Addiction stigma – Making addiction recovery, and addiction treatment entry, even harder

October 13th, 2010

When people think about drug addicts, they often bring-up the negative stereotypical hippie, or homeless, image that movies, television, and much of our daily experience has left us with. Its usually not a successful business man, doctor, or lawyer that comes to mind.

This is an issue because many addicts attempt to disassociate themselves from this negative stigma, often resorting to denial of their drug problem or secrecy coping,  and not seeking the addiction treatment they need.

The truth is that addicts are found in every socioeconomic class and within every ethnic group and gender. On this site we have talked about doctors with addictions, the reality of behavioral addictions, and the science behind the compulsive behavior that addicts are so well known for. We have attempted to destroy myths about addictions, by informing our readers about the neuroscience of addiction, and allowing people “to come out” about their addictions. By doing this we hope to encourage openness about addictions, and not allow stigma to get in in the way of recovery.

Addiction stigma hurts addiction treatment success

The center for Addictions and Substance Abuse Technologies, at The University of Nevada, did a study on the affects of stigmatization on 197 drug users. The findings indicated that there is a direct correlation between the degree to which drug users are perceived negatively (stigmatized) and whether or not they overcome their addiction. The study suggested that addicts become more dependent on the substance they use because of the stigma (actual or perceived).

Researchers looked at six questions regarding stigmatization which were:

1. To what degree do drug users experience stigma?
2. Were the metrics of stigmatization conceptually distinct?
3. Is the perceived stigma related to the number of previous addiction treatment episodes?
4. How does secrecy as a coping strategy affect drug users?
5. Do intravenous drug users have higher levels of perceived stigma than non-intravenous users?
6. Do people with current contact with the legal system report higher levels of stigma?

The study found that there are varying degrees of stigmatization and that the most prevalent stigmas were; drug users felt that people treated them differently after finding out about their drug use (60%), felt that others were afraid of them when finding out about their drug use (46%), felt some of their family gave up on them after finding out about their substance use (45%),  felt that some of their friends rejected them after finding out about their substance use (38%), and felt that employers paid them a lower wages after finding out about their substance use (14%). My own personal experience certainly supports the first three findings – I have encountered people who stopped talking to me after finding out about my drug addiction past, and during my addiction there were long stretches of time during which my family completely gave up on the possibility that I would ever recover. At the time I simply shrugged these things off and pretended like they didn’t matter, but they certainly didn’t give me a good reason to stop using drugs.

The results of the study indicated that the measures of stigma are conceptually unique. These measures included Internalized shame Perceived stigma, and stigma-related rejection, all of which were correlated with one another to some extent.

Users with a higher number of addiction treatment episodes also engendered higher levels of stigma and had a more difficult time succeeding in treatment. These results  support earlier findings (Sirey et al. 2001) that showed that users with higher levels of perceived stigma were more likely to prematurely discontinue treatment, confirming that stigmatized drug users are not likely to seek addiction treatment and are more likely to relapse after starting treatment.

Addicts have a sense of shame associated with seeking treatment for their problem

The current addiction treatment system has produced a seeming paradox within the mind of the struggling addict – By owning up to their addictions, addicts reduce the invisibility of the problem, helping others claim back their lives from the secrecy of substance abuse and behavioral addictions. Unfortunately, that process takes far longer than the stigma the confessing addict has to immediately confront.

The study showed that secrecy coping is associated with lower quality of life because of the drug user’s inability to openly discuss their addiction. Subjects  that dealt with their addiction alone had poorer mental health, decreasing their chances of recover due to the stigma of addiction. Much like with many other chronic mental, and physical, conditions, the stigma attached to addiction, and addiction treatment seeking, can often lead to poorer outcomes in the long run and less successful treatment development due to low participation rates in the kind of groundbreaking research necessary. By reducing the shame associated with confessing to an addiction, society could drive forward the advancement of addiction treatment, helping us treat addiction like we treat cancer, parkinson’s disease, and many other chronic diseases.

Surprisingly the results from the study showed that the legal system does not increase the  level of stigmatization, yet subjects that used intravenous drugs felt a higher level of stigma.

Citations:

Sirey, J. A., Bruce, M. L., Alxopoulos, G. S., Perlick, D., Raue, P., Friedman, S. J., et al. (2001). Perceived stigma as a predictor oftreatment discontinuation in young and older outpatients with depression. American Journal of Psychiatry, 158, 479−481.

Luoma J.B., Twohig M.P., Waltz T., Hayes S.C., Roget N., Padilla M., Fisher G. (2007) An investigation of stigma in individuals receiving treatment for substance abuse.

Posted in:  Anonymous No More, Education, For others, Tips, Treatment Tags: addiction, addiction stigma, addiction treatment episodes, drug, drug users, Drugs, finding substance use treatment, higher level stigma, perceived stigma, stigma, substance use, treatment, users

Anonymous No More: Jennie Ketcham and her sex addiction story

July 22nd, 2010

As part of our Anonymous No More series, we bring addiction stories of addicts who are in different stages of recovery and are willing to share their take with you without the veil of anonymity. The point is to once and for all humanize addiction, and addicts, and reduce the stigma of addiction as a condition that leaves people hopeless forever. Jennie Ketcham has already publicly shared some of her story with the world, and if her recovery from sex addiction isn’t an example of humanizing and de-stigmatizing the addict, I don’t know what is. From her humble beginnings, through her porn career, to her role on Dr. Drew’s show “Sex Rehab with Dr. Drew,” Jennie has been leaving her mark on this world for years. I know her story will leave a mark on you.

Jennie Ketcham – Sex Addiction is a slippery disease

Like in alcoholism or drug addiction, the sex addict must hit rock bottom before any change can be made. The biggest problem with this particular addiction is the intrinsically shame-based nature of the disease, with core issues making that first step into recovery the biggest and most difficult step one could ever take. To say, “I am a sex addict,” is to admit total and utter defeat in an arena that is most private and sacred.

My name is Jennie Ketcham, and I am a sex addict. My bottom line behavior, behavior I absolutely cannot participate in if I wish to lead a healthy and happy life, is compulsive masturbation, porn, sex with strangers, sex outside my committed relationship, selling sex for money, and sexualizing people, places and things when I feel uncomfortable. For most people, these behaviors are already unacceptable. For a sex addict however, it’s regular Tuesday night. I am 27 years old, my sexual sobriety date is April 6th, 2009, and I ended up in the program of recovery by mistake, but it was the best mistake I ever made. And believe me, I’ve made plenty.

Up to April 6th, 2009, I was a Porn Star. I’d been in the adult business since 2001, and had worked my way to the upper echelons of porn. By the time I quit, I was managing a webcam studio, directing and producing my own content, and working whenever I wanted. I had heard about Dr. Drew and his new rehab show, “Sex Rehab with Dr. Drew,” and thought it would be the perfect publicity stunt for my webcam studio. I figured if I could get national press, the studio would take off and I’d be able to retire a happy woman. This is the superficial line of thinking that led me to rehab. These are the reasons I actually needed to be there.

Jennie the sexually addicted porn star

When I lost my virginity at thirteen, I realized I have something boys want, and decided to use my sexuality as a means of getting what I want. From my first sexual experience to my last pre-recovery, I was detached, emotionless, and cruel: it was a power struggle and I wanted to win. However, it never appeared as such, always the actress, and I played my sexual exploits off as curiosity and apathy. I’d have sex because I was curious. I wouldn’t call them (him/her) again because I didn’t care. When I joined the porn business it felt like the perfect career. I could have sex with as many people as I wanted, and didn’t have to care about any of them. And they wouldn’t care about me. I’ve never been able to accept love, and this is one of my biggest problems.

I’ve been a compulsive cheater since my first boyfriend, have never been able to maintain a monogamous relationship, and never felt any guilt about my extra-curricular activities. The problem isn’t that I lacked a conscience, it’s that I never felt significant enough to make an impact on any one person’s life. When I joined the porn industry I was no longer required to be monogamous, as it was my job to have sex. It became harder and harder to care about anybody I had sex with, and if feelings of love did start, I’d shut the relationship down before I could destroy it with my behavior.

I’ve been a compulsive masturbator since I started performing in hardcore boy/girl scenes. I decided to train myself to orgasm to non-sexual things, and nearing the end of the behavior, found myself masturbating upwards of 6 hours every day I wasn’t working. At the time I thought I was bored. In recovery, I am able to see the underlying issues, and have found a solution that works for me.

Sex Rehab with Jennie Ketcham

In rehab with Dr. Drew, I was prohibited from masturbating, sexualizing, having sex, drinking, drugging, every numbing device I’d become accustomed to using. When the effects of these behaviors wore off, when my oxytocin levels started to even out, when the alcohol and marijuana drained from my system, I was left with uncomfortable feelings I couldn’t identify or process. With the help of trained specialists, I started to understand what was going on behind my compulsive, dangerous behavior, and with the program of recovery I’ve learned how to deal with life. I am powerless over compulsive sexual behavior, and my life had become unmanageable. I came to believe that a power greater than myself could restore me to sanity. I made a decision to turn my will and my life over to that power, and every day since has been better than before.

I was celibate for over nine months, trying to get back in touch with the Jennie pre-sex. I attend bi-weekly therapy sessions, and follow every direction given by either therapist or sponsor. I trust in the program of recovery, and have learned how to treat myself like the precious young woman I am. I have become a woman of grace and integrity, I have dreams that aren’t pornographic, and my first healthy committed relationship with a man I love. I have a relationship with my family, something that had fallen off in addiction, and am someone who does what she says she will do. There isn’t a single moment that goes by that I don’t worry about falling back into my destructive cycle, but now I have the tools necessary to live a healthy and productive life.

When I walked into rehab wanting publicity for my company, the joke was on me. I had accidentally walked into the first day of the rest of my life, and one minute in recovery is worth a thousand days in addiction. I am blessed through and through, and I take it one day at a time.

A final word on sex addiction recovery from Adi

You’ll notice that Jennie’s bottom-line behaviors are very far from the often stigmatized view of the sex-addict as a rapist, or pedophile. While there’s little doubt that there are sex addicts that fall into those categories, the vast majority of addict engage in activity that might, for others, be relatively benign but that has become compulsive in their own lives. My issues with sex addiction revolved around seeking sexual partners outside my marriage and migrated from my bedroom to online chat sites after I got caught cheating. What’s also very clear when reading about the recovery experienced by Jennie is that with the proper guidance, treatment, and time, addicts can go on to become fully functional in ways that many out there believe are nearly impossible. As Jennie mentioned in her reference to Oxytocin levels, a huge aspect of addiction recovery is letting the body reset, or at least attempt to re-establish, its  functioning to pre-addictive-behavior levels in the brain and elsewhere.

Jennie Ketcham used to live a life that left her unattached and cold, though for her, it didn’t seem like much was wrong until she saw the other side thanks to her stint on “Sex Rehab with Dr. Drew.” Most other addict’s aren’t very likely to end up on a reality show that specifically addresses their problem (though A&E’s intervention may help some of them), but the knowledge that others with similar problems have recovered and are living full productive lives that would have been unthinkable should give hope to every struggling addict. It’s what works in group therapy everywhere and what gets some people into treatment in the first place. By living her recovery without anonymity, Jennie is showing endless other addicts that life with addiction is possible. That’s what addiction stories do – they give hope.

Posted in:  Addiction Stories, Anonymous No More, Sex Tags: addict, addiction, addiction stories, celebrity, Dr. Drew, jennie, jennie ketcham, porn, recovery, rehab, Sex, sex addiction, sex rehab, sex rehab with dr. drew

Addiction stories – Anonymous no more: Sarah’s recovery is no secret

July 18th, 2010

In case you haven’t noticed, I can’t stand the stigma I’m supposed to carry around as a recovered addict. People expect me to steal from them, or pull out a gun, or maybe just smoke some crystal meth at the dinner table. But guess what, I haven’t been that guy for almost 10 years now, and chances are, I’m never going back there again.

I received the following addiction story from a reader, another recovered addict (from an eating disorder mostly) apparently sick and tired of the misconception. I’m publishing it here with very few changes, and though I’m including it in our Addiction Stories category, I’ve started a new category now and it’s called Anonymous No More. It’s my personal opinion that if more recovered addicts stood-up and told the world that their previously sordid lives are now full and complex, just as they are meant to be, we’d see a lot less of the kind of misjudged treatment Sarah is referring to. So thank you Sarah Henderson for being the first one up to bat on All About Addiction. And here’s to all those who are going to follow everywhere – There’s no doubt in my mind that when it comes to inspiration, addiction stories do as good a job as research-based education.

Anonymous No More: Inside Stigma – A Patient’s Perspective

Hi, my name is Sarah. I’m Anorexic, Bulimic, and a Cutter.

You could call me these things. But they wouldn’t be accurate. Because I am not these things, these labels. And I am not in recovery from these things.

I am recovered.

From those things, I am recovered. I am bipolar, which requires ongoing management. But you wouldn’t know it if I didn’t tell you. I am not the stereotype, I am not the crazy person we all think of, ranting and raving on some street corner. I am like anyone else, except I take a few pills before I brush my teeth in the morning.

And yet.

I still catch flak all the time. For the taking meds, for going to therapy, for the eating disorder history, for the visible scars from years of cutting. People comment on them, I’ve lost jobs because of them. It’s like, what do you want? I used to cut myself. I don’t anymore. I used to starve and binge and purge. I don’t anymore. So eat lunch with me and stop looking at me like I’m going to vomit on the table any second. Deal with me as I am now, not as I was then.

And yes, I take medication for a chemical imbalance. Guess what? So do diabetics. Only their imbalance is in the pancreas, and mine is in my brain. That’s the difference that makes people freak. That’s where the stigma lies.

If you ask a poet, he’ll tell you the seat of the soul lies in the heart. If you ask a neurologist, he will rightly tell you that the seat of the soul lies in the brain. And anyone who’s ever experienced dementia will testify to that. It’s very possible to exist in your body without living in it. And it’s possible for the person you love to die long before their heart stops.

I believe that stigma comes from people’s instinctual knowledge that when you mess with the brain, you mess with the soul. It can be disturbing, it can be terrifying, it can be cruel. And most people just aren’t up for facing that. However, when you don’t face it, you also miss out on everything the other side has to offer: healing, resilience, clarity, and courage. And while they are some people who don’t come back from mental illness, the vast majority of us do. The other side is a beautiful place. And if you can get past the stigma, you can join us.

Closing “Addiction Stories” commentary from Adi

You’ll notice that Sarah considers herself a recovered addict. When it comes to my own drug use, I do the same, and I can tell you that there are quite a few people out there who strongly dislike it when I tell them that I think I’m done with my drug addiction. To me, this is all part of the same stigma equation – It doesn’t matter if others in recovery stigmatize you as having a problem for life or if the people doing it to you are ones who have never walked in your shoes. The bottom line is that I believe people can be “recovered” and though it probably doesn’t apply to everyone (nothing ever does), I think it likely applies to more people than you believe.

And that’s where working through the stigma is important, as we shed off the shackles of our current understanding and get to a clearing that is lighter and offers more freedom for each addict to use the tools that make the biggest difference for her. That way she can live her life after her recovery as she wishes with little judgment and consternation from those around her. And it shouldn’t matter if we’re talking about recovery from an eating disorder (like anorexia or bulimia), drug addiction, gambling, or sex addiction.

Doesn’t that sound nice?

Posted in:  Addiction Stories, Anonymous No More, Food Tags: addiction stories, Anonymous No More, anorexia, bolimia, Brain, eating disorder, going, recovered, recovered addict, stigma, things