Love Without Martinis: Building Healthy Relationships in Recovery

Those who recover and prioritize sobriety almost always do so with the assistance of stories. The books of AA and Al-Anon, the literature given out at treatment centers, memoirs on addiction to alcohol or drugs, therapeutic workbooks, and even religious texts are used to guide both the newly sober and old-timer into a healthier and more stable version of their own sobriety. When it comes to romantic relationships in sobriety, the field is less crowded--there aren’t many guide books for two people who want to work on their relationship after the chaos of addiction.Love Without Martinis seeks to provide that valuable guidance through a collection of six stories of actual couples who found their way to a better place. As author Chantal Jauvin writes in the book’s opening, “Stories are a powerful medium for self-understanding. They help us find ourselves or remember who we are.”Jauvin and her husband Bill went through hell and back in their marriage as they struggled with Bill’s addiction to alcohol. Jauvin eventually worked with Dr. Jeremy Frank, PhD, CADC, a certified alcohol and drug counselor, and together they developed a framework for healing for couples in recovery called the ASCENT Approach. ASCENT includes a specific set of healthy practices that couples who successfully rebuild their relationships in recovery have in common; despite the many differences in couples’ stories--their sexuality, gender, socio-economic background--it is these powerful commonalities that ASCENT was built on, and Love Without Martinis was written to convey.After opening with a chapter outlining the specifics of the ASCENT Approach, the couples’ stories are told chapter by chapter in novelistic prose, instead of the seated in therapy and taking dictation-style of many self-help books. The narrative addresses the emotions, thoughts, and actions of each person in the couple as the addiction worsens, hits crisis, turns to recovery, and then the couple’s journey to heal the rifts between them.“When individuals suffering from substance use disorder get well, it changes the patterns of behavior and interaction in the couple.” writes Doug Tieman, President and CEO of Caron Treatment Center, in the foreword. “This new relationship is truly one of the “Promises of Recovery” and it does materialize if you invest yourself in reclaiming and rebuilding the healthy relationship.” The stories in Love Without Martinis trace the arc of the couples who do invest themselves.“The battle of an addicted person’s partner to either strong-arm a person they love into sobriety, or ignore them until they become sober, often draws a wedge between the partners and the world within us and around us,” the authors point out. It is this disconnect and dysfunctional coping mechanisms--as well as past hurt and anger--that these couples are addressing.Jauvin writes, “Here are the practices of The ASCENT Approach for couples in recovery: Assess your readiness to change. Structure your time. Create your community. Engage in your life. Nurture your spirituality. Treasure your partnership.” The couples' detailed stories are a living illustration of how each of these guide-points plays out.As a couple’s narrative is being driven forward, the changes to their thoughts and behaviors are illuminated to make clear the specific steps that each person must take to repair the relationship. Here is Larry, from the couple Larry and Sherri, moving through a negative thought pattern into a positive one:“Yes, he just needed to keep her in check. That thought was foul on so many levels, he admonished himself. First, it implied the game his psychiatrist warned him against. Larry might be the responsible one, keeping the family together, but he was also the “enabler.” He contributed to the family disease. That was a tall order for Larry to accept. For a long time, maybe even a few years, Larry had transferred the anger he felt towards Sherri onto the professionals whose help he sought. Of course, he tried to control his wife. He could not let her run wild with three young children in the house. Not to mention all the debt from rehab, therapists, and psychiatrists for the entire family. It was a miracle the dogs did not need therapy. Stop, he commanded himself. Control the silent introverted “awfulizing”—such a genius medical term—that is what Larry needed to do. Control himself, not Sherri. He’d accepted the expenses, written the checks, hired the housekeepers. He’d perhaps even played the martyr in the name of keeping the family together. Stop, he dictated to himself. Larry redirected his thoughts.”The work that these couples do individually and within their family can be life-changing for generations to come. Families can create a legacy of recovery with just one person deciding to work for and maintain sobriety; once one person has broken through, any other member of the family is more likely to get into treatment. Not only is the substance use disorder addressed, but years (perhaps generations) of dysfunctional interpersonal habits and thoughts can be changed, freeing the children of that family from those patterns. And those children are then more likely to seek partners of their own who have healthier relationship and coping skills. The legacy that a couple can leave for their family within the work of recovery is priceless.The stories in this book address many of the blocks that partners face in new recovery, but certainly cannot cover all of them. No one in these stories, for example, has severe mental illness, has been a violent abuser or abused, or is living in total poverty. The couples included here are not interchangeable: a gay couple with a partner suffering from Crohn’s disease, a young family with a baby whose father relapses, an executive who loses control once he retires, and the author’s battle with ovarian cancer and her husband’s messy divorce. However, the problems of co-occurring mental health issues are not specifically addressed.It’s obvious that Jauvin is a compassionate and knowledgeable guide from the way she writes and frames each couple’s story; the inner dialogue feels authentic, and raw struggles are portrayed with care to acknowledge the source of pain and the pathway out of it. Jauvin spent five years interviewing these couples--in addition to the work she did with Dr. Jeremy Frank to build the ASCENT guideposts--and that, combined with her own story of her husband Bill’s addiction to alcohol and recovery, makes her a trusted and worthy guide. She writes in the foreword: My favorite definition of recovery remains one written by Earnie Larsen, a pioneer in the field of recovery from addictive behaviors: “The core of recovery is becoming a person increasingly capable of functioning in a healthy relationship.” And now, Jauvin has contributed to that capability with Love Without Martinis.Love Without Martinis is a helpful touchstone and guide for couples seeking to stay together and heal in recovery, and would be a good book to take home on discharge for anyone in a relationship and leaving a rehabilitation center or sober living home to reenter life. Love Without Martinis is available at Amazon and elsewhere.

Apology to the Young Addict

The following is excerpted from a longer work.You post your picture on Facebook. It’s a close-up. Your long hair is dark brown. On one side you have strands of it curled behind your ear. Your eyes are dark brown, too, but they are also glossy and red. In your hand is a glass pipe, the bowl hot and alive, swirling with gray smoke. You’re holding it out to whoever is taking the picture, but it looks as if you’re offering it to me.You must be about twenty now. I lose track of time. In the beginning, as a child, you probably wonder why, when I come to see your father, he always asks you to go to your room and watch TV. After a while, though, and I don’t suppose it takes more than a few visits, you must catch on. By no means am I his only friend, if you can call his many visitors friends, because truthfully we are not. Sure, we laugh and joke and talk too long, like friends do, but we always leave looking and acting differently than when we arrived. Sometimes we move in slow motion. Sometimes we’re fidgety and nervous. It depends on the drug, whether it’s heroin or coke. Or meth. Or all three for an interesting little cocktail. Other times your father’s friends come and go so quickly you must wonder why they ever bothered to visit.Your mother, where is she?When did you last see her?I’m not familiar with this part of your story, knowing only that she’s not there for you at this point in your life. She’s an addict, too, this much I do know, and maybe she’s still using when your father is clean. Maybe that’s why she left. If this is the case, at least with your father you have a roof over your head and food in the refrigerator. At least you attend school instead of bouncing from one dope house to another, crashing on beat-up couches or dirty floors, and sometimes, when your mother wears out her welcome, having to sleep on the streets.To be fair, your father has seven years clean from heroin and cocaine before he receives his disability settlement for an injury he suffers working as a heavy equipment operator. He undergoes spinal fusion surgery but the procedure is hardly successful in relieving his pain. Still, for those seven years, he refuses the Vicodin and Oxycodone the doctors prescribe, knowing it will trigger his old cravings, and even though he walks slowly, wincing often, he nonetheless manages to take you fishing off the docks in Lake Arrowhead. You remember he’s good at it, and teaches you how to be good at it, too, so that you both catch plenty of trout. You also remember him taking you camping and how comforting, how calming, how secure and safe and loved you feel snuggling up to him in your sleeping bags in the tent he shows you how to pitch, because he can’t do much of the work himself. You like helping him. You like knowing he needs you, as you need him, and you think of you and your father as a little team.But money can be a trigger, weakening the addict’s resolve to stay clean. Why this is, I’m not sure, but I’ve seen it happen too often not to believe there’s truth in it -- addicts and alcoholics struggling to make ends meet, and then, when the burden is lifted, finding themselves drunk or strung out again. A seventy-five-thousand-dollar disability settlement is a windfall when you’ve been living month to month on paltry government disability checks.Ironically your father is my first sponsor, once a week taking me through the Big Book page by page, but after one too many slips I give up on myself and he gives up on me, too. I can’t blame him. We stop seeing each other until he calls out of the blue one day, asks if I’m clean, and when I tell him I’m not, that I’m drinking as we speak, he laughs and invites me over. He has it all. Heroin. Coke. Plenty of booze. From that night on we party hard and often, but your father is diligent, always cautious never to let you catch us in the act of getting high. He makes certain that his drugs and paraphernalia are always well hidden and never brought out until they’re needed. Syringes. An old leather belt with teeth marks on it. A couple spoons, the hollow part blackened, the handles bent for better control, easier balance.You aren’t supposed to be there.You are, instead, supposed to be spending the night with a friend. I don’t know the full story, if your friend gets sick or you have a fight and want to come home early, but I remember that you couldn’t have been more than eleven or twelve years old, and that we don’t hear you unlock the front door. We don’t hear your footsteps on the stairs leading to the living room where your father and I sit on the couch beside a coffee table scattered with syringes and booze and little baggies of heroin and coke. I’m already deep on the nod, melting into the couch. Your father has just tied off his arm, biting down on the leather belt with his teeth, searching for a vein. He slips the needle in and presses the plunger. Blood slides down his forearm, and you drop the backpack that’s hanging from your shoulder. It hits the floor and a pair of pajamas with little blue flowers on them tumble out. Your eyes meet with your father’s and I lower mine.“Baby,” he says. “I’m sorry. Come here.”He tries to get up from the couch but falls back. He tries again and succeeds this time, though he’s shaky on his feet. You run to your room, slam and lock the door. Your father weaves down the hallway, calling your name, and when I hear you crying, I pick up my cigarettes and leave. There is no excuse, accidental or otherwise, for an adult to use narcotics in front of a child, and my presence alone that night makes me complicit in your addiction today.I am and am not guilty.I am and am not responsible.Jump in time. Fast-forward a few years. Your father is pulled over for a broken taillight and ends up arrested for possession and distribution of narcotics. By no means is this his first run-in with the law. Once, traveling through Texas, he’s busted with two kilos of heroin and spends four years in the state prison in Huntsville. This time the judge sends him to Glen Helen in San Bernardino County. One day, in another life, I will find myself speaking to the convicts here about drug and alcohol abuse.In his mid-forties, he is, like myself, no longer a young man, and while serving the first of his two-year sentence he suffers a massive heart attack. The doctors save him with bypass surgery, and I’m sure they warn him that if he uses drugs again it will be his last heart attack. But when has the fear of death ever stopped an addict? Certainly it’s an answer to the end of the misery called addiction and all the shame and anguish and self-loathing that’s killing us anyway.Your father used to say, “You can always put more in but you can’t take it out,” which means the wise addict, if there is such a thing, is cautious. You know when you buy Jack Daniel’s that you’re getting eighty proof whiskey. On every bottle there’s a government seal stating exactly that, but there is no quality control when you buy dope. One day your dealer might sell you weak or bunk product. A week later it might be stellar, so the same amount you shot last time might kill you now. What happens, though, when you have a weak heart and any dose, even a small one, is enough to put you under? That’s the case with your father inside of a month after he’s released.Here’s the ugliest part.Here’s the scene where trauma gives you a choice. Break the cycle or join it. I can’t and won’t blame you, as I have no right, because I made the wrong decision, too, when I was young and lost my brother. My sister did the same and also found herself an early grave.That little team, just your father and you, it’s true. He had only you. All other family ties had been severed long ago, and so who do his so-called friends phone when they can’t revive him? Not the paramedics. Paramedics bring police and police make arrests. Take him to hospital? That’s also risky. Besides, by then, he’s probably stopped breathing. Instead, like good junkies concerned only for themselves, they phone you and then grab their dope and get out of whosever house or apartment they’re in. I’m told the message is brief.“Come get your father.”They give you an address and hang up. I have a hard time believing the caller would tell you he’s dead. I don’t suppose it’s fair to generalize, but junkies are notorious for being liars, cowards and thieves.So let me add it up.You’re just a kid the first time we meet and your father and I go on a run. Then he spends two years in prison while I begin the arduous struggle to get clean and sober. That should make you about seventeen or eighteen when you pull up to the house or apartment in your father’s old truck, the one he gave you after he lost his license and went to prison. Maybe you’re thinking that he’s passed out drunk. Possibly you detect the panic in the caller’s voice and already suspect the worst. I doubt it, though, and it has nothing to do with your youth. Old or young, clean or dirty, even the most jaded among us cling to hope where we know there is none.I understand you go there alone.I understand the door is left unlocked, so all you have to do is turn the knob and walk inside and this is how you find him, sprawled out on the couch in the living room, his face blue, his limbs already stiffening. I don’t know if you drew back in horror or kneeled by his side and cried and held him and kissed his cold skin. That’s as far as I let imagination invade this private and heartbreaking moment of your life.Under your picture on Facebook, in the reply box, I write that it doesn’t have to be this way, knowing full well my words mean nothing. I can hear you laughing. I can see you shaking your head and saying:“You motherfucker, of all people, slamming dope with my dad and now this shit. Fuck you. Of course it has to be this way. How could it be any other?”And maybe you’re right. Maybe this motherfucker might as well have snapped your picture. Fuck his laments, you think. Fuck his apologies. You hate the hypocrisy of reformed addicts telling you that the dope will stop working one day, that it always does, and in the end you’ll be left with nothing but misery. That you’ll do things you never imagined yourself capable of doing. Sell your body. Rip off friends and whatever family you might still have left.This is only the beginning.What the older recovering addict has to offer the younger, active addict is the hope and promise of change through example and really nothing more.Listen.I despise him, too, but at least for today he is as dead as your father, and hopefully he will remain dead, this old junkie staring into the photo of your glossy red eyes, who long ago might just as well have passed that glowing hot pipe to you. From Apology to the Young Addict by James Brown. Used with permission of Counterpoint Press. Copyright © 2020 by James Brown. 

Addiction in America: An Interview with Tom Coderre of SAMHSA

Tom Coderre is the first person in active recovery to hold the position of Acting Assistant Secretary for Mental Health and Substance Abuse at the Substance Abuse and Mental Health Services Agency (SAMHSA). Prior to this appointment, Tom was Senior Advisor to Rhode Island Governor Gina Raimondo from 2016-2019, where he helped to coordinate the state’s response to the opioid crisis. During the Obama administration, Tom led the team which produced “Facing Addiction in America: The Surgeon General’s Report on Alcohol, Drugs, and Health,” the first report from a U.S. Surgeon General dedicated to this public health crisis. And as the former National Field Director of Faces & Voices of Recovery, he was a key voice in “The Anonymous People” documentary and helped increase peer support services nationwide. The Fix is honored to have the opportunity to speak with him.The Fix: You are the first person in recovery from substance use disorder to lead SAMHSA. How is this significant? Do you think being in recovery will help you accomplish more?Tom Coderre: That’s a great question, John, but it’s important to point out that I am the acting assistant secretary for mental health and substance use. I am serving in an interim capacity until the Senate confirms Dr. Miriam Delphin-Rittmon. She was nominated by President Biden last week. I’ll serve until the U.S. Senate confirms her. I am currently leading SAMHSA, but I’m not going to be leading it too much more into the future. At the same time, I’ll continue to be a part of our leadership team here at the agency.Still, my acting appointment is significant because I count SAMHSA as partially responsible for me getting into recovery. SAMHSA block grant dollars funded the treatment that I received. Moreover, the recovery support services that I received post-treatment were funded by a SAMHSA discretionary grant program, the Recovery Community Services Program (RCSP). My experience speaks volumes about how the agency helps people.As the acting assistant secretary, being in recovery is the lens from which I view the world. I don’t know if it has helped me accomplish more or will help me moving forward, but it certainly has given me that lens of lived experience to bring to any policy conversation when we are talking about ways we can help more people find sustainable recovery.Has it been difficult to prioritize prevention, treatment, and recovery services for substance use disorder during the COVID-19 pandemic?To begin with, the Biden-Harris Administration obviously is remaining focused on the COVID-19 pandemic. At the same time, it also has prioritized the expansion of evidence-based treatment to get people with substance use disorders the help they need. Already, SAMHSA has received significant increases in funding from Congress and from the President to help address our country’s mental health and addiction crisis.As you know, John, it has only gotten worse during the pandemic. The latest CDC data points to ninety thousand overdose deaths in the twelve-month period that ended last September. It’s the largest increase on record, and that is why SAMHSA has been getting resources to the states and the people who need it the most. In addition to the state block grants, we have awarded a total of almost 700 million dollars to certified community health clinics (CCHPs) across the nation. We just gave a series of COVID Emergency Grants to address mental health disorders that arose during the pandemic. We have even made supplements to those grants with the new American Rescue Plan money.In terms of innovations, early on in the pandemic, we began the mission of expanding the regulatory definition of telehealth to help ensure that people who need medication-based treatment would access that critical support during the pandemic. We also provided free technical assistance and training for physicians who were unfamiliar with the use of telehealth. Out of necessity, telehealth has blown up during the pandemic, and we wanted to ensure that it was both accessible and well-executed. The free virtual trainings we provided were well-attended, and the response was positive. We knew that we could not focus only on COVID-19 because the parallel track of spikes in mental illness and substance use disorders could not be ignored. We had to ensure that people in crisis could access real help.Post-pandemic, what do you think will be the biggest challenges facing SAMHSA?That’s another really good question that we have been discussing at the agency. We know that multiple stressors during the pandemic like isolation, sickness, grief, job loss, food instability, loss of routines, and so many more have been devastating for many Americans. It has led to a series of unprecedented challenges for health providers across the nation.For example, the CDC also reported that American adults in June of 2020 reported elevated levels of adverse mental health conditions, including symptoms of anxiety and depression that were three to four times the levels of those reported in 2019. Going forward, this is a big challenge for us. Traditionally, SAMHSA’s Disaster Distress Help Line has been a low-volume hotline compared to our others that we operate like the National Suicide Prevention Lifeline. However, the call volume on the disaster distress hotline has increased significantly as people have become more aware of its services. We saw a 440% increase in the twelve months from March 2020 to February 2021. It tells us that people are reaching out and seeking help.One of the obstacles during the pandemic has been barriers to accessing services and the treatment that these people need. The challenge is that even people with mild or moderate symptoms who are looking for help cannot access it. They are unable to connect with a community mental health center or a treatment center. In response, SAMHSA is promoting the Disaster Distress Help Line and other similar resources because we want to know who needs help and where they are located. We want to be able to support them in the process of knowing where to go to get help.Another challenge to note is workforce readiness. Are people ready to make the full transition back to work? Mental health professionals have seen a significant increase in people seeking appointments to work past negative public attitudes. We need more trained professionals to help those folks successfully make that transition.President Biden recently dedicated $2.5 billion to prevention and treatment efforts. How do you see the pie chart of those funds being divided up?In the bill that Congress passed and the President signed, those resources are pretty prescriptive. SAMHSA does not really get to decide how to split them up. We have been directed to send that money to states and to territories and tribes. They have the flexibility to address those funds to address those various needs. The $2.5 billion in additional money that went to the different block grants for substance use disorder and mental health and those block grants allows states, territories, and tribes to tailor those grants to address the specific needs that they have identified.As part of the COVID Relief Package, we got $4.25 billion in December and an additional $3.56 billion in March as part of President Biden’s American Rescue Plan. Beyond the block grants targeted at front-line people on the ground, these new grants also help us expand the building out of the Certified Community Behavioral Health Clinics, which provide all sorts of wraparound services for people in the various communities. Each of the bills also dedicated funds to improve suicide prevention efforts and school-based mental health efforts. Also, the money for the National Child Traumatic Stress Initiative is an important step. We are really concerned with what has happened with youth during this pandemic, and we want to make sure they have access to needed resources.We are extremely grateful to President Biden and Congress for making these resources available. This capital is the largest investment in behavioral health in the history of our country. It’s a big step going from an overall budget of $6 billion to $13.8 billion. Thus, we’ve been tasked with a big, big job to get these funds awarded to states and, most importantly, working in local communities, thus reaching the people in need of this kind of help and support. Thank God for the SAMHSA staff because they have been working tirelessly to make this happen.In 2018, commenting on the rise in opioid use disorder (OUD) deaths, you told Fox News, “It took too long to get to where we are today. I think there was thought they could do this without declaring a national emergency, but people are dying.” Post-Covid, will we need to declare another national emergency to combat opioid use disorder and resulting overdose deaths?First of all, did I really say that? It sounds brilliant. Okay, I’m just joking, but I think I was referring to the public health emergency that was being declared at that time. Both SAMHSA and this Administration get the urgency of the current situation. We understand the concept of parity and the importance of delivering care to underserved communities. We understand that all of these statistics related to mental health disorders and substance use are tied to real people with loved ones and families. Suppose you look at the work done under the leadership of the Biden-Harris Administration. In that case, you see that SAMHSA’s funding and efforts are a crucial part of the White House’s tailored response to these challenges, including America’s mental health needs.An emergency is declared to increase access to funds and speed up the delivery of those funds to people in crisis. It’s precisely what is being done right now by this administration to address the opioid crisis, and the hard work at SAMHSA is making those directives happen. We are taking steps to expand access to evidence-based treatment like MAT [Medication-Assisted Treatment] and reduce the stigma that still exists. For example, we are working to reduce the medical stigma around integrating opioid use disorder treatment with primary care in office settings of doctors across the country. We also know that powerful synthetic opioids like fentanyl in the nation’s drug supply compound the overdose risk for Americans significantly. People with little or no opioid-related tolerance are being given this incredibly potent drug, and they are at a much greater risk of dying as a result from an overdose. This danger is one more reason we are grateful to work with the White House to connect more Americans to the treatment and care they truly need. Indeed, these communities need that support more than ever, and this is why it’s an all-hands-on-deck moment at SAMHSA.Under the last administration, there was a shift away from community-led, demographically-targeted interventions. Under the new administration, do you think there will be a renewed focus on evidence-based practices that address substance use disorder (SUD) and mental health from a holistic lens, including strategies to address current health disparities among various racial/ethnic groups?Of course, I do. Both President Biden and Vice President Harris have made diversity, equity, and inclusion a key part of their strategic plan for the nation. At SAMHSA, we have been doing behavioral health equity work for more than a decade. We recognize that there are disparities in treatment services that exist, particularly in Black, Indigenous, and people of color communities. We need to do more to identify those disparities in particular and root them out, do they can be eliminated.It is not okay to turn a blind eye anymore and expect somebody else to take care of these issues. We are making these efforts a strategic priority, and we are considering steps like disparity impact statements as an ongoing part of our grant programs. Also, although we think globally, we act locally. Although the White House or Xavier Becerra, the first Latino to serve as Secretary of Health and Human Services, can issue the policy, we are responsible for helping to make the change locally through our grant programs.We need to emphasize this issue regularly through our long-term relationships with states and local communities. Such essential progress in cultural competence and applying it effectively is now a priority on all levels of the federal government. For example, we need to do a lot more recruitment in the workforce at all levels, so the people providing the services look like the people they are serving. From our experience, the best people for helping local communities are people who came out of those communities and know firsthand the nature of the challenges. As you know, I came from the peer movement, and I believe the peer work that is being done around the country is an excellent example of this proposition working in practice.A perfect exemplification of this work is the success of recovery coaches that walk into emergency rooms. When they sit at the bedside of somebody who has just overdosed, and they can tell that person, “Not that long ago, I was exactly where you are now. I was lying in a bed in this hospital after a drug overdose. I was able to find out, and I am here today as a person in recovery to show you how I did it and how you can do it as well.” It’s so much more likely that such an encounter will lead to a person’s life being saved. We need to recruit a workforce that can walk that journey with people from their communities in need of such help. People who can give them the confidence to take that step, tell them about the pitfalls they’ll encounter along the way, and inspire them to start that journey of recovery.

App Provides Safe, Accessible Recovery Social Media

When Giuseppe Ganci looks at the community of people touched by substance use disorder, he sees too many divides. There are the people who are still actively using, separated from people who are sober and in recovery. The people who practice abstinence or 12 steps are separated from people who take a harm reduction approach.Ganci wants to bring them all together. That’s why he developed Better, an app designed to support people whose lives have been touched by addiction.“We want individuals who are using drugs and those who are in recovery to have a platform to work together on improving their connection to their community,” says Ganci, who is the project manager for Better, and director of community development for Last Door Recovery Society. Better is a social enterprise of Last Door.Using the features of Better, people can support their recovery and overall wellness. The features of Better include:My Recovery WallThe recovery wall is a key feature of Better. It’s designed to let people celebrate all aspects of their recovery, even those that are hard to face.“This is a safe space for people to post about their recovery journeys,” Ganci says. Some aspects of recovery — like fear of relapse — might not be suitable for posting on Facebook or other mainstream media. Better’s Recovery Wall gives people space to make those posts and get support.It’s also a space for people, including professionals, who can’t be open about their recovery on other social media. It’s also more positive — rather than doom scrolling Facebook, people can see posts and inspiration about recovery.Safety NetOne of the most unique aspects of Better is Safety Net. Safety Net is a global overdose prevention tool. People who are using drugs alone can share their location with someone else on the app. Their safety net partner can activate an alarm. If the person using doesn’t turn the alarm off, it may be an indication of an overdose. The volunteer can call emergency services for them, since they know the person’s direct location.“This is a way to make a bridge so that people who are in recovery can support people who are still using,” Ganci says.My Recovery Capital Score This aspect of Better allows people to gamify their recovery, providing some extra motivation. Users can earn recovery capital by doing things like attending digital meetings, journaling or posting on the Recovery Wall.Since Recovery Capital Scores are public, this is another way of building community.“Your friends will know if your points are going down,” says Ganci. “It’s going to help people reach out to people when they need help.”MarketplaceMarketplace allows people in recovery to support other people in the recovery community.“There’s no charge, users can put businesses up for free,” Ganci says.Marketplace also lets people search for sober roommates, and sell or donate items to people who are newly in recovery.“It’s always a struggle being a newcomer," Ganci says.My Recovery PlanMy Recovery Plan is a one-stop shop for keeping track of your short-term and long-term goals, and tracking your progress.Support Circles Support Circles allow group chats for step groups, friend networks, or even alumni groups for treatment centers.People Nearby and LGBTQ SupportThese features allow people to search for people in recovery when they’re traveling. They can make new friends and ask about the local recovery community. The LGBTQ2s Support allows people to connect with people in recovery who have shared values and lifestyles.Recovery Celebrations Recovery Celebrations allows you to congratulate people who are celebrating recovery milestones that day, as well as sharing your own accomplishments.Speaker Tapes and CoachingUsers have access to over 15,000 speaker tapes. The “Higher Power” option allows the app to auto play what you need to hear in that moment. Coaching allows people to connect directly with a recovery coach.MeetingsThis section allows people to connect with their home meeting, without friending or following people on mainstream social media to do so.“It takes away the whole barriers to access in a meeting,” Ganci says.Step WorkStep work features personal growth virtual exercises, decision-making guidance, 12-step exercises to help you live in the solution, and a daily journal.After 13 years in recovery himself and years of working in the recovery industry, Ganci is excited about launching an app that will help more people thrive in recovery, as well as helping others stay safe until they’re ready to change their habits around drugs and alcohol.“I can see how social media has helped recovery become normal, but I also see how not everyone can participate in that conversation about recovery,” he said. Better provides a solution. “It’s all about making recovery attractive. The days of the abstinence community sitting on one side of the room and harm reduction people on the other side of the room are over.”To download the Better app or get more information, visit betterapp.ca.

10 Celebrities Who Talked About Rehab, Recovery and Relapses Amidst COVID-19

The loneliness, the boredom, the need to escape reality—COVID-19 has really put the world through a wringer.Even though our social lives have slowed down, stay-at-home orders and the general rollercoaster of the pandemic have thrown us off our routines. It’s easy to see why some are struggling with sobriety and addiction during this time.The age of COVID-19 has been challenging for those looking to stay sober, and celebrities are no exception. Here is a list of 10 celebs who have opened up about rehab, recovery and relapses during the pandemic.Celebs Who Spoke About Addiction in 2020-2021Miley CyrusA major vocal chord surgery in November 2019 forced singer Miley Cyrus into sobriety, but it sparked a positive change in her life. "I did a lot of family history, which has a lot of addiction and mental health challenges,” she said in a Variety interview. “So just going through that and asking, ‘Why am I the way that I am?’ By understanding the past, we understand the present and the future much more clearly.” However, she did struggle during the pandemic: in November 2020, she said that she was two weeks sober after having a setback due to the COVID-19 pandemic. “I fell off and I realized that I now am back on sobriety, two weeks sober, and I feel like I really accepted that time.”Joe RoganAlthough he was temporarily sober for Sober October, Joe Rogan shone a light on sobriety amid the COVID pandemic. “COVID-19 and 2020 as a whole have presented a unique set of obstacles and a great deal of stress. Many people drink alcohol as a way to blow off steam,” he said. “On the flip side, because there are fewer opportunities to attend social get-togethers, parties and large gatherings such as in-person networking events, weddings, concerts and the like that often serve alcohol or offer it. For some people, there may be less of an outside influence to consume alcoholic beverages, too.”MacklemoreOn a podcast interview with “People’s Party With Talib Kweli” in January 2021, the rapper said, “If it wasn't for my pops having the 10 or 12 racks that it was when I first went to treatment [at 25] and [his ability] to spend that on me, I'd be f—ing dead. I wouldn't be here right now. That's not to be f—ing dramatic, that's just what it is. I was about to die." In the same interview, Macklemore discussed how having a sense of community made a positive impact on his recovery. He said, "There is a therapeutic value of one addict to another sharing their experience, strength and hope [and] that has saved my f—ing life and continues to save my life."Demi LovatoIn order to open up about her overdose, singer Demi Lovato thought it would be best to tell her story and “set the record straight” in her upcoming documentary. In July 2018, Lovato overdosed on a reported mix of fentanyl and oxycodone. “I was left with brain damage, and I still deal with that today. I don’t drive a car due to blind spots with my vision and I had a really hard time reading,” Lovato said. The experience also left her with “three strokes, a heart attack and my doctors saying I had five to ten minutes.” According to Lovato, the documentary covers a lot of aspects of her recovery, including substance, mental health, emotional health, and her own spiritual journey. Demi Lovato: Dancing With the Devil is available to watch on YouTube.Jessica SimpsonIn her memoir, Open Book (published in February 2020), Jessica Simpson opens up about her sobriety journey, candidly sharing that her desire for change was sparked on Halloween 2017. “It was 7:30 in the morning and I’d already had a drink,” she wrote. “I was terrified of letting [the kids] see me in that shape. I am ashamed to say that I don’t know who got them into their costumes that night.” In an interview with People, she divulged, “When I finally said I needed help, it was like I was that little girl that found her calling again in life. Honesty is hard, but it’s the most rewarding thing we have. And getting to the other side of fear is beautiful.”Chrissy TeiganOn December 30, 2020, Chrissy Teigan announced on Instagram that she was four weeks sober and giving up alcohol “for good.” She wrote: “I was done with making an ass of myself in front of people (I'm still embarrassed), tired of day drinking and feeling like s—t by 6, not being able to sleep. I have been sober ever since.” The model and cookbook author also said, "I knew in my heart it wasn't right… I used to think it was kind of nutty to have to go totally sober. But now I get it. I don't want to be that person... I have to fix myself."Celebs Celebrating Milestones During COVIDAnthony HopkinsIn December 2020, the Silence of the Lambs star tweeted: “Forty-five years ago today, I had a wake-up call. I was headed for disaster, I was drinking myself to death...A little thought that said, 'Do you want to live or die?' And I said, 'I want to live.' And suddenly the relief came and my life has been amazing.” He continued, “I have my off days and sometimes little bits of doubt and all that… All in all, I say hang in there. Today is the tomorrow you were so worried about yesterday. Young people, don’t give up. Just keep in there.”Elton JohnIn July 2020, Elton John posted to Instagram: “Reflecting on the most magical day having celebrated my 30th Sobriety Birthday...I’m truly a blessed man. If I hadn’t finally taken the big step of asking for help 30 years ago, I’d be dead. Thank-you from the bottom of my heart to all the people who have inspired and supported me along the way.”Tim AllenDuring an appearance on The Kelly Clarkson Show in March 2020, the Home Improvement star talked about how he has been sober for “about 22 years.” “It doesn’t happen overnight,” he said. “It’s a day-to-day thing. You gotta reprise every day.”Florence WelchIn February 2021, the Florence and the Machine singer posted to social media: “I am 7 years sober today. I send my love and support to anyone who is struggling,” she captioned an Instagram post of a heart painting. “If you are feeling shaky around ED issues, drugs or alcohol, I completely understand. The desire to disassociate is so strong. But please don’t give up. We are going to need you on the other side.♥️.” Drive your online success with WebServ.

The U.S. Alcohol Crisis, Still Deadlier Than the Opioid Epidemic

As deeply disturbing as the U.S. opioid epidemic is now becoming, having taken a record number of lives - over 81,000, in the 12 months up to May, 2020 - and now being firmly driven to worsening depths by the prevalence of the synthetic opioid fentanyl in virtually every other illicit drug, here’s something else for you to consider:Alcohol, our perfectly legal, yet highly addictive, and potentially deadly substance of choice, continues year-on-year to take even more lives - 95,000, at the last count. Thousands and thousands more.“Because their bodies have become sensitized to alcohol, once they have taken that first drink, the tissues of the body cry out for more and more, until sufferers find that they cannot control the amount of alcohol consumed.One drink is too many - a hundred, not enough.”- John G. Cooney, eminent Irish psychiatrist, lecturer, and author of “Under the Weather: Coping with Alcohol Abuse and Alcoholism.”Make no mistake, the record death toll from fatal opioid and other drug overdoses is awful, sad and shocking - there is no doubt about that. However, if you are considering which addictive substances require even more education, far greater awareness, especially for our children and adolescents, and significantly more treatment options for all, you would have to look at the biggest killer, and that, by far, is alcohol.Liking “One Too Many Beers” Doesn’t Make Newspaper HeadlinesAlcohol has continued to be the toxic factor in most year-on-year U.S. substance use deaths for decades. Did you know that alcohol has continued to cause at least 88,000 deaths every single year in the U.S. since 2006? In fact, in 2019, it is estimated that 95,000 U.S. citizens died from alcohol-related illness and accidents, making alcohol the third-leading preventable cause of death in the nation.Let that figure sink in for one moment. 95,000. And preventable, too.Alcohol - the “third-leading preventable cause of death”? You would imagine, then, that the conversation about the recent tragic deaths from substance use, substance use disorders (SUDs) and addiction isn’t focused on the biggest killer, alcohol or alcohol use disorders (AUDs), at all - pandemic or no pandemic.However, the conversation continues to be placed “fairly and squarely” onto drugs, and those who take those drugs, who get their “product” from shady, downtown street corners, purchased from criminals, too - not on those who drink alcohol, perfectly legally (as long as they’re old enough to know better), and who get their tax-generating “product” from corner supermarkets and liquor stores, purchased from normal, law-abiding folk. Folk like you and me.“Alcoholism is an addiction - it’s just one type of addiction. When you break out the specific things that someone who is suffering from alcoholism contends with, they are no different from any other type of addict.”- Dr. John Sharp, M.D., Harvard Medical SchoolThe hard truth of the matter is this: the hard-working, blue-collar guy who shifts of few bottles a beer on his way home after a long day, or the housewife who sneaks a bottle of wine during her lonely day spent at home, do not look upon themselves as “addicts,” and they would be the first to tell you that they are certainly nothing like the media’s constant portrayal of “addicts” as desperate, potentially dangerous people.That’s the simple truth, and the reality of how alcohol has always been viewed in the U.S… “He’s ok, salt of the earth - just likes his beer is all.”Now if that doesn’t tell you we have a seriously long way to go in addressing the unnecessary shame and stigma surrounding substance use and mental health issues in this country, well… monkey’s uncle, and all that.Legal, Easily Available & AcceptableAlcohol doesn’t attract constant media attention as a serious and dangerous killer in the U.S. because it’s legal, it’s easily available, it’s socially acceptable, and those who misuse it aren’t “desperate, potentially dangerous people.” They would consider themselves the exact opposite - quite “normal.”However, should it be considered “normal” when alcohol drives its related death rate in women up a colossal 85% in the space of just 10 years (from 2007 to 2017, to be exact)? In fact, with 95,000 people dying every year now in the U.S., should it be not called what it actually is - an alcohol epidemic? Alcohol: The Subtle & Immediate DangersThe majority of people still know and understand the dangers of high alcohol consumption and AUDs, eg. serious health problems, like liver damage. However, much of the physical damage done by alcohol can be initially subtle, often immediate, and can act as a contributing factor to other serious health issues. Examples of this include:Cardiovascular Symptoms: Alcohol causes cardiomyopathy, which is a disease of the heart muscle, making it harder for your heart to pump blood around your body. This decreases how much blood the left ventricle pumps out with each contraction, known as “ejection fraction,” greatly increasing the real risk of congestive heart failure. As you can imagine, that’s fatal.Furthermore, cardiac arrhythmia, an irregular beating of the heart, can be caused by a few days of hard drinking, and is often called “holiday heart syndrome.” Additionally, it can lead to atrial fibrillation - a fast and irregular heart rhythm. The heart rate in atrial fibrillation can range from 100 to a massive 175 beats a minute. Lastly, alcohol is also associated with high blood pressure and increased stroke risk, particularly among women.Pancytopenia: This serious, yet not fatal condition (in itself, that is), occurs when the bone marrow can only produce limited amounts of blood cells, causing the body’s cell count of red blood cells, white blood cells, and platelets to be low. The cessation of alcohol consumption is usually enough for recovery.Dementia: Excessive alcohol consumption can cause the development of a type of dementia, known as alcohol dementia, understandable considering its drastic effects on the brain. However, alcohol dementia is quite different from Alzheimer’s, and is becoming increasingly more common as dementia diagnoses become more accurate.Cancer: Alcohol is associated with an increased risk of cancer, notably esophageal, liver, mouth, throat, and colorectal cancer. Additionally, it also increases the risk of breast cancer in women.Immune Suppression: Regular alcohol use makes you more susceptible to infections - vital to know during a viral pandemic.Sadly, the truth is your family physician will often overlook alcohol as a contributing factor to your illness, such as the previously mentioned congestive heart failure or atrial fibrillation. However, this “traditional” approach is now changing as more and more healthcare professionals are trained in the vast range in effects of substance use disorders.Mental Health Disorders: Alcohol, among other things, is a powerful central nervous system depressant. Because of the euphoric feeling people get from alcohol, they often don’t believe that drinking alcohol when they are anxious or depressed can further worsen these mental health issues, and, perhaps, lead to an active disorder, eg. major depressive disorder, also known as clinical depression.In fact, a prime example of this direct link in action was seen last year. You’d best read on. We haven’t finished yet, and, unfortunately, neither has alcohol...2020: A Year of Increased Alcohol Use & Decreased Mental HealthIn November 2020, the Pennsylvania Liquor Control Board announced colossal increases in statewide online alcohol purchases, like much of the rest of the U.S. In Pennsylvania, the statistics were quite incredible, when compared to the previous year: Unit alcohol sales increased by 851%, and dollar alcohol sales increased by 436%.Furthermore, in 2020, the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline - 800-662-HELP - for individuals and families seeking either mental health or substance use disorder support saw a 27% increase in phone calls year-on-year.In one particular medical research study, “Alcohol Consumption during the COVID-19 Pandemic: A Cross-Sectional Survey of US Adults,” it was found that nearly two-thirds of the participants reported that their drinking had increased in 2020 when compared with their drinking pre-pandemic, citing a number of reasons, including increased stress, anxiety, ease of alcohol purchase online, and, obviously, sheer boredom.In terms of the nation’s declining mental health, another research study, conducted by the NYU School of Global Public Health, found that people with anxiety and depression were more likely to report an increase in drinking alcohol during the COVID-19 pandemic than those without mental health issues.“This increase in drinking, particularly among people with anxiety and depression, is consistent with concerns that the pandemic may be triggering an epidemic of problematic alcohol use.”- Ariadna Capasso, NYU School of Global Public Health doctoral student, and the above study’s author“Triggering an epidemic of problematic alcohol use”? We’re already there, Ariadna. In fact, we’re probably far, far beyond anything seen before. Furthermore, in the NYU study, the clear link between mental health and increased alcohol consumption was evidenced by the following findings:29% of participants increased their alcohol use during 2020; however, those with symptoms of a depressive disorder were 64% more likely to have increased alcohol useYounger respondents (aged 19-39) had the highest probability of reporting increased alcohol use - regardless of their mental health status, andAdults over the age of 40 with poor mental health were far more likely to report increased drinkingAlcohol Abuse: A Significant Factor in COVID-19 InfectionNumerous studies pre-pandemic and mid-pandemic (as we are now) have all acknowledged the direct link between alcohol abuse and other forms of substance abuse with a greater infection risk for COVID-19. One particular study, “Clinical Vulnerability for Severity and Mortality by COVID-19 among Users of Alcohol and Other Substances,” carried out by the Center for Drug and Alcohol Research, in Porto Alegre, Brazil, found that not only are individuals with addiction more susceptible to a worse COVID-19 prognosis, but additionally, alcohol, crack cocaine and polydrug users had distinct vulnerability factors for the virus.The Link Between Alcohol & Opioid OverdosesOne of the main drivers of the huge increase in fatal drug overdoses seen last year was polyuse, where, knowingly or unknowingly, users combine substances; for example, knowingly, opioids with alcohol, and, unknowingly, methamphetamine cut with fentanyl. In fact, in 2017, considered the peak of the opioid epidemic before 2020, 15% of opioid-related deaths, or 1 in 7, involved alcohol.Why? Because alcohol is a central nervous system depressant, and will contribute negatively to the respiratory depression seen in opioid overdoses - the reason why people die.Furthermore, from 2012 to 2014, more than 2 million people who misused their prescription opioids were also binge drinkers, twice as many as nondrinkers. Evidence indicates that around 23% of people who currently have an opioid use disorder (OUD) have a concurrent AUD.Changing People’s Perspectives: An Uphill BattleThe National Institute on Alcohol Abuse and Alcoholism (NIAAA), among other similar organizations, has since understood that public perceptions about alcohol, particularly what constitutes “low-risk” vs. “high-risk” alcohol consumption, have been very wide of the mark. In response, the NIAAA has since created a new website, titled “Rethinking Drinking,” to highlight the extent of these clear misperceptions.The new website has a wealth of evidence-based information about alcohol and its consumption, such as how much is too much, strategies for cutting down your alcohol intake, and a list of essential help links, with contact information for social support services like Alcoholics Anonymous (AA) and other mutual aid groups.When it comes to changing people’s perspectives about a health issue, alas, it’s an uphill battle - or more accurately, “upmountain” when you consider the huge volume of misinformation circulating in 2020 about COVID-19 (and it’s still circulating, too).The trouble with perceptions nowadays is our world of digital technology, where one online fact is easily disputed with another online “fact.” However, sometimes, it takes more than researched, evidential statistics, published by leading public bodies, like the CDC, to change people’s minds. Unfortunately, for some people, it takes real, first-hand experience of the issue, and, when it comes to the dangers of alcohol, that’s sadly the premature death of a loved one.

Last Door Recovery Society

Last Door Recovery Society, in British Columbia, Canada, has been providing addiction treatment for men and male youth for over 35 years. They offer youth and adult programs with substantial family support, and a “10 day intro to recovery” for individuals who may not be ready to commit to longer-term inpatient care but want to explore that option. More than just a rehab, Last Door is “an inclusive supportive addiction recovery community.” People come to Last Door to find recovery from drug and alcohol addiction, gambling addiction, video game addiction, internet addiction, and nicotine addiction. Last Door is located in New Westminster, a community that has become known as the Recovery Capital of Canada. Keystone, their 40-acre rural property one hour from Metro Vancouver, provides horticultural, wilderness, and recreational therapy.One of the things that sets Last Door apart is the level of participation from their alumni as mentors and volunteers. When invited to participate in a survey for the purpose of this review, more than 90 former residents responded, from recent graduates to alumni who completed the program more than 30 years ago. The bonds formed between residents and alumni have created an unbroken chain of mutual support spanning decades.Last Door alumni describe their fellow residents as coming from a wide range of economic backgrounds, “From homeless to professionals earning 6 or 7 figures,” with diverse histories. Some describe desperate circumstances that led them to Last Door: “I was thinking of doing an armed robbery at 7-11 to get high or go to jail.” A family member connected him with a Last Door alum and he ended up staying for seven months. Many people find their way to Last Door through referrals from former residents, who refer to themselves and others as “Door Boys.” Last Door is well established and connected to the local community, and many clients are also referred by detox facilities, other therapeutic communities, and courts. For this reason, Last Door is the first choice for many people who live in the area. For others it is quite literally the last door: “I was in deep addiction for 35 years, went through many other treatment centres with no luck.” Said another, “A friend told me about Last Door and the success they had with him. I saw the change in him and I wanted it.” His friend, like many alumni, not only referred him, but helped facilitate the transition. The gentleman went on to describe his time at Last Door as “An amazing experience.”Residents’ lengths of stay vary quite a bit, from a few months to a year or more. Some graduates go on to volunteer or become staff members. The youth program (13-18) is based on a “social model” which offers scaffolding in all areas to “improve overall functioning,” with the goal of improving self-esteem and decision-making skills. There is ongoing aftercare support for this group in the form of “Emerging Adult” alumni groups. One resident noted that their peers “were not excited to be in treatment at first” but after some time they became “invested in the other people there and made recovery look fun.” Another alum of the youth program reports that they “made great friends, and worked through problems with people I didn’t like.”Alumni were enthusiastic about the food at Last Door, describing “fresh home-cooked cuisine,” “comfort food,” and “Great variety of healthy, hearty and gourmet meals from day to day” with plenty of leftovers. While nutritious options are always available, one alum recalls that “Meals weren’t always healthy but were always delicious.” Another described “calorie dense” meals “centered on making opioid addicts gain weight.” Coffee, tea, and juices are always available, as well as snacks like fruit, trail mix, chips, and babybel cheese. “Dinners were what you'd get from a really good restaurant,” with a variety of proteins, including steak or ribs on Fridays, “everything carefully made by a trained Chef.” Residents also described “out of this world potlucks” and “amazing” weekend brunches. Least favorite items mentioned were “fish” and “curry.”Accommodations at Last Door are shared, sometimes with four people in one large room. “Relationship skills were gained,” said one alum. “I learned to get along with all kinds of people.” Chores are divided, but “everyone has a chore they must attend to twice daily, which can be anything from cleaning to helping make meals.” Daily life is structured and based around NA meetings in the mornings and evenings. There is group therapy and free time, spent “hanging out with each other,” going to the gym, and “going on outings.” As residents progress through the levels of treatment, they may transition into working an outside job.Most alumni felt that staff were fair when it came to infractions. Misbehavior such as “smoking, aggression, poor attitudes” or “leaving the property” (without permission or notice) was handled “swiftly and evenly. No grey areas.” Depending on the severity of the transgression, discipline could include completing “written exercises,” doing “extra chores," or having "restrictions on access to certain activities." In extreme cases, a resident could be discharged. Generally, “the punishment fit the crime and was usually pretty fair,” and infractions were treated “diligently, respectfully, and sternly.” A few alumni complained that some staff were “unprofessional” and exhibited “favoritism."Amenities at Last Door include a main gym and pool about a 20-minute walk away, weekly yoga and acupuncture, music therapy, martial arts, meditation, and more. Residents are encouraged to get involved with the greater recovery community and participate in NA dances and Recovery Day. Outdoor activities include “bowling, hiking, swimming, paintball,” volley-ball, and frisbee. Keystone, Last Door’s countryside retreat facility, was described as a “fantastic break from the centre while still continuing that fantastic fellowship and the recovery,” while another alum felt that “Keystone was definitely a good experience but not always accessible to everyone and not equally distributed.” Other off-site excursions are encouraged as long as they are approved by staff. Rules governing access to phones and the internet vary depending on the level of treatment. People in the early stages are not allowed to have their phones (or any personal money). After a set amount of time, phone use is allowed in non-group times as long as staff and other residents agree that there will be no misuse. Unsupervised emailing is not allowed, and internet access is only available at the library. TV is available on the weekends, and some alumni reported watching movies three times a week. While transitioning to working at a job, these rules are variable and determined in consultation with one’s caseworker.A doctor is on site at Last Door once a week (as well as on call 24 hours), and there is a clinic about ten minutes away. Alumni praised the doctors as being “very helpful and compassionate,” “extremely easy to be around,” and “extremely knowledgeable in dealing with addicts specifically.”According to the alumni who took our survey, Last Door is a 12-step- and social model-based program, and not centered around religion, although “anyone was free to practice whatever religion they believed in.” The treatment is “very strict in terms of having to follow the rules and participate” and “very much a 'tough-love' approach in that they did not coddle us or baby us." However, “the counsellors and staff were also very supportive, patient and empathetic.”Since leaving Last Door, the majority of the respondents who took our survey have remained clean, sober, and/or abstinent, with one “coming up on 30 years.” Some have relapsed and come back, crediting Last Door with providing “a deep recovery foundation.” Many have stuck around, volunteering at Last Door after finishing treatment. “You feel like you are part of a family,” one alum said, describing the “supportive camaraderie” that ensures “nobody gets left behind.” In fact, after completing treatment, you keep your facility key so “you can come and go as you like, if you want to drop by to have lunch, attend a group session or just visit and hang with the new guys.”When asked what Last Door could do better, most alumni felt that Last Door was already “the most effective treatment centre,” or that they should “add more beds.” Some respondents, however, felt there should be more “awareness on mental health” and a better “platform for mental illness treatment,” with “mental health evaluations when you enter treatment” and counselors with “better credentials.” Overwhelmingly, the alumni who took our survey had high praise for their entire experience at Last Door. Describing the group therapy sessions, one alum recalls “An incredible amount of recovery, healing, tears and growth took place during nearly every group session.” Another resident is grateful for forming “genuine connections with people. And learning to love myself.” One former resident describes “ feeling a sense of belonging and connection for the first time in so long. Having a strong recovery community of men who support each other was something I’ve never had before.” One alum echoed many others’ feelings with this final thought: “A part of me will always be there.. and for that I am forever grateful.” 

Doctors More Likely to Prescribe Opioids to Covid ‘Long Haulers,’ Raising Addiction Fears

Covid survivors are at risk from a separate epidemic of opioid addiction, given the high rate of painkillers being prescribed to these patients, health experts say.A new study in Nature found alarmingly high rates of opioid use among covid survivors with lingering symptoms at Veterans Health Administration facilities. About 10% of covid survivors develop “long covid,” struggling with often disabling health problems even six months or longer after a diagnosis.For every 1,000 long-covid patients, known as “long haulers,” who were treated at a Veterans Affairs facility, doctors wrote nine more prescriptions for opioids than they otherwise would have, along with 22 additional prescriptions for benzodiazepines, which include Xanax and other addictive pills used to treat anxiety.Although previous studies have found many covid survivors experience persistent health problems, the new article is the first to show they’re using more addictive medications, said Dr. Ziyad Al-Aly, the paper’s lead author.He’s concerned that even an apparently small increase in the inappropriate use of addictive pain pills will lead to a resurgence of the prescription opioid crisis, given the large number of covid survivors. More than 3 million of the 31 million Americans infected with covid develop long-term symptoms, which can include fatigue, shortness of breath, depression, anxiety and memory problems known as “brain fog.”The new study also found many patients have significant muscle and bone pain.The frequent use of opioids was surprising, given concerns about their potential for addiction, said Al-Aly, chief of research and education service at the VA St. Louis Health Care System.“Physicians now are supposed to shy away from prescribing opioids,” said Al-Aly, who studied more than 73,000 patients in the VA system. When Al-Aly saw the number of opioids prescriptions, he said, he thought to himself, “Is this really happening all over again?”Doctors need to act now, before “it’s too late to do something,” Al-Aly said. “We must act now and ensure that people are getting the care they need. We do not want this to balloon into a suicide crisis or another opioid epidemic.”As more doctors became aware of their addictive potential, new opioid prescriptions fell, by more than half since 2012. But U.S. doctors still prescribe far more of the drugs — which include OxyContin, Vicodin and codeine — than physicians in other countries, said Dr. Andrew Kolodny, medical director of opioid policy research at Brandeis University.Some patients who became addicted to prescription painkillers switched to heroin, either because it was cheaper or because they could no longer obtain opioids from their doctors. Overdose deaths surged in recent years as drug dealers began spiking heroin with a powerful synthetic opioid called fentanyl.More than 88,000 Americans died from overdoses during the 12 months ending in August 2020, according to the Centers for Disease Control and Prevention. Health experts now advise doctors to avoid prescribing opioids for long periods.The new study “suggests to me that many clinicians still don’t get it,” Kolodny said. “Many clinicians are under the false impression that opioids are appropriate for chronic pain patients.”Hospitalized covid patients often receive a lot of medication to control pain and anxiety, especially in intensive care units, said Dr. Greg Martin, president of the Society of Critical Care Medicine. Patients placed on ventilators, for example, are often sedated to make them more comfortable.Martin said he’s concerned by the study’s findings, which suggest patients are unnecessarily continuing medications after leaving the hospital.“I worry that covid-19 patients, especially those who are severely and critically ill, receive a lot of medications during the hospitalization, and because they have persistent symptoms, the medications are continued after hospital discharge,” Martin said.While some covid patients are experiencing muscle and bone pain for the first time, others say the illness has intensified their preexisting pain.Rachael Sunshine Burnett has suffered from chronic pain in her back and feet for 20 years, ever since an accident at a warehouse where she once worked. But Burnett, who first was diagnosed with covid in April 2020, said the pain soon became 10 times worse and spread to the area between her shoulders and spine. Although she was already taking long-acting OxyContin twice a day, her doctor prescribed an additional opioid called oxycodone, which relieves pain immediately. She was reinfected with covid in December.“It’s been a horrible, horrible year,” said Burnett, 43, of Coxsackie, New York.Doctors should recognize that pain can be a part of long covid, Martin said. “We need to find the proper non-narcotic treatment for it, just like we do with other forms of chronic pain,” he said.The CDC recommends a number of alternatives to opioids — from physical therapy to biofeedback, over-the-counter anti-inflammatories, antidepressants and anti-seizure drugs that also relieve nerve pain.The country also needs an overall strategy to cope with the wave of post-covid complications, Al-Aly said“It’s better to be prepared than to be caught off guard years from now, when doctors realize … ‘Oh, we have a resurgence in opioids,’” Al-Aly said.Al-Aly noted that his study may not capture the full complexity of post-covid patient needs. Although women make up the majority of long-covid patients in most studies, most patients in the VA system are men.The study of VA patients makes it “abundantly clear that we are not prepared to meet the needs of 3 million Americans with long covid,” said Dr. Eric Topol, founder and director of the Scripps Research Translational Institute. “We desperately need an intervention that will effectively treat these individuals.”Al-Aly said covid survivors may need care for years.“That’s going to be a huge, significant burden on the health care system,” Al-Aly said. “Long covid will reverberate in the health system for years or even decades to come.” Subscribe to KHN's free Morning Briefing.

Punk Rock Powers My Recovery Every Day

I was a disheveled and bedraggled disaster of a person back in the winter of 2012. I lived for alcohol. If beer was the entrée, crack-cocaine was my digestif. But after an intervention and rehab, I’ve been sober nine years now. I never could’ve done it without music.Even though I had spent most of my career working in the music industry as a producer for MTV News, music wasn’t really a significant part of my life during the worst of my drinking days. But when I was a teen and again now, music has been of utmost importance. Now as an adult I realize music is better than sex. It’s better than drugs. And it’s better than alcohol. It’s a natural high. If given a choice between music and drugs, I choose music. Starting with punk.A Youth in Revolt“Where do you go now when you’re only 15?”Rancid, “Roots Radical,” off the 1994 album And Out Come the WolvesI’ve always felt like a bit of an outcast. As someone who struggles with the dual diagnosis of addiction and bipolar disorder, in a way, I am. But I’m proud to be an outcast, and my punk rock upbringing only reaffirmed that being different is cool.In the spring of 1995, March 9th to be exact — 26 years ago — I experienced my very first punk show. It was Rancid with the Lunachicks at the Metro in Chicago. I still have the ticket stub. I was 15. And in that crowd of about 1,000, I felt like I belonged. I had found my tribe. It was a moment that would transport me on a decades-long excursion, one that finds my punk rock heart still beating now and forever.I often think in retrospect that maybe there were signs and signals of my bipolar status as I grew up. I was in fact different from the others. And I was experiencing bouts of depression inside the halls and walls of high school. Freshman and sophomore years in particular I did not fit in. I was the quiet kid who had barely any friends. I didn’t belong to a social clique like everyone else. I was a rebel in disguise. Until I found punk rock. Then I let it all hang out."Once a punk, always a punk."Rock ‘n’ Roll High SchoolI am a Catholic school refugee. Punk was my escape from the horrific bullying I experienced in high school. Back then, the kids from the suburbs threw keggers. We city kids — I had three or four punk rock friends — were pretty much sober, save for smoking the occasional bowl of weed if we had any. We were definitely overwhelmingly the minority at school as there were probably only five or so of us in a school of 1,400. For the most part, though, we found our own fun at music venues like the Fireside Bowl and the Metro. We went to shows every weekend at the now-defunct Fireside – the CBGB or punk mecca of Chicago that used to host $5 punk and ska shows almost every night.The Fireside was dilapidated but charming. It was a rundown bowling alley in a rough neighborhood with a small stage in the corner. You couldn’t actually bowl there and the ceiling felt like it was going to cave in. It was a smoke-filled room with a beer-soaked carpet. Punks sported colorful mohawks, and silver-studded motorcycle jackets. Every show was $5.My few friends and I practically lived at the Fireside. We also drove to punk shows all over the city and suburbs of Chicago – from VFW Halls to church basements to punk houses.The Fireside has since been fixed up and has become a working bowling alley with no live music. A casualty of my youth. But it was a cathedral of music for me when it was still a working club. After every show, we would cruise Lake Shore Drive blasting The Clash or The Ramones. I felt so comfortable in my own skin during those halcyon days.Fat Mike of NOFX at Riot Fest in Chicago, 2012Punk Up the VolumePunk isn’t just a style of music, it’s a dynamic idea. It’s about grassroots activism and power to the people. It’s about sticking up for the little guy, empowering the youth, lifting up the poor, and welcoming the ostracized.Punk is inherently anti-establishment. Punk values celebrate that which is abnormal. It is also about pointing out hypocrisy in politics and standing up against politicians who wield too much power and influence, and are racist, homophobic, transphobic, and xenophobic.Everyone is welcome under the umbrella of punk rock. And if you are a musician, they say all you need to play punk is three chords and a bad attitude. Fast and loud is punk at its core.They say “once a punk, always a punk” and it’s true.Punk was and still is sacred and liturgical to me. The music mollified my depression and made me feel a sense of belonging. I went wherever punk rock took me. My ethos — developed through the lens of the punk aesthetic — still pulses through my punk rock veins. It is entrenched in every fiber of my being.Godfather of Punk Iggy Pop at Riot Fest in Chicago, 2015A New DayNow, whether it’s on Spotify on the subway or on vinyl at home, I listen to music intently two to three hours a day. Music is my TV. It’s not just on in the background; I give it my full, undivided attention.I started collecting vinyl about eight years ago right around the time I got sober and I have since amassed more than 100 record albums. There’s a reason why people in audiophile circles refer to vinyl as “black crack.” It’s addictive.I’m glad I’m addicted to something abstract, something that is not a substance. A music addiction is cheaper than alcohol and drugs. And not only that, it’s healthy, invigorating, fun, and liberating.And while my music taste continues to evolve, I’m still a punk rocker through and through. My love affair with punk may have started 26 years ago, but it soldiers on today, even though I mostly listen to indie rock and jazz these days. I recently started bleaching my hair again, platinum blonde as I had when I was a punker back in high school. It’s fun and it also hides the greys.Looking back on my musical self, I knew there was a reason why I can feel the music. Why tiny little flourishes of notes or guitar riffs or drumbeats can make my entire body tingle instantly. Why lyrics speak to me like the Bible and the sound of a needle dropping and popping on a record fills me with anticipationPunk is a movement that lives inside me. It surrounds me. It grounds me. Fifteen or 41 years-old, I’m a punk rocker for life. I’d rather be a punk rocker than an active alcoholic. I’m a proud music addict. I get my fix every day. Please enjoy and subscribe to this Spotify playlist I made of old-school punk anthems and new classics. It’s by no means comprehensive, but it’s pretty close.

The End

The last drink I have is a flute of champagne.It’s New Year’s Eve.My husband reserves a special room for us at a nearby hotel. He buys an imperial bottle of Moet, a misplaced purchase for this particular occasion. We’re making a last ditch effort at saving our marriage. A gala’s going on in the ballroom below, where we journey to join the revelers.Lights twinkle, streamers hang, and chandeliers glisten.I hardly notice.The band plays songs that were once my favorites.I hardly hear. Hoards of gleeful couples celebrate around us.We dance with them, pretending to have a good time.But I know the end is creeping near.My husband’s been having an affair with a woman half his age. He hasn't come clean yet, but my gut knows something’s going on. So I bleach my hair a sassier shade of blond, starve myself in hopes of losing the weight I know he hates, turn myself inside out to get him to notice me again.But mostly I drink.Because of my Catholic upbringing, I have a list of rules I follow.My commandments of drinking. I only have three. Ten is too many.1) No drinking before 5:00. I watch the clock tick away the minutes. It drives me crazy.2) No drinking on Tuesdays or Thursdays. I break this all the time. It’s impossible not to.3) No hard liquor. Only wine and beer. I feel safe drinking those.Anything else means, well, I’ve become my parents.Or even worse, his. I can't bear to go there.One night, when he takes off for a weekend conference, or so he says, I get so stinking drunk after tucking my daughter in for the night, I puke all over our pinewood floor. All over those rich amber boards I spent hours resurfacing with him, splattering my guts out next to our once sexually active and gleaming brass bed.Tarnished now from months of disuse.The following morning, my five-year-old daughter, with sleep encircling her concerned eyes, stands there staring at me, her bare feet immersed in clumps of yellow. The scrambled eggs I managed to whip up the night before are scattered across our bedroom floor, reeking so bad, I’m certain I’ll start retching again. I look down at the mess I made with little recollection of how it got there, then peer at my daughter, her eyes oozing the compassion of an old soul as she says, "Oh Mommy. Are you sick?" Shame grips every part of my trembling body. Its menacing hands, a vice around my pounding head. I can't bear to look in her eyes. The fear of not remembering how I’ve gotten here is palpable. Every morsel of its terror is strewn across my barf-laden tongue and I’m certain my daughter knows the secret I’ve kept from myself and others for years.You’re an alcoholic. You can't hide it anymore. Every last thread of that warm cloak of denial gets ripped away, and here I am, gazing into the eyes of my five-year old daughter who's come to yank me out of my misery.It takes me two more months to quit.Two months of dragging my body, heavy with remorse, out of that tarnished brass bed to send my daughter off to school. Then crawling back into it and staying there, succumbing to the disjointed sleep of depression. Until the bus drops her off hours later, as her little finger, filled with endless kindergarten stories, pokes me awake.Each poke like being smacked in the face with my failures as a mother.And then New Year’s Eve shows up and I dress in a slinky black outfit, a color fitting my descending mood, a dress I buy to win him back. The husband who twelve years before drives hundreds of miles to pursue this wayward woman, wooing me over a dinner I painstakingly prepare, as I allow myself to wonder if he in fact, may be the one. We dine on the roof of the 3rd floor apartment I rent on 23rd and Walnut, in the heart of Philadelphia where I work as a chef, and where I tell him over a bottle of crisp chardonnay that I might be an alcoholic. He laughs, and convinces me I’m not. He knows what alcoholics look like. Growing up with two of them, he assures me I am nothing at all like his parents.His mother, a sensuous woman with flaming hair and lips to match, passes out in the car on late afternoons after spending hours carousing with her best friend, a woman he’s grown to despise. Coming home from school, day after day, he finds her slumped on the bench seat of their black Buick sedan, dragging her into the house to make dinner for him and his little brother and sister, watching as she staggers around their kitchen. His father, a noted attorney in his early years, drinks until he can't see and rarely comes home for supper. He loses his prestigious position in the law firm he fought to get into, and gets half his jaw removed from the mouth cancer he contracts from his unrestrained drinking. He dies at 52, a lonely and miserable man.“I know what alcoholics look like,” he says. “You're not one of them.”I grab onto his reassurance and hold it tight.And with that we polish off the second bottle of chardonnay, crawl back through the kitchen window and slither onto the black and white checkered tile floor, in a haze of lust and booze, before we creep our way into my tousled and beckoning bed. It takes me another twelve years to hit bottom, to peek into the eyes of the only child I bring into this world, reflecting the shame I’ve carted around most of my life.So on New Year's Eve, we make our way up in the hotel elevator. After crooning Auld Lang Syne with the crowd of other booze-laden partiers still hanging on to the evening’s festivities, as the bitter taste of letting go of something so dear, so close to my heart, seeps into my psyche. A woman who totters next to me still sings the song, with red stilettos dangling from her fingers. Her drunken haze reflects in my eyes as she nearly slides down the elevator wall.At that moment, I see myself.The realization reluctantly stumbles down the hall with me, knowing that gleaming bottle of Moet waits with open arms in the silver bucket we crammed with ice before leaving the room. Ripping off the foil encasing the lip of the bottle, my husband quickly unfastens the wire cage and pops the cork that hits the ceiling of our fancy room. Surely an omen for what follows. He carefully pours the sparkling wine, usually a favorite of mine, into two leaded flutes huddling atop our nightstand, making sure to divide this liquid gold evenly into the tall, slim goblets that leave rings at night’s end. We lift our glasses and make a toast, to the New Year and to us, though our eyes quickly break the connection, telling a different story.As soon as the bubbles hit my lips, from the wine that always evokes such tangible joy and plasters my tongue with memories, I know the gig’s up. It tastes like poison. I force myself to drink more, a distinctly foreign concept, coercing a smile that squirms across my face. I nearly gag as I continue to shove the bubbly liquid down my throat, not wanting to hurt my husband’s feelings, who spent half a week's pay on this desperate celebration. But with each sip I take, my brain and body scream you freaking alcoholic, and I know at that moment I can no longer do this. When I put down that glass, on this fateful New Year's Eve, I know I’ll never bring another ounce of liquor to my lips.I’m done.There’s no turning back.And as we tuck ourselves into bed, I keep it to myself. Each kiss that night is loaded with self-loathing and disgust. Those twelve years of knowing squeezes tightly into a fist of shame.Little does my husband know, if he climbs on top of me,he'll be making love to death itself. Instead, I turn the other way and cry myself silently to sleep.Your days of drinking have finally come to an end. And you can’t help but wonder…will your marriage follow? Excerpted from STUMBLING HOME: Life Before and After That Last Drink by Carol Weis, now available on Amazon.