I know! Two days in a row! You are going to get tired of hearing from me!
So what has been churning away in my head the past few weeks are the topics of medication assisted recovery and harm reduction. These are HOT topics in the recovery community. But I have come to fully believe that there is a definite physiological aspect to addiction. Not just being genetically predisposed....but truly a brain that is missing some crucial chemical make up which causes it to misfire and the person will do anything to relieve the discomfort (a mind that won't shut off, paralyzing anxiety and depression, irrational fears, feelings of misery and foreboding.)
I recently read an article by Dr. Howard Wetsman that seemed to confirm this.....if I injected heroin into my body or took a whopping dose of an opioid, it would make me go to sleep. Most of us would....but the way opiates affected my girl and many of our addicted children, was to invigorate them, to fill them with energy and wake them up. I can't tell you how many times I have heard the words, "they make me feel normal." The opiates fill a void for a brain that is depleted of dopamine.
With the above in mind, it makes sense then that a medication assisted recovery plan would be appropriate. Suboxone, Methadone, Vivitrol would fill the place of the illegal and dangerous self medicating that has been going on. Their brains are broken. Whether they started out broken or the drugs broke them....the bottom line is that they are now unable to perform their tasks effectively. They can repair themselves but that takes a very long time. My girl would give recovery a whirl, over and over again, but was not able to function. Her brain was starving. Recovery itself and working the 12 steps and knowing that for that one day she was living an honest life.....was not enough. She couldn't function.
Of course there are other factors involved too.....habitual behaviors, mental illness, what has become comfortable, how they see themselves and understanding that even with appropriate medications, recovery requires hard work. Its the mother of all times of learning how to operate outside of your comfort zone. At first. It gets better if they can hang in there.
My girl needs to enter back into treatment. There is only ONE facility (a little old Victorian house downtown so it can house about 12 girls total) in all of the giant county closest to ours that will accept someone who is in a methadone program. In my opinion, when there is an epidemic of heroin overdose deaths amongst our young people, that is wrong. The Big Book of AA (which I love) was written in 1939. For alcoholics. Someone with a long term heroin addiction, someone who is injecting themselves with needles numereous times every day, is a different breed. The roots may be similar, but the physical addiction and damage done to the body between those substances is very different.
I am thinking that it doesn't matter how we got here, but we are here now. What will be our solution? Will we continue to shame and emotionally flog and brow beat our addicted young people because they physically need a medication to be a bridge to eventual (hopefully) abstinence? Can we begin to acknowledge the physical changes they have either knowingly or unknowingly put their bodies through and allow them the dignity to pursue treatment that will address those changes without making them feel like their recovery isn't as "pure" or authentic as someone who is not being medicated.
Recently my girl and I were discussing this....her solution was, "If I ever go back to 12 step meetings, I will find a sponsor that I can be open and honest with but I won't let anyone else in the program know that I am using methadone to maintain my sobriety." Our judgements have made it not feel like a safe place, the one place where you will be understood and encouraged to keep on moving forward.
I think once again, its important to acknowledge that God is in charge. Even when things don't go the way we think they should.....He is still working. He is fully capable of working out all of the details of someones sobriety.
I will write more on harm reduction soon.....such as needle exchanges and supervised injections sites.
God bless us all......