Going On A Trip And Never Coming Back, Ctd

Andrew Sullivan’s readers continue an excellent discussion on the merits of 12-step based addiction recovery programs. The personal testimonies and archived debates, all accessible here, are also very much worth reading.

The Dish

Reacting to some criticism of 12-step programs, a reader writes movingly in support of AA and NA:

For both of my brothers and myself, 12-step recovery programs have literally been the difference between life and death. My younger brother had recently switched from heroin to crack cocaine by the time he entered the Fellowships of NA and AA; my entire family was quite sure that if a drug overdose didn’t kill him, some of the people to whom he owed money would see to it themselves. Eight years later, he has a wife, a lovely daughter, and a college degree, all thanks to working a 12-step program.

As for me, my drug of choice was alcohol.

I had chronic liver pains by age 26, and my hands shook so badly my mother thought I had Parkinson’s Disease. I needed at least 12 beers a day to feel normal, and a minimum…

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Going On A Trip And Never Coming Back

Andrew Sullivan, as always, has done a great job of curating the web and coming back with some of the most cogent reaction to the tragic death of actor Philip Seymour Hoffman. Not banal pronouncements from pundits and other celebrities, but a balanced look at the nature of addiction and relapse, from a variety of sources, many of them addicts themselves. Well worth a read.

The Dish

Philip Seymour Hoffman’s quick journey from long-term sobriety to relapse to death scares Seth Mnookin, who has struggled with alcohol and heroin addiction:

My first attempt at recovery came in 1991, when I was 19 years old. Almost exactly two years later, I decided to have a drink. Two years after that, I was addicted to heroin. There’s a lot we don’t know about alcoholism and drug addiction, but one thing is clear: Regardless of how much time clean you have, relapsing is always as easy as moving your hand to your mouth.

In response to Hoffman’s death, Sacha Scoblic highlights the shortcomings of twelve-step programs and wonders if another approach could have saved Hoffman:

A big part of the problem is rehab itself, which is almost universally based on twelve-step work, like Alcoholics Anonymous or Narcotics Anonymous. But AA was developed in the 1930s, in the absence of brain…

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On Addiction, Ctd. – Philip Seymour Hoffman

philip seymour hoffman

 

While the world reels from the news of actor Philip Seymour Hoffman’s death by probable heroin overdose, Damian Thompson, writing in The Telegraph, pulls back the curtain on addiction and endeavours to explain how someone with multiple years of clean or sober time such as Hoffman can appear fine (particularly to those on the periphery or observing through the media) in the run-up to a serious or fatal relapse.

Surveying the immediate reaction from friends and colleagues of the actor, Thompson writes:

“But he/she was doing so well … clean and sober for X months/years … really looking forward to their next project.”

This baffled reaction to a drugs tragedy is familiar to anyone who works with addicts. We’re hearing it from friends and fans of Philip Seymour Hoffman, who was clean for 23 years before apparently checking himself into rehab last year. To stay away from drink and drugs for nearly a quarter of a century – and then relapse? Some people will be puzzled by that.

They shouldn’t be.

Indeed they should not be puzzled. Many of the people expressing such surprise may have been friends or acquaintances of Hoffman, but very few would likely have seem him up close and observed his behaviour day-in and day-out to a sufficient degree that alarm bells would necessarily have been raised. Clearly all was not well with the actor, as he had undergone 10 days in a rehabilitation facility last year following a relapse.

Indeed, this raises another point – sometimes it is those who see an addict regularly but not continuously, at intervals well spaced apart, who are best placed to spot signs of impending trouble or emotional relapse (that stage where addictive thoughts and behaviours are creeping back in, but before the person has drunk or picked up). It will be interesting in the coming days to see whether friends and acquaintances of this type had seen a worsening or intensification of mood or using in Hoffman in these final weeks.

Even experts can sometimes be wrongfooted, as Thompson rightly observes:

In Narcotics Anonymous, however [as opposed to someone in Alcoholics Anonymous under the influence of alcohol], someone can address the room loaded up on heroin, or (if they’re careful) cocaine, or with 50mg of unprescribed Valium inside them, and they can get away with it. One or two people in the audience may guess, but they don’t want to point the finger. There are nearly always active users at meetings. Indeed, if you’re an addict looking to score in a strange city, the local NA chapter is often a good place to start.

Damian Thompson does not subscribe to the disease theory of addiction, but fully endorses the description of mind-altering substances and addiction as “cunning, baffling and powerful” – a reading from 12-step literature with which any fellowship member will quickly become familiar. And in closing, he points out the degree to which this was surely true of Hoffman:

Not only is addiction cunning, in that it hangs around for years whistling nonchalantly and leaps out just when you think you’ve turned into a “normal” person, but hiding a drug habit makes you cunning. Far too cunning for your own good.

Our prayers and sympathies must go to the family and friends of Philip Seymour Hoffman who survive him.

The following is a scene from the film 25th Hour, a favourite film of mine and one in which Hoffman plays a wonderful role in the ensemble cast:

 

May he rest in peace.