You Can't Fall Out of a Hole: Ripping the Band Aid Off of Our Addiction Epidemic

By D. R. Osborne

1

Do you know anyone whose life has not been touched by addiction to alcohol or other drugs? For over forty years, I have asked various groups of people how many of them had their lives touched by addiction, either by their own use of that of a friend, family member, or loved one. I think everyone in every gathering has raised their hands, whether it was a college class, church group, corporate work team, executives, working class folks, inmates or soccer moms and little league dads. Addiction is our nation's number one health, social and criminal justice problem. Addiction counselors and people in recovery from addiction have been shouting this since the 1970's.

This book relates lessons learned about what works and what doesn't work in the addiction treatment field during a career that began in the 1970's. It is written for all Americans whose lives have been touched or are being touched by addiction...parents who don't know what to do with their son or daughter who is in the grasp of addiction, doctors and helping professionals who recognize that they didn't get the training they need to identify and treat addiction, the addict who is wondering where to go to get the best treatment, because all treatment programs are not the same. This book is for anyone who knows, loves or lives with an alcoholic or drug addict. It is for the addicts themselves, to give them hope and a direction.

• Language: English
• Publisher: Fulton Books, Inc.
• Release date: Oct 25, 2021
• ISBN: 9781637101308

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You Canand#39;t Fall Out of a Hole

Ripping the Band Aid Off of Our Addiction Epidemic

D. R. Osborne, Jr.

Copyright © 2021 D. R. Osborne, Jr.

All rights reserved

First Edition

Fulton Books, Inc.

Meadville, PA

Published by Fulton Books 2021

ISBN 978-1-63710-129-2 (Paperback)

ISBN 978-1-63710-130-8 (Digital)

Printed in the United States of America

Table of Contents

Chapter 1

Chapter 2

Chapter 3

Chapter 4

Chapter 5

Chapter 6

Chapter 7

Chapter 8

Chapter 9

Chapter 10

Chapter 11

Chapter 12

Chapter 13

To the memory of

Virginia Ginny Barnes, CADAC

Every day, I stared at that poster in the group room. It had two little eyes looking out from a black pit. The caption read, You Can’t Fall Out of a Hole. I didn’t get it. I understood that addiction is like falling into a hole, but what did it mean "you can’t fall out of a hole"? Around the fifth week, it made sense.

Acknowledgments

Sincere gratitude is extended to the following people for their gracious editorial contributions to this book: Richard Hart, Patrick Mitchell, Krisann Osborne, Cynthia McCoy, Dr. Jeff Van Valer, and Daryl Gibson Smith. Special guidance was provided by Daryl Gibson Smith, without whose direction and motivation, this book would never have been completed. The graphic illustrations in chapter 5 were provided by Andrew Whitten.

Preface

I was drowning in a sea of filth. All around me were other people—men and women, teenagers, all sizes, all races—who were also in this sea of filth. Some, like me, were about to go under and drown. A boat came along and pulled out those of us who reached up to take the hands offered to us. Some of the people around me who were drowning refused to reach up and be rescued. I watched them go under. When I was hauled into the boat, I was covered in filth and exhausted. My rescuers cleaned me up and took care of me. As they did, some told me of their own rescue experiences. At one time, they too had been drowning.

I thought back to how I had gotten into the sea of filth. I only wanted to go swimming with friends in what looked like a sparkling clear lake. But I ventured farther out and found myself in over my head. The clear lake became a dark and ugly sea, and I could no longer see the shore. It stank, and I found it increasingly difficult to stay afloat. I had seen boats come by before, but they expected me to reach up to them. I thought if I just kept swimming, I could get back to shore on my own. I was young and proud, but I had grown weary. The more I tried swimming back toward the shore, the more disoriented I became, and I didn’t know in which direction to swim. The shore had disappeared. Eventually, my strength waned, and I began to drown. Rather than die, I reached up when the next boat came by and let them save me.

After a while, I learned that the rescuers themselves continued to reach up to something above them which gave them strength as they reached down. I wanted whatever it was they had. In time, I began reaching up too, though at first, I wasn’t sure to what. When I was clean and stronger, I began to help save others from the sea of filth. As I reached over the side of the boat to help them, some refused to take my hand, and I watched them drown. Some, however, reached up and let me pull them into the boat. I did that for a long time. Then the boat went back to shore, and my next job was to help build more boats. In time, I learned how to make the sturdiest of boats and helped launch them with crews that were clean and strong and who kept reaching upward so they could reach down. Eventually, I accepted the task of teaching others how to build boats.

A few times, as I looked out at the sea, it appeared to be a sparkling lake again. People were swimming about enjoying themselves, and I was tempted to swim out a little way. Then I remembered the poor souls who tried that before me. They had been rescued from the sea of filth and then went back out, believing that they could just wade and swim and have a good time and still make it back to shore. Most never came back. So as time went by, I began writing down all that I had seen, all that I had learned—a manual for building boats and rescuing people from the sea of filth.

Introduction

Do you know anyone whose life has not been touched by addiction to alcohol or other drugs? For over forty years, I have asked various groups of people how many of them have had their lives touched by addiction, either by their own use or that of a friend, family member, or loved one. I think everyone in every gathering has raised their hands, whether it was a college class, church group, corporate work team, executives, working-class folks, inmates, or soccer moms and Little League dads. Addiction is our nation’s number one health, social, and criminal justice problem. Addiction counselors and people in recovery from addiction have been shouting this since the 1970s.

This book relates lessons learned about what works and what doesn’t work in the addiction treatment field during a career that began in the 1970s. It is written for all Americans whose lives have been touched or are being touched by addiction—parents who don’t know what to do with their son or daughter who is in the grasp of addiction, doctors and helping professionals who recognize that they didn’t get the training they need to identify and treat addiction, the addict who is wondering where to go to get the best treatment because all treatment programs are not the same. This book is for anyone who knows, loves, or lives with an alcoholic or drug addict. It is for the addicts themselves, to give them hope and direction.

Our country has long been in the throes of an epidemic of addiction to substances that destroy the users’ lives and their families. Estimates are that each addict touches at least seven other people. Families of addicted people get caught up in terrible patterns. Now, our country’s latest addiction focus is on heroin and opioid medications that have been abused for decades. With increasingly stringent laws trying to regulate physicians’ long-established tendency to overprescribe painkillers, people are turning to heroin because it is now sometimes easier to get than the pills.

Ironically, those who prescribe medications are directly responsible for creating the opioid crisis in the US. Physicians and other legal prescribing professionals have been overprescribing pain pills for decades. Doctors and nurses are not immune to abusing opioids themselves. Their familiarity with the drugs has made it possible for many medical professionals to overestimate their own ability to control them. We had an opioid crisis long before it became popularly recognized. Many physicians had essentially become unwitting drug dealers, supplying prescriptions for pain pills and sedatives with little or no awareness of their patients’ addiction to the medications. Doctors are mandated to relieve pain but are provided no training in recognizing, assessing, diagnosing, or treating addiction to pain-relieving drugs.

As regulating bodies started cracking down on doctors’ overprescribing, patients first sought prescriptions from other doctors and emergency rooms. Pharmacists began refusing to fill prescriptions so readily, so the patient-addicts began looking elsewhere for their pills. Before long, pills sold on the street became less available, and addicts were ripe for an introduction to heroin. Teenagers and young adults didn’t always begin with pain pills for a medical reason; some just started out on opioids as the latest way to seek a good time or escape the angst of youth. With fatal overdoses in the news with some regularity, we now have a multilayered opioid crisis created largely by the medical profession, and they don’t know how to recognize, diagnose, or treat it. Research published in the Journal of the American Medical Association has shown that over 90 percent of physicians cannot recognize alcoholism when presented with its symptoms. It isn’t their fault; training in diagnosing and treating alcohol or other drug addiction is not in the curricula of medical schools.

We have been engulfed in a drug epidemic of one kind or another for at least the forty-odd years I have observed. The focus drug of the moment changes, but the epidemic continues. Actually, opioid abuse is just added to the last epidemic, so now we have cocaine, methamphetamine, and opioid epidemics going on simultaneously. Because of the current focus on opioids, we tend to ignore other drugs of abuse because they are culturally accepted and don’t appear to alter a person’s behavior. Nicotine and caffeine are drugs that are abused every day. Nicotine, delivered to the brain through smoking tobacco or electronic vaping devices, is thought by some researchers to be the most addicting substance known. Caffeine, which many people rely on for boosts in the morning and throughout the day, is not usually thought of as a drug of abuse. Neurologist Dr. Jeff Van Valer’s essay, The Devil’s Tricycle, can be found online on Amazon. In it, he explains the synergistic relationship between caffeine abuse, sleep loss, and migraine headaches that so many people experience every day. It can be downloaded at little charge, as Dr. Van Valer’s motive appears to be aimed at reducing the number of everyday addicts that he sees in his office.

Alcohol is still the number one drug of abuse, creating the most problems in people’s lives, but because it is legal and used by so many people, it is largely ignored. Not everyone who drinks becomes alcoholic, but those who do create the greatest problems related to addiction in the USA.

In the early twentieth century, opium, cocaine, and marijuana were legal. The use of each created serious problems for the people who abused them and for society as a whole, so laws were passed to make them illegal. Advocates for legalizing those drugs today are rewriting history and ignoring the enormous problems they caused. Instead, some suggest those drugs are not harmful enough to be illegal and the real reason laws were passed against them was prejudice against the cultures of the people who brought them to the USA. As a result, we have seen and will continue to see a repeat of our country’s drug abuse history, renewing the epidemics with the naive belief that recreational use of mood-altering drugs is possible without terribly destructive outcomes. As marijuana is legalized from state to state, it will take time before people recognize the devastating problems that it creates for the users, the people around the users, and for society as a whole.

In the 1950s, a landmark addiction treatment emerged when a doctor and a psychologist responsible for treating inebriates at Wilmer State Hospital in Minnesota admitted they had no idea how to help their patients recover from alcoholism. To help them understand how to help, they brought in a recovering alcoholic who was not encumbered by a formal education, and they began to be successful. The treatment program that evolved was called the Minnesota Model. It centered on individualized treatment, group therapy, immersion in Alcoholics Anonymous, abstinence as the goal, and teaching patients to rely on each other to resist the temptation to drink.

In the 1970s, recovering alcoholics and drug addicts began developing professional criteria to certify addiction counselors. They found it necessary to become lay professionals to provide appropriate help for alcoholics and drug addicts because psychiatrists, psychologists, and social workers lacked understanding of addiction and how to treat it. In fact, addicts often suffered at the hands of those who used electroconvulsive (shock) therapy, a variety of medications that had terrible side effects, and misdirected counseling that went nowhere.

The movement peaked in the 1980s with standards set by the National Association of Alcohol and Drug Abuse Counselors (NAADAC) for the knowledge base and suggested skills needed to be an effective addiction professional. At the same time, there was an increase in demand for addiction treatment. The vast majority of universities’ curricula for medical schools, PhDs in psychology, and MSW degrees in social work, however, do not include required courses on our nation’s number one health and social problem. It’s strange, isn’t it? Most of the professionals we expect to know how to help us are not trained to do so. Much of the independent training that is available is factual but focuses on pharmacology and not on treatment strategies.

While doctors, psychologists, and social workers are not educated to treat or even recognize addiction, treatment by them is the only thing insurance companies will pay for. The best estimates by the National Institute on Drug Abuse and the National Institute on Alcohol Abuse and Alcoholism are that success rates average little better than 30 percent. It is not because these professionals are not well-intended; they are simply ignorant of what works and seem oddly unwilling to accept some things that do work. They view the problem from their own disciplines’ perspectives.

As they currently function, our criminal justice, medical, mental health, insurance, and social systems frequently sabotage addicts’ recovery. Most treatment programs operate within those systems because that’s what insurance will pay for.

When I feel frustrated by the obstacles to recovery, I reflect on those alcoholics and other drug addicts who I have been privileged to know who, despite the odds against them, achieved abstinence and are maintaining it one day at a time. But I am angry. When people do not recover, addiction leads to jails, institutions, or death. The government is releasing millions of dollars to fund treatment, but we have no national definition of the problem, no national definition of recovery from addiction, and no agreement in how any of it should be treated. All addiction treatment programs are not equal, and a uninformed public doesn’t know whether to take a loved one to the ABC clinic or the XYZ center.

In my career, there were some tragedies and some triumphs and numerous lessons about what works and what doesn’t work along the way. The messages in this book are intended to point the way for us to change the future and make it possible for more people to recover. If, after reading it, you have some idea of the questions to ask any organization that provides addiction treatment, then you and any loved one for whom you seek treatment will be better off. If you join the movement to demand that treatment programs are held accountable for what they are supposed to accomplish, then this journey has been worth the struggle.

Chapter 1

Even a Servant Leader May Need an Intervention

They buried Alan Dean in October. In the few months leading up to his death, Alan received a good deal of recognition for his life as a servant leader and an award for his service to Indiana’s citizens. My wife, Kris, and I visited him a few months before he died. He was a prominent local politician when we moved to town with our two kids in February 1979. The following year, Alan was a popular candidate for mayor when the morning newspaper showed a front-page picture of him looking hungover with the headline, Dean Facing Indictment for Missing County Funds. He was the county official at the time whose job it was to take all the money collected at the courthouse each day for fines, child support, and so on and deposit it in the bank. It seems quite a bit of money didn’t make it to the bank one day, I forget how much, and so Alan was indicted. He insisted he was innocent, saying that he never stole anything, and he would pay the county back out of his own pocket. He did pay the money back and charges were dropped—right after the mayoral election. That didn’t stop him, though. Alan was always running for public approval if not for public office, and it was well-known throughout the county that he was