Drug Addiction
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AW Sangster
Sunday, August 08, 2004
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CRACKED - Putting Broken Lives Together Again by Dr Drew Pinsky with Todd Gold published by Regan books, an imprint of Harper Collins Publishers in 2003
A common definition of addiction is "the condition of taking a drug habitually and being unable to give it up without incurring adverse effects". The term addiction normally refers to drugs of one kind or another. Addicts know every consequence of their addiction: lost jobs, screwed-up relationships, squandered money, betrayed relatives and so on.
But they can't help their behaviour.
There are of course other kinds of addiction that have their consequences. There is the addiction to:
Food.
Overeating is a common feature of Jamaica today with the consequences of obesity with all that condition brings - heart trouble, diabetes, high blood pressure and more. Many persons just cannot stop eating and we may say they are addicted to food.
Gambling.
This addiction can be the destroyer of homes and families when the weekly or monthly wages are spent on the wild chance to get rich. It is just as much an addiction.
Sex.
The profligate behaviour of many men and women in the society - moving down the age range to boys and girls - gives rise to all the dangers of profligate sexual behaviour. Sexually transmitted diseases and the dreaded HIV/AIDS are the too often consequences of that addiction.
Drugs.
This is the theme of the book CRACKED Putting Broken Lives Together Again.
Pinsky is the physician in charge of the dependency (rehab) unit at the Las Encinas Hospital in California. The book is the no-holds-barred, true-to-life story of his experiences in that hospital. While the patient's names are carefully changed to maintain confidentiality, the reports are stark and they reflect the language of the drug addict - often crude and vulgar.
Some readers may be put off by the narrative, but the author tells it like it is. They're addicts, they're desperate and they are in retreat from the world. Three major themes can be identified in the book.
The first is the society and the culture that creates the climate for drug abuse and addiction. Pinsky argues that addiction is the predominant health issue of our time. In most cases the circumstances of the home were such that drug abuse was almost inevitable. Parents who were drug users, or abusers, or who abandoned their children left the young lives, prey to the habit.
In a broader sense the author contrasts the past where people turned to loved ones, neighbours, or religion to heal their problems. This does not happen anymore. Nowadays the culture is all about arousal and quick fixes that do not work. The author's analysis of the present culture is a serious indictment of its shallowness. Our culture is just like the junk food we live on: it fills you up without the distracting burden of nourishment. An average person exposed to television, movies, and magazines is overwhelmed by messages that arouse, stimulate, and suggest that the answer to all problems is the same: gratification. Have a beer, take a pill, roll on the deodorant get a whopper, JUST DO IT .But none of this has anything to do with happiness. In truth, it's just a setup for disappointment, frustration and failure.
The second theme that comes out is the effect of the patient on the doctor. The story of Amber keeps cropping up in the narrative. She is a challenge to the health care system of the hospital. The process of withdrawal, treatment, sober living and long-term recovery are outlined to Amber. The difficulties of long-term cure are shown in her case when she is discharged. An abusive husband and a problematic home environment take their toll. When Amber comes back to the hospital a final time it is to die. But the staff and Pinsky have become quite fond of her. She is back on drugs and collapses in the hospital room. All the emergency procedures fail and Amber dies while undergoing emergency resuscitation.
This particular case has a profound effect on Pinsky. He stays off work for several days and is lost in introspection. His family - wife and three young children (triplets) are ignored.
Why, he asks himself should I feel this way? It has to do with the feeling that everything and everybody can be cured or helped along the way. With it comes a sense of failure. But he has to come to terms with this feeling. He has to realise that he can't solve all the problems, he can't save everybody and he has to reckon with the realities of the patient's response and their own personal responsibilities. The feeling of omnipotence is challenged, recognised for what it is and put aside. Pinsky resumes his work with a more realistic attitude. Through it all however he is wrestling with the concept of a higher power. Where was the higher power when my patient needed it and where is it now when I need it?
He is prepared to concede that some patients may well have been helped in their recovery process by a religious experience. But this is not at present a part of his personal philosophy. The irony of that ambivalent position is reflected in the circumstances associated with Amber's death. When the CPR crash cart is a long time in coming he exclaims: "Jesus where's the crash cart?" A little later when the procedures fail and Amber is dying he utters a profane exclamation.
The third theme that comes out in the book is that of the process of healing.
Each of the chapters begins with an illustration of the well-known nursery rhyme of Humpty Dumpty (an egg) sitting on a wall. All the kings' horses and all the kings' men couldn't put him together again. Perhaps this is the author's recognition that many of the lives bruised and battered by drug abuse are not easily put back again. Or again it could be the recognition of the lives transformed from the low of drug abuse into being useful and productive citizens.
The process of drug addiction often starts simply and often with children. The excitement of trying new things is the experience that is all a part of the growing up process. Often it is a 'spiff of pot' (marijuana), which may lead to trying harder drugs for the higher level of excitement. Soon the individual is hooked, addiction is real, with an insatiable appetite for the drug. This needs money, so it leads to theft and a downward path of criminal activity.
Early on in the treatment process for Amber (mentioned above), Pinsky describes to her the process of: withdrawal, treatment, sober living, and long term recovery. She can be treated with drugs to help her through the withdrawal and detox stages but she has to concentrate one day at a time and to understand that long-term recovery is up to her. She has to get it. Amber like many others did not make it. The partnership with helpful individuals and programmes represents an important factor in the recovery process. The hospital also recommends the Alcohol Anonymous 12 Step recovery programme.
What can society do about this growing problem? There are a number of agencies in Jamaica that work to challenge and educate people on the dangers and problems of addiction of all kinds.
The National Council on Drug Abuse. The Toll free line is: 1-888-991-4244
Addiction Alert Organisation. (AAO). The Toll free line is: 1-888-991-4146
The organisation provides:
. A telephone lifeline for island-wide drug, alcohol and gambling abuse information
. Individual and group counseling and a referral system
. Drug testing for individuals and company employees
. The Employees Assistance Programme (EAP) to assist Jamaican companies with management control systems for early identification and treatment of drug and emotional problems
. Training workshops and holiday camps
. An extensive island-wide education programme in schools
. Adolescent drug abuse and HIV/AIDS prevention
programmes in a number of inner city communities.
Jamaica Aids Support, 4 Upper Musgrave Ave. Tel. 978-4668 and 978-7876
Alcoholics Anonymous(AA). AA meets at St. Peter and Paul (School Room) at 7.00pm each day
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