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Is addiction a disease? 11 questions with an EHN doctor

The opinions expressed in this article are those of Dr. Charles Mackay and for general information purposes only.

Despite its prevalence in Canada, there’s still plenty of misunderstanding surrounding addiction and substance use disorder.

According to the Centre for Addiction and Mental Health, “one in seven Canadians aged 15 or older (about 3.5 million people) have problems with alcohol; one in 20 (about 1.5 million people) have problems with cannabis…”

Addiction education helps prevent unsafe drug use and reduces stigma, which can create significant barriers for people who use drugs when it comes to accessing life saving services.

We talked with Dr. Mackay, a ASAM (American Society of Addiction Medicine) and ABAM (American Board of Addiction Medicine) certified general practitioner. Dr. Mackay, who is a clinician at Edgewood Health Network’s Nouveau Depart clinic in Quebec, has 30 years experience in the field of addiction.

What is addiction?

Addiction is a term used to describe both substance use disorder or loss of control when it comes to a substance or a behaviour. It’s much more complex than really enjoying a substance or activity: we often hear people say they’re “addicted” to coffee or talk about “binging” a TV show.

But when a person is addicted to a substance (like alcohol or drugs), they fall into a harmful pattern of consumption despite negative outcomes and a desire to stop. There are often symptoms of dependence, including an increased tolerance and withdrawal symptoms. Addiction can impact every aspect of a person’s life. 

Clinicians often use the four C’s to describe addiction: Craving, loss of control, compulsion to use and use despite consequences.

Let’s consider an example of someone who is likely experiencing an addiction:  Emma is a 50-year-old mother of two with a high-stress job. She starts having one or two glasses of wine in the evenings to end a stressful work day. As time progresses, she is having at least five drinks a night and waking up hungover. Her work performance starts to slip and her boss tells her she needs to improve or she could lose her job.

Is addiction a disease?

Yes, addiction has been classified as a disease for at least 200 years. Swedish physician Dr. Magnus Huss was the first to use the term addiction in his 1849 essay “Alcoholismus Chronicus.” Clinicians helped reduce stigma when they stopped viewing addiction as a “choice.” Stigmatizing and criminalizing drug and substance use has created significant barriers to treatment and harm reduction services.

In 1956, the American Medical Association declared alcoholism a disease, which accelerated the development of treatments and reduced stigma around the condition. As a result, individuals with alcohol use disorders were less afraid of judgement and therefore more likely to seek help.

The American Psychiatric Association and the World Health Organization also agree that addiction is, by definition, a chronic disease. Like other chronic illnesses, symptoms affect people over an extended period of time and evolve slowly.

How do psychoactive substances affect the brain?

In short, psychoactive substances are chemicals or drugs that affect the mental state or brain function in some way. These include cannabis, cocaine, alcohol or even prescription medications like painkillers. 

There are several models and theories about how these drugs affect our brains, and the creation of neuroimaging technology has helped clinicians paint a clearer picture of how and where addiction acts.

When we consume a drug, the reward centre of our brain releases a neurochemical called dopamine and creates feelings of satisfaction or happiness. Dopamine plays an important role in movement, motivation and behaviour reinforcement, so substance use has a direct impact on the brain and quietly changes our actions and reactions. Over time, neuroadaptation occurs: our brains adapt and a higher level of dopamine (so, a higher dose of our drug of choice) is needed to create the same satisfying or happy feelings.

Do psychoactive substances affect the brain permanently?

The effects of neuroadaptation don’t resolve quickly, even after someone stops using the substance that caused it. Because these changes can take a long time to resolve, people in recovery are vulnerable to relapse. However, each person is different. Think about how some people can kick a smoking habit by going cold turkey, while others take several failed attempts to quit before it sticks.

Early identification and treatment of addiction or harmful drug use can limit the changes to the brain and make recovery more likely.

Why do some people become addicted while others don’t?

We know that many people can experiment with alcohol, drugs, or certain behaviours without becoming addicted. Why do only some people develop a dependence?

Addiction is a complex issue and there are several different models used to understand it, but it is widely accepted that a combination of biological and social factors are usually at play. We know that there is not one single factor that will reliably predict that some one will develop a substance use disorder or addiction.

Genetics, social environments and/or social exclusion, concurrent mental illness, and past trauma, are just some risk factors for substance use problems.

It is important to look at the social determinants of health when we consider how certain people become addicted while others do not.

How do genetics play a role in addiction?

We know that genetics can play a role in the development of addiction, but this doesn’t mean every person a history of addiction or alcohol use disorder in their family will develop substance use issues.

According to the Society for Clinical Pharmacology and Therapeutics, “addictions are moderately to highly heritable. Family, adoption, and twin studies reveal that an individual’s risk tends to be proportional to the degree of genetic relationship to an addicted relative.” In simper terms, the more genetically similar somebody is to a relative who struggles with addiction, the more likely they are to develop an addiction themselves.

Several academic studies explore the genetic component of substance use disorders. For example, the controversial twin/triplet studies of the 1960s found that genetics is one of the determining factors for alcohol dependence. Similarly, a 2014 Cambridge University study confirmed that heredity is about 50% responsible for a substance use disorder, but that the social environment (including early relationships, education, social inclusion or exclusion) also has a significant impact.

Are there different “types” of substance use problems?

Clinicians have been trying to classify addiction since the 19th century. It’s a difficult task, as a cause isn’t as clear as other with types of disease, such as diabetes. Whereas diabetics can be diagnosed with Type 1 or Type 2, it is not so simple to categorize addiction. But, effective treatment cannot be started until a diagnosis is made.

Elvin Morton Jellinek, a biotstatistician, psychologist and researcher of alcohol-related disorders, was first to classify alcoholism scientifically. He developed a comprehensive, evidence-based theory that confirmed alcoholism is indeed a disease. In the mid-20th century, Jellinek conducted a clinical study of people with chronic alcoholism, where he sought to establish how the disease develops over time. It was from this study that he eventually created the Jellinek Curve. This U-shaped curve shows the progression or phases of the disease, step-by-step.

Methods of categorizing addiction have evolved since then, but Jellinek’s work led to a better understanding of addiction in order to find more effective treatment and care. Today, specialists use the model presented in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The DSM is used by healthcare professionals as a guidebook to diagnose mental illnesses.

How should I talk to youth about substance use?

When it comes to talking to your kids or other young people about substance use, it’s important to be honest. It’s possible to talk about the risks and consequences of addiction without dealing in myths like, “you will become addicted the first time you try a drug.” A young person who is educated and aware will be able to make better, safer choices.

Prevention is most effective when truthful, factual information is used. You don’t have to terrify your kids with anecdotes about drug use; this can often have the opposite effect if the young person no longer trusts you as a reliable source of information.

At any age, we make smart decisions when we’re well informed of the risks and consequences of our choices. When it comes to substances, knowing the facts helps us to make better choices early on in life to prevent the development of addiction or unsafe use.

How is addiction treated?

The first step in treatment is typically detoxification and an assessment for any concurrent, or co-occuring, mental health disorders. In the case of co-occurring disorders, integrated treatment plans are best to help address both issues at once. A holistic treatment model helps prevent relapse by reducing the chance that the substance use will affect the mental health problem or vice versa. Some people will require medicine and supervision to tolerate withdrawal symptoms, such as fever and body aches. 

Someone who is opioid-dependant might choose to start maintenance therapy, where they’ll take an oral dose of medication, like methadone, under medical supervision. This helps reduce cravings and reduce symptoms of withdrawal.

To date, there are only a few pharmacological approaches with a modest therapeutic response for alcohol use disorders.

Other non-medical options for treating addiction include inpatient or outpatient therapy and support groups. Evidence-based therapies help individuals regain control over their substance use and achieve sobriety. One example of this is Cognitive Behavioural Therapy (CBT), which is designed to help control harmful, negative thought patterns.

There is no one-size-fits all solution and several approaches and goals of treatment are possible. A treatment plan must be personalized, therefore, it is important that any person in treatment is involved in determining their plan with the guidance of a registered professional or treatment facility

Where can I seek help for an addiction?

You do a fair amount of research before choosing a course of treatment for yourself or a loved one. When reaching out to a facility or treatment centre, here are some important questions to ask:

Remember that there is no one-size-fits-all solution or treatment program, and that you deserve qualified, empathetic treatment that is tailored to your unique situation.

ABOUT EHN CANADA

EHN Canada is the nation’s largest network of industry-leading mental health, trauma, and addiction treatment facilities, each with a passion for providing quality treatment for Canadians. We are committed to both caring for our patients and supporting their loved ones. With over 75 years of collective experience, our inpatient, outpatient, and online programs are offered across the country, providing essential compassionate care to patients wherever they are.
To learn more, please visit www.ehncanada.com.

References

“Alcoholism.” n.d. In Encyclopædia Britannica.

Babor, Thomas F. 1996.  “The Classification of Alcoholics: Typology Theories from the 19th Century to the Present.” Alcohol Health and Research World 20 (1): 6–14.

Canada, Santé. 2018. “Stigmatisation Entourant La Consommation de Substances.” Canada.ca. 19 février 2018. https://www.canada.ca/fr/sante-canada/services/dependance-aux-drogues/consommation-problematique-medicaments-ordonnance/opioides/stigmatisation.html.

“How Long Has Addiction Been Classified as A Disease?” 2019. Vertavahealth.Com. 3 octobre 2019. https://vertavahealth.com/blog/how-long-addiction-classified-disease/.

Jellinek, E. M. (1942) Alcohol Addiction and Chronic Alcoholism. Yale University Press, New Haven.

Jellinek, E. M. (1960) The Disease Concept of Alcoholism. Hillhouse, New Brunswick.

Kathy Bettinardi-Angres, MS, RN, APN, CADC, and Daniel H. Angres. n.d.  “Understanding the Disease of Addiction.”

Miller, Peter M., ed. 2014. Principles of Addiction: Comprehensive Addictive Behaviors and Disorders. P. 72. Academic Press.

National Institute on Drug Abuse. 2018. “Understanding Drug Use and Addiction DrugFacts.” Drugabuse.Gov. 6 juin 2018. https://www.drugabuse.gov/publications/drugfacts/understanding-drug-use-addiction.

“OMS | Maladies Chroniques.” 2014. https://www.who.int/topics/chronic_diseases/fr/.

Verhulst, B., M. C. Neale, and K. S. Kendler. 2015.  “The Heritability of Alcohol Use Disorders: A Meta-Analysis of Twin and Adoption Studies.” Psychological Medicine 45 (5): 1061–72.

The Importance of Hope in Addiction Recovery

By George Ratnanather. Updated January 6, 2021.

Recovering from an addiction is a complex process. The road is never smooth. In fact, you will probably encounter obstacles, hardships and heartaches. But it’s a journey that everyone hoping to recover from addiction must make. It is the only way to move from a life of destruction to life of health, wellness and joy.

While there are many paths to recovery, there is one element that is constant–and that’s hope. But why is hope so important in recovery?

The Importance of Hope in Recovery

Hope is more than mere wishful thinking; it is the bedrock upon which you build your recovery. Without hope, or a desire to recover, there would be no motivation to get better. With no motivation, there would be very little meaningful action. Finally, with proper action comes improvement through a series of steps leading to a plan for recovery, and working the plan for years to come. I cannot stress harder the significance of hope in recovery.

Addiction Recovery Steps

What is ‘hope’?

Each of us defines hope differently. But in essence, hope is the expectation that things in the future will be better; knowing that the sun will shine again.

Relating to addiction recovery, hope becomes a foundation and the energy that drives us to find a way to get better and heal. It keeps us strong when we encounter challenges. And hope gives us a sense of joy and peace, knowing that a better tomorrow exists.

Finding Hope

When preoccupied in an addictive substance or behaviour, it not always easy to see a life beyond the addiction; beyond the chaos, pain and suffering. But hope can be found. There is no right or wrong way to find hope. Sometimes it comes easy, and sometimes we need to work to find hope.

Below are a few ways that have helped our clients find hope even during times of deep despair.

Listen to Stories of Hope
Hearing stories of hope, success and triumphs of others can help us find hope. These stories not only inspire us, but also shed light on strategies of finding and sustaining hope even during the darkest times. We try to share as many stories of hope on our blog, but there are so many sources to discover online: on blogs, social media (like Instagram, Facebook, Pinterest), podcasts, etc. Finding someone you know or who speaks about their experience often can be really helpful to follow or bookmark for more regular inspiration!

Think of the Future
Look into the future and identify who and what is important to you. It could be a loved one, such as a child, spouse or parent. It can also be an event or something you always wanted to do. Looking into the future helps cultivate a purpose and direction in life (i.e. hope).

Positive Affirmations
Though a simple process, positive affirmations do work. The repetition of positive affirmations leads to belief, and belief is at the heart of hope. Affirmations such as ‘I am strong, I can overcome my challenges, I am a new person, I feel new hope and I can recover’ rebuild a sense of self-worth and your belief that you are capable of achieving your goals. Not only do affirmations build belief, but also a confidence and a drive for change and action.

Leaning on a Higher Power
Many find hope by reaching for a higher power. This could be through spirituality, religion or philosophy. Reaching to a higher power is actually Step 2 in the 12-Step Process: “Came to believe that a power greater than ourselves could restore us to sanity”. Simplified, this reads as, ‘There is help for my problem and I believe I can address it’.

Accept Your Current Situation
For some, it may be hard to accept that they are currently in a bad place. But the courage of acceptance is the first step in desiring a better future (i.e hope). Acceptance helps us realize that our current situation is not where we want to be, and helps us develop a vision of where we want to be. Without acceptance, we cannot take control of our destiny to reach a better tomorrow.

Have Realistic and Meaningful Plan
It is action that makes hopes come true. By the mere fact of developing a plan for a better future, you will build hope. The more your plan has firm action steps and dates, the more successfully you will come to realize that your vision is truly attainable. If you’re working on a self-guided plan, try finding tools online like SMART goal setting or some tips to develop a successful recovery plan.

The journey and recovery from addiction is never an easy one. No one can last long and keep fighting for recovery without hope. Hope is a central ingredient in our recovery. Finding hope and meaning, together with a solid plan, helps us move forward on our journey of recovery.

 

“Everything that is done in the world is done by hope” – Martin Luther

 

EHN Canada Can Help You

If you would like to learn more about the addiction and mental health treatment programs provided by EHN Canada, enroll yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.


References:
https://www.livestrong.org/we-can-help/preparing-yourself/hope/
https://shakeoffthegrind.com/personal-success/10-tips-to-find-meaning-and-hope-during-times-of-despair

How Healthy Eating Can Help You With Addiction Recovery

Written by Munis Topcuoglu, Editor at EHN Canada.

Healthy eating helps you with addiction recovery by allowing your mind and body to work better and heal faster.  It helps you maintain your recovery by supporting your mind and body to function well consistently, thus maintaining your good health. Eating a healthy diet helps you with addiction recovery in a number of specific ways such as stabilizing your mood, improving your focus, increasing your energy, and making you better at resisting cravings for addictive substances and behaviors.  Conversely, nutrient deficiencies can make addiction recovery more difficult by making you more susceptible to depression, distraction, fatigue, and cravings. Substance use disorders can make you are especially vulnerable to nutrient deficiencies, for a number of behavioral and biological reasons—but healthy eating can help correct your nutrient deficiencies and greatly improve your odds of successfully achieving recovery and maintaining it long term.

Healthy Eating Means Getting the Right Nutrients and Calories in the Right Quantities

Your mind and body use up nutrients and energy constantly, so healthy eating requires that you get sufficient nutrients and energy regularly from the foods you eat.  Healthy eating means getting enough of all the nutrients you need to function well and be healthy, but not excessive amounts of any nutrients that would be enough to harm you.  Healthy eating also means getting enough calories (energy) that you need for performing healthy physical activity and maintaining a healthy body weight, but not so much that it would cause you to gain an unhealthy amount of body fat.

There are two main categories of nutrients, macro-nutrients and micro-nutrients.  Macro-nutrients are basic building blocks and energy sources for your body; you must get them in relatively large amounts, such as 10’s or 100’s of grams per day.  In comparison, micro-nutrients have specialized functions in your body; you need them in much smaller amounts, such as micrograms or milligrams per day.

Macro-nutrients

The three macronutrients are protein, fat, and carbohydrate.

Protein

Protein is used for building and repairing all the cells in your body.  It is especially important for muscle and connective tissue, but is also necessary for producing hormones and neurotransmitters.  Proteins are composed of amino acids. There are some amino acids that your body needs but cannot produce: these are called “essential amino acids.”

Fat

Fat is a preferred energy source, but is also essential for your nervous system, building cell membranes, and producing hormones.  There are some fats that your body needs but cannot produce: these are called “essential fatty acids.”

Carbohydrate

Carbohydrates are an optional energy source.  Appropriate carbohydrate intake depends on your physical activity levels and your genetics.  Excessive carbohydrate intake can disrupt your metabolism, cause you to gain unhealthy body fat, and lead to diabetes and cardiovascular disease.

Micro-nutrients

The two main groups of micro-nutrients are vitamins and minerals.  Vitamins are organic molecules and minerals are chemical elements.  Each vitamin and mineral has specialized roles within your body and they are all required in small amounts for your mind and body to function properly.  Your body cannot produce vitamins or minerals.

Essential nutrients and healthy foods

Essential nutrients are nutrients that your body requires to function properly but cannot produce, they are the following: essential amino acids, essential fatty acids, vitamins, and minerals.  Since your body cannot produce them, you must get them from the food you eat.

Healthy eating means getting all the essential nutrients that you need.  Therefore, healthy foods are foods that contain high amounts of essential nutrients; they are usually whole, unprocessed, and fresh.  In contrast, unhealthy foods contain low amounts of essential nutrients and are often refined, processed, and contain preservatives.

Addiction Makes It Difficult to Eat Healthy, Often Resulting in Nutrient Deficiencies

Addictive substances and behaviors can make healthy eating more difficult in a number of ways.  They can also prevent you from getting enough nutrients despite a normally healthy diet. When you don’t get enough of a particular essential nutrient in your body, you develop a nutrient deficiency.  Addictive substances can interfere with healthy eating and cause nutrient deficiencies in the following ways.

Reducing your appetite

When your appetite is reduced and you regularly eat less food, you might not get enough nutrients and energy even if the foods you eat are normally healthy foods.

Increasing cravings for unhealthy foods

When you have cravings and eat a lot of unhealthy foods, it can be difficult to get all the nutrients you need, since unhealthy foods contain low amounts of essential nutrients.

Reducing how well you absorb nutrients

Getting enough nutrients requires that you absorb the nutrients from food in your digestive system.  Since some addictive substances can reduce your ability to absorb nutrients, you might not get enough nutrients even if you have a normally healthy diet.

Depleting nutrients in your body

Getting enough nutrients means that the amount of each nutrient you get equals the amount your body uses up.  Some addictive substances can cause your body to use up nutrients in much larger quantities than normal, or they can destroy nutrients in your body.  When either of these happens, you might not get enough nutrients even if you have a normally healthy diet.

Reduce your motivation to eat healthy

Staying motivated to eat healthy requires maintaining the belief that healthy eating will produce positive outcomes for you.  It also requires the confidence that you will succeed at healthy eating long enough to experience those positive outcomes. Addiction can make it more difficult to maintain a positive outlook on the future and can also negatively affect your confidence.

Take your attention and energy away from your goal of healthy eating

Especially when you first start, healthy eating requires that you pay careful attention to choosing the foods you eat.  Shopping for and preparing healthy foods also usually requires more time and energy compared to unhealthy foods. Addictions can be distracting and take your attention away from healthy eating.  They can also get in the way of healthy eating by draining your time and energy.

Nutrient deficiencies and too few calories

As described above, recovering addicts often do not eat healthy and do not get enough nutrients and calories.  If you are a recovering addict, you may have nutrient deficiencies that are harming your mind and body in ways that make getting sober and staying sober much harder.  A caloric deficit (eating too few calories) can also make getting and staying sober much harder.

Healthy Eating Makes Addiction Recovery Easier—Nutrient Deficiencies Make It Harder

There are a number of factors that are essential for addiction recovery and recovery maintenance.  These factors are positively affected by healthy eating and negatively affected by nutrient deficiencies.

Mood and confidence

A positive outlook and confidence in your ability to overcome challenges makes it easier to accomplish difficult tasks.  Healthy eating can help maintain a stable positive mood whereas nutrient deficiencies can make you more vulnerable to anxiety and depression.  For example, research has shown a relationship between folic acid (vitamin B9) deficiency and depressed mood, and also a relationship between thiamine (vitamin B1) deficiency and decreased self-confidence (Ottley, 2000).

Focus and awareness

Focusing on achieving your goals combined with maintaining awareness of yourself and your environment are very useful practices.  Healthy eating can improve your ability to focus and maintain awareness whereas nutrient deficiencies can make you more vulnerable to distractions.  An example is magnesium deficiency, occurring especially frequently in recovering addicts, which has symptoms including confusion and insomnia (Flink, 1985).

Motivation, drive, and energy

Consistent motivation, drive, and energy are necessary for problem solving and overcoming obstacles.  Healthy eating can help maintain high levels of motivation, drive, and energy whereas nutrient deficiencies can cause you to experience more ups and downs that jeopardize your success.  A well-known example is iron deficiency which can cause apathy and abnormal fatigue (Ottley, 2000).

Experience of cravings and ability to resist them

Feeling cravings less intensely and being able to resist them are both critically important.  Healthy eating can make your cravings for addictive substances and behaviors less intense, it can also strengthen your willpower to resist them.  Conversely, nutrient deficiencies can make your cravings more intense and weaken your willpower. One example is a study which showed that alcoholics treated with a traditional therapy combined with nutritional therapy had less alcohol cravings and were more successful at abstaining compared to alcoholics treated with only traditional therapy (Biery et al., 1991).

Too Much of Certain Macro-Nutrients Can Also Make Recovery and Maintenance Harder

Certain macro-nutrients consumed in excess can harm you and make addiction recovery and recovery maintenance more difficult, a few examples follow.  

Carbohydrate: Sugars

Too much sugars (simple carbohydrates) can cause you to have unstable energy levels, intensified cravings, and lower willpower.  Sugar is a reinforcing substance which has demonstrated cross-sensitization with other addictive substances such as amphetamine and alcohol in rodent models (Hoebel et al., 2009).

Fat: ratio of Omega-6 to Omega-3

Researchers believe that a high ratio of omega-6 to omega-3 (two fatty acids) can increase systemic inflammation which contributes to the development of chronic conditions such as arthritis and cardiovascular disease (Patterson et al., 2012) and also depression (Berk et al., 2013).

Protein: (Any)

Some addictive substances cause kidney damage.  If you have kidney damage, there is evidence which suggests that excessive protein consumption can make it worse (Levey et al., 1996).

For Best Results Make Healthy Eating a Part of Your Addiction Recovery Plan

Healthy eating will ensure that the food you eat is helping your addiction recovery and not holding you back.  It will ensure that the food you eat is protecting you from relapse and not increasing your risk.

Healthy eating is challenging for anyone and to succeed you need a clear plan for how you will start eating a healthier diet and for how you will develop habits to keep eating healthy for the rest of your life.  The following list is a good starting point:

However, each individual’s nutritional requirements are different, due to a wide range of factors.  Professional consultation can help you design a personalized plan for your own specific needs and develop a deeper understanding of your unique nutritional requirements.

EHN Canada Facilities Can Help You Eat Healthy, Achieve Recovery, and Maintain It

The comprehensive drug rehab and other treatment programs at EHN Canada facilities include nutrition planning through consultation with our staff dietitians.  Our nutrition planning aims to get you eating healthy with the following objectives for successful long-term addiction recovery:

Please Call Us for More Information

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Online Treatment and Support

If you’d like to learn more about our online treatment and support options, please call us at 1-800-387-6198 or visit onthewagon.ca.

Further Reading About How Specific Nutrients Can Help Addiction Recovery and Recovery Maintenance

Protein Part 1

Protein Part 2

Fat

Carbohydrate

Sugar (video)

Vitamins & Minerals

References

Berk, M., Williams, L. J., Jacka, F. N., O’Neil, A., Pasco, J. A., Moylan, S., … & Maes, M.
(2013). So depression is an inflammatory disease, but where does the inflammation come from?. BMC medicine, 11(1), 200.

Biery, J. R., Williford, J. J., & McMullen, E. A. (1991). Alcohol craving in rehabilitation: assessment of nutrition therapy. Journal of the American Dietetic Association, 91(4), 463-466.

Flink, E. B. (1985). Magnesium deficiency in human subjects—a personal historical perspective. Journal of the American College of Nutrition, 4(1), 17-31.

Hoebel, B. G., Avena, N. M., Bocarsly, M. E., & Rada, P. (2009). Natural addiction: A behavioral and circuit model based on sugar addiction in rats. Journal of Addiction Medicine, 3, 33-41.  

Levey, A. S., Adler, S., Caggiula, A. W., England, B. K., Greene, T., Hunsicker, L. G., … & Teschan, P. E. (1996). Effects of dietary protein restriction on the progression of moderate renal disease in the modification of diet in renal disease study: modification of diet in renal disease study group. Journal of the American Society of Nephrology, 7(12), 2616-2626.

Ottley, C. (2000). Food and mood. Nursing Standard (through 2013), 15(2), 46.

Patterson, E., Wall, R., Fitzgerald, G. F., Ross, R. P., & Stanton, C. (2012). Health implications of high dietary omega-6 polyunsaturated fatty acids. Journal of nutrition and metabolism, 2012.x

Sex Addiction: Too Much of a Good Thing?

Written by Munis Topcuoglu, Editor at EHN Canada.

A valid definition and diagnostic criteria for “sex addiction” have long eluded experts because, historically, definitions and diagnostic criteria have either represented sexually oppressive cultural norms, or they have been vague and imprecise, requiring too much subjective interpretation. Cultural norms, oppressive or otherwise, are not valid bases for diagnostic criteria, because they have no scientific justification. The definition of “too much sex” has varied widely throughout history and currently varies widely throughout the world, and none of the definitions are supported by scientific evidence.

The following excerpt from the book Nymphomania: A History describes a historical example of the problem of diagnosing sex addiction based on cultural norms:

In the Victorian period, both doctors and patients who sought medical help believed that strong sexual desire in a woman was a symptom of disease. Self-control and moderation were central to the health of both men and women, but women’s presumably milder sexual appetite meant that any signs of excess might signal that she was dangerously close to the edge of sexual madness.

Another excerpt from Nymphomania: A History, illustrates the absurdity of Victorian doctors’ culturally biased understanding of the etiology of “nymphomania”:

Eating rich food, consuming too much chocolate, dwelling on impure thoughts, reading novels, or performing ‘secret pollutions’ [i.e. masturbation]… overstimulated women’s delicate nerve fibers and led to nymphomania.

Interesting to note, is that in the Victorian era, the male equivalent of nymphomania “satyriasis” existed in medical textbooks, but was almost never diagnosed in practice—because “a man wanting too much sex” was not really considered a thing. Fortunately, both science and culture have come a long way since then, and we are now able to understand sex addiction in more functional and less sexist terms.

Evidence-Based Definition and Diagnosis of Sex Addiction

If we make the effort, we can minimize cultural bias, and define and diagnose sex addiction based on evidence. The key element for deciding whether or not a person’s sexual behavior is problematic is determining whether or not their sexual behavior results in real negative outcomes. This is the most effective approach for identifying genuinely problematic sexual behaviors and it lays the groundwork for creating effective treatment programs for the people who have them.

Required criterion: negative consequences or endangerment

The necessary criterion for identifying sex addiction is that the person’s sexual behavior actually results in negative consequences or endangerment in one or more of the following ways:

Other signs of sex addiction: loss of control, frequency, consuming focus, and mood regulation

The following features can be signs of sex addiction when they result in negative consequences or endangerment:

The “other signs” by themselves are too subjective for diagnosis

The inability to control, reduce, or stop sexual behavior is only a sign of sex addiction when the person recognizes that the behavior has negative consequences or is unacceptably dangerous. Similarly, excessive frequency and repetition of sexual behaviors, or excessive focus on sex, can only be signs of sex addiction when the individual recognizes the negative consequences or dangers because, otherwise, “excessive” is merely cultural and subjective. It’s also important to note that, for similar reasons, engaging in sexual behaviors that others find offensive or disturbing does not, per se, indicate sex addiction.

What Is the Underlying Disorder?

Experts tend to agree that the problematic and uncontrollable sexual behaviors associated with sex addiction are usually the result of an underlying mental health disorder. They do not agree on which disorder is most often the cause, but the following is a list of possibilities:

Consequently, there does not exist an established standard process for how to treat sex addiction.

Understanding sex addiction as an attachment disorder

At EHN Canada, we find that nearly all of our sex addiction patients have underlying attachment disorders. Our experience has shown us that treating a patient’s attachment disorder is essential for helping the patient to overcome sex addiction, regain control of their sexual behavior, and have healthy and satisfying intimate relationships.

In adults, attachment disorders usually result in problems with intimate relationships that can include any of the following:

Hence, we understand that sex addiction is a relational and intimacy disorder and this understanding informs our approach to designing the most effective treatment programs to help patients overcome sex addiction.

Interactions with concurrent substance use disorders

Sex addiction and concurrent substance use disorders can interact in a number of different ways including the following:

At EHN Canada, we believe that it’s essential to understand how each patient’s sex addiction interacts with any substance use disorders that they may have. We address these interactions in the individualized treatment programs that we design for each patient. This approach allows us to create the most effective treatment programs according to each patient’s unique needs.

EHN Canada’s Sex Addiction Treatment Programs

Patients are admitted to our treatment programs based on screenings that evaluate the negative outcomes of their sexual behaviors and their persistence in engaging in those behaviors. Since we expect that problematic sexual behavior usually stems from an underlying attachment disorder, we analyze each new patient’s history of family relationships and family dynamics to learn about their attachment style. To allow us to further individualize our treatment programs to address each patient’s particular needs, we also screen for the following:

Ultimately, our goal is to develop a deep understanding of what the problematic sexual behaviors mean and signify personally for each patient, rather than try to understand the sexual behaviors in terms of any standard typology. We believe that this understanding allows us to design the most effective treatment program for each patient and reduces the influence of cultural bias.

Helping patients regain control of their sexual behaviors

EHN Canada treatment programs are designed to help patients regain control of their sexual behaviors. This begins with helping patients recognize and fully acknowledge the consequences of their problematic sexual behaviors. Next, we teach them how to identify and predict situations in which their sexual behaviors might have negative outcomes. We also teach patients how to identify triggers for their problematic sexual behaviors and how to address them in healthy ways. Throughout the process, we help patients with concurrent substance use disorders understand how their substance use disorders interact with their problematic sexual behaviors.

Whenever applicable, group education and therapy activities are conducted in small, intimate groups where patients can learn from each other in an environment free of shame and judgment. The following are some of the activities that help patients regain control of their sexual behaviors:

Teaching patients how to build healthy and satisfying relationships

Since we view sex addiction as a relational and intimacy disorder, our treatment programs include substantial education and therapy components focusing on interpersonal work such as effective communication, relationship building, and developing healthy attachments. Due to their interpersonal and experiential emphasis, our sex addiction programs involve more in-the-moment behavioral interventions compared to our other addiction and trauma programs.

Again, whenever applicable, group education and therapy activities are conducted in small, intimate groups where patients can learn from each other in an environment free of shame and judgment. The following are some of the activities that teach patients how to have healthier and more satisfying relationships:

Other elements of treatment programs

The following elements are included in some of our treatment programs or may be optional for patients:

Full recovery takes much longer than other addictions

A full recovery from sex addiction can take three-to-five years after completion of a treatment program. Therefore, long-term success depends on a patient’s commitment to participating in aftercare programs and to continue working on themselves after they complete one of our residential treatment programs.

EHN Canada Sex Addiction Treatment Programs

If you or someone you love needs help with sex addiction, please call us at one of our numbers below for more information or to enrol in one of our programs.

References

Groneman, C. (2000). Nymphomania: A History. New York, NY: Norton.

Krueger, R. B. (2016). Diagnosis of hypersexual or compulsive sexual behavior can be made using ICD‐10 and DSM‐5 despite rejection of this diagnosis by the American Psychiatric Association. Addiction, 111(12), 2110-2111.

Ley, D.J. (2012). The Myth of Sex Addiction. London, England: Rowman & Littlefield.

https://en.wikipedia.org/wiki/Attachment_in_adults

When the Most Destructive Force in Your Life Is You, Then It’s Time to Reach out for Help

Opinion by Guest Writer
Written by Lorelie Rozzano, an internationally recognized author and advocate.

If you struggle with addiction as I have, you know the dark, hopeless place that exists on the other side of being high. It’s the thing that every addict tries to avoid—reality. Reality is the time and place when you’re not high or intoxicated and forced to face the consequences of your actions. For me, reality was the morning after. I’d lie in bed and remember all the horrible, embarrassing things I’d done the night before. I would replay each moment wishing I could turn back the hands of time and undo my humiliating deeds. To cope with my painful emotions, I sought relief through substance abuse and then the process would start all over again. I was baffled by my inability to use drugs and alcohol socially. I tried changing how much I used, what I used, and the places I used, but it didn’t help. Each time I consumed a substance, the consequences seemed to get worse. In spite of my good intentions, I continued hurting my family and my life was a mess.

At the time, I didn’t believe I was addicted. I didn’t know I was sick or that my thinking had changed. Addiction is sneaky. It starts with subtle shifts in your perception and behavior. The following are five ways it can play tricks on you.

(1) You’re in Denial

Denial is a primary roadblock to getting help. Denial makes things appear smaller than they are. Denial tells you your problems aren’t that bad. Denial says I’m not hurting anyone. Denial says I can quit whenever I want to. Denial protects you from facing the facts. Denial is dangerous as it minimizes warning signs and perpetuates the problem. No amount of pretending can make addiction go away.

(2) You Make Promises You Can’t Keep

You promise to show up on grandma’s birthday. Yes, you’ll pick up the kids after school. Of course, you’re coming home straight after work. But in spite of your good intentions, you’re unable to follow through. You can’t predict what might happen anymore. You’ve lost credibility. The more you try and control your addiction, the more it controls you. Every time you use the substance, you break hearts and hurt the people you love.

(3) You Manipulate Your Friends and Family

You lie to cover up what you’re doing. You tell people what they want to hear to get them off your back. You may pit parent against parent, or friend against friend. You know who to call when you need money. You’re good at fabricating excuses and making it seem like the problems in your life are never your fault. You blame others when cornered and manipulate your loved ones through guilt and fear tactics.

(4) You don’t tell anyone, but you’re scared, and you cope with your fear by using more

While using the substance was fun in the beginning, now it’s become work. Maintaining your addiction is a full-time job. When you’re not high, you feel fearful and anxious. The euphoric release you once found in the substance has disappeared. You’ve developed tolerance and need increasingly larger doses to produce the same physiological and psychological effects. You’re not using to feel high anymore; you’re using to feel okay and avoid withdrawal symptoms.

(5) You feel ashamed

You know your life is out of control, but you don’t know how to make it stop. You hurt everyone who loves you. Your best thinking is killing you. You can’t look in the mirror. You feel ashamed and avoid people. Shame is an uncomfortable, toxic emotion. Shame tells you you’re unworthy, unlovable, and inadequate. Shame says give up. Shame creates feelings of hopelessness and despair.

Take responsibility

While you’re not responsible for your addiction, you are responsible for your recovery.

Nobody wakes up and says “I’m going to be an addict.” But there is one choice addicted people make, and that’s how long they will stay sick. While addiction isn’t a choice, recovery is.

When the most destructive force in your life is you, then it’s time to reach out for help.

Good intentions followed by broken promises don’t mean you’re a terrible person. Substance use disorder is a progressive disease that if left unchecked can be terminal. But there is hope. Addiction is treatable. Recovery happens when you stop making excuses and start taking action. The key to wellness is breaking your silence and admitting you need help. There’s no shame in wanting to get better and the only way you can fail at recovery is to quit trying.

We Can Help You

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Recovering from Sex Addiction: Getting out of the Storm and Back to My Life

Opinion by EHN Alumni
Written by Adam W, a recent graduate of the sex addiction program at Edgewood Treatment Centre.

Before I arrived at Edgewood to start working on my recovery from sex addiction, my life was like being in the eye of a tornado. That might be a tough analogy for someone to understand, but I was in the middle of a storm, with no way out. Everything around me was getting caught in the storm and I was simply waiting for it to take me away with it. I couldn’t find my own way out, and I certainly was trying to harm myself enough so that perhaps I wouldn’t wake up. I remember the feeling of despair and this heavy sadness.  When it was suggested I “go away” for a while, to take a break and heal—despite the tremendous arguments I had to not go—I simply gave up and said “okay.” 

I had lost my wife, been kicked out of my house, and had been removed from being a part of my kids’ lives. My family of origin stopped being involved with me, my business was crumbling, and my closest of friends had given up on trying to help. As typical of a pre-treatment story that is—it was and is my story. 

I quickly packed my personal belongings in Calgary and travelled to Edgewood, soon realizing that I was no longer alone in this storm. The men’s sex addiction group in my treatment program was a critical part of my recovery and healing. I could speak with men who could relate to the pain and shame associated with engaging in problematic sexual behaviours for many years. Although the group structure throughout the week was tremendous for unpacking a lot of stuff, the ability to really do the work in the confidence of men who were walking a similar path made me feel safe to express, accept, and move on from that part of my life. In previous treatments and therapy, I had never been able to explore my problematic sexual behaviours and the associated guilt, shame, and sadness that I held inside. If I had not addressed that pain, I would not have been able to grow and find my footing in recovery. 

Some of the highlights of the program at Edgewood include the sacredness of the room, the compassion from the other men, and the guidance from the sex addiction therapists. The ability to share my story, the unheard version of my life that I was unable to previously share in co-ed settings, with other men who were willing to do the same, was transformational in my healing and essential for my recovery.

I learned that the work, meetings, groups, walking with men in recovery, and service to others are all lifelong habits and commitments that I need to make daily to continue to enjoy the blessings of recovery and good mental and spiritual health. It’s not a destination but a journey of awakenings, blessings, and sharing and giving that allows me to enjoy my life today.

The opportunity to give back in some small way to this program, and to the men with whom I walked, is something I cherish and for which I am thankful.

With gratitude for being in recovery from sex addiction,

Adam W.

We Can Help You!

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

More Information About Our Sex Addiction Programs

You can also find more information about our sex addiction programs on our website:

Four Things You Need to Know About Fentanyl to Stay Safe

Fentanyl has been a problem in Canada for several years now and the situation is not getting any better. It feels like every day brings a new report about an overdose, an arrest, or a large shipment seized on its way to a Canadian city. Fentanyl is a synthetic opioid typically used to treat severe and chronic pain; for example, it is often prescribed for cancer patients. Understandably, digesting all the information from numerous news stories and constant buzz can be difficult, so here we are providing some quick facts about fentanyl in Canada.

(1) It’s Fast and Deadly

Fentanyl is 50 to 100 times more toxic than morphine and 100 times stronger than heroin. It’s so potent that you can overdose on as little as two milligrams. When ingested, it can reach your brain within minutes and cause respiratory failure. Many of the reported deaths have happened this way: someone takes half a pill, falls asleep and never wakes up.

(2) It’s Highly Addictive

Just like any other opioid, fentanyl is extremely addictive. Many users report craving it after just one use. Also like other opioids, regular users build a tolerance: they need to use more and more to get the same high, which is very dangerous with such a toxic drug.

(3) It’s Often Cut into Other Drugs

Fentanyl has been found in many other drugs like heroin, cocaine, and oxycodone. Often, people who think they’re buying oxycodone will really be getting Fentanyl. It has no odour or taste, and it’s invisible, so using a testing kit is the only way you can tell if it’s in your drugs.

(4) A Lot of People Are Dying

Given that you can overdose on an amount the size of two grains of salt, it’s not surprising that people are dying. This is especially true because many people are consuming fentanyl unknowingly through other drugs that are laced with it. People who do consume it intentionally, usually consume non-pharmaceutical street fentanyl produced by an amateur chemist. This implies that impurities and toxicity can be even higher than pharmaceutical fentanyl. Also, dealers often combine it with caffeine, meth, or heroin which increase the probability of a negative reaction or overdose. Vancouver has the highest rate of deaths from overdose in Canada, most of which are likely from fentanyl and other similar opioids like carfentanil. So far, this year (as of the end of September, 2018) there have been over 260 deaths from suspected overdose in Vancouver.

Safety Resources

TestKitPlus Fentanyl Testing Kit
Bunk Police Fentanyl Testing Kit
DanceSafe Fentanyl Testing Kit
How to get a naloxone kit if you live in BC

We Can Help You

If you would like to learn more about the treatment programs provided by EHN Canada, enrol yourself in one of our programs, or refer someone else, please call us at one of the numbers below. Our phone lines are open 24/7—so you can call us anytime.

Johanne’s final story

Johannes never expected to be in jail. He wasn’t counting on smoking pieces of fentanyl patches either. And he hadn’t envisioned dealing with ethnic cleansing in Bosnia or being on patrols in Afghanistan.

In fact, growing up in a small Nova Scotia town, all he wanted was to be outside. Fishing. Swimming. Hanging with his buddies.

Addiction had another plan.

Fit, rested and relaxed as he sits on his mountain bike looking out at the gloriousness that is Queneesh, a massive glacier on Mount Washington towering over the Comox Valley on Vancouver Island, Johannes’ face breaks into a smile.

“I’m very happy,” he says. “I wake up every morning and, when I open my eyes, I’m automatically happy. So, there ya go.”

He’s come so far.

Born in 1977, raised in Nova Scotia and New Brunswick, Johannes is a minister’s son. His mother stayed at home raising Johannes, his brother and two sisters. He had no trouble with faith. Higher Power was all around them.

“I was raised in the church. We lived in the back of a church, actually, in the church parsonage,” he says. “We went to church twice on Sunday, Tuesday night and sometimes Friday night.”

“I was close to all my siblings. I had maybe two or three really close friends.”

There was no drinking or smoking in the family home. No wild parties. No television, even.

“I was kind of a quiet kid — an introvert, if you will. I was always out in nature. Always out with my friends in the woods, building camps, swimming in the creeks, fishing, boating.”

By high school, when friends began experimenting with cigarettes and alcohol, Johannes began to see the differences between himself and his strict, God-based upbringing and the lifestyle his adolescent classmates were beginning to explore. Though he remembers sneaking a taste of fermented grape juice at 14 behind his dad’s pulpit and “feeling a little bit funny”, Johannes would buckle down and stay focused on his career path — one in uniform.

“In high school, I was wanting to be an RCMP. So, I took the co-op program for RCMP, doing ride-alongs, even getting into a couple of high-speed chases,” he says. “When I was in Grade 12, they hired me as a jail guard to watch the drunks when they would come in on weekends, or whenever they would call me on my pager. I wasn’t getting into any trouble at all.”

He also made another move — into the Canadian Armed Forces as a reservist at 16.

As he finished high school, Johannes was in love with his high-school sweetheart and working for the Canadian Forces and the RCMP. His life was going swimmingly. He proposed to his fiancé, they married and began planning for a family. He applied and was accepted into the military Regular Forces and was posted to the Third Battalion, Royal Canadian Regiment – one of the nation’s most decorated and respected army units, based in Petawawa, Ontario. The outfit had served at Vimy Ridge, in Sicily, in Korea. Johannes had joined an honorable, historic family and life was good.

“We were both living a spiritual life. I still had God in my life at that point. We’d go to church at least once a week, sometimes twice a week.”

His wife was soon pregnant; a boy was on the way.

But the storied “3 RCR” was about to get involved in the simmering conflict in Bosnia, and life would change forever.

In the early 1990s, the break up of Yugoslavia had percolated into a cauldron of inter-ethnic conflicts. Yugoslavia, which had been set up as a federation of six republics after the Second World War, had split apart following the death of its president in the 1980s. By the time Johannes and his new bride arrived in Petawawa, Serbs and Croats were just three years removed from the Bosnian War, a horribly complex and vicious conflict which basically ended in a stalemate. But, along with over a million refugees, over 100,000 were left dead, many as a result of the first case of genocide in Europe since World War II.

The capital city of Sarajevo, which had hosted the Olympic Games in 1984, had spent four years under attack before the siege was lifted in 1996. Civilians were targeted and massacred in many parts of the Bosnia and Herzegovina. NATO, of which Canada is a key and active member, was involved during and after the conflict, attempting to establish long-term peace. In fact, over 60,000 soldiers from over 30 countries were eventually deployed under Operation Joint Endeavor as peacekeepers. Twenty-three Canadian soldiers died in that war.

Once the war had ended, stabilization peacekeeping forces continued to get between tense and hostile pockets of resistance to the ceasefire. This was the environment to which Johannes and his brothers in 3 RCR were deployed in Bosnia in July 1998 as Rotation 3 of Operation Palladium.

While his wife was at home, selling Mary Kay and looking after their baby boy, Johannes was thrust into a world in which he had no experience.

“I guess you could say I was pretty innocent, ignorant of the world. I was raised in such a closed environment,” he says quietly.

Johannes was dispatched with medics, going on calls with military and civilian first responders, transported in armored personnel carriers converted into ambulances.

“We’d go pick them up and bring them back to camp.”

As well, there were regular patrols, going from town to town.

“I felt a lot of threat. I was scared for my life many times. It was a whole new side of the world I had never experienced before.”

Not one to speak about the horrors of what he saw and experienced, suffice to say coping was a challenge in the tinderbox of post-War Bosnia.  Three months into his six-month deployment, he was given two weeks’ leave and went to Croatia for some R&R. It quickly deteriorated into something else.

“That’s where I really got into the drinking. In Porec and Bled. I barely remember them. Blackouts. Trying to cope,” he recalls. “My spirituality was non-existent at that point. I didn’t have God in my life. Praying was non-existent. So, I started drinking to fill that hole.”

Peacekeepers have an interesting perspective on what they are called to do. With the war ended, there were progressively fewer incidents of breach of the terms of the ceasefire. Johannes downplays the anxiety with which he and his colleagues were living.

“Danger? Well, that’s the way I felt at that time. It wasn’t a constant threat. 1998 was a little bit different from past tours … but I still felt threatened.”

The consuming of alcohol soon wasn’t restricted to R&R leaves, either.

“Oh, a couple of times a week I’d get drunk. Some Bosnian moonshine stuff they would give us. I forget what they called it, but it was pretty powerful stuff,” he remembers.

And the innocence of a maritime boy, a preacher’s son, was quickly fading.

“It was a combination of being scared and it’s a whole new world. I was excited for this whole different experience. Trying new things. I never really got to party growing up. So, I was liking this drinking thing.”

“It felt so normal. Everyone that I knew was doing it. Everyone was smoking cigarettes, smoking cigars. That’s where I started smoking cigars too. I remember buying some Colts, so now I was smoking cigars too.”

He returned to his new baby, his high school sweetheart bride, and attempted to reclaim his pre-deployment life.

“I would call it a slow climb because, after Bosnia, I came back to Petawawa and didn’t really carry that drinking lifestyle on anymore. I slowed down, maybe had a drink once a month or so. It hadn’t got its claws into my life yet.”

Everything changed two years later when, on a night airborne jump exercise, his parachute malfunctioned. Johannes injured his back and broke both legs.

“I came home from that in two casts and a wheelchair.”

Confined to the chair, on low-dose medications for pain, he would still go to work every day – a military van would pick him up and take him in. But, between his ears, his mind was in a battle.

“The whole accident itself played in my head a lot. I had nightmares steady about it. It really affected my sleep. So, I started drinking a lot.”

The accident, the drinking, the nightmares all took their toll on the marriage. His legs would recover. The marriage would not.

“One day I came home and she was, basically, cheating with the landlord. So, I packed up my truck with some clothes, my uniforms, and that’s about it. I moved into the shacks [barracks].”

His addiction lifestyle blared. The slow climb was over.

“Drinking takes on a life on its own. It gets out of hand. I’d buy 40 pounders, rum or vodka. I’d try to down it. I remember playing music really loud, crying in my room, isolating and drinking.”

He didn’t isolate entirely. He took the show on the road.

“My first night living in the shacks, I went to the bar. I drove back and got my first DUI. A week later, I got caught driving my truck around base again. I got into a cop chase. I had no insurance and was driving while under suspension. So, due to that, I got a little bit of jail time.”

He also discovered ecstasy and cocaine.

“The first night I did them, I loved them. I found my drugs.”

As the needle climbed on the addiction speedometer to oblivion, Johannes passed all the criteria, from abstinence to drinking moonshine to impaired driving to jail time.

“I met all the right people. All the drug dealers in town, [gang] affiliates. A month after first doing dope, I started selling dope. I’d be the guy that everyone would come to.”

He was banned from seeing his first son, but even that wouldn’t wake him up. Johannes’ addiction, fueling the choices he was making, began to rule his life and career.

“Even during training, I was still doing lots of drugs and partying. It was very much a big part of my life. I would be a functioning addict.”

In September of 2001, two planes hit the Twin Towers in New York City. Two years later, as a serving member of the 3rd Battalion, The Royal Canadian Regiment, Johannes was part of Roto 0, Canada’s initial deployment to Kabul, Afghanistan.

As part of the International Security Assistance Force (ISAF), the main purpose was to train the Afghan National Security Force and help them rebuild, while securing Kabul and surrounding areas from Taliban and al Qaeda insurgents. From the summer of 2003 to the winter of 2004, Johannes served in a theatre teeming with tension, fire fights, and constant threat of roadside bombs.

“It was a lot hotter,” quipped Johannes, deflecting from the seriousness of his journey into Afghanistan. “It’s really different from Bosnia. I was a lot more scared in Afghanistan that I was in Bosnia, I can tell you that. In Afghanistan, I was in a section, so we were doing patrols non-stop. Night patrols. Day patrols. Going on missions. Walking on foot. In vehicles. Roadside bombs happened. I felt vulnerable.”

Things got real, and really fast.

By October 2003, Canada had 1,800 soldiers deployed in Kabul. That month, Johannes was in camp when word got back that a friend and fellow New Brunswicker, Sgt. Rob Short, was killed in a bombing that also claimed the life of Ottawa’s Cpl. Robbie Beerenfenger. Three others were injured. By the end of Canada’s engagement in Afghanistan, 158 men and women had been killed. It’s not something Johannes, nor any military member or family, for that matter, can shake easily.

The loss of Sgt. Short was particularly difficult. Though his superior in rank, the two were buddies. They had even run an Iron Man together four years prior.

“Yeah, we had trained all that summer together. I remember at the 43-kilometre point, I passed him, and, at the end, I got 19th and he got 20th,” Johannes says quietly. “I still remember the look on his face when I passed him.”

In the war zone of Afghanistan, it was the drugs and alcohol that kept the ghosts at bay for the 25-year-old minister’s son.

“I was numbing myself out. Still carrying on. Doing drugs when I was there [in Afghanistan]. Cocaine and ecstasy was brought over. I wasn’t into the opiates at that point, thank god. They were everywhere. Poppies. Opium.”

As he counted down the days before his Afghanistan deployment ended, Johannes broke his ankle in a charity function. His war was over.

“I got operated on over there by a German doctor and got sent home about two weeks prior to my six months [service]. I made it back safe. It was meant to be, I guess.”

For the next 12 years, his addiction rampaged, however. The alibi of wartime trauma makes sense. The actions did not.

“Back home, I got harder into the drugs. I didn’t know what was wrong with me. I was a different person when I came back. Numerous people say that. I remember feeling different, too. I had a lot of adrenaline in my body and I just couldn’t stop moving. I felt different. I needed more drugs to fuel the adrenaline. It was the only thing that made me feel safe.”

He was living a double life. Working for the military. Working for drug dealers. Collecting debts. Kicking down doors, beating people up. Splitting proceeds with the dealers. The military police, the OPP, judges, became unwelcome-yet-predictable players in his dangerous lifestyle choices.

Johannes spent most of 2004 behind bars in Ottawa. Assault. Kidnapping. Drug charges.

“It’s another level of fear. A lot of shanks. [There are] a lot of Somalians in there and they’re all packing shanks. Almost every day, I’d see bloodshed. People stabbed with shanks or pencils. Definitely knocked out. Every day, there’s violence. I was included in that sometimes.”

The next year, the military had had enough. Johannes was released, but not before being sent to treatment at Bellwood.

“I was pretty defiant. Very angry. Violent. I got kicked out of Bellwood after 25 days or so for violent behavior. I met a girl in rehab who gave me her condo keys. So, I went AWOL to her condo for a few weeks down by the CN Tower.”

After a few weeks, Johannes decided he’d better go back to Petawawa. He showed up to work and was arrested immediately.

“I did a couple of days in their cells on suicide watch. Somebody watching me all day, all night. I was that dark.”

He was released from the military and discovered needles.

I hadn’t done [needles] before because I don’t think I’d felt that desperate or dark. But, by that point, I was so helpless, I didn’t care about nothing, myself, or anything. I didn’t care if I died or lived.”

He was shooting cocaine, drinking every day. Smoking crack. Crystal meth. Couch surfing.

“Sometimes I was sleeping in hallways. Running from the cops. Doing crime. Busting into houses. Getting in fights. It was just chaos,” he recalls.

The army sent him $13,000 as compensation for his contributions.

“I blew all that on drugs in a month or so. So, [that was] all gone.”

A few more month-long visits to the crowbar hotel later, Johannes was a shell of himself, 40 pounds under his Afghanistan fighting weight. Yet, he soon found another relationship and got off the needles.

“She got me off the needle, so I was just snorting cocaine. I was just doing lines now,” he chuckles, emphasizing the “just” word. “Yep, I was getting better. I was just drinking a lot and doing lines. Everyday. I couldn’t go a day without drinking or doing drugs or something.”

On a doctor’s visit, he was introduced to morphine. Then OxyContin and Percocet. His OxyContin habit alone began at 80 mg a day. By the time he finished, he was at 800 mg per day. Add the Percocet and alcohol on top of that.

In 2013, he was back in prison for a car accident while impaired, without insurance and in possession of drugs. He reached out to Veterans Affairs and asked for help. He had every intention of getting sober for good. He was again sent to Bellwood and completed its two-month, cutting-edge PTSD/OSI program. Johannes got off the drugs — to some degree.

“It didn’t click in that alcohol was a problem, just drugs,” says Johannes. “So, I stopped the drugs. I was off the drugs for a good eight, nine months. But, as soon as I got out of Bellwood, I was drinking the same day. I thought I was sober. I was telling everyone I was sober.”

Anyone who believes they are sober when they are drinking alcohol is destined to revisit their addiction, it seems. At least, that is the way it was for Johannes. Within a year, he was back into drugs, all of it, except for the needles.

“Of course, my doctor at that point cut me off my meds [from] the car accident. So, I had to get all my opiates from the street. I got into heroin. Heroin is cheaper. I was doing lines of heroin and fentanyl patches. Smoking fentanyl patches. What a big mess.”

“I’d reached a point in my life where I was now stealing from big-box stores. Going into Walmart with a shopping cart and coming out with two big 60-inch TVs, going to get a fast $500 bucks from dealers [who] buy them. At that point, my habit per day was a good $400-$500 I needed just for myself.”

Another prison sentence. Another year in jail. Johannes received visits from ministers, and he began trying to get his head around changing his life. A fellow veteran-turned monk visited him weekly and got him into meditation. Again, he intended to stay sober and reclaim his life. His pension contributions were banked while he served his prison time. He got out to $30,000 – a powerful reason to lose, or not lose, control.

“The very first day I got out of jail, one of my drug connections met me at the parking lot and drove me to town. Everyone was doing drugs. I said, ‘Okay, just give me a little piece of the fentanyl.’ I smoked a little piece of the fentanyl, and 25 days and an overdose later, I’d spent $30,000. I got arrested on my birthday. There I was, back in jail. Really, really coming down off the fentanyl like you wouldn’t believe. For about two weeks, I couldn’t sleep. All that good stuff that goes with it.”

He spent his final month in jail, in hell. He had no reason to live.

“That was my ultimate bottom. I was in there for a month. I was trying to hang myself in the washroom with bedsheets. I just wanted to die. I just didn’t want to be in my own skin.”

He reached out to Veterans Affairs one more time, and to Vets Canada. He was given another reprieve, put up in a hotel and fed while a bed was readied for him, one more time, at Bellwood. His third and final kick at the can. He knew it.

He completed six weeks at Bellwood and was offered an opportunity to come to Edgewood for Extended Care. Understandably, his Ontario clinicians thought leaving the province would be a wise move. He had also just finished an anger management course at Bellwood and was practicing meditation daily. Johannes agreed, and, in May 2016, he arrived in a province he’d never been to, in a town with literally hundreds of alumni, sober, connected, and supportive. He has never looked back.

First off, his counselor was a fellow veteran. Ryan Tompkins served 23 years, retiring as a Chief Petty Officer First Class.

“I felt like [I was at] home right away. A fellow vet in authority. I felt comfortable,” Johannes says.

And, the Extended Care program was exactly what was needed, he says.

“It gave me the structure which I so craved. It helped me plan my life. I learned how to live. I didn’t know how to do that before. I didn’t know how to wake up at a certain time and to actually get things done. To live. To actually plan my day. And to socialize and not isolate.”

He was recommended to take up yoga, which he did with vigor. He learned more about what makes him tick, all the while attending Alcoholics Anonymous and Narcotics Anonymous meetings five times a week in and around Nanaimo.

“I had a lot of anger. I had used anger all these years to hide every other emotion. Now I know why. To hide my fear and what have you.”

He got himself a sponsor. Lived in a sober house. And, finally, after 10 months, two treatment centre programs in two provinces later, Johannes moved out to a small town within an hour or so of his most recent alma mater rehabilitation centre. Later this month, he expects to attend Edgewood’s monthly Cake Night celebration and claim his two-year medallion.

“I love Edgewood,” he says with an unmistakable sincerity. “I feel like they always accept me. I’m always welcome there. They’re just so nice all the time to me. They always give me compliments when I go in. They always say how good I’m looking. They always try to bring me up.”

These days, Johannes is keeping a low profile, but not so low he isn’t connected. To his friends. His support system. To Edgewood. To family.

He receives a modest pension for his military service, and the PTSD that came with it.

“They don’t foresee me working at all,” he says. “My PTSD level is quite high. They’re going to leave me alone right now, let me do my thing. Just stay sober.”

Living in a small town with one stoplight is right up the alley for this minister’s son.

“I love it. I’m a country boy, so this is right up my alley. I don’t have a driver’s license as of yet, so there’s a city bus that goes right by my house to town,” he says.

“I got a mountain bike, so I’m always on my bike. I got lots of sober friends that will drive me around. I get around just fine.”

There are good days and bad days, he says, though, “the bad days are very few and far between now.”

“A bad day? Well, it might just look like I sleep in. Feel angry. I want to isolate. I might go into mental relapse. It’s moreso [that] the anger comes back. I’ve got to keep my anger in check because that’s old behavior.”

But he doesn’t want to dwell on the negative days when there is so much peace in life now. He practices yoga and meditation daily and is always looking forward to the next local meditation workshops.

“I’m always out in nature. On my paddleboard or on my kayak, mountain biking. I got a ski pass, so I spent almost 40 days up on the mountain this season. I go to yoga all the time. I’m now dating my yoga teacher. She lives down the road,” he says with grin.

He makes coffee for his 12 Step groups, puts away chairs, and is volunteering for their annual rally. Like Bellwood, Edgewood recently launched its own Concurrent Trauma and Addiction program for first responders and military men and women. This pleases Johannes, and he is obviously highly recommending it for those who have worn uniforms, and who have seen and endured more than can be expected without residual effects.

“If I’m coming in with trauma and I’m a soldier, that C-TAP program is very important. It’s important to have people around me who can relate to me. Who are on my level. Especially being a soldier with trauma. We relate to each other much more than civilians. I feel comfortable talking to you because you are a veteran yourself. That’s the way it is.”

And, if at first you don’t succeed, remember to keep at it, he says.

“Well, for me, three tries is quite a magical number. So, I say to anyone there is hope past the anger. There is hope past the isolation. I was isolating too much. There is comfortability after isolating. It comes easier after time. Have patience. It’s all about the patience. Little bits. Little bits at a time.”

In the end, Johannes has come full cirlcle. A quiet life. A handful of good friends. The outdoors. Love. And a returning, deepening faith with a power greater than himself. He’s never been more at peace.

“You don’t need to fight addiction all alone. You just need to ask for help and get curious about a higher power.”

 

By Jeff Vircoe

LIFE ON THE FRONT LINES: DR. GARY RICHARDSON IS ONE OF THE COUNTRY’S MOST ADDICTION SAVVY PHYSICIANS

­­­­­By Jeff Vircoe

 

Gary Richardson was a young physician in a new country when the warning came. It arrived loud and clear.

An elderly patient in his private practice heard he was leaving to go to work at an addiction treatment centre, and she wanted to offer some advice about his soon-to-be clientele.

“Just remember they’re all liars on wheels.”

And with that one pronouncement, the young doctor was introduced to the most common perception about the tens of millions in North America who suffer from substance use disorders. The judgement, the stigma, that says users are, at their core, dishonest and basically unworthy of the love and compassion with which members of society with other illnesses are treated. Essentially, throwaways.

Thankfully, Richardson kept an open mind to that advice. Today, 15 years later, having treated over 14,000 addicts, his mind remains open, his reservoir of compassion as full as ever. Addicts crying for help continue to arrive. He and his team continue to provide it.

Gary Richardson is the Director of Medical Services at Edgewood Addiction Treatment Centre in Nanaimo, B.C. on Vancouver Island. Established in 1994, Edgewood mental healh and addiction treatment centre treats alcoholics and other addicts, many of whom struggle with multiple mental and physical health complications, with its multi-disciplinary team of physicians, psychiatrists, nurses, Masters-level clinicians and others. It’s a daunting challenge, one the staff take seriously. In fact, staffing at this 85-bed inpatient facility is nearly 150-strong. Nobody slips through the cracks here.

Dr. Richardson’s decade and a half as a full-time physician at one of the country’s busiest and longest-serving addiction treatment centres has enabled him to form uniquely qualified opinions based on science, spirit, experience and plenty of evidence.

Richardson was born and raised in Port Elizabeth, a city of 1.3 million on the most southern portion of the African continent. Though 51, his youthful face hides his age well. He’s fit. He smiles easily and often. Always polite, he makes a point to use first names when addressing those around him.

During his fifth year studying medicine, he married Karen, a friend with whom he had grown up his whole life. The couple’s parents were friends, so Gary likes to say they knew each other from their stroller days.

After completing his internship in 1990, he spent much of the next year and a half working in hospitals in South Africa. The couple purchased a home before deciding to travel and work abroad for a year. Karen, a school teacher, had once been a high school exchange student with the Rotary Club and had spent a year in Canada. She was a big fan of the country. Before settling down to raise children, they felt the time was right to travel. In 1992, they arrived in Lampman, 50 km northeast of Estevan in southern Saskatchewan, where Dr. Richardson commenced work as a family doctor.

It was a bold endeavor in a new country with a new climate. Though he had seen smatterings of snow at higher elevations in his home country, it wasn’t Canadian Prairies snow. The new physician learned the hard way about the severity of Canadian winters.

One blustery, snowy, mid-winter night, while heading for dinner at another physician’s house, his car broke down on a side road. Wearing just a light jacket in a -50 windchill storm, he endeavored to free the vehicle from the snow. “I got the front bumper rocking, my wife’s trying to go back and forth,” he says with a smile. After some time, they managed to get the car free and made their way to their dinner engagement. Their dinner host was alarmed.

“As he opened the door, he just looked at my ears and he went, ‘Oh dear, you’re in trouble.’ He could see that the top part of them had frozen,” recalls Richardson. “I slept the next few weeks with a headband on. I was concerned that my ears were going to end up being deformed. I had sensitive ears for years to heat and cold. That was a good learning experience.”

While the Richardsons were adapting to their new climate and country, their homeland was also in a process of change. Apartheid, a system of racial segregation to which South Africa had adhered since 1948, was heading for an explosive ending. As Nelson Mandela was freed from prison in 1990, he began to work with President F.W. de Klerk’s government on a new constitution. The two would share the Nobel Peace Prize in 1993, enfranchising the non-white majority and ending the apartheid system two years after the Richardsons arrived in Canada. But, by then, the couple had already begun to see Canada as home.

“It took leaving the country to be able to look at things more objectively,” says Richardson. “To realize that there was a lot of stuff there that we thought was normal, but it wasn’t.”

After working in Saskatoon and developing a host of what have become lifelong friends, “we just sort of decided to extend our stay,” he says. “After a couple of years, we realized that this is where we wanted to live. We were very grateful to be here. We wanted to start a family here.”

Three children and 15 years later, they remain. A motorhome trip to Vancouver Island with their newborn son and visiting parents in 1995 left a huge impression on the Richardsons.

“When we saw the Island, my wife and I looked at each other and said, ‘Wow! If there’s ever an opportunity to live out here…’ It was incredible!”

Opportunity knocked when they had a chance to purchase a general family practice. They made their way to Nanaimo in 1998, leaving behind deep connections in Lampman, Regina and Saskatoon.

“Karen and I always say that our time in Saskatchewan Canadianized us. On so many fronts, we are very grateful for our time there.”

Dr. Gary Richardson at work with a member of Edgewood Treatment Centre‘s team of nurses.

The Richardson family in Canada grew. And, over the course of the next 12 years, all the couple’s blood-family members, including parents and in-laws, would leave South Africa and join them on Vancouver Island.

In Nanaimo, Dr. Richardson joined a frantic pace of handling medical issues for an exceptionally busy clinic. It was go-go-go, and the young doctor, now with two young children and another on the way, was soon overwhelmed. For nearly four years he kept the pace, paying the bills, going flat out. Like most doctors, his heart was in the right place, wanting to help people. But there was only so much of him to go around.

“I reached a point where I was probably pretty close to burn out. I was trying to be the best husband I could be, the best dad I could be, the best physician I could be. I was spread pretty thin. I had a good few-thousand [patients],” he recalls.

“Retrospectively, I didn’t know how to say no. People would come to me with significant medical histories. I remember having someone coming to me with severe eating disorder, and here was a specialist coming to me and asking if I’d take them on as a family doc … I didn’t know how to say no. I just wanted to help people, but didn’t have really good boundaries.”

Richardson is a man of deep faith, and he believes things happen for good reasons. One Sunday, a visitor to the church the Richardsons attended told him about a job coming up at a local addiction treatment centre. That facility was Edgewood. The founder and owner was Jane Ferguson, a woman who just happened to be one of his patients.

“It was one of those conversations where time stopped for a moment,” Richardson recalls.

“Jane was actually one of my patients. I’d looked after her for almost two years before my coming to Edgewood. I knew all about Jane. She was Edgewood. So, I had heard all about this incredible place and the work that she did. I think she respected my current position as a family doctor at that time. She could tell that I loved it.”

The interview process was successful and Richardson was offered the position. He began work in 2002.

With a background in private practice and emergency rooms, Edgewood presented an unfamiliar environment for the new doctor. With 85 residential inpatients and another 40 onsite in extended care at any given time, the pace of work was manageable – especially when compared to the more than 3,000 patients he had been looking after in his private practice.

But, working at a busy treatment centre presented a daunting and steep learning curve. After all, addiction was a new realm in which Richardson, like most doctors, had had little training. There was so much to learn. Withdrawal management can be a life-threatening proposition. Certain substances bring higher medical risks. There are many cognition issues. Plenty of patients have experienced serious trauma.

And then there’s the shame of it all. Sometimes an addict fresh out of the fire is less than honest – or downright defiant – about the extent of the issues he or she faces. The ‘liars on wheels’ warning proved appropriate in that sense. But it is also understandable.

“The battle is intense when patients arrive here,” Richardson says with a shrug. “Because the last place the disease wants the patient is in these walls, in this building.”

Being a major part of a medical team of counselors, psychiatrists, nurses and physicians fired up Richardson in a way he hadn’t felt before.

“To be working in a place that so passionately works at putting the disease in its place, that’s the part that I love. Confronting the disease very aggressively and from every angle is what we do as a team. And we see beautiful people come out.”

In 2003, Jane Ferguson would die in a horrible private plane crash near Penticton, B.C.. Shaken but united, Richardson and the rest of the staff came together in their grief. Several joined in an ownership agreement with Ferguson’s family, allowing the centre to continue the work Jane had started.

Today, Edgewood mental health and addiction treatment centre has over 4,000 alumni, a family of previous patients in regular contact with the facility that launched their recoveries, on its mailing list. As well, it has created the Edgewood Health Network, Canada’s largest provider of addiction treatment and mental health services, with treatment centres and clinics from Nanaimo to Montreal.

After 15-plus years at Edgewood, Richardson continues to see his arrival and tenure at the centre as being something that was meant to be.

“Typically, in my medical career, I got itchy feet after four or five years of working in the same area. That never happened here. To me that was a sign.”

Richardson would go on to be certified twice in addiction medicine, once through the American Society of Addiction Medicine (2004) and again a decade later through the American Board of Addiction Medicine. But the formal letters behind his name do not adequately explain the truth of working with patients in their battle to be free from mental health addiction. Richardson has seen all facets of the mental, physical and spiritual warfare that is addiction treatment. His compassion level has not wavered since he arrived.

“I just love seeing the people get healthy. I love seeing the transformation in people’s lives. To be a small part of that is such a privilege. Going into the medical field, you want to see people change and get healthy and be part of that. We get to see that every day of our lives here.”

Doctors having fun. Edgewood’s full time psychiatrists, Dr. Charles Whelton (L) and Mel Vincent, are never shy about having a little photobombing fun with physician Dr. Gary Richardson.

Going back to the warning he received about addicts being ‘liars on wheels’, he understands as well as anyone the fight necessary to find recovery.

“For people active in addiction, they generally are liars on wheels, because nothing else matters to them but to use. But the flip side of that is I see people that had been liars on wheels and they do a complete 180-degree turn. They find themselves in an environment where it’s safe to actually get honest. Get brutally honest,” he says.

He is aware of the stigma addicts face, and he treats them as he treats staff, with respect, integrity, and straightforwardness. He discusses all aspects of the disease with the patients, and does not hesitate to talk prognosis with someone who feels they want to leave early, before what is recommended. When it comes to advice, he is more than likely to bring up the word honesty as one of the most valuable tools for getting well.

“You know that saying, ‘You’re as sick as your secrets?’ Well, your secrets stand between you and health or you and recovery. When I find a patient clearly getting honest with me, I take a moment to actually say, ‘I appreciate your honesty.”

He continues, “My way of putting it into context is I speak of fertile ground. Anything that the person is keeping secret or keeping bottled up that speaks to emotions and feelings becomes fertile ground for the illness. I speak of needing to purge themselves of all that fertile ground so that, by the time they leave Edgewood, there isn’t any fertile ground left for the illness. Then, carrying it forward into their recovery on a daily basis, to actually practice that, so they are being true to themselves, being honest. So they are not laying down any new fertile ground for the illness.”

He understands the liars-on-wheels warning. He knows how it works. And he knows Edgewood is a special place.

“Why am I passionate about that? It is a privilege to work in a place where feedback is allowed and is so important, so critical. It makes for an incredible work environment,” he said. “As much as the work is tough that we do, because there is such a team, on a daily basis I can see how different things happen and how different members of the team play different roles in terms of the patients getting healthy. Seeing the clinical [team] interacting with the medical [team], people walking through medical stuff, sometimes really tough stuff. Having this amazing team that is doing all this good clinical work with the patients.”

“Even bigger than that is the love and support that everyone gets as patients and as staff. I hear it all the time, when people walk into this place, that there’s something about it, right? For that to be one’s workplace, well, I feel really blessed.”

 

SEVENTEEN YEARS LATER, FORMER PATIENTS CONTINUE TO PROVIDE WARMTH TO THE NEXT GENERATION AT EDGEWOOD TREATMENT CENTER

By Jeff Vircoe

The letter arrived this week, just like it does each year.

Enclosed in a box, surrounded by love in the form of a collection of warm toques, it is addressed to the 80 or so inpatients who will be spending Christmas 2017 inside the walls of Edgewood addiction treatment centres.

In the letter, co-penned by Greg J. and Cynthia W., two alumni who, 17 years ago, spent their own winters on Boxwood Road in Nanaimo, they share the importance of passing on what was so freely given to them — the spirit of giving.

“We started this tradition of sending these our first Christmas back in our respective worlds outside of Edgewood addiction treatment centre in 2001,” the letter reads. “May these small gifts bring comfort to those who receive them at Edgewood and may they know each one is given from alumni who are still willing and very grateful for their sobriety.”

Cynthia lives in New Westminster, B.C.. She and Greg are good friends, with hearts in the right place. Each year since the winter of 2000-2001, they have sent a care package to the inpatients as a way of saying we are here for you when you get out, and thanking the mental health and treatment addiction centre that started the fulfilling journey they are on.

“It’s a way of sending respect, and also hope, to the new people coming through the doors of House of Miracles,” says Cynthia, a retired CUPE director. “Our lives were changed for the better for being at Edgewood addiction treatment center, and being part of that community. It’s a way of us saying to the person that receives it, ‘Have hope. We did. We’re doing it. You can do it too.’”

For his part, Greg, a retired heavy duty mechanic, collects the hats and ships them off to Edgewood treatment centre as a way of saying thanks for what he received over Christmas, 2000. He remembers the gift of toques, gloves, scarves and other little presents which meant so much to the man who was once so broken and lost.

Their friendship began in treatment. Cynthia recalls being “so very indignant” attending the detox treatment program at Edgewood addiction treatment center in January of 2001. Greg, who had been in treatment for a month already, was a calming influence as she paced restlessly in her first days at Edgewood.

“I couldn’t sleep, and he’d meander in to [Bridges dining room]. We would read the Big Book and try and figure out what this means and what that means,” she says with a laugh. “He was so encouraging. He had been there several weeks. He reassured me that my head would clear. He told me to remember detox treatment was not a race, not a course. He was so sincere.”

The two friends would end up doing their aftercare sessions in Vancouver when they completed treatment, and their friendship just got richer. Though Cynthia was widowed and Greg recently divorced, it was one of those special platonic relationships that just blossomed.

“When I got sober, my whole word opened up and romance was just not in the cards,” says Cynthia. “Friendship was. Giving back was. We had learned so much at Edgewood, and we both had such a strong commitment to staying sober. We both felt that we had been given a second chance at life. It was that commitment to sobriety that drew us together.”

So, at Christmas time, they naturally think back to the launch of their friendship, their new lives as sober, recovered people.

‘For years, we would gather the toques together, go over to the Army and Navy and pick them out. But, the last few years, he has been picking them up. I write the letter,” she says with a smile.

They also began returning to Edgewood for January’s Cake Night each year, taking the ferry over together, reminiscing.

“We get there and we stand outside and just watch,” says Cynthia. “It’s so funny, it has changed so much. But we always look at the walkers and laugh, ‘There [are] the inmates.’ And we look at the list of people who have passed. We look for the one or two staff we still know. Then we go in, get a coffee and do Cake Night.”

The continuity of recovery, Edgewood style, remains strong for these two alumni. Greg, a Burnaby resident, still attends five or so meetings a week. He’s a regular at the Burnaby Fellowship Centre, a meeting place where plenty of newcomers are trying to fit in.

“He’s always there, holding out his hand,” says his friend. “He just likes to talk to people, to encourage them, to listen to them. He’s a very humble man.”

As for Cynthia, she is looking forward to her annual trek for her medallion on Cake Night next month. Traditions matter to the two. Greg shows up to his home group with treats to mark his time each December, “unannounced, of course”, and the two continue their tradition of sending their tangible message of hope in the form of toques to the newcomers at the House of Miracles.

Meanwhile Cynthia continues to talk the talk and walk the walk.

“I recommend they get into A.A. and get into the middle of it. Me, I make my bed most days and I still say, ‘Thanks, Edgewood.’ We have a deep, deep gratitude to that place for the life we have today.”

 

EDGEWOOD ADDICTION TREATMENT ALUMNUS CARRIES A MESSAGE OF HOPE

By Jeff Vircoe

 

There is a saying in Addiction treatment that, sometimes, the voice of addiction is louder in the building than the voice of recovery.

In the cities of Nanaimo, B.C. and St. John, N.B., the voice of recovery is loud and clear twice a week. And it has a distinctly Edgewood sound to it.

Kevin M. is a presenter and content creator for People First Radio, a weekly community FM radio and online-podcasted program heard on Vancouver Island and off the Bay of Fundy.  In a decade on the airwaves, among his interviews he has spoken with a former Canadian Prime Minister, an impaired crack addict, a man who would go on to murder his own son, and a dad whose daughter was dying of anorexia. He is a big part of a profoundly impactful radio program and an organization whose mission is to promote recovery, social inclusion, safe housing and public education around issues dealing with mental health and addiction.

His connection to community coast-to-coast started while he was in extended care at Edgewood.

It may be cliché, but at 58, Kevin has come full circle. He arrived at Edgewood in October of 2007, a white collar, non-profit management and policy geek with educational credentials and a resume to die for. Yet, all that education — bachelor’s degrees in this, master’s in that — and all those plum postings in civil service and charitable health societies, meant nothing inside his shaking body, sketchy eyes and hurting soul.  By the time he got to Edgewood, he was just another broken down addict with no sense of who he was as a human, asking for help.

Through five months in inpatient treatment and extended care, for another year in after care, and in all the time since, he has done his work on himself. Through service work in the 12 Step community, through a yoga lifestyle that focuses on deep reflection and mindful living, and through his activism on the airwaves, he continues to work on himself while helping others, blossoming into an advocate for mental health issues at a level on which few get to participate.

And to think that, a decade ago, he arrived at the mental health and addiction treatment centres in Nanaimo a giant mess. “I was done. Writhing in the back seat,” he says. “I thought I was in Kelowna, that’s how mixed up I was.”

Addiction Treatment was a gift from his parents, a couple who had never made alcohol consumption part of their lives. Deeply religious, from a small town in Alberta, booze just wasn’t part of their upbringings. Along with his two younger sisters, they were as baffled about Kevin’s choices as anyone.

Still, Kevin’s descent into the dark world of alcohol and drugs was slow but steady. Like most prairie boys, he grew up in a hockey-mad town.

“It was where the Sutters played hockey,” he says, clearly having been asked and stock answered the next questions in the past. “Yes I played hockey at the same time the Sutters did. I was no good. The Sutter in my group was really good. There were Sutters in every group, all the way.”

Life in that part of the country was hockey-crazy.

The brawn and bravado of frozen pucks and outdoor rinks may not have been for Kevin, but he had something they did not. A sharp mind and willingness to pursue academics. By 16, he had left home for Augustana College, a small school with dorms in Camrose, Alberta. He would spend four years at Augustana. It was there he first encountered bush parties, but not often and nothing over the top. It changed when he turned 18, when someone “made a point of taking me out on my birthday and getting me absolutely plastered. I, of course, allowed it.”

“I learned quickly that I was the kind of person that drank more than anyone else,” he recalls.

Funny how some things in an alcoholic’s life stand out when so many other things are fuzzy.

“It was a lounge. The Crystal Spring Lounge. I drank all these lounge drinks hepped up with multiple layers of [liquors]. Just horrible. They’re all made just to make you sick to your stomach an hour later. I got sick. Then I passed out at the Boston Pizza in the men’s washroom.”

That would be a good time for a young man with a sharp mind and religious upbringing to not drink again. Of course, that’s not how it goes.

At school, he developed a pattern of Thursday bar nights. The progression took off.

“Over a period of time, the Thursday Bar Night turned into also a Friday night. Then there were also sometimes parties on the weekend, and then sometimes Tuesdays seemed good. Then maybe Wednesday after the exam was over …”

There were drugs around, but Kevin hadn’t felt any draw to them. Yet.

The non-drinker for religious purposes became a thing of the past. A new man was coming out. That concept took a huge twist when he was 19 and he got honest with his peers and family about his sexual orientation.

“I came out to my parents, the guys in the dorm, my closest friends,” he said. “That was a tremendous challenge because, remember, I did that at a church-based college. In rural Alberta. In 1979.”

Bam. Bam. Bam.

Yes, it was 1979, the height of the emerging gay rights movement. Two years before, activist Harvey Milk had been assassinated in San Francisco. Though Canada and other nations had, a decade earlier, decriminalized homosexuality on the legal books, in practice it was a whole different story. Gays and lesbians were still regularly fired from the work place, beaten in or released from the military, shunned by religions of all types. In short, a stigma as harsh as, or worse than, what addicts were dealing with.

Nonetheless, his parents took it in stride, he says.

“My father seemed not so bothered, but my mother was very troubled because of religion,” he says.  “Over time, it kind of dissipated. They kind of accepted, but not really. But they certainly interacted with me.”

Those who were more accepting included the club scene goers of Edmonton, where Kevin found himself in his early 20s. Working for the provincial government by day, a self-proclaimed weekend “club boy” by night. Things weren’t yet out of control, but trouble was on the horizon.

“Drinking was the thing. It was just about always beer – unless I wanted to impress someone, wine in a restaurant or something. Or I’d come to a party with scotch but hate it and think, ‘Why did I do this?’ It looked good.”

A dark turning point happened in Edmonton. He was taken advantage of one night, horribly, mercilessly. His food was drugged, and Kevin was brutally, sexually assaulted. The naïve country boy would suffer permanent scars mentally, spiritually, and physically.

“In the morning, I woke up in the basement. Naked on the concrete. With bruising. Very sore. Not knowing anything. In those days, it was not something … I’d never even heard of such a thing. I just thought, ‘Oh my God, I must have been really plastered last night.’”

With the times, with the stigma, Kevin felt he could not report it to police.

“What would I do? Go into the University Hospital and say, ‘Excuse me, I think I’ve been raped by a bunch of men.’ ‘Oh really? What were you doing? Where were you?’ ‘Oh, I was in a gay club.’ ‘Oh, really? And you’re complaining about being raped?’”

His consumption of alcohol and drugs took off. For the next 25 years, he tried to bury his memories in bottles, vials and bars.

“The [details of the assault] got buried down and all the drug use started. That’s when I started using marijuana, hashish, mushrooms, acid, on a regular basis. Every weekend. And drinking. It kind of exploded like that.”

He developed a full-on anxiety disorder. Well-meaning doctors filled prescriptions, of anti- this, calming that. As his career took off in higher profile positions, media-savvy Kevin may have had them – an himself – fooled about what was going on behind the scenes.

“I had a doctor, he was an excellent doctor but he prescribed me valium and anti-anxiety things, just pretty much anything I wanted. I guess because I was traveling for work, I was on the news every once in a while … I seemed to have it all together. Plus, I was working on a second master’s degree.”

In a 10-year relationship with a highly successful professional with two children, who were over two weekends a month, the couple had plenty of time and money to travel and party all over Canada. Kevin continued to live the high life.

“Just the whole denial thing. I told myself that I could stop if I wanted to. I drink because I want to. I drink because I like it. I drink because it helps me relax.”

And everything is held together with scotch tape. Just waiting for the wind to blow hard enough.

In his 40s, in a booming, oil-rich Calgary, another lover came into the picture: a powder.

“I’m introduced to it through younger people I’m working alongside, whose drug of choice isn’t pot. It’s cocaine. We could drink more and longer if we snorted cocaine.”

Drinking and drugging, anxiety levels through the roof, his relationship ends. His career is in tatters. He suffers from agoraphobia so bad he can’t leave the house.

“I wasn’t working. I was living alone in my house. I was doing nothing but drinking and using cocaine. Financially, I was more or less okay and had access to money. And then I ran out. I had to sell the house.”

With degrees in History and English, a master’s in social work, and once well-known in many circles in non-governmental organization circles, having served long and short stints in the upper ranks of AIDS and cancer non-profit societies – the crash finally came.

A friend managed the sale of the house for Kevin, who was basically incapable of handling it. The bulk of the money gained from the house was turned over to Kevin’s parents. The friend was trying to save his friend.

“I went along with it because I was completely out of it. I trusted him and nobody else. He had helped me sell the house. Find buyers. Keep everything quiet in the neighborhood.”

This friend had a motive.

“He had seen a number of men, particularly in the gay community, who had achieved something in their lives. It doesn’t matter how or on what level — men who had then lost everything because of drugs and alcohol. They use until the last dollar is gone.”

Kevin was right on the verge.

“I spent the money they gave me on hotels. I was homeless in hotels. Then couch surfing. One day, I was wandering down Eighth Avenue with a street person who was stealing jackets out of stores so we could get money for dope.”

It turns out the friend who helped sell the house had a friend whose family member had gone through Edgewood.

Kevin’s parents were contacted. They made a plea to their son. They offered the financial means to make it happen. And Kevin agreed to come to Nanaimo for treatment.

Asked about the importance of Edgewood in fall and winter of 2007-2008, Kevin gets quiet. He remembers well the process of breaking through to his feelings.

“When I came into treatment, I was at a junior-high emotional mentality. That’s how I experienced my first few weeks at Edgewood. I was scared of the older kids. I felt intimidated. Scared. I thought, ‘What I am is … I don’t know what I am.”

And it all came pouring out.

“I sat in the morning group with Sergio one day. I did a reveal and finally let out what had happened, and almost acted out the emotions. It was very emotional.”

His current doctor describes it as Post Traumatic Stress Disorder.

Edgewood’s addiction treatment program dramatically altered his life. Saved his life.

“In a way, it was like being scoured out. You go inside. You do an inventory, but you kind of get a little bit of a cleaning. Cleaned up on the inside. You get things looked at. Decluttering what is inside. Not necessarily what you can see – because what you can see is just someone whose life is in shambles. Okay. But why is it? Let’s go inside and find out.”

And inside he went, with counselors, with peers. He spent the holidays of 2007 in treatment.

“That Christmas, I wept sitting in my chair. The guys around me asked, ‘Are you okay?’ I said, ‘Yes, I’m fine.’ Because of the memories of my Christmases as a child, my emotions were opened again. As I talked to my friend on the phone, he said, ‘You sound like a human being again.’”

Kevin was offered and accepted extended care, another three months where he could gain traction in his new recovery. Go to plenty of 12 Step meetings, continue group therapy, do some volunteer work. He accepted. While seeking volunteer work, he found a gig helping a non-profit which needed board members. He was soon doing small contract fundraising and event proposals for the organization.

With nothing drawing him back to Calgary, Kevin decided to move to Nanaimo when he completed extended care in the spring of 2008. He got a sponsor, a man who told his story one night at Edgewood, and a man with whom he still meets regularly, 10 years later. He attended meetings, several meetings a week. He joined a home group, got heavily involved in service work. He did a year of weekly aftercare group sessions at Edgewood. He got deeper into his yoga connection and philosophy. And he pursued his volunteer gig which morphed into his present career.

That volunteer commitment lead to the formation of a radio program called People First Radio, funded by the Vancouver Island Mental Health Society. Kevin’s background fit perfectly. Non-profits. Health matters. Policy and procedures. Social work background and education. Heck, he even had a decent radio voice.

He was both shocked at the turn of events and a big believer in how things come to pass when people do the next right thing. In their personal life. In their community.

“Everything has opened up a bit like a flower in a way. In the sense that the stem was A.A. and my recovery work within A.A.. Then it became my involvement in community again.”

While he has reduced his attendance at meetings, he continues to touch base with his sponsor. He comes occasionally to Cake Night at his alma mater. He speaks when asked. He is deeply committed to personal growth and his spirituality through yoga, making regular visits to an ashram in the Kootenay Mountains of British Columbia. And, every week, his voice sounds across the radio waves, educating, comforting and encouraging listeners to a wide variety of paths of hope for those facing mental health issues.

He scans the media, pulls out stories and commentaries on matters in the mental health field, selects topics and guests with his team, and interviews them. He has developed several streams on social media and radio podcasts.

“Education and awareness is the goal. The core for us is mental illness, mental health, addiction and recovery, homelessness and social housing. That’s the kernel. And around the kernel comes a whole bunch of things: Harm Reduction, 12 Steps, poverty, education, lack of education, and anything that affects those core pieces.”

Ever since Edgewood addiction treatment centres, he has found himself in the right place at the right time for the first time in his life. It fits with a promise of the 12 Steps, that addicts will know a new freedom and a new happiness, and no matter how far down the scale they have gone they will see how their experience can benefit others.

“I feel that’s a big part of it. Having walked a road and rubbing up against people that you know can’t just be reduced to platitudes or stereotypes. There’s a lot more going on there.”

 

Helping your child with addiction.

Helping your child with addiction, some important tips.

Being a parent can be very demanding already without having to deal with a teenager struggling with addiction. With everything that is happening in the world today, the last thing you’d want for your child is to have to deal with problems related to substance abuse. There’s a variety of reasons why your child might find him/herself addicted and the problem only becomes worse the more time that goes by without the issue being noticed. Keep an eye open for signs, they are there. If you don’t know them, read about it or seek help from those around you.

Keep in mind that if your teenager uses drugs or alcohol once in a while that wouldn’t make them an addict. Just like the occasional glass of wine for dinner doesn’t make you an alcoholic. But if you believe that they can’t go days without using, then there’s a problem that needs to be dealt with.

Don’t play the blame game.

It is highly suggested that you don’t start a conversation built on reproaches, it will only make your child close up and it will be even more difficult to get crucial information about the dependence. Take a step back, breathe and talk calmly while asking questions in a kind manner. Your child will feel threatened and attacked because they know they have done something wrong. Experts advise talking to someone outside of the family, who is not emotionally invested and can be a neutral party.

Additionally a counsellor will help you to feel that you aren’t alone in facing this type of situation, other parents deal with the same problems as you and can help with past and current experiences.

Establish communication through trust.

It can be difficult to find the right time to be heard, but approach the situation with affection and attention. Your child needs to know that you are only trying to help them out of love and concern for their health. Don’t hesitate to read about the subject or seek professional help before getting into a strong debate you may not have the answers for.

If you have a family doctor who has regular follow-ups with your child, you can ask them if they have seen any changes, the urgency of the situation and perhaps what kind of drugs they’ve been using. If your child doesn’t have a family doctor, you can seek help from a psychologist, or a therapist outside of the family and friend circle that will be able to provide moral support.

Educate yourself about the signs of a child with addiction.

Make sure any unusual behaviour in your child doesn’t go unnoticed. You know your child better than anyone, not the school, not your neighbours or the school counsellor. If you aren’t sure whether something is a sign of addiction, do a drug test. Of course your child won’t like the lack of trust, after all if they are using, they will lie to you about doing so. But it can be one of the easiest ways to know if there is a potential problem.

Beware of potential abuse signs from their surroundings.

One of the common signs of a child with addiction is the circle around them or their being abused. You should know who your child is surrounded by and make sure that they want to be there. Someone who’s abusing or bullying your child will often be threatening them with harm if they talk about it. It is your role as a parent to know if your child is safe. Negative surroundings can be one of the strongest influencers towards substances. After all, everyone wants to fit in somehow and if it seems that the only way to do that, or be “cool”, is to use drugs and alcohol then they are much more likely to make that choice.

Engage in a conversation, stay firm.

You need to be able to say NO without being scared to show your authority, it is simply an essential educational attitude that a parent has to adopt.  Categorically refuse to give your child money until you absolutely know where that money is going. Also knowing what your child is doing in their spare time can really help to understand if the problem is as big as you imagined.

Often, your child will try drugs or alcohol as a way to defy your authority, but through repeated use they end up becoming an addict and that’s when a solution needs to be implemented. Talk to them, ask why this happened, what motivated their decisions, perhaps the problem goes deeper than you are aware. It isn’t always just because some friend said it was cool. Communication is key, as well as knowing how you will approach the situation. As mentioned before, seek professional help if you believe that you don’t have the knowledge to constructively have these conversations. They are trained to help guide you through them.

Remember what you’re doing this for, get the best help you can to make sure your child is in good hands.