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USA

The ultimate accusation we can seemingly make about something today is that it is addictive. Like heroin is. Consider the fate of cigarettes in that regard. Talk now is about sugar being addictive. And what about marijuana?

But aren’t we awash in a sea of addictions? Aren’t we all addicted, more or less?

Horrifying!

In the 19th century, opiates were used by virtually every man, woman, and child in America. A tinctured opiate solution, laudanum, was sold everywhere over-the-counter, and was used to help babies through teething and in order to sleep.

Horrifying!

But opiate addiction was not considered a special problem in 19th-century America. There are two possibilities: One possibility is that people socialized their use (keep in mind that opium and coca have been consumed in Afghanistan, Asia, and South America for eons) so that opiates were taken in a traditional, controlled manner and people were rarely addicted to them. 

The second possibility is that, if everyone around you is addicted to something, you can’t recognize the substance’s addictiveness or your own addiction. Was this the case for 19th-century opiate use?

Moving into the 20th century, consider smoking. When cigarettes were considered harmless—were even marketed for their health effects—people smoked relentlessly, in all settings, indoors and out. (Consider Mad Men.)

Horrifying!

When the Surgeon General’s Report indisputably showed smoking caused cancer in 1964, there was an immediate, shocked reaction. About half of all smokers quit over the next decades, cutting smoking rates in the United States from roughly 40 to 20%.

Some people continue to smoke—oddly enough, less well-educated and poorer people with fewer resources, despite the rising cost of cigarettes. Still, no one today considers smoking healthy, and everyone recognizes that nicotine is addictive. Those who continue to smoke are now, in many places, social pariahs.

But let’s conduct a mind experiment: What if coffee and tea were discovered to cause cancer? Many people would quit making coffee in the morning or going to Starbucks—let’s guess half of all regular coffee drinkers. Others would say they wished to quit, but couldn’t just yet. And a defiant minority would say, “I don’t care if coffee causes cancer—life is unbearable without it!”

It turns out coffee isn’t dangerous (it is actually remarkably healthy). Its worst consequence is contributing to the apparently universal insomnia that grips America. So most people don’t have to (or don’t want to) quit.

But is coffee (caffeine) addictive? Don’t be absurd! On the other hand, as Archie Brodsky and I wrote in Love and Addiction:

“The sufferer is tremulous and loses his self-command; he is subject to fits of agitation and depression. He has a haggard appearance…. As with other such agents, a renewed dose of the poison gives temporary relief, but at the cost of future misery.” 

The drug in question is coffee (caffeine), as seen by the turn-of-the-century British pharmacologists Allbutt and Dixon. Here is their view of tea: “An hour or two after breakfast at which tea has been taken … a grievous sinking … may seize upon a sufferer, so that to speak is an effort. … The speech may become weak and vague…. By miseries such as these, the best years of life may be spoilt.”

What seems dangerous and uncontrollable at one time, or in one place, becomes natural and comfortable to deal with in another setting. 

Let’s turn to the present. Is there anything that people do seemingly compulsively all around us, which they don’t regard as addictive?

Have you been in a park, or airport, or bar lately and watched people check their smartphone or equivalent gadgetry incessantly, going back to their email, text messages, phone messages, personal newsfeed—what have you? They hardly ever look up at the sky outside, or to talk to the person next to them—sometimes the person they entered the space alongside, like their partner or children!

What about people taking these gadgets (and others, like iPods, iPads, whatever) to bed? There are two possibilities: Either they sleep alone, and the instrument becomes their main companion, one that never leaves their side. Or else they sleep with someone, but pay nonstop attention to their electronic companion instead of their real-life partner!

Horrifying!

What is that exactly? What would happen—what happens—when occasionally they lose this gadget, or aren’t allowed to use it, or their battery runs out? How do people cope with their life and time without this crutch? Are they tense, at loose ends, almost unable to bear the passing time? Isn’t that withdrawal?

A few people point out serious negative health and life consequences from these electronic addictions. Some medical publications are even considering this seriously—if perhaps a little bit tongue-in-cheek. And there is rehab for smartphone addiction, just as there is for video game addiction.  

But if everyone is addicted to their cellphone, Facebook page, Instagram (whatever the hell that is), who really cares? And if everyone drinks coffee at breakfast, can it really be called addictive? Or does normalcy protect us from the label “addiction?” Or are we not really even interested in addiction? Do we really only care about what are acceptable and unacceptable addictions?

Or is there a clinical justification for focusing on some addictions because they harm us?

As my fellow addiction psychologist and the president of SMART Recovery, Tom Horvath, recently wrote:  “I suggest that everyone has addictive behavior, and some have problematic addictive behavior (at various levels).” I wrote a paper about marijuana’s addictiveness entitled, “Marijuana is Addictive—So What?” My point was we only worry about some of the myriad addictions in our lives. Something’s being addictive, taken by itself, doesn’t concern us.

By the way, do you know that psychiatry’s manual, DSM-5, recognizes only one addiction: compulsive gambling. No drugs are called addictive in the DSM-5. And only one more activity is being considered currently—electronic games. (No sex, or porn, or love? None of those can be harmfully addictive? Who makes these things up?)

That’s not horrifying; it’s unbelievable!

As for your personal concerns about an addiction, as Archie and I say in Love and Addiction: “Practically speaking, we can only make the personal decision to treat something as an addiction on the basis of how much we see it hurting us, and how much we want to be rid of it.”

For those seeking the definition of addiction in brainwaves, there can be no meaningful answer to these questions. Only when society (or you in your own life) considers an addiction harmful and disapproves of it will the red flag for addiction go up. That labeling process can change, sometimes quite rapidly.

So, to borrow some phrases from literature: Addiction, where is thy sting? (William Shakespeare) Never send to know who is addicted; it is you. (John Donne)

And that old classic: Addiction is as American as apple pie. (H. Rap Brown)

Stanton Peele, Ph.D., is the author of Recover! Stop Thinking Like an Addict. He is the recipient of career achievement awards from the Center for Alcohol Studies and the Drug Policy Alliance. His Life Process Program for treating addiction is available online. He last wrote about memoirists and alcoholism.

When does something veer off from being normal and accepted to being called addictive? The answer isn’t in our neurosystems.
By Stanton Peele
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drive safe

According to The National Highway Traffic Safety Administration: “Drunk driving deaths spike during the holidays. Every 51 minutes, someone in the United States dies in an alcohol-impaired driving crash. Be responsible—don’t drink and drive. If you plan to drink, choose a sober designated driver before going out.”

As the Memorial Day holiday weekend approaches there will be more traffic on the roads, and more people will make the devastating decision to drink and drive.  

The concept of the "designated driver" began in Scandinavia. It was adopted as a formal program by Hiram Walker and Sons, the distillers of Canadian Club Whiskey in Canada, in the 1970s and became a buzzword in the North America shortly after. Mothers Against Drunk Driving (MADD) became the self-declared champion of the designated driver in the 1980s. But designated driver programs, when instigated by groups of people drinking, had its problems. If the driver wasn’t designated the driver before travel, often the designated driver didn’t stay sober. Equally, if complete abstinence is not required, someone would end up driving drunk.

Several volunteer programs across the country focus on college students' weekends and the excellent HERO program vows “...to register one million designated drivers and make having a designated driver be as automatic as wearing a seatbelt.”

Now 35 years old, MADD, the support and advocacy group for the victims of drunk driving, has long been aware that young people between the ages of 21 and 24 are most at risk of being involved in a fatal crash involving alcohol. The group aged 25-34 are the next highest.

Incidentally, the two age groups most at risk, are the most tech savvy. The Pew Research center says: “Younger adults—regardless of income level—are very likely to be smartphone owners.”

So is there an app for that? You bet there is. Uber’s wildly successful 2009 launch into the closed shop of private transportation caused a storm of protest from taxi drivers across the country. But the "ride-sharing" service that connects independent, non-commercial drivers with their own cars with people in need of a ride has been hugely popular with an urban generation raised on technology and the convenience of the Internet. As the taxi app that crowdsources private drivers quickly became a ubiquitous part of modern life, it became a no brainer that Uber (and other ride-sharing start-ups, Lyft and Sidecar) would be the first choice for getting home late at night from a party or bar.

Ride-sharing, for MADD, couldn’t have come at a better time. And both Uber and Lyft have made donations to the charity through the use of promo codes. Over the July 4th weekend in 2014, they began their partnership by giving $1 ($10 for new riders) for every ride taken between 6am on July 4 and 6am on July 5. The cooperation continued over the New Year’s holiday.

But was the new app making a genuine dent in DUI deaths? And was it changing attitudes toward drunk driving?

Back in 2014, Uber looked at publicly available data on DUI arrests in the time before and after Uber’s Seattle entrance in 2013. They noticed a drop in DUI arrests in the city.

Inspired to learn if their business was having a genuine impact on public safety in other markets, they looked at Pittsburg and Miami and noticed a temporary and unusual spike in requests for drivers at closing time in the two very different cities. Satisfyingly, that’s exactly how it looked. Coincidence? Maybe, but in a follow-up look at requests in Chicago, they dug a little deeper—looking into the distance of a request from a bar or restaurant, and sure enough, 45.8% of rides requested came from or near these locations during the peak drinking hours of 10pm and 3am, compared to 28.9% at off-peak times.

But these were only small slices of time, a year at most, and not necessarily hard proof of a change in the habits of young drinkers.

In January 2015, Uber teamed up with MADD to look at California. The California Highway Patrol (CHP) covers the entire state’s highway and county road system. Its publicly available data on DUI crashes, gives a snapshot of activity from across approximately 2,335,000 miles of paved roadways. Uber used this information and looked at the time when the "Uber X" ride-sharing model was introduced into various parts of the state. Uber X is the basic service, where private individuals share their car to people in need of a ride.

As they hoped, in their report, “More options. Shifting mindsets. Driving better choices,” alcohol-related crashes were fewer in parts of the state where Uber X had been introduced—particularly in the key group of those under 30. They conclude:

“...We believe there is a direct relationship between the presence of ‘Uber X’ in a city and the amount of drunk-driving crashes involving younger populations.”

Good news, of course, but what about the attitudes of these young drivers? Were they changing? MADD wanted to see if part of their mission: “to create major social change in the attitudes and behavior of Americans toward drunk driving,” was being accomplished. They commissioned a survey to find out how seriously people wanted to end drunk driving.

“The results of our survey show that the availability of additional, reliable transportation options is shifting mindsets and driving people to make better, safer choices."

"88% of respondents over the age of 21 agree with the statement: 'Uber has made it easier for me to avoid driving home when I’ve had too much to drink.'”

"78% of people say that since Uber launched in their city, their friends are less likely to drive after drinking."

"57% of transportation network service users agreed with the statement: 'Without Uber, I’d probably end up driving more after drinking at a bar or restaurant.’”

And after hearing about Uber’s impact on drunk driving already, 93% of people would recommend a friend take Uber instead of driving, if the friend had been drinking.

Neville Elder is a regular contributor to The Fix. He's also a photographer and writer. Originally from the UK, he's lived in the unfashionable end of Brooklyn for 13 years. He last wrote about the forgotten victory in the War on Drugs and how the DEA under Michele Leonahrt was rotten to the core.

Memorial Day driving could be safer this year, due to an unlikely alliance.
By Neville Elder
Craig Gass
q&a

Craig Gass has been keeping audiences doubled over in laughter for more than 20 years. His knack for impressions of notorious celebrities like Gilbert Gottfried and Al Pacino attracted the attention of radio kingpin Howard Stern, who took him under his wing. He’s since gone on to appear on numerous shows including Sex and the City, The King of Queens and American Dad!, in addition to selling out comedy clubs across the country.

But a cocaine addiction that started in his teens and continued into his 30s, threatened to take all of it away. After having a heart attack at age 32, he vowed to give up drugs once and for all. Although the road was difficult at the beginning, Gass has now been clean and sober for over 10 years.

Speaking exclusively to The Fix, Gass opened up about losing some of his closest friends in the business to drugs, the relationship that led to a relapse, and how he now stays sober on the road.

When did your drug use first begin?

I started drinking alcohol at age 14 and drifted into pot shortly after. But when I discovered cocaine at age 15, it felt like I had discovered the most incredible thing in the world. It lit the fire and I didn’t realize until a few years later that I was in a situation which wasn’t so good. 

Like most people, the first few years were chasing the incredible fun you had your first night doing it, but the bad moments continued to happen more frequently. It’s funny how everything that your parents warned you as a kid about drugs comes true. You start to notice something really bad happening to those around you more often, whether it’s that they die or go to jail, but you see it in the peripheral and ignore it, even as it continues to pile up. 

Would you say that the culture of stand-up, or the business, exacerbated your drug use in any way?

I tried stand-up just for fun at age 20 and really went for it at age 23, so I was well into my addiction at that point. I think I still would have had my addiction following me regardless, but you do surround yourself with other fucked-up people who have a certain intensity to them. 

The crazy thing was that seven friends died in the first year I quit drugs and alcohol and all of them were comedians. Four were from drug overdoses and three were from DUI-related accidents. The first friend to pass away was Mitch Hedberg, who was my roommate at one time. I had really thrown up the white flag at that point and was determined to quit, but we all have doubts in the beginning. You think to yourself, “You can still do drugs. You just have to keep it under control!” It just reinforced that I was doing the right thing. 

Many of the comics we’ve spoken to have said that being alone on the road has tested their sobriety the most. Is that something you’d agree with?

Absolutely. It actually hit me harder after I was clean for about four or five years. I was performing at a club in Austin, Texas, and there were a bunch of local comedians who were really cool and had their own scene going on. Comics will usually hang out together and when you’re in a new city, people will come up just to shoot the shit or ask for advice. But nobody wanted anything to do with me that night. 

I felt really alone and went back to my room, opened up the ring key and thought this would be such a cool moment if I had drugs on me. Maybe it was the feeling of loneliness. But I knew I’d spend all night lowering the volume of the TV until it was on mute or following the shadows under the door, thinking I had to chop my coke more quietly because everyone could hear me. There was nothing enjoyable about the psychosis of it all.

You’ve spoken previously about having a heart attack when you were 32. Was that the moment when you decided to stop using?

It was. It was the first time in my life that I could afford my addiction and I wanted to make sure I had more than enough. I was having moments where my body was sending signals and I’d just move past it. But I was up for a couple of days at one point and could feel my breathing getting more restricted. My roommate took me to the hospital and the doctor said they were calling for a cardiologist to come down immediately because I was having a heart attack. It was surreal because I was making phone calls to people not knowing if I was ever going to talk to them again, all while feeling my breathing becoming more restricted as my body was shutting down. I knew afterwards that something had to change.

Were there any periods of your recovery that were rocky?

I was clean for a year and two weeks the first time, but then I got into a relationship with a girl who just wasn’t right for me. She would beg me to do coke with her, even knowing what happened with the heart attack, and said I just needed to do it in moderation. Finally, I got fucked up on New Year’s Eve and it was amazing how much more intense my addiction got for the next 11 months.

The plan was to quit on New Year’s Day since Jan. 1 is an easy day to remember to be sober. But on the two-year anniversary of my heart attack (on Dec. 14), the switch turned on. I was taking care of my mom at that point and just had clarity. And that’s hitting the fucking lottery because so many of us do this stupid dance where we know we need help, but see what the options are and run away. Just surrendering and accepting the embarrassment and saying I have a problem is something not many of us are able to do. I celebrated 10 years of sobriety last December. 

Do you talk about your past drug use on stage at all?

I talk about it lightly on stage, but there wasn’t anything about that period that was hugely funny to me. I talk about doing coke with someone in the Mexican mafia who put a hunting knife to my face. I was willing to put up with that and hear about what a horrible human being he was just because he had coke. It doesn’t come out as a 10 or 15-minute bit, but more as little sides.

Is there a camaraderie of sorts among other sober comics in the industry or is it not as obvious who they are?

I was able to confide in another sober comedian when I was struggling early on after my heart attack, which was really important for me. The scary thing when I first stopped was thinking about how I’d be alone. I was shocked to find out how many comedians, musicians, actors and radio people are sober. It was like, “Wow, not everyone was getting as shit-faced as I was.” I was realizing that I was actually one of the few people who had reached that level. 

What are some of the things that have helped you most in staying sober?

It was hard for me to do, but the biggest thing in the beginning was getting rid of everyone who I partied with. I was always living two separate lives, so the people I cared about and the people I partied with never mixed. That’s not to say I didn’t care about some of those people, but I couldn’t be around them if that’s what our friendship revolved around. So even when I let that go, I still had people who cared about me. It also took me a while to realize that I had to give up everything as well. I never had a drinking problem, but it took me right back to coke.

Attending group meetings is something that’s therapeutic for me to this day and I’ll do it more often now. I’m just really grateful to be alive.

McCarton Ackerman is a regular contributor to The Fix.

Cocaine addiction that started in his teens and continued into his 30s threatened to take all of his success away. Gass has now been clean and sober for over 10 years.
By McCarton Ackerman

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