IAmA former basement-dwelling heroin junkie that now works as director of admissions at a rehab facility. I’ve seen some things guys. AMA. You won’t be disappointed!

Trying to quit heroin right now. Only on 24 hours, and I feel like someone has a shower on me turning hot and cold every second. What do I do? I don't think I can do it. It's too much.

You've got to want this more than anything too. Think Rocky training for a title fight willingness. Here's something else to consider too. A good life is possible without drugs. And I mean that from my experience and the millions of others living in recovery. I'm pm'ing you my personal number. Call me.

people like you are few and far between. keep it up, brother.

Thanks MTK!

You are a fantastic person.

I can assure you I wasn't one for a long time. Sometimes you have to let the fires of life burn out the bad in you. Thanks for the positivity!

That is beautiful, can I quote that to people? :)

Absolutely! Pulled that one out of my ass :)

Absolutely!

Hot showers and baths. BC Powder. Imodium and antihistamines. Avoid caffeine. That's if you want to quit everything. If you have health insurance or a well-to-do family member, you can go to detox and treatment. Which I highly recommend!

I had a friend pass away from heroin last year. The amount of potential wasted and the aftershocks that disrupted his entire family and inner circle afterward aren't worth it. Hope you get away from the white lady.

Sorry to hear about your loss. It's definitely devastating to watch. I've been off it for awhile now, no plans on going back!

So how did you get clean? I have a 21 year-old niece who is currently a street junkie. Any advice? Anything we, her family, can do? Or is it really all up to her?

One of the biggest misconceptions with family is there is nothing they can do for the substance abuser to change. They hear people say, "They have to want to change."

This is true, but most of the time, we don't decide to stay sober until our head is clear and in treatment. That was true for me.

You can also explore intervention for your niece. An interventionist doesn't just serve to get the substance abuser in treatment. They also get the family united behind a common purpose. They help root out anything within the family that might threaten long-term recovery.

You could also call and let her know you love her. That she is still loved. And remind her that if she ever wants help, to call you.

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You need to start meditating and exercising. But if you aren't willing to do anything to feel different in a healthy way, then relapse is a virtual certainty. This may sound harsh to say. I can assure you, however, that as a junkie I demand to feel good. It's part of me. The question is whether I'm willing to exert the effort to feel better in a positive way, or if I'm going to take the easy way out and use again. Quit beating yourself up about side addictions too. It doesn't do any good, and almost everyone battles with them in early recovery. Start by putting motivational quotes and read at least two on your mirror every morning. When you go to these meetings, start introducing yourself to people you've never met. Are you involved in service work? If not, start brewing that coffee. You don't have to be a Starbucks barista to make coffee at 12 step meetings. Anyone who's tried 12 step coffee knows that!

Establish a morning routine where you begin to meditate everyday. Incorporate exercise or outdoor activities too, like jogging, hiking, fishing, biking, etc. This will do wonders for the soul!

What made you want to make a change?

I looked in the mirror every morning and stared into the emptiness. There wasn't anything in my eyes except an abyss. Then I'd go fill up a spoon and pray that the shot would finally be enough. Enough so that I wouldn't wake up. Ever again.

You get to that point, and you'll find out things about yourself.

Please don't think I'm being rude, but if you had wanted to end it all could you not have shot a bigger load? What stopped you? Congratulations on your recovery.

Trust me I tried. If I would have had a syringe over 100cc's, I wouldn't be developing carpel tunnel syndrome right now :)

Thank you for answering. It's just you hear of so many famous people OD'ing on heroin that I supposed it was a small line between large dose and dead. Especially if that was your preferred outcome!

Thanks for your AMA

No problem. The thing about opiate/heroin addiction is that a tolerance develops quickly. I was kind of like Lord of the Junkies amongst my lesser addicted friends. They would do a fraction of what a normal dose was for me, and be out cold.

Also, they called me the unabomber for the first few weeks in treatment. If that gives you an idea of how impressive I looked when I showed up to get help.

Saddest/happiest recovery story you've seen?

I went to pick a guy up from the courthouse who was in there on his 3rd DUI. He had dropped out of college with a semester left. His friends thought he was a joke. He was looking at some decent incarceration time.

I started sharing my experience with him while he was in a jumpsuit and shackled in the courthouse. He started crying. This was a grown man balling his eyes out. I told him, "I want you to remember this moment, because if you forget it, you'll be here again. If your lucky."

Fast forward almost one year later. The guy is still sober. He just finished college. His life is coming together, and he walked up to me recently and said, "I still remember what you said to me in court that day." I'm tearing up thinking about it.

I was going to say "Hey, that's only one example" but I think it actually covers both ends of that spectrum. Nothing more tear-jerking than a grown man crying. And nothing more fulfilling than knowing he took that advice to heart and remembered it.

He's lucky you were there as a positive influence at one of his more vulnerable moments. Cool story. Thanks for sharing.

No problem, thanks for asking!

Congrats on your recovery. How do you know when you are moving from "I'm having a good time" to "shit i'm hooked" ?

Consequences are the prime sign that you're moving into dangerous territory. Legal consequences, like arrests. Personal consequences, like consistent depression. Professional consequences, like lost jobs.

Consequences aren't the only signs though. In my opinion, if you flirt with the idea you have a problem, you have a problem. People without substance abuse disorders don't entertain the idea they have a problem.

I agree with this whole heartedly. I had an oxy addiction and I never realized I had a problem until the consequences started happening. Things like being arrested, shattered relationships with friends and family over stolen property, losing all your friends and not caring because all you want is a fix. Its a terrible life.

It sure is. But recovery can get it all back, plus interest!

Thank you

Your very welcome!

How did you manage to afford being on that lifestyle for that decade? Did you have some odd jobs when you were not in the basement?

Heroin was the only thing that took me to a cave-dwelling, basement lifestyle. I afforded it like most junkies do. I had hustles. I had family members who would give me money sometimes. But mostly it was a hustle.

Could you be more specific about these "hustles?" Are you talking about stealing, or conman-light activities, or odd jobs? Again, if you're comfortable talking about. I was just curious what you meant by "hustle" in this context.

Sure. I sold drugs, ran gambling rackets and knocked over weak drug dealers. I also stole from my mom and dad, though that rarely happened, maybe a handful of times.

What do you think of an end to prohibition of all drugs with the money currently being spent on enforcement going toward education and treatment of addiction?

100% for it. Prohibition is a joke. Complete failure. I am for all drugs being legal. I recently read an article that stated it costs more to incarcerate addiction than it costs to provide them housing and their drug of choice.

Wow, very interesting hearing that stance from somebody in your position.

Couldn't agree more. Legalizing (or at least decriminalizing) is the first step in making sure people have the resources to learn about how to use drugs safely and effectively. And if it's not illegal activity, the people around them are more likely to know about their drug habits and offer appropriate support and advice.

Agreed. Legalizing drugs isn't society saying we approve, it's society saying there's a better solution to the drug dilemma.

As a recovering heroin addict I want to thank you for showng the world how cool we are once we get our shit together. I mean, we know we are cool, but now, lots of other people know, too. Keep up the good work and blessings to you & yours :)

Haha, thanks man. Congrats on getting off that shit. It's no easy task to quit, and a monumental task to stay quit. We are definitely a unique breed, and I wouldn't have it any other way!

What's the craziest call you've ever received? Or the case that stuck with you the most?

I got a call yesterday from a crack cocaine and alcohol abuser. We talked for a few minutes. I was surprised at how lucid he sounded. Very well-spoken. Probably a con man too.

He broke off the conversation and said that he would need to call me back. I asked why. He said he was in the middle of a store trying to steal a bunch of shit so he could pay for drugs. Funny yet sad at the same time. Gotta love the honest crackheads.

How did you convince the rehab facility to hire you? Do you like your job now?

Well it's kind of a unique place in that almost all of our staff got sober here. So I just kept hanging out here until the boss took a chance with me.

I love my job. It's engaging, exciting, purposeful and challenging. Being a junkie whisperer takes a lot of finesse, but when you see a guy after he has some time sober, it makes it 100% worth it.

Do you believe you were "self-medicating" with drugs, or were you just doing it for fun until you got hooked?

Self-medicating 100%.

What was the biggest life lesson you learned from your experience with addiction?

That a meaningful, positive contribution to this world is something I can choose to be a part of. And the only way to a fulfilling life.

Addicts tend to suffer from a very negative perspective of the world. Addiction taught me that the world has its dark corners, but I can choose to carry a flashlight.

Do you remember there being an exact exact moment where you decided enough was enough and decided to change your life around?

Yes. I looked my mom in the eyes and said, "I am addicted to heroin." It was one of the hardest things I've ever done because I knew it would break her heart. I didn't want her paying for a funeral though. I chose to live.

I don't know very much about herion but I assume you get some pretty bad hallucinations. What was your most memorable "trip"? Do you still keep in touch with the people you used to associate yourself with when you were a user?

Hallucinations on heroin are really weird. They aren't visual or auditory. My main one was thinking people were in the room when no one was there. I forget all about this until one of my junkie friends in treatment asked me if I ever thought someone was there who wasn't when I used. Of course I laughed and said no way. Then I remembered constantly thinking my friend Spencer was in the room with me. He went on to tell me that was my brain having a very minor stroke. Not sure if that's true. But I can assure you anyone who knows me wouldn't doubt my brains taken some hits! Literally.

I do not associate with anyone I used to hang out with. The only exception is when they reach out to me for help, and I take precautions to ensure my sobriety in those circumstances.

I want to add that opiate hallucinations arent open-eyed hallucinations. With an opiate, such as heroin, you go into this dreamy land called a "nod". The nod is a stage right between being awake and being asleep. You "hallucinate" in this stage, kind of like a dream - it can range from anything from hearing sounds or seeing someone talking to you.

After pro-longed use, these nod-dreams go away and are hard to come by for long term users.

Really weird place to go...

What movie do you think accurately reflects the lives of heroin addicts more - Trainspotting or Requiem for a Dream?

Definitely not Trainspotting, because I never knew junkie gangs that spent their days shooting up together. Most junkies are loners. I was.

Requiem for a Dream might be a closer rendition except for the part where he deals drugs. But truthfully, I don't think there's a movie that captures the heroin lifestyle. Because there isn't much glamorous about being a junkie.

Basketball Diaries?

I didn't even think of that one. Much better presentation, probably because it was based on a true story.

Maybe The Wire?

The Wire was legit!! One of my favorites.

What would you think, going through what you have, you want to communicate about heroin for people who have most likely tried cannabis and could be interested in experimenting with heroin?

I would encourage them to try it if they have no qualms with death or losing everything in the world that they care about.

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The government should repel prohibition on all drugs, use the taxes to fund programs with proven outcomes and start seeing real results.

The government's very involvement in the war on drugs makes substance abuse problems worse, not better.

I do not support government-operated treatment centers. I don't support any government-involved activity with regards to substance aside from complete legalization of all narcotics, taxation to fund evidence-based programs and an end to the war on drugs.

It's ironic that in a country like the US, founded on the principles of freedom, they don't take stances like that more often.

Times are changing. Hopefully for the better!

Do you feel urges to relapse? If so, how strong and frequent are they? What are your triggers?

Yes, in fact, a few months ago I was about as close to relapsing as you can get without relapsing. The strongest triggers come when I'm stressed at work, not getting enough sleep and trying to do too much with too little (see brain taking some hits comment).

Mindfulness meditation has been the difference between sobriety and relapse for me. Without it, I'd be dead.

My second strongest trigger is when I'm driving in an area where I frequently scored or used. Still makes my stomach churn and I feel like the Reddit alien looks.

At 2 years clean, I really don't have triggers anymore. I think moving away from my hometown, making new friends, etc plays a big part in minimizing triggers. But my biggest is when I have trouble sleeping. My worst thought is, "I can use once and no one will know." That is, in my opinion, the most diabolical thought a person in recovery can have.

Thank you for doing this. I really identified. I've been sober 8 months now and it's wonderful, never been happier. I've just been dealing with what I think is RLS and Drs so far don't really know what it is, they say it's anxiety which I have a lot of but it's really painful and when it gets bad I just want to use again. Do you know if this is still withdrawals or anything at all? I am at a loss as to what to do about it.

Are you jogging / running daily yet? If not, this is something you should start immediately.

From Wikipedia on RLS:

Treatment is often with levodopa or a dopamine agonist such as pramipexole.[6] Some controversy surrounds the marketing of drug treatments for RLS. It is a "spectrum" disease with some people experiencing only a minor annoyance and others having major disruption of sleep and impairments in quality of life.

I think that's a nice way of saying there aren't too many effective treatments for it. I remember when I was in the midst of RLS, the only thing that alleviated it was walking around. I would also punch my legs, but I don't recommend that.

I remember reading somewhere a long time ago that antihistamines can help with RLS. Has the condition been getting better the longer you stay sober?

Thanks for the thoughtful response. I hope you have great success staying off the stuff.

Thank you! So far, so good!

I was given morphine for pain during a recent hospital stay.

When I got home I nearly ripped my asshole open with that first poop.

How does one deal with opiate poops? Right there that was enough to discourage me from ever taking up an heroin habit.

Yes, that sounds about right. Really an enema is the most effective weapon against the constipation that inevitably comes from opiate-based drugs. You could try some prescription anti-constipation medication too.

Fun fact: In sobriety, a trip to the hospital for an injury that requires pain medication is called a "freelapse."

Thanks. :)

It was a one time thing, and I'm being very careful using my percocets.

Just a suggestion: might give them to someone who does not have a problem to dispense to you.

I'm keeping them until the cast comes off, at least.

I was told I could drop any leftovers off at a pharmacy and they'd properly dispose of them.

Or sell them to schoolchildren.

I've always wondered what happens to leftover prescription drugs. Thanks for clearing that up!

What is the biggest misconception that you find most people have?

That recovery is going to be easy. I'll get sober, and everything will be okay. Recovery isn't for sissies. It takes work, dedication and consistent effort. Life still happens, and I'm not the best at responding to it in a positive way. That's why it's important for me to stay close to those in recovery, and stay active in a program of recovery.

Favorite sandwich?

Phenomenal question. Favorite sandwich is chicken breast with avocado, lettuce, purple onion and tomato on cranberry wheat. Lightly toasted with a spicy mustard/mayo mix.

William S. Burroughs's book 'Junky' often speaks of the fact that once a person becomes an addict, they stay that way for the rest of their lives, even if they recover from it. IIRC Burroughs uses the metaphor of "junkie cells"- once you start using, you'll only have junkie cells in your body for the rest of your life. Would you agree? Do you still identify as an addict?

I would agree. I am comfortable with the fact that I will always have addictive tendencies. I just choose to funnel my addictive tendencies towards positive change. Most would say I'm a workaholic. What I have seen, however, is that as someone progresses in sobriety, there life tends to balance out. Mine has begun to level off too. I do feel we need to get away from the word "addict." Substance abuser / in recovery / whatever sounds much better and doesn't have the stigma associated with the word "addiction."

Thank you for your thoughtful response! I've been wondering about this for many years now. Also, never thought about the word "addict" in that way, that's really good to know!

I wish you all the best in the future. :)

Thanks, hope nothing but good things for you too!

Your thoughts on using ibogaine for treatment?

I know ibogaine can be a valuable asset to addiction treatment, but it is currently banned in the US. The only centers that offer this treatment tend to be sketchy. I've heard some horror stories. I think it's also important to know that it's not a miracle cure. People still get ibogaine treatment and relapse. The key, in my opinion, to sustained sobriety is a consistent, active and ongoing program of recovery. But I would like to see it offered in US addiction treatment.

I know VICE did a piece on addicts in the USA going to recovery programmes in Mexico that used it. They seemed to have a decent recovery rate. The centres all looked pretty legit too. All American run.

I'm sure VICE found some reputable centers, which there are. The best way to research a good facility is by 1) reading all reviews and 2) asking to contact a few of the program's alumni. If a center says you can't talk to their alumni, RED FLAG!

Thanks for the AMA!

Are there any physical side effects of heroin addiction that most people don't know about?

Yes. Here's something they won't tell you in detox. If you are withdrawing from severe heroin addiction, you will have unexpected orgasms. Sounds awesome, but when you wake up in treatment cumming everywhere it's really weird.

Also, heroin addiction starts to kill your pain receptors. Do it long enough, and you'll lose a lot of them. So you don't feel pain like a normal person. I broke my toe last year, but thought I just lightly bumped it. Didn't notice until I was taking a shower and my toe was the color of death.

Post-acute withdrawal syndrome is also something many people don't know about. It's a period of readjustment on the biochemical level that could take 1-3 years for the body to heal. During this time, a recovering abuser might experience bouts of insomnia, heightened sensitivity to stress and uncomfortable levels of anxiety. It's not fun.

What's the greatest excuse you heard from someone who was currently dipping out that they weren't high, they were ______.

How many people ask you for drugs / cash / works on a daily basis?

Do you prefere NA or AA?

I had a vicious drug problem for a while, but I decided to go to AA since I realized they're not really concerned with what got you there as much as working the program. AA made more sense to me and I enjoy the meetings. Have you ever heard of this before?

1. tired.
2. I'm not sure what you mean. Do you mean how many people ask me for drugs / cash / works at my job? Or on the phone? Or while I was using?
3. AA
4. Yes. I prefer AA for exactly that reason. The focus is on the program, not the problem. My experience with NA hasn't been bad, just not a fit for me.

Thanks for getting back to me! For No. 2 I meant where you're working at now. Since you're in contact with so many active users, I'm sure someone has asked you for some things.

Weird, I know, but I have never been asked for anything. At all. The only time I have was when I was in treatment. The guy wanted some of my contacts in Nashville. He didn't get them.

Do you have any family? If so, how did they react to your addiction and how did it affect your relationship with them? Also, how is your relationship with them now? I think it's awesome you overcame your addiction and are now helping others who are in that position. You are awesome!

I have family, and as you might suspect, they were devastated to find out that I was addicted to heroin. My mom later told me in a letter that she felt like she was "sinking in quicksand."

My dad just looked at me in detox and said, "Just do this (recovery) or don't bother being a part of this family." That might sound harsh, but it was long overdue.

I'm pretty sure my brothers thought there was 0% chance I'd stay sober for as long as I have. I knew I would though. I made that decision. Sober, no matter what.

My relationship with them now is incredible. We have dinner together every Sunday. I catch that twinkle of pride in my mom and dad's eye. I love my two little brothers. They're hilarious, smart and both of them are the ladies' man I never was :)

Last year I had neck surgery and I got hooked on painkillers as well. That shit is not fun guys.

Not at all. Hope you're off them now!

Once I realized I was getting hooked I stopped immediately and just delt with mild withdrawl for about a day. I cant even imagine how hard it got for you!

3 weeks of virtually no sleep. Body temperature was like this: it was 110 degrees out one Friday, and I was dressed like an eskimo. Gross/WTF fact: I crapped blood for 3 days straight.

Holy shit! This is why hospitals need a replacement for opiate painkillers.

Trust me, they're trying. First one to come up with a suitable replacement wins 20 billion dollars.

From your personal experience, do you see addiction in more young adults or older adults?

The place where I work treats way more young adults than we do older adults, and I think this is fairly typical. What we do see in older adults is more severe addiction, more health complications and in some cases permanent physical damage. The absolute most difficult cases we get are 40+ year old alcoholics.

What could we be doing in the US to better help people with substance abuse?

Truth be told, 12 step organizations could be more supportive of their long-term sobriety members coming out openly about their sobriety. Anonymity was only established to protect the newcomer. They never intended it to be some super secret society.

Also, the Affordable Care Act has not made treatment more affordable or accessible. It's actually quite the opposite :(

EDIT: Wanted to provide more depth to this answer.

We could also, as a people, be encouraging of substance abusers to seek treatment. We could start to shift the perspective from one of disgust to admiration. It takes a lot for someone to reach through the veil of disdain and uncertainty for help.

Thanks for doing this.

My 24 year old younger brother is a recovering addict. He’s been in and out of treatment for his entire adult life. I’ve always maintained a relationship with him, but I don’t trust him at all. He’s currently in a halfway house/treatment center. Given the limited info I’ve given, what are some things I can do to help him without enabling him?

His recent Face Book activity indicates that he’s heading for a relapse.

Edit: his drugs of choice are opiates, but I think he'll start the relapse with pot.

A lot of relapse starts with pot. I think it does because it's harmless for most to do, but it's a dangerous game for people with substance abuse disorders.

I think the important thing to do is support recovery through positive reinforcement. Let him know how proud you are of him when he is sober. Let him know he has talents, and with hard work, he can make a good life for himself. If he is in relapse and tries to contact you, let him know that you love and care about him, but won't be part of the problem. Tell him if he ever wants help, you'll be there to assist.

Congrats to you for turning your life around - it's wonderful to see that you are supporting others. You rock.

Big thanks for the positivity!

Congratulations on your recovery. I was just wondering if there were any books or films or even music that helped you stay clean. I'm not a user but i've read The Heroin Diaries by Nikki Sixx and I asked myself what would happen if a user read a book like that.

Broken by William Cope Moyers. Solid read.

What's the worst you've done for your next hit?

Steal from my mother's purse. Worst. Feeling. Ever. To make amends, I sneak a $20 bill back into her purse from time to time :)

It's good you righted wrongs

You cant start a new life without reconciling the wrongs of your past.

I knew someone who became addicted to heroin and just curled away, she had her "heroin" friends who were always all helping each other "get good" for the day to make it through work and all that. I stayed around it for a while out of morbid curiosity since I had never been around a hard drug like that. Also because I cared about the person and was trying to steer her away.

After about 2 weeks she started to just drop off the map. I wouldn't hear from her for days at a time and when I did it was when she was trying to quit, so I would load up on things the internet told me were useful for withdrawal and she would try to actually be done with it... For about a day or two usually.

After a few times of that she just started to seem to hate me, I'd not given up on her and I always had a place for her to try to detox if she wanted to try to quit again. I would talk to her and as soon as I started to mention quitting it felt like I had backed a mongoose into a damn corner.

There is so much more to the story but I think the skeleton of it is there so my question is, what else could I have done? What does someone who has zero control over the person do when they choose to run away from the people trying to help? Do you just stop bringing up the fact that they have a problem to keep them around or do you push them away by trying to help?

You went well beyond the call of duty. One of the most curious things about addiction is that it is actually contagious. That might sound like an odd statement, so allow me to explain.

Addiction thrives on the benevolence of others. But what happens when someone is consistently exposed to it is the same behaviors I see in active users.

For example, a mother has a son who starts down a road of substance abuse. The mother loves her son, so she does everything she can to get him to quit, just as the junkie does everything he can to use. The mother even starts lying to friends and family about what's really going on, just as the junkie lies to others to try and get drugs. The mother tries to control what the son does, just as the son tries to control the way he feels.

These behaviors are the natural consequence of someone trying to do all they can to stop addiction. Almost all attempts will fail. Just as the mother cannot admit that she is virtually helpless when it comes to her specifically changing her son, the son is helpless to stop quitting drugs as his body become biochemically dependent.

Thus, addiction spreads, causing the family to engage in behaviors they wouldn't normally do (lying, controlling, etc), just as the substance abuser starts to engage in abnormal behaviors (lying, stealing, etc).

It is best to keep a healthy distance from someone in active substance abuse by communicating your love and support to them, but letting them know you do not support their decision to drink/use.

That actually sounds exactly like what happened. I always heard that people struggling with addiction needed support and I had never seen that before, I guess turning into a mother was all I could think to do.

Also for the people wanting some hope, she is fine now, or so I hear. She moved away after rehab, which I think was one of the best things she could have done for herself.

"Change your playmates, playgrounds and playthings." -Someone who knew what they were talking about!

How common is it for people comming into opiate treatment to have sucked cock for opiates? Is it as common as people sucking cock for uppers?

Have yet to hear of these alleged opiate cock suckers.

I knew a woman that sucked cock for oxy. But most of the cock sucking stories do seem to be about crack for some reason.

Crack and hookers seem to come up a lot in my line of work.

Hey bud, thanks for the AMA..

Much of what I have read hits home, but a couple of things I'd like your opinion on (I also am educated on substance abuse and counseling, but it's hard for me to be objective since it's a family member)

My older sibling has been a substance abuser for as long as I can remember (always lying/manipulating and stealing from us) he's much older than I, has always shown many of the typical symptoms of SA/some mental illness, mostly depression and irrational thinking..We recently kind of cut ties with him and have distanced ourselves after "the last straw" incident occured, which was after we made every attempt to get him to go to treatment, any treatment possible (which he would even lie about attending)

How would you approach someone who is non-compliant, and has that "all or nothing" type of thought process? (i.e. "even if i get a job it won't be good enough, I won't be able to have a nice enough place")

I also feel, that he DOES have to want to make these changes in his life--we can't make it for him, and believe me, we've tried a lot, for many years. I also like how you stated how you had to work so hard, which is a quality I feel he lacks which is concerning..

It just kills me to see my mom so sad over her son (and not seeing her grandson,) I personally am not as bothered because he's always been so shitty to me since I was a little kid (I obviously want him to get his act together and attend Tx but we were never very close..)

Thanks for any input and sorry for the long post, keep up the good work my man!

Here's the thing that many families simply don't know. Most of the time, if someone is abusing substances, there's a strong enabling element present, particularly with narcotics (opiates, cocaine, meth, etc).

A friend of mine told me that when it comes to enabling, if you take the fuel (enabling) off the fire (addiction), the fire eventually burns out. It may not happen immediately, and it could take months or years, but it's just a matter of time.

Since you cut off the sibling, what has he been doing to support himself? What has the family reaction been to the situation?

For someone like this, long, long-term treatment is really the only option. A program that goes in stages, from detox > stabilization > initial treatment > practicing principles of recovery > emotional work > initial transition into more responsibility > etc.

This is someone who is going to need a world-class recovery community to back them up too. Places like Nashville, TN, Prescott, Arizona and Del Ray Beach, Florida all have world class sober communities.

At this point, again, my only suggestion is to let the person know that when they are ready, you'll be there to help. Let me know recovery and a good life is possible because you read about a basement-dwelling junkie who put together a life he never knew imaginable.

Also, what substances is he abusing? This will play a role in me trying to craft some further direction, as different substances have different progression timelines.

I have two stupid questions.

1. What do you think about how the internet is going to affect recovery/therapy and mental health? Because everything (pretty much all the secrets) are out now and available for all to see...there are so many teachers who have lectures up on youtube (i.e. Alan Watts/Mooji/Ram Dass) and books out, who have already pushed the meditation/consciousness conversation so far forward that I think it's almost a waste of time (or a disservice to those who need help) to sit there and talk to some kid out of social work school trying to tell you "that sounds really frustrating," or "how does that make you feel?"

2. Do you think recovering addicts need to serve/a low stress position as a job after they get better? Or do you think they can go into any old high stress situation? (i.e. finance/managing money/medical school/law, etc.)

Thanks. This is one of the best AMA's I have ever read.

First of all, thank you for coming out of retirement, Retired_bot.

1. With all the resources out there today, there's only one reason why someone won't get sober - they want to keep getting drunk or high.

It is my personal opinion that therapeutic and psychiatric methods are not effective with substance abuse disorders until the individual has become established in a program of recovery.

This reason I say this is simple. Most of us lack the qualities necessary for productive work with a medical professional like this. Honesty, the ability to assess oneself lucidly and a willingness to implement change aren't present until at least 6 months sober.

The internet definitely offers a wealth of resources, but the questions is whether those resources are credible. One of the most popular recovery websites, Spiritual River, has all kinds of red flags that most people who aren't knowledgeable won't spot. I've had to find leaving scathing comments on some of their articles.

1. I am convinced that someone who launches from treatment back into a demanding profession has a higher chance of relapse than someone who takes baby steps back into the real world. I think a low stress job will allow the person to continue healing and slowly develop the qualities necessary to succeed in a high stress job.

I have a friend who claims hes trying to get free from opiates and at the moment says hes only using weed and some psychedelics every here and their. I cant currently tell if whether or not hes telling the truth due to his nature of lieing alot. What are some ways/ signs of whether he may be telling the truth about getting clean or possibly lieing?

The best way is to look for a couple physical symptoms: constricted pupils, especially at night (pupils look like a pinhead). Also, itching is a dead giveaway. Excessive itching is a sure sign the person is using. If they approach you for money or want you to buy something they own for super cheap, run.

1. What was it like to be in a chase like that? Was it an adrenaline rush like some would imagine it to be, or were you scared out of your wits?

2. What got you hooked on everything you did?

3. How did you afford your habits?

4. What would you consider the lowest point of your addiction?

5. How did you turn it around?

6. Have you ever come across someone who you would consider too far gone to recover? How did you react? Or, if you've never come across someone that bad, what's the "lowest" you've seen someone?

1. Complete adrenaline rush. Especially going against interstate traffic at night at 120+ mph. It was not something I'm proud of, but I'd be lying if I didn't say that it was an incredible experience. Something like you see in a movie.
2. I'm a guy that loves to feel good all the time + drugs = addiction. Were you asking what underlying causes got me hooked?
3. I sold drugs and ran gambling rackets. No I wasn't in the mafia.
4. The instant after the car accident. For some reason, I remained conscious. I knew what my cruise control was set at. My first thought was, "I've just killed someone." Worst feeling ever.
5. I did something that was totally out of character for me - told the truth and asked for help.
6. Yes. There are a few people, and you really don't see or hear about them often, that develop permanent brain damage from substance abuse. One example is wet brain syndrome in an alcoholic.

The lowest I have ever seen someone was a man who came in with a history of heroin and methamphetamine abuse. You could just tell he had fried his brain. He told everyone he was certain he had a stroke. As a result, he had weird ticks and talked like someone paid him to do it. He talked, talked, talked. All I did was listen and try to show compassion for a sick person.

For #2, I was thinking along the lines of who (coworkers, etc). Thank you for your answers, by the way. I do have to ask one more question, how did you start running gambling rackets? Doesn't seem like the kind of thing that you just wake up and decide to do.

Ironically, I was the one who sought out shooting heroin intravenously. I was horrible at it. The first few times I tried, I missed. If you miss, you watch in horror (and pain) as a giant golf ball-sized lump comes out of your arm.

That didn't deter me though. I just asked a medically trained acquaintance for a tip.

The gambling rackets started with me playing poker in underground games. Got good at poker. But being a greedy junkie led me to get trained dealing poker. Built bankroll then started running my own games. Horrible lifestyle. Was constantly worried about VICE Squad and our state's bureau of investigation. Also there was a group of men who enjoyed robbing poker games with sawed-off shotguns and had no qualms about killing people.

How did you make money as an addict?

Sold drugs. Ran gambling rackets. Robbed drug dealers. On rare occasions, stole from my parents. Maybe a handful of times.

What is one thing that always brings you up when you were down?

The fact that I went to jail for a month the day after graduating college. Spent Christmas and New Years locked up. That always helps give me some levity when I think times are getting tough.

Have you ever had affluenza?

My attorneys weren't expensive and super high-profile. I hear that's the only way you can contract affluenza.

I think what you've been through is really difficult to comprehend and what you do now is really great. I guess my question is: what do you think about how junkies are portrayed in movies and tv nowadays? Like Breaking Bad and Dallas Buyers Club, just as examples. Thanks for doing this AMA!

I think it's a fairly accurate assessment as far as how they are viewed from the lens of society. But I think what it doesn't demonstrate it that substance abuse issues are often highly intelligent and very talented. Why? Because addictive personalities tend to develop skills at a much higher rate than your average bear.

Your most fascinating, heartbreaking, interesting story. What is it?

Probably the story of one of our beloved alumni. "J" came to us from Indiana. He was one of those people magnets. His personality and positivity was contagious. J responded well to our program, and he made great strides in walking a path of recovery.

Before long, he was helping mentor some of the new guys in our program. He walked around campus with that gait we only see once purpose has been restored to a man's life.

He abruptly committed suicide. I'd never seen anything like it. Usually someone gets a warning - signs that there's internal turmoil going on. Not with J. No one saw it coming. His roommate walked into the house and found him hanging from the ceiling.

We later found out his wife filed for divorce while J was in treatment. He bottled up all the soul-wrenching heartache, refusing to allow others to share his pain. When our organization put on a memorial ceremony for him, and his family came down to honor his memory, it was incredibly unsettling. I'd never been in a room that pulsed with such a strong mixture of love and death.

This might not sound too fascinating. I can assure you it was. If you knew J from the start of his treatment until the day before his suicide, you wouldn't have thought he was about to kill himself in a million years. It reminded me how adept addicts are at hiding their true condition. And how the veil that separates our internal complexion can often be as dark as death.

Do you practice Vipassana? I saw your mention mindfulness, so I'm curious whether you practice the real dope.

Sure do! Was trained by a student of Noah Levine.

Not familiar with him, but from brief googling, I can respect his line of work. Spreading Dhamma is a worthwhile task, and to do so in prison is wonderful. Have you ever done a Goenka 10 day course?

Speaking from my own personal experience, I had been in a drug induced haze for years until I did a 10 day course. I began my sobriety five days prior to the start of the course. It's by no means a magic bullet, but it does give one insight into the sensations that they feel. A sensation of craving can be very powerful, and only gets more powerful when you submit to it. The willpower it took to just observe all the sensations in my body and not react to them was astounding. It was more work than I thought myself capable.

I've never done a Goenka 10 day course, but sounds interesting! Researchers are just now publishing the benefits of mindfulness meditation in addiction recovery. It's been a gamechanger for me. Congratulations on your recovery!

If you're interested: http://www.dhamma.org/

University of Virginia medical school has active research in the area of meditation currently which may be of interest to you as well. http://www.medicine.virginia.edu/clinical/departments/medicine/divisions/general-med/wellness/the-mindfulness-center/home.html

The first mindfulness meditation and addiction treatment study was just completed too. https://www.drugfree.org/join-together/addiction/mindfulness-meditation-can-help-reduce-addiction-relapse-rates-study

Thanks for the resource!

What made you shake the foggy head/addiction in the end?

If there was any sign that you needed to change, what was it that helped you to realise?

The main sign that I needed to change was the fact that I couldn't wear short-sleeved shirts anymore, despite how warm it was outside, because of track marks.

That's another element to look for if you suspect something is using drugs intravenously. Do they always cover up their arms?

What made me shake the addiction is that using wasn't fun anymore. There was no enjoyment. The party was over. And I was the guy awkwardly waking up the next morning in a house full of people I didn't know, lingering about aimlessly trying to connect with people I knew didn't care about me. You know exactly the guy I'm talking about. That was me.

Thanks for your reply dprecovery, I can imagine that it would be an extremely scary thing to be watching your arms slowly becoming pin-cushions.

Apart from the physical signs that made you quit, and like you already said "using wasn't fun anymore", did you experience any change in mentality, for example feeling out of touch with yourself or noticing a marked change in the effects of substances on your personality?

i guess what i'm trying to ask is, did you still feel like yourself underneath the addiction, or was it like you were subduing the real you throughout the process?

I felt like a zombie. There was no more me. Just a garbage disposal for heroin.

One of the things that stuck with me was a roommate and friend of mine, who I would later pick up from the hospital to come to treatment for acute alcoholism, saying, "Dude, you don't even crack jokes anymore. You don't laugh at all."

i just want to say that i appreciate this…i just had a friend die from his addiction. i have a huge problem with "the program" but i know it saves a lot of people one day at a time. my best friend got over his addiction to benzos and black due to an inpatient rehab and more people need to make their story heard on a pulbic forum such as this and refrain from locking it up and preaching to the choir in voluntary meetings.

Couldn't agree with you more! One of the unintended side effects of anonymity is perpetuation of addiction's stigma. There are a lot of organizations out there trying to change this landscape. The most prominent is the documentary "The Anonymous People."

Are you currently on suboxene or methadone?

No.

What advice would you give to your younger self?

Don't chew tobacco. At all. I quit, but not before it wrecked havoc on my oral hygiene.

I wouldn't tell myself not to do drugs because it led me to the life I live today. That invites a lot of interesting philosophical questions, which I leave for men better qualified to discuss them.

You mentioned consequences. What happens if there is a physical addiction to a substance, but no consequences? Is it possible?

Highly unlikely. There's plenty of people who experience minor consequences. This is where the term "functioning alcoholic" or "functioning drug addict" (though I've never heard that term) come from. Minor consequences would primarily be relationship troubles. It could also be legal problems that you navigated due to strong legal representation.

How did you get an admissions director position? Did you go to school first?

I have a college degree with a minor in business. But really it's due to my reputation as a "junkie whisperer." :)

Tell us your best tranny hooker story.

Wow, this is ironic. We were playing a sober poker tournament this past Saturday night. A guy I know in recovery was talking about his experience on ecstacy, cocaine and alcohol. It involved an Asian cross-dresser. He ended up going home with him/her and thought her/his penis was a clitoris. True story.

There's this one dude, he's always talking about his heroin days, and hanging around with tranny hookers. Dunno if it's a Lou Reed reference, or just a San Fran thing. http://www.freedomfeens.com/tag/krokodil-and-tranny-hookers/

As we sometimes say, some are sicker than others!

What's the saddest or most disturbing thing you had seen?

Without a doubt, right before I got sober, I was riding in the car with a dope dealer. He got busted not long after I cleaned up. We were having a casual conversation, and he casually mentioned that someone he had sold dope too a week or so ago died. Just overdosed and died. He had no remorse in his voice. He told it to me like you would tell someone how you're weekend went. Still gives me chills thinking about it.

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The biggest tell that someone is using is general flakiness. Saying they will show up somewhere and don't, or show up late. Moodiness is another symptom. Really it varies from substance to substance. With alcohol, it's tough to hide. You can tell if someone is smoking pot by their propensity to talk about cerebral things. With opiates, it's itching and nodding out. If someone tends to itch excessively, that's a dead giveaway. Physical appearance is another sign. Are they pale, look sleepy, a little on the skinny side. Won't look you in the eyes... another symptom.