“Alcoholism” Antisocial Personality Disorder, and Homelessness

In my experience it seems that the people who engage in highly destructive behaviors related to substance use always have a dual diagnosis of substance abuse AND antisocial personality disorder.

When these people fall into the hands of the chemical dependency treatment industry they are virtually always given a single diagnosis of “addiction” and their antisocial personality disorder goes unrecognized.

Yet the junkie on the street who will rob you for ten dollars is NOT representative of junkies in general–there are a lot of white collar junkies that fly under the radar.

The same is true of boozehounds.

In self righteous American society we always talk about “alcoholism” causing homelessness and never the reverse.

Yet I often wonder if most of the alkies living on the street were driven to drink like that BECAUSE of the fact that they had to live on the streets.

I would like to see some evidence of whether drunkenness is more likely to cause homelessness or homelessness is more likely to cause drunkenness.

Copyright © 2009, The HAMS Harm Reduction Network

Calling People Bad Names Never Solved Anything

It is quite amazing to me how so many people who consider themselves liberal and enlightened go around calling other folks bad names like “alcoholic” or “addict”. These same people would never think about calling others bad names based on their race, ethnicity, religion, IQ, sexual orientation or even sanity.

It seems that even most of the liberals in American society need a scapegoat and people who like to engage in recreational intoxication or other vices such as gambling or even promiscuity are now subject to getting labeled as an “alcoholic” or an “addict” by every uneducated un-degreed yay-hoo on the street.

The fact is that the words alcoholic and addict do not even occur in the DSM-IV and even if they did then you would still be diagnosing folks without a license if you used them to label people.

The simple fact is that “alcoholic” and “addict” are merely dirty words that some people use to make other people feel bad about themselves. If you use them, then shame on you–you oughtta have your mouth washed out with soap.

Copyright © 2009, The HAMS Harm Reduction Network

Let’s Get Rid Of The Stigma For Real

It is just as wrong for the segment of society which does not use drugs or alcohol to attempt to impose their value system upon people who choose to engage in recreational intoxication as it is for the heterosexual majority to impose their value system and sexual practices on the homosexual minority. We no longer lock homosexual men in prison for the practice of consensual sodomy. Nor do we send them to therapists to “treat” their “mental illness” of homosexuality. In 1973 the American Psychiatric Association voted that homosexuality was no longer a disease and removed it from the DSM.

We are told by many people that homosexuality is genetic and inherited and that since people cannot choose to be other than what they are that we should accept it and not blame them for who they are–they cannot help it.

Yet we are also told that people who choose to engage in recreational intoxication by using drugs or alcohol are diseased. Why are they diseased? Because they are born that way and they cannot help it and therefore they must be treated until l they change whether they like it or not.

Homosexuality is NOT a disease. This is because it is genetic. Recreational intoxication IS a disease. This is because it is genetic. HUH???!!

What an outrage it would be to take all the homosexuals in America and lock them up in religiously oriented brainwashing camps and to tell them that every time they engaged in homosexual sex it meant that they had “relapsed” into their “disease” and that their only hope was to admit that they were powerless over their homosexuality and to ask a “Higher Power” to give them a daily reprieve from their homosexual behavior.

Yet this is exactly the sort of gross and repellant violation of basic human rights which is accorded to those in America who choose to engage in recreational intoxication. Just get caught even once in possession of a joint and you will be locked up in a religious brainwashing camp and be told that that which you like to do is a disease and that the only cure for your disease is to spend every day for the rest of your life sitting around some godawful religious meeting. Good grief–it is enough to drive one to drink!

Calling something a “disease” or a “mental illness” does not remove stigma. Calling it a personal lifestyle choice is what removes the stigma.

No gay person of my acquaintance has ever said to me “Let is put homosexuality back in the DSM and call homosexuality a mental illness instead of a lifestyle choice so that we can remove the stigma.”

Classifying things as crimes or diseases stigmatizes them. Classifying them as lifestyle choices removes the stigma. The NIAAA wants to refer to recreational alcohol intoxication as “binge drinking” in order to stigmatize it and to force people to stop engaging in it because the NIAAA feels that it has an inalienable right to force its value system upon others against their will.

From my perspective forcing one’s values upon others against their will is a far worse addiction than is engaging in a bit of recreational drug or alcohol use. So is locking someone up in a religious brainwashing camp and forcing your conception of a “Higher Power” on them against their wills.

I do not believe that G.O.D. stands for Group Of Drunks. I don’t believe in creationism in the first place–but even if I did I would not believe that a group of drunks created the universe. Nor do I believe that AA created the universe. Group Of Drunks = G. O. D. indeed!

Let us recognize that engaging in recreational drug or alcohol intoxication–just like homosexuality–is a lifestyle choice. Yes–drug or alcohol use can be a high risk behavior–but so can homosexuality. Both call for personal responsibility and good harm reduction practices to reduce the accompanying risks.

Just as safe sex is good sex–safe intoxication is good intoxication.

How about doing away with abstinence-only programs for drugs and alcohol and teaching kids about safe drug and alcohol use instead?

And how about doing away with abstinence-only programs for sex and teaching kids about safe sex whether it is straight sex or gay sex?

The life you save may be your child’s.

Copyright © 2009, The HAMS Harm Reduction Network

Let’s Put An End To Discrimination Based On Treatment Goal

The following is a true story: A short time ago I was under a tremendous amount of situational stress involving leaving an old job and starting a new venture. Not only was I leaving an old job behind, this new venture also entailed leaving many close old friends behind. I was depressed and stressed from all sides from emotional to financial. I needed someone to talk to so I sought out a mental health professional.

I filled out an intake questionnaire which asked if I had any problems with drugs or alcohol. Since I currently had no problems with drugs or alcohol, I truthfully answered “No”. Then it came time for my intake interview and the interviewer asked if I had ever been in a chemical dependency treatment program. I truthfully replied yes that I had checked myself into such a program many years before. I was then asked if I had been perfectly abstinent from alcohol and all other recreational drugs (except for nicotine and caffeine) for the past six months. I truthfully replied that I was not totally abstinent from alcohol because I was drinking within NIAAA approved guidelines for moderate drinking.

I was told by the intake person that I would not be allowed any mental health services until I had been totally abstinent for all addicting drugs (except for caffeine and nicotine) for six months and that I would have to enroll in their chemical dependency treatment program for six months before I would be allowed access to any mental health services to deal with my stress and depression.

I tried to explain that my previous experience with chemical dependency treatment had been damaging and had caused me to drink more and that it had taken me two years to recover from the treatment and establish a non-problematic relationship with alcohol. I was still refused necessary mental health treatment unless I was willing to undergo a chemical dependency treatment which was not only unnecessary but which was in violation of my religious beliefs and which had proved harmful in the past.

It is a total outrage and morally reprehensible to deny client needed mental health services which might save their lives simply because the client’s goal vis a vis alcohol or drug use might be moderation or harm reduction rather than total abstinence. It is a violation of the most basic principles of humanistic psychotherapy for the therapists to force their goals and beliefs and values on the clients against the clients’ wills.

The time has come to eliminate discrimination against clients who are successfully pursuing treatment goals of moderation or harm reduction. The evidence from the NIAAA itself shows that people are just as likely to resolve and alcohol problem with a goal of moderation as with a goal of abstinence and that most problems with drugs or alcohol are resolved successfully without recourse to any sort of formal chemical dependency treatment at all.

People like Patt Denning and Andrew Tatarsky have clearly demonstrated that drug and alcohol users respond to psychotherapy even while they are still actively using drugs and alcohol and that giving them access to mental health treatment while actively using can actually help them to resolve drug or alcohol problems successfully via harm reduction, moderation or abstinence.

The time has come for the Department of Health and Mental Hygiene of the City of New York and the New York State Office of Alcoholism and Substance Abuse to insure that no active user of drugs or alcohol is refused access to mental health services for refusing to undergo chemical dependency treatment. Let us put an end to this sort of discrimination once and for all.

Copyright © 2009, The HAMS Harm Reduction Network

To the wives

This title of course is a take on a chapter in the AA ‘Big Book”.   Everything that we are saying here holds true for any significant other or friend or family of any drinker–male or female.

Here at HAMS we have a saying:”perfectionism is the enemy of the good”

If your husband improves in his drinking habits then you need to support that no matter how small the improvement. It doesn’t matter if he drinks more safely, or cuts back or even quits–every positive change is a positive change and needs to be recognized as such.

If you keep demanding that your husband be perfectly abstinent because that is what he has to do to satisfy you the odds that you will make him actually become abstinent are infinitesimal. It is far more likely that his drinking will become far worse than it ever has before.

Alanon is poison. Demands for perfection almost always backfire and blow up in your face. If you want to see your husband dead in a drunk driving accident then go ahead and throw that Alanon shit and those demands for perfection in his face.

Alanon has probably killed more drinkers and broken up more marriages than any organization since AA itself.

If you really love your husband and want to see him get better then you need to recognize that better IS better and you need to encourage every positive change. Harm reduction may be just the thing that works for your husband.

People like Miller and Rollnick who invented Motivational Interviewing have taught us that the way to get people to change is not to nag them. It is to give them a chance to examine what they really want and to support them in making positive changes.

The life you save may be your husband’s.

Copyright © 2009, The HAMS Harm Reduction Network

Why Do Doctors Want To Punish Us For Trying To Get Better?

Why is it that if we go to a Doctor to try and get a medication to help with a drinking problem that this can screw us up in trying to get insurance and even employment for the rest of our lives? The very fact that we are choosing to try and change for the better should speak in our favor and not against us. And why should Doctors suggest that we join the AA religion if we seek to get better even when we tell them that the AA religion violates our personal beliefs and has harmed us in the past? Prejudice is all–sheer prejudice.

I am posting the following exchange from the HAMS yahoo group on this topic with the author’s permission for those whom it might help.

*******************

This probably sounds like a stupid question, but how can one get a prescription for Naltrexone without going to a doctor, and risking to have “alcoholic” be forever on your medical records? I think that any other health problem to come in the future would be secondary to the label of having an addiction problem.

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I asked the same question a few weeks ago.  I don’t think anyone had an idea for getting a prescription without going to a doctor.  There is the possibility of getting Naltrexone without a prescription, either by purchasing online (haven’t tried this yet, but if people can get Viagra online without a prescription, why not Naltrexone?), or by going to Mexico (last I checked, ten years ago, you could purchase any non-addictive pharmaceutical without a prescription in Mexico, and at low cost too), but then I believe you’re at legal risk while “smuggling” it across the border, and Mexico is dangerous these days as you’ve probably heard.

A third option I’m considering is going through a doctor here in the States, but hiding it.  This involves finding an old-fashioned GP type doctor; the kind who runs his own small practice out of a small office in a poor part of town, and hates working with insurance (They are still out there; I know one here in town, but he is getting old.  And notice I said “he”; doctors this old school are from the generation when virtually all doctors were men.)  Do not go to your usual doctor; do not involve your health plan; do not give your social security number.  Pay cash, and request confidentiality.  Since Naltrexone is fairly safe and is not addictive (it’s not like you’re looking up a new doctor for a Vicodin refill!), chances are, he’ll write you the prescription.  Hand carry the prescription to a single, family-owned pharmacy.  Not a chain, and not any pharmacy you’ve ever been to before.  For instance, I get a Prozac prescription from Rite Aid.  They have all my records and my health insurance info.  Any prescription I bring to *any* Rite Aid is automatically added to my records.  So find another old-fashioned family business.  Tell them you don’t have insurance and will just pay cash. &nb sp;With luck, your records at the GP and at the small pharmacy will never become part of your insurance records, since the insurance company won’t even know that you ever interacted with those two businesses, and won’t know to request records.  Caveat:  I haven’t tried this yet, but am thinking of it.  Anyone seeing a hole in this plan, please point it out.

It’s very sad that we have to be so sneaky to try and get better without screwing ourselves.  I for one usually have to purchase my health insurance as an individual (i.e. not part of a group or employer plan), and an “alcoholic” brand on my records (the Scarlet Letter!) would either make it impossible or unaffordable for me to purchase the minimal insurance that I need for emergencies…

Good luck!

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Just wanted to give you an update on my earlier shared doctor idea

(how to get prescriptions for alcohol treatment medications without

screwing up your health insurance records). I finally bit the bullet

yesterday and made an appointment to visit my old fashioned, cash

only, sole practitioner family doctor. I’ve been having trouble

tapering off and finally decided that I wanted to try using valium to

taper off so that I could stop alcohol cold turkey. I also wanted to

get a prescription for naltrexone. I had (mostly) success. My doctor

was very understanding, sat down and talked with me for an hour, and

wrote me a prescription for a very small dose of valium which I hope

will allow me to be abstinent for a couple of weeks at least, to

detox. He also measured my blood pressure (a little high but not too

bad), and checked the size of my liver by palpation and by oscultation

(i.e. thumping over the liver area to find the size of the liver by

the type of solid or empty sound returned). My liver is not enlarged,

thank Goddess! I did not get my naltrexone yet, though, although I

expect I will next time I go in. He asked me if I were attending any

“meetings”. I said “no, I don’t like meetings, but I am part of an

online support group”. Turns out (unsurprisingly, since the whole

point of this exercise was to find an old fashioned, conservative

doctor) that he believes naltrexone works best in the context of AA

work, and he wasn’t sure that an online group would be enough, so he

recommended that I visit some of the local groups, and check in with

him in a month if I still want to try the naltrexone. Having been

educated by PCT and others, I didn’t bother arguing about the

usefulness of AA. Instead, since I don’t want to lie to the very

kindly older gentleman, I’ll visit two AA meetings, and if I still

want the naltrexone in a month, I’ll go back and say that I’m now

going to meetings *and* my online group, that I’ve stopped or greatly

reduced my alcohol intake, but I still want the back-up help of the

naltrexone.

I then took the valium script to a small family pharmacy, and paid

cash (no insurance records that way). I’m looking forward to detoxing

for a bit, and do expect that I’ll be able to get the naltrexone, if I

want it, in a month.

Based on this experience, I would add one thing to my earlier advice:

participate regularly in HAMS chat, which, after all, is a *meeting*,

IMHO. Then if you’re asked about going to meetings or etc, you can be

prepared to say that you are regularly attending meetings of your

alcohol use support group. I could easily have said this myself if I

hadn’t been surprised (caught off guard) by the question. Now I’ll

have to suffer through two AA meetings. Well, perhaps it’ll be

educational; I’ve never attended an AA meeting, though I tried OA a

couple of times in the past (and did not find it helpful). Now at

least when you AA veterans complain, I’ll know what you’re talking

about!

Cost for the hour exam was $85, and the valium cost $15. I expect my

next office visit, in a month, will be shorter and cheaper. If it all

works, it’ll be money well spent, even just on reduced alcohol

purchases…

Wish me luck!

Copyright © 2009, The HAMS Harm Reduction Network

Addiction Genetics and Nazi Race “Science”

The politics of genetics has been used throughout history to create scapegoats and to oppress various segments of humanity. Tremendous efforts were made in Nazi Germany to establish Rassenwissenschaft–race science–as a legitimate science. Tremendous efforts were made to prove that Jews, Gypsies, and others were genetically different, subhuman, and curable only by extermination. All these efforts failed because they had no basis in reality–they were nothing but political artifacts intended to satisfy hate.

The more things change the more they stay the same. Today’s political forces have decreed that the drunkard and the drug addict are somehow fundamentally different from other human beings. These hate mongers have declared that the drug user and the drunkard comprise a subhuman, racially inferior underclass whose basic human rights are not protected under the Constitution of the United States of America.

The “addiction gene” or an “alcoholism gene” is such a hot political prize that its discovery has been announced with great hoopla at least a dozen times in the past couple of decades. The problem was that in every single case the scientists announcing this great discover had to recant–for the simple fact that the evidence did not back up their extravagant claims. Most serious geneticists know that the “addiction gene” is a chimera, a will-o’-the-wisp which does not exist–but an innocent public still sits and awaits the discovery of the mythical “addiction gene”.

The simple fact is that there is no such thing as a “disease” of “addiction” or “alcoholism”. People use what means they have to cope with difficult situations. Sometimes the only means that they have is drugs or alcohol; sometimes it is the case that drugs and alcohol are just so readily available. Anyone can adopt a maladaptive coping strategy under difficult enough circumstances. Genetics has nothing to do with it. Period.

The really sick and diseased people in the United States of America today are the ones who promote the Nazification of science by promoting the idea that drunkards and drug addicts are genetically different from the rest of us. These people are doing nothing short of what the Nazis did in Germany–giving the general public a scapegoat to blame their troubles on–and setting up a new race science and a new racially inferior subhuman subset of humanity–all based on a tissue of lies.

One of the worst results of this new scapegoating has been the consistent stripping of this supposedly “genetically diseased” group of people of their most basic and fundamental human rights under the Bill of Rights of the Constitution of the United States –to wit:

The Eighth Amendment to the Constitution protects people in prison in the United States from “cruel and unusual punishment”. However, people in treatment programs for “addiction” or “alcoholism” are not given the same protections as criminals. Therapeutic Communities and “tough love” programs based on Synanon often force adults to wear nothing but diapers and call them big babies. Men are forced to dress as women for weeks at a time for the “crime” of saying hello to a woman. Occupational therapy includes things like scrubbing toilets with toothbrushes for 8 hours a day.

The First Amendment right to freedom of religion is respected in prisons–prisoners in the United States are not forced to believe in God or attend religious services against their will.

However this is not true in drug and alcohol “treatment” programs where inmates are browbeaten and threatened with a horrifying death from drug or alcohol use unless they accept a “Higher Power”–and not just any “Higher Power”–but one that fits the steps of AA. Can a door knob be a higher power? Only if you can make conscious contact with a door knob like step 11 requires. Inmates in 12 step treatment programs are also forced to attend AA meetings against their will–a violation of the first amendment rights of anyone who feels that AA meetings violate their personal religious freedoms.

Then we have the Salvation Army which as a part of their “occupational therapy” makes the inmates in their treatment programs work eight hours a day in their thrift shops and pays them two dollars for the whole day. And I thought slavery was ended with the Emancipation Proclamation. I guess the laws against slavery don’t count if you are one of those “genetically diseased” alcoholics or drug addicts. Like the sign hanging over Auschwitz said “Arbeit Macht Frei”–work will set you free.

It is long past time that we start treating human beings as responsible adults with the basic unalienable human right to decide what they want to put into their own mouths. “No more drug war” means “no more war on drug users”.

No one should be considered subhuman because of what they choose to put in their mouths. No one should be stripped of their unalienable basic human rights based on what they choose to put in their mouths.

The war criminals are those who wage the drug war–not the drug users who are the innocent victims of the war on drugs.

Copyright © 2009, The HAMS Harm Reduction Network

The Social Cost Of Television Viewing – a tongue in cheek view

Doom sayers are oft warning us of the social costs of drug or alcohol use–but what about the horror of television addiction??

The average American spends over 4 hours a day watching TV (Nielsen Media Research http://www.nielsenmedia.com/nc/portal/site/Public/menuitem.55dc65b4a7d5adff3f65936147a062a0/?vgnextoid=4156527aacccd010VgnVCM100000ac0a260aRCRD ). This is more than half the time the average American spends working. The average fulltime worker in the US earns 43,000 dollars a year. This means that by watching television for 4 hours a day the average American is losing 21,500 dollars a year in terms of lost productivity. Multiply this by the population of the United States, 304,059,724. Hence the social cost of television viewing in the United States is $6,537,284,066,000. Let me spell that out–six trillion, five hundred and thirty seven billion, two hundred and eighty four million, sixty six thousand dollars!

According to NIDA (The National Institute on Drug Abuse) “The economic cost to society from alcohol and drug abuse was an estimated $246 billion in 1992. Alcohol abuse and alcoholism cost an estimated $148 billion, while drug abuse and dependence cost an estimated $98 billion.”

( http://www.nida.nih.gov/EconomicCosts/Index.html )

Clearly drug and alcohol abuse are a mere drop in the bucket compared to the horrifying scourge of television addiction! The social cost is 2,600 percent greater!!

So why is our government giving out HDTV vouchers to feed this addiction? The forces of Big Television are far reaching and powerful indeed!!

Copyright © 2009, The HAMS Harm Reduction Network

Psychotherapy and Drinkers – Harm Reduction, Alcohol, Suicide and Depression

It is understandable that a psychotherapist might object to doing therapy with a client who always showed up at sessions dead drunk and never, ever remembered one session to the net because he/she was in a blackout during the session.

However it is an outrage for persons seeking help with severe psychiatric problems to be refused psychotherapy because they have been drinking within moderate limits within the past several months.

I personally had the experience of being refused treatment for depression and suicidal ideation because I did not lie to the intake person and claim that I had six months of “sobriety”. At that point in time my drinking had been within perfectly moderate limits for the preceding month but because I told the truth I was refused therapy. This was at a hospital based provider that took Medicaid–and not in Podunk USA but in supposedly enlightened New York City. I am lucky to be alive.

All the evidence we have points to the idea that drug and alcohol users benefit from voluntarily sought psychotherapy regardless of their alcohol or drug use (Tatarsky, Dwnning). It is morally wrong and inhumane to refuse mental health services to people who choose to use alcohol or drugs. It is just as bad to stigmatize people for their alcohol or drug use as it is to stigmatize them for the color of their skin, their ethnicity, their religious beliefs or their place of birth.

The World Health Organization (WHO) has the following to say about depression:

“Major depression is now the leading cause of disability globally and ranks fourth in the ten leading causes of the global burden of disease. If projections are correct, within the next 20 years, depression will have the dubious distinction of becoming the second cause of the global disease burden.” http://www.who.int/whr/2001/dg_message/en

WHO also tells is that “Suicide is a leading cause of death for young adults. It is among the top three causes of death in the population aged 15–34 years…[S]uicide is predominant in the 15–34-year-old age group, where it ranks as the first or second cause of death for both the sexes. This represents a massive loss to societies of young persons in their productive years of life. Data on suicide attempts are only available from a few countries; they indicate that the number of suicide attempts may be up to 20 times higher than the number of completed suicides.” http://www.who.int/whr/2001/chapter2/en/index6.html

WHO also tells us that “The most common mental disorder leading to suicide is depression, although the rates are also high for schizophrenia. In addition, suicide is often related to substance use ­ either in the person who commits it or within the family.” http://www.who.int/whr/2001/chapter2/en/index6.html

And yet the United States is filled with psychotherapists who refuse to treat people for mental illnesses such as depression unless these people first abstain perfectly from all drugs and alcohol for six months.

Let us give three cheers for all the harm reduction psychotherapists like Dr. Tatarsky and Dr. Denning and many, many others who treat people for their mental health problems regardless of their alcohol or drug use.

Stigmatizing people for their drug or alcohol use and refusing them essential mental health services which might save their lives is–in the words of Penn and Teller–BULLSHIT!

References:

WHO – The world health report 2001 – Mental Health: New Understanding, New Hope

http://www.who.int/whr/2001/en

Harm reduction psychotherapy : a new treatment for drug and alcohol problems / edited by Andrew Tatarsky with forward by Alan Marlatt.

Northvale, NJ : Jason Aronson, 2001.

Practicing harm reduction psychotherapy : an alternative approach to addictions / Patt Denning ; foreword by G. Alan Marlatt.

New York : Guilford Press, c2000.

Copyright © 2008, The HAMS Harm Reduction Network

Why I Choose Harm Reduction

If I wanted to extend my life span to the maximum here is what I would do: I would have myself locked in a padded cell so it would be impossible for me to be injured by anyone or to injure myself. I would eat a perfectly balanced diet with no meat or sugar or anything else that tasted good. No drugs or alcohol or other fun stuff either. I would have to be in a padded cell because I would be so frigging miserable and bored that I would definitely kill myself given the choice.

Instead of choosing to merely maximize my life span I have chosen a harm reduction approach to all aspects of my life. I quit the cigarettes because they are too likely to kill me and give no real pay-off, but I still allow myself a cigar a week if I want it–no inhaling. I get intoxicated on alcohol twice a week but do it safely at home and I abstain on work nights so that it does not interfere with my life. I eat a lot of pork fat but my doctor says my cholesterol is good. I abstain from TV because it is too addictive for me and it wastes my time too much.

I have never done any illicit drugs but marijuana–but it started making me depressed so I gave it up decades ago.

Mostly I enjoy myself in a reasonable manner and have fun with life–that is why I choose harm reduction.

Copyright © 2008, The HAMS Harm Reduction Network