Category Archives: Recovery

Revovery IS a Reality – Letter to the Editor

Letter published in the Cape Argus, Monday June 29th 2009, pg. 11.

The Editor                                                                                      27June 2009

Cape Argus

Dear Sir,

ADDICTION – THERE IS HOPE.

We all know about the destructiveness of drug abuse, and every week we read about more horrors, more violence, more crime that is directly attributed to drug abuse.

The disease of alcohol and drug abuse – described by some experts as a ‘social health nightmare –  is an epidemic of global proportions affecting millions of individuals, families, work places and communities.

The number of young people engaged in drug experimentation and regular use is alarming and demands urgent attention.

Addiction wreaks devastation, and respects no boundaries of income, race, occupation or geography. Crime is out of hand, and more than 80% of reported crime is drug related. Violence is entrenched in our families and more than 70% of gender abuse is drug related.

A conservative estimate of the health and other social cost associated with drug abuse in South Africa is R 12 billion per year. Drug trafficking also continue to foment corruption, one of the most formidable obstacles to good governance.

Yet, having just observed the International Day against Drug Abuse and Illicit Trafficking last Friday, the silence about addiction is entrenched in communities, workplaces, our churches, and in our homes.

This monster is living in our homes, yet we still ignore its presence.

It is easy for people to talk about their heart disease or kidney disease or diabetes or hypertension. Yet, the Disease of Addiction?

Generally our society still views drinking and drug use as a behaviour of choice or a moral failing instead of a health issue.

People impacted by addiction are reticent about asking for help as society at large still perpetuating norms that foster shame and stigma.

We tend to think of alcohol and drug problems in terms of junkies and alcoholics who need to be treated to overcome their addiction.

Of course providing treatment is important because it is likely to benefit treated individuals, yet it is not enough.

No matter how effective treatment is for the individual, if the family and community dynamics contributing to these problems are unchanged, it will do little to reduce the overall level of harm experienced at the family and community level.

Our health system traditionally addresses addiction when a crisis occurs: car wrecks, violence, criminal arrests, or firing from a job.

We act as though entry to a treatment centre is the beginning of the disease. The illness’s emerging symptoms and the remarkable fact or recovery remain below society’s awareness level. Both aspects of this inattention breed the ignorance and misinformation that cost us all so much pain and money.

Responding to the symptoms of addiction when they present themselves is consistent with the fact that alcoholism and drug addiction is a primary, chronic, and progressive disease.

Early awareness and early intervention lead to early recovery. Better education and life skills are needed to inform young people about the devastating effects of drugs, and to help them resist the pressures to experiment.

Efforts need to be in place to raise awareness.  Drugs are illegal because they are a problem, and not a problem because they are illegal. Drug education is HIV/Aids prevention.

Governments, NGO’s, schools, the workplace and the media must work hand-in-hand. Our collective efforts must focus especially on young people through education, outreach, peer-to-peer networks, and using platforms such as such as sport, music and entertainment that inspire young people.

Equally important is to engage parents, teachers and employers to play their part in full. Our efforts also require working to reduce supply. The light of science and not the darkness of fear and ignorance should guide these efforts.

Individuals and families who have survived addiction should now become visible and vocal stakeholders. Recovery is a Reality.

The good news is that today we enjoy a generation of people in recovery that is ready and willing to speak out and take on the role of mentors.

History teaches us that the voices of survivors, their family members and allies drive public responses to major illness.

Addiction is no exception. Recovery from addiction is happening for thousands of South Africans – rich and poor, young and old, executives and school drop-outs, women and men, black and white, country and city dwellers.

Achieving a stable, productive and fulfilling life is, in fact, a reality when proven solutions are applied. Appropriately diagnosed and treated cases of addiction yield many happy outcomes: Recovery happens. Families heal. Money is saved. Life gets better. Recovering people give back. Everyone wins.

We need to take responsibility to heal ourselves, our families and our communities. We need to embrace the hope of recovery, and  the spirit of courage, knowing  that Recovery is a Reality!

Yours Faithfully,

Jurgens Smit

Executive Director

FavorSA

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The Heroes of Recovery

Beyond Addiction: The will to change

It seems as if people will do just about anything to garner attention, fame or fortune. But those weren’t Aron Lee Ralston’s goals when he sawed off his hand with a makeshift multi-tool after becoming pinned by a boulder in the backcountry of Utah six years ago. All he wanted to do was live.

His true grit has made him a celebrity, a best-selling author and a motivational speaker. In The New York Times recently, Ralston said the experience has changed him. “It was a blessing in a way,” he said. “It made me think about the way I was living.”

Ralston’s case is a prime example of the opportunity that comes from adversity. By cutting off his hand, he changed his whole life. Courage can’t be quantified. Ralston deserves everything he’s got today.

But his story is not unique, though it isn’t often that people resort to chopping off limbs to free themselves of what otherwise might kill them. I know scores of people who, like Ralston, faced adversity and were desperate to live — who were pinned down by circumstances unforeseen and unjustified, who made it because they had the courage to cut off those parts of themselves that held them back from the freedom of life.

They’re called addicts and alcoholics who have embraced recovery. And like Ralston, they survive day after day only because at the moment of their deepest crises, at the bottom, they discovered the strength to reach deep into themselves to tap a superhuman ability to make tough choices. By giving away parts of themselves, they’ve been restored. They survive.

But you won’t read about them in the newspaper or online. They don’t garner five-figure fees for speeches or write books that are bought by millions of people. Heck, rarely do they even seek public attention. Yet I believe it is time for people in recovery to stand up and speak out and for the public to pay attention.

Ralston made a conscious choice to hike in the Utah wilderness alone without telling anybody where he was. And while a few critics call him a “heedless fool” for not weighing the life-threatening risks of his deliberate choices, to most of us he is a genuine hero, somebody we admire.

Addicts and alcoholics made conscious choices, too — to drink or take drugs, usually without telling anybody. Their critics call them “bad” or “evil” or “weak-willed” and wage a “war on drugs” against them. Nobody admires them or calls them heroes.

Why? Because while Ralston was ready to tell his story — even admitting his foolishness — people in recovery remain invisible or silently anonymous or in the shadows of addiction’s stigma, preferring to share their stories only among themselves, usually in 12-step meetings. The result is that the public cannot grasp the indiscriminate power of addiction or what it takes in terms of sacrifice, personal responsibility and hard work on the parts of addicts and alcoholics to make recovery a reality by changing their entire lives. How can people admire or be inspired by what they can’t see?

Every day in this country, addicts and alcoholics make decisions to cut off essential components of their existences: the alcohol or other drugs that defined their lives. Like Ralston, they don’t do it to become heroes or make money or sell books. They do it simply because they want to live. What they give up in those moments comes back to them in what they gain from the rest of their lives. It is a lesson too many others who struggle with addiction have yet to realize because nobody has told them.

William Moyers
BendWeekly

“Exploring Myths about Drug Abuse”

Myth 1: Drug addiction is voluntary behavior.
A person starts out as an occasional drug user, and that is a voluntary decision. But as times passes, something happens, and that person goes from being a voluntary drug user to being a compulsive drug user. Why? Because over time, continued use of addictive drugs changes your brain — at times in dramatic, toxic ways, at others in more subtle ways, but virtually always in ways that result in compulsive and even uncontrollable drug use.
Myth 2: More than anything else, drug addiction is a character flaw.
Drug addiction is a brain disease. Every type of drug of abuse has its own individual mechanism for changing how the brain functions. But regardless of which drug a person is addicted to, many of the effects it has on the brain are similar: they range from changes in the molecules and cells that make up the brain, to mood changes, to changes in memory processes and in such motor skills as walking and talking. And these changes have a huge influence on all aspects of a person’s behavior. The drug becomes the single most powerful motivator in a drug abuser’s existence. He or she will do almost anything for the drug. This comes about because drug use has changed the individual’s brain and its functioning in critical ways.
Myth 3: You have to want drug treatment for it to be effective.
Virtually no one wants drug treatment. Two of the primary reasons people seek drug treatment are because the court ordered them to do so, or because loved ones urged them to seek treatment. Many scientific studies have shown convincingly that those who enter drug treatment programs in which they face “high pressure” to confront and attempt to surmount their addiction do comparatively better in treatment, regardless of the reason they sought treatment in the first place.
Myth 4: Treatment for drug addiction should be a one-shot deal.
Like many other illnesses, drug addiction typically is a chronic disorder. To be sure, some people can quit drug use “cold turkey,” or they can quit after receiving treatment just one time at a rehabilitation facility. But most of those who abuse drugs require longer-term treatment and, in many instances, repeated treatments.
Myth 5: We should strive to find a “magic bullet” to treat all forms of drug abuse.
There is no “one size fits all” form of drug treatment, much less a magic bullet that suddenly will cure addiction. Different people have different drug abuse-related problems. And they respond very differently to similar forms of treatment, even when they’re abusing the same drug. As a result, drug addicts need an array of treatments and services tailored to address their unique needs.

Thanks to: Alan I. Leshner, Ph.D., Director, National Institute on Drug Abuse, National Institutes of Health

Teens in South Africa Smoke Anti-Retroviral Drug for Cheap High

No Turning Back’: Teens Abuse HIV Drugs

A drug intended to treat HIV and AIDS is sweeping the townships of KwaZulu-Natal, South Africa. It is cheap and powerfully addictive.

South Africa has one of the highest HIV infection rates in the world and KwaZulu-Natal province has the highest rate in South Africa — 40 percent. For the infected, anti-retroviral drugs, or ARVs, are the only things standing between life and a painful death.

The drug is so cheap and plentiful, thanks in part to a well-meaning effort by the American government to distribute ARV’, a program that has helped extend the lives of more than 500,000 AIDS patients.
But as the medical director of one U.S.-funded clinic said, ARV abuse is threatening to turn an HIV success story into a health crisis.

“It’s extremely frustrating,” said Dr. Njabulo Masabo, from the AIDS Healthcare Foundation. “It’s extremely, you know, discouraging because on one end you’re trying to fight this epidemic that has ravaged the world so much … the results are catastrophic.”

How ARV abuse began is uncertain. Taken as prescribed, Efavirenz can cause vivid dreams. Someone — possibly an HIV patient experimenting — discovered that smoking the drug greatly enhances those hallucinations.
Today, some of the illegal drugs come from HIV patients selling their own lifesaving medication for profit. Others are stolen from patients or pharmacies.

Pharmacies in the townships have banklike security. The drugs are kept behind vault doors, because they have an enormous black market value. Just one container of the ARVs is worth $60, and a whole shelf is worth $3,000.
Driving through the townships, a local AIDS health worker named Zola Shezi showed us the extent of the black market in ARVs. She saw drug dens everywhere; one she identified had children playing right outside.
“Just here, the man he owns the house, he built all these rooms … one, there’s one room where his customers stay and crush and do things.”

The few police we saw did nothing.

In just three years, ARVs have grown from a niche drug abused by a small number of HIV patients into a widespread addiction, increasingly among young people.

Many ARV abusers are young students, and in a neighborhood like the one we visited you’ll find dealers on almost every street, selling to students during school hours and just after.

In his house that doubles as a drug den, we met one of the dealers face-to-face. Dinda — he gave us a false name to hide his identity — said he earns many times what he could make, if he could find a job.

He acknowledged that the drugs are meant for people with HIV, but said “nobody can give me that money while I’m sitting at home; I have to go and do something for money.”

Recounting a story that’s not unusual in the area, he said he’s the only one of eight siblings still alive. His siblings were all victims of HIV or gang violence, leaving him to take care of a large, extended family.

“I’m unemployed, four of these years I am not working, if I can stop this we can all suffer,” he said. “So they shouldn’t blame me for what I’m trying to make a living out of.”


HIV Could Build Resistance to Medication
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For families of abusers, it’s a very different story. ARVs are powerful enough to turn even young people into violent addicts. We met Dudu, who told us her 21-year-old son steals from her to pay for his habit.

“Sometimes if I said I’m going to call the police he said he going to kill me,” she said. “I believe him.”

Now, South Africa may soon face a deadly consequence of ARV addiction. By smoking the drug, abusers are in effect giving HIV a small taste of anti-retroviral medication — not enough to kill the virus, but enough for it to potentially develop resistance to the drug.

It’s like “educating the HIV,” said Masabo. “And so you’ll find that we have a second epidemic emerging, an epidemic that we cannot control with the current drug that we have.”

Back in the drug den, the teenage addict Joshua told us what happens to HIV patients isn’t his problem.
“I feel guilty sometimes, but hey. I know what I’m doing is wrong, but what I’ve started I must carry on.”
The cemeteries of South Africa are already crowded with victims of HIV. Now, a new danger is threatening to put the country’s best defense up in smoke.

Read JIM SCIUTTO’s story here: http://abcnews.go.com/Health/MindMoodNews/Story?id=7227982&page=3

Understanding Addiction

“Oops: How Casual Drug Use Leads to Addiction”

By Alan I. Leshner, Ph.D., Director, National Institute of Drug Abuse, National Institutes of Health


It is an all-too-common scenario: A person experiments with an addictive drug like cocaine. Perhaps he intends to try it just once, for “the experience” of it. It turns out, though, that he enjoys the drug’s euphoric effect so much that in ensuing weeks and months he uses it again — and again. But in due time, he decides he really should quit. He knows that despite the incomparable short-term high he gets from using cocaine, the long-term consequences of its use are perilous. So he vows to stop using it.

His brain, however, has a different agenda. It now demands cocaine. While his rational mind knows full well that he shouldn’t use it again, his brain overrides such warnings. Unbeknown to him, repeated use of cocaine has brought about dramatic changes in both the structure and function of his brain. In fact, if he’d known the danger signs for which to be on the lookout, he would have realized that the euphoric effect derived from cocaine use is itself a sure sign that the drug is inducing a change in the brain — just as he would have known that as time passes, and the drug is used with increasing regularity, this change becomes more pronounced, and indelible, until finally his brain has become addicted to the drug.

And so, despite his heartfelt vow never again to use cocaine, he continues using it. Again and again.

His drug use is now beyond his control. It is compulsive. He is addicted.

While this turn of events is a shock to the drug user, it is no surprise at all to researchers who study the effects of addictive drugs. To them, it is a predictable outcome.

To be sure, no one ever starts out using drugs intending to become a drug addict. All drug users are just trying it, once or a few times. Every drug user starts out as an occasional user, and that initial use is a voluntary and controllable decision. But as time passes and drug use continues, a person goes from being a voluntary to a compulsive drug user. This change occurs because over time, use of addictive drugs changes the brain — at times in big dramatic toxic ways, at others in more subtle ways, but always in destructive ways that can result in compulsive and even uncontrollable drug use.

The fact is, drug addiction is a brain disease. While every type of drug of abuse has its own individual “trigger” for affecting or transforming the brain, many of the results of the transformation are strikingly similar regardless of the addictive drug that is used — and of course in each instance the result is compulsive use. The brain changes range from fundamental and long-lasting changes in the biochemical makeup of the brain, to mood changes, to changes in memory processes and motor skills. And these changes have a tremendous impact on all aspects of a person’s behavior. In fact, in addiction the drug becomes the single most powerful motivator in the life of the drug user. He will do virtually anything for the drug.

This unexpected consequence of drug use is what I have come to call the oops phenomenon. Why oops? Because the harmful outcome is in no way intentional. Just as no one starts out to have lung cancer when they smoke, or no one starts out to have clogged arteries when they eat fried foods which in turn usually cause heart attacks, no one starts out to become a drug addict when they use drugs. But in each case, though no one meant to behave in a way that would lead to tragic health consequences, that is what happened just the same, because of the inexorable, and undetected, destructive biochemical processes at work.

While we haven’t yet pinpointed precisely all the triggers for the changes in the brain’s structure and function that culminate in the “oops” phenomenon, a vast body of hard evidence shows that it is virtually inevitable that prolonged drug use will lead to addiction. From this we can soundly conclude that drug addiction is indeed a brain disease.

I realize that this flies in the face of the notion that drug addiction boils down to a serious character flaw — that those addicted to drugs are just too weak-willed to quit drug use on their own. But the moral weakness notion itself flies in the face of all scientific evidence, and so it should be discarded.

t should be stressed, however, that to assert that drug addiction is a brain disease is by no means the same thing as saying that those addicted to drugs are not accountable for their actions, or that they are just unwitting, hapless victims of the harmful effects that use of addictive drugs has on their brains, and in every facet of their lives.

Just as their behavior at the outset was pivotal in putting them on a collision course with compulsive drug use, their behavior after becoming addicted is just as critical if they are to be effectively treated and to recover.

At minimum, they have to adhere to their drug treatment regimen. But this can pose an enormous challenge. The changes in their brain that turned them into compulsive users make it a daunting enough task to control their actions and complete treatment. Making it even more difficult is the fact that their craving becomes more heightened and irresistible whenever they are exposed to any situation that triggers a memory of the euphoric experience of drug use. Little wonder, then, that most compulsive drug users can’t quit on their own, even if they want to (for instance, at most only 7 percent of those who try in any one year to quit smoking cigarettes on their own actually succeed). This is why it is essential that they enter a drug treatment program, even if they don’t want to at the outset.

Clearly, a host of biological and behavioral factors conspires to trigger the oops phenomenon in drug addiction. So the widely held sentiment that drug addiction has to be explained from either the standpoint of biology or the standpoint of behavior, and never the twain shall meet, is terribly flawed. Biological and behavioral explanations of drug abuse must be given equal weight and integrated with each other if we are to gain an in-depth understanding of the root causes of drug addiction and then develop more effective treatments. Modern science has shown us that we reduce one explanation to the other — the behavioral to the biological, or vice versa – at our own peril. We have to recognize that brain disease stemming from drug use cannot and should not be artificially isolated from its behavioral components, as well as its larger social components. They all are critical pieces of the puzzle that interact with and impact on one another at every turn.

A wealth of scientific evidence, by the way, makes it clear that rarely if ever are any forms of brain disease only biological in nature. To the contrary, such brain diseases as stroke, Alzheimer’s, Parkinson’s, schizophrenia, and clinical depression all have their behavioral and social dimensions. What is unique about the type of brain disease that results from drug abuse is that it starts out as voluntary behavior. But once continued use of an addictive drug brings about structural and functional changes in the brain that cause compulsive use, the disease-ravaged brain of a drug user closely resembles that of people with other kinds of brain diseases.

It’s also important to bear in mind that we now see addiction as a chronic, virtually life-long illness for many people. And relapse is a common phenomenon in all forms of chronic illness — from asthma and diabetes, to hypertension and addiction. The goals of successive treatments, as with other chronic illnesses, are to manage the illness and increase the intervals between relapses, until there are no more.

An increasing body of scientific evidence makes the compelling case that the most effective treatment programs for overcoming drug addiction incorporate an array of approaches — from medications, to behavior therapies, to social services and rehabilitation. The National Institute on Drug Abuse recently published Principles of Effective Drug Addiction Treatment, which features many of the most promising drug treatment programs to date. As this booklet explains, the programs with the most successful track records treat the whole individual. Their treatment strategies place just as much emphasis on the unique social and behavioral aspects of drug addiction treatment and recovery as on the biological aspects. By doing so, they better enable those who have abused drugs to surmount the unexpected consequences of drug use and once again lead fruitful lives.