or possible consequences.So what?I’m not sitting in the spotless Oval Office getting my dick sucked like Clinton had originally planned, but I’m pretty sure I’m making more money than Obama right now.Not sure which one of us has a more stressful job, but whatever.If I made it this far without my vagina falling off, I’m sure it’ll be fine that my private parts are smashed up against some shitty folding chair right now.I always used the extra sheet stashed in the closet of the hotel when I was wrestling. Whether it was arm wrestling or wrestling, body parts rarely touched the carpet. However, I can’t say the same when it came to lying on airport floors when I was on tour and had to find a way to sneak a workout in. Looking good and getting attention was more of a priority than the possibility of what diseases could be entrenched in high foot-traffic carpets.The fear of laying down on his own carpet without a sheet never crossed Clark’s mind because he never saw it coming. Neither one of us did, actually. But that’s how my life kept playing out. Even when I’m right in the middle of the shit, and there’s a quiet whisper telling me, ‘you’re not a tree, move bitch!’, I’d still stay stuck because I never saw it coming. I was always moving too fast, worrying about all the wrong things.With the perfect amount of leverage and torque, I had him right where I wanted him. Intentionally blowing hot air, I leaned in and whispered in Clark’s ear, “You ready to experience sheer, unfathomable fear little boy?”. Before he could as much as nod his head, I went straight to eighty percent and started squeezing my vice grip around his neck while waiting for him to tap, signaling that he’d had enough.I started counting in my head.One.Two. Like someone with a megaphone in the bleachers, my mom’s voice blasted through and into my thoughts,Don’t let me get to three, Kortney Kay!Four. Suddenly the sound of a loud “POP” cascaded through my ears.Clark suddenly dropped his hands from my leg as his entire body went limp.Impulsively, I extended my right leg to let all of the pressure off of my left leg which was still wrapped around his neck. Waiting for some kind of movement or sound, I lay on my side in paralysis contemplating if I had just snapped Clark’s neck. Dropping my legs off of him completely, I quickly sat up and shifted them on either side of his back and waited for him to move or make a sound.With no movement or sound coming from him, I felt that familiar feeling of my heart dropping down to my anus.As I looked around the room in an absolute panic, I felt my fate cracking down like the federal judge's gavel whom I used to slap around.Why the fuck was there a blue tarp on the floor again?This can’t be happening. Not right now. Not ever. Semi standing up with both arms under Clark’s armpits, I proceeded to gently lay him on his back before taking a knee.Should I perform CPR?Idiot- not on a fucking broken neck you moron!Fuck what should I do?Will I go to prison for unintentional manslaughter?Should I call 9-1-1?Roll him up in the blue tarp and dump the body?This isn’t Dexter you fucking fool!As I sat there holding back tears, the panic had fully set in. Similar to emailing a friend intimate details about something your mutual friend had shared after you promised to not share, to only realise you’d emailed the friend you were writing about on accident, I was suffocating in terror. Then, in an instant and like the second coming of Jesus Christ, Clark let out the loudest, most earth shattering snore I’d ever heard in my life.FUCK! Then another one. By the second snore, Clark had rabid looking foam collecting at the corner of his mouth. A few more seconds passed when miraculously, he slowly opened his eyes, and let out a sound.”Huuuuuuuuuuuuuuuuuuugh”, he gasped. “Where, where am I?”Unlike my response to Adriana when she woke up from her blackout after flying off the highway at sixty miles per hour, I replied to Clark with a different tone of voice while stroking his head.“Hi there,” I said sweetly while trying to play it cool. “How was your nap?”.”It... it was incredible!”“Yeah, I told you everything about me is incredible, Clark.”As he looked up at me with glossy, dark brown eyes, I sat in a pool of brief gratitude before it was onto the next thing.“Shall we get to crushing these watermelons?” I coyly asked.. . .I used to always find myself cursing whoever the hell this ‘Murphy’s law’ person was. My life events have consistently shown me that there are unexpected twists and turns at every corner. Being a control freak and always feeling like I need ‘a plan’, it seems that my higher power has decided to award me all sorts of opportunities to experience what it feels like to lose control, light my plans on fire, thus giving me a chance to practice going with the flow. Such as when you think you may have just snapped someone’s neck and potentially looking at twenty five to life for involuntary manslaughter. Do the F*cking WorkHave you hated or currently hate parts of your body?Where do you think the dislike (or hatred) for your body originated from?Do you feel comfortable in your skin when you’re interacting with others but when you’re by yourself, the story changes? If so, what do you think started this?In what ways do you identify with being a control freak?Can you be sporadic and just whimsically decide to take a trip without having accommodations booked and gas stations planned out along the way?What areas of your life are you constantly trying to control?What would happen if you eased up on it? Crushing It is a masterpiece memoir showing you how to take back your power and learn to love yourself no matter the odds. No more excuses. Kortney’s not only owning it, she’s wearing it and sharing it with pride. She has been there. She has suffered. She has triumphed. And now so can you.

Raising Rock Bottom

Many people involved with treatment and recovery for substance use disorder used to believe that in order for someone to be ready to accept help, they first need to hit rock bottom — the point where they could sink no lower into the depths of their addiction.Unfortunately, the opioid epidemic and the proliferation of dangerous synthetic opioids like fentanyl meant that for too many people, rock bottom was only found in the morgue. As the risks of dying from an overdose increased, more treatment centers advocated for a harm reduction model to treatment. This approach, which focuses on reducing the severe consequences of substance use, is designed to save lives.What is a harm reduction model?A harm reduction model rejects an all-or-nothing approach to sobriety. This approach is meant to meet people where they’re at, and to engage them with wellness and safety programs even if they’re not yet ready to get sober.The National Harm Reduction Coalition operates on eight principals. They’re summarized as:Accepting that drug use will happenAcknowledging that some ways of using drugs are safer than othersFocusing on quality of life, rather than total abstinence, as a marker of successCalling for services for people who use drugsInvolving people who use drugs in the development of policy around drug useSeeking to empower people with informationRecognizing the role that systems of racism, classism and more play in drug useAccepting the real, tragic consequences that drug use can haveIt’s important to recognize that there’s not just one approach to harm reduction for people with substance use disorder. At its core, harm reduction is focused on keeping people safe, even when they’re not ready to abstain from drugs and alcohol. Needle exchanges and naloxone distribution are examples of harm reduction programs.How does harm reduction affect treatment?Treatment for drug or alcohol abuse is often focused on sobriety. However, underpinning that objective is the desire to keep people safe and alive. With that in mind, it’s easy to see how harm reduction principals can be incorporated into treatment.Many people resist getting treatment for their substance use disorder because they aren’t ready to give up drugs or alcohol completely. Taking a harm reduction approach — without focusing on absolute abstinence as the only way to improve one’s life — can make people more willing to engage with treatment.The benefits and drawbacks of harm reduction. Harm reduction strategies are all aimed at keeping people alive. With stronger drugs available more widely, we can no longer wait for people to hit rock bottom before offering a hand — we need to help them avoid a deadly consequence of their addiction.Total abstinence and sobriety is the best way to keep from the negative consequences of addiction. However, other steps can be taken to protect people before they’re totally sober.A harm-reduction approach to treatment provides information and resources to people in a non-judgmental way. The person enrolled in treatment might focus on learning how to cope with stressors in a more healthy way. They might get treatment for underlying mental health conditions, or counseling for past traumas that are contributing to their substance abuse. They could connect with doctors and community resources that are able to help support sobriety.In this way, a harm reduction approach empowers people, even those who are still using. It helps to give them the tools and resources that they need to make lasting change in their lives. Knowing that they have that support can make it less frightening to say yes to treatment.Some people might, at first glance, see the harm-reduction approach as enabling. However, it’s not about encouraging a person’s substance use. Instead, the approach builds them up in order to encourage them to make changes. It also acknowledges the reality that too often, substance use disorder can be deadly. By raising rock bottom and helping someone even before they’re entirely sober, you very well could safe a life.Learn more about Oceanside Malibu at http://oceansidemalibu.com/. Reach Oceanside Malibu by phone at (866) 738-6550. Find Oceanside Malibu on Facebook.

Techno-Punk’s Louisahhh Celebrates 21st Century Feminism and Sobriety

Called Techno’s next superstar by DJ Mag, Louisahhh expresses her musical liberation in her debut album, The Practice of Freedom. Walking in the footsteps of her uncompromising musical heroes Siouxsie Sioux and Shirley Manson, Louisahhh’s raw, anti-establishment message hopes to open the once bolted door to a fresh dawn of musical feminism. By embracing a new prototype of the "feminist submissive," she willingly exposes her most vulnerable side to the modern punk scene and exclusionary club dance floors' harsh glare.Louisahhh believes she can play with the submissive female archetype, enjoying the raw sexuality of tradition while also being empowered and strong. She takes a dedicated stance to defend women's innate rights anywhere in the world. Alongside her passionate feminism, Louisahhh does not shy away from expressing how sobriety is the cornerstone of her expression.Indeed, being sober is what allows Louisahhh to venture into the darkest corners of her soul and come out of the shadows with a purity of creative expression. She does not shy from the naked truth in all its wonder and all its brutality. Soon that naked truth will be shared with the world: The Practice of Freedom can be preordered here in digital or album form.In an exclusive interview with The Fix, Louisahhh details the role that sobriety plays in her creative process. She says, “Everything I do is working with the backdrop of addiction and recovery, not only in practical terms, like the things I do every day to stay clean and sober and sane, but also creatively. There are endless ways to frame, to navigate and to explore how this disease of addiction expresses itself and what healing looks like today. I’ve felt since early sobriety that getting to do this job, to exist in the sordid dens of nightlife as a recovered person, would mean grounding in and carrying the message as if my life depended on it, and I still believe that to be true.”Produced by American musician, music video director, and photographer Vice Cooler, the inaugural release of The Practice of Freedom will commence on March 12, 2020 via the polysexual polymath label HE.SHE.THEY. Influenced by American alternative rock's angst and honesty, Louisahhh's music fights to provide an angry yet redemptive voice for her listeners, allowing them to revel in the intensity of both the dancefloor and the mosh pit. Nobody is excluded when she performs live.Yet, Louisahhh, also known as Louisa Pillot, knows that performing in punk venues and dance clubs presents a danger to any sober human being. As she told mixmag in a 2017 interview, “It comes down to this: my sobriety is my responsibility and no one else's. Drugs and alcohol are a part of my chosen career. There is no grey area: my recovery comes first and everything else falls into place. My recovery comes second and I'm fucked."Expressing this reality, Louisahhh utilizes barking dogs, industrial machines, and demonic screams on her dystopian anthem “Numb, Undone,” which will be released as the album’s first single. Beyond making her music, Louisahhh is committed to the craft of DJing, which earned her the cover of DJ Mag and mixes for Boiler Room, ID, DJ, NTS, and Electronic Beats. Explaining her success, Louisahhh says, “As far as I’m concerned, any success I have today is a direct result of this foundation stone of sobriety, and I am happy to say that it’s a really good deal.”Complementing her musical explorations, she currently hosts a podcast series called Sober Sex with friend Rose Romain on Apple Podcasts, delving into questions of sexuality and creativity. In all arenas, Louisahhh never backs down from her authenticity. As it states on her Facebook artist's page, she is “raw coal thrown at a wall still burning.” In her music and her recovery, she does not fear the primal flames.

Teen Vaping Remains High

Teenagers are vaping marijuana and nicotine at alarming rates. That’s the finding from the most recent Monitoring the Future survey of substance use behaviors among adolescents. The survey is sponsored by the Institute for Social Research at the University of Michigan. Each year students in eighth, tenth and twelfth grades are asked about their use of substances and their perception of drug availability and risk.The percentage of high school seniors vaping marijuana increased from nearly ten percent in 2017 to twenty-two percent in 2020 and the rate among sophomores jumped from eight percent to nineteen percent. About eight percent of eighth graders are vaping marijuana.Nicotine vaping is also increasing at alarming rates. Over thirty percent of sophomores and seniors vape nicotine. The National Institute on Drug Abuse believes “The rapid rise of teen nicotine vaping in recent years has been unprecedented and deeply concerning.” Apparently, teens have switched from smoking cigarettes to vaping nicotine. Cigarette smoking among teens “has dropped at least four-fold since the mid-1990s and is at or near historic lows.”Marijuana is the most widely used illicit substance among adolescents. Daily marijuana use “defined as use on 20 or more occasions in the past 30 days by any method, significantly increased in 10th and 8th grade”. In 2020, eleven percent of eighth graders used marijuana while twenty-eight percent of sophomores and thirty-five percent of seniors used it.How students perceive the risk associated with smoking marijuana has changed significantly over the past decade. In 2009, over half of seniors believed smoking marijuana regularly involved a great risk. Today, only thirty percent believe regular use involves great risk. A similar trend was found with eighth and twelfth graders.The percentage of students who disapprove or strongly disapprove smoking marijuana has also changed over the past decade. In 2010, 84 percent of eighth graders disapproved smoking marijuana regularly. Today, only 76 percent disapprove. Disapproval declines as students grow older. The 76 percent disapproval rate among eighth graders falls to 67% when they become seniorsAlcohol remains the most widely used substance by teens. In 2020, one in five eight graders, forty percent of sophomores and fifty-five percent of seniors reported drinking alcohol. Although these percentages are high, they are much lower than from 2000 to 2010. Binge drinking is down by more than half since reaching peak levels in the 1990s. Also, only twenty-four percent of seniors believe taking one or two drinks of alcohol every day involves great risk and only thirty-six percent believe having five or more drinks once or twice each weekend involves great risk.Eighth graders increased their use of over-the-counter cough medicine during the past five years, from about 2 percent to almost five percent in 2020. That’s the highest rate since 2006. There has also been an increase in inhalant use among eighth graders. Its use increased to six percent. As students grow older their use of inhalants declines. While 6% of eight graders use inhalants, only one percent of senior do so. Inhalant use among seniors was at an all-time low in 2020. Sadly, only about fifty percent of eighth graders believe regular inhalant use is harmful.Among other drugs, about four percent of seniors are using LSD, three percent use cocaine, about two percent use OxyContin without a doctor’s order and four percent use Adderall without a doctor’s order. Three percent of sophomores and seniors use OTC/Cough/Cold medicine without a doctor’s order.Apparently, it’s not difficult for today’s teen to find the alcohol or drugs they want. Nearly eighty percent of seniors believe it’s fairly easy or very easy for them to find marijuana. Over eighty-one percent said it’s easy to get alcohol or a vaping devise. Among the more “hard core” drugs, twenty-nine percent of seniors believe it’s easy to obtain LSD, twenty-eight percent said getting cocaine is easy, and twenty-four percent believe it’s easy for them to get ecstasy.Alcohol and marijuana continue to be popular substances among today’s teens while rates of vaping nicotine and marijuana have increased to “markedly high levels.” Researchers believe “New efforts are needed to protect youth from using nicotine during adolescence – and in particular nicotine vaping – when the developing brain is particularly susceptible to permanent changes from nicotine use and when almost all nicotine addiction is established.”

The Least Secretive Life

The following is an excerpt from The Forgiveness Tour: How To Find the Perfect Apology by Susan Shapiro.After our volatile six-month estrangement, Dr. Winters emailed to see if he could apologize in person. I refused to meet at his office. An addiction specialist, he saw evening patients on his visits to New York. So I suggested a drink at a café between my home and his work, on Tuesday at 10 p.m.When the seminar I ran at my apartment ended at nine, I was edgy. I took a shower, as if to cleanse away a hundred and eighty days of sadness. I feared I’d be pathetically early, waiting an hour; he was always late. He was the father figure who'd helped me with my sobriety, marriage and work. It was the longest I hadn't seen him in fifteen years.“With all that Pluto, just thank God you were betrayed by your shrink and not your husband," my Jungian astrologer said. I didn’t feel thankful, reliving the shock I’d felt six months before, catching my student Haley leaving his office. I repainted my face and put on a black sweater, black boots, and black pants, funeral attire. The upside to my severed link with Winters was that I hadn’t regained the thirteen pounds I’d lost. But what I used to call “the breakup diet” seemed less cute at this age, accompanied by a breakdown.Walking to the restaurant, I rehearsed telling him how his lies about treating Haley - after he'd promised not to - had infiltrated my nightmares. I kept checking my watch, paranoia lurking. Vatsal, the psychiatrist I'd tried, felt there was something I couldn't see that would unlock the mystery of what happened. I hated mysteries. But Vatsal warned me not to expect a reconciliatory "Rolls-Royce of endings." What would be the most defective lemon on the lot? Arriving to find Dr. Winters sitting at a table with Haley, running her fingers through her fiery red hair.Turning the corner on West 9th Street, I caught his silhouette. He was waiting outside, typing on his BlackBerry. For the first time ever, he was early. By himself. His brown bomber jacket reminded me of a favorite picture of my real father as a teenager on the Lower East Side, in his dusty leather jacket, looking like an old-time gangster. Winters seemed thinner, almost gaunt, his hair shorter. He saw me and clicked off his device, nodding.We headed wordlessly inside the Italian bistro I frequented. Martino, the charming owner, double kissed me. I didn’t introduce them. Who would I say Winters was? He wasn’t my friend. “Former therapist” would sting, like saying “ex-husband” fresh from signing divorce papers. I asked for a table in the back room, which was empty. I was guarded, Ingrid Bergman in an old spy movie. This public meeting with him felt illicit, like something terrible could happen any second. I flashed to all the mobsters who'd shot each other in restaurants.We sat down, took off our jackets as the waiter brought menus and little glasses of water. I sipped slowly, simmering. In therapy, I’d spill everything the second I sat down. Now I stayed silent.“I’m sorry I hurt you.” He fidgeted with his napkin. His tone was genuine, regretful.Gripping my glass, I took another sip. “Traumatized me,” I corrected, crunching ice.“I didn’t mean to.” He drank his water.If there were four parts to a good apology, he’d hit a double: #1 acknowledging the offense and #3 expressing remorse. I longed for #2, the explanation. I looked up to scan his eyes. What couldn’t I see?“I’ve lived through more emotional cycles with you than anyone in my life,” I confessed, stealing Vatsal’s theory. “I needed you, loved you, idolized you, hated you, killed you off, mourned you, and now you’re resurrecting.”“How Catholic of us,” he said.Especially for a Jew and a WASP, I thought, suppressing the urge to scrawl that down, the way I recorded intriguing lines he’d say during our sessions.“So what’s going on with you?” I crossed my legs to appear casual, pretending my sanity hadn’t been at stake.“I’m seeing my mother next month. At a nursing home in Texas. She had a stroke.”That totally threw me. He'd once mentioned that he hadn't seen his ninety-year-old alcoholic mom in decades. He looked vulnerable, a battered little boy. A ploy for sympathy? It was working. At least he wasn’t small-talking me.“You must have mixed feelings about that reunion." I sounded like him.“That’s the understatement of the century.” He smiled.Sinatra’s I’ve Got You Under My Skin played. Winters ordered a Diet Coke. I craved a vodka tonic, joint, and a cigarette. I chose Chamomile tea with honey. “Can you turn the music down?” I asked the waiter. “You’re such a New Yorker,” Winters commented.What did that mean? In Arizona where he'd moved they tolerated loud music getting in the way? The waiter brought our drinks. I spooned honey into my mug.He watched me, then commented, “You’re using too much.”How rude. Then I realized we’d never been in a restaurant together. In fifteen years, we’d discussed substance abuse in his office, analyzing my smoking, eating, toking and drinking habits ad nauseum. Yet he’d never actually seen me smoke, toke, eat, or drink.“How’s Aaron?” he asked.Enraged at you, I didn’t say. He had to save me from you. “Good. How’s your wife?”I’d never met Claudia, a therapist for cancer patients. She ran a charity in Arizona, where they’d relocated after their Battery Park brownstone was ruined on 9/11. She'd sounded like a fearless crusader. A year ago he’d mentioned, in passing, that she’d needed minor surgery to remove a benign tumor. When I'd asked over the summer, he said she was expected to make a full recovery.“She’s not well,” he said now, his voice cracking.I leaned forward. “What happened?”“It was malignant. She needed neurosurgery. There was nerve damage.”“What does that mean?” I was alarmed. “Is she in the hospital?”“No, she’s recovering at home. But she’s half-deaf, can’t drive, work, fly, or walk without a cane. They don’t know if she’ll improve.”“Oh no. I had no idea.”This was what I couldn’t see! Hearing the sadness in his voice erased my anger, his eyes no longer menacing, just agonized.“They sent me a $50,000 hospital bill the insurance didn’t cover,” he added.“Why didn’t you just tell me your wife was sick?” If he’d said he was treating Haley and any patient who called him to pay medical bills, I would have understood. And recommended him to others. It was his deception that unnerved me.“It was hard for me tell anyone for a while.” I'd never seen him look so stressed. “She’s very private. Maybe I was in denial that I couldn’t keep working."What I hadn’t known was that behind his healing façade, his life was falling apart. Here was #2, the explanation for his behavior. If my husband was seriously ill, I doubted I could keep working. Still, a spouse’s illness didn’t immediately exonerate everything. He should have trusted me with the truth.“Why not email me that you had medical issues? Or personal problems?” I asked. After fifteen years, didn’t he owe me that?“They said she was dying and there was nothing we could do. I regressed back to the nightmare of my childhood, shattering the illusion that the world was safe,” he said. “I lost my home, sanctuary, city. I was scared I’d lose my wife. I couldn’t fix her or protect my family.”The Jewish guilt toward my Protestant shrink ricocheted. How unfair he’d had to leave his native city in the aftermath of the World Trade Center catastrophe, to have his Arizona life upended too. I irrationally worried he’d given me all of his wisdom and magical powers but didn’t keep enough for himself.I drank my tea, resisting the urge for more honey. “The cancer didn’t spread?”“No. The surgeon who operated said it was a miracle they were able to get the whole tumor. But she may not recover any further.”“How’s your daughter handling it?” I recalled his only girl was thirteen.“Kathy was diagnosed with chronic lung disease. She needs treatment too.”His entire family was sick. How horrible. He was like Job. “I’m so sorry," I told him. The way he’d acted had nothing to do with me. He morphed from mean monster into a healer too overcome with grief to focus on work. I wanted to apologize for not knowing, to reach for his hand to comfort him. But physical contact was the one boundary we never broke.Exchanging the words “I’m sorry” with him made me feel lighter. The unbearable burden of believing he’d intentionally hurt me lifted.“Hating you screwed up my senses,” I said. “It felt like my blood was clogging my veins.”“I’m glad you had Aaron to talk to,” he told me. “It was hard for him to leave you that phone message telling you to stop contacting me,” I conceded, recalling the heated exchange six months earlier.“What message? I never got it.”Of course he had. He’d responded by emailing, “So your husband speaks for you now?" I’d been so astonished, I’d printed it out for proof. But I saw he’d really forgotten. It was a different kind of heartache, like catching the initial sign of a parent’s dementia. For the first time, I felt older, stronger, clearer than him.“You’ve been through hell.” I mirrored his feelings, his therapist.“I feel like I lost the whole year,” he said.In the months without him, I’d confided much more to my husband. Yet there were secrets I’d rather share with a therapist, like the details of my insatiable addictions. And how upset I remained that he’d chosen Haley’s feelings over mine. If this was our last meeting, I didn’t want to fake it or leave anything unsaid.“It still bothers me you’re treating my student after I told you she was stalking me,” I admitted.“I’m not."“Not at all?” I hated that this still mattered so much. I could hear him saying, “Susan, everything is too important to you.” “I haven’t seen her in five months.”I was confused. I’d pictured them Skyping daily, in harmony and constant touch, the way he and I had been.“It was a mistake,” Winters conceded.This update seemed game-changing. Because I won the contest I hadn’t wanted to play?“You’ll have no contact with Haley?”That was #4, the reparation: He was here with me, admitting I was right, cutting her out of the picture she never belonged in.“I will not see or speak to Haley again,” he said.I was elated that Haley was out. But wait! I wasn’t back in. This was the conclusion Vatsal said was too dangerous to hope for. Only now I didn’t want a Rolls-Royce ending; I wanted Daniel's pain to end and his family to heal. He looked worn down. He needed this debacle to go away as much as I did. But why?“Are you doing this to shut me up?” I asked.“Yes! Shut the hell up already!” he said.We laughed. But then I feared it was true. “You really just want to quiet me down?” “Things co-exist,” he said. “I don’t want you upset anymore. I want this bad blood finished.”It was. It occurred to me that talking about our rift to my husband and others we knew in common—"leading the least secret life," as he'd instructed, pushed him towards this apology. His advice saved me from him.“Anything else?” the waiter asked. We shook our heads.I wasn’t ready to bid Daniel goodbye forever. He was the mentor who'd seen me clearest. For years we’d ended each talk by confirming our following session. Now everything was altered. Cutting him off while angry kept us entwined; hatred was easier. Letting go of my wrath, I’d have to deal with how much I missed the good Dr. Winters and move on, without him. I felt grateful that he’d given me a complete apology. He'd offered valid acknowledgment of the offense. Explanation for why it occurred. Sincere expression of remorse. Reparation ensuring it wouldn’t happen again.Yet mending our broken bond was still complicated. The real problem with forgiving: what comes next? “How are you feeling now?” He wrestled the shrink reins back.“My mind is racing. I keep coming up with different subtexts for what happened,” I said.“Like what?”“You scheduled Haley right before me, then ran late so I’d catch you lying. You felt guilty. So having me see her leave your office was a way to get out of the deception,” I tried. “You alienated me, expecting me to cut you off, like your mother did. Then you apologized and wanted a reunion, knowing I’d forgive you.”“How would I know that?”“Because you know me. And unlike your mom, I’m not a raging alcoholic. You fixed my addictions, the way you couldn’t fix hers,” I said, wishing we could go on talking, start over. Anything but end. “I read over the pages of the addiction book we worked on. It’s not bad. Maybe we should finish it.”“We should.” His eyes lit up, like it was the best idea anyone ever had.It was like a married couple, seconds away from divorce, deciding to give it another shot.The waiter brought the check. I looked at my watch. Our fifty minutes was up. I let him pay this time. In her entrancing, heartfelt new memoir The Forgiveness Tour: How to Find the Perfect Apology, Shapiro wrestles with  how to exonerate someone who can’t cough up a measly “my bad” or mumble “mea culpa.” Seeking wisdom, she explores the billion-dollar Forgiveness Industry touting the personal benefits of absolution, where the only choice on every channel is: radical forgiveness. She fears it’s all bullshit.  Available at Amazon.

The Top 10 Drug Policy Stories of 2020

A pandemic, civil unrest, national elections—2020 has been a year of tumult that couldn’t be done with soon enough. But when it comes to drug policy, it wasn’t all bad; in fact, it was a pretty good year, with several drug reform initiatives getting approved. Here’s a roundup of the biggest drug policy stories of 2020.1. How the Pandemic Is Affecting Drug Use and Drug PolicyJust as it has infiltrated every aspect of American life, the effect of the coronavirus pandemic has been felt in the world of drugs and drug policy. Social distancing requirements early in the pandemic—when many drug reform initiative campaigns were in the midst of signature-gathering drives—proved particularly lethal to marijuana legalization efforts in the heartland as initiative campaigns in Arkansas, Missouri, Nebraska, North Dakota, and Oklahoma all succumbed. It also helped end a Washington state drug decriminalization campaign, with organizers there opting instead to go the legislative route.Amidst the layoffs, shutdowns, and social distancing imposed due to the pandemic, drug use jumped. In July, the specialty laboratory Millennium Health reported that its analysis of more than half a million urine drug test results found large increases in the use of four illicit drugs during the coronavirus pandemic. Since March, when the pandemic was declared “a national emergency,” the lab found a 32 percent increase for non-prescribed fentanyl, a 20 percent increase for methamphetamine, a 10 percent increase for cocaine, and a 12.5 percent increase for heroin. In September, another study by Millennium Health and the U.S. Department of Health and Human Services “found that drug test positivity rates for cocaine, fentanyl, heroin and methamphetamine have increased nationwide during the COVID-19 pandemic.” The study was based “on urine drug test results from 150,000 patients between Nov. 14 and July 10,” said a Times of San Diego article. The pandemic almost certainly also has had an impact on fatal drug overdoses (see below).One of the most striking impacts of the pandemic has been on policing. Early on, big cities began to forgo drug arrests and prosecutions as a discretionary luxury they could no longer afford as they struggled with the coronavirus. In Philadelphia, Baltimore, and Chicago, police or prosecutors announced they would not arrest or would not prosecute small-time drug possession cases. In March, prosecutors from more than 30 cities, including Baltimore, New York, San Francisco, and St. Louis, signed on to an open letter urging local governments to make a change in the face of COVID-19. They called for police to “[a]dopt cite and release policies for offenses which pose no immediate physical threat to the community, including simple possession of controlled substances.” They also called for the release of people being held solely because they can’t come up with cash bail and for reducing jail and prison populations “to promote the health and safety of staff, those incarcerated, and visitors.” These were not intended as permanent moves, but perhaps politicians, police and prosecutors will take the opportunity to break their addiction to punishing drug users and sellers by going cold turkey amidst the pandemic.Advocates for marijuana legalization folded the pandemic into their arguments for ending federal marijuana prohibition. More than 30 state attorneys general cited the pandemic in calling for Congress to pass the Secure and Fair Enforcement (SAFE) Banking Act, which would allow state-legal marijuana businesses to gain access to banking and financial services. The House Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act coronavirus relief bill, passed in May, included a handful of criminal justice and drug policy reforms, mostly aimed at reducing the prison population during the pandemic, but also included language in support of allowing marijuana businesses to have access to the banking system.COVID-19 was also cited as making it even more imperative to pass the Marijuana Opportunity Reinvestment and Expungement (MORE) Act (H.R. 3884). Over the summer, as the pandemic simmered, a coalition of justice and drug reform groups, collectively known as Marijuana Justice Coalition, called on Congress to pass the bill, arguing that legalization was especially urgent in the context of the coronavirus pandemic and nationwide protests over police brutality. Given the current situation, “marijuana reform as a modest first step at chipping away at the war on drugs is more relevant and more pressing than ever before,” the coalition wrote in a letter to Congress, according to Marijuana Moment. That was followed by an even broader assemblage of 125 religious, human rights, and drug reform groups calling for passage of the bill. “[T]he circumstances of 2020 have made the failed War on Drugs even more untenable and amplified the voices of those demanding transformation in our criminal legal system. In the face of the evolving COVID-19 pandemic and a growing national dialogue on unjust law enforcement practices, marijuana reform as a modest first step at chipping away at the War on Drugs is more relevant and more pressing than ever before. The MORE Act remains the most effective and equitable way forward,” the groups said. The MORE Act passed in December.2. The Uprising Against Police Violence and Racism Leads Efforts to End Unjust No-Knock WarrantsIt all started with the release of a video of George Floyd dying under the knee of a Minneapolis police officer over an alleged minuscule offense in May, but as people took to the streets all over the country, the name Breonna Taylor also loomed large. The 26-year-old Black EMT was gunned down by Louisville police in a misbegotten “no-knock” drug raid (it might be more accurate to call them “home invasion raids”) in March, and her killing not only powered months of street demonstrations in her hometown, but it also engendered howls of outrage and promises of reform from politicians around the land. And it brought heightened scrutiny to business as usual in the war on drugs.As the streets overflowed with protesters in May, nearly four dozen members of Congress called for an independent investigation of the raid, calling Taylor’s death “an unspeakable tragedy that requires immediate answers and accountability,” according to a letter sent by the members of Congress. That was followed by a bevy of bills in Congress, including the Justice in Policing Act, which would ban no-knock warrants in federal drug cases. House Democrats pushed the bill through in three weeks in June. Republicans in the Senate responded with Senator Tim Scott’s Justice Act, which wouldn’t ban no-knock raids, but would increase federal reporting requirements for no-knock raids and use of force. But the GOP bill never moved in Senator Mitch McConnell’s Senate. As with so many measures passed by the House, McConnell’s domain was where a congressional response to the crisis went to die.But some states and localities actually enacted laws or ordinances aimed at reining in no-knocks. The Louisville metro council banned no-knock search warrants by unanimously passing “Breonna’s Law” in June. Other cities, including Indianapolis, Memphis, Minneapolis, San Antonio, and Santa Fe, moved to either restrict or ban no-knocks. And while several states saw efforts to join Oregon and Florida as the only two states that banned no-knock warrants before Taylor’s death, the only state where recent efforts have come to fruition so far is in Virginia, where Governor Ralph Northam (D) signed into law House Bill 5099, which bars police from breaking into a home or business to conduct a raid without first announcing their presence.3. In a Historic Move, the House Votes to End Federal Marijuana ProhibitionBreaking almost entirely along party lines, the House voted to approve the MORE Act on December 4. The MORE Act would effectively end federal pot prohibition by removing marijuana from the Controlled Substances Act’s list of scheduled substances and eliminating federal criminal penalties for its possession, cultivation and sale. The bill would not affect state laws that criminalize marijuana, but it would end the conflict between states that have already legalized marijuana and federal law.The bill also includes strong social equity provisions, including the creation of a fund to support programs and services for communities devastated by the war on drugs, a provision for expungement of past federal marijuana offenses, and a provision that bars the federal government from discriminating against people for marijuana use. The latter would protect immigrants from being deported for past marijuana convictions and would ensure that earned benefits are not denied to marijuana users. The historic vote marks the first time either chamber of Congress has voted for legalization. But there was virtually no chance that the Republican-led Senate would have taken up—let alone approved—the measure in the remaining days of the last session, meaning this is a battle that will continue in the next Congress.4. Psychedelic Drug Law Reform WinsDenver made history in May 2019 by becoming the first city in the United States to effectively decriminalize a psychedelic drug—psilocybin-bearing magic mushrooms—and as a psychedelic reform movement spread across the land, 2020 saw other important advances. As the year went on, three more cities—Ann Arbor, Oakland, and Santa Cruz—passed similar ordinances, and on Election Day, voters in Oregon approved the groundbreaking Measure 109, the Oregon Psilocybin Services Act, with 56 percent of the vote. It will create a program to allow the administration of psilocybin products, such as magic mushrooms, to adults 21 and over, for therapeutic purposes. People will be allowed to buy, possess, and consume psilocybin at a psilocybin services center, but only after undergoing a preparation session and under the supervision of a psilocybin service facilitator.And on the East Coast, Washington, D.C., voters approved Initiative 81, the Entheogenic Plant and Fungi Policy Act of 2020, with 76 percent of the vote. The measure will have police treat natural plant medicines (entheogens) as their lowest law enforcement priority. The measure also asks the city’s top prosecutor and its U.S. attorney not to prosecute such cases. This string of psychedelic reform victories has generated momentum that is likely to result in more pushes in more places in 2021 and beyond. Since Election Day, activists in San Francisco and Washington state have announced plans for decriminalization, New Jersey State Senator Teresa Ruiz (D) has filed a bill to downgrade the offense of magic mushroom possession, and California State Senator Scott Wiener (D) has announced he plans to file a bill that would decriminalize the possession of psilocybin mushrooms and other psychedelics.5. Oregon Decriminalizes DrugsWith the passage by voters of Measure 110, the Drug Addiction Treatment and Recovery Act, Oregon broke new ground by becoming the first state to decriminalize the possession of personal use amounts of all drugs, including cocaine, heroin, and methamphetamine. The quantities decriminalized are up to 1 gram of heroin, up to 1 gram or five pills of MDMA, up to 2 grams of methamphetamine, up to 40 units of LSD, up to 12 grams of psilocybin, up to 40 units of methadone, up to 40 pills of oxycodone, and up to 2 grams of cocaine. That’s thousands of drug arrests that now will not occur in Oregon—and Oregon can set an example for other states to follow.6. Red State or Blue State, Voters Choose Legal Marijuana When Given the ChanceThe November election saw marijuana legalization on the ballot in four states and medical marijuana on the ballot in two states. They all won. Evenly-divided Arizona saw Proposition 207: The Smart and Safe Arizona Act cruising to victory with 60 percent of the vote, while in blue New Jersey, Public Question 1 garnered a resounding 67 percent of the vote. But the really surprising results were in two red states: In Montana, Constitutional Initiative 118 and its companion Initiative 190 won with 58 percent and 57 percent of the vote, respectively, while in South Dakota, Constitutional Amendment A won with 54 percent of the vote. Both those states are red states, with Trump taking 57 percent of the vote in Montana and 62 percent in South Dakota. It was the same story with medical marijuana, as Mississippi approved Initiative 65 with 74 percent of the vote, while South Dakota’s Measure 26 won with 70 percent of the vote. Marijuana for adult use is now legal in 15 states and medical marijuana is now legal in 35 (plus D.C.).7. Progressive Prosecutors WinThe November 3 elections didn’t just end the reign of Donald Trump and bring drug reform victories at the state level; they also ushered in a new crop of progressive prosecutors who will have the ability to affect the conduct of the war on drugs at the local level. Led by George Gascón, who was elected prosecutor of the nation’s most populous county, Los Angeles County, and running on progressive platforms that included confronting police misconduct, ramping down the war on drugs, and shrinking prison populations, progressives won prosecutor races in Detroit (Oakland County), Orlando (Orange and Osceola counties), and two large Colorado districts long held by Republicans. Progressives didn’t win everywhere they ran, but the shift from “law and order” district attorneys toward progressives that began with Kim Foxx in Chicago and Larry Krasner in Philadelphia really gathered momentum in 2020.8. A Tough Year for Safe Injection SitesSafe injection sites (also called supervised injection facilities or supervised consumption services) are a proven harm reduction intervention with 120 in operation in 10 countries around the world, but no legal ones are operating in the United States. It looked like that would change in 2020, but it didn’t. A proposed site in Philadelphia got the final go-ahead from a federal judge in February, but the local U.S. attorney then tried to block the facility’s opening, with a hearing on the earlier stay held in October and the decision from the bench still pending. Things were also looking good in San Francisco after the board of supervisors okayed a pilot program in June, but the state-level bill that would have allowed the city to proceed, Assembly Bill 362, died in the Senate after passing the Assembly. A similar fate befell a Massachusetts safe injection site bill, House Bill 4723, which managed to win a committee vote but then stalled. Maybe there will be gains for this harm reduction method in 2021.9. Asset Forfeiture ReformsAsset forfeiture, especially civil asset forfeiture (without a criminal conviction), is increasingly unpopular, with 35 states and the District of Columbia approving reforms between 2014 and 2019. A September poll by YouGov found that only 26 percent support allowing police to seize cash or property from someone without a criminal conviction. According to a Forbes article, “59 percent of Americans oppose ‘allowing law enforcement agencies to use forfeited property or its proceeds for their own use.’ … Opposition to equitable sharing [a federal program that allows state and local police to evade state laws against civil asset forfeiture] was even higher, with 70 percent against the program.”Here are some reasons why: In March, in Georgia, the department of revenue got caught spending millions of dollars in seized cash on “engraved firearms, pricey gym equipment, clothing, personal items, even $130 sunglasses.” That same month, in Michigan, Macomb County prosecutor Eric Smith was hit with a slew of criminal charges for allegedly taking funds seized from drug and other suspects for his own personal use, including “a personal security system for his house, country club parties, campaign expenses and to buy flowers and make-up for his secretaries.” In July, in Chicago, the city agreed to a $5 million payout to settle a class-action lawsuit filed by two people whose vehicle was seized after a passenger was arrested for marijuana possession. The settlement will apply to hundreds of other cases where drivers had their vehicles impounded as part of drug cases. Also in Michigan, the Wayne County Sheriff’s office faces a similar lawsuit for seizing thousands of cars and other property belonging to residents without criminal convictions.Such abuses helped New Jersey become the 16th asset forfeiture reform state when Governor Phil Murphy (D) signed into law a bill mandating comprehensive disclosure and transparency requirements for the system of civil asset forfeiture in January. Unfortunately, the few remaining non-reform states are tough nuts to crack, as we saw with reform bills killed in Arizona, Georgia, Kentucky, and Tennessee. But, at least Tyson Timbs, the Indiana man whose seized Land Rover resulted in a 2019 Supreme Court decision scaling back civil asset forfeiture, finally got his Land Rover back—six years after it was seized over a drug bust.10. America Keeps ODingAmidst all the death in the pandemic, the ongoing epidemic of drug overdose deaths got short shrift in 2020, but Americans are continuing to die by the tens of thousands. In July, the CDC reported preliminary data showing that after declining for the first time in decades in 2018, fatal ODs rose by 4.6 percent in 2019. There’s a lag in data for 2020, but initial reports suggested bad news ahead. As mentioned earlier, specialty laboratory Millennium Health reported in its July analysis of more than half a million urine drug tests that they found large increases in the use of fentanyl, heroin, cocaine, and methamphetamine during the pandemic. Also in July, the Washington Post reported that fatal ODs have jumped and keep jumping during the pandemic. The Post’s data showed overdose deaths up “18 percent in March, 29 percent in April and 42 percent in May.” The Post pointed to “continued isolation, economic devastation and disruptions to the drug trade” as contributing factors. And in December, fears of rising overdose deaths got some confirmation, with the CDC reporting that in the 12-month period ending in May 2020, overdose deaths hit an all-time high of 81,000.This article was produced by Drug Reporter, a project of the Independent Media Institute.

How Death Acceptance Can Help Relieve Your Anxiety

To date, more than half a million Americans have died from the novel coronavirus. That’s a shocking number, especially considering that most of the deaths have been in the past six months. It’s enough to send anyone into a spiral of fear and anxiety.That’s why Geoff Thompson, PhD, program director for Sunshine Coast Health Centre in British Columbia, says accepting death can make it easier to deal with the grim news about the pandemic.“Those who accept death have much better mental health than those who are afraid of it,” Thompson says.Death as a Part of LifeDeath is the one certainty in life. We’re all going to die at some point, and there is little we can do to control when or how. Coming to peace with that fact can alleviate a lot of stress during your life, and free you to focus on living life to the fullest while you can.Thompson says that happiest and mentally healthiest people are often those who have a controlled sense of fear of death, which they come to through acceptance.“This lack of fear doesn’t mean that they want to die or that they don’t care whether they live or die. Accepting death simply recognizes that death is a natural and expected part of existence,” he explains.Death During the PandemicUnder normal circumstances, it’s easy for many people to choose not to think about death. Absent a chronic or terminal illness in ourselves or a loved one, most of us would rather not think about our eventual demise.However, the pandemic has upended this sense of comfort. With death and illness in the headlines every day, we’re constantly facing reminders about our own mortality.“Fear of death is driving many anxieties during the pandemic,” Thompson says. “We feel dread when we worry about losing ourselves or families to infection, and this fear is so powerful that it drives our perceptions, choices, and actions.”Fear of death is impacting the way that many of us act. In some cases, that’s warranted, but it’s also easy to go overboard. It’s important to check in with yourself and determine whether your decisions about school, work, and socializing are rooted in science, or have become based in fear.Combating Fear of DeathThe best way to reduce your fear of death is to live a meaningful life, Thompson says. It may sound cheesy or cliché to advise people to live their lives to the fullest, but the truth is that people who have meaning and quality in life are less likely to fear death, perhaps because they feel that they have done their best with the time they were afforded.“Psychologists who study meaning and purpose tell us that those who are most afraid of death have not really felt alive during their lifetime,” Thompson says. “On the other hand, those who live full and productive lives typically do not let fear of death drive their choices.”The pandemic is causing many people to reevaluate how fulfilled they are with their lives. Perhaps you’re one of the people who has discovered that you’re working too much, or are caught in the pursuit of ambitions that don’t actually bring you happiness. If you were to die during the pandemic, you might worry that you didn’t live your life how you really wanted to.In that way, the pandemic, and the fear of death that accompanies it, brings a welcome opportunity for change. Although the death rates for COVID-19 are shocking, most of us will survive the pandemic in good health. However, your brush with death, even from afar, can have a big impact on how you live your life going forward.Sunshine Coast Health Centre is a non 12-step drug and alcohol rehabilitation center in British Columbia. Learn more here.