Appendix A: Poems

The Perfect High

Shel Silverstein

There once was a boy named Gimmesome Roy. He was nothing like me or you.
‘Cause laying back and getting high was all he cared to do.
As a kid, he sat in the cellar, sniffing airplane glue.
And then he smoked bananas — which was then the thing to do.
He tried aspirin in Coca-Cola, breathed helium on the sly,
And his life was just one endless search to find that perfect high.
But grass just made him want to lay back and eat chocolate-chip pizza all night,
And the great things he wrote while he was stoned looked like shit in the morning light.
And speed just made him rap all day, reds just laid him back,
And Cocaine Rose was sweet to his nose, but the price nearly broke his back.
He tried PCP and THC, but they didn’t quite do the trick,
And poppers nearly blew his heart and mushrooms made him sick.
Acid made him see the light, but he couldn’t remember it long.
And hashish was just a little too weak, and smack was a lot too strong,
And Quaaludes made him stumble, and booze just made him cry,
Till he heard of a cat named Baba Fats who knew of the perfect high.

Now, Baba Fats was a hermit cat who lived up in Nepal,
High on a craggy mountaintop, up a sheer and icy wall.
“But hell,” says Roy, “I’m a healthy boy, and I’ll crawl or climb or fly,
But I’ll find that guru who’ll give me the clue as to what’s the perfect high.”
So out and off goes Gimmesome Roy to the land that knows no time,
Up a trail no man could conquer to a cliff no man could climb.
For fourteen years he tries that cliff, then back down again he slides
Then sits — and cries — and climbs again, pursuing the perfect high.
He’s grinding his teeth, he’s coughing blood, he’s aching and shaking and weak,
As starving and sore and bleeding and tore, he reaches the mountain peak.
And his eyes blink red like a snow-blind wolf, and he snarls the snarl of a rat,
As there in perfect repose and wearing no clothes — sits the godlike Baba Fats.

“What’s happening, Fats?” says Roy with joy, “I’ve come to state my biz.
I hear you’re hip to the perfect trip. Please tell me what it is.
For you can see,” says Roy to he, “that I’m about to die,
So for my last ride, Fats, how can I achieve the perfect high?”
“Well, dog my cats!” says Baba Fats. “here’s one more burnt-out soul,
Who’s looking for some alchemist to turn his trip to gold.
But you won’t find it in no dealer’s stash, or on no druggist’s shelf.
Son, if you would seek the perfect high — find it in yourself.”

“Why, you jive mother_______!” screamed Gimmesome Roy, “I’ve climbed through rain and sleet,
I’ve lost three fingers off my hands and four toes off my feet!
I’ve braved the lair of the polar bear and tasted the maggot’s kiss.
Now, you tell me the high is in myself. What kind of sh__ is this?
My ears ‘fore they froze off,” says Roy, “had heard all kind of crap,
But I didn’t climb for fourteen years to listen to that sophomore rap.
And I didn’t crawl up here to hear that the high is on the natch,
So you tell me where the real stuff is or I’ll kill your guru ass!”

“Ok, OK,” says Baba Fats, “you’re forcing it out of me.
There is a land beyond the sun that’s known as Zaboli.
A wretched land of stone and sand where snakes and buzzards scream,
And in this devil’s garden blooms the mystic Tzu-Tzu tree.
And every ten years it blooms one flower as white as the Key West sky,
And he who eats of the Tzu-Tzu flower will know the perfect high.
For the rush comes on like a tidal wave and it hits like the blazing sun.
And the high, it lasts a lifetime and the down don’t ever come.
But the Zaboli land is ruled by a giant who stands twelve cubits high.
With eyes of red in his hundred heads, he waits for the passers-by.
And you must slay the red-eyed giant, and swim the River of Slime,
Where the mucous beasts, they wait to feast on those who journey by.
And if you survive the giant and the beasts and swim that slimy sea,
There’s a blood-drinking witch who sharpens her teeth as she guards that Tzu-Tzu tree.”
“To hell with your witches and giants,” laughs Roy. “To hell with the beasts of the sea.
As long as the Tzu-Tzu flower blooms, some hope still blooms for me.”
And with tears of joy in his snow-blind eye, Roy hands the guru a five,
Then back down the icy mountain he crawls, pursuing that perfect high.

“Well, that is that,” says Baba Fats, sitting back down on his stone,
Facing another thousand years of talking to God alone.
“It seems, Lord”, says Fats, “it’s always the same, old men or bright-eyed youth,
It’s always easier to sell them some shit than it is to give them the truth.”

Gimme-some Roy’s boy:The Quest for the Perfect High

Jon Ricketts

You remember, Gimme-some Roy, that boy, who searched for the perfect high

Couldn’t find it with drugs, couldn’t find it with thugs, so he climbed that mountain high

A little known fact, about Gimme-some’s past, he found out and then left after awhile

His girlfriend Sharon, she knew Roy wasn’t carin’, that she was pregnant with his child.

Ol’ Roy still run off, to that mountain top, looking for that guru Baba Fats

As the story still goes, as everyone knows, the secrets of life are found with Fats.

Ol’ Roy never came back, from that meeting with Fats, he set out for the Tzu Tuz tree

Meanwhile Sharon had his child and man, was he wild, he was nothing like you and me.

The boy heard only stories of his Dad, it was ever so sad, how he searched for the perfect plan

They say the apple isn’t far from the tree, nothing like you and me, the boy was just like his old man

He was about it all, oxcies, weed, and 8 balls, then he climbed that same mountain slope.

He stood face to face with Baba Fats, the legend of the past, to hear what was better than dope.

Well, dog my cats, says Babba Fats, another burnt out soul

Come here to find, if what he left behind, was worth paying the toll.

I’ve seen your face, right here in this place, right there where you stand

But you’re his son, following’ his father’s fun, because Roy was your old man

Let’s cut to the chase, said Roy’s only grace, you know why I’ve come

So, tell me the deal, while I sit here and chill, and don’t act lie I’m dumb.

Yeah, my Dad was here, all he left me was beer, I guess I’ll catch him on the fly

But I know you Fats, let’s cut the crap, tell me about the Perfect High.

If I tell you the truth, and give you the scoop, will you go on this mission?

I’ll tell you the facts, and won’t hold nothing back, but tell me, will you listen?

Cause I told your Dad, it was oh so sad, all those years ago

He didn’t believe, thought I tried to deceive, so I had to let him go

Am I wastin’ my time, givin’ you this line, should I even bother

Will be defeated, and get all heated, with the truth, just like your father.

Those words sank in, like burns to the skin, the boy knew Fats was right

He knew the stories of Roy, that white trash boy, and he hated how Dad left them in the night.

He said, “Alright Dude, I’m sorry I was rude, please tell me all that is good

I’m miserable inside and all I do is hide behind alcohol and drugs.

So come on fam, don’t give me a scam, and don’t lie to my face

Where is the perfect High, cause when we say good-bye, I’m going to that place.

Babba Fats took a breath, placed his hands on his chest, and let it out with a sigh

He said, “Alright man, give me your hand, I’ll tell you about the perfect high.

It don’t come from dope, or something you smoke, it done come from liquor or beer

It’s not in the hooter, and not in the tooter, you don’t get it from ever-clear.

It’s not in the pills, not in the thrills, not in money or cash

It’s not the gold mine, and it’s not in the line, you can’t find it smoking hash.

Oxcies won’t do it, even if you shoot it, it’s not with the girls who are flirty

Cocaine don’t get it, Crack! Just forget it, it’s not in smoking that dirty.

Peace you will find, when you give up this grind, let go and let God

Quit tryin’ to quit and this time just quit, turn it all over to God.

Right now is the hour, you got not power, your powerless, yes, that is it

Give up control, let God have your soul, knowing you can’t control it is when you will quit.

That’s the deal cuz, just like callin’ the fuzz, it happens and you find the release

It’s an inside job, between your ears in your mind, that were God gives us the peace.

It’s a simple plan, not hard to understand, just let the Spirit flow into your soul.

Then you experience this peace, find the sweet release, and you don’t need drugs no mo’.

Babba Fats knew, from his head to his shoes, that the boy hung on every word

He let out another sigh, saw a tear in his eye, hoping this boy wasn’t just another terd.

Mr. Fats, said the boy, I ain’t goin’ be like ol’Roy, I believe what you said

I know in my heart, right now I’m going to start, cause I don’t want to end up in jails/institutions, or dead.

The boy feel to his knees, as pretty as you please, and asked God into his heart.

When his head rose form prayer, there was something new there, a fire and a spark

With a gleam in his eye, he started to cry, and said, “I’ve found the perfect high.”

He turned to go, then his step slowed, he turned towards Babba Fats then stopped

Fats ol’ boy, I’m lovin’ this joy, but tell me, why do you stay on this mountain top.

Fats said with a smile, I’ll tell you my child, while I’m here and this is my lot.

This is the place, where my sins were erased, and I found communion with God

I decided to stay, that very day, to Him I began to cleave

He is all that I need, I stopped smoking weed, and it was so good, I never did leave.

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Closing Thoughts

As I said at the outset, it is not my job to convince you to stop using. Perhaps, this is only a half-truth. My real motive is to get inside you head and mess up your next buzz. Perhaps I should’ve put a warning label on the book, “Warning, I will mess up your next buzz.” You see, once you’ve been exposed to powerlessness, delusional thinking, addictive behaviors, thinking errors, and defense mechanisms, you can’t just go back to using “drugs as usual.” I’ve gotten into your head. You may find yourself rolling your next blunt saying, “I’m not powerless over this stuff, I can quit whenever I want to.” You may say, “I wonder if this is the phenomena of craving” after you’ve had two or three and are planning to use of the rest of the night. You may hear my voice in you heard saying, “If you always do what you always did, you’ll always get what you always got.” Things just won’t be the same between you and your substance of choice. A patient once remarked to me, “Your trying to brainwash me!” “Yes!!” I responded. “Your mind is dirty and it needs to be clean.” then I stated, “You tell me who is brainwashed. The man who says Get God and get clean, or the man who continues to ingest a substance that he knows is self-destructive.” Most of us addicts are already brain-washed. We need to be cleaned up.

Finally, this volume is just the beginning of getting clean. It has been an attempt to educate and demonstrate what we addicts are like. If you identified with me and have exercised the spiritual truths outlined thus far, this is only the beginning. There is still more work to be done but you can rest assured that you have begun well. If this is you, I’m very grateful.

Thank you for reading this book. It has been my prayer that you’ve come to understand us addicts a little deeper than before. If so, praise God! If not, the reader is refereed to several other programs mentioned in the endnotes of the chapters of the book. They are wonderful programs and have wonderful stuff in them. It is also my hope that you have developed a deeper relationship with a higher power and that it has brought you into a place to experience the ultimate power in the universe. As the AA big book says, “That one is God, may you find Him now.” (1)

Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World Services, New York, NY, third edition, page 59

Chapter 4

Abuse versus Dependence: What does the Doctor Say?

It is important for people who are not sure if they have an issue with substances to understand how the medical/psychiatric/psychological community sees the issue. None of these folks will necessarily use the term “addict”, they don’t like it because it is to vague. They are correct, it is just to obscure. We use it in this book for reasons mentioned in the introduction. Be that as it may, the psychiatric community has developed its own terminology. The two terms they will use are substance abuse vs. substance dependence.

This section is taken entirely from the Diagnostics and Statistical Manual of the American Psychiatric Associations, 4th edition, which is affectionately known as the DSM-IV. It is the book that Doctors, social workers, and mental health professionals will use to make a “diagnosis” of a condition. Therefore, what it says about substances is very relevant to our discussion. It is important for us to see what the Doctors sees and what He/She will say. What they “say” will be the determining factor for which treatment modality is required. Thus, in order for us to see what the doctors sees we must look at certain factors through their glasses. Before we put on their glasses, let us first set the stage.

No one who begins using substances initially is an abuser or someone who becomes dependent. In the beginning, the behavior or the substances is not really an issue. But, for whatever reason, we continue to use substances until we cross the line from social use and into abuse. If use is continued, we will cross another line from abuse into dependence. In the beginning, it starts as a social function until it becomes pathological and moves into the abuse phase. That is when substances begin to become an issue.

The DSM states, “Symptoms of substance abuse include one or more of the following occurring during a given 12 month period.” (1) Meaning, that just one of these characteristics in your live in the last year, and the Doctor can give the diagnosis of abuse. Here are the four:

1. “Substance use resulting in a recurrent failure to fulfill work, social, or home obligations.” We all have roles in the culture within which we live. I have a role as a nurse, a teacher, a husband, and a father. What this is saying is, if my use of substances has resulted in a failure in one of these roles, then there is an issue. The DSM gives the example of “work absences, school suspensions, neglect of children.” Basically, the substance in interfering with my success in my roles in life.

2. “Substances use in physically hazardous situations:” Pretty self-explanatory. Using meth wild driving a truck, using cocaine while driving a school bus, and drinking and driving. There are many common examples that could be offered here.

3. “Substance use resulting in legal problems.” An arrest on any substance related issues will always result in some mandatory form of treatment. DUI, PI, Possession, and Paraphernalia, are common charges.

4. “Continued substance use despite negative social and relationship consequences of use.” When the people that you party with begin to tell you that you need to cut back and you don’t, then they will label you. For example, pot-head, meth-head, pill-head, and crack-head or just plain old “Drunk!” are just a few examples. ?Social circles do this when they see someone who lacks the ability to “cut-back.” Generally, this is the point where the addictive user finds a more drug friendly peer group to hang out with and leaves those “light-weights” behind.

There are the four criteria for the Doctor to diagnosis someone with a “substance abuse” issue. This is very relevant to the individual who thinks they don’t have a problem. If just one of these four has occurred in the last year, the doctor sees an issue. So, who is right? We can’t both be right? Either the user is right and it is a non-issue, or the Doctor is right and there is something there. Personally, I don’t always agree with doctors. However, in this case, to disagree with the doctor would only be an example of the delusional thinking that we discussed in chapter two. Simply because one is an abuser of substances doesn’t make them dependent upon it, there must be more for that to happen. What does the Doctor say about Dependence? Lets take a look. Again, the DSM-IV.

The DSM-IV identifies seven criteria (symptoms) , at least three of which must be met during a given 12-month period.” In this case, just three of the seven in the last year would warrant a diagnosis of substance dependence. Here are the seven:

1. “Tolerance: as defined either by the need for increasing amounts of the substance to obtain the desired effects or by experiencing less effect with the extended use of the same amount of the substance.” Basically, it takes more “junk” to get your head right or the same amount of “junk” you’ve been using doesn’t get your head right anymore.

2. “Withdrawal, as exhibited either by experiencing unpleasant mental, physiological, and emotional changes when taking the drug ceases or by using a substance as a way to relieve or prevent withdrawal from substances.” The latter part of the statement is easy to understand. If someone needs the substance everyday to prevent the physical, mental, emotional sickness that they feel without the substance, then that qualifies. The former part states that primary definition that people think of when someone says drug withdrawal. They think of the guy with the shakes, seeing strange stuff that nobody else sees, itching, and “freaking out” because they don’t have the stuff. Nausea and diarrhea are common withdrawal from opiates. However, there is a very common form of withdrawal that is very seldom diagnoses. It is called, Post Acute Withdrawal Syndrome or PAWS. It is defined as, Post-acute-withdrawal syndrome (PAWS) (also sometimes referred to as post-withdrawal syndrome or protracted withdrawal syndrome) is a set of persistent impairments that occur after withdrawal from alcohol, opiates, benzodiazepines and other substances. Post acute withdrawal syndrome affects many aspects of recovery and everyday life, including the ability to keep a job and interact with family and friends. Symptoms occur in over 90% of people withdrawing from a long-term opioid (such as heroin habit), three-quarters of persons recovering from long-term use of alcohol, methamphetamine, or benzodiazepines and to a lesser degree other psychotropic drugs. Symptoms include mood swings resembling an affective disorder, anhedonia (the inability to feel pleasure from anything beyond use of the drug) insomnia, extreme drug craving and obsession, anxiety and panic attacks, depression, suicidal ideation and suicide and general cognitive impairment.” (2) So, if after about a two week abstinence period, one begins to experience the above mentioned symptoms, it means they could be experiencing this withdrawal syndrome. One of the most common features that I have seen in working with adolescence is insomnia. Folks just don’t sleep good even when they are clean. If this is you, then you qualify here for withdrawal.

3. “Longer duration of substance us or using in greater amounts than was intended.” We addressed this in the section on physical powerlessness and identified it as the phenomena of craving. The identifying factor here is the inability to stop after one starts.

4. “Persistent desire or repeated unsuccessful efforts to stop substance use.” An overall admission by the client of absolute powerlessness. The individual is incapable of stopping as evidenced by their desire to desist juxtaposed with their repeated unsuccessful efforts toward abstinence.

5. “A relatively large amount of time spent in securing and using the substance, or in reordering from the effects of it.” Much of this is a culmination of the sections on emotional, mental, and physical powerlessness. To paint a picture of what those looks like, it looks like someone who can’t get up in the morning because of all their partying the night before. Finally, when they do get out of bed, they spend their time developing resources to get more the substance or spend the rest of the day recovering from the effects of it. Then, they execute the plans that have been made and repeat the same night partying as the previous night. The cycle then repeats itself over and over until something stops the individual, usually law-enforcement officials. It is an ugly painting in real life.

6. “Important work or social activities reduced because of substance use.” The addict is never able to commit to anything requiring a great deal of time outside of using drugs. Simply, because it cuts into my using time.

7. “Continued substance use despite negative physical and psychological effects of use.” I wish their were not so many stores available about how this lifestyle will eventually cause some negative effects in our lives and, if we continue to use, we will die. I once knew a woman who needed a liver transplant because of her alcoholism. She was clean for eight years, in and out of hospitals, until finally, she was the next on the donor list. Two weeks before receiving her new liver, when relapsed which disqualified her for the transplant. She passed away shortly thereafter. Tragically, I could go on and one with very similar stories of how continuing to use despite negative effects has destroyed peoples lives. Don’t let it get yours.

If you qualify as substance dependent, as the doctor sees it, you will have three of these seven criteria in the last year of your using career. Please consider what is going to happen if you continue to use. At a very minimum, we could disagree with the doctor. At a minimum, three of these present in you life in the last year, makes a statement about how much you love the substance. If those who have died in functional substance abuse or substance dependence could tell us one thing from the grave, it would not be “Keep on partying.” It would be, “Listen to the Doctor!” Get help now before things get worse, because, they will.

Endnotes

1. DSM-IV

2. http://en.wikipedia.org/wiki/Post-acute-withdrawal_syndrome.

Chapter 3

A Decision about DecisionsThe Battle of the Wills

Once someone has had an experience with a power greater than themselves, the next step is a logical one. That being, to recruit the assistance of this power in order to change ones lifestyle. This should make perfect sense to us addicts because this is exactly what we did with drugs and alcohol. We had an intense experience with them and then we incorporated them into our lives. This is the essence of the third step, “Made a decision to turn our will and our lives over to the care of God, as we understood Him.” (1) Alright, three frogs are sitting on a log and one of them makes a decision, how many are left? That’s right!! Three. A decision doesn’t necessarily mean that any action is taken. Noah Webster defines decision as, “Determination, as of a question or doubt; final judgment or opinion, in a case that has been under deliberation,” (2) Basically, we have considered the evidence and decided to allow these higher powers, that we have experienced, to have control of our lives the way that drugs have had control. A decision is a statement of determination to never go back to the insanity of the addictive lifestyle. (The seven challenges program sets this principal forward in challenge 5. It states, “We thought about where we seemed to be headed, where we wanted to go, and what we wanted to accomplish.”) (3) We set our priorities and use the new power to achieve a new destiny. Mainly, to not do what we have always done; thus, restoring us to sanity.

We do need to define some terms in this step. Will, to begin with. We will define “will” as our ability to choose. Every human being is born with a free will. It is a gift of God. It is the only way that love can exist. Love requires a choice. Love can’t exist unless it has the ability to walk away. When it chooses to stay, it acts of its own free will and chooses. Thus, displaying devotion. God is Love (I John 4:16) and God desired to create humans to have relationships with Him, but we, must have the ability to walk away. This is the whole reason why that tree was in the Garden of Eden. Humans must have the ability to walk away from God in order for love to exist. Adam and Eve had the ability to obey God or seek self-fulfillment (which is an addictive behavior). One is an expression of love for God and another is an expression of the love of self. Both choices have spiritual consequences. (see the chapter on selfishness) That brings us to another point.

One of the number one questions I’ve been asked over the years of working with addicts is this, “If God is a God of love, why did He allow evil to be perpetrated in my life.” This is a great question and if it goes unanswered, it generates agnosticism. So, let’s answer it. First, as already stated, God has given humans and spiritual angelic beings a free will because it is the only way for love to exist. Secondly, if we have the capacity to choose good, we also have the capacity to choose evil. God doesn’t override our free will. He allows us to make our choices, then He deals with the fall out. Humans and Evil Satanic/Demonic Spirits choose evil and commit evil acts. Let us lay the blame for evil where it belongs, at the feet of the perpetrators, mainly, humans and the demonic hordes of hell led by Satan. Let us not make the mistake and lay the blame for evil with God. He has given us a greater responsibility to choose good. He will not take this away. If He did, love couldn’t exist. Sadly, humans, under the influence of evil spirits, choose evil more often than good and this is why evil has been perpetrated in our lives. Evil is not in the will of God, it lies in the will of humans and demons. Now that I got that off my chest, let’s go back to step 3.

We also need to define “life.” Our life is basically the summation of our decisions. Robert Schwebel follows this logic with challenge six which states, “We made thoughtful decisions about our lives and about our use of alcohol and other drugs.” (4) This is the logical conclusion after one has dealt with the issues of challenge 5. Basically, we are committing ourselves to allow our identified higher powers complete influence over our lives. We are attempting to use our free will to move our free will out of the way in order that grace (the ability for God to do for me what I can’t do for myself) to work through us. There will be times when we will not want the influence of those powers. We will be bent on selfishness. It is at this juncture, that self must be crucified. This is the battle of the wills. Our will versus our Higher Powers will. We must “surrender to win.” Meaning, we must give up our will in order to win. If we exercise our free will in a direction of selfishness, we slip back into insanity. Futiley seeking self fulfillment. We must allow our Higher Powers will to become ours. We must use our free will to surrender our desires/will in order to accept His will for our lives. We unconditionally accept that His plans for our life are without any evil intentions and we trust a God in which love is His very character and nature. Even when I don’t want too, or when I can’t see the logic in it, I let His will have the greatest sway in all my decisions. This is the essence of step three.

Lastly, we need to clear up, “God, as we understand Him.” All of us have different concepts of God. What addicts need to do is figure out the concepts that work for us. This doesn’t mean that we define God. Quite the contrary, He defines us. The point we are making here is that God is big enough for all of our different understandings. In Exodus chapter 3, God tells Moses, “His Name.” It is loosely translated, “I am who I am” meaning I am the existing One. The natural implication is that God is indefinable. Logically, as humans we don’t really define God, if we could define Him, we would be God and not Him. God, by definition, must have a certain amount of mystery associated with Him. But, He tells us, “I am” and leaves it somewhat open. The suggestion here is that, God will be whomever His children need Him to be. How you understand Him to be is your understanding of Him. This is your God concept. He is big enough to handle it.  He’s big enough for us all.

Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World Services, New York, NY, third edition, page 68

2. Webster, Noah, American Dictionary of the English Language 1828 version, Foundation for American Christian Education, Chesapeake, VA, 1995.

3. Schwebel, Robert, The Seven Challenges, Viva Press, Tucson, AZ, 2004.

4. Ibid.

Concluding Remarks of Chapter One

What we have really been discussing in this first chapter is the mechanisms behind our powerlessness to our addictive substances and behaviors. Having read this, it is my hope that the reader can begin to understand that, if they possess an emotional dependency, a mental obsession, and a phenomena of craving, then they truly are powerless over this substance/behavior. They just can’t help it. And if we are powerless, then our lives are, subsequently, out of control and unmanageable. This is the first step of the twelve step program. “We admitted we were powerless over addictions, and our lives had become unmanageable.” This is the premise behind the step. That our entire being, soul-mental, body-physical, and spirit-emotional, is completely powerless to this substance. It has complete control of our lives and is the very thing that is the most destructive force present in our lives. Only, we see it as the ultimate source of fulfillment. Because of this powerlessness, we are living a lie. The lie, that using is fulfilling our lives, and to not use would not be “living.” In fact, it is the opposite that is the truth. This dissection of powerlessness should bring one to the realization of the control that substances/behaviors have over their lives. This is the point of the first chapter. To begin to open our minds to the lie that we have bought into and to free us from the evil power that promises life but can only deliver death.

One might argue regarding powerlessness saying, “Well they just have to choose not to do it, it is a matter of will power.” This is simply not the case for addicts. With this statement, neuroscience agrees. “The effects of drugs on projections to the frontal lobes are what eventually lead to the impaired control over drug use, through a reduction of cortical decision making functions. Thus, such characteristics as ‘lack of will-power’ and ‘personal weakness’ do not play a significant role in the development of drug dependence.” (1) The brain of an addict is hardwired to eliminate the free-will. Only the absence of the substance returns the power of choice. However, many believe to not use is to live a life that is unfulfilled and boring. Addicts will not accept this proposition. Indeed, many of us who struggle with addiction have used the same “choice” argument saying, “I can quit whenever I want to but I just have chosen not to quit.” Generally this statement is made when the user is in some kind of trouble for their use and they are trying to get the attention of their use of substances. This statement is also usually followed by a “until now” proclamation by the addict. Not so, the fact that we have to defend our use declares us guilty before the world. People who don’t suffer from addiction don’t have to explain their use to the rest of the world. Only us delusional thinkers have to do this. In fact, this will be the subject of our next section, the delusionality of our own thinking.

Endnotes

1. Erickson, Carlton, “The Science of Addiction”, W.W. Norton and Company, New York and London, 2007, page 53

The Physical Dependence Chapter One continued

This is the section that will need some updating.  Much more research is available now, particularly with the mesolimbic dopamine system.  At some point, I will try to write an update for those who are interested.  This MDS will clarify why one can be addicted to anything.

In the section entitled, “The Doctors Opinion” of the Alcoholics Anonymous book, it reads, “that the body of the alcoholic is quite as abnormal as his mind. It did not satisfy us to be told that we could not control our drinking just because we were maladjusted to life, that we were in full flight from reality, or were outright mental defectives. These things were true to some extent, in fact, to a considerable extent with some of us. But we are sure that our bodies were sickened as well. In our belief, any picture of the alcoholic which leaves out this physical factor is incomplete.” (1) From the beginning, we seem to know that there was more to our powerlessness over our substances than just what we have discussed in the previous chapter. The older AA guys described this “something physical” as an allergy. They believed that alcoholics had some type of allergy that caused them to continue drinking despite all that was falling apart around them. I used to tell people that I was allergic to drugs and alcohol. When I drink it, I break out in felonies! Setting the humor of that remark aside, those of us who have struggled with moderate use have come to the conclusion that moderation is not in our make-up. When we use, we use to “get the job done.” To use to a point of extreme intoxication. The very idea of moderate use makes no sense to us. What is the point? If we are going to use, then let’s do it! If not, then we are just wasting good substances. Not only do we live by this motto, but it becomes the pattern of our use. Namely, that when I start, I can’t stop. In fact, the very idea of stopping is absolute lunacy to me. Once I take that first drink, I will continue to use until I’m completely wasted. What we are trying to say, in this section, is that this mindset with its subsequent action, has a physical, if not genetic root. That’s right, it has to do with the way that our bodies process drugs as opposed to the way that non-addicts process those same substances. It came as a welcome relief to me to find out this had to do with my genetic makeup and not my own lack of will power or weakness. It was physiological. Again, the Doctors Opinion, “We believe, and so suggested a few years ago, that the action of alcohol on these chronic alcoholics is a manifestation of an allergy; that the phenomenon of craving is limited to this class and never occurs in the average temperate drinker. These allergic types can never safely use alcohol in any form at all; and once having formed the habit and found they cannot break it, once having lost their self-confidence, their reliance upon things human, their problems pile up on them and become astonishingly difficult to solve.” (2) It would be a mistake to only limit the discussion to alcohol, all of the intoxicating substances seem to have a very similar biochemical response in the bodies of those prone to these issues. Let’s review some of the science on the matter.

From his book, “The Science of Addiction”, Carlton Erickson writes, “New research has found that genes for two neurotransmitter receptors are probably involved in the causes of alcohols dependence. These two receptors, GABA-A, and a form of the gene that codes for the serotonin transporter (SERT, also known as 5-HTT), may produce abnormalities in the mesolimbic dopamine system that cause people to be unable to stop drinking. Other neurotransmitter receptors have also been implicated.” (3) Everybody got that! Clear as mud! I‘ll offer a humble explanation. What this means is that alcohol, and probably other substances as well, trigger two brain receptors to release GABA-A and SERT 5. These are little do-dads (parts of cells called receptors) in the brain that trigger the brain to release more of the “I feel like the greatest person alive” chemical called Dopamine. Dopamine is what triggers that wonderful and great feeling, we like to call “a buzz.” It is what I was experiencing with “Cool Don” at the arcade. This release of Dopamine is so wonderful that we begin to crave more of it. Well, how did we get this release of dopamine in the first place? By using! Hence, in order to get more of the feeling, we continue to use and the idea of stopping, is goofy to say the least. This is what we call the phenomena of craving. It never happens when drugs are outside of your body. It happens as soon as we put that substance into our bodies. That is when the craving begins and drinking/using in moderation is not within our scope of practice. This is a biochemical response triggered by our genetic make-up. In other words, you can’t help it, you are powerless to the way your body process substances.

Here is a little more on Dopamine, “We believe that some people who are born with lower D2 (dopamine receptor) levels are more vulnerable to alcohol or drug abuse,” A team led by Dr. Panayotis K. Thanos of Brookhaven National Laboratory (news – web sites) in Upton, New York, reports the findings in the current issue of the Journal of Neurochemistry. Dopamine is part of the brain’s “reward system,” playing what is thought to be a key role in mood and motivation. Previous research has suggested that people who are vulnerable to addiction may have fewer-than-normal brain receptors for dopamine. The theory is that this pushes them to make up the difference by using substances–including alcohol and other drugs–that elevate dopamine levels in the body. In the new study, researchers used gene therapy in rats to show that the level of dopamine receptors in the brain determined the animals’ motivation for getting alcohol. The rats drank far less alcohol after scientists increased their dopamine receptor levels by injecting the gene for the dopamine D2 receptor into the animals’ brains. This gene delivery allowed the rats’ brain cells to churn out more D2 receptors in the nucleus acumens, a brain structure known to be involved in feelings of pleasure.” (4) The supposition put forth here is that addicts are born with “less than normal” amounts of the “thing” that releases Dopamine in our brains. Because our levels of Dopamine are too low, when we use substances, the level of Dopamine increases which makes us “feel better.” Even good old weed, which is only an herb and doesn’t hurt you. Yeah right! (see chapter six for details) has a similar response.

Again, Dr. Erickson, “These people (referring to folks who chronically stay in trouble regarding the amount of weed they smoke) have a dysregualtion of endocannabinoids or cannabis receptors in their mesolimbic 1 A system (Maldonado, Valverde and Berrenderro, 2006) (5, parenthetical note mine for clarification) Everybody got that! Of course, your average everyday pothead would understand this with absolute clarity and certainty. Just Joking. What is being said is that even weed triggers a very similar response, it makes those who smoke it crave more of it after they have experienced the effects on their brains.

We could go on and on quoting scientific journals, studies, and articles which reiterate the same thing. First, that this is a genetic response. It can’t be helped. It is the bodies biochemical, neurological, neurophysiologic reaction to the ingestion of substances upon the genes that we have inherited. Every time the substance is placed in the body, the body will respond the same way. The person with this genetic make-up will have this response and automatically be incapable of moderate use. They will use like it is their jobs, on a professional level. The individual with this genetic makes has an extremely low probability of being able to use drugs successfully. They simply can’t use in moderation. Hence, the idea of successful use must be smashed and the idea of moderation be equally destroyed. These ideas don’t match our genetic make-up.

Mainly, these genes are passed down from the father’s side of the family. I can’t quote a particular study to validate it, but it seems to be my experience, both personal and professional. One of the reasons that we have bad relationships with our fathers is because of their addictive lifestyles. Hence, the genes that drove them are the same genes that drive us. This is powerless. It is in your genes. My mother’s side of the family is pretty normal. My father’s side of the family is replete with alcoholism. I get it from that side of my family. My allergy to the substances comes through that paternal genetic link.

The old Chinese saying goes, “First a man takes a drink, then the drink takes the man.” In essence, this is what we are saying in this section. We are validating our powerlessness from a physical standpoint because we can’t change our genes. We will always consume to the point of acute intoxication every time we use because our bodies drive us to do so. This is the allergy and this is the phenomena of craving. If you have it, your ability to use successfully is virtually non-existent.

We are not fools. We are acutely aware that many who are reading this will, in fact, use drugs again. This is not a requirement but a reality. So, here is our advice to those who are going to take the plunge again and try to use successfully. The next time you use, try to use in a controlled manner. Try to take two pills and quit. Try to stop abruptly and not touch it again. Try to just take two hits, two lines, two of whatever your substance of choice is, and see if you have this capability. Try it more than once and try it when you don’t expect to do it. This will test if you have this phenomenon. Again, we never encourage relapse. We acknowledge it as a sad fact with addicts. Hence, we try to make the most out of this situation. With this advice, the AA big book agrees. It states, “We do not like to pronounce any individual as alcoholic, but you can quickly diagnose yourself. Step over to the nearest barroom and try some controlled drinking. Try to drink and stop abruptly. Try it more than once. It will not take long for you to decide, if you are honest with yourself about it. It may be worth a bad case of jitters if you get a full knowledge of your condition.” (6)
Endnotes

1. Alcoholics Anonymous, Alcoholics Anonymous, Alcoholics Anonymous World services, Inc. New York, New York, third edition, page xxiv.

2. Ibid, page xxvi

3. Erickson, Carlton, “The Science of Addiction”, W.W. Norton and Company, New York and London, 2007, page 221.

4. As quoted from: author unknown; http://www.discussanything.com/forums/archive/index.php/t-1882.html

5. Ibid, Erickson, page 140.

6. Ibid, AA, page 31-32.

Chapter One continuted Mental Obsession/Powerlessness

The mind of addicts never strays very far from one of three places. First, we are either using. People with addictions are engaged in their addictive behaviors. Hence, we are using our substances of choice. Our minds are under the influence of the substance we are using. Secondly, the mind of the addicts is planning to use. This generally occurs with the addict is unable to engage in the use of the substance. Thus, we plan to use again. This is such a wonderful point to bring up to folks in treatment centers. Particularly if the individual doesn’t think they have an addictive problem. If we can get the person to be honest, they will often admit that they have planned their next use. If so, they are thinking exactly like an addict.
The very substance that has caused us to be locked up is the very substance that we are planning to use again. Planning to use is a strong indicator of the hold that a substance or an activity has on individual’s life. Particularly if one is planning to use from inside a rehab center or outpatient program. Even if not in treatment, these plans can be in effect anytime the user is not able to use the substance at any particular time. If one finds their mind drifting to when “can I use the substance again” they are thinking exactly as addicts. These plans can range from very simple plans such as, “Can’t wait to get of work to go drink at happy hour” to very complex schemes such as, “ I will steal my mother’s computer, pawn it, go to the dope mans house, get some oxcies, then tell mom a lie about my whereabouts and stay up all night partying.” Humans tend to dwell, in their thought-life, about the things that they love. Planning to use is an indication of the “love affair” that addicts have with their substance of choice.

Planning to use can also include plans to not get caught. This is a good place to reiterate a previously listed concept, that being, the goal of all addicts is to use drugs/substances successfully. Hence, plans to use generally include plans to not get caught. Generally, we know one thing about everyone who ends up in some kind of treatment program. Namely, they can’t use successfully or they wouldn’t be in the treat program. We will develop this theme more fully in a later section, but suffice it to say, that no one plans to get caught. But, some of us do, in fact, most of us do. This proves that the very best plans, strategies, wiles, and efforts on our part to not get caught using drugs have failed us. We have proven our own inability to fully develop a long term plan for successful use of the substances. Again, this should tell us something about our ability to use substances.

Thirdly, my personal favorite place the mind of an addict wanders, Planning to use while using! Generally, this takes place when the individual has some of the substance on hand, but not really enough for tomorrow, so “let’s smoke this on the way to the dealers house.” I live in Kentucky, and it is illegal to sell alcohol on Sunday, but, in Tennessee, it is legal to sell on Sundays. Hence, every Sunday afternoon, folks take their last six pack and take a “road trip” down to Portland, TN, in order to buy some more goods. If you find yourself laughing and identifying with these statements, your thinking just like someone who has an addiction. Planning to use while using, doesn’t get much clearer than that! At a minimum it makes a statement for the love we have for the substance, at a maximum, it relates us to the mind of thousands of addicts before us.

Theses thought patterns develop almost as the natural response to the encounter of something spectacular in one’s life. As previously stated, most of us never knew how bad we felt until we knew that we could feel so good. After this encounter, it seems to develop, on subconscious level. It is rooted in a tremendous love for the thing that has brought us to a state for fulfillment.

“Some people have even related chemical dependence to obsessive compulsive disorder (OCD)…Obsession means ‘thinking about it all the time’ and compulsion is ‘doing it all the time.‘”(1) Noah Webster defines obsession as, “the act of besieging.” (2) To besiege something is to block out all other forces that might assist the enemy until they are in such a weakened state that conquering them is relatively simple. This is exactly what happens in the mind of the addict once that fulfillment from the substance is experienced. The three patterns of using, planning to use, and planning to use while using, seal of our mind from any other power that is apposed to them until conquering the individual is easy. Once one realizes that they are engaged in these three patterns of thinking, it is to late. The siege is on, and they are generally already conquered but don’t yet realize it. Once the thought patterns are established, its got you. The only thing that can bring relief against the besieging force is another power that is greater than it and greater than you. The greater force drives off the besieging force which brings relief. If the invasion of the greater force is coupled with an experience that is similar to that of the substance; then, thought patterns about the new power will automatically begin to develop. The same mental mechanism that established the besieging force can now, establish the greater force to remain in our lives and in our thought process. This will ultimately bring about a lifestyle change.

The establishment of these thought patterns render the thinker powerless over the addiction. Simply because, it is all they are going to think about. Just as Willie Nelson sang, “You were always on my mind.”
Endnotes

1. . Erickson, Carlton, “The Science of Addiction”, W.W. Norton and Company, New York and London, 2007, page 56.

2. Webster, Noah, American Dictionary of the English Language 1828 version, Foundation for American Christian Education, Chesapeake, VA, 1995.