by Susan Juby
One of the great benefits of sobering up early is that most young people haven’t had a chance to build much of a family or a career, so there’s less wreckage to deal with. Plus, young bodies and minds are more resilient.
Two of the participants had spent some time in recovery while they were still in high school and both said they felt well accepted. This was in contrast to another young woman I interviewed. She was sixteen when she sobered up and characterized her last two years of high school as “hell.” She got through it by hanging out with religious students, because they were more “open-minded” about someone who didn’t drink.
The people in the aftercare group talked about connecting with their friends and having fun, like any young people, but all said that when they have real problems, they call the older people in recovery. Most of them had much older sponsors. Kelli talked about choosing the “old crabby English lady who sits in the corner” who had a habit of hanging up on her when she felt Kelli wasn’t listening. They asked if I had a sponsor and I was relieved I could tell them I did.
When asked about their dreams during active addiction, several said they had given them up. “If you accept you have no future, it’s easier to follow your addiction,” said one. Annie, a pretty, pensive twenty-two-year-old, talked of her persistent fantasies about death, most of which involved taking acid and jumping off a building.
She’d sobered up in a treatment centre two years before and after treatment had gone home to a small town on Vancouver Island. There, she was by far the youngest person at meetings. The people were kind to her, but they weren’t her peers. It was hard to change her old friends. And one of the things most treatment programs emphasize is that being in constant proximity with people who are drinking or using is one of the major factors in relapse. Dr. Steven Jaffe, an addictions specialist, writes that the most common pathway to relapse is “involvement with peers who use alcohol or drugs.… Spending time with using peers becomes too tempting and the [person] relapses.”*
Annie finally moved to Victoria after hearing that there were lots of other young people in recovery there.
I asked the group about letting go of the darkness that surrounds most addicts and alcoholics, but the question was sufficiently vague that none of them seemed to know what I was talking about.
“You mean chaos?” one asked.
That they knew.
I asked them if they felt isolated in the non-recovery community and most said no. That they in fact felt more comfortable now.
At this point, Jessie, a twenty-four-year-old who’d been silent, spoke up. “I’ve just been keeping quiet over here, taking things in. But everything they said, about not feeling isolated, I feel the opposite.” He went on to say that he’d gotten into a relationship in treatment. The relationship was “co-dependent” and he’d invested more in his girlfriend than in his recovery.
“These aftercare meetings are the only thing that saved me,” he said. “I hated the other meetings.” He talked about feeling judged because of the relationship.
Dale turned to him and said, very firmly, “So why’d you get into one if you were told not to?”
Jessie didn’t respond. I gathered that the relationship was over, but he still seemed a little bruised.
I asked them if they struggled with substitute addictions and mentioned my experience of feeling like my addictive self was always casting around for somewhere to land.
They nodded and laughed. Dale talked about shopping, gambling, and working out obsessively. Annie called herself a “schoolaholic.”
I asked if the educational component of treatment had been useful. In other words, did it help them to understand how their addictions had changed their brains. Most agreed that it was helpful. It took the “guilt away,” said one. Don, who’d attended a different treatment centre, one that did not subscribe to the disease model but instead used harm reduction, objected to the idea that he had a disease. It was very clear from the discussion that followed that the recovery model employed by individual treatment centres had a profound influence on the way each viewed the root of his or her addiction.
Before we finished the meeting, I asked if any of them had anything they wanted to add. One said, “Tell people that recovery’s cool.” I made a note of it. A startlingly beautiful nineteen-year-old who’d come in late spoke about how several people in her workplace, including much older people, had started going to meetings because she’d told them about her recovery. Her face glowed. “I feel really good about that,” she said. I thought that if I weren’t already in recovery, I’d be inspired to consider it by the sheer joy in her face.
Then they were up and making plans to go out for dinner. I heard two of them discussing how they were going on a cruise with a bunch of other young people in recovery. One of the guys asked out one of the girls. She laughed. And so did I. I walked out of the building and made my way back along Douglas Street, the main drag into Victoria. As I walked past the knots of strung-out street kids, dealers, addicts, and drunks, I wished for each of them a bit of the light that I’d seen in the eyes of the young people I had just left.
* Katherine Ketcham and Nicholas Pace, Teens Under the Influence. Ballantine Books, page 303.
24
Insane in the Brain
REMEMBER THOSE old public-service drug announcements featuring a brain and a fried egg? You know the ones: This is your brain, then the image of the egg being fried: This is your brain on drugs. Turns out those ads were fairly accurate, although our brains are likely being poached, soft boiled, or scrambled, depending on what substances we use to cook them.
Most addiction researchers have come around to the idea that addiction is, in part, a brain disease. This is something that twelve-step groups seem to have figured out by instinct and trial and error a long time ago. AA’s second step—”[We] came to believe that a power greater than ourselves could restore us to sanity”—recognizes that the alcoholic or addict is not operating with optimal mental function, and brain scans of alcoholics and addicts do show significant changes to brain function and chemistry. Some people question whether addicts and alcoholics have altered brain patterns even before they start using. Either way, the brains of alcoholics and addicts operate differently from those of other people. HBO’s documentary series and accompanying book Addiction: Why Can’t They Just Stop? New Knowledge, New Treatments, New Hope do an excellent job of explaining and demonstrating the relationship between addiction and altered brain chemistry and function.
My friends and I used to joke about the thousands of brain cells we killed every time we got high or drank until we blacked out. It turns out we were doing more than just deleting brain cells. We were training our brains how to deal with life. This is one reason it is more difficult to treat people who start drinking and using at a young age and why people who come into recovery now are often sicker now than those thirty years ago.
To illustrate, Neal Berger posed the following scenario. A twelve-year-old girl is socially awkward, shy, all those things that go along with being a preteen. She’s facing a stressful social situation, maybe the first day at a new school. She arrives at school, heart pounding. She passes a group of older kids, and one of them says something mean about her pants. The girl is so embarrassed and self-conscious she feels like running home and hiding. Instead of running home, the girl tells a friendly teacher or calls her mom or her older brother or a friend. That person reassures her that her pants look good and the older kids were being jerks and don’t know nice pants when they see them. The girl feels better and gets through the rest of her day, secure in the knowledge that talking about her problems and reaching out to others will help when she’s in trouble.
However, suppose that rather than calling someone, the girl heads behind the nearest convenience store and smokes a joint. Or goes into the school washroom and has a drink. What has she taught her brain then?
Both methods of dealing with stress achieve the same thing: relief. The brain p
erceives both talking over the problem and getting high as effective. But one method helps the girl to grow and feel more comfortable in the world, and the other one teaches her brain that relief can be found in substances. In her wonderful book Drinking: A Love Story, Caroline Knapp calls this the “mathematics of self-transformation … Discomfort + Drink = No Discomfort.”
When I was being bullied in school or was simply uncomfortable in my own skin, the thought of calling my mother or any other adult never crossed my mind. Not once. By the time I finally took a drink to deal with my social discomfort, my brain was desperate for relief. For the next seven years, I put my brain pathways on a strenuous training program. When I got stressed—excited, happy, upset, or uncomfortable—I dealt with it by getting loaded. The drinking made my behaviour worse and served to isolate me from other forms of support. The chances of my reaching out to an adult or even a friend became much slimmer. I was, after all, a bad kid. I knew it, and I thought most of those around me knew it.
In recovery one hears people talk about how booze and drugs saved their lives, especially when they were younger. Then the substances stopped working and the cure became the disease.
The whole addictive experience may be connected to the phases of brain development. The brain goes through two main growth periods. The first lasts from birth to age five. The second occurs from age ten to twenty-one. This second phase of brain development is “an opportunity to grow more gray matter and, even more important, to organize the electrical and chemical brain circuitry that underlies maturity, self-control, emotional balance, rational decision-making, memory formation, social skills, intelligence, and personality.”* But ironically, during this second stage of brain growth, from ages thirteen to eighteen, the brain is actually shrinking as it gets rid of unused pathways and makes the ones you do use more efficient. In other words, when we don’t develop or make or use of healthy brain connections or patterns, they disappear.
Thus, you have trained your brain that drugs and alcohol are the best cure for dealing with discomfort, and it lets go of other possible pathways. You literally don’t have other strategies available, at least so far as your brain is concerned. I can still remember how astonished I was to find out that talking about my issues with my sponsor and other people in recovery produced a quieter, but still powerful, feeling of release. Sharing, like drugs, is powerful.
This information made my behaviour and feelings after I first stopped drinking more understandable, but the onset of insanity when you’re young is difficult to identify. It seems to merge into the whole teen experience. I was already self-conscious and shy. When I got drunk, those feelings went away. When I sobered up, they came back, worse than ever, requiring me to drink more. This last piece didn’t register very well. I still saw drinking and taking drugs as the solution. I was lucky because, other than a phase when I was fourteen, during which I attempted to become a pothead, and later flings with cocaine and speed, I mostly stuck to alcohol. Younger people who use highly addictive hard drugs, such as meth and crack, do even more radical alterations to their brain chemistry. The stronger the drug, the more powerfully the brain remembers the effect.
Dopamine is central to this whole process. Dopamine is the chemical in the brain that makes us feel good. We get a little hit of dopamine when we eat something good, see something pretty, listen to music, or have sex. When we get drunk or high, our dopamine levels spike. After each spike, our dopamine levels fall, eventually to below the normal level. The following spike doesn’t go quite as high as the one before it. Over time, the rush becomes smaller and the crash that follows becomes deeper. Most addicts and alcoholics have had the deeply disappointing experience of finding that the drink or the drug doesn’t work any more. Often, this betrayal is the thing that precedes someone’s entrance into recovery.
Meanwhile, the brain has been fooled into “thinking” that achieving that high is equivalent to survival (even more so than with food or sex).… Eventually, the brain is forced to turn on a self-defense mechanism, reducing the production of dopamine altogether—and weakening the pleasure circuit’s function. At this point, the addicted person is compelled to use the substance not to get high, but to feel “normal”—since there’s little or no dopamine to be had. (Addiction, p. 59)
In other words, abusing drugs and alcohol destroys our ability to feel pleasure in everyday life when we are not high, which explains why early recovery can feel like such a brutal slog.
The good news is, the brain can be reprogrammed, if somewhat slowly. This lag time is something that the founders of twelve-step programs seem to have intuited. There’s a line in the Big Book of Alcoholics Anonymous about “trudging the road of happy destiny.” They used the word trudging as opposed to skipping or prancing because early sobriety is not for the faint of heart. The length of time it takes for brain damage inflicted by addiction to heal differs based on your early life and on what substances and what quantities of substances you were using. Most experts suggest that if you can make it six months without a relapse, your chances are greatly enhanced. If you can go two years, you are really on the road to long-term recovery. That doesn’t mean, however, you’ll be able to use safely after two years. It just means that much of the damage you’ve done to yourself that can be repaired will have been by then.
Why, then, do people go to self-help programs and stay in them, year after year? The reason is that twelve-step programs not only help to heal brain function, they provide social supports that are uniquely tailored to people in recovery. Programs based on the twelve steps and other types of support, such as counselling and behaviour modification, help people to learn to delay gratification (addicts and alcoholics are notoriously impatient for a quick fix) and to deal with the discomfort often found in everyday life.
Ongoing brain health, not to mention physical and spiritual health, is aided by participation in recovery programs. Also, there are often potlucks. So that’s something.
* Teens Under the Influence, pages 42–43.
25
Just When You Think You Can’t Hang on Any More
ONE OF THE PEOPLE I enjoy listening to most in meetings is Ruby. She’s been clean and sober about seven years and I’ve known her since she was brand new. I’ve watched her go through relationships, her college education, the beginning of a new career, marriage, and the birth of her first child. And I’ve learned from everything she’s had to say about what it’s like to live as a sober young woman.
Years ago a young DJ told me that when I spoke I was “droppin’ science.” I was pleased to discover this was a compliment. Well, Ruby drops some serious science every time she shares.
Ruby, in common with everyone else who is happily clean and sober, takes full responsibility for her addiction and recovery. The adults in her family drank, but not excessively. Even if they had used excessively, she says they weren’t “brilliant enough to create alcoholism.” She always felt that sense of anxious apartness that seems to be particularly acute in people who become addicts. Ruby describes having serious suicidal feelings starting by age ten and an overwhelming feeling that she missed the course called “Life 101.” In grade seven she and some friends were going through a punk rock phase. They listened to loud, fast music and wore Doc Martens and black clothes. A teacher accused them publicly of being Satan worshippers. The entire experience spiralled out of control, and although the teacher eventually backed off, every kid he’d accused wound up traumatized.
By grade eight, Ruby’s grades had gone from A’s to barely passing. She was smoking cigarettes and marijuana and drinking what she referred to as “shit mix” (alcoholic concoctions stolen from parents’ liquor cabinets). Drinking proved very effective in helping her escape her feelings.
She admits that from a young age she was very attracted to the “dark side.” She says she glamorized people who’d had difficult upbringings or were down and out. She was a successful chameleon and could move from group to group, but was happiest with t
he rocker/drug crowd because she found no judgment there.
At fourteen, she met her first serious boyfriend. He was eighteen and had just been released from jail. Over their three-and-a-half-year relationship, his heroin addiction progressed and he was in and out of several institutions. Ruby says he gave her something to focus on other than herself. She was, she says, “wired to the addict.” The year she turned eighteen, her boyfriend died of an overdose. That’s when Ruby really began to go downhill, drinking very heavily and doing harder drugs. Her goal was never to be sober.
Her first go at treatment was an outpatient program in Victoria, B.C. She was sent there in lieu of being charged with fraud. She reports leaving the program and going home to get drunk every night. By this time, she was spending time with very serious people: murderers, dealers, and assorted criminals. And she herself was dealing. Every time she got loaded, she would talk about cleaning up. In fact, she says that’s all she talked about.
After a long binge during which she couldn’t stop drinking or using, despite the fact that the drugs and alcohol weren’t providing any relief, she called a crisis line. They told her to go to the hospital. She did as suggested and begged to be admitted. The hospital sent her home. This incident, she believes, was a huge blessing in disguise. If she’d been taken in and diagnosed with something like depressive disorder or some other label, she might never have sobered up.
Finally, she called her mother, who’d joined Alanon to help her cope with Ruby’s disintegration. Twenty-four hours later Ruby was in treatment at Edgewood. Many alcohol and drug programs insist people be clean and sober for a period of time before they can be admitted. Ruby is grateful that Edgewood didn’t have any such policy.
At treatment Ruby says she surrendered almost right away. It wasn’t hard to admit that her life was a shambles. A few months before entering treatment, she’d found out that she was three months pregnant. She’d been drinking and getting high the whole time and had no idea that she was pregnant. She’d had an abortion. That was what ultimately put her over the edge. “I couldn’t believe that I was living a life so polluted that keeping my baby wasn’t even a choice.” She spent forty-four days in treatment. When she got out, she went to meetings, but she also picked up with an old boyfriend. She had no clean and sober friends, and to stay busy and “make up for lost time” she started working eighty hours a week.
