Changing the Laguage

This came across my Facebook feed today about language and addiction. It was in the Science of Us section of New York Magazine online.

Think of the words and phrases we use to describe drug and alcohol addiction: “clean and sober,” “addicts,” “junkies.” It’s a vocabulary loaded with moralistic connotations. This isn’t good, argue the authors of a new editorial in the journal Substance Abuse, because the use of those terms can inadvertently lay the blame solely on the behavior of the person with the drug or alcohol addiction. And when people struggling with addiction internalize that attitude, it can undermine recovery.
-Link

My first thought was it reminded me of language usage 30 years ago as the AIDS epidemic was just ramping up and becoming really scary. The general phrase "AIDS victims" was often used at first. Then the AIDS activists decided that gave a bad morale to the individuals with HIV/AIDS. From then on it became "People with AIDS" or PWAs. It worked so well that I had to stop for a moment to even remember what we used before PWA. It also changed the face of AIDS in the country, most prominently for the people with AIDS themselves.

Victims is not what we want to make people with a disease feel like. That can engender self-pity, ongoing victimization,hopelessness.

I then put the two thoughts together in my head and realized the power of that insight. Dirty -vs.- clean? Drunks and junkies -vs.- people with addiction? The article even goes on to talk about the results of urine drug screens. For many years the phrase has been, a "dirty urine." (As if there is such a thing as "clean urine?") It is the difference language places on things. Dirty is bad- inherently bad. It is a negative state of being.

We have been working for years to change the metaphors of addiction language. We have been struggling to get beyond the ancient and incorrect moral judgements that we have often put on addiction and alcoholism. We have been wrestling with the greater society as well as the medical field itself to see the disease as real and not just some immorality.

Maybe part of it can become the language we decide to use. Even moving from a pathology to a healing language can help.

Here's a quote from another section of the editorial itself:

Recovery-oriented language refocuses the lens from pathology and suffering to resilience and healing. Recovery-oriented language also changes the discussion from one rooted in notions of one-time, acute treatments or interventions to one that appreciates the long-term modalities and strategies needed to sustain recovery.
-Link

One More Week for Now

I am coming to the end of one full quarter (13 weeks) of being at work "full-time" even though I went to a type of "semi-retirement" last December. By this time next week (actually Thursday at 4:30) I will be back as a supplemental employee working one to three days per week, depending on the week. I got back from our month in Alabama back in March to find that I was needed to come back and do some filling-in for a colleague on leave. I said yes for a number of reasons, not the least of which was that it was going back to the position I held for about 4 full years that I loved the most of all that I have done in 20 years as an addictions counselor. It was also still winter around these parts, but that was only a small part of the reasoning. I truly liked the job and was excited to get one last chance to go back and do it one more time.

So, for the past 13 weeks that is what I have done. I have not regretted it for a moment.

Over there on the right sidebar is a quote that for me describes what I have been doing for most of my adult working life.

Some want to live
within the sound
of church or chapel bell;
I want to run
a rescue shop
within a yard of hell.
-- C. T. Studd

As a pastor and substance abuse counselor I have been along one of those front lines where people come to do something unique and different with their lives. Most of the time these amounted to standing with them as they attempted to turn from the "gates of hell" itself. When I first saw that quote about 10 years ago it jumped at me, grabbed me, and I knew it was mine.

It brought to mind an incident back about 22 years or so ago. A member of the church was in a bad situation and was threatening suicide. They showed up at the front door of the parsonage and I spent the next three hours talking with them in my living room, attempting to contact a counselor they had been working with and finally contacting a treatment center in a neighboring community. At the end of those three hours I took them to that center for an evaluation and care.

A few days later I was at my own therapy appointment and was describing the event to my therapist. My counselor looked at me and said that she never thought about those of us who were there on the front line of situations like that. She, as an outpatient, hospital-based counselor only saw people after they were stabilized, "talked-down" so to speak. She commented on how important that front-line work was.

I remembered many other such times. Some were being there with a family as their loved-one died. Sometimes it was sitting in the ICU waiting room as life was artificially upheld long enough to make arrangements for an organ donation. It has also been the young mother who has discovered her husband was abusing their daughter and was shaking with anger and a sense of deep betrayal. Or it was baptizing a baby who may not make it. Once it was being a "shaman-like" presence in a wind-swept cemetery as a few family members, the funeral director and myself paid our last respects to a recently found homeless relative who had died of tuberculosis or AIDS or both.

I could go on and on. There are many I no longer remember in detail but in that spiritual place in my memory where rest the spirit of those souls who were facing the gates of hell. These moments of seeming hopelessness, fear, sadness, panic or just plain numbness at the depth of ones soul need not be faced alone. We humans have known this for millennia. We seek the people who can stand with us and the places where a sense of peace can begin to permeate the emptiness that has suddenly or even slowly taken over our world.

To be a counselor, a presence of hope and healing with those facing the devastation of addiction and alcoholism is to be at the same kind of junction of hope and despair, life and death. No, I don't believe that is too strong. Many people in that position are at the place where life is teetering. They are facing hell- or perhaps realize they have just stepped back from an abyss that can only be described as hell. They do not know if they can make it. They are aware of a sense of powerlessness. To be there with them is at once humbling, scary, and challenging. It is a place where the deepest compassion and acceptance is needed. But they must be tempered with a willingness to speak to the truth of what they are facing, to not sugar-coat it or make it seem less dangerous.

It is to run a rescue station at the gate of hell- their very own personal torment of hell.

So for the past 3 months I have had that privilege one more time as a full-time counselor. It was developing the helping and healing relationship that can hopefully break through denial and uncertainty.

It is a great way to work and I am grateful I had the chance to do it again. I am sure there will be other ways I am called to do that work in the future. But for today, as much as part of me doesn't want to stop, I know it is what I am going to do next that needs my attention.

Back in December I spoke of my move to part-time employment as beginning my Third Career. I have no doubt it will continue as part of my lifelong call to be part of that rescue shop. It may not be as immediate or quite as close to the gates as I have been, but it is where I have been called.

So it's back to semi-retirement. I have lots of music to make, especially over the next two months, lots of genealogical research to do for those ghosts in my family that are nowhere to be found prior to 1940, time with my wife and daughter and her boyfriend, time to write and read and dream of more ways to be what I am called to do next. Yet always to be one who can help bring healing and to continue to build my life in secular ministry- ministry beyond the doors and walls of the institutional church where I am now called to serve.

Back On the Addiction Front

Two addiction related items have caught my attention in the apst few weeks. First is one idea that I think I have blogged about before, but science, in its single-minded purpose, keeps missing an underlying problem.

Frustrated by the high relapse rate of traditional addiction treatments, scientists are working on a strategy that recruits the body's own defenses to help addicts kick drug habits.

The new approach uses injected vaccines to block some addictive substances from reaching the brain. If a vaccinated addict on the path to recovery slips and indulges in a drug, such as tobacco or cocaine, no pleasure will result.--WSJ

Much of what this article is talking about centers on nicotine addiction where there is some indication that a vaccine can be developed. Nicotine works in different ways and we respond as nicotine addicts in some different ways behaviorally. There is little hope for the same thing for alcohol. Or even other drugs of abuse. The reason is simple. There is a habitual awareness of...

Hey! If I keep using this SOMETHING is going to happen. I'm going to feel SOMETHING. I just need MORE!!!!

Intellectually, i.e. in the advanced thinking part of the brain, we know that because we are taking this medication to stop the effects (or have had the vaccination) we will not have the effects. But that deep reptilian brain doesn't know- or care. "Give me more. It's supposed to work," is what happens. We obey. The danger is obvious.Overdose as we try to satisfy the reptilian pleasure center.

The second item a couple weeks ago prompted me to go, "Well, yeah...."

Only 1.2 percent of the 7.4 million American adults whose alcohol abuse is untreated think they need help, a new report shows. The results were released by the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA)

The survey also found that only 7.8 percent of the nearly 6 million American adults with untreated alcohol dependence, which is more serious than alcohol abuse, realize they need treatment.
--Join Together

The results provide "striking evidence that millions of Americans are in serious denial regarding problem drinking," Pamela S. Hyde, administrator of the Substance Abuse and Mental Health Services Administration, said in a statement.
--Live Science

Anyone who knows an alcoholic (or addict) knows that denial is at the heart of the drugs' bio-psycho-social heart. It is not that they are lying when they say they don't need or want treatment or wouldn't find treatment able to help them. It is a cunning, baffling, powerful mixture of believing what we want to believe. It is the misunderstood misconception that is at work- I am okay. I don't need any help.

Sometimes that is a misdirected sense of power. Sometimes it is hopelessness. Sometimes it is just blaming others. But in the end it is deadly.

Because addiction and alcoholism have so many aspects and factors that grow and "metastasize" in our neurochemistry no one thing alone will break through this. Which is where these two articles come together. A vaccine alone won't do it if we are prone to relapse because of seemingly intractable denial. Breaking denial alone won't work if the internal, neurochemistry has us prone to severe cravings and self-destructive habits.

As the treatment field broadens and deepens we will find more and more integration of these aspects. Hopefully, we will then see relapse rates drop and an increased perception that treatment in many different forms can and will help.

Article first published as On The Addiction Front on Blogcritics.