Staying in The Moment Even When The Moment Sucks

Somewhere along day fortysomething of quarantine, I’d had it.

I’d had it with baking bread, I’d had with making funny videos, I’d had it with hanging out with myself for 12 hours a day. I’d had it with hearing crap like ‘we’re all in this together” because we are not and especially stuff like “think positively!” because that’s dismissive and inauthentic. But what I had really had it with was not having a way to check out and not feel any of the real-time trauma and global loss we are all going through.  Sure, every streaming service under the sun provided some relief but it wasn’t like drinking and using. Sorry back to back episodes of The Great British Baking Show isn’t an 8 ball of cocaine. Never will be.  But I don’t drink and use any more nor have I for over 11 years. That escape hatch was no longer an option. So how does somebody like me who isn’t a huge fan of reality stay present when drugs or alcohol are off the table?

People always say “just do today” or “stay in the moment” when you first get sober. It’s good advice but good god is it hard. Like sure “stay in the moment” but what if the moment, like the current scary-ass pandemic one, is a terrible moment?  I’ll stay in the moment but can I exchange this one for a different moment? Staying in the moment would be easier if this moment was a little less depressing and more glamorous, to be honest. This kind of thinking is what made such a good drug addict. Having a bad day? Hate your current reality? Simply take three hits of ecstasy, drink some vodka, and who cares if it’s a Tuesday. Regardless, it is true. Staying present and breathing through whatever difficult things are happening gives me a chance to stay sober. If I try a little to wait for some of my discomforts to pass, maybe it will. Or maybe it won’t right away but at least I will still be sober. Therefore, the first thing I have to do is just not drink or use it. I recognize saying “just don’t use” to an addict is kind of like telling koalas to just not be adorable. It feels and sounds impossible. But I swear it’s worked for me. My early recovery was jam-packed with rough moments I REALLY wanted to get wasted over but I listened to sober people who said “don’t use and it’ll pass.” I didn’t always feel great right away but later I felt proud of myself for moving through something hard without my old toxic ways of coping, or not coping as the case may be.

The next thing that helps me is owning the suckiness of the moment. A big part of my drinking using was the dishonesty and delusion that it really wasn’t all that bad. I was the king of singing “I’m fine!’ as I was on the verge of eviction or moments after a cocaine-induced panic attack. What sobriety has gifted me with is honesty. By first honestly admitting I needed help, I blew the doors open to speaking more truthfully about where I was at and what I was feeling. Staying sober required me to continue to do that so I wouldn’t drink or use the parts of life that hurt. Over the years, I have gone through the death of loved ones, divorce, major health dramas, and done it all sober. That’s been able to happen because I’ve talked openly about it to other people. It’s vital and lifesaving to my recovery. As someone who also works in the addiction field, I can honestly say I have never seen people who act like everything is okay to be able to stay sober. The folks who make it are the ones who share about what’s going on. They share like their lives depend on it because they do. 

It helps to have people who I can call when I’m trying to stay in a not so good moment. Not long ago, my sister and I were on the phone. We were lamenting about how everything kind of sucks. We laughed and sort of just owned the horrible moment together. She’s sober too so she gets it. What we didn’t do was try to give each other a silver lining or fix one another with bad advice. We just shrugged and sort of said “yeah everything is the worst right now.” By doing that, things felt a little better. I talked with someone about how I felt so I didn’t have to carry all of this heaviness alone. Let’s be real all of this is incredibly heavy. We’re frail, little humans, not strong, mighty elephants. There’s only so much we can carry. Talking openly with sober people helps me feel lighter, less broken, and not alone. 

The last thing that helps me is undoubtedly the hardest when it comes to difficult moments: acceptance. When I first heard that word in recovery I thought it meant if I accepted something I had to like it. It was later explained to me that acceptance wasn’t about loving your circumstances or the actions of others. It was about accepting the truth of those people and things. With so much sadness, racism, and death in the world currently, acceptance is a tall order. But it’s vital if I want to stay sober. I can change myself and my reactions and I’ve discovered that’s about it. Changing people’s actions, changing the weather, changing global crises? Child. Not so much. Once I accept these things, there’s a ton of freedom that comes. I feel like less of a victim of circumstance, less self-centered. What’s more, is acceptance means I’m not tortured in the moment by things I really have no control over.

 As I wrote the first draft of this, protests raged blocks away from my house. The moment felt scary. It felt heartbreaking. It felt inevitable. But it would have felt worse if I was drinking or using. By accepting what was happening outside my door and not hide in a bottle. Also, this acceptance lets me focus on what I can change: I can help other people struggling, I can listen and I can stay sober no matter what the moment is.

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Alcohol Companies Sponsoring Pride Month is Still the Worst

You would think with what we know about the LGBTQ+ community and its toxic relationship with alcohol that we still wouldn’t be talking about liquor companies sponsoring pride. 

After all, tents filled beer and float sponsored by Stoli vodka feel a little outdated in this day and age. Widely considered an at-risk community to develop substance use disorders, a booze brand sponsoring Pride feels like a high school dance being sponsored by gun manufacture. Likewise, you would think that in this COVID-19 era with Pride celebrations canceled around the globe, Big Alcohol might sit this year out. You would think that and you would be wrong. The doomed marriage between alcohol and Pride rages on, the pandemic is damned. 

Wine, beer, and liquor brands early on hopped on the already super questionable marketing push for consumers to “party at home” in quarantine. This, apparently, was a smart strategy. Alcohol sales hit all-time highs early in the pandemic and have held steady. With in-quarantine holidays like Cinco De Mayo (a racist, problematic alcohol marketing bonanza which deserves its own essay, if not documentary) and Memorial Day proving to be big hits for drinkers, Pride was the next one on the list. Myself and the other queer people I knew folks happily threw ourselves behind the pressing issues of Black Lives Matters and police brutality among the black community. Nevertheless, alcohol makers already had bottles of rainbow liquor and cases of Gay Beer ready for the shelves. Check out your grocery store’s wine aisle this month and I guarantee you will spot at least one bottle ready for Pride.  The party was going to carry on even for booze brands, even if the parade was canceled. 

Absolut, a longtime pusher to the gay community once again packaged its rainbow bottles under the guise and pomp that they are allies to the community. According to GLAAD’s chief program officer Zeke Stokes, “Absolut’s commitment to celebrating the LGBTQ community all year long, and not only during Pride month, is a shining example of how brands can bring inclusivity, diversity, and acceptance to the forefront of their mission.” These are all nice words but when said product is literally killing a group of people, they’re meaningless. If Absolut was so in love with serving the LGBTQ+ community, profits donated towards culturally specific treatment centers would mean a hell of a lot more than cheap rainbow-colored bottles. Just saying. 

But is marketing alcohol to LGBTQ+ really all that bad? In a word, yes. Personally, I came out in the era where you came out in bars which were also safe spaces but definitely places people like me who loved to party could find any and everything they wanted with relative ease. The gay culture in the ’90s was everybody met while drinking or using drugs. It’s who we were. We didn’t have the language then to identify that many of us, self-included, were drawn to drugs and alcohol to help self-soothe our various traumas, many of which were caused by being queer. Sure, dozens of statistics show that queer individuals are twice as likely as their straight counterparts to develop substance use disorders. But I know in my own life that the societal weight I carried as a gay man, the discrimination, the internal hatred because of my sexual orientation mixed with a family tree filled with addicts and alcoholics, made me the perfect target for this kind of marketing. In my early twenties in the 1990’s I had moved to Los Angeles. Brands like Budweiser, Coors, and Absolute were already marching in Pride parades and setting up booths at gay festivals. At the time, it felt like these brands were being bold. After all, Ellen had just come out and Will & Grace were on TV. Being gay was now cool and more acceptable. It seemed like it was finally time for all of America to get on board with the LGBT community. 

As a young bar and nightclub regular, to me, it was cool and progressive that brands would laugh in the face of heteronormativity. They were selling their products directly to me and my friends.  These brands weren’t like my parent’s brands. They were down with the cause and supported us. But as it turns out, it wasn’t cool at all. 

 These huge companies launched campaigns targeted to me and my friends for the same reasons they put billboards for malt liquor in black communities or marketed cigarettes in Spanish in Latino neighborhoods: because they knew their customers. Companies like Coors and Smirnoff spend millions on demographics and research to figure who’s buying what so they can push even harder to those folks. Once they figured out that my people were spending lots of money on booze, they heavily invested in ways to find out how to make us spend even more. What’s beyond messed up about this is that we now know better in 2020. We have the receipts of years of data that shows it isn’t solidarity or support. We know the rate of addiction with queer people is out of control. We know that LGBTQ+ face more mental health conditions than their straight counterparts.  It’s simply about money and money made from people struggling the most. Yet they continue to do it anyway. 

Pushing aside the bottles and shot glasses decked out in rainbow colors, it’s important to remember that Pride celebrates the Stonewall Riots which were the first move toward gay rights in this country and started by queer and trans people of color. This wasn’t about being a product. It was about being treated fairly like everyone else. As our rights are constantly threatened even today, we don’t need your stuff. We need your help. If we really want to show our support to gay, lesbian, bisexual, asexual, trans and queer people, it will take more than buying merchandise. What my community deserves is access to a culturally specific treatment, free mental healthcare, and comprehensive campaigns that don’t sell vodka but sell the idea of recovery while smashing the stigma. Now, that would be something to really be proud of. 

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The Crisis Inside the Crisis

For the last nearly three months, I’ve scrolled the Instagram and Facebook pages of friends and family members who while on unemployment have spent their time baking banana bread, playing Animal Crossing, and coming up with an at-home workout.

I’ve maybe been a little jealous…

Okay, a lot jealous. Because while I know the uncertainty of life as we know it is stressful for everyone particularly those who no longer have jobs, there’s part of it that seems carefree and like an opportunity to recharge. Yet when I’ve talked to sober friends stuck at home suddenly without jobs, the fears are real. They’re afraid they won’t have work when life returns to whatever the hell normal is. They’re afraid of relapsing. They’re afraid of losing connections with their recovery communities. So the grass isn’t so green on the other side. From working in the very real and very intense current worlds of mental health and addiction this entire time, I know their worlds are not all baking and Tiger King. See while we’re watching the current COVID-19 crisis calm down, the ripple and fallout it’s caused in the recovery world is only beginning. 

For me, a person in long term recovery with a condo, Wi-Fi, and food in his refrigerator, not to mention access to any recovery ZOOM meeting in the world, this whole thing hasn’t been so bad. But for the people, we support at my job and the majority of folks struggling with substance use disorders all over, this virus is deadly on several levels. The first crack we saw in the system as places closed down and services became more and more limited was vulnerable populations immediately at higher risk for relapse. By the very nature of shutting down spaces where people had 12 step meetings, received MAT, group therapy, or spiritual support, a population that struggles under the best case scenarios had their lifelines cut off or at least harder to access. Also, we’ve always told people in recovery to reach out, to ask for help and that connection is the opposite of addiction but all of a sudden we were saying staying home and stay away from people. Sure, there’s online and digital support but that sort of support and social distancing, in general, is soaked in privilege. Around 75% of the people I supported at a busy hospital here in Portland, Oregon were homeless. They didn’t have phones or iPads, they didn’t even have somewhere to sleep.  So these meeting spaces and clinics weren’t just vital to their recovery but to their survival for things like snacks, warmth, and human interaction. The fallout from all of this from what I’ve seen begins with people falling off the radar. Now as a program manager, the mentors I supervise have lamented that people who they once saw weekly and who they could support at appointments, were now left to go at it alone. People struggling with mental health and addiction need the connection and haven’t always been able to get it over the last few months. 

Unsurprisingly, relapse is also on the rise. The people my team support who were struggling before the pandemic were suddenly at a higher risk. Add to this a huge amount of stress, loss, grief, and financial uncertainty and you’ve got the perfect recipe for relapse. For example one of our mentors who work in a hospital is usually given access to hospital rooms to build connections with folks with substance use disorders. This work is vital and it works to help get them connected to recovery resources outside of the hospital walls. She’s now forced to do this work over the phone and as you can imagine, it ain’t the same. The opportunity for a face-to-face to perhaps disrupt a pattern of use is now nonexistent. It’s a leap of faith that some connection can be made over the phone. Despite the limitations, she’s been able to get people into treatment and deliver much needed basic needs items like food boxes and phones. But the undertaking is monumental and the deck is stacked against recovery mentors with limited access and forever dwindling resources. She’s seen twice as many patients return to using as she has got into treatment. Again, this is difficult work even when a pandemic isn’t happening but now it’s blossomed into a crisis of its own.

I work for an agency that provides peer support and one of the things I love about the field is that we meet people where they’re at. If they want to get sober, terrific we help with that. If they’re interested in MAT, we help connect them to various clinics around town, and if they want to keep suing we talk about keeping them safe and harm reduction. Yet now actually meeting where they’re at is a challenge. We can’t pick them up and take them to the DHS office. We can’t take them to a recovery group. We can’t even meet them for a much-needed cup of coffee. Our magic trick of meeting people where they’re at is now made harder as we don’t know where many of our homeless people are and we couldn’t be near them even if we did know.

The final fallout from all of this is the worst and most final of all: suicide. I happen to live by one of those historic bridges you always see in photos of Portland, Oregon. About two weeks ago, a neighbor of mine ran through our courtyard frantic and told me to call 911. Someone had jumped off the bridge near my house and into the Willamette River. It shook me to the core obviously because it was right in my backyard but also because it illustrated what must be happening right now in communities around the country. The Washington Post recently ran an article outlining how America’s treatment centers and mental health facilities were ill-equipped for what was about to happen. Writer Brene Brown described it as “the crisis inside of the crisis” which is completely accurate. But for those of us working inside of that crisis, it feels more like a tidal wave after an earthquake. You see it coming but there’s very little you can do to get out of the way. 

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Recovery Isn’t Just For Straight People

If you were only to look online and never meet real sober folks you might think that we’re all nice, straight white people. Yet despite what we know about LGBTQ and substances, my people recover too.

Two modern tropes, the boozy gay man’s best friend and the sober enlightened straight cisgender white woman, became tropes for a reason. The first, and I speak from personal experience here exists because most of us came out of the closet and walked right into a bar. Alcohol and the places they serve is an integral part of the gay experience, whether we like it or not. Was I a drinker who then became gay or was I gay and then started drinking or was I, in fact, born both, a hard drinker and a flaming homosexual (ding ding ding!) who the hell knows. But what I do know is that my drinking (and drug use-duh) and my gayness are so entwined that when I went to get sober in 2009 I couldn’t imagine being one without the other. The other trope (which I clearly am not) seems to be the loudest voice in the online sober-sphere as of late. And why the hell not? The real world has been mainly male-dominated since the advent of 12 Step groups so it’s about time for women to share their stories of recovery.  The countless fearless, female voices to hit the digital world in the past decade is overwhelming and inspiring. Yet if you take a look at these voices, it feels like that’s all there is: straight women who get sober. Granted, women account for the largest percentage of folks who buy books and read online but there’s a disparity is queer voices in the recovery space overall. 

What we do know about my community and its relationship with drugs and alcohol isn’t pretty. The very real numbers are grim to say the least. A recent survey reports that some 18 million LGBT live with substance use disorders. Also people who identify as gay or lesbian are more than twice as likely as heterosexuals to a severe alcohol or tobacco use disorder while people who identify as bisexual are three times as likely to develop a substance use disorder. Not to mention the surge in meth related deaths among gay men and the losses of gay icons like George Michael. Couple all of this with the still devastatingly high numbers of LGBTQ youth suicides and overdoses, the outlook for my people isn’t exactly the inspiring stuff that the gals from the suburbs want to read about in their book clubs. Many studies point to higher instances of trauma, discrimination and internalized homophobia as some of the possible reasons why our addiction rates are so much higher. 

Yet talk to anybody who has been to an intensive outpatient program, a 12 Step meeting or an inpatient treatment facility has probably shared space with gay, lesbian, queer or trans folks. Since we struggled more than our average heterosexual friends, we also wind up seeking treatment more too. Barely visible online or not, the truth is we exist in large numbers in recovery and many of us have long term recovery. To bounce back to the celebrity example, for every five George Michaels there’s at least two or three Elton Johns. Plus, gay communities across the country have long responded to the high risks of addiction by providing support and are currently stepping up to address everything from drinking to the dangerous “chemsex” trend. Yet for examples of queer folks conquering addiction, I need not look further than my own inbox.

Ever since I got sober, I have been fortunate to have a life filled with gay men doing what I previously thought was impossible: getting and staying sober. We text one another all day long, we check in and make sure we’re all okay. Mainly we laugh a lot, far more than you’d expect from people who nearly died at the hands of drugs and alcohol.  In my first gay meeting in Santa Monica in 2009, I couldn’t believe that people, particularly gay people had stopped drinking and using drugs. Dozens of them had 60 days, 6 months and 6 years sober. It blew my mind but it showed me it was possible. I might have come out in a bar but I didn’t have to stay there. In early recovery, I had to find real self-esteem where I finally learned how to accept my sexuality and learn to love my big gay self without drinking and using. It was no picnic. After decades of self-hate, shame, internalized homophobia, untreated mental illness and lost and lots of drugs, I was forced to the real Sean for the first time.  Turns out I was enough: gay, sober, living with depression, PTSD and HIV- I was enough. What’s more is the longer I stayed sober, the more I authentically really love myself. Who knew that would ever be possible? 

 11 years later, I get to help other gay men new to recovery too. All these things about myself that caused me shame or embarrassment, like being HIV positive and being gay, are now professional assets in my work as a peer support specialist and recovery mentor. When I get to work with people who have the same experiences as me, something magical happens. Sure, I’m there to support them but I always feel better too. We’re both suddenly less alone. We show one another that we can survive, pull through and stay sober. The feeling of belonging that I wanted in gay bars is now found in people bravely beating the odds and walking the same path as me. Sure, that path forged by my LGBTQ sober brothers and sisters might not be a much talked about blog or hip best seller which fits snuggly into our current marketable version of what sobriety looks like. But it’s one that exists and for that I’m forever thankful.  Remember recovery isn’t just for straight people. 

When Your Family Wants You to Get Sober

“We’re Really Worried About You”: When Loved Ones have THE TALK About Your Drinking and Using. 

There are certain conversations burned into your mind that stay fresh, no matter how long ago they happened. My sister and I had one of those about 27 years ago. It was a hot Denver summer and we were walking down a tree-lined street near the house she and her friends were renting. With tears in her eyes, she confronted me. She had heard from a hard-partying but in this case totally accurate, a friend of ours that I had been using meth. This was the kind of friend who was always wasted and totally unreliable so I laughed it off to that. I then went on to attack my sister for even believing such a thing. Defensive and mean spirited, I accused my sister of being dramatic and believing gossip instead of asking her own brother. It was an ugly conversation and my reaction was uncalled for. She was someone I loved just asking if I was okay. But I was about 16 years away from being ready to have that conversation.  I stayed unready to talk about my relationship to substances that were always worse than any bit of gossip anyone could ever imagine. Yet it begs to question if there is ever a good time to hear that you need help and that the people in your life are worried about you?

Look nobody, addict or not wants to hear stuff like “Wow! You were really wasted last night!’ or “Maybe you should slow down on the wine?” These kinds of observations, although perhaps dripping with judgment, immediately turn the mirror on ourselves and we have to look, if even for a moment, at our relationships to substances. So when a family member or friend takes it to a more serious place and tells you they think you need help, no wonder people like myself explode. Quite honestly, I don’t know if there’s a “good way” to react to these conversations. Trying to reassure people I had it under control was always my default response. “It was bad but now it’s better” or “I like to have fun! I’m not hurting anyone” seemed to roll off the tongue for me when questioned. Likewise so did minimize how much I was using, talking about how someone we all knew had a worse problem then me and blaming my increased partying on stress. I guess my advice would be to try to hear when people tell you they’re worried about you. Maybe try to leave aside feelings of being attacked and know that whatever is coming out of a friend or family member’s mouth, it’s out of love. But honestly, even when we’re ignoring concerned people, we hear them. I had an old boss told me at age 21 that she thought my drinking and using was getting in the way of my job- and this was at a restaurant/bar where the bartender was our cocaine dealer! I was obviously a mess for her to even notice among the other drunken disasters who worked there. I shrugged it off but I never forgot it. She told me I should slow down and take care of myself. And then she fired me. 

Long gone from my restaurant days, I now work in the world of substance use disorders at a hospital. Daily, I see upset moms, dads, and siblings struggling with these conversations. There’s a belief on their end if they could just get through to their loved one with how much they care and how scared they are then the person would stop using. From bringing in friends and therapists to inviting medical staff in, I’ve seen families make attempts to have “the talk” that will hopefully save their loved one’s life and get them to choose recovery. Things like interventions are popular and make for good television but the reality is if the person isn’t ready to quit, there’s no conversation in the world that can make it all better. 

As I write this at age 47 with over a decade sober, I’m currently wondering if there is the best way to give or receive these kinds of conversations. The shoe is on the other foot for me, as I now find myself worried about two people in my life and their respective relationships with substances. Our basic human instinct is to shake people and say “WHAT THE ACTUAL HELL ARE YOU DOIN?!” but I know that never worked for me in my addiction. I also have to remember that I wouldn’t scream at someone with cancer or diabetes and likewise it wouldn’t help them at all. When pushed and threatened and given ultimatums, no one is going to hear that you’re concerned. My poor sister wasn’t even being accusatory and I exploded so I can’t even imagine what my reaction would’ve been if she was even remotely punitive. Therefore, I know the same applies for me and the people who I love that I’m concerned about. What I’ve been able to come up with is this: I love you. That’s it. That’s where I have to start the conversation. I love you and I hope you know I’m here for you if you need help or if you want to talk about anything. Working in the world of peer support, I’ve learned the art of meeting people where they’re at. If someone I’m concerned about wants to get sober help, I’ll ask them if they want me to help them with that goal. If they want to keep using, I have to respect that too. That tough conversation also starts with I love you while maybe introducing ideas of harm reduction and letting them know I want them alive and healthy, regardless.

But the point is we keep saying something, we keep saying I love you. Because even 27 years later, I can still hear the people who said it to me. 

Why Is Meth Left Out of Medication-Assisted Treatment?

When it comes to meth, there’s no MAT, no funding and little hope

For being in the middle of an opioid epidemic, we sure did talk a lot about meth when I worked on the addiction medicine team at a local hospital as a recovery mentor. In fact, we talked about it all of the time and depending on our patient list, we talked about it all day long. The collective brilliant brains of social workers, doctors and mentors like myself couldn’t fix the meth problem for our dozens of suffering patients. Yet for something we all talked about endlessly, for an American tragedy we desperately were trying to help solve, it certainly felt like no one beyond the hospital walls was talking about it. After all, medications like buprenorphine and methadone were lifesaving medical interventions helping combat opioids and heroin addictions. But why aren’t there the same types of medications for meth and why don’t we talk about meth and the thousands of lives destroyed by it? 

From what my creative and certainly not medical brain has learned, MAT (medicated assisted treatment) for meth is a very tricky thing. I’ve heard many doctors say something like stimulant replacement therapy (for example replacing meth with a prescribed stimulant like Wellbutrin) is too inconclusive in results and too controversial in concept to ever be taken seriously. Plus, patients going for the extreme highs for meth probably wouldn’t respond to a more subdued and controlled medication. Conversely, there are gateway medications to meth like Adderall. Adderall is high in amphetamines and considered by some to be as addictive and dangerous as meth itself. Lastly, there are the real results from years of tests that really aren’t that encouraging. Inconsistent and mostly negative findings mixed with a heavy stigma have landed MAT for grounded before liftoff. But it shouldn’t be especially since deaths from meth rose at a frightening rate in 2019. 

Then there’s the additional problem of the crippling stigma that goes along with meth. Mildly put, meth has a bit of an image problem. The reality is we aren’t hearing about nice white ladies from upper middle-class families dying from meth like we were when the opioid crisis exploded. When we hear meth we think of a long canceled tv show featuring desperate criminals, poor, uneducated folks or the LGBT community. Meth, or so we would like to believe, doesn’t affect our friends or neighbors and isn’t as lethal as heroin. It’s out of sight and out of mind with meth. A homeless man I supported in the hospital once remarked, “Nobody cares about people who use meth because we are all poor, homeless or have mental illness.”  It was hard to argue with him. We somehow forget the psychosis, the deadly heart problems and the endless burden of meth use on our criminal justice and healthcare systems. As someone who struggled with meth in the past, I can say that as an addiction it is absolute hell and anyone suffering from it deserves out help, stigma or not.

So what’s the answer? The key when it comes to meth, it probably won’t be one answer but lots of answers. For example, cities like Portland, Oregon, and San Francisco are having clinical trials featuring micro-dosing of prescription stimulants and other drug combinations to see if they can crack the code. Also, some doctors are circling back around to a study from 2009 that reported ADHD medication dexamphetamine helped decrease meth use in study participants. Likewise, Naltrexone is currently being hailed as a possible MAT solution for meth users. In a report last fall, NPR talked to doctors, psychologists, and patients who all had success using Naltrexone to help with symptoms of meth withdrawal. The report found that the combination of the drug with other medications like the antidepressant bupropion proved to be helped for treating meth use disorder. While the use of Naltrexone to treat meth use disorder has yet to be approved by the FDA, it’s at least now being seriously considered as a medication that might provide hope. 

 Next, there are a number of non-medication options that provide a little hope. The one I’ve seen work incredibly well for people struggling to quit meth is contingency management. For the uninitiated in recovery world lingo, contingency management is a simple system of rewards for goals met. For example, giving out coffee shop gift cards for each month a patient stays sober or things like snacks and candy for negative drug tests. Sounds silly and a little like bribery but studies show that the rewards coupled with therapeutic positive reinforcement really work on methamphetamine users. At the hospital, much of my job as a peer recovery mentor was encouraging the people I worked with to stay and complete a long course of antibiotics to treat infections caused by IV drug use. Promising and delivering little rewards for each week they stayed in the hospital gave them something to work towards and be proud of. 

But the biggest answer for America’s meth problem is better access to treatment. Working with folks battling meth addiction on the streets and in hospitals, I’ve seen the devastation this epidemic is causing firsthand. There aren’t enough treatment beds, too many insurance barriers and a broken criminal justice system that all stand in the way of people wanting help. This means thousands of people who want help are unable to get it. This a mind-blowing and baffling truth for a rich country with endless resources. Consider how fast Washington acted to address the dangers of vaping. Yet it’s taken decades to get more treatment for people dying of substance use disorders.  Much like other health epidemics such as the AIDS epidemic, our addiction crisis might have to be solved and pushed for by the people dying from it. Policy changes and political activism to increase treatment and reduce stigma will have to work side by side with medication interventions to bring about a solution for a meth nightmare currently spinning out of control.

New Drugs, New Drinks, Same Sober Me

Having recently celebrated 11 years sober, it occurred to me that drinking and using has changed since I stopped. Not changed in a way like “Poof! No one uses drugs or drinks any more!” Far from it, I think our substance use disorder crisis has gotten far worse since I got sober.

No, I mean changed in like now in 2020 there are so many new products, new avenues and new ways to get inebriated. And while I cherish my sobriety and work pretty darn hard to hang onto it, I would be like if said there wasn’t just a teensy bit of FOMO when I hear about the plethora of new cool drugs and trendy new alcoholic beverages that all the kids are enjoying. 

For example, the other day a friend of mine was talking about going into a dispensary here in Portland. She said it was like a jewelry store and there were all sorts of glamorous options and different flavors of edibles all of which promised their own unique mind-altering high. I wondered as she spoke and my first thought was “Gee that sounds like fun. I should check one of those out.” My second thought, however, was “Oh wait. I don’t smoke weed anymore and like I didn’t really ever love it to begin with.” Likewise, another sober person in my life and I were laughing about all the cute, chic little cans of fancy wines that are on the market now, things that did not exist when I was drinking daily in 2008. I sighed and said out loud how nice that must be to go to events with adorable little to-go versions of wine. My friend was fast to remind me that a mini serving of wine would barely scratch the surface for a seasoned daily blackout drinker like myself. It’s definitely the same with smoking. I loved smoked cigarettes and started when I was 13. I didn’t stop until I was 37. Yet I totally missed the entire vaping phenomenon.  Despite not having a cigarette in 9 years, I really considered vaping over the summer. My brain convinced me fairly quickly that vaping could work and after all, I’d had a lot of loss over the summer. What harm could a little cupcake scented cloud of nicotine actually do? I already knew the answer to that question in the pit of my stomach. It wouldn’t be vaping just that once. I know that my inner addict would be off to the races after on puff.

Since 2009, I have seen lots of drug and alcohol trends come and go. I watched hipsters sip Moscow Mules out of fancy copper cups in 2011. I read articles about people being worried, understandably, about the presence of elephant tranquilizer showing up in heroin supplies in 2017. Just last summer at the swimming pool in my building, I saw skinny blondes guzzle back White Claws while tanning on deck chairs. I’ve also missed out on the big-time return of cocaine (But really? Did it ever leave?), the deep obsession with IPA, the momentary blip on the radar of frightening Flakka, Skittling, tainted CBD, spiked Kombucha, Kratom and probably countless others. Working as a recovery mentor in a hospital, there was no end to the new drug combinations or varieties we would see in the patients who wound up in the emergency room. I said “missed out” but when you see them in a list like that there’s zero real FOMO involved.

The daily screen time report at the end of the year on my new iPhone was, metaphorically, like looking at one of my old bar tabs. Let’s just say it was a daily average under 10 hours but not by freaking much.  It also started to make me feel depressed and filled with anxiety and not the fun entertaining thing it once was.

Yet I am reminded regularly that when it comes to anything that makes me feel good, I am not wired like “normal” people. As part of starting my new year off right, I decided to take a 90-day social media detox. Granted this in no way at all compares to quitting drinking or using drugs. It’s the luxury kind of detox that bored sober people like myself get to do when they have enough of a clear head to see other things in their lives that are problematic. The daily screen time report at the end of the year on my new iPhone was, metaphorically, like looking at one of my old bar tabs. Let’s just say it was a daily average under 10 hours but not by freaking much.  It also started to make me feel depressed and filled with anxiety and not the fun entertaining thing it once was. Thus, I decided a little break from social media would and maybe even helped me feel less anxious and depressed about the state of humanity. Also, maybe a social media break could usher in new healthy habits. I went to the bookstore to hopefully return to my love of reading and started practicing better sleeping hygiene. A few weeks in, I can honestly say this experiment is going well. I feel better and I’m getting more stuff done without being a slave to likes and notifications. But it definitely has highlighted how addicted to social media I actually am. It took a few days to not look at my phone out of sheer habit. I also found myself with a plethora of thoughts that I couldn’t instantly share. Thank god I’m a writer.  Also, it simply unleashed the inner addict in other parts of my life. Like the minute I deleted social media from my phone, I bought an AppleTV and started watching tv, in the same manner, I used to drink and reading books just like I chain smoked. Sigh.

In the end, drugs have changed and will continue to change. They may even be some validity to my thoughts that maybe these new drugs would be the ones that could work for me, the ones that wouldn’t destroy my life. Maybe vaping crack and drinking White Claw is the missing combination to help me use substances like a normal person! But I don’t want to find out because while the drugs have changed, I certainly have not. 

The Benzo Epidemic Won’t Go Away On Its Own

Benzo addiction and the story you are about to read is becoming increasingly more common in the United States. It’s an epidemic that will not go away without raising awareness for the people struggling.

“I can’t stop and if I do stop, I have a seizure,” a frantic voice on the other end of the phone to me a few months ago. The voice belonged to a young man I met in the hospital in my role as a recovery mentor. By the time we talked on the phone, this substance had already caused him to blackout, get physically attacked, and lose most of his personal items as well as entire days and weeks of his life. It was slowly killing him but the thought of quitting scared the crap out of him. The drug he was so afraid of yet so enslaved to? Benzodiazepines and his story is becoming increasingly more common across the United States.

See, it would be one thing if this young man was the first guy I’d worked with who had struggled with benzos. But the fact of the matter is, in my two-plus years as a recovery mentor and peer support specialist, I’ve met dozens of people meet with severe benzodiazepine use disorders. Even more terrifying, the appeal of benzos stretches across other addictions. The peers I support who struggle with meth, heroin, and alcohol usually have a problematic relationship with benzos too. So common in fact that me and the other people on my team ask our patients about benzos when we first meet them. Through these frank conversations and some chart digging, we often find that our people have been taking them for years. I recently met a man in the emergency room who started dipping into his mother’s Valium in his teen years. He is now in his 50’s and unable to stop. It’s a mini epidemic maybe not be as talked about as our current opioid crisis but one outlet like CNN and the New York Times have stood up and taken notice of. But how did we get here?

“Even more terrifying, the appeal of benzos stretches across other addictions. The peers I support who struggle with meth, heroin, and alcohol usually have a problematic relationship with benzos too.

Touted as a wonder drug in its early days, Valium was at one time the country’s most prescribed drug. What we didn’t know then was how highly addictive it could be and how some of the side effects included depression, suicidal thoughts, and overdose. Valium prescriptions were easy to get at one time and just as easy to get your hands on if you were like the man I met in the ER who was a kid in the Valium heyday. Since the early 2000s Xanax has taken over as the benzo catchall drug for everything from anxiety to panic disorders to even nerve pain. Mixed with alcohol Xanax can be incredibly dangerous. As someone who has done that not so magical combo more than once I can tell you the one thing it’s good for is forgetting larger chunks of your life. In addition to being easy to get your hands on a prescription, Xanax is now being sold on the street in pressed bar versions that contain lethal substances like Fentanyl and the very dangerous benzo hybrid Etizolam. This Xanax (often referred to as “Xanie Bars”) can be easily picked up on the street, online and even out in front of many urban outpatient treatment clinics. This is all incredibly problematic for the folks I work with who are also receiving Suboxone or Methadone as part of their treatment as the interaction of benzos with those medications can be incredibly dangerous. About two years ago, I sat with someone during a terrifying overdose caused by a combination of Xanax and Suboxone. He lived but continued to battle getting off benzos and other substances for months. To make things even more complicated, recent studies have found that benzodiazepines are more prescribed in poorer areas, causing addiction to already vulnerable populations. Yet due to their relative easy availability and sometimes unnoticed dependence, benzo addictions are often minimized or ignored by medical providers.

“Recent studies have found that benzodiazepines are more prescribed in poorer areas, causing addiction to already vulnerable populations. Yet due to their relative easy availability and sometimes unnoticed dependence, benzo addictions are often minimized or ignored by medical providers.

The very 2019 mess of benzo addiction carries with it an additional deadly twist: withdrawal. Withdrawal from benzos, like my friend at the top of this essay alluded to, are something to be afraid of. Like alcohol withdrawal, benzo withdrawal can literally kill. Grand mal seizures, hypertension, elevated temperature and increased bizarre behavior are just a few of the things that can happen when a person tries to quit benzos on their own. Working in the field and seeing real people in the grips of this addiction, I’ve had to develop very real strategies and conversations to keep people alive and safe. The first thing we talk about is if they want to stop taking benzos they should go to the ER, a local detox or at the bare minimum their primary care doctor. Again, the physical and medical ramifications are too intense and scary for someone to navigate on their own. Next, we talk about ways to keep them safe if they want to continue to use benzos. Using the compassion-based principle of harm reduction I walk through with them about ways benzos can be less problematic. This ideas include not mixing them with alcohol, letting others know how many and what you’ve taken, accessing Fentanyl testing strips, using them as prescribed and also making sure they have access to Naloxone, which can literally save a life of someone who has overdosed on an opiate and benzo combo.

I wish I could say that was the only phone call I ever got from this guy, this kid, really with the benzos problem. But it wasn’t. For months, we looked for safe ways that he could detox and get the help he desperately needed. Riddled by the combination of addiction and fear, he is, as of this writing, still battling this very real and common problem. Yet he isn’t alone. The microcosm of Portland, Oregon where I live and work is but one of many hundreds of battlegrounds fighting this epidemic. While there are no easy solutions what I do know is that people with benzo use disorders don’t need to be ignored any longer. They need our understanding, our help and our love.

Sober and Suddenly Single

“It’s just us three from here on out,” I remember thinking as I stood in my kitchen and stared at the scruffy faces of my two cats. See, I was getting divorced and it was hard not to feel like a divorced old cat lady.

This person is a cliché for reason: they actually exist and now I was them.  Here I was a gay man at 46 years old as my ex-husband went off with his new, younger boyfriend and I was left the consolation prize of these two felines. Oh, don’t get me wrong. They are delightful creatures and better than most people I know. It’s just that I never pictured myself here. Ten years sober and suddenly single. Yet that is precisely where I found myself this summer.  If you would have told me this is where I would wind up when I was new to recovery in 2009, I might have rethought this whole getting sober thing. Instead of nonstop glitter and rainbows, this unexpected turn in sobriety was really hard and full of challenges. Plus, completely lacking in substances to help me take the edge off. What was even more daunting was the idea of returning to dating after being out of the game for over 9 years. The world of gay dating had changed since I took myself off the market. I had missed the advent of Grindr, Scruff and all of the other dating apps. Also, I was left with a surplus of time and nobody to come home to.  How was I going to survive any of this without my old coping strategies (i.e. lots of drugs and alcohol.)?

“In a lot of ways, being newly single is like being newly sober.  When I was new to recovery, much of what I faced was just trying to do this whole life thing without drugs and alcohol. ”

The answer in short was I wasn’t if I tried it alone. This didn’t mean hopping right into another relationship. Dear god. No. I knew as much as I problem that I have with drugs and alcohol, I had at least that much of a problem with relationships. Not only am I from a long line of folks with mental health challenges and substance use disorders, but codependency also runs in my family as well. This genetic jackpot meant if I knew what was good for me, I’d avoid love and drugs of any kind and run screaming to my therapist’s office, which is exactly what I did. The only man I saw with regularity was my therapist and I paid him to put up with me. Not that a similar arrangement couldn’t be found elsewhere but I kept it in the purely therapeutic lane. I meant not alone in the sense of not having any support. If sobriety has taught me anything, it’s that I can’t get through change or challenging times all by my lonesome. Therefore, in addition to my therapist, I leaned heavily on my other sober friends. In addition to late-night crying sessions and moments when I just needed someone to remind me to eat and take a shower, my sober support system help me see that I was eventually going to be okay but until then it was normal to not be okay too. Feeling all of my feelings, another horrible, icky thing I avoided when I was using,  was key in this whole newly single thing. It was okay to feel heartbroken, to feel mad, to feel overwhelmed and bewildered by this newly single thing. Every person I talked to who had gone through a breakup had described the same rollercoaster of emotions. Every sober person I talked to about this, however, said something else: no person, no heartache no matter how bad it was worth losing my sobriety over. They were right and it wasn’t going to go down like that.

“Sure, sure it sucks being a 46-year-old sober gay man being single in a youth obsessed culture but it sucks more being stuck in a marriage that wasn’t working. I now got the opportunity to find out who I am without out him, like I did when I said goodbye to substances. ”

In a lot of ways, being newly single is like being newly sober.  When I was new to recovery, much of what I faced was just trying to do this whole life thing without drugs and alcohol. My breakup has felt the same. The comfort, the thing I relied on, the fuel for my day to day life was no longer. I would have to figure out how to navigate life without it. Much like when booze and drugs had been gone for a while, I also started to realize how my old relationship wasn’t serving me. So here I am without my relationship and drugs and alcohol and in uncharted waters and you know what? It’s kind of incredible. Sure, sure it sucks being a 46-year-old sober gay man being single in a youth-obsessed culture but it sucks more being stuck in a marriage that wasn’t working. I now got the opportunity to find out who I am without out him like I did when I said goodbye to substances. What did I even like? Did I even want another relationship? Who was I? Turns out, I’m pretty awesome. I am incredible company and recovery helped me figure that out in the first place.  I like going to dinner and movies by myself. I like having plans with friends and not coming home at any specific time. It wasn’t some sad ass cat lady existence because I liked myself and for what it’s worth, as my cats very much too.

Last week, I woke up with the two scruffy aforementioned faces on my bed. It was just us and it was okay. Better than okay. I felt grateful to be on the other side of the bulk of all the sadness and chaos that a breakup brings.  Oh, of course, newly single life still scares the hell out of me and I feel lonely and sad on a regular basis. There are still a lot of mechanical pieces in play about this divorce which have unknown and potentially stressful outcomes. But oddly none of it matters.  Recovery prepared me for the idea that everything changes and that as long as I didn’t pick up a drink or use I would be okay. Sober with cats beats drunk and in a relationship any day of the week. Plus I never have to worry about my cats leaving me for someone younger.