In the late 1980s, when I was trained to work with addicts, we were still fighting against the image of an addict as being someone who was depicted stereotypically as the bum on the street corner. Worse still, physicians in every area of medicine (including psychiatry) were often not taught how to identify and/or how to treat an addict. In fact, when people entered hospitals for routine surgeries, they were seldom asked how much alcohol they normally consumed or whether or not they used other substances or prescription drugs. Not having that information, doctors often prescribed addictive pain killers upon releasing such patients and thereby enabled their addiction to continue, sometimes even intensifying their addictive needs.

Although medical schools have begun to educate their students better and we are becoming more knowledgeable as a society, we are also, I fear, only a few steps ahead of where were years ago.

What provokes me to address the problem of addiction at this particular time is the death of Michael Jackson.

In the past several weeks there hasn’t been one day when the media hasn’t covered and re-covered the tragedy of his life and his death. It matters not to me what any of us think we know about Jackson’s proclivities and lavish life-style. What is indisputable is that the man was uniquely talented but at the same time allegedly suffered from a variety of addictions.

Naturally, I hope that his story does, in the end, better educate us all. However, what I find most disturbing is the fact that there seems to have been so many people enabling him throughout the years of his addictions. Additionally, the crimes against his body and his psyche are horrific enough, but somehow omitted in the coverage of his suffering is the consequences of his absence from the lives of his three children during the days when he apparently required total isolation.

Also, because his life and death have been made so outrageously public – the money he had and the ability he possessed to convince others to support his various habits will hopefully uncover sufficient evidence leading to those who aided and abetted in his death. But, the tragedy of Jackson’s life is not what will be disputed. What caused his death will no doubt be the subject argued by prosecutors and defenders who will present their cases adnauseam, along with so-called friends and hangers on, all wanting their moment in the spotlight. The multitude of factors that led to his addictions will most likely be an occasional side-bar.

What the public needs to understand and where the focus must be placed is on the fact that Michael Jackson was self-medicating just as every addict has before him and will after him. His need for his drug(s) of choice was no different than any addict whether rich, poor, White, Black, Native American Indian, or Latino. Once someone becomes addicted to any drug or any behavior, satisfying the need for that drug will lead to desperate acts.
The addict of 2009 is as likely to be a CEO, a working/single parent, a family man or college professor, as a homeless person. There is no one face for an addict.  The person’s history may differ in a variety of ways and the drug of choice each one chooses may be different. But, his/her life eventually spirals downward in very similar, sad, and often tragic ways.

What clearly distinguishes Jackson and other wealthy addicts from the public at large is that they have the money to lure professionals into satisfying their habit. Whatever personal experiences may have led to their addictions – whether forms of abuse, neglect, or fame that afforded them wealth at too early an age – in Jackson’s case they will, I assume, be submerged in an attempt to discover the exact cause of his death. What is certain, though, is that no amount of external wealth could ever satisfy the underlying causes for the self-destructive behaviors that led him to self-medicate, that forced him to seek treatment for an impoverished psyche. Therein lies the real tragedy!

The important question that needs to be addressed, therefore, is whether addicts can be helped without supporting their habit. The answer has been proven time and again to be YES.  However, the percentage of those who remain abstinent depends on what statistics you read and who has sponsored any given study.

One thing is certain, though.  With the exception of infants who are born addicted due to their mother’s “use” during pregnancy, nobody who does not use drugs is an addict.  However, once addicted to any drug or drugs, it is possible to become abstinent.  It’s never easy.  But many have done so, and it is possible.

What needs to be understood is that an addict chooses a drug (or drugs) of choice to relieve anxiety,  depression, or both.  The drug of choice is always helpful at first, because it is a quick, easy fix to a problem the addict can not name and may not consciously be able to understand or explain. What he does know is that whatever he is experiencing isn’t tolerable and he must seek relief. That was as true for Michael Jackson as it is for any addict.  At first, drug(s) offer relief.  Yet, once the bloom wears off, addiction takes hold and the addict becomes the victim, a person no longer in control of his life but controlled by his addiction.

Unfortunately, most addicts only seek help when they hit rock bottom. Why?  Because, when they first began to use, they did so because they believed it made them feel better. It was even empowering. But, there’s the trickery! For while it might have taken as few as one or two drinks or one or two pills or hits to offer comfort in the beginning, in time many pills or countless drinks or needles were needed to obtain the same relief. And relief is what is craved not only emotionally but physiologically. It is at that point that they will do anything to chase after that relief.

If we are to examine addiction further, we know that most addicts have to hit rock bottom before they will seek help or accept help.

When addicted to a chemical substance or prescription drug, the addict must first be de-toxed in a safe medical environment in order to be helped. Ideally, if insurance permits, the de-tox will be followed by a daily program involving the support of individual counseling and requiring attendance at a Twelve-Step meeting.  But, once released from the safety of such a secure setting, they are at the mercy of people, places and things that are likely to trigger a recurrence of their “habit.”  This is when entering an out-patient treatment facility is necessary. Counseling with a professional specifically trained to work with addicts can help maintain abstinence by offering constructive options to ease anxiety or depression and relieve the pain. Yet, until they come face to face with their personal demons, they will forever chase after the drug that – at least at first – took that pain away.

Even given all that – as with any disease – once identified, the patient’s responsibility is to do whatever is necessary to remain healthy.  For addicts, their demons are devilish. They must be acknowledged and confronted in order to remain abstinent.

The best treatment includes a combination of individual therapy along with a Self-Help program such as any one of the Twelve-Step programs, Alcoholics Anonymous being only one of many.  Attending such meetings, and having a sponsor to turn to at any time of the day or night, can be life-altering and life-saving.

For there is life after addiction!  And that life can be one of quality, despite the fact that there are no guarantees for any of us.

At this point, I offer the reader something that most people attending in any one of the many programs is likely to have read at one time or another.  Although the author is anonymous, the message is profound.  I hope by including it here, the reader will better understand the Michael Jacksons of our world as well as any person who suffers from any addiction.

Hello, old friend! I’ve come to visit once again. I live to see you SUFFER
MENTALLY, PHYSICALLY, Spiritually and SOCIALLY! I want to make you RESTLESS so you can never relax! I want you to be JUMPY and NERVOUS and ANXIOUS! I want to make you AGITATED and IRRITABLE so everything and everybody makes you UNCOMFORTABLE! I want you to be CONFUSED and DEPRESSED so that you can’t think clearly or positively! I want to make you HATE everything and everybody. Especially yourself! I want you to feel GUILTY and REMORSEFUL for the things you’ve done in the past that you’ll never be able to let go of! I want to make you ANGRY and HATEFUL toward the world for the way it is and the way you are!

I want you to FEEL SORRY for yourself and BLAME everything but your addiction for the way things are! I want you to be DECEITFUL and UNTRUSTWORTHY and to MANIPULATE and CON as many people as possible! I want to make you FEARFUL and PARANOID for no reason at all! I want you to wake up during all hours of the night and scream for me! You know you can’t sleep without me! I’m even in your dreams! I want to be the first thing you wake up to every morning and the last thing you touch before you black out or pass out!

I would rather kill you, but I’ll be happy enough to put you back in the hospital, another institution or jail! But you know I’ll still be waiting for you when you get out! I love to watch you slowly go INSANE! I love to see all the physical damage that I’m causing you. I cant’ help but sneer and chuckle when you shiver and shake, when you freeze and sweat at the same time, and when you wake with your sheets and blankets soaking wet! It’s amazing how much destruction I can do to your internal organs while, at the same time, I work on your brain, destroying it bit by bit!

I deeply appreciate how much you sacrifice for me! The countless good jobs you’ve lost for me! Remember all the fine friends that you deeply cared for and gave up for me? Plus, what’s more, the ones you turned against yourself because of your inexcusable actions … for that, I’m even more grateful! Think specifically of your loved ones, your family … the most important people in the world to you … you even threw them away for me! I cannot express in words the gratitude I have for the loyalty and respect you have for me … you sacrificed all these beautiful things in your life, just to devote yourself completely to me! But do not despair, my friend, for on me you can always depend! For after you have lost all these things, you can still depend on me to take even more! You can depend on me to keep you in a living hell, to keep your mind, body and soul … for I will not be satisfied until you are DEAD, my friend!

My name is your addiction …!!!”

*Should you know anyone in need of help, contact me and I will do my best to connect you with the proper people and places that can best offer the assistance needed.  Remember: any un-treated addict is a tragedy waiting to happen!