What You Can Do to Help Fight Addiction

“Love, evidence & respect.”
Maia Szalavitz’s answer via Twitter to the question, “What fights addiction?”

When I talk with people about the state of addictions treatment in the Blacksburg, Virginia area, I am increasingly asked, “What can I do to help?”

Here are my suggestions:

1) If addiction is a problem right this moment, take yourself or your loved one to a doctor.

Addiction is a health condition that needs health care. In the Blacksburg, Virginia area, most medical care for addiction is offered by primary care physicians and emergency room personnel. These health care professionals can provide individualized initial care, make recommendations for follow-up care based on that person’s individual needs, and make appointments and connections for follow-up care. (Starting with a psychiatrist might be optimal but wait lists for psychiatric care in our rural area are 6 months or more.)

If challenging experiences with substance use and health care professionals have happened in the past, take someone with you/go with someone who needs help. We’re all still learning.

We can do this

2) Inform yourself.

Addiction is complex and the consequences of insufficient or incorrect information may be dire. Take matters into your own hands and learn as much as you can about addiction and its treatment. To help with getting started, I have compiled a simple list of evidence-based treatment options, reworded much of that page’s content as a personal recovery checklist, and compiled a list of local recovery resources. I also personally and professionally recommend Maia Szalavitz’s work on the science of addiction.

But don’t take my word for it. Start Googling, start asking those who are knowledgeable about addiction, use your powers of discernment, and join the growing numbers of people seeing the difference between evidence-based treatment and belief-based practices.

3) Understand the difference between treatment and  support.

Treatment is direct, personal, expert care for an individual’s unique presentation of symptoms. Support is help from volunteer survivors in adjusting to having those symptoms. To use Maia Szalavitz’s metaphor, going to a cancer support group is not equivalent to going to an oncologist. To use a business metaphor, attending a business networking event is not a “treatment” for a cash flow problem; selling something to a customer is.

Attending support groups can be hugely helpful in providing comfort, reassurance, and practical suggestions for handling having a condition. Attending support groups may be a component of an individual’s comprehensive treatment plan. Some people may find support group attendance all they need to attain their recovery goals. But attending support groups is not availing oneself of treatment.

“Families and loved ones can improve the odds for people with addiction by helping motivate them to get treatment; seeking evidence-based care; keeping naloxone on hand; and treating addicted people with the empathy, support and respect they’d offer if they faced any other life-threatening medical problem.”
Maia Szalavitz

4) Familiarize yourself with 12-step recovery.

Addictions treatment is currently dominated by 12-step recovery, although a recent article from the American Medical Association Journal of Ethics states, “TS [12-step] programs of recovery are a respectable modality to recommend to those seeking help with addiction; however, the effect is not sizeable enough for clinicians to insist on TS for everyone seeking treatment for addiction.” In addition, treatment programs and drug courts receiving federal funding that include 12-step components in their programs or require 12-step meeting attendance of their clients may be violating First Amendment rights. Nonetheless, 12-step recovery will be a direct or indirect component of local addictions treatment.

To begin to orient yourself to 12-step recovery support groups, ask someone you know who attends meetings if you can attend with him or her. If you don’t know someone, go by yourself or with a small group to an open 12-step recovery meeting. Respect those seeking help for this serious condition, observe silence, and, as a humanitarian, citizen and consumer, listen and observe.

If you or or a loved one is considering 12-step meeting attendance, perhaps you can find a way to make 12-step meetings work for you. If the content isn’t a fit, see if you can think about attending meetings for social support. In 1996, Blacksburg was designated “Most Wired Town in America.” My dream for our next accolade? “Most Recovered Town in America.” For now, however, options for addictions recovery support are limited. A SMART Recovery meeting is held in Blacksburg and on the Virginia Tech campus when classes are in session.

Addiction is a bully, very difficult to fight alone. Addictions treatment can feel that way when it mandates 12-step practices. Like the sun and the moon, for now, 12-step recovery will exist in addictions treatment. Try to find ways, personally helpful to you, to work with its existence.

5) Become aware of your feelings, thoughts, beliefs and words about people with addictions.

One of the most heartbreaking features of addiction is that it often manifests in inexplicable words and actions that hurt others. So many people have been emotionally, physically and financially harmed, abused, neglected, or injured by an addicted parent, partner, sibling, family member, community member or complete stranger. It’s understandable to feel hurt and baffled, even to want to hurt back.

To begin trying to see addiction as a health condition rather than a personal problem, try starting small. Maybe try saying “person with addiction” rather than “addict.” Try saying “person with alcoholism” rather than “alcoholic.” Even this small change in thinking about addiction can help others who have it.

6) Hold sober events.

Designate some events in your home, work place, community, and organizations as substance-free. Hold a sober holiday meal, a 5:00 PM alcohol-free business networking event, a gourmet street festival without brews or corks. (It’s just not Thanksgiving without wine, you say? Believe me, I hear you.) Help the 1 in 10 Americans and the 16,000+ in our area with substance use challenges to have something pleasant to do that doesn’t include environmental cues, the “people, places and things” notorious for triggering a return to active use.

7) Support doctors being doctors.

Did you know that in order for physicians to offer the top treatment for opioid use disorder – to prescribe medication for what’s considered a national health crisis – physicians must receive special training and approval and, once they receive it, are limited to treating 30 patients in the first year and must apply to treat a cap of 100 patients in the second and subsequent years? Did you know that wait lists to receive medication-assisted treatment for what’s been termed an epidemic – the supply of which is plentiful and often covered by health insurance – can be months long? It’s madness. More madness is ahead: that 100-patient limit is going to be extended to, wow, 200. Inform yourself, then talk to every influential person you know and ask them to help us get readily available medical care to people who need it.

8) Help watch over people who have what I have.

Having a condition that causes personal suffering, causes suffering for those I love, may cause me to do something that harms my fellow citizens – for me, driving while drinking or burdening the health care system with trips to the ER after falls – that has no cure, for which effective treatments are essentially unknown, of which so few of those uncertain treatments are available in my town, that makes me one of those people, has put me into a place of misery beyond words.

Help. Please help.

Thanks to Rosemary Sullivan, Kelly Shushok, Harry Sontheimer, Lara Hayward, my father, Robert Giles, and thousands of others for the conversations that helped me write this post.

Image credit: iStock

What else would help? Feel free to comment or to contact me and let me know.

If you are a resident of the Blacksburg, Virginia area and you or someone else is experiencing a substance use and/or mental health emergency, call 911 and/or ACCESS, 540-961-8400.

The opinions expressed here are mine and do not necessarily reflect the positions of my associates, clients, employers, friends or relatives.

The content of this post is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.

Last updated 7/22/16

Reading Maia Szalavitz

I estimate it took me between 15 and 20 hours over 10 days to read Maia Szalavitz’s new book, Unbroken BrainI read every word of its 288 pages, 33 pages of notes, and 14 pages of  index subjects.

A few pages in, as I wrote for The Fix, “When I read these words in Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction: ‘I felt utterly stripped of safety and love. And so, what tormented me most as I shook through August of 1988 wasn’t the nausea and chills but the recurring fear that I’d never have lasting comfort or joy again,’ I stopped reading, put my face in my hands, and cried. I wasn’t alone anymore.”

Reading Unbroken Brain by Maia Szalavitz

A few more pages in, I posted on my personal Facebook page, “I am experiencing cognitive dissonance,” and linked to the term’s definition on Wikipedia: “In psychology, cognitive dissonance is the mental stress or discomfort experienced by an individual who holds two or more contradictory beliefs, ideas, or values at the same time, performs an action that is contradictory to one or more beliefs, ideas, or values, or is confronted by new information that conflicts with existing beliefs, ideas, or values.”

Unbroken Brain came out on April 5, 2016. I wish I could remember the exact search phrase I used to discover the book on Amazon, but on April 13, I typed in something like “how to save myself from addiction with long-term sobriety.” Once I read the book’s description, “[O]ur understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as a brain disease, and in equally outdated treatment,” I downloaded the book for my Kindle and began reading immediately. Finding myself desperate to underline passages desperately important to me, I ordered a hardback copy which arrived April 26.

A careful reading of Unbroken Brain

Why have I included dates? I have probed and probed for more erudite phrasing, some way to step back from this personal, personalized statement. About reading a book. One book. In 10 days. But I truly can compose no lesser or greater sentence: I have a pre-Maia and post-Maia life.

I tried very, very hard to have “good sobriety” once I became abstinent from alcohol. I tried to feel “happy, joyous, and free.” I did everything I could to help myself. But those first 3 1/3 years of abstinence were spent primarily in pain.

At essence, I hated myself for what I had done to myself by becoming addicted to alcohol. I hated myself for bringing upon myself the contempt of others. I hated myself for my inability to feel better. Wasn’t I treating myself for alcoholism by attending support groups? What was I doing wrong to keep that from working?

I felt contempt from some members of support groups for my intractable longing to drink and intractable unhappiness. Not feeling better was my fault. I was doing things right enough, but I wasn’t being right. I was selfish and prideful and egotistical because I would not subsume my identity beneath the identity of a power greater than myself.

Brené Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done, or failed to do makes us unworthy of connection.”

“Shame and stigma are the exact opposite of what fights addiction.”
– Maia Szalavitz, letter to the New York Times, 2/3/16

How in the world did I end up so excruciatingly scorned by myself, by people close to me, by society as a whole?!

Friends and people who know of my anguish and have started reading Maia Szalavitz’s Unbroken Brain universally start their next conversations with me, “Oh, Anne. Now I understand.”

Yes. I understand now, too.

“For those moving from experience-based and belief-based addictions treatment to evidence-based treatment, i.e., for those familiar with the research on addiction, Szalavitz’s book [Unbroken Brain] is not controversial, but masterful…In her weaving of personal narrative, scholarly knowledge of the evidence, logic that feels like she has intimate knowledge of how the reader thinks best, skillful, artful writing, and sheer, awe-inspiring intellect, Szalavitz jettisons the foolish and unfounded and, from the remaining discord of what the science says, creates a treatise on addiction as concise, exquisite and moving as poetry.”
– excerpt from my piece on Unbroken Brain for The Fix

In my “post-Maia life,” as my cognitive dissonance helps me confront and make new sense of a 10-year struggle with addiction, what I understand is how deeply, profoundly and harmfully I have misunderstood addiction. Foremost among my new understandings is that support isn’t treatment. My misunderstandings have hurt me and others.

No more.

. . . . .

When I finished Unbroken Brain, I started reading everything I could by Maia Szalavitz. On May 11, I tweeted Maia Szalavitz about a possible speaking gig. And she replied.

Maia Szalavitz, author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction, has graciously agreed to speak in my hometown of Blacksburg, Virginia on Wednesday, August 3, 2016.

Learn more about Maia Szalavitz’s visit to Blacksburg, Virginia

Anything, Everything, Not to Take a Drink

I am one of the predictable casualties of community violence. I began to drink in Blacksburg, Virginia, during the year of the Virginia Tech shootings in 2007. When I realized I could not stop drinking, I did what was popularly believed to be the only choice in southwest Virginia in 2012: tell no one of my shame and go to a support group meeting.

First step towards addictions recovery: hug yourself
In 2016, thanks to heroic efforts by people in recovery from addiction, relentless researchers, and intrepid public officials, we know now that abruptly stopping using a substance to which one is addicted releases one – not into just a world – but into a universe of pain. That anyone with alcoholism remains abstinent in year one is nearly impossible.

If I knew then what I know now, I would have done things so differently. First, I would have hugged myself…

I cried when I read Nora Volkow’s essay in the Fall 2015 issue of Advances in Addictions & Recovery : “People suffering from addictions are not morally weak; they suffer a disease that has compromised something that the rest of us take for granted: the ability to exert will and follow through with it.”

I thought alcoholism was the final eruption of the inner pox I believed was who I truly was and had worked with all my might for a half-century to remedy. My formidable will failed me when I tried to stop drinking. I didn’t know that my first drinks were volitional but then something turned. After that, I didn’t have alcoholism. It had me.

– Excerpts from Anything, Everything, Not to Take a Drink, by Anne Giles, published by The Fix, 5/26/16

. . . . .

Thanks to Laurel Sindewald‘s editing and mastering, you can listen to this podcast of me reading aloud “Anything, Everything, Not to Take a Drink” from my podcast channel.

We’re Reading Unbroken Brain by Maia Szalavitz in Blacksburg, VA

In Blacksburg, Virginia, we’ve been reading Maia Szalavitz’s latest book, Unbroken Brain: A Revolutionary New Way of Understanding Addictionsince it was released two months ago on April 6, 2016.

We’re ready to meet and talk!Unbroken Brain by Maia Szalavitz

We’ll gather for a community book discussion of Unbroken Brain on Wednesday, June 22, 2016 at 7:00 PM in the Community Room at Blacksburg Library, 200 Miller Street, in Blacksburg, Virginia.

The event is free and open to the public!

We invite you to prepare for a lively discussion by considering these questions.

If you’ll sign up on the Facebook event page, we’ll know how many chairs to set up!

If you have any questions, feel free to contact Anne Giles, 540-808-6334, anne@annegiles.com.

To learn more about author Maia Szalavitz:

Unbroken Brain – Reading Group Discussion Questions

Unbroken Brain: A Revolutionary New Way of Understanding Addiction, by Maia Szalavitz, St. Martin’s Press, April 6, 2016

Unbroken Brain by Maia SzalavitzUnbroken Brain braids together three narratives: Maia Szalavitz’s personal story, what the science reports about addiction, and a call to action to change belief-based addictions treatment to evidence-based treatment.

Questions for discussion:

  1. What could you relate to in Maia’s personal story?
  2. What have you believed to be true about addiction? Has Unbroken Brain challenged your beliefs about addiction? If so, in what ways?
  3. The subtitle of Unbroken Brain is “a revolutionary new way of understanding addiction.” Do you have a new understanding of addiction as a result of reading Unbroken Brain? If so, what are the highlights of what you now understand?
  4. What do you still not understand about addiction? If you could speak with the author, what three questions would you ask her that seem unanswered to you in Unbroken Brain?
  5. If your life, or the lives of loved ones or of those you know, has been touched by addiction, does Unbroken Brain help you better understand what happened? If so, how?
  6. What concepts in Unbroken Brain did you find most challenging? Please select three to discuss.
  7. What concepts in Unbroken Brain did you find most relieving or satisfying? Please select three to discuss.
  8. Has your idea of drugs and drug use changed after reading Unbroken Brain? If so, how?
  9. Did anything in Unbroken Brain shock or surprise you? If so, what?
  10. After reading Unbroken Brain, how would you describe addiction to someone who doesn’t understand it?
  11. Do you feel called to take action after reading Unbroken Brain? If so, what would that be?
  12. What discussion question do you wish had been on this list? Please write it here and consider sharing it with the group: _________________________________________

To learn more about author Maia Szalavitz:

The Reading Group Discussion Questions for Unbroken Brain were written by Anne Giles and Laurel Sindewald.

Last updated 6/18/16