“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

How HAMS Split Off From MM

“Breaking up is hard to do.”

It was quite inevitable that the harm reduction faction within Moderation Management (MM) would eventually split off from MM and move on to do its own thing. The events of the summer of 2006 merely served to hasten things along.

I have nothing but the utmost respect for the MM program; MM was the only place for me to go when I was seeking support for the changes which I was making in my drinking. However–MM was never a good fit for me–although MM is a good fit for many people.

My other great source of support and learning was needle exchange where I worked as a volunteer–however since my drug of choice was alcohol and I didn’t do any illegal drugs much less shoot drugs there was limited support available to me via this avenue as well.

First let us look at some of the things that the MM program is about:

The following is from MM’s website (http://www.moderation.org/whatisMM.shtml, accessed Oct 4, 2009)

What if moderation does not work for you?

After completing 30 days of abstinence (step two of the MM program) and then starting the moderation part of the program, you may discover that it is more difficult for you to moderate your drinking than to abstain. In this case, consider a self-management goal of abstinence. Some members of MM who choose abstinence remain in our program; others find an abstinence-only group to attend.

MM’s definition of moderate drinking is as follows according to the current MM trifold (http://www.moderation.org/images/tools/trifold2008_sample.pdf accessed Oct 4, 2009)

For Men:

No more than 14 drinks per week or 4 drinks per occasion.

For Women:

No more than 9 drinks per week or 3 drinks per occasion.

For All:

3-4 non-drinking days per week.

Current statements by MM are actually somewhat milder than the ones found earlier in MM–for example those found on this earlier trifold of MM’s which reiterate statements in the Kishline book (http://www.doctordeluca.com/Documents/MM%20Tri-fold.pdf accessed Oct 4, 2009)

MM is not for alcoholics, chronic drinkers, or those who experience significant withdrawal symptoms when they stop drinking. MM is also not intended for former dependent drinkers who are now abstaining. Chronic drinkers should consider contacting an abstinence-based support group. MM is intended for problem drinkers who have experienced mild to moderate levels of alcohol-related problems.

What I learned by volunteering in needle exchange was that it was essential to foster and encourage every positive change rather than to think about who was a “problem user” and who was an “addict”. Indeed–it would be nothing but bizarre to offer clean needles only to people who shot heroin in moderation but to tell those who exceeded some sort of imaginary moderate limit that they would not be allowed access to clean needles or other harm reduction resources because they were addicted and therefore needed an abstinence based program!

My harm reduction goal with alcohol was to drink a fifth of booze (17 standard drinks) safely at home one night a week and to abstain the other six nights per week–clearly a harm reduction goal when compared with the fact that I had previously gotten this intoxicated 4 nights per week–but also clearly at odds with MM’s definitions of moderate drinking.

I spent around four years from 2002 until 2006 working as an administrator for MM and during this time I introduced many harm reduction concepts which I had learned at needle exchange into the MM online community–these concepts were received with great enthusiasm by those who were unable to “toe the line” of the strict MM limits and who also did even worse if attempts were made to impose abstinence upon them.

Then around August of 2006 a faction arose within the MM online community which proceeded to viciously and sadistically attack anyone who failed to be either perfectly moderate or to be perfectly abstinent. I say a faction but it was primarily a single individual. Rather than banning these sadistic attacks the MM administration decided to ban swear words.

September 13, 2006 I created the modsabshr yahoo group as a subgroup of MM for people who wanted to escape the sadistic attacks and the censorship that was occurring on the main MM email group. I also resigned as administrator of the main MM email group at this point in time.

In December of 2006 I decided that it was a bit ridiculous for me to continue working a 40 hour work week running MM’s chat room since I had neither job title at MM nor even a nominal stipend from MM for doing so.

Therefore on January 15, 2007 I created the hamshrn yahoo group and thus founded The HAMS Harm Reduction Network as an entity independent of MM. HAMS was incorporated in the state of New York August 21, 2007 (the same date as our first live meeting by coincidence) and we were granted 501(c)3 status by the IRS November 15, 2007.

This is the first time I have spoken publicly about what happened since we split with MM way back in 2006. That is because I have finally calmed down a bit and can now speak objectively without flying off the handle and acting like an asshole.

MM is a good fit for a lot of early stage problem drinkers and many people have benefited from MM–if you are an early stage problem drinker then you may find that MM is a good fit for you, too. SMART is a good fit for rational abstainers and even the dreaded AA can be a good fit for some people who want to abstain and who have the right kind of personality type to fit with a 12 step program.

HAMS is a good fit for a lot of us who want to define our own programs and who want to make positive changes which might be quite different from moderation–HAMS also fits those of us who want to abstain or moderate in our own way.

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

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

Seatbelts, Harm Reduction, and Enabling

In a perfect world no one would ever exceed the speed limit or engage in reckless driving. In a perfect world no one would ever violate a traffic law or make an error in judgment while driving. In a perfect world there would be no automobile accidents because everyone’s driving would be perfect. However, we do not live in a perfect world. To err is human–and automobile accidents are an inevitable result of human error. It is for this reason that a simple and wonderful little harm reduction device called the seatbelt was invented–a harm reduction device which saves countless lives each year.

Would anyone in their right mind propose that seatbelts are “enablers” of reckless driving? Would we ever propose that the only way to learn good driving habits is to lose life or limb in an automobile accident? Would anyone propose that we must do away with seatbelts because they prevent people from suffering the consequences of their behaviors and keep them from “hitting bottom”?

Of course not! Even proposing such a thing sounds nonsensical!

So how can we treat other obvious harm reduction strategies such as needle exchange as a form of “enabling”? Is a person more likely to quit heroin after contracting AIDS? Hell no!!! Then there is more reason to shoot up than ever before!

Now where did this utterly bizarre notion of “enabling” come from? It is not really present in the AA “Big Book”. It seems rather to be a product of the 12 step treatment industry. The idea seems to be that anything that kept you out of treatment was bad. So the sicker you were the better. Getting better was bad because if you got better then you might not become a life-long AA member. You might even become a moderate drinker.

But getting worse was better–if you lost a leg in a drunk driving accident then it might scare you into treatment where the staff could work at scaring you into attending AA for life.

The people who believe in “enabling theory” seem to buy into the following:

Better is worse

Worse is better

Black is white

White is black

It reminds me of what George Orwell said:

Freedom is slavery

War is peace

Ignorance is strength

Now you know why Hamsters say “Better Is Better!!”

Copyright © 2008, 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