How Recovery Prepared Us for Coronavirus

Fear, confusion, anger, grief. What a crazy month this has been! Moods are rightfully heavy right now, due to the unprecedented COVID19 crisis. With the whole world seemingly in panic mode, and everyone struggling to cope with the forever life-altering implications of this virus and the current shutdowns, I cling to one silver lining: Recovery has definitely prepared me for this shit.The crisis is both global and personal. And although it’s definitely the first global crisis of its kind in my lifetime, it’s far from my first huge personal crisis. This ain’t my first rodeo: That one was getting sober. The gravity of the life change I had to make felt heavy and undoable. But so did continuing to live in addiction. Day by day, I got through it. And day by day, I began to accept the permanence of the change, and eventually find all the benefits in it. Basically, I was far from thrilled about my switch to sobriety in the beginning. But gradually, as I continued to work a program of sobriety and take the next right steps, my mindset changed. I learned to love and appreciate my new sober life. Right now, I am far from an attitude of acceptance towards the current medical crisis. However, I know that I can get there, because I have learned to accept and then appreciate hard changes in the past.I also learned the value of service and community in recovery. Right now we need our support communities more than ever, and I am so grateful for the abundance of online meetings and gatherings popping up every day. I’m lucky that because I am sober I have real friends I can turn to when times are tough. We are staying connected however possible! I also know, thanks to recovery, that my ability to be of service is vital to my mental health. Regularly reaching out to others and asking them how I can help them keeps me out of my own demoralizing pity party.I asked a few of my friends in recovery how they felt their journeys of sobriety have helped them cope this week. Here’s what they said:“I used to deal with every semi-stressful situation the same way. I would buy a bunch of whatever booze I was into at the time, and numb myself until I had made the situation drastically worse. I did this for years, never feeling my feelings, never dealing with the bad stuff, just drowning it away.Transitioning from alcoholic life to a clean life was a drastic change. I changed my job, my friends, moved, started exercising regularly… this list goes on. Whatever happens how, I know that I will be ok. I know that changing my life into a life of recovery was the biggest change that will ever happen in my life. I know that 'this too shall pass' and it always does.The community I have in recovery is a group of people that has my back. When I was drinking I thought I had friends, but they weren’t there when the times got tough, only when there was a party. These sober people around me are the ones holding shit together. They are the ones that are holding me up through this crisis.Self-isolation is something I had to do in the early days of getting sober. Everything outside of my safe zone was triggering and far too many paths existed that would take me to destroying myself. Quarantining for COVID-19 reminds me of those days. Recovery taught me to deal with the bad shit without tearing myself apart. I now have dozens of ways to entertain myself from home that also cultivate positivity instead of self-destruction or fear.Experts have recommended drastically cutting down alcohol intake as one of the best things you can do for your immune system. So basically, without recovery I would be in terrible health and have no positive coping mechanisms or people to support me through this.” - Zachary Minnich“Recovery has given me the gift of acceptance. Acceptance has taught me to not freak out about what I cannot control—empty shelves, shuttered businesses, and canceled plans. I may not like it but I can accept it—and even find the gift in it.” - Roses"My recovery journey has everything to do with how I have been able to stay semi-calm through this current crisis. The principles I have learned in 12-step programs such as 'One day at a time, this too shall pass' and keeping an 'attitude of gratitude,' have been monumental for me when fear starts to creep in. My yoga practice has taught me to slow down, be patient, and trust that everything is going to be okay. Also, that things don't always go as planned and I do my best to stay open and optimistic and hope for the best possible outcomes. These practices help me find peace and serenity amidst the chaos and I am grateful that I have been on this spiritual path to prepare me for the uncertainty that we are all experiencing.” -Emily Killeen“Self-care means more than a trip to the nail salon. It means listening to your body’s needs, both emotionally and physically. Eat, sleep, exercise. Whatever it takes to get through the day. Some days this might mean taking the dog for three walks, on others it may be binge watching Schitt’s Creek until noon. Listen to your emotions, they are telling you something. We must allow ourselves to grieve losses and disappointments.Asking for help is not a sign of weakness but rather strength. Learning to lean in to fear is a superpower.The phrases 'one day at a time,' 'keep it simple,' and 'this too shall pass' are words we live by. Fostering connections, especially in times of change and uncertainty, is the single most important thing we can do for ourselves and our communities.” -Margaret Ward“My life was hell in addiction! Getting through that and getting sober has given me hope that things will always be okay as long as I put faith in my higher power.” -Alessandra Hurt“My sobriety (a collection of tools including yoga, breath work, meditation and AA) has taught me to slow down, to think things through before I act on them and to be considerate of others around me. In this time that a lot of people are in crisis, I can be of service by putting others first and not drop into my selfish ways that could lead to relapse. I choose to be of service.” - Ryan Griffis

New Study Supports AA’s Effectiveness, but Professionals Caution

In the past few weeks, the pace of news has been unrelenting, so it would be understandable if you missed a flutter of headlines last month claiming that Alcoholics Anonymous and other 12-step programs are more effective and cheaper than other treatments for addiction.While the work is important — and validating for the millions of people who have used AA to get and stay sober — there are caveats to the research. Here’s what you should know about the latest study about the effectiveness of AA.What the study foundOn March 11, a team of researchers with the Cochrane Collaboration published a scientific review looking at the effectiveness of AA and other 12-step programs. The review looked at the conclusions of 27 different scientific studies, which overall included 10,565 participants.After examining the results from these studies, the authors concluded, “There is high quality evidence that [AA and 12-step programs] are more effective than other established treatments, such as [cognitive behavioral therapy], for increasing abstinence.”It’s important to note that the studies in the review specifically looked at alcohol use disorder, not any other types of addiction. Still, the results were striking. People in 12-step programs were more likely than those getting other therapies to be continuously sober at 12 months, and two studies found this benefit continued up to 36 months. People in 12-step programs had a higher percentage of days abstinent at 24 and 36 months. And, unsurprisingly, the cost associated with 12-step treatment was lower than the cost associated with other therapies.The study was a followup to a 2006 review by the Cochrane Collaboration that found inconclusive evidence to support that AA was more effective than other treatments. Since then, additional studies have provided evidence for the superior effectiveness of 12-step programs."High-certainty clinical research evidence now clarifies that AA is a viable recovery option," study author John Kelly told Medscape Medical News. Kelly is the director of the Recovery Research Institute, Massachusetts General Hospital and a professor of psychiatry in addiction medicine at Harvard Medical School.The study’s limitationsIt may be tempting to look at the headlines surrounding this study and conclude that anyone struggling with addiction just needs to get themselves to a meeting. However, that’s not the case. The study only looked at alcohol use disorder. Plus, it only compared AA to other behavioral interventions, not medication-assisted treatment (MAT).“Our concern is that people will misinterpret the study, to assume that nothing else is needed other than 12 steps,” says William C. Moyers, vice-president of public affairs and community relations at the Hazelden Betty Ford Foundation.This could be particularly harmful for people with opioid use disorder, for which MAT is the standard of care. It could also be dangerous for more than 9 million Americans who have substance use disorder and a co-occurring mental illness.“The 12 steps themselves are not going to help with depression, bipolar disorder or trauma,” Moyers says. “Whether it’s medication, CBT or talk therapy, there are many tools that are vital to how people struggling with substance abuse are treated.”The 12 steps as an adjunct to treatmentMoyers says that while the 12 steps are “a proven pathway to recovery” for millions of people — himself included — they should not be classified as a treatment. This became especially clear to the providers at Hazelden Betty Ford when the opioid epidemic began.“When it came to treatment of opioid patients, the 12 steps by themselves are not enough to keep patients on the course of recovery, particularly after they left treatment,” he says. “The physical cravings are too powerful for the 12 steps to keep at bay.”That’s why Hazelden Betty Ford began using MAT in addition to 12-step programs to treat people with opioid use disorder.“Now, we’re truly treating the mind, body and spirits of our patients,” Moyers says. “It’s working.”Laurence M. Westreich, MD, a professor of psychiatry at New York University School of Medicine, shared a similar message with Medscape when he commented on the recent study."AA can be a powerful adjunct for those trying to stop addictive behaviors,” he said.He added that those "who are most successful in addressing an addiction choose the most productive idea from professional therapies and peer-led support groups like AA in bolstering their recovery.”The study supports this. Researchers found that 12-step programs were particularly effective when used alongside and after professional treatment. In short: when you’re trying to get and stay sober, use all the tools that are available.The 12 steps can increase access to treatmentOne of the biggest issues in the treatment of substance use disorder nationally is the “treatment gap.” The National Institutes of Health has estimated that as few as 10% of people who need addiction treatment get it. Cost and time to dedicate to residential treatment are huge factors that keep people from accessing care.AA and other 12-step modalities are free and readily available, both in person and online. Because of that, they can be a powerful tool for people who might not have other means to get treatment."It's universally available any time of day, any day of the week, and it's free,” Carol J. Weiss, MD, a professor of psychiatry at Weill Cornell Medical College, told Medscape.While ideally everyone who needs treatment would have access to MAT, high-quality therapy, and 12-step programs, that’s simply not the case. For people facing a frustrating and expensive healthcare system, free 12-step programs can provide benefits at a very low cost, Kelly told The New York Times.“It’s the closest thing in public health we have to a free lunch,” he said.

Practicing Our Principles in Perilous Times

Fear. I’ve been paralyzed by my real and imagined fears about the COVID-19 pandemic and all that will be asked of me and all of us to keep ourselves and our communities safe… for weeks? For months? And when I wake up in the middle of the night panicked? It feels like forever. Fear of the known, but also of the unknown, and so much is unknown about this pandemic. Oh sure, I am stocking up on the recommended four weeks’ worth of groceries (though honestly, more chocolate than canned corn), shifting to online work (while simultaneously downshifting), practicing restraint in my toilet paper use (just enough but not too much!), video chatting with family and friends (sending virtual hugs and kisses), and fending off out-of-the COVID-blue text messages (past boyfriends who ghosted me and are now looking to relieve their stay-at-home boredom). I’m also watching the news, scrolling through Twitter, and keeping diligent count of rising infection numbers and my simultaneously plummeting optimism.But my pandemic fears are controlled by a more fundamental primal fear: I am controlled by my fear of losing control. A “no win-no win” oxymoron. This fear of losing control is inextricably linked to my hubris: while I am fully aware that I am human (so fallible and shortsighted), I sometimes believe I am a god (goddess) in disguise, so in control of my addiction, my karma, my 24 hours at all times. Also, this hubris is linked to my ridiculous belief that I can control how others feel and act, the speed of the world’s rotation, the alignment of stars in the sky, and the sun rising and setting according to my whims and needs. Consequently, in this pandemic, I believe that if I stock up on exactly the right number of canned vegetables, frozen pizzas, bags of rice, hand sanitizer products, and rolls of toilet paper, if I stay bunkered at home and keep others at least 6 feet (better 12) away (my dog excepted), if I remain productive, sticking to a strict work-and-play-and-clean-and-exercise at-home regimen? Then I will be safe.My frenzied attempt at control during this national crisis and under real duress mirrors my other long-ago attempt to control my drinking and eating, all the while I was still guzzling wine, cutting my arms, parsing out my daily allotment of 500 calories, and running precisely five miles every day to burn off those calories. That manic micromanagement? An absolute failure that landed me in the psychiatric unit and in residential recovery programs more than 20 times.So, in this pandemic, I’m trying to regroup, to practice my principles and regain balance. As anxiety’s vise tightens, I can get caught up in the doing, doing, doing instead of breathing and being. Time to revisit Step 1 of the 12 Steps: “We admitted we were powerless over alcohol and that our lives had become unmanageable.” Nine years ago, I took my first 1st Step when I walked into my first meeting. I was bereft, emptied out, and close to my end (but certain that I was in control even if only in control of my end). This group helped me to stay alive, to get sober, and to reclaim my life. "Just do the next right thing," they said."Honesty, Open-mindedness, and Willingness," they said."Trust us to help you see how you can transform your life and find purpose and joy again," they said.Also, nine years ago, my therapist asked me to push back my long sleeves. “What do you see?” he asked.“Scars upon scars,” I said. Dozens of scars criss-crossed my forearms from my years of self-injury.“What’s missing?” he asked.I looked away in shame.“What’s missing?” he asked again.“Oh,” I said. “Words.”Words. He insisted I write words up and down my forearms with a Sharpie: Hope, Loved, Forgiven, Resilient, Beautiful, Compassionate, Worthy. Visible perseverance.“Wear your words,” he said.I started with Hope. Courage might seem the obvious counterweight to Fear, but before I could summon courage, I needed hope. This morning, watching the news and counting my cans of garbanzo beans, I picked up a Sharpie and on one arm wrote Hope, and on the other Courage. I am not in control of this pandemic and I am powerful nonetheless. Both/And. So are you.Two choices are within our sphere of control:(1) Give in to fear or hold fast to hope(2) Proceed with extreme caution or with radical courage. Hope and courage offer directional integrity. Isn’t the world always uncertain? Aren’t our lives always provisional? One day at a time, across time. Many years ago, I took riding lessons at a stable that fostered rescue horses, many of whom had suffered neglect and abuse. For a few months, I rode Chandi, a horse that spooked at everything. One morning, rain pounded the arena ceiling, wind howled outside, and barn sparrows flitted and darted every which way. Chandi was paralyzed and disorganized by fear: he snorted and hopped away from the jumps and shifted haphazardly from trot to canter to a halting stop. My own first fear-filled instinct: If I could control the environment, I could control Chandi’s fears (and mine!). So I kept us to a guarded tentative walk and studiously avoided the jumps. Why court trouble? Just bypass them!My instructor put a quick end to that. “Of course it’s easier,” she said. “But you haven’t tried to go over the jumps yet, so you don’t know how he’ll react. Remember: calm line and pace.”Calm line and pace: prepare to proceed with hope and courage. I gathered myself, steadied my breathing, relaxed deep in my seat, and applied firm but light pressure with my legs and reins. Onward in a trot. We approached the jump and as expected, Chandi snorted and tried to sidestep it. I flapped my calves to keep him moving and centered, and then, as if he could see where I wanted us to go, he flew over the jump and through his fear--over and through, again and again. “Smart riding,” my instructor said. “You kept your cool. Really good there.”Balanced seat. Balanced riding. We jumped the obstacles together.Similarly, in recovery haven’t we been practicing this principle in all our affairs? Might we be uniquely equipped to help others proceed with hope and courage in these perilous times? We’ve been learning how to gather ourselves through fellowship and right action, proceeding forward one day at a time, one step at a time. 

Before and After I Got Sober: Musings on Creativity

Before I got sober, I feared I would lose my ability to write. If I’m honest, I was afraid I’d lose my ability to create at all, from writing poetry, to writing fiction or memoir, to roasting a pan full of broccoli rabe, to knitting a scarf.When I think back, I wasn’t much of a writer when intoxicated. Freshman year of college, I’d written a paper when I was drunk for my first year composition class. The paper was on Fear and Loathing in Las Vegas. I was, of course, the central character in what I'd written. I was on the roof of my dorm, holding a draft of the piece, and a helicopter came to pick it up for me and take it to my professor. I essentially wrote about hallucinating at a time when hallucination wasn't far from the forefront of my daily activities. Sophomore year, I’d written a paper on Sartre that self-destructed so that the reader would feel he or she was left with a handful of loose letters.I had a vintage light blue Smith Corona typewriter I bought because it looked like the one Raymond Carver used. I can’t call to mind if I was drunk the years I typed poetry on that typewriter – that time period all melds into itself – but I do remember that after I’d type a poem, I’d be left with a handful of “O’s,” because the typewriter broke through the paper and carved out the letter “O” each time it printed it. I do remember that I sold the typewriter when I needed money for alcohol, a trade I regret to this day. It was like giving up a pet because you can’t take care of it.I can’t prove that I was a better writer when I was drunk or high, although I did nearly finish a draft of a memoir when I was high. I can’t remember one word of that draft, nor can I locate it on any of my old computers. I remember it had to do with a mental health diagnosis I had recently received, but beyond that, I draw a blank. When I think back, I can picture my dog lying in my lap or in his bed at my feet while I wrote, hunched over my computer, between periods of suicidality marked by brief periods of elation where I’d buy a coat online or some book I would probably never read.When I was drunk, I was filled with ideas. The alcohol made me feel like I could invent the next light bulb, or in-ground swimming pool. It made me feel like I could take home the prize on Dancing with the Stars every time I danced in a bar, or on a table, or in my studio apartment in New York City. More to the point, it made me feel like I could write the next great novel, or memoir.I wrote emails to literary agents nearly every day, even sold a few on my poorly thought-through outlines that would never amount to anything. One particular idea agents seemed keen on was that I would attend all sorts of 12-step meetings, from Sex and Love Addicts Anonymous to Clutterers Anonymous to Alcoholics Anonymous and write about being a fake; some of these meetings I might have qualified for, like AA, others I clearly didn’t. The point was that I would be a fraud, spying on everyone, reporting back to “the publishing world.” I had no business even contemplating such a false existence, but I titled my emails to agents “Stories from the Rulebreaker” and planned on writing one short story for each autonomous group. I hadn’t named the stories yet, but I imagined the titles sounding like “How I Messed Up: In the Clutches of a Clutter.” Nothing about this project was good or funny or well-conceived; when I was drunk or high, I started many projects and followed through with very few. I passed the name of an agent I was “working” with (she was trying to get me to write something cohesive) along to a writer friend who didn’t have a drinking problem, and the friend signed with the agent while I just got a handful of quippy emails and a passing nod.Still, in my mind, I was a creative success. I’d knitted an afghan that covered my queen-sized bed, and there were notes for poems and stories littering my room. I’d write on paper napkins and business cards, notes I imagined would be auctioned off on eBay once I became famous. Instead, I’d find them, years later, crumpled at the bottom of my bag.When I was drunk, I wanted to be famous. I deserved to be famous. My friends always said what a good writer I was, and I believed them. Which is part of the beauty of my disease – it didn’t kill my confidence in myself as a writer. Alcohol was actually the builder of confidences – I was on top of the pyramid for about 20 minutes a day when I was drinking. The other 23 and some odd hours, I was on the bottom. And I didn’t have the confidence to finish anything I managed to start in the first place. I was picturing myself walking into 12-step meetings aimed at treating something I didn’t have. I was foolish, a foolish woman who was trying too hard. Rather than accepting that I was a worker among workers, I felt like a failure when I didn’t get a poem into a top literary journal, even when it was published in a decent one.Today, in sobriety, I still write. I’ve been sober 13 years, and I’ve written much of that time. Not always well, and my work isn’t always accepted into a top journal, but now I work hard at what I set out to do, and I usually finish. Granted, I’ve published a chapbook of poetry, have self-published a novel and have a few more in plastic containers of works I've abandoned under my bed, but I have written them. I’m not proud of everything I write, but I’m always proud that I’ve written.

What It’s Like to Be on Methadone During a Pandemic

There is a large group of people in America who have been affected by the novel virus COVID-19 in a different way than most. We are the people who rely on methadone clinics to dispense medication for our opioid use disorder (OUD). Imagine a life where you depend on a building to stay open so that you can function and take care of your responsibilities. This is my reality along with thousands of other patients. We receive our medication at a location outside of the house on a daily, weekly, or biweekly basis. Because of this, we are unable to #StayTheFuckHome.Methadone is a synthetic opioid that has been in use since the 1950s. It was originally created as an alternative to morphine and is now considered the “gold standard” for treating opioid dependence. It is strictly regulated by the federal government and only certain facilities are able to dispense it, i.e. methadone clinics. When you become a patient at a methadone clinic, you have to come in every day for your dose. Why would anyone in their right mind agree to this? This is the biggest complaint that patients have. Methadone is often referred to as “liquid handcuffs” for this reason. When I first started treatment four years ago, I had to come in every day and take my medicine in front of a nurse. After months of clean drug tests, I was able to take a bottle of methadone home with me. Today, I get 13 bottles every other week. I have been successful in creating a life that is free from illicit substances. When I stopped using, I became a wife and mother, an active member of my church, and I went back to college last January. There have been tons of other success stories similar to mine. People have gone from homeless and addicted to heroin to buying their first home and graduating from college. Stopping the use of opioids completely is a success in itself. Methadone is a lifesaving medication. When news of COVID-19 broke, I started to worry about my clinic closing. And I wasn’t the only one: message boards became flooded with patients who were panicking. All of us had the same kinds of questions: Would they give us extra bottles until a cure is found? Am I going to show up to the clinic only to find the lights off and the door locked? Will I have to go back to street drugs when the medicine that I have runs out? Will the clinic run out of methadone completely? The staff at these clinics now have to worry about controlling the possible spread of the virus in their facilities and their patients becoming panicked. I have overheard patients talk about hoarding their medication in case they aren’t able to dose at their clinic. Others have decided to taper off of their medication completely and quickly so they won’t be sick if their clinic can’t accommodate them. Schools are closing, people are being told to stay home, the NBA cancelled their season…Are we cared enough about to be taken care of? Are we important enough that our recovery won’t be jeopardized during this time? It seems like, as former drug addicts, we don’t really garner the kind of sympathy that someone denied their insulin would get. So, what does this mean for us? Will we get our strictly controlled but very much needed medicine while everything seems to be closing down? The answer: Yes, but the rules are changing during this national crisis. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), Opioid Treatment Programs (OTP) have been granted the ability to give stable patients 28 days of medication. Less stable patients are able to be given up to 14 days of medication as long as they are able to demonstrate the capacity to store their methadone safely. Each clinic has their own set of rules, but across the board they are all trying to prevent long lines and close contact between patients. When I go to the clinic this week, I will be coming home with 28 individual doses of methadone instead of my usual 13. I am very fortunate to have had years of clean drug tests, which has enabled me to come in once every two weeks. For safety reasons, most clinics have completely suspended the requirement to attend group therapy indefinitely. Some are also having patients attend their individual counseling sessions over the phone. Whatever can be done to prevent long lines and packed waiting rooms is being implemented in different ways across the country. Many methadone (and suboxone) clinics have an employee outside of the building screening patients and taking their temperature. If someone has contracted the virus or are in a high-risk category, a dosing nurse might even bring your medication out to your car. It seems that these OTP’s are doing everything they can to keep their patients stable.Imagine the effect on society if the methadone clinics suddenly shut their doors? There would be rioting, robbery, and a lot of people going back to using illicit drugs just to be able to function.But what about those new to the program? The ones who haven’t passed enough drug tests to earn these take-home privileges? Are they still going to have to come in every day and risk increased exposure to this virus? I belong to an online community that has patients from across the country so I decided to ask these questions. One person answered that they went from going daily to receiving two days of medication every time they go in. This lowers the number of patients in the building significantly. Not everyone will be able to take their methadone at home while drinking their morning coffee. One of the biggest problems that the methadone clinics deal with is diversion: when the patient sells their take-home methadone or trades it for illicit drugs. Other patients will take two days’ worth of medication at one time. Methadone is one of THE STRONGEST opioids and the consequences of taking the wrong dose of this medication for an opiate-naïve individual could be fatal. Taking methadone on top of other opioids can also have tragic results. This is something that the Program Director considers when changing the rules during this pandemic to make sure that everyone is taken care of. Do you give someone an extremely potent, addictive medication to take home when they haven’t passed a drug test and are still using heroin and other substances? Different places are implementing different strategies depending on their statistics, directors, and concerns. Some clinics are requiring these patients to continue coming in daily but will ask that they come in at different times during their hours of operation. Or a nurse may come outside to deliver daily doses of methadone to patients showing symptoms of COVID-19. Sadly, not everyone has been following the new rules and allowing patients to take home extra medications. I spoke to a patient in Indiana who told me her clinic still had long lines and people standing close to each other. This is dangerous and unacceptable. If your clinic isn't following the SAMHSA guidelines and not practicing social distancing then you can try talking to the program director, who is likely the highest authority at the clinic. Find out what they plan to do to protect you and the other clients at risk. It's important to advocate for yourself.If you are a patient on MMT and are reading this today, I hope that I have put your mind at ease for the time being. The social and economic repercussions of closing down our country’s methadone clinics would be catastrophic. The government knows this and have set rules in place to accommodate us and keep us stable. There is no need to panic or jeopardize your recovery because of what’s going on. Our families need us to stay strong and stable right now more than ever.

Control, or the Myth of It: Mental Health and Addiction

In the twenty-first year of my recovery, I was minding my own business when the universe provided me with one of my biggest challenges to date.I was sitting on the couch on an ordinary night scrolling through my social media when I felt both a tightness in my chest and a rapidly escalating inability to breathe. I had experienced these feelings before many times in the late nineties when I was still going hard. Only this time, this wasn’t brought on by the injection of too much cocaine (or even like the time I ended up in the emergency room with chest pains after drinking too much coffee in a meeting). This was something entirely different that would alter my daily living,As I sat in an assless smock on a bed, separated by a curtain from an eighth grader vomiting into a bedpan, I felt my legs start to shake uncontrollably. What the fuck was going on? I was asked a series of questions. A list of possible health issues was ruled out. The kind doctor with the round face had a suggestion. Did I want to take an ativan?But I’m in recovery...my mind trailed off. An internal conflict quickly devolved into a different kind of panic. Wait, would this be considered a relapse? The 12-step program spun around in my mind. Then the rational part of my brain kicked in, overruling my own internal stigma. Yes, I want to breathe. I will take the medication. Thank you. Sigh. There are times in recovery when drugs that used to be “fun drugs” become “I need this medication.” This was one of those times.As the panic attack slowly subsided, I was awash in emotions. I felt exhausted from the physical residue of what had just occurred. I felt angry at myself for having to drag my ass to the emergency room at ten o’clock at night while my children lay sleeping in their beds. Finally, I felt as if I was a failure, though it took a few sessions of therapy to tease that out. The way I viewed my life versus how I was actually doing were far, far apart. How had I let myself get to this point? I knew my recovery from substances requires a level of daily maintenance but I had forgotten what happens when I ignore my mental health issues.Many mornings since the pink cloud wore off in the late nineties, I wake up with an existential crisis. I lie under my two comforters in a pool of sweat following a four am hot flash, wondering why I’m still here. There are a few levels to this why. There is the why of how I survived an addiction that killed so many others. Why am I so lucky? I have a good life, great friends, kids that find me loveable. Why am I here? (As in, what is my purpose?) So many questions and not many answers, especially when I’ve slowly drifted away from the spiritual center I had in the early days of recovery.Growing up firmly entrenched in codependency, I like to have a “reason” for my being. I am uncomfortable when I am choosing my own path, my own way. I like to go where I’m needed. Unfortunately for the still sick part of myself, my life in recovery has reached a level of stability. I am no longer providing a hit for my dopesick partner or wondering where my next drink is coming from. The years of crisis management have settled into a place where my free time involves thinking about my wants and my needs. Who’d have believed this would be possible? I fucking hate sitting with myself. Whether it is filling my time up with work, service commitments, friend drama, or mindlessly looking through websites, I like to have my time filled. Anxiety manifests itself in “what am I going to do next?!” I begin to spiral when there is no clear path, no project. I run through all the worst-case scenarios without even leaving the comfort of my well-worn couch.As a survivor of sexual abuse, at times I’ve created a rigid system in place for my mental and physical safety. I like to know where I am going at all times. I like the details, I like to know my escape routes. I like to know everything that might happen so I can work out contingencies in my mind. It is nearly impossible for me to relax unless I feel like I have gone through a complete mental list of the details. There are times when it feels like the world cannot spin on its axis without my personal attention.Because of these accumulated stressors, my brain decided to halt the machinery, forcing a hard stop. The mental load of having to be in control of everything 24/7 created a system overload. The perceived threats and diminished joy in daily situations made my life come to a crashing halt. My body felt like a bear was chasing me. In reality, I was running away from all of my problems. The rigid system of control can only exist holding things together for so long before it starts to crack like a rubber band that has aged in the sun. So here I am, patching things back together.Dealing with anxiety and PTSD without having substances to block my emotions has been a challenge, even from the earliest days. I manage it with varying degrees of success. Yet it has been occurring in such increasing frequency, it is no longer possible to ignore: Excessive worry over my health; examining every ache and pain; recounting every conversation and pointing out my every error. Anxiety is the constant regurgitation of all outcomes versus allowing things to just be without my assistance.What have I discovered through this process? That as ridiculous as it may sound to me with 22 years sober, I need to turn things over to the universe or the process or whatever order exists outside myself. I can’t control everything. I need to meditate. I need to journal. I need to ask myself for permission to tune everything out for a set period of time each day to unwind. I’ve started reading books again. Taking the dog for long walks. I got on a psychiatric medication that helps and I actually refill it on time. I put my phone down when I pet the cat. I planted a tiny garden. Most of all, I have given myself permission to be human. I have learned to be in the present moment and enjoy the gift known as the present, as simple as that may sound. I don’t know why I made it this far but I know I want to enjoy whatever is left of my second chances.

Post-Traumatic Pals: How a Rescue Dog Taught Me Faith and Trust in Recovery

On October 10, 2011, I sideswiped a taxi while blind drunk, then sped away into the streets of Manhattan. Police tend to frown upon that; I received a night in jail, a hefty fine and a suspended driver’s license.More importantly, I also received the precious gift of desperation. I was finally scared enough to get sober after years of steadily worsening alcoholism. Despite the disease’s discouraging statistics, I haven't had a drink since.I believe addiction is a takes-one-to-help-one disease. It thrives on degradation and hopelessness and, to combat both, recovery relies upon identifying with others who compulsively drank and drugged before finding an unlikely solution. That solution is one another: a bunch of former fall-down drunks who went from doomed to deliverance, and whose experiences in addiction and sobriety are invaluable to fellow sufferers.My dog, Vector, is a more traditional form of rescue. He is alive by the scarred skin of his mauled-off tail and the saint-like kindness of the Sato Project, an organization that rescues strays from Puerto Rico's infamous Dead Dog Beach.On an island with some 300,000 starved strays, the gaunt 22-pound mutt endured hellish Caribbean heat for about three years, competing with fellow canines for scraps and shelter from searing sun and thunderstorms. In addition to his tail, he's missing a toe and chunks of ear. A deep wound adorns his snout.We have both known pain, fear, hopelessness. We have both had the odds stacked severely against us. Given our histories, Vector and I could each easily be dead.But we're not dead. Nowhere near it. We're here, in my spacious backyard, playing fetch in the grass and sunshine. Just a few years ago, the chances of this coming to pass were so remote they approached impossibility. The combined unlikelihoods that led us to this point make our loving relationship among the greatest miracles of my life.But this is more than a rescue narrative, more than the understandable attractiveness a now-sober drunk feels toward a fellow redemption story, four-legged or otherwise. The bond between Vector and me extends beyond the straightforward rags-to-riches tale of two lost souls spared from the trash heap of existence.Vector doesn't just exemplify my past; he plays an active part in my ongoing recovery. Let’s explore why rescue dogs can be so inspiring to those recovering from alcoholism or addiction.A Faith That WorksWhether it's Alcoholics Anonymous or other reputable group-centric recovery program, a key tenet of overcoming addiction can be finding something greater than yourself that helps keep you physically sober and emotionally sound. Some might call this a higher power; AA, my path because it remains the most robust, accessible organization, would call it a God of one's individual understanding.People who aren't religious, including me, naturally struggle with this. I will never believe in an interventionist deity who, for some arbitrary reason, chose to save me while leaving the drunk on the next barstool to drink himself to death. Recovery requires honesty, and trying to "fake it 'til you make it" with something as fundamental as spirituality is disingenuous and counterproductive. Still, my road would have been smoother had I shared the ironclad faith many of my recovery peers possessed.Vector helped me overcome my spiritual inferiority complex. He did this with a duality that, I believe, only a rescue dog can embody.First, there is his very existence. Given the brutal environment and his diminutive size, it seems impossible that Vector survived three years before being rescued. That island is a doggie death trap; that Vector ran this gauntlet losing only a tail and a toe is living proof that life finds a way. Vector showed me that.Life is so resilient that ascribing to some Essence of the Universe becomes more logic than leap of faith. There are inexplicable microbes under the Antarctic ice shelf. There are blind fish thriving in the lightless ocean depths. And there is Vector, who spent 1,000 days in a war zone and lived to bark about it.But it was Vector's rapid rise from frightened to frolicking that placed this newfound faith into action.Understandably given his past, when I first adopted Vector he was a shaking nervous wreck, too shell-shocked to so much as relieve himself outdoors. He spent hours on end curled up and shaking, my wife and I petting him while whispering gentle encouragement.Two weeks later Vector was a nub-wagging, fetch-playing, full-fledged dog. He had assessed the situation and decided that these new circumstances had real potential. He was safe, fed, sheltered, loved. He was home.Vector's faith – ironically, his faith in me – taught me to stop intellectually fighting recovery and just recover. Group-centric recovery has gotten millions clean and sober. Trust the process and the good people you've met through it, and move forward one day at a time. Vector's uncomplicated spirit showed me I was overcomplicating spirituality.Unaffected vs. DisaffectedAlcoholics and addicts are, by both nature and nurture, an emotionally unstable set. Many of us have concurrent psychological conditions such as depression and anxiety. All of us have fears, insecurities, and trauma that led us to drink and drug to excess and, from there, fueled that excess into obligatory obsession. Our physical addictions are, at their root, mere symptoms of deeper emotional affliction.When we first put away the bottles and baggies, alcoholics and addicts are piles of rubbed-raw nerve endings suddenly robbed of our anesthetics of choice. Early sobriety especially is a period of dangerous hypersensitivity. Had I let my feelings get the better of me, I would have felt my way to a bar.Addiction wants its sufferers discouraged and disaffected. Emotional sobriety comes with patience and practice, and serves to buttress physical sobriety. The less we let life rattle us, the less likely we are to relapse.Vector is Exhibit A for being unaffected – the emotionally mature yin to disaffected’s yang. Blessed with an animal’s amnesia, rescue dogs live in the treasured present rather than the troubled past.Does Vector have some PTSD in the depths of his doggie brain? Absolutely. To this day he doesn’t like other dogs, the result of literally fighting for his life against fellow canines. And he hates being left alone, hinting at potential abandonment in his past.But past that, Vector, like all dogs, is a creature of the current. And his current situation, like mine, is very, very good.I wonder if Vector remembers any of his harrowing history. I'm unsure whether or not I would want him to. I'm not certain which is preferable: a survivor's gratitude for the plenty of today, or the eternal sunshine of a spotless mind.Regardless, Vector is an unknowing teacher in what for us humans is easier said than done: living in the now. This simple message is invaluable to a set of people for whom living in the past can mean succumbing to it.“We’re here now,” his tongue-out doggie smile says, “so whatever remorse or resentment you’re harboring, let it go. Give yourself a break, and give me a treat.”We are post-traumatic pals, two beings back from the brink of the abyss, scarred from the past but no longer scared of the future. Each day, Vector and I walk a little further from our separate hells together, leash in hand.