Continued:

There are people that re-discover their freedom from an addiction dependency, so I am writing down things for others if they find it interesting or helpful.

Before going on, this blog it not meant to convince any one of anything, it is not meant to reach out with good intentions, or to "lead to a right, or noble way," in fact, this BLOG is more like a stack of firewood.

Leaving a stack of firewood for other people before leaving a campsite was a something my father did when we went camping. But as an adolescent, it seemed pointless and a waste of time, yet now it is clearly the human thing to do.
After going though a major life experience like the addiction and recovery cycle, it now seems like common-sense.
This Blog is meant in the same spirit as leaving some firewood.

An addiction can ultimately open doors for some individuals

Addiction is traditionally seen as a weakness, a Life long struggle, etc, etc

But once a person finds themselves seriously addicted to something, these antiquated and condemning terms themselves can become a chronic source of doubt, that can undermine an individuals sense of self-trust, competence and abilities concerning the addiction, for the rest of their lives.

Although the addiction and recovery struggle can be inherently traumatic, and even life-threatening, the insights and wisdom experienced from the recovery process can be profoundly contributive and enriching to a person's life-experience as a whole.

AN EXAMPLE

Please be aware that a few paragraphs of text does not convey the extreme, traumatic and profound feelings and realizations that can be experienced during a persons addiction and recovery period.

The JUGGLING Analogy:

During the recovery phase, people kept talking about "keeping all the balls in the air".
by which they meant, "Maintaining Sobriety".
However, trying to continuously and consciously "keep all the balls in the air", was clearly an impossible and endless task, and in a fit of desperation, it suddenly occurred to me, that this juggling analogy was BACKWARDS.
It was the DRINKING that was actively being "MAINTAINED".

SOBRIETY was when the Juggling balls were simply on the floor...naturally lying around and requiring no maintenance to do so. Nor are you ENGAGED in a continuously and conscious ACTIVITY, (like maintaining an inebriated state, which fades and must be repeated to be maintained)

This notion kept coming back to me..and the common sense-ness of this reversal..kept growing.

Now remember, this relates to FEELING, and it affected the way I felt about MYSELF when I was drinking and not-drinking. This is not about
"how-not-to-drink"... that is a completely different thing.

But back to the point here.
Slowly, this concept gained gravity the more often I thought about it. And over a period of time it felt real. It began to FEEL like a basic and universal "common sense" type-thing again.

Please note, the desire to NOT drink had become very very strong by this point in my life, and drinking now felt much more like a PRISON
than a HAVEN, so some people reading this may think I "wagged the dog" or something. But no, the analogy reversal helped me re-trust my
feeling of self-trust. Its like my thoughts, feelings, and sence of self (spirit) concerning drinking and not drinking.... were becoming in CAHOOTS, or aligning again.

This reversal of the Juggling analogy was a major source of relief and an important realization in my recovery period.

This is just a a summary, but once again, please be aware that a few
paragraphs of descriptive text do not convey the extreme and profound
feelings and emotions that are experienced during a struggle with
addiction and recovery.

Addiction/Dedication are the same mechanism

ADDICTION and DEDICATION are the same mechanism

The human traits that sustain a person's
devotion to worthy causes, lofty goals and respectable activities, are
the same traits for sustaining something as clearly destructive as an
addiction.

I will use a
professional athlete as an example.

In time, professional athletes change their life's goal that they have
been obsessed with. It is a goal they have been focused on for a good
part of their life. It is almost all they know, and it's a goal that
friends and people have bent over backwards to help them achieve. This is a mirror image of an addiction.
Changing the lifestyle is probably as foreign and as difficult,
requiring as much soul searching and spiritual reflection as recovering
from a destructive and debilitating addiction. Society praises one and
condemns the other, for obvious reasons.

During my recovery process, it slowly became apparent to me that these
human mechanisms involved with Addiction and Dedication are basicaly same mechanism. They are nearly identical, and it led to the evaporation of the inevitable shame and guilt that is present during the addiction
recovery process.

It also allowed me to proceed and to finally trust
myself, and trust in my common sense again.

Whether becoming habitualised to something negative like an addictionor something positive like a sport, these 'habits' become an identity... they become something you know A LOT about, something you
can bank on, be at home with and feel "normal" about.

Whether you struggle to embrace that identity (as an Olympic athlete
does) or find it imprisoning (as an addicted person does), YOU
PERCEIVE and FEEL IT to be WHO AND WHAT YOU ARE.

It must be traumatic for an Olympic athlete to "surrender" this
lifetime goal and identity, the very thing they have spent most of
their conscious life submerged in. So, also, it is traumatic to leave
the lifestyle and function of an addictive life.
It dawned on me that the trauma of quitting something, is therefore
"normal", or NATURALLY traumatic for any human being, and is not unique
to the addicted.

With this insight, I was able to perceive myself as a human being with
a problem, and that "common sense" about the addiction could be
realized again. I felt like a human being with a problem rather than a
human being with an abnormal weakness. This was to become a very
important distinction, that eventually helped to discover things that
freed me from the addiction and the recovery process itself.

it is not too hard to see that if addiction was a weakness, then I would
always be in a state of vigilance and anxiety about keeping the addiction at bay..
and in this everchanging and unpredictable world...it is common sense that in the long run, I would most probably succumb to it at sometime throughout the remaining time of my life. This alone would undermine any effort of ever feeling realizing a solid, trusting
feeling of "recovery" and I would probably never feel like I could
"trust myself" again... and how can a person ever re-trust themselves
and lose the self-doubting fear of an addiction, if they feel cannot
trust themselves?

Although physically not drinking is a valuable step toward recovery,
It was such CHANGES of my MINDSET that was allowing me to FEEL to recovered, because it helped change how I FELT, about what I was desperately struggling to do.

When a MINDSET changes, the FEELINGS can naturally follow, or align with "common sense" . Basic feelings can then "re-align" away from the daily
addictive life, and return to the person's original (or additional)
interests or concerns, pursuits, passions and pleasures in life. You do
not really "take on a new, consciously fabricated "sober" life, but you
can "re-align" with the original design, or person that you are.
Sobriety
is a natural state of ALL living things. At some point in the recovery
process it does not need to be consciously "maintained". But only the
individual can know this, because it is a feeling, not a thought, hope,
wish or belief.

It was a profound discovery to finally realize (and feel) that "sober"
is the "default" of all living things... that at some point, sobriety
is not something that needs to be "maintained" or "sustained". Since it
is the very nature of life itself, you can trust, re-discover and feel
yourself trust again.

In hindsight, it is now quite clear that it was the ADDICTIVE
lifestyle that had to be vigilantly maintained and sustained; not
sobriety. And the FREEDOM from that daily addictive and restrictive
lifestyle and activities, undermines the desire to return to that
prison - that day-to-day way of living that was a way of life for so
long. In short, the WANT to stop drinking can be realized and it is not
just a thought, wish, hope or belief. It is a feeling.

EXAMPLE #2

Two Views, 180 degrees different ( but neither good nor bad)

It had always felt that it was "written in stone" that drinking was invaluable for getting through life. I had struggled and carved out a niche just trying to get through life.
Sometime during my recovery period, I said to someone, "I couldn't have gotten this far in life without drinking "..... and without a beat, and in an objective, calm tone they replied :
"or you could say, you have gotten this far in life DESPITE the drinking."

At the time, I poo-poo-ed this as a cute and clever use of semantics... but in actually, it is profound. Note that there are two views, or Mindsets, of the same identical thing..all in one sentence. This is an example of Reframing the viewpoint. And although you can THINK about both views, how you FEEL is probably either one or the other.

Now.... how can a person change how they FEEL about something, it that is indeed how they feel about it?

Topic Titles for A THIRD VIEW

The following is a new model for Addiction that I have been working on for a few years.

It was arrived at in Hindsight, so not a really a theory or speculation.

The working title is the DILECTION Model, (Di`lec´tion .1.Love; choice.)

This Model considers the attraction, desire and bonding that occur with an addiction are the very same thing as the attraction, desire and bonding that occur with Love.

Seen this way, Recovery is when the attraction and desire change, and the bond is no longer binding.

so it is not really an analogy, I am still working on the wording to make it clearer.

It is commonly understood that solid and long-term friendships, marriages, and partnerships can linger for life, the want and desire forever remaining.
Human history, stories, films and books are filled examples of this.

It is also commonly understood that solid and long-term friendships, marriages, and partnerships that have ended, sometimes abruptly, and with no lingering desire to return.
Plays, stories, films and books are filled with unrequited love, where long-term friendships, marriages, partnerships come to a physical end, yet the desire and want to return, remain for life.
Addiction will no longer be seen only as a terminal, uncurable disease per se, yet will still be understood as a very serious even a life- threatening thing.

A public service of the Dilection Model, will be to
allow the public to relate to addiction in a new and familier way, and lift the mystery and stigma surroundng it.

Oddly , I think some of the pop-music lyrics and song titles from the last few decades will underscore this new Public understanding.

The stigma may finally shift away from fear and puzzlement, to sympathy and understanding for the addicted.

Section I:

Relapse and Spontaneous Remission in the Dilection Model of Addiction

Relapse:
Realizations that generate the indelible feelings of freedom from an addiction can to occur, sometimes after relapses.
Deep, existential realizations such as choosing, or not choosing to live with the addiction may occur.

The Dilection Model of Addiction can account for this.
Most people have experienced existential realizations of this nature in their human, pet and other relationships.
These types of realizations have been depicted in key scenes from numerous plays, films and books throughout time.

It is commonly understood that solid and long-term friendships, marriages, and partnerships can linger for life, the want and desire forever remaining.
Human history, stories, films and books are filled examples of this.

It is also commonly understood that solid and long-term friendships, marriages, and partnerships that have ended, sometimes abruptly, and with no lingering desire to return.
Plays, stories, films and books are filled with unrequited love, where long-term friendships, marriages, partnerships come to a physical end, yet the desire and want to return, remain for life.

Sudden, or Spontaneous Remission
Sudden, or Spontaneous Remission describes when a persons addictive feelings, thoughts and behavior instantly change and they are no longer craving or be interested in the addiction.
Time is not an element, and this occurs at all levels of addiction.

In the physical medical field, the factors or mechanisms responsible for spontaneous regression are currently obscure or unknown.

But this is readily known in human relations, and the Direction model for Addiction can account for this.
It is common knowledge that long-term and intense friendships, loyalties etc, can instantly change, due to a realization that occurs.

Specific and actual accounts of these instant changes are key scenes in numerous plays, films and books throughout time.

(These will be uploaded in time, but feel free to inquire)

"WHO AM I TO KNOW WHO I AM ?!"
"WHEN do you know you can TRUST YOURSELF AGAIN?"
"Why it is not "SUCCESS" but a "REALIZATION "
"UN-HOBBLED SPONTANEITY .. AH YES"
"ARE YOU RECOVERING or RETIRING?"
" BRUSHING TEETH, TRIMMING NAILS, MEDITATING, etc... THEY are SIMPLY HYGIENE, not REMEDIES"
"BODY/MIND/SPIRIT anything missing?"

"Discovering what does NOT work is just as valuable"
"RECALLING some of the RECOVERY PROCESS "
"WHAT will they THINK?"
"IT CAME DOWN TO THIS"
"THE WELL-WORN HANDLES OF CONTROL"
"That "NORMAL PEOPLE" Issue"
"AIR, WATER, FOOD AND ALCOHOL"
"OTHERS CAN, I CANNOT"
"THEY MUST BE SUPERMEN"
"The relevancy or irrelevancy of "TRIGGERS"
"RIGHT WAY/WRONG WAY... relevant or irrelevant ?

"MISSING THE BOAT"
"SOBER is a DEFAULT"
"LEST I FORGET'
"CANT IMAGINE HOW"
"AN INCONVENIENT TRUTH"

"YOU cant READ the writing on the when your back is up AGAINST
it."
"THE IRRATIONALITY of VIGILANCE"
" THE BEAUTY OF THE IRRATIONAL "
"SOME MAJOR INSIGHTS" (a few horrendous experiences without returning
to alcohol)
"MYTHOLOGICAL AHA'S"
"WATERCOLORS & TURPENTINE"

"ACCIDENTAL MYTHS"
"15 MINUTES, 15 HOURS 15 DAYS OR 15 YEARS-.."
"THE DEPTHS OF DESPONDENCY "
" The Trauma of LOSS, or the Trauma of BIRTH?

"AT THE END OF THE ROPE"
"WHEN THE STONE CRACKS"
"WHEN THE LEVI BREAKS"
"TERRIFYING to some , LIBERATING to others"
"The POLAR EXPLORER Analogy"

"MORE HERETICAL THOUGHTS AND IDEAS " (this my be deleted)

Example #3

Recovery-Relapse-A REALIZATION-Recovery

In hindsight, I can clearly see that a key revelation in my personal recovery, was the due to the last relapse I had.
Relapses can build up a horrendous feeling of despondency,
and at the same time they can lead toward breakthroughs, or critically valuable shifts in a persons "mindset" about an addiction and their dependance on it.

In 2001, after seemingly endless years of false starts & stops, hospital stays, detox, forays into recovery programs, private therapists, self-help books, drinking books,
etc, etc, I finally managed to go for the longest time ( a few months) without drinking.

Here is the description of the relapse:
I vividly remember the moment of drinking that followed that sobriety spell. I do not remember the actual situation or event that would be traditionally considered the "trigger", but I do remember the overwhelming sense of anxiety and finally saying "fuck it" , and going into the liqueur store and buying my old "usual" (1/2 pink vodka) , and walking down the sidewalk swigging it.... feeling certain and finally relieved that I was returning to something that could actually provide instant relief. and as I got inebriated. I felt two simultaneous feelings.. the first thing that I was back to "my way".., those hard fought for days and weeks were felt history, and seemed like they never seemed to have happened.

Now this may seem a frivolous and comic analogy, but up to now, the majority of the periods restraining from drinking (aka, "sobriety') seemed like an old popular TV dog commercial where a dog is shown balancing a dog biscuit on his nose.. that is all you see.. and the dog is quivering in anticipation-.. and a voiceover is talking about the product..
and after a seemingly endlessly long period, the dogs masters voice says 'ok!" and INSTANTLY the dog twirls his head and the dog biscuit disappears-..
(I copied & pasted a youtube address to see a dog video of something like this:

http://www.youtube.com/watch?v=Nq5RQJDMRWI&feature=related

Now.... how can a person in the midst of a debilitating addiction not perceive "sobriety" as a very self-conscious, angst -filled period that simply separates the times between "biscuits??

But as mentioned earlier, there was another feeling.

If felt like a relationship had come to a crossroads.
A horrific realization came over me that either I was going to always drink, or never drink. It was like the feeling when you realize a relationship has permanently changed, and it was going to be either all or nothing, and this realization was completely between me and myself.

It felt like it may be a feeling that people (like the Olympic athlete example above, or a musician that re-dedicates themselves to another cause, or career, etc), feel when they find they are going to be doing something the rest of their lives, or change direction completely.
There is feeling or relief when you feel you re not going to try to hang on to something, even when it seems critical an invaluable.

I guess a modern version is when a hardive have a problem and you spend days trying to get it going.
When yu finally feel you have looked under every stone for a way to resurrect it, and you accept that its over.
Its still sitting there, but your feelings and efforts "shift",
and you realize you will be living without what was on it, and proceed with your life. Sometimes this forced re-beginning begins to feel refreshing, because you are not "holding on" anymore and are re-establishing yourself.

To continue the analogy, I accidentally ingested a few ounces of alcohol several years after my personal recovery process, and found the alcohol effects identical, but instead of feeling relieved and freed, I felt limited and trapped.
It was like getting the hardive working again, and you discover that you have " moved on" and the old files are dated and no longer of value or desire. because you have continued on found your newer ways of doing things, and not cling to something, that you thought you could never be without, and would always be a loss, but in hindsight, you are glad you
didn't stay in the relationship.

A little about the blogger

By the late 1970's I was dependent on alcohol, and in the mid-1990's, began doing something about my drinking addiction. I got involved with several recovery programs.
such as AA, Cornerstone, St, Judes, Peter Styvesant, and SMART Recovery.
I went through a couple of detoxes , and have been hospitalized due to the drinking a few times. In early 2002 , I physically ended the alcohol dependency, and later became fully independent from the alcohol addiction in from about late 2003 to early 2004.

By the way, I usually only did something about my drinking when life forced me to, so I am no "hero" or "warrior", and many uncomfortable feelings, like feeling scared, afraid, and hopeless during the recovery process simply cannot be expressed in text, but they were horrendous and extreme, and yet strong motivations for venturing into unexplored , and unknown territory, that were essential for realizing things that may not have been realized otherwise.

"A Recovery Group for Loners"

As a kid, I had once dreamed that a magician was transforming my face into an infinite variety for facial features..
I feel thrilled and excited.. what a feeling of expectation. to have any face you WANTED!
But after a while, and after a plethora of combinations, and fascinating possibilities, I eventually felt that the one that I would ultimately feel most comfortable with, would be my original face.
And thats what I wanted to do when I sought help from drinking, Initially, the Alcohol was offering a whole new "me".. and a whole new and improved way of seeing and feeling related to the world. During the years of drinking, the great fear was going back to that bland, dull, uninspired original me.

but eventually the "Drunk Me" became something I felt stuck with.. in fact, IMPRISONED with, and the seemingly unending struggle to become the "SOBER ME" did not seem to be the REAL me, if felt "unnatural" to be vigilant and MAINTAIN myself FROM myself... but I am getting way ahead of myself here.

Various thoughts garnished from all over

"No work or love will flourish out of guilt, fear, or hollowness of heart, just as no valid plans for the future can be made by those who have no capacity for living now."
Alan Watts

"For many an individual entity those things that are of sorrow are the greater helps for unfoldment. "
Edgar Cayce

"Everything that the human race has done and thought is concerned with the satisfaction of deeply felt needs and the assuagement of pain. Feeling and longing are the motive force behind all human endeavor and human creation."
Albert Einstein

If it is held . . . as a cross, it will remain as one . . . with individuals where there is in their experience crosses to bear, hardships or surroundings that to them are overpowering, overwhelming, by slights, slurs, and fancies of the inactivity of a coordinating force. If these are held continually as crosses, or as things to be overcome, then they will remain as crosses. But if they are to be met with the spirit of truth and right in their own selves, they should create joy; for that is what will be built.
Reading 552-2

conversations

A friend and I go into spirals of spontaneous dialogue that runs back and forth across the full spectrum of possibilities... from the most deep and profound to the most outrageously absurd,irreverent and ridiculous. Its about the inner dialogues, questions and pondering that can go on in a persons mind as they wrestle with the the seemingly endless fight between drinking or not drinking. We banter about and embody the various voices and posturing that goes on during struggle with drinking and recovering. Here is a test try at a sample of one of our
dialogues:

"".... When yer burrowed in real deep, its Ok.....cus even thou yo's Hates yourself, know yer also scared shittless that yer might hav ta go though life WITHOUT this little private burrow to hide in, This endless drinkin has gotten f*ckin scary, but at some point every day its f*ckin COMFY in there!!..

Ya Know, ... its like everyone out there is tryin to cox you out of the warm little burrow....... "c'mom on out little puppy,.. c'mon out.. we'er all worried about yea..and yer gonna LIKE it out here in the sunny sober sunshine.. ..
OH Yeah!??....well its it so f*ckin wonderful.. how cum it aint Pullin me like a f*ukin MAGNET !!....

...thats a first try , waddya thunk?

A persons recovery process can morh. It can begin with diligence, limitations, control, but morphs into things like re-framing perceptions and allowing the heart-based feelings to blossom in areas that were E=eclipsed during the Addictive period of ones life. When these regain their natural gravity, Things like diligence, limitations, control, may no longer be necessary..

Consider this:
If you loose the desire and interest in something, say... a TV show, or a Musical Band, a person, etc... will you need to "Maintain" your loss of interest and desire for the rest of your life?
Rather, you probbly have "realizations" mentally, and emotionally about it.

Once you go though an intense involvement or infatuation or something, and then distance yourself because you want too, Your perception changes, and your feelings about it change too.

I dare say the motivators fro regaining ones freedom for an addiction, can be based on love, realizations, discoveres, and even respect one has for oneself, rather than fear and shame and guilt of oneself.

Article #001

Rethinking Addiction’s Roots, and Its Treatment

By DOUGLAS QUENQUA

Published: July 10, 2011

comments (263)

There is an age-old debate over alcoholism: is the problem in the sufferer’s head — something that can be overcome through willpower, spirituality or talk therapy, perhaps — or is it a physical disease, one that needs continuing medical treatment in much the same way as, say, diabetes or epilepsy?

Increasingly, the medical establishment is putting its weight behind the physical diagnosis. In the latest evidence, 10 medical institutions have just introduced the first accredited residency programs in addiction medicine, where doctors who have completed medical school and a primary residency will be able to spend a year studying the relationship between addiction and brain chemistry.

“This is a first step toward bringing recognition, respectability and rigor to addiction medicine,” said David Withers, who oversees the new residency program at the Marworth Alcohol and Chemical Dependency Treatment Center in Waverly, Pa.

The goal of the residency programs, which started July 1 with 20 students at the various institutions, is to establish addiction medicine as a standard specialty along the lines of pediatrics, oncology or dermatology. The residents will treat patients with a range of addictions — to alcohol, drugs, prescription medicines, nicotine and more — and study the brain chemistry involved, as well as the role of heredity.

“In the past, the specialty was very much targeted toward psychiatrists,” said Nora D. Volkow, the neuroscientist in charge of the National Institute on Drug Abuse. “It’s a gap in our training program.” She called the lack of substance-abuse education among general practitioners “a very serious problem.”

Institutions offering the one-year residency are St. Luke’s-Roosevelt Hospital in New York, the University of Maryland Medical System, the University at Buffalo School of Medicine, the University of Cincinnati College of Medicine, the University of Minnesota Medical School, the University of Florida College of Medicine, the John A. Burns School of Medicine at the University of Hawaii, the University of Wisconsin School of Medicine and Public Health, Marworth and Boston University Medical Center. Some, like Marworth, have been offering programs in addiction medicine for years, simply without accreditation.

The new accreditation comes courtesy of the American Board of Addiction Medicine, or ABAM, which was founded in 2007 to help promote the medical treatment of addiction.

The board aims to also get the program accredited by the Accreditation Council for Graduate Medical Education, a step that requires, among other things, establishing the program at a minimum of 20 institutions. The recognition would mean that the addictions specialty would qualify as a “primary” residency, one that a newly minted doctor could enter right out of school.

Richard Blondell, the chairman of the training committee at ABAM, said the group expected to accredit an additional 10 to 15 institutions this year.

The rethinking of addiction as a medical disease rather than a strictly psychological one began about 15 years ago, when researchers discovered through high-resonance imaging that drug addiction resulted in actual physical changes to the brain.

Armed with that understanding, “the management of folks with addiction becomes very much like the management of other chronic diseases, such as asthma, hypertension or diabetes,” said Dr. Daniel Alford, who oversees the program at Boston University Medical Center. “It’s hard necessarily to cure people, but you can certainly manage the problem to the point where they are able to function” through a combination of pharmaceuticals and therapy.

Central to the understanding of addiction as a physical ailment is the belief that treatment must be continuing in order to avoid relapse. Just as no one expects a diabetes patient to be cured after six weeks of diet and insulin management, Dr. Alford said, it is unrealistic to expect most drug addicts to be cured after 28 days in a detoxification facility.

“It’s not surprising to us now that when you stop the treatment, people relapse,” Dr. Alford said. “It doesn’t mean that the treatment doesn’t work, it just means that you need to continue treatment.” Those physical changes in the brain could also explain why some smokers will still crave a cigarette 30 years after quitting, Dr. Alford said.

If the idea of addiction as a chronic disease has been slow to take hold in medical circles, it could be because doctors sometime struggle to grasp brain function, Dr. Volkow said. “While it is very simple to understand a disease of the heart — the heart is very simple, it’s just a muscle — it’s much more complex to understand the brain,” she said.

Increasing interest in addiction medicine is a handful of promising new pharmaceuticals, most notably buprenorphine (sold under names like Suboxone), which has proved to ease withdrawal symptoms in heroin addicts and subsequently block cravings, though it causes side effects of its own. Other drugs for treating opioid or alcohol dependence have shown promise as well.

Few addiction medicine specialists advocate a path to recovery that depends solely on pharmacology, however. “The more we learn about the treatment of addiction, the more we realize that one size does not fit all,” said Petros Levounis, who is in charge of the residency at the Addiction Institute of New York at St. Luke’s-Roosevelt Hospital.

Equally maligned is the idea that psychiatry or 12-step programs are adequate for curing a disease with physical roots. Many people who abuse substances do not have psychiatric problems, Dr. Alford noted, adding, “I think there’s absolutely a role for addiction psychiatrists.”

While each institution has developed its own curriculum, the basic competencies each seeks to impart are the same. Residents will learn to recognize and diagnose substance abuse, conduct brief interventions that spell out the treatment options and prescribe the proper medications. The doctors will also be expected to understand the legal and practical implications of substance abuse.

Christine Pace, a 31-year-old graduate of Harvard Medical School, is the first addiction resident at Boston University Medical Center. She got interested in the subject as a teenager, when she volunteered at an AIDS organization and overheard heroin addicts complaining about doctors who could not — or would not — help them.

This year, when she became the in-house doctor at a methadone clinic in Boston, she was dismayed to find that the complaints had not changed. “I saw physicians over and over again pushing it aside, just calling a social-work consult to deal with a patient who is struggling with addiction,” Dr. Pace said.

One of her patients is Derek Anderson, 53, who credits Suboxone — as well as a general practitioner who six years ago recognized his signs of addiction — with helping him kick his 35-year heroin habit.

“I used to go to detoxes and go back and forth and back and forth,” he said. But the Suboxone “got me to where I don’t have the dependency every day, consuming you, swallowing you like a fish in water. I’m able to work now, I’m able to take care of my daughter, I’m able to pay rent — all the things I couldn’t do when I was using.”

http://www.nytimes.com/2011/07/11/health/11addictions.html?ref=sunday

Article #002

Opinion

Addictive Personality? You Might be a Leader

By DAVID J. LINDEN

Published: July 23, 2011

WHEN we think of the qualities we seek in visionary leaders, we think of intelligence, creativity, wisdom and charisma, but also the drive to succeed, a hunger for innovation, a willingness to challenge established ideas and practices.

But in fact, the psychological profile of a compelling leader — think of tech pioneers like Jeff Bezos, Larry Ellison and Steven P. Jobs — is also that of the compulsive risk-taker, someone with a high degree of novelty-seeking behavior. In short, what we seek in leaders is often the same kind of personality type that is found in addicts, whether they are dependent on gambling, alcohol, sex or drugs.

How can this be? We typically see addicts as weak-willed losers, and chief executives and entrepreneurs are people with discipline and fortitude. To understand this apparent contradiction we need to look under the hood of the brain, and in particular at the functions that relate to pleasure and reward.

As a key motivator, pleasure is central to learning; if we did not find food, water and sex rewarding we would not survive and have children. Pleasure evokes neural signals that converge on a small group of interconnected brain areas called the medial forebrain pleasure circuit — tiny clumps of neurons in which the neurotransmitter dopamine plays a crucial role.

This dopamine-using pleasure circuitry, refined over millenniums of evolution, can also be artificially activated by some, but not all, psychoactive substances that carry a risk for addiction, like cocaine, heroin, nicotine or alcohol. Our brain’s pleasure circuits are also hard-wired to be activated by unpredictable rewards: While a roulette wheel is spinning or horses are on the track, we get a pleasure buzz even if we don’t get a payout in the end. Uncertainty itself can be rewarding — clearly a useful attribute for high-risk, high-reward business ventures.

So why do some people become addicted to drugs, alcohol, gambling or sex while others can indulge in a moderate, noncompulsive manner? One hypothesis is that addicts feel those pleasures unusually strongly and are motivated to seek them more intently. It’s reasonable, but wrong. Evidence from animal experiments and human brain scans indicates that the opposite is true: Addicts want their pleasures more but like them less.

We’re now starting to understand the biology behind the blunted pleasure of addicts. From studies comparing identical and fraternal twins, it is estimated that genetic factors account for 40 to 60 percent of the variation in the risk for addiction. But we are only in the early stages of understanding the role of genes in addiction; there is no one “addiction gene,” but it is likely that a large number of genes are involved in this complex trait.

Crucially, genetic variants that suppress dopamine signaling in the pleasure circuit substantially increase pleasure- and novelty-seeking behaviors — their bearers must seek high levels of stimulation to reach the same level of pleasure that others can achieve with more moderate indulgence. Those blunted dopamine receptor variants are associated with substantially increased risk of addiction to a range of substances and behaviors.

Is there a silver lining to the addictive personality? Some of our most revered historical figures were addicts — not only the obvious creative types like Charles Baudelaire (hashish and opium) and Aldous Huxley (alcohol and the nonaddictive hallucinogens mescaline and LSD), but also scientists like Sigmund Freud (cocaine) and warriors and statesmen from Alexander the Great and Winston Churchill (both known to be heavy drinkers) to Otto von Bismarck, the unifier of Germany, who typically drank two bottles of wine with lunch and topped them off with a little morphine in the evening.

Leaders in America rarely admit to addictions in public, but one recent example is Henry T. Nicholas III, a founder of Broadcom, a multibillion-dollar company that makes microchips for cellphones, game consoles, wireless headsets and other electronic devices. Starting with a $10,000 investment, Mr. Nicholas and his partners created a company that now has 9,000 employees and 5,100 patents. Along the way, he struggled with alcohol, cocaine and Ecstasy; he entered a rehab program in 2008. (He also successfully fought off criminal charges related to backdating stock options and drug distribution.)

The risk-taking, novelty-seeking and obsessive personality traits often found in addicts can be harnessed to make them very effective in the workplace. For many leaders, it’s not the case that they succeed in spite of their addiction; rather, the same brain wiring and chemistry that make them addicts also confer on them behavioral traits that serve them well.

So, when searching for your organization’s next leader, look for someone with an attenuated dopamine function: someone who is never satisfied with the status quo, someone who wants the feeling of success more than others — but likes it less.

http://www.nytimes.com/2011/07/24/opinion/sunday/24addicts.html?ref=global

In-hindsight

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