I love the old song by the band, Faces entitled, Ooh La La. The song laments, “I wish I knew what I know now, when I was younger, I wish I knew what I know now, when I was stronger.” Relax and listen–and I’ll be surprised if you don’t agree it’s a toe tapper and a nostalgic reminder for all of us:
Addiction Treatment | From Sick Care to Health Care
I had the recent privilege of attending the 2nd Annual David E. Smith, M.D. Addiction Symposium in San Francisco. The event attracted addiction treatment professionals from all over the nation. We listened to seasoned clinicians and cutting edge thought leaders in addiction science and treatment on topics ranging from pharmacotherapy to spirituality. If I were to sum it all up in a nutshell, the common thread was that we actually are moving from sick care to health care with addiction treatment leading the way.
It’s All About Brain Health, Any Questions?
Good health starts with brain health.
Time and time again I heard ultra credible, mainstream people saying that addiction treatment is all about brain health and brain health is all about ensuring the essential nutrients of eating, exercising, thinking, feeling and sleeping well.
Something inside stood up and cheered as I heard for example, the addiction psychiatrist and trend setter, Daniel Amen, M.D. say things like, “Why is psychiatry the only discipline that doesn’t ever look at the brain–the organ it is treating?” and, “Why do I get recommendations for a colonoscopy but never for a non invasive brain scan when brain health is what it’s ALL about?”
Each talk surveyed the literature and as pointed out, the research gets edited and updated about every twenty minutes. But the bottom line was this; every vetted approach works a little bit, however if people are not practicing the good brain health practices of eating, exercising, mindfulness and sleep–fogettaboutit’.
What’s really changed in the way people think and talk about addiction treatment is that we’re getting calls to action–and I mean seriously–people standing up in solidarity and declaring we cannot practice addiction treatment in the compartmentalized, symptom suppression way we’ve been trying for decades. Rings a Herby Bell in my, “experience of one” in addiction recovery…Yes!
Monetize Wellness: NOW
I love my squishy brain…
As I sit here between thoughts and squeeze my palm sized, squishy brain the Amen Clinics distributes as marketing tools, I realize we really are on the brink of commitment to delivering a new paradigm of healthcare because we’re learning how to market and monetize wellness.
Yeah, there are a lot of fancy ways to get into the practices of this new paradigm–healthcare–and it takes what it takes. How about a “single photon emission tomography scan” or better known as the SPECT scan? A test that takes a snapshot of how the brain is working to determine what practices of–you guessed it; eating, exercising, thinking, feeling and sleeping well will best serve that brain.
So what about all the other high powered, high tech, biochemical/mechanical approaches that we’re so used to hearing about “curing” us? Fantastic stuff all of which can be used for the far end of the sick care spectrum when indicated. But for the remaining 85% plus of the population, let’s evangelize the brain health basics up the yin-yang and develop services and practices that offer healthcare to the masses, shall we?
Live Long and Drop Dead
What we’ve learned the hard way, (and another refreshing, repeated point stressed at the symposium) is the longer people are in addiction treatment, the better. Another way to think about it is that people need to stay inhealthcare for life, because nobody gets out alive. How we facilitate this current inconvenient truth remains in the storming and forming phases, but people, we have ignition!
As more people are taught by doctors, (Latin; to teach) to take on the “experiment of one” by practicing good brain health, my mentor and colleague, Mark Sisson‘s adage makes more and more sense; “Live long and drop dead.”
Take a hands-on approach to taking care of your brain
Okay, so while we’re still in the interim space of being sold on the idea that one’s gotta have symptoms before learning to take care of oneself with good brain health practices, it’s an important step toward a better way to be the self-regulating and self-healing humans we already are.
Here’s to the time when we all realize that symptoms are an indication we have not been “in” or practicing healthcare–a time when we’re all taking a hands-on approach to eating, exercising, thinking, feeling and sleeping well–as matters of fact and practice.
A special thanks to Dr. David Smith who has been writing, saying and practicing all of the above for decades and who will be an upcoming guest interview on Sober Conversations. My deepest gratitude to you, Dr. Smith for all of the gifts bestowed upon so many at your symposium. I look forward to learning more from you very soon.
Recently I was made aware of a proposed, new, residential treatment center right here in my own backyard on the mid-Peninsula of the San Francisco Bay Area. For one reason or another residential addiction treatment is conspicuously few and far between here especially on the mid-Peninsula, which is equidistant from San Jose and San Francisco. The region is San Mateo County very near where Silicon Valley lives and thrives.
Among the 40 million people nation-wide, it is estimated there are approximately 66,000 individuals in San Mateo County alone who need addiction treatment and who fall somewhere on the spectrum of treatment needs from detoxification to continued care. The county now has less than 300 beds for residential treatment. Residential treatment is not indicated for everyone who enters addiction treatment, but certainly more than 300 beds are required in this county to meet the needs of 21st Century addiction treatment care.
The “Great Room” of Stillpath Recovery Center
The name of the proposed facility is Stillpath Recovery Center. It is located in an unincorporated 16 acres of San Mateo County above Woodside, California in the coastal mountain range. The owner purchased what was Stillheart Retreat Center where weekend retreats were conducted on this world-class destination of a venue.
I was so enthusiastic to learn about this project, I contacted the owner to ask if I might see the site and learn more about his approach. He was very generous with his time and invited me on two occasions to visit Stillpath and to learn what the project meant to addiction treatment in the Bay Area.
The place is a veritable vortex for healing. Surrounded by the nature from which it and we all emerge, while visiting and now, I cannot get over the quintessential perfection of what such a venue could mean for the Bay Area and addiction treatment/recovery. The site is not visible from the road and clearly far away from any neighboring concerns as the land parcels are quite large in the area.
I learned that the center would follow 21st Century brain science protocols outlined by the American Society of Addiction Medicine. A place for applied brain science, brain health to be practiced and realized right here in my own backyard. From integrated nutrition and functional movement to cutting edge psychological approaches–the stuff of addiction recovery.
The staff would be an integrated, multidisciplinary, communicative team of professionals dedicated to this work. I learned that the cost for such treatment could be reimbursed in large part by insurance through the advent of new coverage available via the current health reform legislation, The Affordable Care and Mental Health Parity acts.
I also learned that Stillpath would add 76 beds to the residential treatment potential to address the embarrassing deficit in San Mateo County not to mention the remainder of the nation.
I asked what I could do to help. The owner asked me if I would attend the next San Mateo County Board of Supervisors session as an addiction treatment and recovery advocate. The project, which had already received approval from the planning commision, (this approval being appealed by the local residents) was on the agenda to be approved or struck down by the supes. All of the concerns including traffic, zoning, water consumption, fire hazards and more were addressed in the planning commission’s approval. I looked forward to standing up for a potentially life saving project and for something that could raise the bar and the self-esteem of addiction treatment in our beautiful, trendsetting Bay Area.
Addiction Treatment? Okay, but…
The Board of Supervisor’s session took nearly 3 hours to come to a conclusion. Approximately 50 to 60 people attended equally representing the applicant, Stillpath Recovery Center and the local residents and their representatives who adamantly opposed the project. After each perspective’s representatives were given time to make their cases beginning with the planning commission’s detailed report for approval, the public was allowed 2 minute testimonials when 30 of us, one after another, stood up and spoke to our concerns and why we were there.
The local residents spoke to the planning commission’s report as being incomplete and largely incredible. One young woman repeatedly called the attorney and other members of the applicant’s team liars. Most of the testimony against the approval had to do with comments, (including one supervisor) relative to statistics about “addicts” smoking cigarettes, which will lead to forest fires and trespassing, “Everyone knows how addicts are, it’s from one addiction to another–they’ll smoke.”…This, in the face of the applicant testifying it would be a non-smoking center where resident’s personal belongings are searched as part of addiction treatment protocol. Another woman stood up and said her own family was involved with addiction treatment and how she believed in it, but…not here, please, not here in her own backyard.
In the opening presentation, Stillpath’s Clinical Director had already clearly addressed and answered questions regarding staffing/resident ratios. She discussed the nuances of the social model proposed incorporating the highest standard of practice concerning medical presence and monitoring.
The other testimonials in favor of the project including me, spoke to the dire need for such a treatment facility especially one we can all be proud of in an area where the best health care in the world for other health issues–including other chronic illnesses–is available.
People spoke to the pristine record of other similar centers and the prospect of this center aligning with outpatient centers and continued care services. A dream come true with a perfect place to live the dream. We spoke to the heart of addiction as many people stood up and talked about the ravages and deaths in their families or how residential treatment saved their lives. We heard from experts in the field to a son who had lost his Dad and a Dad who had lost his son.
We Get Letters That Say, “Not in my Backyard”
Okay…just not here
Finally all that needed to be said and heard was complete except closing comments by each side. Closing comments were given by a representative from each side including the attorney for the opposition declaring the proceedings were done all wrong and elaborated categorically. The attorney for the applicant’s side asked for a continuance until the 3 out of 5 supervisors who had not taken the time to visit the site could do so. One of those 3 supervisors spoke up to say she didn’t need to see the site or tour the specifics of what and why the planning commission had already approved the project, that she knew all about it and where it was…
The board then closed the formal proceedings and moved to a vote. Each of the supervisors cited an overwhelming number of letters and emails they had received or heard about asking not to approve the project, IE, addiction treatment is fine, just not in my backyard.
The board voted unanimously to strike down the applicant’s project, Stillpath Recovery Center.
I really believe the supervisors listened too. And I really believe they, as representatives of the culture, and at some very key and core level, continue to perpetuate the conundrum instead of offering proactive, collaborative solutions in this set of circumstances where the benefits clearly outweighed any mitigatable risks.
Addiction is a Cultural Phenomenon
Addiction is our number one public health challenge in the United States today in epidemic proportions. The cost of untreated addiction in terms of lost productivity, related health issues, and multi-generational social and psychological consequences, is staggering.
The potential residents of the proposed, Stillpath Recovery Center ARE the friends, family, co-workers and neighbors of the people in opposition to its approval. Addiction is a cultural phenomenon, and until we have leadership with vision, ready and willing to champion solutions for this now 21st Century plague of ours, we’ll keep getting what we’re getting; more addiction accompanied by the incessant denial that it lives in all of our backyards.
Surely, the culture that produces addiction can step up to the facts that if we are not all part of the problem, there is no solution.
Besides not having the benefits of long term addiction recovery care, what do Corey Monteith (actor), Sid Vicious, Dee Dee Ramone, Kurt Cobain, Peter Farndon (Pretenders), Lenny Bruce, Jim Morrison, Billie Holiday, Paula Yates (INXS mate), Jimi Hendrix, Hillel Slovak (Chilli Peppers), Judy Garland, Elvis Presley, Chris Farley, John Belushi, Whitney Houston, Corey Haim (actor), Janis Joplin, Heath Ledger, Marilyn Monroe, River Phoenix, Dana Plato (actor), Anna Nicole Smith and Philip Seymour Hoffman have in common?
36,500 people died last year of drug overdose. That means on average, 100 will die today.
You know the answer. These sadly extinguished Hollywood Stars put a face on death by drug overdose–death from addiction. Multiply these 24 souls by the number, ONE THOUSAND FIVE HUNDRED and we’ll get to the ~ 36,500 number of the other nameless, faceless people who died the same way last year. More than 100 people will die of drug overdoses in this country: TODAY. I know, I know…all kinds of chatter about accidental death in some cases, but really, I mean REALLY, can we get serious?
So what’s up America? We know the risk factors for addiction, we know how to prevent and treat addiction and even maintain recovery, but something is STILL woefully missing/wrong. What is it?!
Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.
Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response. Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.
Could it possibly be that we just can’t have it both ways–we can’t have addiction recovery and no infrastructure in place to deliver the ongoing and necessary care spelled out by the brain science? That’s what the good docs say above, no?
To this point and for the most recent ultra sad example, I do not think it was possible for a former athlete like Philip Seymour Hoffman who just happened to have the disorder of addiction to somehow become morbidly obese, smoke cigarettes and NOT have it profoundly jeopardize his ability to prevent what eventually killed him. You want science? We’ve got science. Recovering from addiction while nurturing metabolic syndrome with awful eating habits while smoking cigarettes? C’mon.
Brain Science and Brain–Body Neurophysiology Don’t Lie
Brain science and neurophysiology confirm how important overall good health is in recovery.
NO, we cannot have it both ways by going to rehab for 4 weeks 23 years ago and then hammering ourselves with other forms of toxicity and deficiency and not expect these tragic outcomes! Sorry, but addiction just won’t let us do it as we see at least 100 times per day in this society.
Nor will our minds, bodies or spirits let us misuse and abuse them without some other symptom picture emerging. It’s just that the symptoms of addiction are expressed in this characteristic, threefold, mind, body and spirit way. This reinforces the fact that it is neurophysiologically IMPOSSIBLE to feed our systems toxic and deficient input and NOT have the system adapt its neurophysiology accordingly giving rise to craving, Reward Deficiency Syndrome and a ticket to relapse that can result in frank suicide or the, we’ll-never-know “whoops.” Let’s call it “parasuicide.” Someone explain the difference when science and experience have outlined the prevention, treatment and maintenance landscape so clearly. Neurophysiological adaptation due to risky lifestyle habits is what leads to the breeding ground for relapse and in the above mentioned cases, premature death.
So why the RANT? Because 100 people will die today and we can do something about it. Because the addiction epidemic is just a reflection of the bad health epidemic in this country and that’s because we’ve got it backwards. Health and wellness takes precedence and practice–not waiting to merely treat acute symptoms with drugs and surgery when the feces hits the fan. And finally because I’m really tired of seeing misinformed mainstream media perpetuate lies in order to stay hypnotized by the quick fix, harmful notions about addiction and all other adaptive lifestyle disorders.
Long Term Addiction Recovery Care | A Go-Brainer
What’s missing is long term addiction recovery care and services. The solution is implicit in the rant and that’s a “go-brainer.” Go-brainer because it’s all about brain health and practices that foster what’s required for a healthy mind, body and spirit; eating, moving, thinking and sleeping well–just for today.
Recovery Health Centers | Get Well and Stay Well–For Life
And how will this be delivered? In a health care system where people like Phil Hoffman can and will check-in for that initial intensive care and then on a regular basisbecause they are armed with the knowledge, the “just say know”–from the get-go–that their lives depend upon it. A place where they are given wellness intervention, mind, body, spirit tuneups from scheduled, predictable time-to-times to uphold wellness thresholds. From illness to maintained wellness–a place where integrated and multidisciplinary teams are dedicated to interest their practice members in the care of the human brain-body, in a proper diet, and in the cause and prevention of dis-ease and active addiction.
Sharing childhood trauma as a risk factor for addiction helps students understand the importance of working through it with the right professional help.
I recently had the privilege of giving some talks to High School students on the topic of addiction. I enjoy doing this on a regular basis. The “entree” for such a topic of discussion–addiction–is best received through the regular curriculum, in this case anatomy and physiology classes and ideally after they’ve studied the brain and/or nervous system since addiction is a brain disorder and disease. Studies reveal that this approach has far better outcomes than delivering the information as an extraordinary event.
I really enjoy being in the presence of High School aged people. The unpretentious, creative curiosity they naturally bring is contagious. My challenge is to invite discussion about an issue that’s not easy to talk about, especially when addiction remains an enigma to most in our society. And I love the challenge and the sense I get, when it happens, that the students really understand why I’m there; because I care about my life and about the world and about them as a direct extension of what addiction and recovery are all about. Not an ego trip, just a real human interaction that nurtures the Soul–and people get that.
I begin by throwing it out there from definitions to causes to prevention to treatment. I let people know how it worked for me and that I’m not unique by any means–that 3 out of 4 of our families have addiction issues. Honestly, I can feel the deeper breaths, the “Oh, thank God, I thought it was just my family” kind of nodding release in the room.
I’m beyond touched and moved by the student’s questions during and after the talks. And the questions beget more questions as people give themselves permission to articulate wonderings and just put it out there themselves. It’s clear that younger people appreciate straight talk and transparency and in that environment great things can happen and in this last round of talks, did happen.
Childhood Trauma Can Lead to Substance Abuse | Addiction
A few days after my last visit, a teacher called to tell me a story emerging out of the recent talks. He said that one of his students did not return the day after my visit to his class. Upon returning to school the next day, the student was asked where he’d been by the teacher, if everything was alright. The student told the teacher the day before had been one of the longest days of his life. He said that when he asked me how childhood trauma, (one of the discussed, five risk factors of addiction) had affected my own addiction and I told him that the suicide of my father was a very traumatic event in my life and part of the reason I used drugs and alcohol, and that until I really looked at it, I wasn’t able to get well–he knew he had to do something.
The student told the teacher that he had been sexually abused when he was younger, that he could not keep it a secret any longer and that he thinks it may be a reason he’s abusing drugs and alcohol. He wants to stop. He took the day to tell his parents about it and about the other person involved. The family all decided to take the day off to seek the help from a mental health professional who will now help the student and his family work through it, (See the Adverse Childhood Experience Study for more information).
One student reported after hearing my talk that he was able to reveal that he’d been sexually abused to family members.
Okay, I can feel the tears welling up again. To think that a young man can step forward proactively in his own life when he’s given information that just may save his life is one of those divine surprises and gifts that is surely beyond me. The undeniable takeaway for me with this whole story is that human beings will do the right thing if they are informed with the right information. Human beings will get and stay well if they know how. Because in my experience, when I don’t know how, I’m less likely to try.
Obviously, I’m encouraged and invigorated by this experience. I’m so impressed with the quality of teachers and the genuine interest of their students wherever I speak. It’s abundantly clear all are interested in learning how to best take care of themselves and their families so that they may find out how to best contribute to our world. My faith in human nature and the dignity of our humanity is over flowing after being in their presence. We just need to find more forums for conversation and discussion about these issues that affect all of us profoundly.
As some of you know, I produce a podcast called Sober Conversations. The podcast is designed to be another forum to talk about these not-so-easy to talk about things. I close each conversation with the tag line: “All great beginnings start with a conversation.” How true it is.