crystal meth addiction

blood like lemonade

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“There are wounds that never show on the body that are deeper and more hurtful than anything that bleeds.”Laurell K. Hamilton, Mistral’s Kiss

Once upon a time there was a group of merchants who wanted to go to the sea. A guide was required. They set out in quest of such a man. After finding such a man, they started the trip and saw a temple when they reached a land of wilderness. A man had to be immolated to cross it.

After consultation, the group of merchants said that they could not choose anyone in the company to be killed, for they were all related. The only one fit to be sacrificed was the guide. So they killed him. After performing the rites, they soon lost their way and knew not which direction to go. They then died one after another.

So are the people in general.

Those who seek to fish for treasure in the sea of Dharma should keep the commandments of doing good deeds as their guide. If they break them, they will end their lives in the wilderness and can never be rescued. Furthermore, they will have to go through the Three Evil Paths of Transmigration and suffer forever and ever.

Such men are just like the group of merchants who killed the guide and died in a body as a result….Buddhist Fable.

image credit- peter stein’s faust at marathon theatre
“If one good deed in all my life I did, 
I do repent it from my very soul.” 
William Shakespeare

today’s post is full of allegory. after the recent passing of a friend. i have come to a sort of secret compartment in my life. i was talking about how strange it was to have known someone on both a professional (counselor to client) level and as a fellow community member and volunteer. this caused me to pause for a while and consider the hidden cost of being an addictions counselor working with lgbt persons with addictions (who may or may not be hiv positive).
it is a complete recurrence that gay men (hiv + and hiv -) will appear when they need support and then disappear when they no longer feel the need for support (for a variety of reasons). as a professional there is an ongoing and undisclosed cost of knowing and caring for a person and then having them leave your life just as quickly as they appeared. and my experience is that when the “gay” factor, and the “hiv +” factor are combined, i have found that the boundaries have been a bit less distinctive. i might have cared a little more, or offered a little more support. and of course the disappearance of these folks from my practice has consistently left a deeper impression. but after they leave the treatment cocoon, they enter back into the community arena along with me and the rest of our world. because these individuals and i have engaged in a therapeutic relationship, returning to a friendly relationship is strained at best. i know more about them than they probably would like to admit. they have shared secrets with me. if they did not complete, nor were successful with treatment, then this usually means they won’t want to see me in person, nor see themselves in my eyes. this is perfectly understandable- almost expected. but it does have a price tag- especially in a smaller community. it is not a deal breaker at all. it is simply that i haven’t really looked at my own real needs in all this.
until this week, i have not looked at my own feelings about this whole brief therapy process. with bryan’s passing, i now understand that it has had a price. i have assumed that my skills as a practitioner are lacking at times. i have felt that i am too blunt for people too early. i have even felt that i am too old at times and out of touch with current lgbt culture.

“I became what I am today at the age of twelve, on a frigid overcast day in the winter of 1975. I remember the precise moment, crouching behind a crumbling mud wall, peeking into the alley near the frozen creek. That was a long time ago, but it’s wrong what they say about the past, I’ve learned, about how you can bury it. Because the past claws its way out. Looking back now, I realize I have been peeking into that deserted alley for the last twenty-six years.”
Khaled Hosseini, The Kite Runner

although all of these are probable and appropriate, i have never considered that i might need some support around the loss this process brings. i now know that i have just hunkered down, trudged forward, cut my losses and tucked those feelings without processing or examining them with any concern. i don’t regret this after realizing this, but i do want to make some changes from here forward. and because of my childhood history of relationship and loss, i have had auto-responses of shutting down when i have become saddened. i have let go of friends because i honestly haven’t figured out yet how to do anything else quite yet.
to be less vague, i now understand that i have a primal feeling that i am not okay, so i assume that these losses are the price i am required to pay for being me-(conversely, there are many benefits to being me as well so i don’t think this as simply dark and morose).
since my work has recently shifted away from cultural specific clients, i have gained some distance and some perspective on all this. this reminds me yet again that situations and experiences in our lives shape, form, and mold who we are. and all the relationships, fabulous jobs, exciting or relaxing vacations, spas, makeovers, workouts, and new clothes in the world won’t really make me any different. i am required to do the work, look at my life and my part in it, feel my feelings, accept them, understand them, and make room for change if needed. and change is probably needed in this case.
i am posting from a quiet place of gratitude today. i hope your holiday brings even a small portion of the grace i feel today. happy thanksgiving.

vicious pink…. cccan’t you see

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How did it happen? If I have asked myself that question once, I have asked it a thousand times, and I still don’t have the answer. By now you are probably asking yourself, how did WHAT happen? How did a reasonably intelligent, hard working guy like myself get hooked on drugs? More specifically, that nasty bitch we lovingly, at first, call Mz. Tina….

Oh, it started innocently at first when I stop and think back on it. Out for the weekend at a club and a friend says, here try this, it’s great you’ll feel like a million dollars and we can party on ALL night!!! And the sex is going to just be Fabulous…with a recommendation like that, I thought, I’d be a fool to not try it. At least once, I said.

I tried it, just a small “line” at first I mean its not like I was one of those “druggies”, or one of those low life homeless guys…I had a job and a car and a house. I wasn’t like them. That could never happen. Guess what? I DID feel like a million bucks and sex WAS fabulous…even sex with people I would not normally even speak to let alone have sex with!!! It just made me incredibly horny and sexual and I just felt like every one was my friend…there wasn’t always a cute guy around who was my type but with Mz. Tina around, I didn’t care…I’d just “snort” them pretty and go ahead and do the deed anyway…yes the standards definitely got lowered a bit…at first it was just once every couple of weeks or so…I was only partying on the weekends, Friday night and Saturday night. I had to work on Monday so I stopped partying Sunday so I was good to go on Monday morning. By this time Id been doing Mz. Tina for about 6 months, but only “recreationally”, meaning on weekends. I told myself it was okay because it was only 2 days a week and I did have a job and a car and a house…and it WAS the weekend I deserved to have some fun…

I managed to always get to work on Monday and get thru the week in good shape…. I soon found myself daydreaming and wishing that Friday would hurry up and get here…hey I was ready to have some more fun again, as so often happens with Mz. Tina, the weekends began to start on Thursday and end on Sun night…I started to show up at work looking like the wrath of God has been thrown at me. BUT I was still at work on Monday so how bad good it be I told myself…and I did have fun, I think, hmmmmm parts of the weekend are awfully fuzzy. I just did not always remember the whole weekend…I knew that Id had fun and id made some new friends…now if I could just remember what his name was. Did he give me his phone number? Did I give him mine?

I wrote it on a scrap of paper somewhere. Ill find it later. He liked me, I could tell…but what the hell did he look like? Did we have sex? Was it fun? Better yet, was it safe…?

No time to worry about it now Id tell myself…I’ll be better next weekend…..

quoted and reposted from

i was scrolling through an fb page for the club i used to manage back in the 80’s and savoring many of the songs that the dj/vj’s posted. bands like skinny puppy, nitzer ebb, front 242, and even rights of the accused. but then all the way at the bottom was a band i had nearly forgotten about- vicious pink.

ccccan’t you see was such a complete anthem in my eyes. it had so much of that quintessential crossover sound of that decade. and it opened up a floodgate of feelings and memories when i heard it.

at the same time i noticed that a friend was celebrating his birthday at the same time, so i posted it to him with a short and sweet (hopefully) note of good wishes.

i got back a quiet message which was a bit of a surprise. it was about his new relationship and how they have been slamming T a coupla times a week. Also detailed was how that part felt like it was getting outa hand and going south quickly. he wrote about shaking so much he doesn’t get a good hit, and maybe it’s a good day to say “done with it”.  the note was finished with a tender bit about me being a safe place to drop a random note like this because i could understand after having been through what i’ve been through.

quite a birthday note eh? and it does lead me to consider where my life has led. he is correct- i do understand. i have honed my understanding to include never going back. it’s odd that i have about 3 or 4 really close friends (from those days) who all continue to engage in serious dance moves with getting high. for  this one it’s iv crystal, for one it’s iv crystal and crack, for the 3rd its crack. they maintain (something i could never do) but i wonder if they grow. i know i feel my life has really opened up since throwing down the sword and walking away from the battle. and i also know i cannot live my friends lives.

there are not so many people left who hold my history in their hearts. it’s important for me to love them, albeit from a distance. too close would be toxic. perhaps for each of us.

when i was in a gala chorus in the 90’s here in colorado, i remember an introduction by one of the gala organizers describing lgbt people as those who said “yes” to pleasure in ways that others were afraid to do. that has resonated with me all these years and still does. there is a lot to be found in the idea that denied inclusion, acceptance, and visible demonstration for so long might just lead to a determination of having pleasure after the coming out process.

that day held some quiet and remarkable reminders about my life, my friends, my culture, and my journey. i numbed out for a minute after the note, but felt empathy almost immediately. i felt allegiance for the trust that was given me. i cannot help really other than hold good thoughts for my friend and the situation. it continues to be a twisted web we weave and it’s remarkable the challenges we traverse in the name of love.

stepping through doorways

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image credit…. vadim piskaryov

it occurred to me today that i have spouted the phrase that is the title of this post so many times that my audiences certainly have grown weary of hearing. i wonder sometimes why i haven’t done the same. truth be told however, it is my truth that it seems i have been stepping through doorways of opportunity since i laid down the meth pipe and let go of the wine glass.

in 1995, i was visiting paris with a friend. we stayed in a 2 bedroom apartment on the isle st. louis for a week. we visited versaille, pere lachaise cemetary, la reine restaurante, veaux le vicomte, and the unforgettable flea market. in the middle of my stay (which was rife with alcohol abuse) i was awakened one night feeling a poking on my upper arm. it was direct and it felt purposed. i woke to see a hooded figure standing beside my bed. this figure gestured with its left arm and directed the movement towards a doorway that stood behind him. as i remember it, i paused for a few moments, but chose to symbolically go through that doorway. 
it is a haunting and very vivid memory. visually i can still recall it, and i can recall the feelings surrounding this event in my life still. my belief is that i volunteered that night and much of the hullabaloo that has made up my life since then is connected to that decision somehow. shortly thereafter, i began to circle the drain with alcohol use. i drank heavily and got a repeat dui. during treatment for that offense, i had a strange psychological break as well as a physical meltdown. i became so weary- what with my full time job and community service- and my hiv was proliferating like ivy in my body. a good friend trapped me in his car to discuss his overwhelming concern about my well being and demanded that i go to a doctor. 
it  turned out that to continue living,  i needed to start “the cocktail”. luckily, it was 1996 and the meds had really advanced. that began a trail of health rejuvenation that was remarkable to me. continued drinking and a topsy turvy sense of my life’s purpose caused me to leave my job of 11 years and take a corporate post. this led to frustration and anger at living in a city where i had come to die. anger led me to san francisco which brought me to my knees with dot com bust followed by 9/11 followed by 3 bouts of kidney stones followed by a sinister crystal meth addiction. 
this particular addiction tumbled me through some outrageous craziness like fred flintstone in his time machine.  my last days on the west coast were absurd and obtuse. when i look back at living on the street in la’s skid row with a hooker who worked out of a pup tent to distract me, it seems more like a performance piece than a slow descent into madness.  and when a fellow addict hustled me yet again by stealing the brillo out of my pipe, the straw that broke appeared. 
back to denver, addiction to avoidance in tow, i landed here and rekindled my slow burn in hell. embezzling money from a longtime friend for the purpose of keeping meaningless sex going found me hallucinating at the bathhouse like ebeneizer in his bedroom on christmas eve. the nightmares on that night remain just as vivid as the paris dream. each of these incidents led me to the next and then the next. 
i found sobriety after the embezzlement issue. treatment was an albatross that didn’t really work. therapy with a counselor and psych meds became the path to my resurrection. i had no idea where to find sober folks so i hit the 12 step rooms. i got a call to work as an advocate for plwh- nothing i had ever planned. this led me to understand that i had understanding and communication skills that could be helpful to people. i took classes for counseling. i got a call to work on a meth project for gay men. i got to be creative. this positioned me to get hugely triggered with ptsd which led me to more therapy and working through old old misery. this led me to a job at a hospital. through a few jostles with trauma triggers, i have found myself in a position to help shape some changes at this public entity. at the same time i find myself serving as chairperson for two boards of directors and am helping shape the evolution of both these organizations. 
these opportunities and situations have all appeared like doorways in front of me- much like the night in paris. i have only recently come to understand (and accept). that i am compelled to continue stepping through these opportunities. they are leading me somewhere, and the process colors my life with a sense of adventure and fulfillment. 
as i thought about writing this post, i came across several similar articles about going through doorways. i am not sure if i have lost sight of my path because of the luminescence of what’s ahead. i honestly hope i am not overlooking the wisdom of what’s already been. 
much of these last paragraphs are new insight. i don’t honestly know where my movements will lead. i can’t say for sure that my motives are holistic. inspiration, drive, intuition collectively contribute to my decisions.  i can only trust that i am where i am supposed to be.
image credit…. fotofacade
“Entering or exiting through a doorway serves as an ‘event boundary’ in the mind, which separates episodes of activity and files them away,” study researcher Gabriel Radvansky, a psychology professor at the University of Notre Dame, said in a statement.
“Recalling the decision or activity that was made in a different room is difficult because it has been compartmentalized,” he added.
To come to this conclusion, Ravansky and his colleagues conducted three experiments, the results of which are published in The Quarterly Journal of Experimental Psychology. In the first, they had college students virtually move objects from a table at one side of a room to a table at the other side of the room, as well as to virtually move objects from one room to another room and crossing beneath the doorway…. reposted frum huffington post
The researchers found that the students were more forgetful when they moved between the rooms, versus when they were just moving from one table to another in the same room.


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image credit…. kuku smigun

the reasons i do what i do sometimes reveal themselves to me quietly and unexpectedly. i received a copy of a letter to be read at the “reckoning” of an acquaintance. i am without much to say. i think the words speak for themselves.

                I would like to apologize for bringing a syringe into the facility.  I didn’t have the foresight to see the risk it might have caused others.  I didn’t do it purposely but it came about through deviant behavior none the less.  This behavior is what I would like help addressing.  I don’t wish for forgiveness but instead am asking for help if there is any, to change my behaviors. 

 I don’t like who I am or how I came to be here.  I struggle every day with self esteem and find myself feeling sad and desperate with every decision I have made, but I understand need help to get on the right track.   I understand I have forgotten the skills to successfully make it in the community and it makes me feel hopeless and hate myself even more.  My only hope is there some type of “Change of behavior boot camp” available that I can use to my advantage.  I’m sick of just getting by and I don’t feel prison or jail will give me the necessary skills to be the person I want to become.  If I go back to jail, I will come back out the same person that I hate today.

                 When I was arrested last year I was a homeless, full time I.V. drug user with AIDS who was getting by with stealing and living off of government funding to get by. I was just barely getting by and there was no part of living about it. I was unhappy being who I was but using dope seemed to smudge the reality of being me, to get through the day to day grind.  Now that I am no longer homeless or using drugs, I see what is left of me in a clear and sad way.  I am very much a damaged individual. There is so much work to be done to come up to where I would like to be, that I don’t even know where to start at times.  It would be easy if I could take on just one problem at a time like I’m correcting clerical errors in this letter with word perfect, but life doesn’t come at me like that and I’m pretty sure yours either.  It’s overwhelming at times and again leaves me discouraged and hopeless.  

                                To get through these hard times, I look at what I have good going for me.  I am no longer homeless.  I am no longer using drugs on a daily basis to blur reality.  I am getting the best health care from a top doctor who really cares about me and wants me to succeed.  I am taking the bests drugs out there to maintain my health and understand staying off of dope is more than relevant to do this.  I am getting help from a very caring addictions counselor with my relapse prevention and cognitive classes.  I now have family and friends who will talk to me again.  When I was using they chose to have no contact with me.  Although I may not like myself yet, having someone tell me that they love me gives me the strength to do better and try harder.  I am even capable of getting employment but didn’t have the basic skills to maintain it, due to my recidivist behavior.   So I keep on doing what I think will work but the fact is, I am lacking some basic skills to continue and succeed at this program and life.   Please take all of this into consideration.  I do want to be here and if there is any program available to assist me in getting to a better place, other than prison, I am open to the change.

                                                                                                Thank you for help in this matter,

MAT- medicated assisted treatment

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image credit onur dogu

the clinic where i work has been working with medication assisted therapy for quite some time. the most well known mat is antabuse for alcohol abuse/dependence. with the onset of meth and cocaine in the last 30 years and the advancement of pharmatech, the use of mat to address stimulant dependence is being looked at much more seriously.
i have several clients that are currently using naltrexone to combat the cravings and the obsession for the next buzz. there are some mixed results certainly, but i believe that these studies are studies are still in their infancy. it is interesting to work with folk who are very protective of their systems when medications are involved, but behave as such raconteurs where smoking or injecting homemade speed is concerned.
we have clients that are using starting to work with injections of vivitrol as well. this is a monthly shot that works on the same principles of naltrexone, but without having to take a pill every day. below is an article describing some of the science behind the meth-focused mat.

One of the most vexing drug dependencies is that of methamphetamine Known as “speed,” “crank”, “ice,” “gak” and “crystal”; methamphetamine has emerged as the street drug with the greatest potential for harm and the most stubborn resistance to treatment. Methamphetamine works on sensitive neurotransmitters that regulate the synthesis and release of dopamine and nor-epinehprine. The most powerful of human emotions and feelings are directed and controlled by the activity of these two monoamines. Methamphetamine use, especially when abused chronically, turns the regulatory systems for dopamine and nor-epinephrine upside down. The very powerful direct effects of the drugs use means that withdrawal from it will be equally ferocious and difficult; relapses and reoccurrences in use are common if not predestined. Developing the therapies and pharmaceutical agents that can combat methamphetamine addiction has been difficult and has resulted in only marginally effective results. The search for medications that can soften the withdrawal and mute intense cravings is never ending. Recently a drug that’s widely used to treat opiate and alcohol dependencies has been experimented with in treating methamphetamine-addicted patients, the results have been promising.

Because opioids receptors in the brain are co-localized, microscopic neighbors so to speak on dopamine neurons, scientific suspicion brewed that inhibition of opioid receptors next door to those of dopamine, might help reduce the action of methamphetamine as that drug seeks to activate and release stored up dopamine. In a Swedish study, naltrexone was studied for its role in reducing the cravings and direct effects of methamphetamine[1]. Methamphetamine using patients using naltrexone reported substantial reductions in the impact of methamphetamine’s central effects; they also reported that in abstinence, their cravings for methamphetamine were markedly reduced.
Naltrexone is a drug that has been in use since the late 60’s. The drug is a powerful antagonist at all three major opiate receptor sites. By locking up the opiate receptor sites in the brain, naltrexone prevents powerful agonists like heroin, morphine and oxycodone from getting to them. The drug is approved for use in the treatment of opiate and alcohol dependency. The sustained release form of naltrexone (Revia) has garnered high marks for its ability to reduce cravings in the treatment of alcoholics. In the case of Revia, a dose of the drug is injected intramuscularly and is slowly absorbed into the circulatory system over a period of 4 weeks. With structural chemistry similar to the powerful opiate oxymorphone and that of a like-acting cousin called naloxone (Narcan), naltrexone is a well-tolerated drug with few side effects. Naltrexone users must understand however that when taking the drug, their opiate receptors are blockaded and that should an opiate need to be administered to them for severe pain, opiate receptors would be locked up and unusable for analgesia. Physicians have several medications as options to use in situations like that, but it is important that natlrexone patients understand the change in brain chemistry that’s occurred with the use of the drug.
The study undertaken by the Swedish government clearly points out naltrexone’s abilities in reducing and muting the effects of methamphetamine on dopamine nerve cells in the brain. By diluting the intensity of craving for the drug, methamphetamine addicts find it easier to maintain their sobriety and to participate in activities and therapies that support a sober lifestyle. What remains to be seen, what wasn’t evaluated in this study is the direct effects that naltrexone has on rates of relapse in methamphetamine addiction. Perhaps this will be the next area of study in the use of this drug. In any case, the Swedish study points out the value that naltrexone has in aiding the methamphetamine addict through recovery…..reprinted from

why the pain

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Hungry Ghosts:

Characterised by – Greed; Insatiable cravings; Addictions.

“I want this, I need this, 1 have to have this”.

This is the realm of intense craving. The Hungry Ghosts are shown with enormous stomachs and tiny necks – they want to cat, but cannot swallow; when they try to drink. the liquid turns to fire, intensifying their thirst. The torture of the hungry ghost is not so much the frustration of not being able to get what he wants. rather it is his clinging to those things he mistakenly thinks will bring satisfaction and relief. The Buddha in this Realm holds a Bowl from which the ‘gifts of the gods’ are distributed. This is to entice the hungry ghosts to desire for the Truth which is the only way that the deepest longings and hungers can be satisfied.
Consider: ‘Gollum’ from Lord of the Rings; The obssessive nature of Video Games; Addictions of various sorts; We can be helped in this Realm by our willingness to ‘look up’, to see beyond our obssessions…… reposted from buddhamind

i went to a dinner hosted by the harm reduction action center in denver last night. the hrac work with injection drug users to reduce health risks and also inject human kindness into their worlds. the evening was also benefiting improbable pictures who have been filming the creation and development of u.s.e.d (underground syringe exchange denver) as needle exchange has been completely illegal in colorado until may of this year. btw, exchange has not been implemented anywhere in colorado to date, the only legalization was that local governments can now decide for themselves about appropriateness.

the keynote speaker was dr. gabor mate, a vancouver physician who has been working with idu (injection drug users) for 12 years and runs a residential program in that city. he recently wrote a book that i have previously written about briefly called “in a realm of hungry ghosts”. it refers to a buddhist concept of the 7 realms that we move through in life. the realm of hungry ghosts is depicted by a very thin dark creature who is always eating and never full. his perspective on addiction and causation and treatment. he blends  20 years of addiction science with a sense of common sense and simple human kindness to highlight a whole new direction of treatment which makes the assumption that the reason someone is over medicating is due to pain. and he maintains that instead of asking individuals “why the addiction”, we should ask the question “why the pain” and his experience demonstrates a completely different response. he frankly finds that all the female addicts he works with were sexually abused when they were young.

“why the pain” is a question that seems so simple, yet i don’t actually think there is an easy answer at all.  i don’t mean that the response “my mother abandoned me” or ” my uncle molested me” or ” my father abused my mother during my childhood” are not simple. the words are simple. not more than 7 or 8 strung together at one time. no, the complications are not in the expression of the concrete aspects of theanswer. the challenges in the answer come forward in the manner in which the individual comes in the treatment door.the bio-psycho-social factors that have brought them this far. they have a lifetime of (not) coping skills that have been built up. a trauma that happens early in life (especially when repeated or endured over time) can cause a person to shut down so as to stop the emotional pain.  it makes complete sense that these individuals would find external chemicals such as opiates or alcohol that help them feel (especially pleasure). what makes even more sound sense is that letting go of these compounds is not an easy task, especially since for most of them, they may connect to the only pleasure these individuals have felt for as long as they can remember. btw, they usually forget a lot of the pain that led them to addiction with good intention- survival.

for me, i look to the explosion of crystal meth use in the gay male population in the industrialized world in the last two decades, with the highest percentage being hiv positive. this reasoning brings clearly into focus an explanation of this madness. is it not common that gay men identify feeling love and intimacy through their sexual contact, and being hiv positive would directly inhibit this process. crystal meth no doubt allows men to circumvent this inhibition and refill their emotional coffers. but when the emotional coffers never feel full, happiness is elusive, and continues to be chased.

it’s a simple question… why are they doing meth? to feel better. to connect with ohters sexually, to feel loved.  if sex is how we communicate- how else do they make this happen?  the only way they have known to feel loved has been diminished and neutered?