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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsWhy Philip Seymour Hoffman’s Death Is So Scary
http://www.slate.com/articles/health_and_science/medical_examiner/2014/02/philip_seymour_hoffman_s_drug_death_the_science_of_addiction_recovery_and.html?wpisrc=burger_barI cried when I heard about Philip Seymour Hoffman. The news scared me: He got sober when he was 22 and didnt drink or use drugs for the next 23 years. During that time, he won an Academy Award, was nominated for three more, and was widely cited as the most talented actor of his generation. He also became a father to three children. Then, one day in 2012, he began popping prescription pain pills. And now he's dead.
The root causes of addiction, like those of many multifactorial diseases, are frustratingly elusive, a nebulous mixture of genetics, exposure, and environment. Addiction runs in families, but plenty of addicts come from families with no history of the disease. Availability plays a role, toobut having access to crack doesnt make someone a crack addict. The science about recovery is also hazy: Alcoholics Anonymous, the most widely used form of treatment in the country, has no set structure or methodology, which makes it tough to evaluate its effectiveness. (Theres also the fact that its core principlethat members never publicly acknowledge their presence in the programmakes broad longitudinal studies difficult, to say the least.) In-patient treatment centers, like the one Hoffman checked himself into last May, have been accused of obfuscating their success rates.
If anything, the science on relapses is even more slippery. (We do know that relapse rates for drug and alcohol addiction are comparable to peoples inability to control other chronic illnesses, such as type 2 diabetes, asthma, and hypertension.) The challenges are as basic as agreeing on a definition for long-term sobriety. In a graphic titled Extended Abstinence is Predictive of Sustained Recovery, the National Institute of Drug Abuse says, After 5 yearsif you are sober, you will probably stay that way. I unconsciously added a forever to the end of that sentencebut the study that chart is based on ran for eight years, a bar Hoffman cleared easily.
My first attempt at recovery came in 1991, when I was 19 years old. Almost exactly two years later, I decided to have a drink. Two years after that, I was addicted to heroin. Theres a lot we dont know about alcoholism and drug addiction, but one thing is clear: Regardless of how much time clean you have, relapsing is always as easy as moving your hand to your mouth.
Lesleymo
(236 posts)My son is an addict. He's currently in a state prison in Georgia. He'll be out in May and he has all the good intentions and high hopes in the world. I have hope for him as well. But I'm terrified at the same time. Hoffman's death reminded me that addiction is relentless. I hope and pray that my son is strong enough to recover forever. But still ... I'm terrified.
steve2470
(37,457 posts)narnian60
(3,510 posts)Auntie Bush
(17,528 posts)Think positive. Vision him mowing the lawn next Summer. Good luck!
daleanime
(17,796 posts)Warpy
(111,237 posts)AA is big on anecdata and I have to admit that the only family members and acquaintances I know who have gotten sober and stayed that way have done it with AA's help. It's not just the program, which tends to be hokey and hyper religious, it's the support system that a sponsor and other sober people can give. In addition, they're correct that an addict is always an addict and if they slip, they'll be back just where they started. Addiction is like any other chronic illness, you have to take care of it properly if you want to live.
"One is too many and a thousand isn't enough" describes addiction to a T, the addict taking one dose of his drug of choice and then compulsively using, chasing an elusive high, limited only by unconsciousness or death.
Addiction and dependency are two different animals, but this post is about addiction, defined by cravings and compulsive overuse. Dependent people have an "off" switch. Addicts don't.
Blue_Tires
(55,445 posts)thanks for the insight
johnp3907
(3,730 posts)I always wonder if it's their different personalities. She's the outgoing people person type, and he's the snide cynical type.
Warpy
(111,237 posts)but you've got to have a bombed out landscape of a life before you're desperate enough to ask for and receive help reconstructing it. He's likely not there yet. He might never get there. Some people do die from this disease. People on both sides of my own family did.
johnp3907
(3,730 posts)We always think it's going to be "that call."
Flying Squirrel
(3,041 posts)Yet AA managed to help me. You just never know who's gonna make it and who isn't.
Warpy
(111,237 posts)who went to meetings in the "you people are no fun, you don't drink" sister organization to learn how to cope with an alcoholic spouse.
I left and he got sober 2 years later when it finally dawned on him that his problems had stuck around after I left and he did it through inpatient rehab followed by AA.
Yeah, you just never know.
loyalsister
(13,390 posts)Some of my observations....
My mom's side has had their problems but they have mostly been aunts uncles and cousins.
* My great grandfather was an alcoholic. My grandma used to take him booze when he was in a nursing home. She never developed and problems with substance abuse.
* I have an uncle who, if I saw in the AM would shake until he got bourbon in his coffee. He quit smoking and drinking at the same time 20 yrs. ago. He has never been to an AA meeting and is sober to this day.
* One aunt was an alcoholic and found her way to sobriety temporarily. The she started having medical problems and addicted to pain killers and. Tried AA a couple of times and was never able to make it work.
* Another aunt married a sort of low key, high functioning alcoholic. One managed to follow in his footsteps. Out of seven, 2 went to prison for substance abuse related offenses. And, 1 has gotten sober. He has community support along with AA. The other has relapsed, and sort of goes back and forth. Another one was homeless, and died on the street.
A number of their children seem to have some trouble. He was the only one who tried AA
* Another aunt has revolving addictions (alcohol, food, and gambling) which she manages to maintain because she has the resources. AA is no use
* A cousin who nearly died from Cirrhosis and has quit started gambling soon after and wound up stealing and burning a lot of bridges in the family. She is not aware of her addiction.
* One of my sisters stopped drinking and has been active with AA. She has done very well.
* Another attended a few meetings and has been sober since. She can't kick cigarettes and probably has some trouble with weed.
I worry a little about 2 others.
The other side of my family. Wow....
* My dad sopped after nearly dying from alcoholic pancreatitis, but has since relapsed. My dad does not see a problem with his behavior when he's drinking. Both of his parents, and most aunts, uncles and cousins are alcoholics. Of 5 siblings, one is not and never has even drank socially. Of those extended family members, I can't think of one who has even tried AA.
_______
I think that both of your descriptions are present in my observations. I also think there is probably a lot of overlap. If nothing else, it shows how complex and difficult it is to understand. I think AA provides mixed results.
I have friends who have gotten sober who have also had a range of experiences. In conversations with them, statements like "I don't understand" are usually met with "that's because your not an alcoholic."
Is what you call dependency a situation where a person has minor withdrawal symptoms when they stop taking pain killers after a broken leg or something, but they think they have a flu virus or something?
abelenkpe
(9,933 posts)Thought they wouldn't do that if one had a history of addiction?
cally
(21,593 posts)I've told Doctors not to prescribe any painkillers and then have them offered to me or another time as I'm leaving told there is a prescription waiting for me whenever I want to fill it. Another time, told that I could take cough syrup with alcohol because it wouldn't be a problem short term. Most just do not get it.
AndyTiedye
(23,500 posts)get the red out
(13,461 posts)Should an addict be punished by being forced to endure horrific pain?
AndyTiedye
(23,500 posts)A friend of mine was not only being refused pain meds, the doctors completely blew her off, for FOUR YEARS.
Finally when she found a doc who would take her seriously she was diagnosed. She has ovarian cancer!
Now she is getting the care she needs for that, and got some pain medication, but not enough,
they let her go into withdrawal from the meds they gave her before they got around to prescribing more.
get the red out
(13,461 posts)I knew that people bragged in meetings about never taking pain meds, and going through horrible pain, but my God. I am a recovering alcoholic, and thankfully my doctors have given me pain meds after a couple of surgeries I have had with zero issues. What has been done to your friend should be considered malpractice.
I know someone in recovery who had kind of the opposite form of malpractice. He had a reaction to doctor prescribed medication that cannot screw you up or addict you. He became very sick, and in the emergency room the nurse practitioner seeing him was convinced that he had abused that medication rather than had a reaction to it. They kept him in the hospital and the next day they tried to give him a dose of the same medication that had almost knocked out his kidneys. He refused it and thankfully the Nephrologist took over his case and told the hospital staff they were idiots and that he had been prescribed medication improperly.
WestSeattle2
(1,730 posts)families that fight this battle on a daily basis.
One day at a time.
Lost_Count
(555 posts)Bet you dollars to donuts he didn't make it.
steve2470
(37,457 posts)Lost_Count
(555 posts)Then I don't know why he buys it then. Towards the top of the list of defining characteristics of addicts is the word "liar" in big bold letters...
Flying Squirrel
(3,041 posts)because they lie to themselves. That's why on an AA coin it says "To Thine Own Self Be True"
Lost_Count
(555 posts)... to themselves and everyone else.
CreekDog
(46,192 posts)gets in your way.
steve2470
(37,457 posts)Yeah, he could have lied to everyone and secretly relapsed one night on alcohol or another drug and never told anyone. Technically, that's a relapse. He might not have considered it a relapse or a "slip". Plenty of people do honestly make it many years in recovery with no relapses.
Lost_Count
(555 posts)My question was about declaring it as fact...
I think it would be more accurate to say something along the lines of "Hoffman claimed that he had been sober for 23 years..." etc.. etc...
steve2470
(37,457 posts)morningfog
(18,115 posts)Addicts can't usually get "just a little" high.
Samantha
(9,314 posts)It is very hard to accept. I really feel badly for his children and his partner.
Sam
MarianJack
(10,237 posts)...I smelled an empty beer bottle of my wife's. I didn't drink that night, but I DID struggle. Addiction is a disease that NEVER goes away. You must ALWAYS be onyour guard.
PEACE!
hotrod0808
(323 posts)how it is for an alcoholic/addict: Long-term sobriety is never a guarantee. All an addict has is today. Just stay sober today. The addict must seek support. He or she cannot do it themselves. They are suggested to join groups and be active, seeking a sponsor as a guide through The Twelve Steps. The must have the humility to know that they are not the center of the universe, and are therefore not in charge. AA/NA are full of Christians and they are God-oriented programs. Yet, and addict does not have to automatically convert to Christianity upon entry into the program. It is possible to be an Atheist and be a member. The only requirement for membership is the desire to stop drinking/using.
As a member of AA for several 24 hours, all I know is that a program of recovery saved my life. It only continues to save my life if I continue to practice the principles of the program in all my affairs. Sadly, I have heard several stories of those in recovery who had decades of sobriety who used again, and their story was all the same: they ceased to practice their daily program of recovery.
I grieve Mr. Hoffman, and never met him. I grieve every addict or alcoholic who has died from their disease. I will not judge him and I will not belittle him. My only hope from this horrible story is that those who are sick and suffering from this disease may use this as a catalyst to seek help themselves.
steve2470
(37,457 posts)Some people for their own uniquely personal reasons cannot accept NA or AA. For those people there's Rational Recovery and other groups whose names escape me right now. You are correct, however, that you can be an atheist/agnostic/non-Christian and use AA or NA. You're so right about not doing it alone.
phil89
(1,043 posts)There are other approaches besides the outdated AA model. Rational Recovery/SMART Recovery, for example. Neither of which support the idea of higher power/gods or tell people they are powerless, etc. In fact some people DO quit on their own. I don't understand the need for some people to make the unsupportable claims that they MUST have help from other people or work a 12 step program to be successful.
Cha
(297,102 posts)So sad.. I didn't know the history of PSH.
Addiction is a scary scary thing. So many pitfalls.. and Why some people are pre-disposed and lucky others are not.
steve2470
(37,457 posts)It's not fair that most of us can have one beer or drink and walk away. The alcoholic cannot do that. Addiction is a lifetime illness and very scary. It's true that you can be sober for many years, relapse and die from that relapse (or at minimum be plunged back into active addiction).
Cha
(297,102 posts)the addiction side of things.
dsc
(52,155 posts)no kidding this death is scary. I know that just one drink could put me back to where I was fourteen years ago. RIP Mr. Hoffman.
Flying Squirrel
(3,041 posts)colsohlibgal
(5,275 posts)I wish the best for all those dealing with addiction with themselves or family members.
I drank quite a bit until I just really tapered off in my mid 30's after a 15 month trip into the really fast lane. I still drink from time to time, here and there, but the vast majority of days I don't, Diet Pepsi and coffee is it for me most of these days now.
I dabbled in a few drugs in my 20's, did LSD once did not like it, coke once did not like it or even get the appeal. I think I'm a pretty non addictive type but that said knew I should avoid opiates since I sure liked them when given to me in the hospital a time or two. The appeal of negative anxiety is indeed strong.
steve2470
(37,457 posts)Response to steve2470 (Original post)
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TBF
(32,041 posts)Response to TBF (Reply #39)
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muriel_volestrangler
(101,295 posts)As more bodies beyond Neptune were discovered, it became clear there was some use in having a separate class into which they fall. No fact about Pluto was revised. Science gets rechecked, and that sometimes does mean revising a 'fact', but that doesn't mean "it's just speculation". Scientific theories have remarkable predictive power.
It's strange that you complain that Psychology 101 wasn't about disorders, because that would be looking at psychology for nothing more than molecular structures and chemical reactions. A typical Psychology 101 course looks at emotion, personality and other aspects of psychology that are not just studies of molecular structures and chemical reactions.
Response to muriel_volestrangler (Reply #42)
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steve2470
(37,457 posts)Congrats for offending a significant subset of DU. Very debatable assertion there.
Response to steve2470 (Reply #45)
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steve2470
(37,457 posts)Social workers, counselors, addiction counselors, therapists, you name it. Some of us used to work in the field. Some of us want to work in the field.
Response to steve2470 (Reply #48)
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Blecht
(3,803 posts)Then you can avoid the embarrassment of saying things like this:
Science is nothing but a set of THEORIES. It's just speculation.
English is a complex language in which context plays a large role in determining the meaning of the words used. You are not using the correct meaning of the word "theory" in the context of the scientific method in your statement. A science class can help you understand how silly it is to write what you did.
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Heidi
(58,237 posts)SidDithers
(44,228 posts)Sid
MineralMan
(146,284 posts)In some areas, it's just moist.
jeff47
(26,549 posts)There was a time you did not know how to do addition. Does the fact you can add 27 and 63 now mean you were slippery?
Once, you didn't know how to do division. Does the fact you can divide 15 by 5 now mean you were slippery?
Mysticism in any form is consistent only because its answers are in a book pulled from someone's imagination. People pretend that book has never changed in order to create the illusion of consistency.
Science changes as we learn more about the world around us. Inconsistency is it's strength.
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jeff47
(26,549 posts)Response to jeff47 (Reply #58)
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Why?
Couldn't his consciousness have also died? Why couldn't the "spark" that "animated Fred" go out with his death?
hfojvt
(37,573 posts)this writer was a recovering addict by the time he/she was 19.
According to one guy I heard - it is about dopamine and the developing brain.
That you need a certain level of dopamine in your brain just to "feel" normal. He claimed research shows that the brains of young addicts are permanently altered. Altered in such a way that they will always need an ELEVATED level of dopamine just to feel normal.
A level that is readily obtained by drug use.
steve2470
(37,457 posts)sibelian
(7,804 posts)The quick fix is usually chosen because there is no meaningful living process to take it's place.
The necessity for meaningful existence is rarely included in conversations around addition of any kind, which is very sad.
TroglodyteScholar
(5,477 posts)steve2470
(37,457 posts)Response to steve2470 (Original post)
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get the red out
(13,461 posts)But I haven't drank in a long time, and still consider myself a member of a 12-step fellowship; but we have got to start moving past the black and white view of "recovery" because it is killing people. In a 12-step fellowship abstinence is the most important, followed closely by "emotional sobriety"; after a long period of abstinence who do you turn to when your life gets hard without being considered to be someone who "isn't working the steps"? A person gets really isolated after years of sobriety and trying to work the steps right and say the right things in meetings. I didn't drink but I started having non-stop suicidal thoughts after 17 years without a drink. I didn't really know who to turn to, I had heard so many people in the 12-step fellowship say medication for mental health was a crutch, or was "alcohol in pill form", but times were hard. Finally I sought help for the damned depression that had plagued me since I was 9 years old and it was like waking up after a long, bad dream.
The idea that is planted in people's heads in many 12-step meetings, that they have to do the steps just right and constantly go to meetings or they will drink/drug and DIE can be a self-fulling prophecy. If a person picks up a drink or a drug they've lost EVERYTHING that second, they go from someone to pitiful if they have any time in their fellowship, so they might as well tie on a damn good one, right?
If our society can't look beyond 12 step to help people there will just be more and more death with people saying that the person "didn't want it", or "couldn't get it", or "that dead guy in the coffin hadn't hit bottom yet". We have to get off our puritanical asses and look for other solutions. I am grateful to the fellowship that got me sober, but I've seen a hell of a lot of death along the way, and I can tell you it is still fully planted in my mind that I would rather fucking OFF MYSELF than walk back into a room full of smug looks with my head hung low telling them that I have failed and am now nothing and have LOST 21 YEARS. Do we really do that? Lose 21 hard fought years on this planet? Addiction and recovery both have screwed me up, and I am trying to sort it out properly.
The people that fight the hardest against any mention of new recovery methods are the treatment centers and those employed by them. So often these centers employ people whose main qualification is being sober in a 12 step fellowship. These folks work cheaper than someone with actual credentials. The treatment centers are either nearly impossible to get into or extremely expensive. They don't want change, change threatens their $$$.
Every time I have read about a new method or idea to treat addiction it is recovering people who scream the loudest against it. Even Bill Wilson, co-founder of AA said "we know but a little.....more will be revealed" but this isn't put into practice very well or very often. Surely the most we will ever know about treating addiction didn't begin and end in 1938?
Response to get the red out (Reply #64)
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get the red out
(13,461 posts)Depression is a disease, my Mother has it, my Grandmother had it, my Grandfather on the other side had it, my Aunt had it, my Uncle had it. My brain isn't wired right.
I was going through a rough time in my personal life and could confide in very few people. It brought the depression to the surface in a very bad way. I can tell you that taking inventory and declaring what a piece of shit I was and how I was failing my 12-step fellowship of choice wasn't going to solve it either.
steve2470
(37,457 posts)Depression can be just as bad and fatal as addiction.
pipi_k
(21,020 posts)Is not true.
Its core principle is anonymity for other people.
People are always free to self identify as being AA members if they want. If that were not true, then we wouldn't see members driving around in cars with bumper stickers that say, "I'm a friend of Bill W"
I've seen obits where that same sentiment is mentioned..."He was a friend of Bill W"
What they cannot do is disclose the membership of anyone else unless they have that person's permission.
steve2470
(37,457 posts)steve2470
(37,457 posts)Th1onein
(8,514 posts)I have a drink, now, about once a year. Sometimes two drinks a year, if things are stressful. I don't buy into the AA crap. Once your liver heals and you can store sugars as glycogen again, I think you're cured from that craving for alcohol.
I have no idea about drugs, other than alcohol, though.