Sunday, 9 November 2014

A Deeper Kind of Love

A guest post by Geri Barcheski, a loving mom who lost her son to addiction:

I believe we are sent into each life time to learn and be taught very valuable lessons. Some we are reluctant to learn and afterwards we have that aha moment.  I've learned so very much in this lifetime of 50 years so far.

The lessons have been hard, very hard, but the ways in which I've been given to learn them have been the experiences of my life. And what I have learned so far is this:

We are brought here to learn to give love and to take love. We are here to learn about the value of it and all the many facets of love.

And it is not always the easy kind of love like when you fall head-over-heels in love with someone and you experience a whirlwind of emotions.

And not just the kind of pure joy and love that you feel when your amazing infant smiles at you or holds your finger with their little hand for the first time.

But we are here to learn about a deeper kind of love. Unconditional love.

Sometimes it comes in the form of a relationship gone wrong with someone that's loved and hurt you. But sometimes it comes from loving someone so deep that we must love them deeper than the wounds they created within us. Sometimes this someone is our parents but mostly I think it's our children often suffering from an addiction.

It isn't fair, it seems so unjust. Somehow, it seems the world has tilted on us a little too far over. I felt this way about my mother and father. Though I'd loved them, I resented the normal family life I never had in the crazy dysfunctional family I grew up in.

And yet with my mom, being the second parent to pass and me taking care of her for a few years, I grew impatient at the end. And in my grief, I realized the lesson of love I was being taught. It was this: have as few regrets as possible in loving the ones in our hearts. Give of self even when we feel we are entitled and have earned the right to be selfish and to put ourselves first, especially when we feel we have been taken advantage of. These are the times we are being tested to come to know the many facets of love. Of the pain it takes to love. And to show our love even if it doesn’t seem to be reciprocated or appreciated.

The same holds true in loving our children in the throes of addiction, which we all know now is a brain disease.

If God himself said to me in the wake of losing my son that He would wipe out the memory of him so that I would not have to live this pain till my last breath, I would turn Him down without a second’s hesitation because even through the pain, the anguish, the heartbreak and the loss, I would not take away one second of the love he gave to me and brought to my life. I loved him deeper than the hurt.

And I wish I had known that everything I worried about like how others would think I was less of a mother for having an addict for a child was so lame. The fact is I was more of a mother because I loved beyond all reason - when it was hard.

I wish I had known how insignificant the material treasures were; the jewelry and money and other missing things like my crystal figurines and my daughter’s gold necklace. They mean absolutely nothing in the loss of the child who was the one who took them. If God said I'll give him back to you and you will have nothing ever again, I would jump at it without a second’s hesitation.

But the lesson doesn't allow for that. I was given a bad hand to play in this life. Some cards I've played very badly. And those are the regret cards. Some cards I played from my heart without any logic or sense for doing so. Those are my saving grace cards, which help me balance the regrets. Yet the regrets are still there.

I wish I could have known about this multifaceted level of loving before.

I know this: the night my son passed at a friend’s house was just hours after he stood in front of me and his little sister as he was going out for the evening. He kissed us and hugged us both and told us he loved us as he always did, and she and I said the same to him. I had some inkling that he might have been growing weak. This was just a few weeks after treatment that was too short of a stay thanks to insurance. But I know looking back that if it had to be, it was one card I didn't have to put in the regret pile that cold rainy January morning.

Saturday, 1 November 2014

Why is this acceptable?

Both Type-II diabetes and addiction are diseases that have genetic and lifestyle elements to them, which is why they are often compared when it comes to treatment. The parody below covers what it would look like if we treated people with diabetes like we treat people with addiction. It is a real eye-opener.

The Use of Insulin in
the Treatment of Diabetes:
An Analogy to
Methadone Maintenance

by J. Thomas Payte, M.D.*

A five-year study was conducted on 300 insulin-dependent diabetics. The purpose of the study was to determine if the use of insulin resulted in any long-term benefit to diabetics. The concept was based on two widely accepted hypotheses: (1) that a formerly insulin-dependent diabetic could learn to live a comfortable and responsible life without insulin, provided that he or she wanted to badly enough; and (2) that the use of any exogenous substance to replace or simply substitute for a deficient endogenous substance is conceptually unacceptable to modern scientific thinking and may be inherently evil.

It is obvious that exogenous insulin, being highly suspect at the outset, should be used in the lowest possible doses and for the shortest time possible. In this study, treatment with insulin was limited to two years and the daily dose was limited to a maximum of 40 units. The post-treatment follow-up period varied from three days to three years, depending on the duration of survival. During the treatment phase (insulin maintenance), random urine samples were collected under direct supervision and tested for glucose at least weekly. A positive urine glucose resulted in a warning to the patient. After three positive urine tests, the dose of insulin was reduced by five units daily for each positive urine test. This policy was intended to increase motivation on the part of the patient to provide urine specimens negative for glucose. If positives continued, the insulin was eventually discontinued and the patients were placed in the follow-up group. The authors of the study felt that patients would have a better chance of re-entry into insulin maintenance at a later date if (a) the patients survived and (b) patients accepted full responsibility for their insulin dependence and were willing to go to any lengths to recover.

All patients were required to endure one hour of individual or group counseling each week, which addressed such subjects as meal planning, hygiene for the feet, pancreatic imagery, and dietary assertiveness. Counseling patients fell into one of three categories: those who had no need or desire for counseling; those who might need counseling but were entirely unwilling to participate; and those who both wanted and needed extensive counseling, but the counselors were so busy spending an hour a week with the others that they were unable to meet the increased demands and needs of this group. Avoiding this bothersome, time-consuming, and costly process of individualized treatment also served to reduce the risk of enabling the patients' maladaptive behaviors by what could seem to be a reward system. The resulting uniformity of service assured that the needs of no one were met. It was hoped that by making the treatment unpleasant that motivation for recovery would be enhanced.

Half the participants failed to complete the two-year treatment with insulin maintenance. Some patients simply dropped out of treatment, but most were terminated for continued glucose-positive urines. This was despite repeated warnings and in absolute defiance of the reductions in insulin dosage with each glucose-positive urine. It was concluded that this population is poorly motivated, difficult to work with, and is lacking the resources needed to effect the major life changes required for recovery. Many of this group died during follow-up. Some survived with amputations, blindness, neuropathies, and other conditions associated with the unhealthy life-styles of the diabetic.

The remaining half did manage to complete the two-year treatment and even appeared to experience relatively good health and seemingly normal functioning. Of course, this illusion of apparent good health was at the expense of continuing to maintain the insulin-dependent status with daily insulin. Some investigators speculated that insulin might be continued over a longer period of time and at higher doses. This notion was quickly rejected as being absurd because good health should not be obtained at just any cost. As the patients approached the two-year period, the insulin doses were tapered over the final two months. All subjects began having positive urine tests and again were showing active insulin-dependent diabetes. The obvious conclusion is that insulin does not help the insulin-dependent diabetic and is not effective in treatment. The high mortality rate of post-treatment patients suggests that insulin may have had some delayed, deadly toxic effects. This concept should be the subject of future research.


This "insulin spoof" was originally written with the idea to share it among friends and colleagues. Somewhat surprisingly, the spoof was well received by many who urged that it be shared with a wider audience. Initially, the intention was to transpose rather typical and illogical clinical thought processes about methadone maintenance to another more familiar chronic and incurable disease.

The transposition to a disease that is much more widely understood made the line of reasoning clearly absurd in the new context. Yet when this pseudo logic is applied to chronic opioid dependence and methadone maintenance, few people find anything wrong or out of place. One might conclude that the vision of some is clouded by the philosophical and ideological considerations that erect barriers to understanding, accepting, and implementing this lifesaving treatment modality for those chronic intractable opioid addicts who need it.

Any humor in this parody is quickly lost when one estimates the loss of life and other costs associated with untreated opiate addiction that can be attributed to a persistent shortage of methadone treatment slots. This shortage is due, in part, to persistent negative attitudes toward the methadone treatment modality.

*Chairperson, Committee on Methadone Treatment, American Society of Addiction Medicine; Founder and Medical Director, Drug Dependence Associates, 3701 West Commerce Street, San Antonio, Texas 78207

Originally printed in the Journal of Psychoactive Drugs, Vol. 23(2), Apr-Jun 1991