SOCIAL CHANGE & GLOBAL HEALTH

 

The evidence is clear that addiction is a disease, yet our response has been to stigmatise and punish people. Arresting people is not arresting addiction.

We allow negative perceptions of people with substance use disorders to shape our thinking and our actions.

A 2014 Johns Hopkins study in Psychiatric Services showed that respondents held significantly more negative views of people with addiction than of those with other mental health issues.

Respondents saw those with addiction as less deserving of treatment or housing and employment opportunities than people with other health issues.

Those kinds of attitudes lead to discrimination and stigmatization with serious consequences. Fear of negatively impacting their job or their neighbours’ and friends’ attitudes keeps people from seeking care.

Only 10 to 15 percent of people who have a substance use disorder are actually getting treatment, according to recent data from the National Survey on Drug Use and Health.

Of those, about 35 percent are referred for treatment by the criminal justice system. Only about 8 percent of referrals come from our health care system. These numbers represent huge missed opportunities with a terrible cost for individuals and the country.

People facing a host of challenges, however, need more than luck. They need consistent, effective national and state policies. Here are some concrete steps that we as a nation need to take to ensure that people with substance use disorders get critical help:

My 19 year old step son is studying “Social Medicine and Global Health” at Kings College University, and neuroscience is the  educational backbone – thus our common meeting ground is the topic of global health and how his  world view is better informed.

Modern medicine is fabulously exciting – I love the surge in   digital devices that can  “total-health” monitor and mindbody motivate – A.I. at is best is helping people become their wellbeing advocate.

Neuroscience’s mindbody evidence based data is changing how we access and treat addiction and mental ill-health.

I love my life. It is enriched by 30 years of abstinence based recovery from addiction cocaine, valium and vodka. I self medicated for 20 years to cope with anxiety, low self esteem and lack of confidence.

What changed?  On a cellular level – basically everything…from core beliefs to how life is today: consciously living consciously…  the benefits of immersing  myself in deep meditative therapeutic  processes  – way beyond conditioned negativity attached to  stigma and shame… and a daily intention to do my best, be my best…

When  I went to rehab, self-defensive   denial  shattered in a trillion pieces…and I learnt the value of engaging in a therapeutic  process, and without a doubt, collaborating and connecting with the world wide recovery  i.e.

…the road to recovery is challenging, and  a few  needed to be worked through…i.e. how to function with a drug, cigarette  or drink…all the while struggling with the fear of living and dying was huge….so it was  on my home from rehab I arrived @ LA airport  to cach my flight home New York and  I needed a drink…  I switched the Evian bottle of mineral water to vodka…the madness returned with a vengeance…escalating stress,  free-floating anxiety, paranoia… I   stopped going to 12step meets, could not leave my house and  or answer  the phone…

Insane thinking….5am in Central Park looking for someone to kill me…is where a cocaine binge took me…exiting the park I jumped in a cab to  Payne Whitney Psychiatric Hospital, where I begged them to admit me…

The psychiatrist that listened to my cry for help, responded and  recommended  I reconnect with  12step meetings, not take any medication, find a new therapist, ( who did not want to date me)  ..saved my life.

It takes courage to  return to 12step meetings, find  a sponsor even though asking for help is incredibly difficult.   I  found  an empowered  psychotherapist for 1-1 and group therapy, she  helped me thrive, and rise  phoenix-like from the ashes of  my self  self-destruction  and daily suicidal ideation.

An important act of self accountability in early recovery is to ‘be of  service’ …a few of us went regularly from our Park Avenue meeting to prisons, hospitals, and homeless shelters.

On a daily basis I connected with my tribe, and sustained a lifelong  commitment to   12step programmes. In addition to   volunteering at the Manhattan Centre for Living, founded by Louise Hay and Marianne Williamson.

The Centre’s design was all-white,  an  open plan kitchen and dining room where we made gorgeous nurturing food and small consulting rooms space for people who were dying from aids, alienated  by society…

I learnt to never “say goodbye” from the courageous  men and women…  just a simple “see-ya” because that was how it was – living with an illness  that knew at that time, no cure….

The first half of the 80’s in NYC,  (what I can remember) was totally fabulous, wild. Work hard, play even harder! I was a video and film producer primarily in the fashion industry, and riding the wave of the MTV era of music and fashion video production: mini-filmgenre-big budgets…we were young, had unlimited fuck-you-money and no “off-switch.”

Adjusting to life without drugs meant a commitment to living in the day with a “just for today attitude”  and for a bunch of us in early recovery our day began with an attitude of gratitude of not being hung over, consumed with dread that being in  blackout for huge chunks of the night before….

We supported one another by  learning how to live life sober… formed 12step study groups, sponsorship workshops and often went to upstate New York for immersive meditation retreats.

It was a natural segue for me to begin training and  specialising in addiction counselling,  I  returned home  to London.

Confident that my previous “life experience” as fashion magazine  editor, (Mode–Australia) film and video producer would find an a creative outlet – that would come later… when I wrote a book about the male archetypes.

The benefits of the timeless teaching of  philosophy, mythology, spirituality, and psychology continue to ground, stimulate and inspire me.

It is a privilege to pass the message of recovery on to the still suffering addict….if I can recover you can..you are not alone.

Recovery communities across the globe know that   sustaining sobriety  is possible.  Here are some more strategies and to help you succeed:

Share your feelings with someone you can trust. Stay focused on your intention to heal.

Challenges accepted. If you stay aware and hold your intention clearly in mind, recovery is attainable.
Attend: a 12-step group  on a regular  basis.
Action: Get moving  to refresh your mind and keep your body active.
Eat:  a healthy diet to focus on whole foods, raw veg juice,  fruits, vegetables, and nuts.  Get current with with the plethora of digital detox communities:

I am following with great interest and enthusiasm  Anthony William : Medical Medium: https://www.instagram.com/medicalmedium/

Spiritual Practice is in daily meditation and yoga to integrate all the realms of consciously living consciously.  Mindbody:  emotional, psychological, and spiritual.

Be of service: the fast track to living an abundant life is to embody a generosity of spirit!   This will help you connect with other people, increase your self-esteem, and prevent you from experiencing too many feelings of restlessness or boredom that can lead to relapse.

 Sleep is a vital part of the healing process and helps you maintain your natural state of balance and joy.

Maintaining long-term recovery requires support, hard work, persistence, techniques for dealing with difficult situations, courage, new habits, and a change of environment.

Impossible? It’s not. It can be done. You ARE  worth the effort.

When it was time to go deeper into my meditation… I went off to India, and for a year  I  lived in a small village outside Pune, near an ashram  founded by Meher Baba – who came to teach and not start another religion. Meher Baba  coined the term “Don’t worry. Be happy.”

Since the 90’s I have travelled to sacred sites in  Egypt, Italy, Turkey, and Scotland. I prefer to spend time in silent meditation. I continue to meet  remarkable,  enlightened, happy people, whose collective beliefs form the view that “we are One”- which makes sense to me in this incredible age of enlightenment.

My training in psychology, mythology and philosophy continues today motivated by curiosity in how best to be balanced, healthy and happy.

All change begins within: If you want to reduce stress, anxiety and depression then think about learning how to meditate.
Meditation is my happy/peace of mind preferred state of mind.

My tribe: people who inspire me to thrive are likened souls primary purpose is to end the silence and stigma of addiction and mental health issues.

We are not silent. We are not alone. We are courageous, compassionate human beings.

Compassionate inquiry is  so much inviting than self-seeking,  doing  service is about connection, communication and collaboration: being available, present, and purposefully in the moment.

My lived experience with addiction awareness is an amalgam of a continuing compassionate inquiry into understanding how our greatest challenges transform us by becoming valuable sources of wisdom and expressed compassion.

Evidence based research from The American  Society of Addiction Medicine helped me understand the medical model of addiction, that it is a moral failing, nor lack of willpower, but the “why” is a blend of family history, genetics, and mystery…

ASAM- American Society Addiction Medicine states that:

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 behaviours.

Addiction is characterised by inability to consistently abstain, impairment in behavioural control, craving, diminished recognition of significant problems with one’s behaviours and interpersonal relationships, and a dysfunctional emotional response.

Like other chronic diseases, addiction often involves cycles of relapse and remission. Without treatment or engagement in recovery activities, addiction is progressive and can result in disability or premature death.

The neurobiology of addiction encompasses more than the neurochemistry of reward.

The frontal cortex of the brain and underlying white matter connections between the frontal cortex and circuits of reward, motivation and memory are fundamental in the manifestations of altered impulse control, altered judgment.

The dysfunctional pursuit of rewards – despite cumulative adverse consequences experienced from engagement in substance use and other addictive behaviours.

A BioPsychoSocial approach (BPS)
With many differing theories all purporting to explain addiction, some sort of integrative approach was inevitable.

First articulated by George Engel in 1977, The BPS model was originally designed as an alternative to the prevailing biomedical model, which tends to reduce illness to a single source, then treat the illness with little regard for other contributing factors such as a patient’s psychological experiences or social behaviours.

A decade later, Donovan (1988) and Wallace (1990) articulated a BPS model for addictive behaviours in recognition that drinking behaviour and alcohol problems are multidimensional. Donovan recommended comprehensive assessment that could capture the biological, psychological and social aspects of the individual’s life that are affected by drinking. This information, Donovan hypothesized, would improve diagnosis and treatment.

It is important to understand the brains complex circuitry systems,  that underpin the onset and maintenance of additive behaviours, it is necessary to place these systems in the context of the individual and their surroundings.

Epigenetics and individual differences in brain architecture do not adequately explain why particular individuals initiate drug taking, develop addictions and then may or may not respond to a variety of interventions.

Several psychological traits have been associated with addiction – impulsivity, depression, anxiety, reward sensitivity and learning capacity. Such characteristics are the product of biology, personality and circumstance.

Paying attention to  healthcare  organisations  is  not enough to actually improve people’s health. Healthcare around the world is often  ineffective, or inappropriate for a patient’s condition, and can even leave patients worse off.

I want to introduce into the NHS a RECOVERY ROOM  open 24 hours day within the A&E space. Facilitated by medical doctors, nurses, mental and addiction healthcare workers, recovery volunteers  who are trained in working with mood altering substances: alcohol, opioid, prescription and illicit drug overdoses…away from the general emergency services and specific to addicts in crisis to  assess, refer and at at all times keep safe those  who has come to  A&E for help.