Alcoholism – Opiate Nation

Remembering The Least of Us on Int’l Overdose Awareness Day August 31st, 2022

(Translation into most languages at tab to the right)

I wish everyone could read the penultimate chapter of The Least of Us by Sam Quinones. Its title is the same as that of the book. I have almost every line underlined and starred. In it, he describes the dire state we in Western society are in with addiction, the well-thought out reasons many of our public policies are still getting it wrong, and the slivers of hope that encourage us that the world could look differently for the next generation of young people. Some poignant quotes:

“Underground chemists seem to be searching the chemistry literature for drugs that might be molecularly modified to be more potent…The world Gary Henderson predicted when he coined the term ‘designer drugs’ in 1988 is now with us. Counterfeit pills laced with fentanyl (and new synthetics every day) and made in Mexico now dominate the market…There seems now no way to stop all the bizarre drugs devised by those whose own brain chemistry has been twisted by the profits of the underworld’s free market…recovering addicts face scary odds as long as the drugs that torment them are widely available, potent, and almost free. The now-cliché is ‘We can’t arrest our way out of this.’ We can’t treat our way out of it either, as long as supply is so potent and cheap.”

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.

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.

The Rescuers: Enabling, Caretaking, and Drama

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

Historically, “enabling” referred to facilitating or empowering someone in order to help them accomplish something. By teaching children to read, we enable them to develop their intellect and further their learning. Or, as in 1933 Germany, “The Enabling Act” gave Adolf Hitler the power to enact laws without the involvement of the legislative bodies: he was enabled to become a legal dictator. In modern psychology, enabling can be positive, but it is also used in a negative sense when it encourages dysfunctional, unhealthy behavior and habits, as it is used in addiction and recovery vocabulary. Rescuing and caretaking are terms that mean what they say. They are closely connected to enabling: we rescue people from their responsibilities and we take care of people’s responsibilities for them.

Melody Beattie (Codependent No More) refers to the “Drama Triangle” roles of victim, persecutor, rescuer, and says “Rescuing/caretaking looks like a much friendlier act than it is. It requires a victim who is actually capable of taking care of themselves even though we and they don’t admit it…After we rescue, we will inevitably move to the next corner of the triangle, persecutor. We become resentful and angry at the person we have so generously helped…Then we move to the victim corner of the triangle, at the bottom, the predictable and unavoidable result of a rescue.”

The Vortex of Shame

(Twenty-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.)

For generations, the combination of personal shame and public stigma has produced tremendous obstacles to addressing the problem of alcoholism and drug addiction in America. Addiction stigma prevents too many people from getting the help they need. –Hazelden-Betty Ford Institute for Recovery

Historically, the word shame was used interchangeably with guilt – the appropriate pang of conscience that followed doing something wrong. In reality, there is an important distinction between shame and guilt. Shame is about who you think you are; guilt is about what you have done.

Stigmas are linked to shame. In the Greek and Latin worlds, a stigma was a mark or brand, especially for a slave, identifying them as “inferior.” Later, it became known as a mark or stain we can’t see with our eyes: social stigmas that are based on perceivable characteristics, associated with certain behaviors that distinguish a person from other members of society. They convey disapproval and disgrace.

Hopes & Dreams

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

I know how men in exile feed on dreams of hope.

–Aeschylus, Agamemnon

After our son’s death from overdose, John and I truly felt like “men in exile,” forced into separation from our son, banished from each other’s’ lives. We are not just on different continents, but in different worlds, different dimensions. And hope? Any hope would have been just that—a dream, a mirage.

His untimely death took all hope of a sober and content son in this life away. Lost hope is what crushes parents when their child dies a needless death, an ignoble death to many. Had he fought in a war and been killed in action, to society it would have been a noble death. Most people who are separated from the life-and-death battle with addiction can’t see the struggle that this generation of young people are fighting on a moment-by-moment basis against an enemy that is in their brain, in their body—not outside it—one they can’t shoot and kill or put in prison. But we, as parents and friends, see it and wonder how much longer can they fight before they lose?

The Secret Keepers

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

National secrecy. Communal secrecy. Familial secrecy. Cloaked as “Discretion” it perpetuates problems. What it did for us when we found out that our son was addicted to heroin was to create a puzzle that we were forced to try to put together in the dark with many missing pieces. No one was talking – not friends, parents, school leaders. When the drug bust happened at his high school in the spring of 2005, and the administration didn’t call a meeting of all parents to alert us to what was going on, one wonders what motivation was behind that decision? Clearly, it wasn’t what was best for the rest of the students, families, or our community.

Years ago, while working through our angst with the systemic problems in organized Christianity, and continuing to run into absolute resistance, secrets, and denial, we came upon a quote that finally explained why we were not, and never would be, making headway: “If you speak about the problem, you become the problem.” This wisdom came from an important and insightful book, The Subtle Power of Spiritual Abuse. But the subtle power of abuse is not limited to churches: governments, schools, communities, families—no one wants to be seen as part of the problem, especially with drug addiction and alcoholism. So, if we just keep troublesome or messy things secret, if we don’t speak about them, we can all just get along.

The Important 0.1 Percent

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

DNA sequences for any human is approximately 99.9 percent identical to every other human. That means that only 0.1 percent of our genetic makeup is unique to us. Genes are functional units of DNA that make up the human genome. But don’t be fooled into thinking that 0.1 percent variation is insignificant. It is nearly 3 billion base pairs of DNA which boils down to 3 million differences that determine our physical features like hair and eye color and health risks or protection from diseases such as heart disease, diabetes – and addiction. Genes influence the numbers and types of receptors in peoples’ brains, how quickly their bodies metabolize drugs, and how well they respond to different medications.

The National Institute of Drug Abuse (NIDA) reports that family studies that include identical twins, fraternal twins, adoptees, and siblings suggest that as much as half of a person’s risk of becoming addicted to nicotine, alcohol, or other drugs depends on his or her genetic makeup. Scientists estimate that genes – including the effects environmental factors have on a person’s gene expression, called epigenetics – account for between 40 and 60 percent of a person’s risk of addiction.

Epigenetics – epi meaning “above” – is the study of functional, and sometimes inherited, changes in the regulation of gene activity and expression that are not dependent on gene sequence. This means exposures or choices people make can actually “mark” (remodel) the structure of DNA at the cell level. So epigenetic regulatory systems enable the development of different cell types (e.g., skin, liver, or nerve cells) in response to the environment. These epigenetic marks can affect health and even the expression of the traits passed to children. For example, when a person uses cocaine, it can “mark” the DNA, increasing the production of proteins common in addiction which is believed to correspond with drug-seeking behaviors.

An Ounce of Prevention

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

In 1735, Benjamin Franklin wrote a letter to his own newspaper, The Pennsylvania Gazette, where he used this now-famous phrase: An ounce of prevention is worth a pound of cure. He wasn’t referring to a pandemic or keeping your roof in good condition so it won’t leak or changing the oil in your car so you won’t ruin your engine or, my personal example, brushing your teeth to avoid tooth decay and gum disease.

When I was growing up in the 1960’s, brushing our teeth every day was a new habit for most Americans. Even though the toothbrush was invented in 1857, it wasn’t until after WWII that we got in the habit of regularly brushing our teeth. When I was young, I didn’t give much thought to personal care and it seems I didn’t brush my teeth often – I was too busy living life – which is why my two older sisters gave me the endearing nick-name “moss-mouth”. (FYI, I must have good teeth genetics because I didn’t have my first cavity until I was 30.)