Meeting the Intoxication Coach Doc Wilmot

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Meeting the Intoxication Coach Doc Wilmot

By John Lavitt 02/05/15

The Fix Q&A with harm reduction maverick Doc Wilmot, the founder of DrugCraft, “an innovative harm reduction approach to drug/alcohol use, misuse, abuse, and addiction” that he describes as intoxication coaching.

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Doc Wilmot
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Dr. Richard Wilmot, known as Doc Wilmot by his colleagues and his clients, is a sociologist with a specialization in the social psychology of substance abuse. Doc Wilmot is the founder of DrugCraft, an innovative harm reduction approach to drug/alcohol use, misuse, abuse, and addiction that he describes as "intoxication coaching." A maverick in the field of harm reduction, Doc Wilmot is a former editor of the Journal of Drug Issues and the author of American Euphoria: Saying 'Know' to Drugs, an investigation into how the very private experience of intoxication is conditioned by public policy and culture. 

Dr. Chip Evans provides a glowing review of the controversial book on Amazon, writing, “I have been practicing psychology for 36 years and have worked with 1000s of patients with drug issues, almost always badly diagnosed Our world shows only portions of understanding about the use/abuse and the spiritual and psychological implications. I've ordered this book for a large group of other psychologists.“

After working for the Addiction Research Foundation in Toronto, Wilmot received a scholarship to complete a Ph.D. in Drug Studies at the University of California at San Diego. After obtaining his degree, he spent years in the recovery field, doing research, counseling clients on Skid Row, lecturing at the Drug Policy Foundation in Washington D.C., and teaching courses in drug studies as an Adjunct Professor at the College of Alameda.

(Note of Identity clarification: Doc Wilmot is not the same Dr. Richard Wilmot as the practitioner from Guilderland, New York who was accused of improper conduct with a female patient while treating her for fibromyalgia in 2011.)

You call yourself Doc? What is the origin of that moniker? Is it because you’re not actually a doctor?

I have been asked that several times before when I say something that’s unorthodox, but, in fact, I do have a Ph.D. in social psychology with an emphasis in the study of drug abuse. My passion for drug studies grew out of my own experience with a variety of drugs, with the drug subculture while in college, and later working in the so-called culture of recovery. After having worked for the Addiction Research Foundation in Toronto, Canada, I received a scholarship in drug studies at the University of California at San Diego. I got there after an article I had written when I was with The Addiction Research Foundation called "The Skid Row Imperative" gained the attention of some faculty members. I lived for six months on Skid Row and wrote this paper about my experiences. 

This happened in the late 1970s. Nixon had come out with what would later be known as “The War on Drugs” and there was a profound lack of expertise on the subject. As a result, they were trying to create experts in the field. In truth, the drug war under Nixon was really a political hit-list. 

As for the use of the word “Doc,” it came from a time when I was working in a Dual Diagnosis Center in Oakland, and there were two clients that were fighting in front. One had a broken bottle and the other had a two by four with a spike through it, and they had both been smoking crack. It was in a crack area of the city. I actually disarmed both, put them in the back seat of my car and we drove around the neighborhood listening to jazz and talking. They vented, and I listened to them. I think this was the most surprising aspect of the interaction for both of them. I made some proposals, they agreed. When I drove them back, there was a crowd in front of the center. The two former combatants got out, shook hands, and we were cheered. The people standing there were all calling me Doc. Since that day, I was no longer Dr. Wilmot, but Doc. 

In American Euphoria: Saying 'Know' to Drugs, you show how what you describe as the very private experience of intoxication is conditioned by public policy and culture. You connect intoxication to euphoria. You write, “Euphoria is something for which people will die. If they are not allowed to express such feelings, drug and alcohol recovery will continue to remain a dismal and tragic failure.” How is euphoria conditioned by history and culture? Why is the prohibition of drug use the same thing as the prohibition of euphoria? Can’t euphoric experiences be achieved without drugs?

In terms of how euphoria is conditioned by history and culture, this is a sociological principle. How do you separate something, which is private from socialization in the sense that people learn to like what they like by going through an experience? Although such an experience is universal for everyone going through it, the question is, what makes it private? The answer is mindfulness. When we think about an experience that almost everyone has, when we think about it and analyze it through the lens of critical thinking, it makes it more of our own experience. 

What I am suggesting in this context is what people need in terms of the drug crisis is more mindfulness. The essence of such mindfulness is defining one's high. What does one mean when they say, “I want to get high,” and what does that imply? Where do you want to go with that impulse? A lot of people will just take a drug and say, “Well, let’s see where this drug is going to take me.” I believe that’s a sure hook towards drug abuse. 

We’ve got to have a plan when taking a drug and we have to ask what the plan is for our high. But you don’t find this type of talk in treatment because of the abstinence-only approach. People don’t talk about the high. It’s kind of like being a sex addict and not being allowed to talk about your orgasm. It’s like not being allowed to admit that you even have one. Admitting your high is forbidden because it’s like a form of heresy. 

I don’t think that getting high is necessarily something that’s related to prohibition. I think that you can be still surrounded by drugs and still be able to function and still be able to have mindfulness and consciousness, if you’re not afraid of them. I do think there are a lot of ways that people can get euphoric experiences, but not with the intensity and convenience that intoxicating substances offer and this is why I developed this term of intoxication coaching.  

In the book, you go into detail about the ongoing influence of the Puritan ethos on the soul of the United States. You write, “Drug abuse in America today is not a problem due to the availability of drugs. Rather, its roots lie deep within our cultural heritage. It is this heritage that perpetuates the abuse. Both public drug policy and the individual quest for euphoria are still possessed by the ‘ghosts’ of our puritan past.” Can the modern repugnance towards drugs be blamed on the Puritans? Would you connect it to the later Salem Witch Trials as well?

Most people do not know that the concept of addiction started way back in 1785 with a Puritan member of Congress named Benjamin Rush. He also was a physician, and he believed that alcohol, particularly hard alcohol, had a negative effect on the morality center in the brain. Nobody’s discovered where that morality center is yet, but Benjamin Rush insisted that it existed in the brain and that alcohol had a negative effect on it. As a result, he was strongly against the consumption of any hard liquor.

Mind you, people at that time drank beer, sometimes wine, all throughout the day because the water was usually tainted. Since people were drinking an intoxicating beverage throughout the day, they were under constant surveillance to see that their behavior and their bearing did not reflect intoxication. The whole community was like carefully watching each other. Even laughter was suspect. If you were laughing, you might be high. Intoxication was a sin and it was not permitted. Basically, I believe that all of our profound feelings and negativity towards drug abuse in the United States can be traced back to the Puritans. Drug education and treatment in America must change to end the fear and loathing many Americans have about drug use, in general. A new understanding of addiction must recognize the subjective pleasure and euphoria that drugs produce for users and occasionally for abusers.

As for the Salem Witch Trials, I think the drug wars are very much like them. In the drug wars, you are accused of a crime simply because of your desires. Back then, what you were saying or believing indicted you. Now, what you have ingested into your own body has become the crime. As a result, a comparison between the Salem Witch Trials and the War on Drugs seems quite appropriate.

You write, “In America, we have a constitutional guarantee of religious freedom and a clear separation between church and state. However, when it comes to the “religion” of euphoric drug experiences, federal and state governments make no distinction. Even the spiritual use of a sacramental drug is a crime.” What about the use of Peyote in native cultures, the Church of Ayahuasca in New Mexico and the spiritual use of cannabis in the Rastafarian movement? Aren’t these sacramental uses of drugs approved by our society or, at least, ignored?

Another thing that most people do not realize and I have learned on account of my experience in the field of drug studies is that the only places were cannabis is legal is in California, Washington, and now Colorado. That’s throughout the world. Other countries have decriminalized drugs, but they haven’t legalized them. Even in Amsterdam, in Holland, you don’t have legal drugs. You just have police not enforcing those laws. The United States signed a UN Charter with all the countries of the world that stated that they would not allow the legalization of drugs. This is starting to change in terms of thinking, but not in terms of actual policy.

There is so much evidence now, like the California Medical Association recently saying that marijuana should be legalized not just for its medical benefits, but because it is the safest intoxicant in the world. People want and need an intoxicant, which is safe and free of harm. In Jamaica, where there is a very open Rastafarian movement, marijuana is still illegal. A lot of these people who are using drugs spiritually today, they are very much like the early Christians. They have to hide out in order to practice their faith and have what they consider to be a religious ceremony. 

In American Euphoria: Saying 'Know' to Drugs, you write, “Appropriate ceremonial sets and ritualistic settings can act as controls and safeguards for the drug experience by predefining and predetermining titration levels (amount, frequency, and method) during the period of intoxication. When intoxication occurs without a commitment to become intoxicated, ritual and ceremony are lacking, and so, too, is control.” Do you believe a ritual approach to drug usage would supply the safeguards needed to prevent addiction?

Yes, because a lot of the problem that we have is from people who take drugs to see what happens. The attitude is that I am going to take a drug to get high and I’m just going to see what happens after I take it. Without having an educational background, in regards to the drugs they take, particularly psychoactive drugs, they open themselves up to the dangers of abuse. 

You can’t just take drugs in order to see how they feel. You need to be guided and coached through the process. This is why my intoxication coaching is based in mindfulness and consciousness.

You write often in your book about what you call “the spirit of intoxication” in an enthusiastic and impassioned tone. Are you romanticizing getting high and providing addicts with ammunition to continue on a road that clearly leads to “jails, institutions and death” as described by Alcoholics Anonymous?

I think that what I should do is describe what is meant by harm reduction from my point of view. First of all, most people say I am going to go out and drink and drug, then I’ll just see where it takes me. Without knowing what a drug experience is like, they drink and drug and end up on the wrong path. That’s why I so often talk about the idea of the drug experience because it is composed of a number of different components. The very first component is sensation. 

What do drugs do? What do drugs physically do to you when you take them? What they do is create sensations in the sense of things we can feel. For example, a person is sitting against an open window and they are smoking marijuana, making them more mindful of the sensations they were experiencing. They turn around quite suddenly and say that they think there is a spider crawling on their back. My immediate analysis is pot paranoia. The person is experiencing a sensation that they can’t immediately explain. In trying to make that explanation, sometimes your thoughts become paranoiac. As a result, he thinks there is a spider crawling on his back and becomes alarmed. In fact, it was a breeze blowing through the fine mesh of the screen on the open window. It is a humorous moment when a scary spider becomes a pleasant breeze.

What we do is we take these sensations derived from the drug that we experience and we interpret them according to our psychological set of pre-determined expectations. This psychological set of pre-determined expectations is the second component of the drug experience. The third component is the social, environmental and physical setting in which we do the drug. All of those things have an effect on how we experience the drug. Through mindfulness, the components can be ordered in such a way to improve and guide the drug experience from the negative to the positive.  

You express quite clearly in American Euphoria: Saying 'Know' to Drugs that, “All the social institutions of American society are obligatory anti-drug. These include the family, religion, education, the economy and government. All of these institutions applaud and promote the puritan secularized values of hard work and status enhancing consumerism. It is through institutionalization that such values are preserved and implemented.” Are you mixing apples and oranges by implying a society not based on capitalist consumerism would naturally be pro-drug and pro-euphoric experience?

Of course not. I never implied such a connection because, for example, both communist Russia and China had and have more draconian drug policies than the United States. I am not saying that drug abuse will flourish positively or negatively depending on the economy. 

How would you describe harm reduction and how does it relate to your approach to treatment?

It’s a revolutionary approach because the approach right now in therapy is that there’s something wrong with you if you want to get high. The harm reduction approach is there’s nothing wrong with you if you want to get high. It’s a universal feeling. Lots and lots of people want to get high, and they do so in a variety of ways. That’s okay because it’s part of human nature to want to get high.

What we have to do is to figure out how to do it in a way that is the least harmful. Once again, it’s a lot like sex in that way. Sex is a universal drive, but there are ways of having sex that are harmful and there are ways of having sex that are not harmful, or at least, less harmful. 

The first thing we would talk about is the high. What happens when you go into therapy for a drug problem? You don’t talk about the high even though it’s the thing that is the most essential and the most critical for such therapy to be effective. You are allowed to talk about it because it’s not supposed to be talked about.

You state in your CV that your specialty is called DrugCraft. You write that DrugCraft “includes innovative approaches to alcohol and substance use, misuse, abuse and dependency. This 'harm reduction' program teaches a non-abusive code for 'getting high' that can be learned so that people who drink or take drugs do not end-up embarrassed, incarcerated, sick, dependent or dead.” Are you basically trying to allow drug addicts and alcoholics to have their cake and eat it too?

(Laughing) Yes. If what you mean by that is to take their drugs and derive pleasure from those drugs, and not problems, that is exactly what I mean. Learning to enjoy a drug is a social psychological learning experience. It does not happen automatically. People do not become addicted to a drug overnight. You’re going to be surrounded by drugs all of your life. There have been cases made that you can trace the history of humanity by looking at the history of drugs. Drugs have been traded and sold and bought since the beginning of recorded time. 

In the past, society tried to relate to drugs and the idea of intoxication through bacchanals and the like. Such socially approved drug-taking rituals provided rules and structure to the drug-taking practice. Our society doesn’t yet understand that there can be rules that govern drug use just as there are rules that govern sexual behavior. Proper drug taking can be instituted through intoxication coaching that connects drug usage to the principles of mindfulness and consciousness. 

How would you feel if a person you coached to use drugs euphorically overdosed or killed someone while driving under the influence? What if their substance abuse led to them losing their job or hurting their family? What if their health was destroyed by their substance abuse? How would you handle such a negative outcome?

How would I feel? I would feel bad, just like rehab workers feel bad when one of their colleagues goes out and gets a DUI. I am not in competition with people who want to remain abstinent. If some people have chosen abstinence and it works for them, that’s fine. But they don’t really need my services and I’m not trying to win them over to my point-of-view. I only work with people who want to continue to take drugs, but want to do so in a way that provides the least harm. 

The simple truth is that there are a lot of people out there who want to continue to use drugs and those are the people that I have chosen to help. I am not competing with Alcoholics Anonymous or the other total sobriety and complete abstinence programs. The majority of my clients come from referrals from other professionals who have clients that they know are going to continue to use. When people see a problem developing with one of their friends or relatives and they intuitively know that the complete abstinence programs won’t work, I offer a harm reduction alternative that is designed to reduce the damage being done through intoxication coaching.

In the Diagnostic and Statistical Manual of Mental Disorders (DSM), you point out the term “addiction” is not mentioned because it lacks the science to sustain it beyond use as a moral term. You ask whether addiction is in the eye of the beholder, then go on to write:

“As for the ‘disease’ of alcoholism and drug addiction, such notions will, in the future, be relegated to curious cultural anomalies rather than medical conditions in need of a cure. The same disease concept was applied to masturbation at the turn of the last century.” Despite potentially deadly withdrawal symptoms that are brought on by a physical addiction to substances like heroin, benzodiazepines and alcohol, do you deny the disease concept of addiction? If it’s not a disease, what is addiction?

It’s a very expensive misunderstanding. I tell people that only you can prevent a drug overdose. When I say that what I mean is the knowledge that you have about taking drugs and the manner in which they should be taken. If you don’t have that knowledge, you can die from an overdose. I’ll give you a good example of such knowledge. 

A lot of people on methadone die from overdosing on methadone. The reason they overdose is because they do not know enough about methadone and the reason they don’t know enough about it is because people are not willing to talk about it. Since methadone is orally ingested, it takes longer to affect the user when compared to an intravenous injection of heroin. It takes longer to feel relaxed and methadone also does not provide the heroin rush. People will take multiple doses of methadone because they are not experiencing that rush or even the state of relaxation, then overdose and die because ultimately what they want is the rush. Since their desire for the rush is not talked about, they lack the knowledge needed to prevent an overdose. But in our society to want such a rush is not only heretical, it’s considered insane.

Once again, this denial of the rush and even the discussion of it are due to the prohibition on pleasure we have in our society and culture because of our Puritan origins. Instead of one person being able to say “I want that rush,” and another person saying, “Well, I want to help you obtain it,” the rush is verboten and nobody is allowed to have it.

You write in American Euphoria: Saying 'Know' to Drugs, “As long as drug rehabilitation continues to define any use as abuse, we will continue to have eighty percent recovery failure… The goal for the future is to learn how to attain drug euphoria safely and with dignity.” Is this just wishful thinking? Can you teach people how to use drugs like crack cocaine, heroin and crystal meth in a constructive, non-addictive manner? Where would such teaching even take place?

This is already being done with Desoxyn in the army and the air force. Desoxyn is a methamphetamine that is given to Seal teams and to pilots. How is that possible? If methamphetamine is a chemical that makes people go crazy and just ruins their lives totally, how can they give it out in the military and use it as a performance enhancer? I believe the answer is the military is using harm reduction principles. But these harm reduction principles just shouldn’t be for the military. They should be for everyone. 

I believe science is about observation and measurement, and we should be applying those two scientific principles to our drug use. If we do that, we won’t have the problems. By measurement in terms of drug use, I am talking about titration. By effectively controlling amount, frequency, and method during the period of intoxication, you can safeguard the use of any intoxicating substance. This is the essence of a harm reduction perspective. 

For example, most people do not know that you can’t get another cocaine rush like the initial rush without waiting five hours. You have to wait five hours between each ingestion of cocaine before a comparable rush to the initial rush can be achieved. Now would we ever tell somebody something like that in a treatment setting? Would we ever provide them with such information? 

If we did, we would be harshly criticized for it even if we knew the person was bound to use cocaine again. Even though we know that we should provide them with this information, it is not allowed. We can’t tell them that they won’t get high again unless they are willing to wait the five hours before ingesting cocaine again. We can only tell them never to use cocaine again because it’s an abstinent world. As a result, the person in treatment won’t be allowed to experiment. Now if they were allowed to experiment, they might be able to modify their use through the realization that by using without the five-hour waiting period they are just wasting their stash.

Adults need to know at what dose they should stop drinking and drugging to avoid negative consequences from their usage. This is why I now specialize in a unique harm reduction perspective called DrugCraft that includes innovative approaches to alcohol and substance use, misuse, abuse and dependency. I teach a non-abusive code for “getting high” that can be learned so that people who drink or take drugs do not end-up embarrassed, incarcerated, sick, dependent or dead.

In order to do that, they need to have an open and honest discussion about drug education that includes things like sensation recognition and socio-environmental influences and an understanding of the experience of the high. If we could talk about such things, we could help people have a better handle on drugs and intoxicants, in general. If drug rehabilitation continues to ignore the power of euphoria to shape peoples lives, drug abuse will continue unabated.  

Finally, we need to stop the hostile takeover of obsessive-compulsive disorder by the addiction industry and return to a basic understanding of obsession and compulsion without the dominating influence of the non-scientific idea of addiction. The definition of addiction is just OCD behavior in the form of an overwhelming compulsion to do a drug. The whole idea of addiction is already covered in the DSM under compulsion so it does not need its own category as a separate disease. The emphasis on addiction in today’s world is because it’s a moneymaker. If you have OCD and the focus of your OCD is about drugs, it’s now called addiction. If they just call it Obsessive-Compulsive Disorder like in the old days, they can’t make as much money off of it. Addiction allows the treatment industry to bring in the big bucks.

John Lavitt is a regular contributor to The Fix. He last interviewed David Sheff.

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