Posts Tagged ‘bibliotherapy’

Bibliotherapy: Books About the History of Addiction and Treatment

Great books about the history of addiction and its treatment have languished in obscurity, never getting the recognition that these bits of history richly deserve.  I’m going to do my small part to encourage people to read these great books.

 The Addicts Who Survived: An Oral History of Narcotic Use in America, 1923-1965, by Courtwright, Joseph, and Des Jarlais. This book, published by the University of Tennessee Press in 1989, is now out of print, so hopefully you can find a copy at your library. I’m so glad I bought one of the few copies. This amazing book is filled with interviews with intravenous heroin addicts who lived through the so called “classic era” of opioid addiction. I got a feel for how fragile life is for IV addicts, and how miraculous it is to survive addiction for 30 years. Many of the survivors went into methadone programs, and credit methadone with saving their lives. Other addicts went on methadone, but are frank about their criticisms of methadone treatment, and their regrets. As an added bonus, this book has interviews with key people who made history during the classic era of opioid addiction in the U.S.: Vincent Dole, M.D., one of the three original investigators of the efficacy of methadone maintenance as a treatment. Dr. Dole describes the harassment and interference he experienced during his work, both from law enforcement and the medical community.

 The Fix, by Michael Massing.  There’s much great history in this book. Much of the book talks about the governmental decisions regarding the treatment of addiction and addicts. The author describes effective treatments for addiction which weren’t continued, because of political pressures. It also describes how policies that didn’t work nonetheless remained in practice because of politics. This book gives us insight into dealing with the present wave of pain pill addiction. If you have to read one book on the history of addiction treatment in the U.S., make it this one. It’s interesting because the author also includes stories of real-life addicts and their struggles to find treatment and recover.

 The American Disease: Origins of Narcotic Control, by David Musto. This may be the best-known book about the history of opioid addiction and treatment in the U.S. The author gives exhaustive references, valuable in their own right. This book may be dense reading for anyone not already interested in the topic, but I loved it. He gives a painstaking history of drug addiction against the background of American culture and politics. Anyone who has input into drug policies needs to read this book.

Dark Paradise: A History of Opioid Addiction in America, by David Courtwright. Much like The American Disease, it is packed full of information, along with insights and interpretation of the information. It covers much of the same information as the other book. It differs in the interpretation of opioid addiction history.

 Hooked: Five Addicts Challenge our Misguided Drug Rehab System, by Lonnie Shavelson. The author, a physician and journalist, follows five addicts with no money through the process of accessing addiction treatment. He documents in excruciating detail the pitiful systems called “treatment” for these addicts. Gaps in care and communication breakdowns would frustrate anyone, but these people are more fragile than most. The roadblocks they face are depressing. This is a fascinating and entertaining book, and left me with a feeling of frustration. It’s a vivid description of how broken our healthcare system is for the indigent.

Slaying the Dragon: The History of Addiction Treatment and Recovery in America, by William White. Written in 1998, this book has it all. It’s probably the most comprehensive book about the history of addiction treatments. Even if you don’t work in the field, you’ll think the book is interesting. It’s a well-written and scholarly book.  Particularly interesting was the descriptions of quack cures for addiction promoted throughout the ages. Some things never change. People desperate and suffering from a disease are vulnerable to different species of snake oil treatments now, as ever in history.

Addiction: from Biology to Drug Policy, by Avram Mack. Written nearly 10 years ago, parts of this might be a little out of date, but it’s still packed with information. It covers technical material, but is accessible to the educated layperson. He has some interesting stories to illustrate his meanings.

 The Narcotic Farm: The Rise and Fall of America’s First Prison for Drug Addicts, by Nancy Campbell, 2008. In this little-known book, the author explains how drug addiction was treated from 1935 until 1975. The Narcotic Farm was a unique facility that served both voluntary patients and prisoners who had addiction. For its time, the Farm was moderately open-minded and willing to try new treatments. Sadly, most of the addicts treated to the Farm relapsed, probably because they had no continuing treatment when the addicts returned home. The pictures in the book are great, and tell much of the story of the Narcotic Farm.

We need these books. We don’t have to keep re-inventing the wheel because we can look to the past for guidance about the treatment of the addicts in this country. Our past method of incarcerating addicts clearly did not, is not, working. Public policy makers all over the country at all levels of government need to read these books.

If you know of more such books, tell me.

Advertisements

Bibliotherapy for Families Affected By Addiction

It’s never just the addict (or alcoholic) who suffers.

Anyone who cares about or depends upon the addict suffers. Living with active addiction is too much for most people. Thank God there are more resources now than ever before for the families afflicted by addiction. Treatment centers have family groups and family days, and many therapists are skilled at helping family members. There are 12-step groups devoted to helping family and friends of alcoholics (Alanon) and addiction (Naranon) in nearly every area of the country. Alanon does make a distinction between alcohol and other drugs, while Naranon is for families of people addicted to any drug including alcohol. However, in practice, many people attending Alanon do so because their loved ones use drugs in addition to alcohol.

Well-written books for families of addicts can help initiate the process of understanding and healing. These books can give a starting point to desperate family members, literally worried sick about the addict in their lives.

Popularized by the TV show “Intervention,” some families hold these interventions for the addicted family member. An intervention usually contains certain elements: the addicted person’s friends and family gather together in the presence of the addict, they tell the addict how much they love him or her, they tell the addict how much their addiction hurts them, and what they want the addict to do about his/her problem. Usually this means going to an addiction treatment center. Families usually also tell the addict there will be definite consequences for non-compliance with their requests.

Other people deal with addiction in less directive ways. For example, in Alanon, the focus is kept not on the addict, but on the distressed family member or friend who is affected by the addiction. Alanon helps people deal with the dilemmas that appear with addiction, whether the addict is in or out of the home. Some people go to Alanon years after the addict is dead, because of the long-lasting emotional effects addiction can have. More about Alanon’s approach to dealing with the distress of addiction can be found at their website: http://www.al-anon.alateen.org   Alateen is not for alcoholic teens, but for teenagers who have been affected by the alcoholism of a parent or other close relative, or friend.

I’ve compiled a list of books I’ve found to be useful for family members. These books range widely in their approaches, and at times may contradict each other.

When Enough is Enough, by Candy and Sean Finnegan

            This great book clearly explains the mechanics of holding an intervention, as well as the risks and possible pitfalls. It’s 208 pages long and the paperback version is quite affordable. The authors cover much ground. They discuss all of the factors that must be considered, like financial concerns, physical and mental health issues, and legal issues. Candy is sometimes the interventionist on A&E’s “Intervention,” and has worked for treatment centers with stellar reputations. This is a top choice if you are considering holding an intervention.

Getting Them Sober, Volumes 1, 2, 3, and 4, by Toby Rice Drews

            Don’t let the title mislead you. These books aren’t all about forcing someone to get sober. These slender volumes, written in the 1980’s, have short chapters, written clearly and simply, and are packed with wisdom. I like that these books don’t give absolutes but rather suggestions. I don’t think there’s only one correct solution for every problem. Some people criticize the book, and say the best answer if you are married to an addict is to leave. And that might be the best answer for some people, but not all. It’s rarely so simple. Sometimes there are children involved. Sometimes the addict is your adult child, so there’s no “just leave” solution. The last volume, #4, is subtitled “Separations and Healings”

How Alanon Works For Friends and Families, by Alanon Family Groups

            This book gives a great description of what Alanon is all about. It tells about the common behaviors seen in the alcoholic and the family, and gives hope that even if the alcoholic never quits drinking, you can still have a happy life. It contains stories from other people who’ve lived with addiction, and much can be learned from their experiences. Alanon has several other great books: Paths of Recovery: Alanon’s Steps, Traditions, and Concepts; Alanon’s Twelve Steps and Twelve Traditions; From Survival to Recovery: Growing Up in an Alcoholic Home; The Dilemma of an Alcoholic Marriage. They also publish three small books containing daily meditations, or readings, on some topic connected to Alanon: One Day at a Time, Courage to Change (a bit old-fashioned, assumes the wife is the alanon member) and Hope for Healing (to me it seems this last one has more material for people who had alcoholic parents than the other two)

Codependent No More: How to Stop Controlling Others and Start Caring for Yourself, by Melody Beattie

            This is a classic. Written in the 1980’s, it still contains useful information that isn’t necessarily specific to addiction and the family, but most families with addiction of any sort do have codependent behaviors. The examples are helpful, and her writing is clear. I’m not sure anyone has come up with a great definition of codependency, but if you read this book to the end, you’ll know it when you see it. Also consider reading her daily meditation book, The Language of Letting Go.

Terry: My Daughter’s Life-and-Death Struggle with Alcoholism, by George McGovern

            This is a sad book, written by the father of an alcoholic, who died of exposure outside while drunk. The author is a famous politician, and his writing reveals how addiction is an equal opportunity destroyer. I got the feeling after reading this book that Mr. McGovern regretted not having done things differently. Though Terry went to treatment centers, she wasn’t successful at remaining sober. It sounds like the family detached with love, but now the author regrets detaching to the degree that he did.

 I think each family decides differently how much they can do for the addicted one. Should you provide free room and board to keep the addict off the street? Is that harm reduction… or enabling? Is it, “loving them to death?” Often, addicts say it was only when they had to face the unpleasant consequences of addiction, like sleeping outside in the cold, or going to jail, that they turned towards recovery. But then you read a story like this one, where Terry froze to death in a snow bank.

Beautiful Boy: A Father’s Journey Through his Son’s Addiction, by David Sheff

            This book was on one of my other lists. The book is poignant. In places it is heart-breaking. Over and over, I would think, “Ah, the kid’s finally in good recovery.” And the next sentence contained the next relapse. This author caught exactly the rollercoaster ride of emotions felt by someone who loves a person in active addicition.

From Binge to Blackout, by Toren and Chris Volkmann

            This is an unusual book because it contains the viewpoints of both the alcoholic and the mother of the alcoholic. This book hasn’t gotten the attention it deserves. Both authors are eloquent when describing their thoughts and feelings about what is happening with the son’s alcohol addiction. I believe this book would be interesting to any parent, particularly those with adolescents. From a doctor’s point of view, I was pleased to see Chris Volkmann quoted accurate information when she writes of the science of addiction to alcohol. I was impressed with her ability to convey these scientific concepts lucidly. You should get this book. Really.

Last Call, by Jack Hedblom

            This book is about alcohol addiction, but I don’t recall that it talked about other drugs. It contained a great description of why addiction is classified as a disease. The author, a psychotherapist with a PhD, goes into some detail about recovery from alcohol addiction from mostly a 12-step perspective. It’s a great book, covering all the necessary topics in a straightforward way but without “talking down” to the reader. I like that the book has end notes and references, and also an index. It’s recent – published in 2007, but kind of pricey – new book is $40 on Amazon but used copies are available &  much cheaper.

 This is barely scratching the surface. I have many more recent books that are still in my ever-towering “to read” pile.

 Please tell me about your favorites.

Bibliotherapy

I love books. I love to huff that magical smell of a library, or a bookstore. (Bibliophiles can detect the slight differences in the aroma of these two.) I love to stick my nose into a book, and draw a quick sniff. I do this furtively, looking around to make sure no one is watching me, sensing how ridiculous I would look to anyone except another book huffer. Thankfully, my sister also huffs books, so we often go together to the bookstore.

I read all types of books, but some of my favorites have described some aspect of addiction or recovery. My bookshelves sag from the weight of these books, but some are so good I have to keep them. Frequently I’ll prescribe this book or that to help a patient. I give recommendations for books to friends even when they don’t ask. Many of these books have never made it to the best seller list. Many are hard to find.

Here’s a partial list of my favorite addiction memoirs:

“Junky,” by William Burroughs, reminds me addiction is nothing new. This classic addiction memoir of an intravenous opiate addiction is graphic, and may trigger people in early recovery. The author tells about his life, day to day. He shows the despair and hopelessness of active addiction. Though written in the 1950’s, he describes the same old actions and feelings as addicts have now.

“Leaving Dirty Jersey” by James Salant. This memoir tells how the author’s life went downhill while using methamphetamine. He does a great job of describing the daily struggles for drugs, food, and shelter, usually obtained in this order. It’s interesting to read what social niceties remained important to addicts, and to watch even those fall away as addiction progresses.

“Dry,” by Augusten Burroughs. I love this author. Once I listened to another of his books, “Side Effects,” on CD while I was driving. At one point, I had to pull off the road because I was laughing to hard. “Dry” isn’t that kind of hilarious book, but still funny in some places, and touching in many places. I found myself really wanting the author to be successful in recovery.

“Rolling Away,” by Lyn Marie Smith gave me an intimate feel for what it’s like to use and fall in love with the drug Ecstasy. Honestly, it kind of made me want to use Ecstasy, so this book could trigger people in early recovery. But then the author conducts the reader through the hell of active addiction, with all its poor decisions, shame, and rupture of important relationships.

“A Million Little Pieces,” Oh, seriously. I only read a few of the first page, then laid it down. I knew he was lying. Prominent inpatient treatment centers don’t do dental surgery without anesthesia. There’s no reason to do so, because Novocain and similar anesthetics aren’t addictive, and don’t give cocaine-type feelings. Duh. This one I don’t recommend, but listed it because I wanted to vent about it.

“Beautiful Boy,” by David Sheffield was a wonderful description of the pain of a loving father, heart broken by his son’s methamphetamine addiction. Beautifully written, it reminds me it isn’t only the addict who suffers. I haven’t yet read the book by the son, Nic Sheffield, “Tweaker,” but I plan to.

“Drinking: A Love Story,” by Caroline Knapp. Get it and read it, particularly if you are a female alcoholic, in or out of recovery. She describes alcohol addiction and despair, and then her recovery. Sadly, this wonderful author died of cancer a few years after this book was written.

“Lit,” by Mary Karr. This is a recent book and a bestseller. For a change, it’s a bestseller that I really enjoyed. She gives a lyric description of how addiction creeps into a life slowly, like a mist, gradually obscuring common sense and healthy living. She also described how recovery helped her handle life events that happened later in life.

“Addiction By Prescription,” by Joan Gatsby. She explains the hell of her benzodiazepine addiction. She conveys her emotional states well, and the writing was interesting. But it was hard for me to read the sections where she seemed to shirk responsibility for her addiction. She mixed benzodiazepines with alcohol, with the predictably bad results. She seems to blame the doctor for this. Didn’t her pill bottle have that little label that says, “Do Not Take With Alcohol?”

“Happy Hours,” by Devon Jersild. This isn’t so much a memoir as a collection of the experiences of many female alcoholics. It’s entertaining, and also a great book for addiction professionals to read. The gamut of emotions of female addicts is portrayed well.

“More, Now, Again,” by Elizabeth Wurtzel. I was spellbound by this book; I couldn’t put it down. She gives such an interesting description of the personal details of methamphetamine addiction. Don’t miss her other book, “Prozac Nation.”

I’m a big believer in bibliotherapy, meaning using books as therapy. The written word has as much power to heal as the spoken word. It’s not just non-fiction that teaches. Some of the most important lessons are taught in stories. Remember the “Velveteen Rabbit?”

Next time, I’ll list books for addiction professionals to read.

Meanwhile, let me know your favorite addiction memoirs.