LifeRing in New Living (NY)

An excerpt adapted from Chapter 2 of my new book (Empowering Your Sober Self) appears in the April issue of New Living, a free 20-p health and wellness newspaper published in Stony Brook NY and distributed in the New York City area and Long Island.

This chapter from my book contains a set of tips and exercises designed to help the person who wants to stop using addictive substances to move across the gap from contemplation to action. They include visualization, laughter, self-forgiveness, reframing, exercise, and other attitude-builders. I wrote a 900-word excerpt for the paper.

The editors took some minor liberties with the chapter. They took the sentence, "Becoming drug or alcohol-free can exhilarate you and enable you to accomplish great things in life," and added the phrase "... and perhaps, more importantly, give you gratitude and humility, two spiritual qualities hard to find in most people."

OK, I may not be the most original writer in the world. But I try not to stoop to moth-eaten cliches like "gratitude and humility." But it's good to have the article in the paper, with a plug for the book, and a plug for the two LifeRing meetings in Long Island; and I guess there's a small price to pay for that. I am humbly grateful.

Don't drink that marshmallow

The marshamallow experiments are famous by now, thanks in large part to Daniel Goleman's Emotional Intelligence books, and their relevance to addiction seems obvious.  In 1968, Stanford psychology prof Walter Mischel presented four-year olds with a marshmallow and the choice: Eat it now, or wait 15 minutes and get two.  The kids who could delay the gratification ended up, a decade and more later, with higher SAT scores, higher graduation rates, better jobs -- in short, twice as many of the marshmallows life had to offer.  

It was often believed that the kids who could delay gratification did so thanks to more "will power."  Mischel -- according to a helpful and informative summary in this week's New Yorker, by Jonah Lehrer -- analyzed what this "will power" really consisted of.  He paid very careful attention to what went through the delaying kids' minds as they resisted the bait.  They succeeded because they had methods of distracting their minds from the lure.  They covered their eyes, or played hide-and-seek under the desk, or sang songs.  "Their desire wasn't defeated -- it was merely forgotten."  The key, Mischel found, was not to resist the marshmallow -- that didn't work --- but to avoid thinking about it.  

In further experiments, Mischel found that children could be taught cognitive tricks that helped them distract themselves.  Even reducing the intensity of the temptation by pretending that the marshmallow was only a picture of a marshmallow or that the marshmallow was really a cloud worked for some children.   

Mischel and other researchers Lehrer quotes are skeptical of finding a genetic basis for the ability to delay gratification.  Too many genes are involved in even the simplest aspects of personality.  The cutting edge of research lies in classroom curricula that teach self-distraction, and in educating parents to cultivate simple cognitive skills in children.  Says Mischel:

"We should give mashmallows to every kindergartner... We should say, 'You see this marshmallow"  You don't have to eat it.  You can wait.  Here's how.'"

Another Court Rules that AA/NA are Religious

A recent court case ruled that a parolee can sue a parole officer for damages if the parole officer requires the parolee to attend 12-step groups such as Alcoholics Anonymous or Narcotics Anonymous when this violates the parolee's religious or non-religious beliefs.

The case is titled Inouye v. Kemna, issued Sept. 7, 2007. The full text of the opinion is here. The court that issued the decision is the Ninth Circuit of the United States Courts of Appeal. The court's ruling is the law in California, Oregon, Washington, Arizona, Montana, Idaho, Nevada, Alaska, Hawaii, Guam, and the Northern Mariana Islands.

Ricky Inouye was imprisoned in Hawaii after conviction on drug charges, and served his time. As a Buddhist, he objected to participating in 12-step treatment programs because of their religious nature. After his release, he sued his parole officer, Nanamori, for giving him the "choice" of AA/NA meetings or prison.

When that case came to trial in the federal court in Hawaii, Nanamori argued that he, a parole officer, could not have known whether AA/NA are "religious" because the law on that issue was foggy at the time he ordered Inouye to participate (2001). If the issue was unclear, Nanamori was immune from suit. Nanamori won on that issue in the lower federal court in Hawaii. Inouye (or rather his son Zenn, Ricky having meanwhile died) appealed to the Ninth Circuit.

The Ninth Circuit's opinion makes short work of the claim that the law was fuzzy on the religious nature of AA/NA. The court points to virtually identical cases decided before 2001 by the federal courts of appeal for the Seventh Circuit (Illinois, Indiana, Wisconsin) and the Second Circuit (New York, Connecticut, Vermont), in addition to a string of similar cases in lower federal courts and in state courts, all with the same result. The "unanimous conclusion" of these courts was that coercing a person into AA/NA or into AA/NA based treatment programs was unconstitutional because of their religious nature. Because the law on this issue was "uncommonly well settled," Nanamori cannot claim immunity.

Accordingly, the Ninth Circuit sent the case back to the lower federal court in Hawaii to decide how much, if anything, Nanamori has to pay Inouye's estate in monetary damages.

The court's ruling means that criminal justice officers -- or, arguably, any agents of the state, local, or federal government within the bounds of the Ninth Circuit -- can be sued for damages if they ignore a client's religious or anti-religious objections and coerce the person to attend 12-step meetings or 12-step based treatment programs.

What should prisoners, parolees, and criminal justice officers do in response to this ruling?

(1) Prisoners and parolees who have problems with the religious content of 12-step programs should stand up for their beliefs and make their objections heard, loud, clear, early, and on paper. In this case, Ricky Inouye won in part because he wrote letters and filed suit promptly after he was coerced into 12-step programs. He held to his position consistently, and enlisted legal help as soon as possible. Prisoners and parolees need to make it clear both in words and deeds that they earnestly want to remain clean and sober, that they are willing to participate in alcohol and other drug treatment programs and to attend support groups, but that the religious content in the 12-step programs violates their constitutionally protected beliefs and interferes with their recovery. Prisoners and parolees can match these words with actions by demanding referral to non-religious (secular) treatment options, if they exist, and by taking the initiative to organize secular support groups, such as LifeRing, on their own.

(2) Officials in the criminal justice system (and other government officials with coercive powers over addiction offenders) need to offer their clients a choice between religious and secular treatment programs and support groups. The "choice" between AA/NA or prison offends the constitution, and officers who insist on it need to check their professional liability insurance. Government officials can help themselves as well as their clients by sending the message to treatment programs that the programs must embody a secular track along with the 12-step track, or risk losing referrals. Officials need to inform themselves and their clients about the availability of secular support group alternatives, such as LifeRing. Where clients take the initiative to organize such support groups, officials need to be cooperative and provide a level playing field when it comes to rooms, publicity, literature, referrals, and other resources. In an appropriate case, officials may take the lead in initiating secular support groups themselves.

The Ninth Circuit decision ruffles some feathers because it contradicts the belief of many AA/NA members that the 12-step approach is "spiritual not religious." Of course, these words can have many meanings. But as far as the First Amendment of the US Constitution is concerned, the 12-step approach is clearly religious, and the Ninth Circuit only joins a "march of unanimity" of other courts who have come to the same conclusion.

The basic thrust of this line of cases is that the constitutional guarantee of freedom of and from religion extends over the whole of the United States, including the ever-expanding areas enclosed by prison walls. Since such a large proportion of prisoners are there because of drug and/or alcohol abuse, this recent ruling serves as an important refresher. Jails and prisons, notoriously in California, are overcrowded and in deplorable condition. The Ninth Circuit's decision says that the freedom of religious belief or disbelief must not go down the drain along with so many other elements of civilized penal treatment.

Reviews Pan Bill W bio-drama

March 6, 2007, N.Y. Post:

Who would have guessed a drama about the founders of Alcoholics Anonymous would be the laugh riot of the year? But that's the unfortunate result of "Bill W. and Dr. Bob," the well-intentioned but haplessly executed effort written by novelist Stephen Bergman and clinical psychologist Janet Surrey that opened last night.

What should have been a powerful and inspirational story plays instead like a drunken road-show version of "The Producers."

Read full review

Broadway World.Com's reviewer writes:

A program note for Stephen Bergman and Janet Surrey's Bill W. and Dr. Bob advises us that performance of the work does not imply affiliation with nor approval or endorsement from Alcoholics Anonymous World Services, Inc.

Smart move, A.A.

Doing for alcoholism what Reefer Madness did for drug abuse (or at least what its New World Stages neighbor Sealed For Freshness does for Tupperware), Bill W. and Dr. Bob is a frightfully melodramatic bio-drama which uses the same kind of character-probing sensitivity one might find in a driver ed movie to tell the story of two men who, in dealing with their own demons, developed the treatment techniques that would birth Alcoholics Anonymous.

... The authors turn their heroes and everyone around them into cardboard cutouts ... while I can't imagine anyone feeling inspired or enriched by this misdirected corn, I know a few more evenings like this could have me swearing off theatre for a while.

Source.

New study confirms dopamine depletion

A researcher at the University of Buffalo's Research Institute on Addictions (RIA) has found a change in the brain that occurs after drug use and that may contribute to drug addiction.

The finding, reported in the January issue of Biological Psychiatry, demonstrates that repeated exposure to different types of drugs of abuse, such as cocaine, nicotine, amphetamine and alcohol, lead to a persistent or long-term reduction in the electrical activity of dopamine neurons in the brain.

Dopamine neurons are the origin of the reward pathway responsible for the "feel good" experience that is such a strong component of drug use and abuse.

"A persistent reduction in dopamine neuron electrical activity after repeated exposure to different types of drugs appears to be the result of excessive excitation of dopamine neurons," according to Roh-Yu Shen (photo), a neuroscientist and the lead investigator on the study. "This represents a new and potentially critical neural mechanism for addiction and provides a working model that suggests how the reward pathway function is altered and how these changes can be responsible for triggering intense craving and compulsive drug-seeking." Source.

Man convicted of tenth DUI

What's wrong with this picture?

SALEM, MA: An Arlington man will spend up to five years in prison after he was convicted of his tenth drunk driving offense.

According to prosecutors, John McNeil, 43, drove through a stop sign in Haverhill on Christmas Day in 2005 and crashed into an ambulance responding to a call with its lights flashing.

The crash injured two emergency medical technicians.

McNeil had been convicted of drunken driving eight times in Massachusetts and once in New York before this incident, according to court documents.

McNeil's lawyer said his client is "a decent guy who has a severe alcohol problem." Source.

Why are felonies committed with automobiles considered more excusable than those committed with bare fists or ax handles? If this man had done a string of any other crimes he would have been in prison long term after the second or third offense, severe alcohol problem or not. He's not to be blamed for his alcoholism. He is responsible, though, for his decision to drive. The laws that allowed him back on the road again and again and again are broken. They need to be fixed, or they're meaningless.

Alcoholism a "disinhibitory disorder"

Alcohol dependence is linked with impaired impulse control, as are several psychiatric disorders, a study led by Bernice Porjesz, professor and director of the Henri Begleiter Neurodynamics Laboratory at SUNY Downstate Medical Center, has found. The study is said to be the first that strongly links alcoholism to malfunctions in the frontal lobe of the brain. Older studies typically locate factors associated with alcoholism in the more primitive lower brain regions. Discussion. Abstract.

More women in jail, their children in foster homes

Between 1977 and 2001, figures from the Women's Prison Association show a 592 percent increase in the number of women jailed, from 12,279 to 85,031. According to the WPA, the growth "corresponds directly to the mandatory minimum sentencing laws in effect since the early 1970s. Since more women are convicted for nonviolent, drug-related crimes than for any other, these sentencing policies have had a particularly profound effect on women."

Though men still far outnumber women in arrests for drug-related crimes, women now represent the fastest-growing prison population nationwide for drug offenses. In 1996, the number of female state and federal inmates in jail for drug crimes grew at nearly double the rate of males. In New York State, whose Rockefeller Drug Laws are among the harshest sentencing laws in the country, nearly half of all women in prisons are serving time for drug-related offenses.

Seventy percent of women in jails and 65 percent of women in state prisons are mothers of minor children, according to the National Institute of Corrections. Not surprisingly, 80 percent of children in the foster care system are the offspring of incarcerated parents. Details.

Fewer heroin detox beds available

Just in time for the coming tide of cheap Afghan heroin, New York state has slashed the number of beds available for detoxing patients from opiates. Details.

Have another puff of polonium

Polonium, the radioactive element that killed Russian researcher Alexander Litvinenko in London last week, is present in cigarettes. A New York Times op-ed by Robert N. Proctor says that the tobacco industry "has been aware at least since the 1960s that cigarettes contain significant levels of polonium." Details.

So much for anonymity (again)

"Lindsay Lohan Attending AA," say the headlines in dozens of papers today, for example the Chicago Tribune. The story comes (of course) from Lohan's publicist, who knows that anything related to addiction guarantees headlines for his client. (Remember the adage: "There's no such thing as bad publicity.") And just to make sure that we know it's only a publicity stunt, the PR squirt adds that this doesn't mean Lohan is actually intending to give up drinking as soon as, say, next week. OK, but what about AA's role in all this? Didn't anybody clue in Lohan or her flack about Tradition whatever-it-is that requires "anonymity at the level of the press"? Maybe after AA has basked in the sunshine of these headlines for a week or so and the buzz begins to fade, AA World Services will issue a "tsk-tsk" admonition -- thus reviving the item for a few more days. As I've said here before, AA applies the anonymity rule only to its notorious losers like Mel Gibson.

Postscript Dec. 6: Right on schedule: just as the story about this bratty actress was beginning to bore readers to tears, the AA office in New York issues a pro forma admonition about anonymity ... and thereby gives the item new legs. Source.

Postscript Dec. 13: This story is being milked expertly, and the longer it lingers the more obvious it becomes that AA is very happy to have its name linked with Lohan's. Today's tidbit is that Lohan had been attending AA for a year before her announcement last week (e.g. source) , which suggests that the concept of "anonymity at the level of the press" would not be exactly news to her. She must have sought and got the green light from AA to go public, if in fact AA didn't encourage her to do so. In today's publicity-greedy AA, anonymity is only for losers like Mel Gibson.

Only about one out of a hundred newspapers and bloggers are noticing that Lohan's flashing her AA attendance, the way she used to flash her pantiless privates, is a bit out of sync with the anonymity concept.

Grand jury: Cop drove drunk, hit teens

Syracuse NY: – A grand jury has indicted the former Syracuse Police officer that allegedly drove drunk off duty and hit two teens in August.

26 year old Derek Backus, of Baldwinsville, allegedly drank with other officers in a police parking lot and later at a Syracuse bar, on August 2nd. Later that night, police say he was driving drunk and crossed the double yellow line on Route 57 in Clay, hitting a car with two teens inside, head on. Source.

"Reality" TV hyped with booze

Under the headline, "Drink Up. It’s Not Like You Have Lines to Learn," staff writer Heather Fletcher in Sunday's New York Times exposes one of the seamier sides of "reality" tv -- the use of booze to loosen the actors' tongues and generate unusual dialogue and action. She quotes a number of reality show veterans who say that alcohol was one of the producers’ favorite tools. Producers made alcohol, but not food, very available, and encouraged them to drink before emotional scenes.

Sarah Kozer was a contestant on the 2003 Fox hit “Joe Millionaire,” in which she and others competed to win the affections of a bachelor. She says she was drunk or close to it in 90 percent of her on-air scenes. Champagne was served with lunch, dinner and in between during her 29 days on the set, she said in a telephone interview: “It was available 24/7.”

A 10-hour date at a winery with Evan Marriott (the show’s male love interest) and a 10-hour grand ball with one tray of appetizers and unlimited Champagne led Ms. Kozer to one conclusion: Producers were trying to get her sloshed. “Anytime anyone ever wanted something to drink, it was made available,” said Ms. Kozer, 31, who works as a television host and writer in Los Angeles. “Whereas if you requested tampons you’d have to wait a couple days.”

Several reality tv producers denied the charges and asserted that all alcohol use on their sets was monitored responsibly. Read more.

Free-base nicotine: why cigs contain ammonia

Tobacco companies add ammonia and urea to cigarettes to make them more alkaline when hot. The alkaline pH converts nicotine into its free-base form, instantly absorbed in the lungs and transmitted to the brain. Without the ammonia and urea, nicotine would remain in its natural form and go to the stomach, taking a long time to get to the brain. Researchers think that the action of free-base nicotine is key to its highly addictive properties. Read more here in the Middletown NY Times Herald-Record.

Hello Faith, Goodbye Taxes

Religious employers don't have to pay into the state unemployment compensation fund, and ministers don't have to pay income tax on their housing allowances, says an article in today's New York Times. Source. In many states, religious publications are also exempt from the sales tax. The result is that religion gets a tax subsidy of at least $500 million a year -- a tax burden that's shifted to the rest of us, thank you. Among the consequences: treatment counselors working for "faith-based" agencies may not be eligible for unemployment compensation if they're laid off. See also Hello Faith, Goodbye Rights, below.

Hello Faith, Goodbye Rights

Addiction professionals concerned to upgrade their salaries, benefits, and professional standing need to read "Where Faith Abides, Employees Have Few Rights" in today's New York Times. Source. Correspondent Diana Henriques details a string of court cases in which employees of faith-based institutions have been denied elementary protections that employees of secular companies take for granted: disability rights, the right to pensions and healthcare, protection against sexual or other discrimination and harassment, against arbitrary firing, and for the right to organize, and others. Typical is the case of Sister Mary Rosati (right), dismissed from her order after she was found to have cancer. Faith-based employers run roughshod over employee rights under the doctrine of "church autonomy" or "ministerial exception." The spectre of the Bush administration's heavily subsidized "faith-based treatment" spells relapse for the few protections and benefits that addiction professionals have been able to win in recent years. See also Bush Spends 2.2 Billion (September) and Bush Taking the Axe to Recovery (2004).

Fraternities: Another Jungle

Upton Sinclair's novel The Jungle did more than any other single work to arouse public opinion against the malevolent excesses of the American meat packing industry, and to initiate its reform. Now another literary heavyweight, the prolific author Joyce Carol Oates, has come forward with a short story (Landfill in the current New Yorker, source) that ought to arouse a similar passion about the jungle of college fraternities.

Oates' fictional story describes the death of Hector Campos Jr., a Latino student at Michigan State University, who got drunk and either fell or was pushed down a trash chute into the dumpster behind the Phi Epsilon fraternity. Authorities found his body three weeks later -- three weeks of agony for his parents -- in the county landfill. Oates writes in a documentary style, sequencing factual detail after detail until the resulting tapestry becomes emotionally overwhelming.

Newspaper reports of real deaths of real college students don't seem to have made much of a dent in the college fraternity drinking scene. Source. Maybe Oates' intensely felt and written fictional piece in the New Yorker will succeed where journalism has failed. Thank you, Ms. Oates, for the effort.

Anonymity: Outing and Inning

A book review in this week's New York Observer observes that there is a rash of books now hitting the market in which more-or-less prominent people out themselves as AA members. Source. Cases in point: reporter Tom Sykes, Hazelden exec William Cope Moyers (son of the media icon Bill Moyers), reporter Jason Leopold, author Augusten Burroughs, and a number of others who are, in reviewer Choire Sicha's phrase, alcoholics who are "anonymous no more."

Sicha astutely observes that this small deluge of addict memoirs comes in the wake of James Frey's A Million Little Pieces, a work that was not flattering to AA or to the AA-based treatment industry. Frey's blockbuster stayed on the bestseller lists for a long time despite (or because of) Frey's grudging admission that some key points were fictitious. (Remember, "there's no such thing as bad publicity.")

Sicha sees no connection between the negative impact of Frey's bestseller and the current crop of pro-AA testimonials. He thinks the books just respond to a perceived public thirst for more addiction memoirs. He naively quotes Bill W. 's bromides about anonymity and humility, as if these had anything to do with how AA really operates. It doesn't occur to Sicha that this crop of promotionals might be a kind of P.R. campaign to counteract the shadow that Frey's book cast over some sacred cows of American recovery.

If you're a lovable celebrity, and you got sober in AA, AA itself will "out" you. You will be invited to speak at openly or covertly AA events, the press will be there, and you will be quoted about your successful recovery from alcoholism thanks to a 12-step recovery organization that you can't identify but whose abbreviated name has two identical letters which happen to fall at the beginning of the alphabet. And since there might be readers who still don't get it, you might as well, in your memoirs, name its name. As long as you remain a lovable celebrity, you will get no static from AA for bending your anonymity into a pretzel, or breaking it outright. On the contrary, you'll be lionized and in demand on the AA speaker circuit, and Hazelden may publish you.

"Outing" is a useful word. We also need a word for the opposite process, namely cloaking someone's AA affiliation after they've stopped being a lovable celebrity and become a big ugly public embarrassment. Will "inning" or "re-closeting" work? The most recent case in point is Mel Gibson, who had been attending AA religiously since 1991, and used to be a big lovable celebrity whose AA membership was a matter of public knowledge. All that changed when Gibson was caught on Aug. 28 driving drunk and spouting sexist, anti-Semitic, arrogant, belligerent and obscene remarks. Definitely not lovable. Suddenly the American press stopped referring to him as an AA member, and his story was reframed as if AA participation would be a New Thing for him and would Make a Difference. I've written about this case earlier here and here.

Anonymity? Humility? Those are only for the losers. Sicha's book review is that of an acolyte who can't or doesn't want to see through the cloud of spiritual smoke in the cathedral. Shouldn't journalists writing about others who break anonymity come out of the closet themselves?