Alcoholism – Opiate Nation

The Importance of Friends – Pt 2

(Translation into most languages at tab to the right.)

How do clean and sober friends stay involved with a friend who is in active addiction and/or alcoholism? I ended last month’s blog asking this question. In particular, I want to discuss ways that teens and young adults can deal with this difficult and at times very frustrating problem.

What does being a good friend to someone who is addicted look like?

The first thing is to not pretend you don’t know about their addiction. Talk about it openly but without judgment. Understand that they may deny any problem, so you may have to cite specifics that have made you concerned. Express that you care about them and don’t think less of them as a person because of their struggles. Risk your comfort zone. “Greater love has no one than this: to lay down your life for your friends.” (1)

Be a good listener. A problem with drugs or alcohol may start from just experimenting with drugs at a party or concert. It may then turn into addiction and be fueled by problems at home or with friends or underlying mental health issues. When your friend feels cared for and accepted and not confronted with more guilt or shame, they will be willing to open up. Nobody planned to become addicted and nobody wants to be an addict. Here’s links to good info on how to help someone trapped in addiction. (2,3)

But, if you remain a good friend to someone who is living a self-destructive life, how do you help them without enabling their addiction? For young people who are good friends, enabling might be keeping secrets for them about their problem, especially from adults who may need to know in order to take life-saving action. It may be loaning them money or driving them to get drugs. The pressure would sound something like: “If you’re my real friend, you won’t tell…” Or “If you really want to help me you would…” Basically, when you support their problematic behavior in the name of ‘helping’ them, you are actually keeping them from living with the consequences of their poor choices. And this will only prolong their problems and delay change. (4)

Encourage them to get help through programs like SMART Recovery groups or AA for alcohol and NA for narcotics. Very few people overcome addictive behaviors alone. Community is key. Go with them if you can or drive them. And remember, drug and alcohol recovery take lots of time and most people don’t succeed the first time they try to quit. Dr. John F. Kelly, clinical psychologist and addiction medicine expert, says it can take 8 years and 4-5 treatment attempts at recovery to achieve one year of sobriety from opioid and other drug addiction. It can take years to achieve stable recovery and Medication Assisted Treatment (MAT) is an important aspect. Gone are the times when a 30-day detox/treatment was seen as the solution to addiction. It may be an important first step in the process of ongoing recovery. People can and do recover, but it will likely be a lifetime journey. Here’s a YouTube 2025 video of Dr. Kelly giving a session on: The New Science on Addiction Recovery. (5)

You can encourage your friend with each small step and success, even through relapses. In our son’s recovery program, we ended each session by saying together: “Keep coming back ‘cause it works if you work it.” It takes hard work and it can be very discouraging for your friend to relapse because your friend wants to be free. No one wants to live controlled by addiction. No one. Encouragement to stick with it is vital.

If your friend or family member is using opioids, you should get naloxone (a medicine that can temporarily reverse the effects of an opioid overdose) and keep it handy. Available through local community-based programs or pharmacies.

It’s worth saying again: Friends are SO important for people in active addiction.

Don’t ever give up on your friends trapped in addiction. They need friends more than ever, friends who love them and will invest in their lives and let them know they are a worthwhile human – while you also need to encourage them to seek help in order to become sober and stable. And to remind them by example of what a normal and joy-filled life is like and one that they too can have.

A best friend is someone who believes in you

even when you’ve stopped believing in yourself.

– Unknown

John 15:13, New Testament
Helping Someone with a Drug Addiction

https://www.helpguide.org/mental-health/addiction/helping-someone-with-drug-addiction

How to help someone who is misusing drugs or alcohol:

https://www.healthdirect.gov.au/help-someone-who-is-misusing-drugs-or-alcohol#:~:text=Celebrate%20small%20successes%20and%20try,Narcotics%20Anonymous%20and%20SMART%20Recovery.

Four Signs of Enabling and How to Stop

https://health.clevelandclinic.org/enabling

Dr. John F. Kelly, Ph.D. The New Science on Addiction Recovery (lecture)

The Importance of Friends – Part 1

(Translation into most language at tab to the right.)

Approaching what would be my son’s 36^th birthday, I thought about the last year of his life. I don’t think about it often because it is painful – so many wishes that things had gone differently for him.

One sadness is that when in active addiction, he was very alone. It’s not that JL didn’t have lots of friends – he did. He was friendly and likeable and the large group of friends who came to his memorial is a testament to that. But most of his high school and university-era friends were not involved in his life during the last few years of his life, and the last year in particular. After his accidental fall and relapse to opiates in 2008 and the next seven years in and out of recovery programs, his life became narrower and something he was ashamed of.

An event that stands out was during a time of heroin use that we were not fully aware of as he lived in our rental house, and we thought he was attending his classes at university. We received an urgent call from two of his friends telling us that they knew he was back to spending all his time with his friend that used heroin with him and they were not getting an answer to their calls. They were at his house and he wasn’t responding to their knocks on his door – did they have our permission to break his door down? Our frightened response was “Yes!” They found him deep in drugged sleep and alive but very startled when they burst in. They confronted him with what they knew and their concern about his drug use. He of course was defensive and pretended that nothing was wrong.

Gradually, these friends, along with others, were no longer part of his life. JL did make a good friend or two in his recovery programs, but he always kept his addicted friends and dealers separate from his sober friends who were mostly not aware of his use and relapses – he had a pretty good poker face. Most of them were shocked to hear of his overdose death because he had been in a sober living house for six months and doing well.

Many of the friends who had such good times together when JL was clean (although not necessarily sober, as they enjoyed drinking with him not realizing how that always led back to drugs for JL) felt guilt after his death. Guilt because he called several of them the week before his death when he had just relapsed. It seems he wanted a friend to talk to and perhaps perceive that he was struggling. And guilt because they wished they had stayed in touch with JL and not distanced themselves from him when he continued to struggle with addiction.

But there’s the rub: How do sober friends stay involved with a friend who is in active addiction? I think it is especially difficult for young people, who don’t know what they can do, who may be more concerned with their own lives and issues, and who are not yet mature. This is not to suggest that any human is ever totally selfless regardless of how old we are – I know myself too well to hold this delusion. But the passing of years does bring relational experience and can help us focus more on those around us.

Next month I will try to share some insights and ideas for teens and young adults for how to truly be a friend to someone who is struggling with addiction and sobriety. Just remember:

Don’t ever give up on your friends or family who are trapped in addiction. They need good friends more than ever. King Solomon gave this wise insight 3,000 years ago: Two are better than one, because they have a good return for their labor: If either of them falls down, one can help the other up. But pity anyone who falls and has no one to help them up. (1)

Many people will walk in and out of your life,

but only true friends will leave footprints in your heart.

—Eleanor Roosevelt

Ecclesiastes 4:9-10

TEMPTATION: Fight it or Heed the warning signs?

(Translation into most languages at tab to the right)

I have been thinking about temptation recently and how differently we each respond when we face something that is hard for us to resist. How do we resist something that is alluring and that we have repeatedly succumbed to in the past? Something that we are addicted to like lying or shoplifting, alcohol or drugs, gossip or gambling, social media or overeating? The list of behaviors that can derail our lives in one way or the other is endless. It’s not just how an addiction can cause us harm, but also how it can debilitate or destroy our relationships, that makes learning how to beat temptation important.

So, when we are tempted to indulge in our pet addiction, what do we do?

I read an article on Medium about temptation and willpower that supports the thoughts I’ve held throughout my life. Riikka Iivanainen (1) confesses that she has high self-control and discusses her research into why some people succeed at resisting temptation while others don’t.

She says, High self-control does predict many positive life outcomes: People who’re good at self-control do better in school, have fewer mental health problems, have better relationships with friends and family, and generally exhibit fewer impulsive behaviors like binge eating and alcohol abuse. They’re even happier.

From the many scientific studies she researched, she goes on to say, Having good self-control doesn’t mean a constant battle against temptations. The kind of self-control that gets you all those good outcomes is more effortless than what’s commonly suggested by the term’s “willpower” and “self-discipline.”

Psychologists tell us that constantly resisting temptation is exhausting and will soon leave us with ego-depletion. Relying on self-control in the face of temptation is destined to fail. So what kind of self-control is “more effortless”? Riikka says, The people who reported fewer problematic desires and less conflict related to those desires were good at avoiding temptation, not resisting it.

Isn’t this insight what the basis of what most recovery programs are built upon? The acronym HALT is a tool to remind us to take a moment and avoid temptation by being aware of the primary things that can lead us to it: Hungry, Angry, Lonely, Tired. We are susceptible to self-destructive behaviors, temptations, and relapse when these basic human needs are unmet. HALT is a reminder, an early warning system. Being self-aware helps us recognize our needs and address them in a positive way before turning to harmful habits or destructive people.

Hungry – being hungry can be physical or emotional hunger

Angry – being angry at someone else or at yourself

Lonely – being lonely can be while in a crowd or from self-isolation

Tired – being tired affects our body, mind, and spirit

Some ways to deal with these needs is the subject of my Opiate Nation blog post April 14, 2018, H.A.L.T. https://opiatenation.com/2018/04/14/h-a-l-t/

We need to know ourselves and be honest about what our problematic desires are and avoid them rather than flirt with them. Desires are matters of the heart and we need to do all we can to support the healthy, life-affirming desires we have. I’ll end with pertinent insights from some of my favorite sources:

There are several good protections against temptation, but the surest is cowardice.(2)

Strength comes prior to temptation, not during it. Overcoming is a prior act. It involves making a decision to remain pure before the temptation comes. (3)

Rather than waiting for temptation to raise its inevitable head and struggling to resist it, researchers at the University of Wyoming say it’s more effective to plan in advance to manage those temptations with well-thought-out self-control strategies. (4)

It is easier to prevent bad habits than to break them. (5)

Paul repeatedly told the early Christians in their very pagan cultures to “flee” temptation. (6)

Learning takes us through many states of life, but it fails utterly in the hour of danger and temptation. Then faith alone saves. (7)

But for persons needlessly to expose themselves to temptation, and to do those things that tend to sin, is unwarrantable, and contrary to that excellent example set before us. (8)

Jesus showed us by example when we are confronted with unavoidable temptation to speak the truth in order to help us resist until we are able to escape. (9)

Temptations, of course, cannot be avoided, but because we cannot prevent the birds from flying over our heads, there is no need that we should let them nest in our hair. (10)

https://riikkaiivanainen.medium.com/the-secret-life-of-people-with-high-self-control-its-easier-than-you-think-7dd26fb5282c
Mark Twain
The Mind of Christ by T.W. Hunt & Claude V. King, 1990
https://www.psychologytoday.com/au/blog/cravings/201911/4-ways-avoid-temptation-and-reach-your-goals
Benjamin Franklin
I Corinthians 10:14; I Timothy 6:11; II Timothy 2:22
Mahatma Gandhi, Mohandas Gandhi, Homer A. Jack (2005). “The Wit and Wisdom of Gandhi”, p.40, Courier Corporation
Jonathan Edwards, https://www.biblebb.com/files/edwards/temptation.htm
Matthew 4:1-11
Martin Luther

Addiction Constriction

John Leif Trang – March 10, 1989 – August 2, 2014

(Translation into most languages at tab on right)

On March 10th, our son would have been celebrating his 33^rd birthday. That day is now a painful reminder of all the potentials and possibilities that a young person should be experiencing in the 4^th decade of their life.

After JL died of a heroin overdose in 2014, I began the dreaded process of sorting through his belongings – which included his computer and phone. Many of the photos on his phone I had never seen and some have now become permanently seared into my visual memory. One is of JL with a Boa wrapped around his shoulders and neck.

Boas are constrictors. Constrictors don’t chase their prey. They are ambush hunters. A boa grabs its prey with its teeth, then quickly coils its body around the prey and squeezes. It doesn’t break the bones – it constricts so tightly that its prey can’t breathe. With each exhale, it tightens its coils until its prey dies slowly from an overwhelmed circulatory system due to blood not getting to the brain. Once dead, the snake swallows its prey whole.

Advocacy or Cheerleading?

(Translation into most languages at tab to the right.)

A few months ago, John was on a phone call with a physician who was asking his input about a new drug to help with opioid addiction. John shared about our son’s addiction and death and how we hoped that by speaking openly about his life and writing our book and blog we could help in some small way. His response was something I did not expect and will never forget. He said, “Don’t underestimate advocacy because it is the surest way to change things. Science and medicine take a long time and have limited effectiveness.”

An advocate is someone who works by speaking, acting, or writing truthfully on behalf of a person or group in order to promote, protect, and defend their welfare and to seek justice for their rights. To speak out for those who have no voice. But advocacy is not cheerleading. A cheerleader is someone who only supports their team or player – since they are in competition against another team. They are indiscriminate about what their team does or doesn’t do. They don’t necessarily look at the big picture or causes and effects. Their role is to simply cheer on their team or player and boost support from their fans with slogans that may or may not be true.

Serious problems that affect the wellbeing of individuals, communities, and entire societies, such as the Covid-19 pandemic, addictions, and racial prejudice and inequality, are not helped by cheerleading. People in danger and suffering need advocates who have compassion, who are truth-tellers, and who will vigorously and untiringly work for a solution.

When I see a young person on the streets, homeless and struggling, enslaved to a substance that is stealing their life – or anyone living with addiction of any sort – I long to be helpful in a meaningful way and become discouraged at my inability to do so. And if I feel discouraged, how must they feel? What will help bring real, substantive change and hope to these lives and in these circumstances?

As parents of a son with a deadly addiction, we were sometimes cheerleaders when we needed to be advocates. Cheering him on and telling him he could do it without any medical help was not being realistic or being the advocates he needed. I think it is difficult to be an effective advocate for those we love because we are too close to have a clear perspective. Which is why a supportive recovery community – for both the family and the one struggling – is vital. We must try and use whatever resources we have: our voice for those who are not being heard, our writing to bring clarity to public thinking, our physical presence to stand or march with others, and our time, energy, and finances to step in where we can or offer help to find those resources.

There are as many ways to be an advocate as there are needs in this world. I have friends involved in racial justice, in refugee struggles, in stopping sexual exploitation and abuse, homelessness and poverty – the list is endless. The question is: How can each one of us be an advocate for the people and needs we are aware of and that we have a passion for?

Isolation Loneliness

It has been said thatthe opposite of addiction is not sobriety, it is connection – to others, to a community.The Coronavirus pandemic has brought disconnection and magnified loneliness and stress for people the world over due to social isolation, economic instability, reduced access to spiritual communities, and overall national anxiety and fear of the future. “We certainly have data from years of multiple studies showing that social isolation and social stress plays a significant role in relapse…relapsing to drug use can play a role in overdose.” Dr. Wilson Compton, deputy director NIDA.

The acronym HALT: Hungry, Angry, Lonely, Tired, is used in Alcoholics Anonymous and most recovery programs. It is a simple reminder that when our basic human needs are not met, one is susceptible to toxic thoughts and self-destructive behaviors including relapse and suicide.

Regardless of where you live, there have likely been restrictions imposed to limit the number of people who can gather together – from dozens in some countries to only the members of your immediate household in others – in order to slow down the high-speed train that is Covid-19. For many of us, we have been able to maintain our emotional equilibrium because we know this is for a limited time and we can look forward with hope to the future.

But what about those vulnerable members of society who already struggle on a daily basis with insecure housing and food supplies and to maintain their mental health, sobriety, or recovery? In the midst of one of the most isolating crises the modern world has known, it is no surprise then that cities across America, and around the world, are reporting dramatic increases in drug overdoses, alcohol relapses, and suicides.

In-person community meetings are at the foundation of recovery programs. And no wonder. It is in community where individuals become part of something greater than themselves. And I believe it is in the breakdown of communal life in individualistic American ideology that has, to a great degree, contributed to the anxiety, insecurity, and depression that so characterizes our national psyche and has led to the pursuit of finding relief in so many unhealthy ways.

A friend of our son who is an alcoholic who has been working his recovery for the past 8 years, put it this way:

“Self-isolation breeds relapse for people in recovery. With quarantine, people are losing the accountability they have relied on from in-person meetings and it’s a lot easier for people to further isolate and close off their emotions. Attending virtual meetings keeps me grounded and gets the message across as much as regular in-person meetings but lacks the fellowship aspect. This will no doubt expose many in recovery to loneliness.”

Even though increasing numbers of people around the world are vaccinated, it will not stop some of the isolation and loneliness. Is there anything those of us who are not isolated emotionally can do to help? The one thing my husband and I have made as a priority in our weekly schedule is to check in with friends around the world via texts, emails, letters, phone or video calls – including our young friends who are in recovery and elderly friends who just need to know they are not forgotten. With our social networks and finances, we can support organizations that are working the front lines to serve the addiction/mental health population. We can make or purchase masks, buy food and basic supplies, to give to those in need and support recovery programs in our area.

The Tattoo – Stigma

(Translation into most languages at tab to right.)

In the Greek and Roman worlds, a stigma was a tattoo or brand, especially for a slave, identifying the person as “inferior.” As stigma moved into English, it referred to a mark you couldn’t actually see but which was nonetheless powerful. Social stigmas are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace. Dis-approval. Non-approval. Dis-grace. Non-grace.

In an article on The Stigma of Addiction from Hazelden Recovery we learn: “The stigma of addiction stems from behavioral symptoms of substance use disorder…which can result in negative consequences including legal, occupational and relationship problems. Understandably, these consequences cause embarrassment and shame among those affected. They also create stigmatized attitudes and perceptions among the wider public, a response that perpetuates and exacerbates the private shame associated with drug addiction. For generations, this combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and addiction. Today, the stigma of addiction is seen as a primary barrier to effective addiction prevention, treatment and recovery efforts at the individual, family, societal levels. Addiction stigma prevents too many people from getting the help they need.” Yes, only one in 10 people struggling with addiction receive treatment. The article goes on to discuss the irony that many of these stigmatizing behaviors diminish and/or disappear when a person is appropriately treated in recovery.

When talking recently with some of our son’s friends, they have been unwilling to let their past drug use become public knowledge because of the potential negative repercussions they justifiably fear in their careers and relationships. How much worse would it be if they were still living with addiction? What does this say about us as individuals, communities, employers, and society in general? When an individual is seen as having a moral failure instead of a chronic health condition, stigma is the logical result. But no one makes the decision about how their brain will react to a substance and whether they will become addicted after minimal use or hate how it makes them feel and never use it again.

Negative labels stick like glue to our hearts and soul and, for those struggling with addiction and alcoholism, the personal shame becomes how they define themselves. The public stigma that follows is the tattoo they never asked to have. If we can reject stigmatizing and instead provide a safe and listening ear to those struggling with addiction, inviting them to share their stories and encourage them to consider recovery options, they may be willing to join the many people who do learn to manage their disease and successfully recover. Let’s remember that they are just as valuable and able and worthy of love – and as human – as you and me.

https://www.hazeldenbettyford.org/recovery-advocacy/stigma-of-addiction

Reaction Recovery

Translation into most languages at tab to the right.

A few weeks ago, John and I were interviewed by Jeff Simone for his Surviving the Opioid Epidemic podcast (see YouTube link). We had a really great conversation about our family living with a teenage son with opioid addiction and how his death from overdose affected us and changed our lives. Jeff serves the addiction community with a coaching service called Reaction Recovery.

https://reactionrecovery.com

Here are some insights into his recovery approach.

Reaction Recovery is a private coaching service designed to help individuals thrive in their life of recovery from substance use disorders. It is a one to one, intensive behavioral approach to help individuals identify areas to make focused and intentional lifestyle modifications. Dr. Simone has been formally trained in clinical pharmaceutical and dietary supplementation advisory and management. He has earned degrees in nutrition, physiology, is a certified life coach, and has personally worked with over 200 people recovering from substance addictions.

Why ‘Reaction’ Recovery? Who is reacting and to what?

Reaction Recovery was started as a “reaction” to the current treatment approach to addiction. The medical community is doing a good job offering short-term acute care crisis management for addictive disorders, but are doing poorly offering long-term treatment for those who have become abstinent but not yet stabilized. This describes our son’s – and most others we know – situation perfectly. Addiction needs long-term care and support.

The basic coaching approach addresses the physiology of the addiction, post-acute withdrawal syndromes, nutritional interventions, dietary supplementation, and how this all can safely integrate with other pharmaceutical treatment strategies that might already be on board.

Based on what Dr. Simone has called the ’12 Daily Rules for Recovery,’ their coaching techniques will systematically and methodically help the individual identify specific areas to be adjusted and then develop individually tailored strategies to affect real change.

The 12 Rules focus on building up a support community – first and foremost – then developing a healthy and consistent morning routine, understanding the importance of full-day nutrition, ensuring the body is receiving all nutrients necessary to support a strong and optimal brain and body, establishing a safe and appropriate dietary supplement regimen, expanding the mind with helpful books and information, developing a realistic exercise routine, carefully auditing the external distractions in our lives, constructing a regular nighttime routine, and more.

When these considerations get repeated across thousands of iterations, and with a little guidance and accountability, they become a foundation upon which the rest of the individual’s recovery will be built. Eventually – through ruthless repetition – new neural pathways begin to form until eventually this life of abstinence doesn’t feel so difficult and a sustainable, meaningful recovery is able to take shape.

Jeff’s approach of community as essential and creating new, healthy habits to replace old, destructive ones has been the topic of several of my blogs (see below). Whatever habits we create will become automatic and will serve us and our life-goals well as we go through each day.

2021 Aug 15, Connection is Crucial

2021 March 28, The Freedom of Habits

2021 Jan 03, Who is My Neighbor?

2020 Dec 27, Missing Community

2020 Aug 15 & 22, Loneliness

Peter’s Story: Alcohol The Gateway Drug

(Thirty-fifth in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

This week’s Story of Hope is from a friend of JL’s, Peter (not his real name). Here are some excerpts from his story in Opiate Nation (5 min read):

My name is Peter and I’m an alcoholic and addict. This is how I introduce myself at the AA meetings I attend several times every week, as I have done for over 10 years. I am from a fairly affluent family, raised with high moral standards, and attended the best schools. So how is it that I became an alcoholic by the time I was a senior in high school and an opioid addict and dealer by the time I was 20?

The first time I used alcohol was in my junior year in high school. I was new to the school and I felt like I didn’t get the playbook for how to be a part of the group. I had been raised with strong values against using drugs and alcohol – but I wanted to fit in with the popular kids.

I tried a capful of vodka—that was it. I hated the way it tasted. The next day I was sick—not so much from the alcohol, but with guilt. This would be a consistent theme in my drinking and using: I always felt guilt and the consequences of doing something soul-crushing and bending the moral line I had deep within me. Once that barrier had been crossed, then anything was permissible. Initially I only drank on weekends at parties so that I wouldn’t be the outsider.

Hank’s Story: Drinking Loneliness

(Thirty-third in a series of topical blogs based on chapter by chapter excerpts from Opiate Nation. Translation into most languages is available to the right.)

This week’s Story of Hope is from our son’s friend, Hank (not his real name). Here are some excerpts from his story in Opiate Nation (5 min read):

I grew up in a loving home – the youngest of seven kids in a Catholic family. Although there are no alcoholics in my immediate family, my mother’s side of the family consists of proud Irish New Yorkers where alcoholism runs rampant. I experienced my first drunk at the age of 13.