Talk on the Opioid Crisis in Blacksburg, VA, March 13, 2018

I will be giving a talk entitled “Opioid Epidemic? What Are the Facts?” for the Lifelong Learning Institute at Virginia Tech on Tuesday, March, 13, 2018, 3:15 – 4:30 PM, at Warm Hearth Village Center in Blacksburg, Virginia. The event is free and open to the public.

If America is facing an “opioid epidemic,” why isn’t evidence-based emergency, urgent, and routine medical care for opioid use disorder available in our town? Ask that question of lawmakers, judges, policymakers, public officials, journalists, treatment professionals, and society at large and watch the spluttering begin. For no other health care condition is belief, opinion, and myth accepted as the standard of care. This presentation focuses on the latest addiction research, with a focus on opioid use disorder, challenging what society has to say about addiction with the available science.

I have compiled my background research for this talk here.

For context, I recommend this article:

And this one, too:

For further reading, I’ve compiled suggestions here.

I gave a talk on opioids for the Montgomery County, Virginia Democratic Party on August 17, 2017. Here is the first half of an expanded version of the talk. The second half is here.

Speaking in Blacksburg, Virginia

Directions to Warm Hearth. As you enter the Warm Hearth complex on Warm Hearth Drive, you will pass Nuthatch Way on your left. Take the next left into the driveway and parking lots for Warm Hearth Village Center.

(LLI requests mail-in registration, but it is not required. Here’s the registration form and here’s a list of all events scheduled for LLI during Spring 2018.)

If you have questions or I can be of service, please feel free to contact me.

Photo: Bonnie Lyons

Reading Maia Szalavitz

I estimate it took me between 15 and 20 hours over 10 days to read Maia Szalavitz’s new book, Unbroken BrainI read every word of its 288 pages, 33 pages of notes, and 14 pages of  index subjects.

A few pages in, as I wrote for The Fix, “When I read these words in Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction: ‘I felt utterly stripped of safety and love. And so, what tormented me most as I shook through August of 1988 wasn’t the nausea and chills but the recurring fear that I’d never have lasting comfort or joy again,’ I stopped reading, put my face in my hands, and cried. I wasn’t alone anymore.”

Reading Unbroken Brain by Maia Szalavitz

A few more pages in, I posted on my personal Facebook page, “I am experiencing cognitive dissonance,” and linked to the term’s definition on Wikipedia: “In psychology, cognitive dissonance is the mental stress or discomfort experienced by an individual who holds two or more contradictory beliefs, ideas, or values at the same time, performs an action that is contradictory to one or more beliefs, ideas, or values, or is confronted by new information that conflicts with existing beliefs, ideas, or values.”

Unbroken Brain came out on April 5, 2016. I wish I could remember the exact search phrase I used to discover the book on Amazon, but on April 13, I typed in something like “how to save myself from addiction with long-term sobriety.” Once I read the book’s description, “[O]ur understanding of addiction is trapped in unfounded 20th century ideas, addiction as a crime or as a brain disease, and in equally outdated treatment,” I downloaded the book for my Kindle and began reading immediately. Finding myself desperate to underline passages desperately important to me, I ordered a hardback copy which arrived April 26.

A careful reading of Unbroken Brain

Why have I included dates? I have probed and probed for more erudite phrasing, some way to step back from this personal, personalized statement. About reading a book. One book. In 10 days. But I truly can compose no lesser or greater sentence: I have a pre-Maia and post-Maia life.

I tried very, very hard to have “good sobriety” once I became abstinent from alcohol. I tried to feel “happy, joyous, and free.” I did everything I could to help myself. But those first 3 1/3 years of abstinence were spent primarily in pain.

At essence, I hated myself for what I had done to myself by becoming addicted to alcohol. I hated myself for bringing upon myself the contempt of others. I hated myself for my inability to feel better. Wasn’t I treating myself for alcoholism by attending support groups? What was I doing wrong to keep that from working?

I felt contempt from some members of support groups for my intractable longing to drink and intractable unhappiness. Not feeling better was my fault. I was doing things right enough, but I wasn’t being right. I was selfish and prideful and egotistical because I would not subsume my identity beneath the identity of a power greater than myself.

Brené Brown defines shame as “the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging – something we’ve experienced, done, or failed to do makes us unworthy of connection.”

“Shame and stigma are the exact opposite of what fights addiction.”
– Maia Szalavitz, letter to the New York Times, 2/3/16

How in the world did I end up so excruciatingly scorned by myself, by people close to me, by society as a whole?!

Friends and people who know of my anguish and have started reading Maia Szalavitz’s Unbroken Brain universally start their next conversations with me, “Oh, Anne. Now I understand.”

Yes. I understand now, too.

“For those moving from experience-based and belief-based addictions treatment to evidence-based treatment, i.e., for those familiar with the research on addiction, Szalavitz’s book [Unbroken Brain] is not controversial, but masterful…In her weaving of personal narrative, scholarly knowledge of the evidence, logic that feels like she has intimate knowledge of how the reader thinks best, skillful, artful writing, and sheer, awe-inspiring intellect, Szalavitz jettisons the foolish and unfounded and, from the remaining discord of what the science says, creates a treatise on addiction as concise, exquisite and moving as poetry.”
– excerpt from my piece on Unbroken Brain for The Fix

In my “post-Maia life,” as my cognitive dissonance helps me confront and make new sense of a 10-year struggle with addiction, what I understand is how deeply, profoundly and harmfully I have misunderstood addiction. Foremost among my new understandings is that support isn’t treatment. My misunderstandings have hurt me and others.

No more.

. . . . .

When I finished Unbroken Brain, I started reading everything I could by Maia Szalavitz. On May 11, I tweeted Maia Szalavitz about a possible speaking gig. And she replied.

Maia Szalavitz, author of Unbroken Brain: A Revolutionary New Way of Understanding Addiction, has graciously agreed to speak in my hometown of Blacksburg, Virginia on Wednesday, August 3, 2016.

Learn more about Maia Szalavitz’s visit to Blacksburg, Virginia

Unbroken Brain – Reading Group Discussion Questions

Unbroken Brain: A Revolutionary New Way of Understanding Addiction, by Maia Szalavitz, St. Martin’s Press, April 6, 2016

Unbroken Brain by Maia SzalavitzUnbroken Brain braids together three narratives: Maia Szalavitz’s personal story, what the science reports about addiction, and a call to action to change belief-based addictions treatment to evidence-based treatment.

Questions for discussion:

  1. What could you relate to in Maia’s personal story?
  2. What have you believed to be true about addiction? Has Unbroken Brain challenged your beliefs about addiction? If so, in what ways?
  3. The subtitle of Unbroken Brain is “a revolutionary new way of understanding addiction.” Do you have a new understanding of addiction as a result of reading Unbroken Brain? If so, what are the highlights of what you now understand?
  4. What do you still not understand about addiction? If you could speak with the author, what three questions would you ask her that seem unanswered to you in Unbroken Brain?
  5. If your life, or the lives of loved ones or of those you know, has been touched by addiction, does Unbroken Brain help you better understand what happened? If so, how?
  6. What concepts in Unbroken Brain did you find most challenging? Please select three to discuss.
  7. What concepts in Unbroken Brain did you find most relieving or satisfying? Please select three to discuss.
  8. Has your idea of drugs and drug use changed after reading Unbroken Brain? If so, how?
  9. Did anything in Unbroken Brain shock or surprise you? If so, what?
  10. After reading Unbroken Brain, how would you describe addiction to someone who doesn’t understand it?
  11. Do you feel called to take action after reading Unbroken Brain? If so, what would that be?
  12. What discussion question do you wish had been on this list? Please write it here and consider sharing it with the group: _________________________________________

To learn more about author Maia Szalavitz:

The Reading Group Discussion Questions for Unbroken Brain were written by Anne Giles and Laurel Sindewald.

Last updated 6/18/16

The Science of Addiction Is In

As a person recovering from alcohol use disorder for 3 and 1/3 years, I acknowledge that, early on, I made the mistake of believing my personal experience with what was helpful could and should be replicated. I realized that my sample size of one is absolutely not sufficient data from which to draw inferences about a larger population, especially given the complexity and variability of addiction.

Unbroken Brain by Maia SzalavitzMaia Szalavitz expresses this fallacy in logic in her article on Prince’s death: “I thought that simply having experienced addiction qualified me as an expert and incorrectly relied on anecdote, not data.” To correct my own error, I have relentlessly studied the research on addiction to grow evidence-based expertise.

That’s been a miserably difficult task. I’ve written extensively on my blog about my inability to find consensus in the literature about what addiction is and what effectively treats it. What I have found often plunges me into despair.

According to the definition used in addictions treatment from the American Society of Addiction Medicine (ASAM), addiction has “characteristic bio-psycho-socio-spiritual manifestations.”

Wikipedia defines spirituality as how one seeks meaning.

Did I become addicted to alcohol because my method of seeking meaning has been flawed?! Half a century of “Know thyself“and “The unexamined life is not worth living” and it was all wrong?! According to ASAM, it must have been. Because there I was, unable to stop drinking. The sorrow, the grief, the shame – unbearable! And now here I am, wishing I could drink.

Criticizing the ASAM definition, Maia Szalavitz writes in Why the “Disease Model” Fails to Convince Americans That Addiction Is a Health Issue, “The ‘spiritual’ part is something no other medical specialty feels compelled to mention in its official documents.”

What world have I fallen into? Why doesn’t anyone know what’s happening and what to do about it? Melted Dali clocks are everywhere. I’ve never been more frightened, more uncertain, more disoriented. How am I to save myself from addiction if no one knows what to do? What does the science say?

The science is in – comprehensively reported in the just-released book by Maia Szalavitz, Unbroken Brain: A Revolutionary New Way of Understanding Addiction. Finally, someone understands what abstinence has been like for me: “I felt utterly stripped of safety and love…what tormented me most wasn’t the nausea and chills but the recurring fear that I’d never have lasting comfort or joy again.” (34)

I cried with relief when I read that. And I cried a few more times, but primarily felt my spirits and hope rise as I read Unbroken Brain. Szalavitz braids together her personal narrative, the science of addiction, and a call to action to replace experience-based and belief-based treatment with evidence-based treatment. Whew, yes, let’s do that.

Whatever term one uses for addiction – disease, disorder, illness – I didn’t make this happen to myself through moral or “spiritual” failing. I’m released from the fruitless, desperate search to figure out what I did wrong so I don’t do it again and return to drinking. My job is to keep figuring out what helps me stay abstinent from alcohol – the treatment I need, not the one for all.

. . . . .

I am part of a local community group in the Blacksburg, Virginia area reading Maia Szalavitz’s Unbroken Brain: A Revolutionary New Way of Understanding Addiction. We’re compiling a list of her recent publications and interviews here. If you would like to join us, please contact me and I’ll invite you to our discussion meetings.

Last updated 1/12/17

Announcing Publication of Phoenix Rising

I am delighted to announce the publication of Phoenix Rising:  A Journey of Self-Discovery through Addiction Recovery. The book is comprised of excerpts from my blog, edited by Laurel Sindewald. Phoenix Rising is available for the Kindle through Amazon.

Truly, I am indebted to thousands for help in writing this book.

Phoenix Rising:  A Journey of Self-Discovery through Addiction Recovery Many times over the two years about which this book is written – my first two years in recovery from addiction to alcohol – when I was confronted with a challenge, I envisioned myself standing alone in front of an inquisitor. The answer would be life or death for me or for someone I cared about. But seated behind me were rows of the strongest people who have guided me my entire life: my teachers – Mrs. Shane Pollet, Mrs. Loreta Walker, Mrs. Annette Perkins, Dr. Doreen Hunter; my family – my mother, my father, my Uncle Gaines, my Aunt Peg, my Uncle George, my Aunt Lena; my counselors – Mr. N., Dr. P., Dr. X., Mary, Dr. S., Dr. H. – all there for me to consult. And my sister, Margaret, for whom I was once protectress and so regret becoming like another child for which to care. Even my former husbands and boyfriends are there, if silent. I have no right to ask them anything, but I remember well their intelligence and skills.

All the knowledge and experience and wisdom of all the people were at my back. I felt as if I spoke my answers alternately, confidently, with their voices.

Even though I haven’t seen many of them in decades, they have been with me and I am grateful for their efforts on my behalf.

Many people contributed to the writing of this book but I am naming several specifically for their direct help with this particular project, or for their direct help with me making it through the two years of my life this book covers. In every moment was a potential dealbreaker. Those are high stakes and none of these people flinched.

Alex Edelman is the one with whom I can share the hardest questions and count on receiving probing, expansive, radically informed, humane answers.

Dan Smith read my blog and sent me supportive emails when I was rolling in agony on the floor in early recovery and a “this is a book” email when I began to regain my balance.

Coach Sarah Beth Jones shared what she felt and thought about my writing, then asked me to probe more deeply about what I wanted and what I meant.

Robert Giles, my father, has nudged me for decades to do what I said I’ve wanted to do since Mrs. Pollet asked us in fifth grade to make dolls of who we wanted to be when we grew up. My doll was a writer. My father has personally and financially supported his troubled daughter and I think my mind would be broken and my body homeless if he had not. He made the leisure required to write this book possible and I am grateful.

Janeson Keeley models writing honestly and deeply and commented generously and supportively on my blog, even before this book was an idea. Kelly Alcorn also commented thoughtfully and often on my blog.

Debbie Palombo climbed her Mt. Everest – the real one! – and in her inimitable, genuine, cheerful way said I should and could climb my own.

Karan Rains told me decades ago, “It’s harder with smart people.” But she helps me find my way, or my way back, to my heart.

Rosemary Sullivan stated outright to me that hiring an addictions counselor at 15 months sober was a risk but she took a chance and gave my desperately grief-stricken life meaning and purpose.

Z. Kelly Queijo and Gail Billingsley reside with me in a small town. They were my friends before and they are still my friends. They would not say so, but I consider their unwavering support heroic.

The cover art for Phoenix Rising is a detail from “Woman Rising,” created and designed by Jackie Harder then painted by, in alphabetical order: Gail Billingsley, Catherine Fae, Anne Giles, Robert Giles, Ben Harder, Jackie Harder, Greg Kiebuzinski, Brandon Lowe, Kelly Queijo and Laurel Sindewald.

The men and women who seek addictions treatment awe me and steel me with their honesty and bravery.

Without the men and women who attend support group meetings, I would be floating, spread-eagled, in chaos. They calm me, then guide me, then inspire me. How can I adequately thank rescuers? I hope this book in some small way honors their gifts to me by attempting to pass them forward.

Without Laurel Sindewald, this book would not exist. When she began assisting my father with his work in June, 2013, I was secretly six months into my first year of abstinence from alcohol. It would take me another ten months to share in public that I was in recovery from addiction to alcohol. I shared for many reasons, but one of them was seeing the bright, shining, passionate honesty of Laurel Sindewald and not matching it with my own.

Openness created a synergy I’ve experienced with only a few. Laurel deepened my thinking, feeling, insights and writing with her fine mind, thoughtful discussion, and impeccable, extensive research. Then she took on a herculean task. She read my entire blog, excerpted it, organized it, and edited it as a book manuscript. As if it were her own, she entitled the book, designed the cover, and meticulously prepared the entire package for publication. The writing is mine. The book is hers. My gratitude is without bounds. I appreciate, respect and love you, Laurel.