Finding the Way Out and the Way Forward
Addiction has been the primary focus of my professional work for more than 30 years. I’ve worked with thousands of clients and hundreds of organizations. I provide consulting services for the development of addictions programs, clinical supervision for counsellors, psychotherapists, and front-line staff, and education for the wider community. The complex landscape of recovery is my neighbourhood. The resources on these pages are drawn from my experience and reflect my interest in the deeply creative aspects of addiction and trauma. As a result, these pages relate the unique stories of individual clients which, in turn, reflect the broader landscape. Recovery is an odyssey that reaches back as well as forward. It weaves together childhood development, adolescent vulnerability, mental health, and trauma. It’s a complex and layered experience that cannot be understood by reducing the process to substance use or behaviour. Addiction is more than that. It’s deeper. These pages describe what this means, and, in turn, how to seek healing.
Five of these resource pages focus on specific addictions: hallucinogens (MDMA, ayahuasca, etc.), opioids (heroin, Fentanyl, etc.), stimulants (cocaine, crystal meth, etc.), alcohol, and cannabis (marijuana). Two further pages focus on trauma and pathways of healing. A final page summarizes the journey of recovery along with reflections from my own experience. View all of the pages by clicking on the Addictions link in the Categories menu or by scrolling to the bottom of this page.
This page serves as an introduction and offers a few considerations for beginning the recovery process.
The morning is warm, though it is no longer summer. On the south side of the street, metal roofs incise sharp outlines against a cloudless sky. A bright corona above a storefront on the southeast corner indicates where the sun will climb above the skyline. A row of tumbledown brick buildings lies farther down the street, and beyond these, far to the west, I glimpse the towers of downtown. I imagine the rush and hum of the business district; but here it’s quiet, as though the reckless and urgent vibrancy of the neighborhood has, for a moment, been suspended.
A man in a heavy coat, ragged and torn on the right cuff, crosses the street ahead of me. I’ve seen him around. I recognize his mane of straggling hair, grown long enough that the matted lump at its end bounces off his lower back as he walks. I glimpse two figures in a doorway on the north side, warming themselves as the sun reaches toward them over the city. Down by the corner, three ambling and disconnected figures walk toward the park. Spindrift in the eddy of a slow-moving creek, they pitch and turn and slide.
I make my way along the street and toward the clinic, feeling the languid slowness of the day, moving into it as a swimmer strokes down into cooler water. And I hear that same high-pitched hum I sometimes notice underwater: a clear, sustained tone at the threshold of my hearing. The sidewalks are decorated with countless flattened pieces of gum and dark marks and streaks from who knows what. A jumbled calligraphy of stains and colors and wayward shapes.
I reach the grimy, recessed vestibule of the clinic and peek through the security grille that protects the front window. The reception desk is vacant. The waiting area is empty and the door is locked. I’m early, but I don’t mind waiting. The street, which sometimes feels saturated with threat, seems more forgiving this morning. Perhaps it’s just the weather, or my own carelessness.
Hanging around the entrance to an addictions clinic is bound to attract attention. While I’ve been ruminating on sunshine and chewing gum, waiting for the clinic to open, a trio of men has noticed and begun to approach me. They walk with the jangly, halting gait common among street-entrenched substance users. The one on the right scans up and down the street, darting his head back and forth, sensitive to the sudden and the peripheral. His movements are quick and jittery, and I make a guess – two hours – about how long it has been since his last hit of cocaine. The other two are slower, more withdrawn. Their shoulders are rolled forward – not hunched, but eased downward, as though their strength cannot resist the gravity of collapse. Even at this distance, thirty feet or so, I can see that these men are shuttered inside, protected by heroin and methadone and whatever else they can find to turn down the noise. And now it is morning, time to find more.
The three men approach, but not too close. They know precisely the distance of civility in this neighborhood: two broad steps, two seconds to flee or flail. The jittery one, with his grungy baseball cap pulled down to shade his eyes from the slanting sun, asks me if the clinic is open. He speaks quickly, clipping the consonants:
“Cli’ic open yet?”
I tell him no, not yet. But now a little crew is gathering, people from the corner and the other side of the street. They’re making their way purposefully toward us, settling near the door. And though it’s clear that many know each other, there’s not much in the way of conversation; just patient shuffling and waiting as they surrender to the current of this slow and liquid morning.
I ease my way out to the sidewalk again, sidestepping the loose knot of supplicants. The sun’s illumination has made its way halfway across the street, but buildings on the south side are still casting shadows. A young woman walks slowly alongside the curb, looking downward, searching. She stutters forward, pauses, reaches for the discarded stub of a cigarette, and gathers it up with slender fingers: precise, economical, and entirely instinctual. She reminds me of a bird gathering seeds. As she passes, I see that the bones of her skull have been slightly shifted, skewed out of true. One of her cheekbones stretches out from her face while the other recedes. Her head, with its crown of short and patchy hair, is more prominently rounded on one side than the other. It’s not a deformity as such, nothing noticeable at a quick glance; but you’d see it if she looked you in the eye. Her skin, drawn tight over the errant architecture of her head, is pale, clear, and smooth.
She drops, gathers, comes up again, and moves on. I watch her go, wondering how much pressure, how much measured and overwhelming force, must be applied to the body and to the psyche to create such results. She has the look of someone who was born into this business.
I look toward the front window of the clinic and glimpse movement inside. Olivier has come in from the back door and is settling his gear at a desk. Out front, the crowd has thinned and I have no trouble making my way to the entrance. I tap on the glass of the locked door – lightly, once, twice – and Olivier looks up. He waves, smiles, and comes forward. He unlocks and opens the door, and there’s a brief, delicate moment in which he explains to the gathered company that the clinic is not yet open. Then he opens the door wider and ushers me in. I smile awkwardly as I pass. The folks waiting in the street don’t know why I’m jumping the queue, and they don’t care. I want to be polite, to explain the situation to them, especially in this environment so bereft of social niceties. They’ve been living out, many of them, sleeping on the street or in the park, fending off assaults and illness and hunger. Some have tiny apartments, or rooms in grungy hotels a few blocks down. They are accustomed to being invisible. The back of the line is where they live.
In my earnestness not to offend, I consider an explanation. But the door is open, Olivier is waiting, and if the door stays open for more than two or three seconds the small crowd will surge forward with their daily urgencies: housing, medical issues, money. And methadone – or, as it’s sometimes called, juice. Always, first and foremost, in the natural order of things, juice.
I point to Olivier, as though my gesture will explain everything, and move quickly through the door. He closes it, locks it again, mouths “Five more minutes” through the glass, offers a warm smile and a wave, then turns toward me.
We head down the corridor and into the coolness of the back offices. The clinic is small, and none of the rooms has much space, but as we have the place to ourselves, we choose the largest of the examination rooms in which to sit and talk. Once a month I meet with the counseling staff – spread across various addictions clinics – but sometimes issues arise between meetings, and occasionally I find myself consulting with individual staff members. Today Olivier wants to talk about opening a resource center next door, a place where clients can come for support groups, to learn how to use a computer, to explore any number of activities that seem straightforward to most people but are bewildering to those who have been swept up by the tide of substance use.
It’s exciting to discuss the possibilities with Olivier, to speculate on the positive benefits that might come from such an initiative. For the addicted, the rituals of substance use – smoke, inject, snort, swallow – are a currency for which no equivalents exist. But sometimes exchanges are made, between substance use and other, healthier pursuits, and the brokering of those deals typically involves social and community ties. Recovery is a renegotiation of the deal, and the dealer. The resource center might give a few clients a place to haggle.
I hear keys in the front lock, then the sound of the security grille being pulled back. The receptionist is here, and in a few minutes the little crowd outside will fill the waiting room. As always, most of them will ignore the pamphlet rack with its collection of community service bulletins. The broad continuum of help eludes most of these people: appointments, goals, initiatives. For them, daily life has been distilled down into a single, irresistible polarity: loaded or not loaded. It’s a simple formula: not loaded leads to loaded, and loaded leads to not loaded. Then it’s time to get loaded again. Easy. And far from easy.
Olivier excuses himself to let the receptionist know we’re in the back. He heads down the hallway and I am left alone momentarily with the anti-smoking posters and illustrations showing the progress of hepatitis. Much of Olivier’s counseling work is enacted on the street, and his office here in the clinic is a cramped alcove near the back door; I’m glad for the extra space the examination room offers. But it is spare, and not particularly inviting. I get up to take a closer look at the various stages of decay shown on the hepatitis illustration. The final phase shows a section of liver in the guise of rotting meat. I turn from this object lesson and make my way back to the chair, but before I get there I glimpse something scrawled on the wall. A smattering of penciled words in the corner of the room, almost hidden by the wall’s shadow. The letters are raked hard over, the angles rounded into curves. A declaration written with haste, in secrecy, and yet intended, I think, for an audience. It says:
I will kill myself today.
How long has this been here? And who, among the hundreds of clients who come to the clinic, stood in this corner – alone, desperate, yet without the means and perhaps the will to speak directly to a staff member – and wrote these words? And where is the author now?
I fetch Olivier from the front office, where a knot of clients wait in threadbare chairs. The trio from the sidewalk are there: one tapping foot and two slumped forms. Back in the examination room, I point to the note and ask Olivier if he knows anything about it. He rubs his chin, squints, leans forward, and reads. Then he nods, looks up, and tells me that he didn’t know about the note – but its likely author is a client from yesterday, a guy who came in festooned with crises and without a shred of hope. Olivier smiles and tells me that yesterday was a crazy day. When he’s tired, or when the stress of this place cracks through the shield of his humor, his Rwandan accent grows stronger. It must be twenty years since Olivier fled, though the facts of his voluntary exile are scarce in my mind. He does not speak of his former life.
The guy came in, says Olivier, jacked up on crystal meth and cocaine, shouting at the staff, scratching his scalp, trying to make sense of his crazy pain. Like so many of the folks we’ve known: angry, lost, searching.
Olivier spent time with the man, drew him out, listened as the emotional pressure came down – but not before the obligatory doctor’s visit, in this examination room, not before the doctor left the room to fetch the client’s file. A few spare moments, that was all, in which some primal instinct – to make a testament, a stand, a final defiance of the avalanche – urged the man to get up from the chair, snatch the pencil from the desk, cross the room, and write frantically in the corner. Ten seconds, perhaps less. Then back into the chair: withdrawn, silent as the doctor returned to the room and asked how things were going. No mention of the note, no discussion of the means or mechanism of the planned suicide. The doctor probably picked up the pencil and ticked off the client’s name on the schedule.
Olivier is reasonably sure the client did not kill himself yesterday. He left the clinic, after a long talk with Olivier. He seemed calmer, less desperate. But we cannot establish if the man is alive today. He has no phone, no regular home, and no interest in establishing reliable routes of contact. He wanders, sinks, and surfaces. And for now, at least, he’s gone.
People disappear into their addictions. They become unreachable, unfathomable, their marks and messages not discovered until it’s too late. Sometimes the impulse for peace, for the end of the long struggle, becomes a wish for death.
I walk to the sink, crank the handle on the paper towel dispenser, spool out a handful, and run it briefly under the tap. I stand over the running water, ruminating on the similarity of this moment to so many others, thinking about all the obscure gestures and misdirected appeals I’ve seen and heard. The late night phone call, at home, from a client who said she had a handful of pills and wanted one good reason not to swallow them. The client who brought her pills to my office, carried like sacred relics in a small wicker box, and surrendered them to me for safekeeping. I think of those who have wandered off, led by dreams and nightmares, carried off by cocaine and heroin and, most common of all, drawn away by alcohol, the spirit of spirits.
Olivier is quiet. Like me, he has been here too many times. I walk back toward him, to the writing on the wall, and I slowly erase the message with the paper towel. It comes off easily. Only the first few letters require any rubbing. When I’m done, the faintest impression of the I remains. And it occurs to me that this is the essence of addiction: the slow erasure of the I, an escape from the troubled self, an easing of the struggle – and within that easing, the germination of a lifetime’s worth of turmoil. The addicted are looking for the same things as most of us: solace, intimacy, a release from suffering, a glimpse of the glorious flash that answers the unanswerable. And they do find it. For a moment, an hour, a day. But a great light casts a great shadow, and it is this shadow that comes to inhabit the daily life of those on the paths of addiction.
Such paths are mythological: Icarus, seeking escape and flying too close to the sun; Orpheus, descending to the underworld; Moses, seared by the heat of illumination; Ahab, rolled under by the white and terrifying whale. The addict is the unwitting companion to the spiritual seeker, the warrior, the traveler, the trickster: reckless and desperate and heroic all at once. Grasping and falling, gasping and drowning, addicts flail and wrack and bleed on their way to wholeness. Their human frailty lies on the surface, glaring and defiant and corrosive. They search for healing by way of the shadow path.
The addictions resources on this website are a record of my own messages scrawled upon the wall. They trace their origin to my experience as a substance abuse counselor, as a clinical supervisor to addictions agencies, and to my own family background in which substance abuse has claimed many lives. This is not an unusual situation: addiction has shaped – twisted, torn, broken – almost every family I’ve known. And it’s not the addicted who call for help in moments of crisis: it’s the family, overwhelmed and panicked and utterly unaware of how to deal with someone who has been swallowed by the monster. The family cannot understand how it has come to be that love and support and care are insufficient to the task of rescuing the parent or child or sibling who wanders in the fugue of alcohol, the flurry of cocaine, the paranoia of crystal meth. Typically, families are paralyzed by the dawning awareness that the primary allegiance of any addicted person is to the substance itself, to its rituals and urgencies and kaleidoscopic logic. This is just unbelievable: that someone would choose illness and dishonesty and the furtive ingestion of toxins over the readily available assistance of friends, family, and the many community services designed specifically for the purpose of helping people through addiction.
But chronic substance users – indeed, addicts of every ilk – are not responsive to such inducements. They’re looking for something else: a destination, a secret, a bright, still center at which all the contradictions will make sense. Most don’t know they’re searching for it. They just try to get away from the intrusions, the futile interventions, the hassles from people who want to divert them from the inescapable quest for getting high.
These resources are for those who have been left behind by the addicted: families, friends, counselors; the caring and the empathic whose appeals so often go unanswered. There is much you can do. There are clear reasons for the strange, disturbing behavior of the addicted. They have wandered far from themselves, perhaps, have meandered in endless, fruitless, fractured spirals of duress – but they are not entirely lost.
Addiction is not purposeless; it has a trajectory, a momentum that is neither random nor impenetrable. And this trajectory, despite all appearances and evidence to the contrary, is directed toward healing. It may seem strange to think of addiction in this way; after all, its trappings are destructive and debilitating. But addiction does not begin this way. It starts with the search for joy, wonder, and human connection. Addiction is a positive urge thwarted by negative circumstances. It is not a character defect, or simply a matter of chemical dependency. In fact, substance use is not even the central feature of addiction. People can be addicted to an endless swath of things: exercise, work, food, sex, technologies of various kinds. But always the core is something else, something behind: an unfinished constellation of impulses and dreams.
The addictions resources on this website deal with the story, which is almost identical in every addicted person, of the call to change, of descent into the labyrinth or the deep waters, of challenge, confrontation, and, sometimes, the eventual return to wholeness. This is the arc of the hero and heroine told in countless tales; it is a mythological journey with consistent stages and turns. Many addicted people (and their families) believe their situation to be particular, perhaps even unique; but the stages of addiction could not be more plain and predictable to those familiar with the cycle. Addiction levels people, treats them all the same, places them on tracks identical to those who’ve gone before. These tracks lead to one of two destinations: death or healing. In a way, the final stages of addiction embody the essence of sacrifice: something has to go, and one hopes it is not life itself. But the impulse, the I will kill myself today, is often part of the process. Most survive it.
Addiction is a war like all the others: terrible and heroic and with a profound meaning hidden in the pain. I’m interested in survival, and the meaning of that struggle, and the recapturing of human connection. I am not drawn to statistics about the success of various modalities or the politics of addiction or the reasons why there never seem to be enough treatment facilities. Addiction is a personal journey, an odyssey deep inside the self. My reflections upon that journey derive from my work with people, not programs. It is the person who heals, who grows, who knows. Allies can be of help, but the shadow path is always taken alone.
It begins early. Experiences in childhood provide the most common nudge toward later difficulties with addiction (and toward many other challenges as well). The connection between childhood trauma and subsequent struggles with drugs and alcohol is almost a universal law of addiction . It is a kind of gravity: persistent, implacable, and difficult to avoid. This link will be of interest to parents, and much material in these pages is relevant to inoculating, so to speak, children against the vulnerabilities that lead to addiction. Parents cannot, ultimately, prevent addiction in their children; but they can become aware of risk factors and respond to them. These resources are therefore also for those wishing to make generational change, in families and in the community, so that our descendants might be better resourced than we have been.
And, finally, these resources are for practicing addicts, in whose company I have been privileged to spend a great deal of time. I know of no other group of people closer to the cutting edge of life. They have been my friends and teachers. I grew up in a family in which the intensity and desperation and crazy beauty of my mother’s addicted life formed the hub around which we all turned, and I have not stopped following that strange spiral.
Addicts are well-known for their short attention spans. This is as far as many will get in exploring these pages. Other, more compelling concerns will intrude. Accordingly, I’ll share the essentials up front: the paths of addiction are the shadow paths. Yet every shadow is cast by illumination, and the discovery of the source of that light is the core of healing.
Untangling the roots of addiction is a long and difficult process, mostly because those roots lie farther back in people’s lives than they realize or care to admit. The slow rebuilding of damaged or shattered relationships, the restoration of physical health, the work of insight and planning and new directions: these and the many other steps require between many years of consistent and dedicated attention. The medical and recovery communities typically speak in terms of months, because their resources are limited and their incentive, in a highly competitive market, is to offer clients and their families immediate and tangible hope. But among those who’ve managed to reconstruct the totality of their lives, most report that the work of recovery continues long after the substance (or the addictive behavior, in the case of gambling, gaming, and similar dependencies) is discarded.
The illuminated path meanders beyond relapse – almost everyone goes through a series of these – beyond the final surrender to assistance, beyond detox and treatment and whatever type of recovery people choose. Until finally they emerge blinking into the sunlight, without a clear sense of confidence, dogged by a sense of how much of their life was occupied in running and hiding. Feelings of loss and hope and freedom all wrapped up together. But when they get this far, they’re already most of the way home, though the actual homecoming – to themselves – is always the great and final challenge. And not only for the addict: this homecoming is the core of all human development.
The buried wound must be explored, mapped and known. Inside the wound lies our deepest wisdom, our illumination.
1 Almost a universal law. I have met addicts who claim to be free of childhood trauma, and I commonly hear assertions from parents that their addicted kids are free from earlier emotional injuries and other travails. Some of these people may be correct. Most are not. The tendency to discount or minimize trauma and mental health problems is the most common means by which addictions spread within families and across generations.