Day #168 The fatality of relapse

I was catching up on my Facebook feed this morning and finally spotted an explanation of why I was seeing a sudden glut of references to Carrie Fisher. I had not realised that her autopsy report had been made public, revealing that she had cocaine, heroin, and ecstasy in her system at the time of her death.

59484d30210000f01b33cfb5However, the article I was reading wasn’t about the autopsy result itself. The author, Ryan Hampton, was lamenting the fact that this information, which some would argue should have been kept private to the family, is now going to hijack Carrie Fisher’s legacy. The author fears that she will become just another one of those famous people who died of overdose following a relapse. On this point, the author is defiant.

“I won’t let that happen to Carrie. You know why? Because relapse is not the point, and I want to make it abundantly clear that Carrie was so much more than her substance use. Saying that she “lost the battle with addiction” totally overlooks not only the amazing amount of good she brought to the world, but also perpetuates a deadly stereotype about substance use.”

~ Hold Your Head High, Princess Leia. You Are So Much More Than An Autopsy Report.

The main point of the article is one I have heard before – the misunderstanding and stigma surrounding relapse when it comes to the treatment of addiction. John Spencer, in his famous West Wing role as Chief of Staff Leo McGarry, described it best in the episode titled “Bartlet for America” when he shares a story with his personal attorney, Jordan Kendall:

“You had a drink.”

“I’m an alcoholic. I don’t have ‘one drink’. I don’t understand people who have ‘one drink’. I don’t understand people who leave half a glass of wine on the table. I don’t understand people who say they’ve had enough. How can you have enough of feeling like this? How can you not want to feel like this longer. My brain works differently.”

“I don’t understand how you could have a drink. I don’t understand how, after everything you’ve worked for, how on that day of all days, you could be so stupid!”

That’s because you think it has something to do with smart and stupid. Do you have any idea how many alcoholics are in Mensa? You think it’s a lack of willpower? That’s like thinking that somebody with anorexia nervosa has an overdeveloped sense of vanity. My father was an alcoholic. His father was an alcoholic. So in my case…”

“… ‘it ain’t nothing but a family thing’…”

“That’s right.”

“Who else knows?”

“Josh Lyman and the President.”

“Why nobody else?”

“Because.”

“That’s a little boy’s answer.” 

“I went to rehab, my friends embraced me when I got out. When you relapse, it’s not like that. “Get away from me” – that’s what it’s like. 

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In an earlier season of the show, in an episode titled “Taking out the Trash Day”, Leo McGarry meets with a White House staffer, Karen Larsen, after she is fired for leaking documents relating to his treatment for alcohol and drug abuse while he was Secretary of Labor. The two have a very frank exchange in his office about Leo’s addiction issues.

“When you read in my personnel file that I had been treated for alcohol and drug abuse what went through your mind?”

“My father drank a lot.”

“So did mine. In fact, he died from it.” 

“Is that why you drank and took drugs?”

“I drank and took drugs because I’m a drug addict and an alcoholic.”

“How long did it take you to get cured?”

I’m not cured. You don’t get cured. I haven’t had a drink or a pill in six and a half years, which isn’t to say I won’t have one tomorrow.”

“What would happen if you did?” 

“I don’t know. But probably a nightmare the likes of which our fathers experienced, and me too.” 

“And… So after six and a half years, you’re still not allowed to have a drink?”

“The problem is I don’t want a drink. I want ten drinks.” 

“Are things that bad?”

(laughs) “No.”

“Then why?”

“Because I’m an alcoholic.”

“I don’t understand.”

“I know. It’s ok, hardly anyone does. It’s very hard to understand.”

These two conversations very beautifully portray the difficulty that people who have never experienced addiction face when interacting with people who are recovering addicts. The truth is, we just don’t get it. I might say I’m addicted to chocolate, or my smartphone, but at the end of the day I can admit that I honestly don’t understand what that sort of craving must be like – something so powerful that all your rational thought and logic flees in the face of its dominance. We like to think that, once people have received treatment, that they have, in some fashion “seen the light”. That they understand the error of their ways, the dangers of their previous habits, the devastating effects their addiction has on the people around them. With such a mindset, it’s not difficult to understand why those addicts who suffer a relapse are shunned – because having acquired the knowledge of the error of your ways, such a relapse must clearly demonstrate a personal failing. How else would you commit such an grievous mistake in the full knowledge of the damage you are doing to yourself and your friends and family?

And therein lies the problem. We, sober people who don’t suffer from addiction, don’t have a frame of reference for how such relapses can come about. We don’t understand the lure, the attraction. We think that, once an addict has recovered, that they are “cured” from this desire to fall back into old habits.

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In this regard, the most potent explanation I have come across that I felt I could truly understand, despite never having been in such a situation myself, was written by the actor and comedian Russell Brand. I may not be a huge fan of his work, but the man sometimes has a way with words which is powerful and hard to deny.

Shortly in the aftermath of the death of Philip Seymour Hoffman, he wrote an article for the Guardian. In his piece “My life without drugs” he talks about the need for compassion for those affected by addiction. And he very honestly confronts us with the brutal truth about addiction being a life long condition for which, as Leo McGarry says, there is no cure.

He admits that, despite ten years of sobriety, the last time he contemplated taking heroin was the day before after receiving some unpleasant news. The price for his sobriety, he reflects, is “constant vigilance”. He describes how easy it is for him to succumb to that lust for oblivion that heroin provides and the support network he uses to try and avoid going down that road each time he feels the same pull. Honestly, I feel tired just reading his article. I can’t imagine having this fight within myself every. single. day. This is the most striking portion of his account:

“Recently for the purposes of a documentary on this subject I reviewed some footage of myself smoking heroin that my friend had shot as part of a typically exhibitionist attempt of mine to get clean. I sit wasted and slumped with an unacceptable haircut against a wall in another Hackney flat inhaling fizzy, black snakes of smack off a scrap of crumpled foil. When I saw the tape a month or so ago, what is surprising is that my reaction is not one of gratitude for the positive changes I’ve experienced but envy at witnessing an earlier version of myself unencumbered by the burden of abstinence. I sat in a suite at the Savoy hotel, in privilege, resenting the woeful ratbag I once was, who, for all his problems, had drugs. That is obviously irrational. The mentality and behaviour of drug addicts and alcoholics is wholly irrational until you understand that they are completely powerless over their addiction and unless they have structured help they have no hope.”

I just sat there for a while after reading that because it is such a powerful statement of the effects of addiction. I can’t quite wrap my mind around it, but I do understand the point he is trying to make, which is that we, sober people who don’t have an addiction problem, treat recovering addicts by expecting them to be grateful for their recovery. But while it may be easy to appreciate the improvements in life that sobriety brings, we can’t understand that sobriety doesn’t mean that addicts leave behind that longing, that desire to lose themselves in something so powerful and overwhelming that it appears to diminish all of their immediate problems. Would that not appeal to any of us? If we had a taste of something that Russell Brand manages to convey as just blissfully divine, wouldn’t we too want to indulge in it, constantly?

“Drugs and alcohol are not my problem, reality is my problem, drugs and alcohol are my solution.”

He does put forward a simple solution: Don’t pick up a drink or drug, one day at a time.

Simple, as he says, but not easy. He admits that, even when surrounded by supportive family who, with each relapse, wring their hands and wonder what they did wrong, each sufferer “must be a willing participant in their own recovery.” And it’s frustrating when they seem unable to stick with that participation.

“It is difficult to feel sympathy for these people. It is difficult to regard some bawdy drunk and see them as sick and powerless. It is difficult to suffer the selfishness of a drug addict who will lie to you and steal from you and forgive them and offer them help. Can there be any other disease that renders its victims so unappealing?”

His support network, Russell Brand reveals, is other alcoholics and drug addicts. People in recovery who understand this illogical disease better than anyone. And he freely admits that just that one other person, at the end of a phone, is the reason he is still sober ten years later. One day at a time.

Why am I writing about this? To be honest, I don’t know. Although I am aware of the devastation wreaked by addiction, it has not thankfully impacted my own life directly. But that doesn’t mean that I have not witnessed other people who have had to cope with its effects on their friends and family. And often what I see is frustration and impatience. And dare I say it? Lack of compassion. Not because those people don’t care, but because it’s almost impossible to truly have unreserved empathy for someone when the main outward symptom of their disease appears to us as selfishness. We forget, after a while, that it’s not like an acute illness, where the bad memories may linger but the disease itself is long gone. It’s a lifelong, incurable condition that never goes away. Maybe I’m writing about this because sometimes I need a reminder myself when I see my icons fall and falter in the media. I need to remember that relapse is not a moral failing. It’s not selfishness. It’s not surrender. It’s a failure of the sufferer, in that one crucial moment, to find and grasp a lifeline that can help remind them why they’re fighting this fight every day. Because it just takes that one short moment of forgetfulness for the disease to leap from simply being incurable to being fatal.

It’s exhausting to think about it. I can’t imagine how exhausting it must be to live it. And I think that’s the thought I must try to hang on to when I encounter someone who has relapsed. Maybe if we can’t summon forth the necessary compassion for those in our lives who suffer from this disease, we should admit it to them and put them in touch with a person who can offer that because they also live the same reality.

Perhaps that’s the most compassionate act we can make is to admit defeat and relinquish the field, without judgment, to those who have survived it themselves.


Photos of Russell Brand and Carrie Fisher are sourced from their respective publications in The Guardian and Huffington Post, and links to the original articles are provided.

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