Creatives & Addiction: Rethinking Our Approach

science / Social Commentary

Creatives & Addiction: Rethinking Our Approach

October 22, 2016

Every form of addiction is bad, no matter whether the narcotic be alcohol or morphine or idealism. —Carl Jung

charles i. letbetter - creative & addiction: re-thinking our approach

Recent changes in the definition of addiction should have us re-thinking how we respond to addicts. [photo concept and makeup by Sasha Starz]

I’m not sugar-coating this one for you: addiction among creatives is too common and too frequently undiagnosed. Even when it is diagnosed, it has previously been almost impossible to “cure.” Some handle it better than others, but we’ve lost too many, from Janis Joplin to Amy Winehouse and, apparently, even Prince. And those are just the names you recognize. I’ve seen addiction in photographers old and young, ruining creative lives before their full vision is ever realized. Writers seem to be especially prone to addiction. I’ve had several tell me they couldn’t even start to write without being high or being drunk.

I’ve always taken a hard line in my attitude toward addicts. I don’t like them. I don’t want them around. Addiction is something I’ve always seen as a weakness, a fundamental flaw in one’s character. If you know you have a problem with something, stay away. Understanding how anything can control someone to such a fatal degree is not something I’ve been able to do. I try to be sympathetic for those struggling, but I tend to blame them for their own problems.

Now, the American Society of Addiction Medicine (ASAM) has me re-thinking my disdain for addicts. As it turns out, taking such a hard line has probably been exactly the opposite of what those people have needed. Shoving them into rehab facilities might not have been as productive as we thought. 12-step groups could possibly be completely misdirected.

Maybe we were all wrong.

A New Definition

Addiction is a chronic brain disorder and not simply a behavior problem involving alcohol, drugs, gambling or sex. That’s the direction the ASAM is now taking in regard to addiction. Stop and think about that for a moment. Addiction is a chronic brain disorder. Let that sink in. All these years, we’ve been looking at addiction as a character flaw, perhaps a psychological psychosis brought about by some childhood trauma or something. We have ultimately looked at addiction as a choice one makes and faulted them for making that choice.

Here’s the first part of the ASAM’s short definition of addiction:

Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors.

Make special note of the use of the word “chronic.” That’s important. “Chronic” puts addiction is the same class as heart disease and diabetes. “Chronic” means that it’s not going to go away. Either one deals with addiction their entire life, religiously, continually, or they risk dying. There is no cure. There is only treatment and without that treatment, the disease gets worse.

Obviously, there’s some disagreement with this definition. Therapeutical psychologists, the folks who make their living getting one to lie on their couch at $500 an hour, don’t care much for this definition because it means their attempts to treat addiction as a psychosis is misdirected. One is not an addict because their father slapped them when they were four-years-old or because they didn’t get the bicycle they wanted when they were seven. Instead, genetic factors are responsible about half the time. We’ve been looking at this totally wrong.

A Personal Story

Mark Cummings was one of the best young photographers I ever knew. We first met out on assignment, both of us covering the same event for different entities. He was sharp, funny, and had an incredible eye for seeing things that everyone else was missing. He noticed, for example, that one particular Senator from Oklahoma always had his shoes untied. Always. He caught the look of burnout in a young pop star whose label was pushing her too hard. Mark infuriated editors because he didn’t capture the image they wanted to see. Instead, he captured a dark reality that was unnerving.

Mark also had an addiction to alcohol. He carried a flask of whiskey in his camera bag. Always. He would have another in his car, a third in his suitcase, and kept a bottle hidden in his office. Mark started the day with a shot of whiskey in his coffee, then dropped the coffee by 10. In the three years that I knew him, I don’t think I ever saw him sober. He was functional. He took fantastic pictures. Mark Cummings was never sober.

Cummings wasn’t one to admit he’d had too much. Truth was, most days he was over the legal blood alcohol limit by noon. One evening, after being yelled at for over an hour by his editor for “wasting” five rolls of film and not getting anything printable, Mark was “extra thirsty.” When I saw him, he was already six glasses in. I stayed for two more and tried to get him to share the cab ride home with me. He wouldn’t leave.

I received the phone call early the next day. About three hours after I left, and who knows how much more whiskey, Mark put his head down on the bar, fell off his bar stool, and died from alcohol poisoning. Another brilliant photographer, gone.

Understanding The Problem

Again, quoting from the long definition of addiction from the ASAM:

Addiction affects neurotransmission and interactions within reward structures of the brain, including the nucleus accumbens, anterior cingulate cortex, basal forebrain and amygdala, such that motivational hierarchies are altered and addictive behaviors, which may or may not include alcohol and other drug use, supplant healthy, self-care related behaviors. Addiction also affects neurotransmission and interactions between cortical and hippocampal circuits and brain reward structures, such that the memory of previous exposures to rewards (such as food, sex, alcohol and other drugs) leads to a biological and behavioral response to external cues, in turn triggering craving and/or engagement in addictive behaviors.

Understand, two decades of neurological research have gone into formulating this definition. Mark, along with every other creative addict we’ve known, was repeatedly told he had “a problem.” What he should have been told was that he had a neurological disease, one for which there is no cure, only treatment. I can’t say that would have saved Mark. He was stubborn, as a log of addicts are. It would have, however, made a difference in how everyone responded to him.

The causes of addiction are worth noting as well. Again, from ASAM:

When persons with addiction manifest problems in deferring gratification, there is a neurological locus of these problems in the frontal cortex. Frontal lobe morphology, connectivity and functioning are still in the process of maturation during adolescence and young adulthood, and early exposure to substance use is another significant factor in the development of addiction. Many neuroscientists believe that developmental morphology is the basis that makes early-life exposure to substances such an important factor.

There’s a lot more that I encourage you to read on the ASAM website.

Our Response Is Part Of The Solution

Dr. Michael Miller, past president of ASAM who oversaw the development of the new definition, states, “… we have to stop moralizing, blaming, controlling or smirking at the person with the disease of addiction, and start creating opportunities for individuals and families to get help and providing assistance in choosing proper treatment.”

When I think of all the times we’ve gotten it wrong, I want to cry. We blamed Mark for being a drunk, for not taking responsibility for his “habit.” His boss tried to control Mark’s drinking by pairing him with writers who would confiscate any alcohol they found. People would laugh at him when he couldn’t stand or took pictures too blurred to tell what they were. Every last one of those responses was wrong.

We have to change our way of thinking about addiction. If someone has a stroke you don’t laugh at them, do you? Should a friend you’re with suddenly have a heart attack, are you going to tell them they need to do something about that problem and walk away? No, you help them get help. Addicts are exactly the same. While the choice to get help is ultimately their own, we have to guide them toward professionals who genuinely understand the problem. While a 12-step program might help, they need a lot more than just a weekly meeting or two.

The ASAM states:

Recovery from addiction is best achieved through a combination of self-management, mutual support, and professional care provided by trained and certified professionals.

Each year, we lose too many wonderfully creative people to addiction. Help them get help. The ASAM can help connect you or a friend with the appropriate professional. Let’s stop treating addiction as just “a problem” and treat it like the disease that it is. Let’s do more to save our addicted friends. The world needs their creativity.

pop culture / PotD

Spring Break Fake

March 28, 2016

I feel as though I lost every ounce of dignity on Spring Break. What’s worse is that I don’t regret any of it. —Someecards

Not everyone can afford to go someplace exotic for Spring Break, but there are ways to fake that

Ah, Spring Break. This is that time of year when I exercise just a bit of old man indignation because there was no Spring Break for anyone not in college until after I was out of college. I’m sure I have my own generation to blame for that. We had entirely too much fun back in the early 80s and decided we needed to keep the annual tradition going despite the fact we were supposed to be gainfully employed. We kept taking vacations in March and April and as our children hit school age we insisted on taking them with us. So now, even elementary schools let out for Spring Break.

More than anything, I’m jealous. I’ve not been on a real Spring Break trip since 1984. I’m always working through this time of year, so the very concept of taking a week off to go play on a beach just doesn’t work for me and the same is true for Kat. Even if we could take the time off, we likely wouldn’t be able to take some long road trip to Florida or North Carolina. Travel is expensive and we’re on a budget.

How much does Spring Break cost now? Travel site Orbitz lists the top Spring Break destinations along with the average hotel rates. $216 a night in Orlando. $335 a night for Cancun. Fort Meyers is $236 and Miami is $228. Add in food, travel costs, and copious amounts of alcohol and sunscreen and you’re looking at $2,500 or more for the week. Who the fuck can afford that when there are bills to pay?

However, do not be disheartened. Just because we may not be able to afford an exotic Spring Break vacation, we can, at least, pretend that we are one of the cool kids and fake our way through Spring Break. Just because we’re responsible with our finances doesn’t mean we can’t give the impression that we know how to have fun, too. Here are some tips for totally faking your Spring Break.

Find a really big sandbox and roll around in it until your clothes are all full of sand. Make sure you are wearing your shoes. That way, you can walk into work or Aldi’s complaining that you still have sand in everything as you pull sand from your pockets or brush it out of your purse.
Walk around with sunscreen on your face. A lot of sunscreen. While the UV index isn’t very high in Indiana this time of year, it is in Jamaica and you can’t be too careful with your skin. There’s even this article for how to reapply sunscreen over a face full of makeup. You may look silly, but your skin will be safe.
Carry travel brochures in your purse or iPad case. When co-workers see them, talk about how exhausting the trip was and say something about needing a vacation to recover from your vacation. Make sure you’ve Goggled the weather for the past week at your destination, though. There’s nothing as bad as talking about how much fun you were having on the beach when there were actually torrential rains and flooding.
Swap houses with a friend for the week so your neighbors will think you have someone house sitting for you. In a way, this is a fairly cool vacation on its own. You get to sleep in a different bed, eat food from someone else’s pantry, and rifle through their personal belongings. Sure, they’re doing the same thing at your house, but you hid all the sex toys before leaving, didn’t you?
Spend way too much time in a tanning bed. Now, we all know this is bad for you. Sunburns are bad for you. And most tanning salons monitor the number of visits you have in a week, so you will have to mix it up between two or three places. But you can’t pretend to go on an exotic Spring Break and come back with the same pasty skin as when you left. Go extreme. You only live once, right?
Don’t sleep for a couple of days. While Spring Break is supposed to be refreshing, if you come back actually feeling refreshed you didn’t do it right. So, what you’ll want to do is stock up on the energy drinks and binge watch all the combined episodes of every iteration of NCIS that is on Netflix. That should guarantee your eyes look just as tired and bloodshot as though you’d been partying with the best.
Wear a bikini under your clothes in place of a bra, because, you know, you just got into the habit while you were on the beach and this is just so much more comfortable.
Take pictures in your swimsuit and photoshop a beach into the background. There are plenty of stock photography websites where you can get pictures of beaches from around the world. For even more fun, talk some random strangers into taking the photos with you. Do it right and everyone will think you were the life of the party!
Talk constantly about the new “friend” you met on the “beach.” Give them a cool name and make sure they’re from a cool place. Develop a reasonable back story for them and a good reason why, even though they gave you the most wonderful nights of your life, you can never, ever see them again.
Spend the next two weeks “recovering.” Your boss and co-workers won’t expect anything less. In fact, if you recover too quickly, they’ll know you were faking the whole thing. Complain about jet lag and how something you ate totally disagreed with your body and, god, the sunburn!

Not everyone can afford to annually revisit the locations of some of our greatest heartbreaks and biggest regrets, and I’m not sure we really want to. Sometimes it is better to just hold on to the memories of our youth and not try to recreate those college days even though we’re over 40. Way over 40. We still have the memories of those nights in Mazatlan. Maybe that’s enough.

PotD

Opening Old Bottles Of Wine

February 13, 2016

Age is just a number. It’s totally irrelevant unless, of course, you happen to be a bottle of wine.—Joan Collins

charles i. letbetter - opening old bottles of wine

Relationships and conversations, like an open bottle of wine, have a point at which they are of no use to anyone

I was not raised in a house that understood wine. Sure, there was an academic knowledge of how it is made but beyond that, there was a fierce denial that wine could have any positive qualities at all. Our family not only didn’t drink, but we were raised to avoid anyone who did for fear they might be a “bad influence” on us, or drag down our reputation.

Then, I had my first glass of the real thing. Sweet. Red. Low alcohol content. I discovered that I could enjoy the glass presented with my desert and, contrary to all my mother’s warnings, not instantly become a gutter-hugging drunk. A few days later, I tried a glass of merlot with a meal and fell in love. I suddenly wanted to know everything about wine. I read. I talked to sommeliers. I went to tastings. We even bought a wine rack that was shaped like a cluster of grapes.

Normally, a bottle of wine never lasted more than 24 hours once it was opened. We enjoyed the wine too much to let any dregs sit in a bottle. One day, however, I was going through the wine rack looking for a specific vintage and came across a bottle that had been opened and then returned. When it had been opened, I didn’t know. Who had opened it was a mystery. The bottle was still almost full, less than half a glass had been removed. So, I took the bottle, removed the cork, and promptly took three steps back. The wine had turned to vinegar, and not a pleasant vinegar at that. Down the sink went the remains.

I bring up that subject because this weekend is one of those times when we can be tempted to re-open the old bottles of wine in our lives. With Valentine’s Day, we can be tempted to re-open past conversations, re-visit past relationships, things that we have left behind for good reason, but still wonder if they might yet be salvaged. The answer in most cases is no, they can’t. Like wine that has been opened, those things from the past have only soured.

One of the worst mistakes I made when I was younger was to re-open conversations that had been set aside. These would be tense words where no solution had been found, where walking away and not mentioning the matter had been the best solution. Conversations involving matters of human rights, religion, or constructs of government were topics that I frequently, and incorrectly, thought I had under command. I always thought I was right. Why else would I revisit a topic if I wasn’t sure that I needed to correct a gross misunderstanding?

I can be a slow learner sometimes and didn’t realize that there are moments where being right or wrong on a topic is irrelevant. Acquaintances who were once friendly became distant and found reasons to avoid contact when they feared I might yet, again, bring up a conversation that had been uncomfortable or contentious. I was sadly oblivious to the social vinegar I was asking, forcing, others to drink.

Even worse can be when we return to past relationships. When I’m looking through old pictures, such as the two used here that are over ten years old, I often think to myself, “I wonder what they are doing now?” For better or worse, social media makes it easier than ever to answer that question. I’ll find someone on Facebook, or, far too frequently, LinkedIn will insist that I need to connect with someone I had willfully forgotten. Many times I am tempted to click that button, to make a new friend request, but I’ve learned to leave those old relationships alone and just enjoy the memories. If we have not spoken for years, there is quite likely a very good reason.

As I get older, I sometimes regret letting relationships grow sour, especially when a simple apology might have negated ill feelings in the first place. One sits and looks at that old bottle of wine wondering if it might yet be salvaged. Is it too late to apologize? If an apology is offered, will it be accepted?

Occasionally, I’ll come across an article (like this one) that claims to have a solution for “fixing” wine that has gone bad; it’s a nice dream, but I’ve not found one yet that actually works. Sure, we all like the fairy tale of lost souls finding each other again after all the years and falling in love, or becoming close friends. Sometimes the risk pays off and if that old bottle of wine represents a relationship with a family member, then perhaps taking the risk is justified.

Still, more often than not, it’s best to just not re-open those old bottles at all. Enjoy the memories of the wine when it was good. Keep the bottle as a token of a special time if you wish. But should you open that bottle, be prepared for the reality that all you’re likely to get is vinegar.

Current Issues / PotD

The CDC Is Victim Blaming

February 5, 2016

charles i. letbetter - CDC is victim blaming

You cannot have maternal health without reproductive health. And reproductive health includes contraception and family planning and access to legal, safe abortion.—Hillary Clinton

charles i. letbetter - maternal instincts vs. the cdc

Having a uterus should not in any way limit a woman’s activity, regardless of what her future plans may or may not be

Yep, I’m going there. While I, myself, can never bear children (for which I am intensely thankful), most of my favorite people in the world can, and many have. That factor is naturally limiting to some degree I suppose. Scheduling get-togethers can be a nightmare when one has children. Budgets are strained when one has children. Fatigue is often a factor when one has children, as is stress and worry. However, at no point would I, or any other sane person, suggest that women should limit their activity in any way, shape or form simply because they have, or might have at some point down the line, a child. Yet, that is exactly what the Centers for Disease Control (CDC) just did.

The assessment comes in Vital Signs, the CDC’s monthly health report and to say it is insulting to women is putting it mildly. Even the CDC’s press release is offensive when, right off the bat, it states: “Sexually active women who stop using birth control should stop drinking alcohol, but most keep drinking.” Yes, you read that correctly. It is the CDC’s opinion that, should you have any ability to have children, then you should either be on birth control or not drink. Ever.

What many women find especially offensive, and I wholeheartedly support their outrage, is this infographic the CDC released with the report:

Centers for Disease Control and Prevention

Now, let’s be totally fair before we go off flaming the entire report. Yes, fetal alcohol syndrome is a totally preventable problem and yes, women who continue drinking heavily during the first 4-6 weeks of pregnancy, when not everyone knows they’re pregnant, is a problem. And yes, if one is intentionally trying to get pregnant, then abstaining from alcohol is just one of a very long list of adjustments one makes. Those portions of the report are based upon real science and are backed with several years of empirical scientific evidence.

However, not all the statements in the report are weighted equally. Much of the information related to women who are not pregnant is a derivation of data collected by the National Survey of Family Growth. Surveys, while useful for studies of social behavior at a given point in time, are not science. They can be flawed in hundreds of different ways from the type of questions asked, to the tone of voice used by the person asking, to how participants are chosen. Under no circumstances should the results of such surveys ever be considered anything more than opinion, not fact. Yet, that is exactly the error the CDC has made. As a result, they come up with some really offensive and scientifically unsupportable statements.

I’m running almost 48 hours late with my response here. What angers me is the inference that women who drink are sexually irresponsible. Such an attitude feeds directly into the infuriating rape culture which we screamed about yesterday. Anyone who takes advantage of a woman who is drunk or otherwise impaired is committing rape. Women who are drunk cannot give informed consent for sex and should, therefore, be left alone! To blame women for pregnancy or the transmission of disease during the course of a rape is wholly and unapologetically immoral ! Way to blame the victim, CDC.

Understandably, condemnation of the report, and especially that damn infographic, has been swift and severe. Here are a few you might want to read:

Yes, we understand what the CDC is trying to do in eliminating any chance of fetal alcohol syndrome. But so much of what they are recommending in this report actually relies not merely on abstinence from alcohol, but regular medical screenings and readily available birth control, something the US Congress has repeatedly attempted to make impossible by defunding Planned Parenthood. Sorry, you can’t have it both ways folks. If you want healthy babies, you have to fund health care for mommies, especially those at greatest risk.

We should also mention that women who might be planning to become pregnant are already concerned about the Zika virus, which is still new but poses a potentially greater threat. Can we expect the CDC to also suggest that women who don’t use bug spray are equally irresponsible?

Fetal alcohol syndrome is a problem, we get that, but I would challenge that victim blaming and perpetuation of the rape culture is an even larger problem that affects the health of both women and children far more substantially than does drinking alcohol. Blaming women for rape and sexual assault, which this report inherently does, is inexcusable. Shape up, CDC. Use science and abandon the good ol’ boy mentality that is dangerous to women.

Advertising

What Women Really Want

January 14, 2016

Living with integrity means: Not settling for less than what you know you deserve in your relationships. Asking for what you want and need from others. Speaking your truth, even though it might create conflict or tension. Behaving in ways that are in harmony with your personal values. Making choices based on what you believe, and not what others believe.—Barbara De Angelis

Could a beer company have an answer to one of humanity’s oldest questions?

“What do women want?”

On most days I would respond to that question with a cynical, “Hell if I know,” and keep going. Most intelligent men know better than attempting to answer a question they can never hope to get correct. Every woman is different and, therefore, is going to have different desires and wants than the one sitting next to her. There’s no one desire that is universal to them all. Besides, “you can’t please everyone,” is another platitude with which we are all well aware. We should know the futility of trying to please women.

However, a study of premium beer drinkers between the ages of 21-35 showed that knowing your limit, drinking in moderation rather than getting shit-faced, passed-out drunk has a certain coolness factor. Millenials prefer hanging out with people who don’t let their drink define them. Women, especially, prefer partners who remain sober throughout the evening. So, the good folks over at Publicis Italy, a division of Publicis Worldwide, used that information as the basis for a new ad for a client very involved in the subject of over drinking: Heineken.

This isn’t the first time Heineken has taken on the subject of responsible drinking. Two years ago, their “Drink Less, Dance More,” campaing featuring DJ Armin Van Buren, examined how a DJ that keeps people dancing reduces the amount of drinking in a Miami night club.

Nuno Teles, CMO of Heineken USA told AdWeek, “Responsibility is becoming an active and attractive choice for a motivated generation who want to stay in control.”

This opens up the question of whether millennials are learning from the sins of their parents and correcting their bad habits. While we might like to give the generation some credit for doing better than we did, the numbers aren’t necessarily flattering.

The Centers for Disease Control and Prevention (CDC) keeps track of binge drinking. While the problem is not unique to males, nor to millennials, there are some specific challenges needing to be addressed. Consider this list of disturbing facts:

70% of binge drinking episodes involve adults age 26 years and older.
Men are twice as likely to binge drink as are women.
Most people who binge drink are not alcohol dependents, or what we might commonly refer to as “drunks.”
Binge drinking is for the upper middle class and higher, those with over $75,000 in annual income.
Roughly 90% of those under 21 who drink are involved in binge drinking.
Binge drinkers are more likely to drive drunk.
More than half the alcohol consumed in the US is done in the form of binge drinking.

The problem is so significant that a number of colleges and universities now have departments and facilities set up to deal with the issue and some have even banned certain fraternity activities in an attempt to reduce the amount of binge drinking on campus.

With a problem so very big, is one ad enough to make a significant change in the problem? That’s difficult to say. While the campaign started in 30 worldwide markets this week, it would take an immense amount of targeting and a more significant than usual budget to get the ad in front of the right eyes enough times for the message to sink in. The ad uses a soft, subtle visual backed by a popular, pounding soundtrack. Young men are notoriously thick-headed (I know because I’m still that way). We can’t expect them to get the message without seeing the ad several times, possibly in the company of young women who point out the commercial’s purpose.

Still, we have to applaud Publicis Italy and Heineken for at least taking on the issue, especially going into the Super Bowl and Spring Break, both of which are notoriously heavy drinking times for college-age students. Here’s the ad. Feel free to share with someone who might benefit from paying attention.