Some Practical Realities of Opiate Addiction and Its Treatment in the U.S.

Methadone or suboxone maintenance is just the substitution of the state for the street dealer.  Addicts remain addicts, but now they’re strung out on non-natural chemicals that are much more destructive to their bodies than natural or semi-natural opiates, and which are harder to kick.  The implicit assumption behind this policy is “once an addict, always an addict.”  It is a means of socio-political control for the economic benefit of the state at the expense of the addict.  The reasoning which generates such policies is that addicts are criminals, so let’s bag and tag them and keep them on a short lease so we can monitor their location and actions, controlling them through their addiction – which we maintain.  Ignore the fact that they are criminals because we have defined them to be so by having made any opiate use beyond the control of the medical and pharmaceutical gate-keeping communities illegal.  Eventually, of course, they will become criminals by virtue of having been forced into contact with the criminal community which has control of the illegal drug trade; and by having to commit theft, breaking and entering, script forging, prostitution, etc. in order to get the money necessary to maintain their habits because they have to buy exorbitantly expensive, illegal opiates.

Remember that it was not illegal to obtain, possess, or use a variety of opiates in the U.S. before the 1914 Harrison Act.  Anyone, your grandmother, could walk into a pharmacy and request to buy an opiate preparation – laudanum, codeine cough syrup, morphine tablets, or in some areas opium balls – over the counter without a prescription.  Citizens buying these medications were not adversely judged by their peers unless they committed socially inappropriate acts while under their influence – just like alcohol today.  Recall that Bayer manufactured heroin tablets, which could be purchased by mail order and in pharmacies, for headache, cough, bronchitis and other pains, and which were used by both adults and children for 23 years between 1890 and 1913, when they discontinued production after it had been discovered that their claim about heroin being non-addictive was false.

So opiate addiction is as much a socio-culturally and politically defined condition as it is a medical one.  Alcohol can lead to alcoholism, which is now recognized as an addiction; yet it remains legal.  We see and hear the phrase, “Drink responsibly.”  Why can’t there be a broader statement: “Use substances responsibly”?  Like, well, marijuana, for instance?

Addiction is usually first detected through the addict’s behavior.  In fact, most addictions are expressed through behaviors other than substance abuse, as in addiction to gambling, sex, food, dangerous thrill-seeking, the internet, and of course the one addiction that is not only not proscribed in the U.S., but is in fact encouraged: work addiction.  Behavior is secondary; consciousness – in this case, state of mind – is primary.  Addiction begins as a developing psychological, emotional, and possibly spiritual problem that finally demands expression through behavior.  It grows in the personal subconscious from suppressed or forgotten origins and influences the behavior of the addict from there, which explains why in early-stage addiction the addict is the last to recognize that anything is amiss, and why they react strongly against suggestions that they need help.  Claims that behavior results from physiological and biochemical imbalances are therefore, in most cases, a matter of putting the cart before the horse (so to speak).  After addictive behavior has continued for a period of time, of course such imbalances develop; but they cannot explain why the behavior began in the first place.

So what’s this book thang all about? An explication of Climbing the Holy Mountain of Recovery

What it was not was an intended, deliberate book project.  I did not set out to write the Great American Novel, a definitive treatise, or an effort to achieve fame and fortune.

Instead, it began as a spontaneous and natural effort of my psyche to purge itself of unprocessed toxic material that was evidently an impediment to my health.  I had 15 years clean as a recovering addict and evidently Inner Healer had determined I was ready to withstand this grueling but necessary effort as a stage in my continued, successful recovery.  It happened like this:

One morning in the summer of 2012, I awoke from an intense, nightmare-quality dream which was the re-living of an episode from my using career.  It had the quality of a lucid dream, except for the fact that I had no control over its outcome; the script had been written in the summer of the late 1980s.  Thus the nightmare quality: I knew where it led but could not avert the outcome.

When I awoke shaking and exhausted, and realized that I had dreamed the episode – that it had not just happened, thank God – I suddenly realized that this was the third time I had had this dream within a few months.  When that salient fact dawned upon me, I knew at once that I must write it down while he details were still crystal clear.  I sprang up and began writing in a stream of consciousness, Kerouac-style.  My only deliberate act was to refrain from editing or elaborating in any way, so that the narrative would as closely as possible be a true record of my recent experience.

By the time I finished, I was almost as shaken as I had been when I awoke.  The act of writing it took me right back there again.  So when I finished, I breathed a sigh of relief and put it aside, knowing that I had done the right thing: a purgative journaling effort.  I thought that by writing it down, I had expunged this toxic memory and could now rest easy.

Nothing could be further from the truth.  I had pulled the cork from the genie’s bottle, and over the next several weeks a tremendous outpouring of other material from my using history came gushing forth.  By the time this natural process dwindled to an end, I had written about 125 single-spaced pages of material.  Over and over I had been reduced to a shaking ball of tears and snot, exhausted and devastated, so I was very thankful when I perceived that the episode was over!  I gratefully stashed the whole mess in a folder on my computer and lay back to rest and recuperate, in order to prepare myself for the coming fall semester of classes of my doctoral program in East-West Psychology at the California Institute of Integral Studies.

That was my last semester of coursework.  After it, I looked forward to beginning my dissertation work the following year.  Inner Healer, however, had other ideas.  I began a gradual slide into what became a two-year long passage of inner work.  During this time, I “peeled the onion” right down to the core, or close to it.  I was incapable of doing almost anything but surviving during this period.  I had a sense that a process was unfolding, but had no idea of how to handle myself.  I floated in an opaque soup of thoughts, feelings, insights, and impressions, with barely a sense of self to form a focused core.  Sometimes I felt like a jellyfish adrift in an amniotic Gulf Stream that was taking me somewhere; but at other times I seemed to stagnate in a Sargasso of vaguely-sensed, primary material.  Ultimately I came to feel that I had returned to Grof’s BPM I, becoming aware of a sense of my mother’s feelings about having me.  I experienced many unpleasant revelations.

In 2015 I began to emerge from this soup.  By the summer I felt I could begin to focus and write again, and managed to complete the first chapter of my dissertation.  But halfway through the second chapter, I suddenly received a constellation of signs and symptoms which created a sense in me that it was time for me to reopen the work I had begun three years before in order to bring it forth as a book.

I should pause here to mention that I have a definite sense of having been preserved in order to fulfill a mission: to bring about a new, deeper, and more complete understanding of addiction and recovery.  At the end of my using career, when I went to the island of St. Kitts to become a subject in the ibogaine research of Dr. Deborah Mash, I felt that I was only two weeks away from dying.  The reason I had this sense is explained at the end of Book II in my book.  Dr. Mash hesitated to give me the ibogaine because I looked so weak, she wasn’t sure that I had enough vital strength left to withstand the “flood” dose used to treat opiate addicts.  Yet the ibogaine experience was nothing short of miraculous for me, not only saving me from death but transforming me and setting me on a new path to a new life.  As a result, I feel that I was preserved by Grace; and thus I have a responsibility to use the additional time granted me to advance the cause of addiction treatment.

I don’t want to sound evangelical, but I do feel that I possess special insight into the nature of addiction, the principles of recovery, and of course the worth of ibogaine for the treatment of opiate addiction.  To quote Leary’s Politics of Ecstasy (1998):

It is of interest that the heroin addict and the illuminated Buddha end up at the same place.  The void.  The junkie is a deeply religious person.  The alcoholic is, too.  Thus our physicians and psychiatrists have no luck in ‘curing’ addicts.  If you see an addict as a social misfit, a civic nuisance who must be rehabilitated, you completely miss the point.

To cure the junkie and the alcoholic, you must humbly admit that he is a more deeply spiritual person than you, and you accept the cosmic validity of his search to transcend the game, and you help him see that blackout drugs are just bad methodology because you just can’t keep holding the ‘off’ switch and that the way to reach the void is through psychedelic rather than anesthetic experience. (p.43)

When in 1956 William S. Burroughs published his first book, Junkie, there were only 20 to 30 thousand heroin addicts, mostly in New York City.  The words “addict,” “addiction,” as well as “junk” and “junkie,” were not in the public lexicon.  The terms “alcoholic” and “alcoholism” were also unknown; the public just knew that some people had “a drinking problem.”  And yet this book, followed by Exterminator andNaked Lunch, established Burroughs as the Godfather of Junk.  How?  Burroughs was an intelligent, educated man, possessing a bachelor’s degree in cultural anthropology at a time when “a college man” was equivalent to having a graduate degree today.  Junkie was essentially an ethnography of the junk subculture.  Burroughs was strung out for 15 years, which puts his duration of exploration on a par with Michael Harner’s ethnographic investigation of the Jivaro people of the north Amazonian rainforest over the course of 17 years – though Harner periodically returned to U.S. culture to assess and write about his findings.  Burroughs had a literary gift, so Junkie was cast as literature because Burroughs explored the inner characteristics of that subculture through the agency of a fictional character, William Lee, a thinly-veiled representation of himself.  If he had “come out” as the fully-immersed investigator, it would have been styled an autoethnography – like my book – if that methodology had been developed at the time.

Unlike Burroughs, I have chosen to self-reveal, or “come out of the closet” about my junk history.  I was strung out for about 19 ½ years of my 22-year using period, with most of the remaining 2 1/2 years spent in jail and treatment programs.  I have two BAs, an MA, and now a Ph.D.c, so I bring my academic education as well as my spiritual and shamanic experiences to bear on the topic of addiction; and I’ve been told by many that I have some literary gift, too.  So like Burroughs, I’ve been there and am equipped to speak about the experiences of addiction and recovery.  I am strongly influenced by Burroughs’ work; by his raw and descriptive power to capture the surreal and despairing nature of addiction.  I am not, however, also a homosexual, as he was; and I don’t use his “cut-up” writing style, which he used in writing Naked Lunch.  However, I endorse his use of the terms “junk” and “junkie” because they bring to light the the ugly and grotesque nature of the condition as well as the hypocrisy of society in its dealings with addicts, which further degrades them in the course of their habits.  I feel about this situation as African Americans feel about slavery or as all Americans should feel about our national treatment of Native Americans – that is, as any conscious and humane human being does.  Addicts are enslaved, and society plays some, though not of course the only, role in this.  Gabor Maté speaks about this in his book In the Realm of Hungry Ghosts, most specifically in chapter 23.

So while I do not overtly style myself as the inheritor of the mantle of Burroughs, I do feel I am an inheritor walking in his path, with sufficient credentials to do so.

I characterize my mission as one of teaching the professional community and the affected public as well.  Because I’m a scholar, I’m writing my Ph.D. dissertation about this topic; but it is unlikely that anyone outside the Academy will read it, and not too many even there.  Besides, it will be partly incomprehensible to the general public, who actually need it more than academics.  My realization of this, and that the loved ones of addicts need it almost as much as the addicts themselves, was why I decided to transform the incomplete narrative I began in 2012 into a finished book as an important and legitimate part of my mission: to express my vision to the public who need it and not just to the Academy.