Mayim Bialik's Breakdown - David Poses: Get to the Root of Addiction

Episode Date: October 19, 2021

David Poses (speaker, expert, activist, author of The Weight of Air) discusses the intersection of addiction and mental health. He opens up about becoming addicted to heroin in an attempt to treat his depression after learning about it in a school drug education program, and how he was able to function on and effectively hide his addiction to the drug. Mayim and David debate the benefits and disadvantages of 12-step programs and consider how society’s need for instant gratification may contribute to the ongoing opioid epidemic. They discuss the need to change our perceptions about those with substance abuse issues and restructure the way we view mental illness in general. Mayim explains the effects of marijuana on depression in another installment of Ask Mayim Anything. David Poses' Book: https://davidposes.com/the-weight-of-air BialikBreakdown.com YouTube.com/mayimbialik Learn more about your ad choices. Visit megaphone.fm/adchoices

In fifth grade, maybe you had this assembly, too, with the cop from the DARE program. Oh, yeah. Just say no. Okay, so the cop at my school came in and he said, heroin is the worst drug because it's a painkiller so strong that you don't have feelings. And he said that like it was undesirable. And for me, it was like, this is exactly what I need. Hi, I'm Myambialic and welcome to my breakdown. This is the place where we break things down so you don't have to.

It's Mymbialik's Breakdown. She's going to break it down for you. you because you know she knows a thing or two. And now she's going to break down. We're going to be breaking down a different perspective on addiction with David Poses. And David has written a really, really lovely book called The Weight of Air. It's his memoir. It's available worldwide.

It debuted at number one in substance abuse and number one in popular psychology. It's really, really fascinating. And it is a very different perspective on addiction. and mental health and the intersection of those things and how we treat that. But before we get into more about David, I'd like to introduce you to my favorite 13th step, Jonathan Cohen. Hello, my name. I'm working those steps every day just to get to me.

That's the end result of all of my working? Correct. All roads lead to Jonathan Cohen. All steps lead straight up. Very tall. He's quite. high off the ground, this gangly Toronto-born

person is the 13th step. This is going to be a controversial episode. Number one, the weight of air is not as heavy as water. I know because I carry a lot of water. Not that I'm bloated. I just like lug extra water because I like purified water.

Number two, he goes against some of the principles that you very much believe in. He had a really bad experience with 12 Step programs. Let's just say that. And if anyone has listened to this podcast before, they know that Mayam loves a good step or 12 or even 13.

Well, I mean, and I'm happy to talk about this with him, the widely accepted way that many, many, many, many, many people get sober is through 12-step programs. That's not to say the 12-step programs are beyond reproach or beyond criticism. The foundations of the 12-step programs is something you can look up and research, and I'm happy to talk about it, something we spoke about with Moshe-Cat. when he was on. There are many ways to live a sober life. And, you know, mostly I think what I'm eager to talk to David about is his experience with mental health and how science and pain, you know, in particular, different kinds of pain can work together.

We talk about 12 steps and they're not just for addiction. We've had many guests talk about their involvement in program and having, feeling the support of, program. I'm not going to list all of them, but it is a common theme that has reappeared. The other thing, if people want the overview of the mechanisms of addiction, because we cover that in the John Ross Bowie episode early on. So scroll back, multiple flicks of your little finger there. Scroll back on that feed. One of our first episodes, I think, that aired was John Ross Bowie. He's in the top first five, I think. And we cover addiction. Mine gives a whole overview of the mechanisms of addiction and dopamine and how it all works. So if you want more info on that,

hit up John Ross Bowie's app. Just the intro covers that. David is a writer, speaker, an expert, and an activist. He focuses on evidence-based addiction treatment, drug policy, and harm reduction. His writing has been published many, many reputable places. He's appeared also on various TV and radio shows. The Weight of Air is called a Memoir of a Double Life fueled by Addiction and Mental Illness. It's raw. I mean, it is not for the faint of heart. You know, he was raised as he describes it. He was raised an upper middle class Jewish kid from Westchester, which, if anyone knows

Westchester County, it's a very specific way to grow up. He first got high at 16. He was a heroin addict. It's a beautifully written book, but it is very painful. It's very painful to read about attempts at, you know, kicking the habit and withdrawal. But there's a lot of hope in this book. and it's a lot of short chapters, which makes it, I don't want to say, like an easy read,

but it really moves along. And it's a really, it is a beautiful book. And I'm very, very glad to welcome David to Myambialics Breakdown. Welcome, David. Break it down. I mean, writing anything at all is brave. Writing anything close to a memoir is exceptionally brave. And writing about mental illness and addiction.

is a special level, but you've kind of reached the highest level and also it's in many ways kind of a confessional. I mean, you, you know, you kind of like you hit all the points and also like it feels really ridiculous to be like, thanks for sharing the deepest, darkest parts of your soul with us. And then we get to ask you a million questions about it. But, you know, I don't know if you know much about what Jonathan and I do hear, but we're pretty brutally honest, you know, in our own way. And I've been very, um, um, um, um, um, um, um, um, um, um, um, I've been pretty open. I don't think there's a thing I haven't discussed that I've been through. I like to say I'm a person who like name a diagnosis and they've thrown it at me at some point.

Name a medication. They tried it on me. They tried combining them in all sorts of different ways. And, you know, like I've had that cocktail experience. You know, I'm not a person who has sought to fill what we call the God-shaped hole with alcohol or drugs. that those are not my things. Jonathan likes to point out, I have an actual allergy to alcohol. It makes my palms itchy. I think I might have an allergy to alcohol, too.

I got drunk once when I was 15 and I haven't gone near alcohol since. I mean, it was just horrifying. Yeah, not my thing. You know, I use food and I use restricting food, you know, as a thing. You know, it's no secret that we talk a lot about 12-step programs here. And, you know, maybe you can share a little bit, you know, kind of in a nutshell. about how you got to recovery in the first place. You know, you describe, you know, kind of a quote,

normal, you know, middle upper class upbringing, is. Tell us a little bit about kind of what you were like and what your childhood was like and sort of how you found, yeah, how you found drugs. Sure. So my parents got divorced when I was four and mom started taking me to, therapy appointments every week.

Before I knew depression was a word, I just thought I was broken, basically. Some of my earliest memories are of my mom, looking at me in the car and saying, like, why are you so sad? Don't you want to be happy? Like, as if it was a choice. And I knew that I didn't want to be sad.

I didn't know how not to be sad. I didn't know how to talk about it. I was very ashamed. And so I kept those bad feelings inside in therapy, but they figured it out anyway. And so by the time I got to like high school, they had tried every conceivable antidepressant, and none of them worked. And in the back of my mind, there was this, in fifth grade, maybe you had this assembly too with the cop from the DARE program.

Oh, yeah. Just say no. Okay, so the cop at my school came in and he said, pot makes you stupid, cocaine makes you angry, and you can't drive if you drink alcohol. And so, you know, it was easy to cross those things out. I was much angrier than I had any business being. and I thought I was stupid, so pot was useless. And I mean, at that point, my lifelong dream was to drive into a tree, so alcohol was out of the question. Then he told this very scary story about hallucinogens or about acid that I never took a hallucinogen after that story, even though I later learned it was not true.

And he said, heroin is the worst drug because it's a painkiller so strong that you don't have feelings. And he said that like it was undesirable. And for me, it was like, this is exactly what I need. So, you know, in my neck of the suburban woods, in the, you know, 80s. and 90s, heroin was like trying to find weapons-grade plutonium. Like, it was just nowhere. And everything else was available. And I tried smoking pot and that one time with alcohol. And I just, I hated it. I don't like the feeling of being intoxicated. Like, reality was fine. I was the

problem. So eventually I found heroin and there was so much hype built up in my mind. But like, I was pretty much thinking, if this stuff does what I think it's going to do, like, I'm all in. I don't care that it's illegal. This is going to keep me alive. If it does it. I'm out. I mean, I don't have any other options. I didn't know what else to do. And it worked. I mean, it really worked. It is a painkiller. And our opiate receptors regulate physical pain and emotional well-being. Opioids work by, you know, you know how they work. No, but you can go ahead and say it. Fine. So they flood your brain with dopamine and serotonin and they bind to your opiate receptors. They don't know. They don't care if you have a prescription, if you're using it to kill

physical pain, emotional pain, like that's just what they do. And it seems like, you know, for a lot of people, it's easier to believe that people who use drugs are bad people instead of people who use painkillers are in pain. You know, but that was it. So I was in a world of pain and it worked. But I hated the lifestyle. I want to stop you there because, you know, a lot of us obviously have, you know, images of heroin addicts, of junkies, you know, like that was the term, you know, that I always heard as a kid. And, you know, and I'm not saying this to point out, you know, how crafty and clever you are, although I'm certain that you're a crafty and clever person, but what you were able to do was,

as they say, like, find your dose, meaning you operated at a functioning, I mean, a functioning level. So can you talk a little bit about that? Because, you know, I think a lot of people see like Breaking Bad or they, you know, like they have these perceptions of like train spotting or like what you see in the movies. And the fact is, and I'm not saying this to be like, here, find your dose of heroin. But I'd like you to kind of explain a little bit about what kind of passing, you know, looks like in this case. Yeah. I mean, I think, you know, the thing about it is like these myths are so easy to debunk just in regular everyday life. Like we, we know that nobody can,

you know, wake up at 7 o'clock in the morning and start guzzling down rum and function. You'd smell it on them. We do know that there are painkillers much more powerful than heroin. They're prescribed by doctors every day to people who not only function on them, but need. them specifically to function. And nobody ever thinks like, oh, my God, grandma's on, you know, morphine again. Watch out. She's going to steal your VCR and, you know, kill you. You don't know my grandma. Sorry. Well, right. But so, you know, this, this idea that, like, you can't function on heroin. I think part of why it persists is, like, I was functioning on heroin. I, everybody that I know that used heroin was functional on heroin, but we don't go around

saying, like, hello, this, you think that you don't know that people can function on heroin because we're not telling you. You know, I mean, who's going to admit that? So for me, I could function just fine on it. I was actually much better because when I wasn't on it, like, I couldn't get out of bed. I mean, it was a disaster. And, you know, back to this idea of painkillers, like, that's what they do. So it worked. You know, obviously there's a lot of undesirable, you know, side effects. Do you want to list those just because you and I both have teenagers and I feel like we probably should give a little bit of a disclaimer here? Yeah, absolutely. So, um,

I mean, for me, you know, my fear of needles was rendered impractical fairly quickly because of a high tolerance. It's awfully expensive. Very expensive. I mean, you talk about money in here. It's expensive. It's very expensive. It's very expensive. No question.

I mean, the biggest danger with illicit drugs is not the drug itself. It's not knowing what you're getting. I mean, like with, you know, if we had two pint glasses of alcohol and one of them was, you know, methanol and the other one was hard seltzer and you didn't know which was which, like, you're dead if you drink the wrong one. You don't get another chance with that. So a bag of heroin has, you know, this archaic little stamp on it and there's no quality assurance statement or like, here's the potency and purity. You know, so that's really the danger. And I thought I was being so careful with like, oh, you know, this is, I'm going to shoot a bag

of dope and that's it. But if this bag is 20 times more powerful than that bag, like, it's it. You know, lights out. And that's why people are done. And that's why people during alcohol prohibition, I mean, alcohol fatalities surged for the very same reasons. So, you know, we think alcohol is legal because it's safer. Alcohol is safer because it's legal. Yeah, I would argue, I mean, just in terms of like mechanisms, there's a very different kind of dosing procedure for alcohol, which is much more highly regulated. My MBELX breakdown is supported by superpower. We all know the feeling of leaving a doctor's office and kind of feeling like we didn't get anything out of the experience that was useful.

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I'm just trying to be, like, really responsible here because I do know other people who hid and functioned for years with a heroin habit, even sleeping next to people who did not know. And people are like, how could you not know? It's very, it happens when you've had the kind of chemical relief that we're talking. about from the kind of pain, you know, that you were in. It takes over. So it's not like, oh, I like to party on the weekends. Like, you know, but it's, you know, the thing about it is like, I mean, and I'm totally with you on the being responsible. Like this is definitely not a paid or unpaid endorsement for drugs at all. But I think, I forget what the statistic. I think it's like 88, some very, very high percentage of people, alcohol is not a problem for those people.

drugs are the same thing. So with, you know, opioids are physically addictive. So you're going to get sick if you stop taking them. Like, that's a disaster. Stimulants, cocaine, meth, crack, you know, all of those crack is addictive from the first hit. Crack has no physical withdrawal symptoms. So you can just stop smoking crack and you're, you know, displeased, but you're not going to be ill. So with, with the drugs, what's interesting to me about the heroin is that, like, there was never a situation where I would, you know, have, I mean, I would have gone into withdrawal before I would have, like, you know, missed one of my kids' soccer games if I, if I was on drugs at that time. I mean, that was the whole reason to stop. And I think it's interesting how, you know, there's so many people who run these ultramarathons and wake up at 5 o'clock in morning and they don't see their kids on weekends and they get injured and, you know, they have all of these really bad consequences, but like, that's okay. And if they're doing that to deal with their depression, nobody blames the running,

you know, on the depression. And if we would look at drugs that way, way. I think it would be so much more effective for treatment because we're just blaming, you know, we're glossing over the problem. I do want to get to kind of those larger points because I think they're really important, but I also do want to kind of confirm what you talk about in the book, which was that the 12-step model did not work for you. It did not work for you. It does not work for some people. I will say that as someone who spent a lot of time in the rooms, there are people who are not great representations of the program. And there are people who misinterpret the program. And also, the program has a history. There was a, you know, it was a, it was a Christian incarnation

before it was established with Bill W. and Dr. Bob. So there's a lot, there's a lot of room for interpretation. And as much as, you know, as much as we have a World Service organization and they try and this, that the other. And we spoke to Mosha Cash, I don't know if you know Moshe, but But he spoke a lot also about, you know, his experience very young in 12-step programs. Maybe you can talk a little bit about because I do want to, you know, make sure that you are able to voice, you know, the things that didn't work for you. Sure. I mean, for me, it was, you know, the moment I walked in the door and they started talking about, you know, you're going to be dead in five minutes unless you put your life and will in God's hands and work the steps of our anonymous support group, which really screams you have nothing to be ashamed of. anonymity. Is that why you think it's anonymous because people are ashamed? Yeah, absolutely. I mean, yeah, AA, when, when A.A was developed in the 1930s, they labeled addiction

a disease to reduce stigma. Sure. Yeah. So, I mean, you know, there's, there's no question. I mean, you know, look, like my mom is involved with a, you know, a cancer support group, like there's support groups for everything. Everybody knows my mom is, you know, down with Gilda's Club. You know, there's a reason that we're not screaming. I'm an alcoholic. And I'm an alcoholic. And that makes it hard to, you know, mine data because it's so anonymous. But like Lance Dodes had this book a few years ago that he found, I want to say it was like 8% success. And he defined success as the people who are still in the program. Right. So for me, you know, I hear medical experts without medical credentials and magical thinking cures. And if you look up quack medicine in the dictionary, that's exactly what you get. You know, it just, it felt like there was no science and medicine behind it. And they're telling you. And they're telling you. science and medicine is bad. Like if you take antidepressants, I mean, all of these, you know, there's an AA group in Syracuse that's being sued for basically shaming somebody

into killing himself because he didn't, he stopped taking antidepressants when they shamed him. So like all of that kind of stuff, it didn't work for me. I was much too pragmatic. And they were just, you know, way too long on faith and short on facts for me. So today it's very different. apart from like all of these JAMA studies that that show that faith and abstinence programs increase your risk of death overdose and relapse as dramatically as methadone and buprenorphine reduce those risks. And you know, certainly if you have if you're abstinent and you have zero

tolerance, you're at the highest risk of overdose and the highest drugs with overdose risk are the illicit drugs because you don't know what you're getting. Well, and I was also going to say that, you know, I mean, I take issue with the fact that something didn't work. for you and therefore maybe. No, no, no, no. It works for, I know a lot of people who works for. I mean, I think that's important to say is that for a lot of people, you know, for a lot of people abstinence, you know, is a solution. And, you know, I could tell you a dozen people who have OD, you know, from the rooms, just from, you know, kind of like my circle of people just in this last year. And, you know, you're absolutely

right. Very, very difficult also to quantify a lot of this. And, you know, for me, I, I love the anonymity of our program because it allows people who otherwise might be called out. for being bad people simply for, you know, having mental illness, which is, you know, in many cases, you know, I talk about this a lot. It's just what you cover, you know, your challenges with, right? Yeah, yeah. But absolutely. But that aside, you know, I think that a lot of what you talk about as sort of solutions to how we deal with this are not as easy to implement as abstinence. Many people don't use God as a higher power. They use the group, they use nature, whatever it is, you know, a spiritual recovery path is something that's true.

It's free and it's available to everyone, you know, meaning, you know, it's about the books and the meetings and the fellowship and having friends who are on a similar path. Great. But, you know, a lot of what you talk about is a much larger and very, very necessary restructuring of how we look at mental illness in general. So can you speak to that more specifically? because I think that's something we agree on. Not that we can't talk about things we don't agree on.

I'm just saying, like, that's, I think, a really important point. I think it's important to add that I never would suggest that anybody, you know, do what I did because that's how it works. I do know people that AA worked for. I think a very important difference is like the idea that, you know, a drug is a drug and addiction is the problem. Like, we learn at a very early age that every type of substance affects our neural pathways differently.

So it so happens that Alcoholics Anonymous was developed for alcohol. I'm never around people who drink. I have this friend who's recovering alcoholic, and he relapsed, and he called me a few months ago at like 2 o'clock in the morning, and he was drunk. And he was drunk, and I didn't know it. Like, I thought like maybe he had a stroke. I mean, it was really, really scary. I can't remember the last time I was around anybody or talking to somebody who was drunk. And it was really scary.

And then when I talked to him the next day and I knew what was going on, and we had this conversation, he said, you know, I think I just realized. why AA is very effective for alcoholics and not for you guys. And everybody that I know that AA works for, alcohol is the problem. When we look at how things are evolving here, like, how the opioid crisis came to be, like, we're a nation in pain. We're an instant gratification society. We're very, very hurting. Somebody shows up with painkillers, and, you know, we're all in.

And so the question that needs to be asked is, like, why? I mean, I think part of it is just by virtue of being this instant gratification society and everything is, you know, so fast. But like depression, it's not just why we hurt. It's what we're doing about the hurt. Like for 49% of depressed adults, antidepressants are completely ineffective. Like they're just unresponsive to antidepressants. Well, you mean, classical SSRIs. Yeah. Right. I mean, there's basically two kinds of antidepressants. And then when people are like, oh my God, like heroin doesn't work, you know, opioid. Like, why are you taking it? Like, it's an excuse that you're in pain. but like they work. I just want to make a point that classic SSRIs, you know, like those are like the Paxils and the Zolofts, you know, the ones that your intern, like your internist will prescribe you, which I have a large problem with. I do too. Yeah.

You know, those are drugs that work for a very specific kind of unipolar depression. The larger problem that I see, you know, as someone also who worked in neuropsychiatry is that many people don't have classical depression that responds to SSRIs. They may have some cyclothymia. They may have dyshthymia that also has some mania. I mean, like, we're a spectrum. So the notion, like, that's a rough statistic because, you know, atypical neuroleptics and some of the, you know, kind of fancier medications often do treat depression.

But the problem is they're more expensive. your internist doesn't know about them and it involves you going to a psychiatrist which most people don't have access to and can't afford. And I have friends on Medicare and Medicaid they can't even get to a psychiatrist. So it's like the brokenness of the system shouldn't be dismissed as your choices are SSRIs or heroin.

I mean, unfortunately, that's how it is for like, you know, these kids in West Virginia. I mean, I forget exactly what it is, but some very high percentage of depressed people don't have access to any kind of, you know, resources. And then there's the stigma on top of it. You know, like, I feel like we can, we know, you know, you break your ankle and, like, we know that your ankle is broken and there's nothing you can do about it.

You have bad feelings. Like, we've all been told to snap out of it and look on the bright side and, you know, all of these things. So, like, there's so much shame in having bad feelings. David, I've had people on this podcast, very respected, you know, professors who were just like, I just had to shake it off. Right. Well, right. And that's, you know, and it's, that's, I mean, that's, that's really awful. It's not a choice. And, you know, the symptoms are obviously very invisible. I mean, you know, we try to hide them as much as we can. But getting good treatment is very hard. And with the internists, you know, prescribing these things. I mean, you know, I can't tell you how many stories I've heard of like, I took my daughter to the doctor because she was feeling sad and he was like trisome prozac. And, you know, the problem with that is the, the,

doctor is you know can prescribe it but he's not qualified to treat it or respond with them i like to point out that like i went to a bad psychiatrist for a period of time and also not to be more controversial than this episode might already be usually if you're female and you report not feeling good they put you on the pill like that's what they do like oh you're 15 oh you're 14 oh here so then like that's also again And endogenous, you know, it's endogenous all sorts of chemicals and hormones. Is that still true? That is 100%. Oh my God.

That's gross. So when I went to what I consider a more qualified psychiatrist, it was the questions that he asked me that allowed him to understand what was actually going on, things that I never even realized. And I think I've spoken about this before. He was like, do you have a special number? I was like, who doesn't? What's yours?

Well, I'm a nine person, also three, because that's three, three times. I got a lot of numbers. But anyway, I didn't know. And so he started asking me all these things. And what he got to is that I had mania. I had an interesting kind of depression. I looked more like this than that, as opposed to just, we'll put you on the pill and we'll give you some Xanax, you know? Yeah, that's so awful.

I'm going to clarify something because we get some messages and people can get upset at the notion, that were anti-medication. I love medication. Yes, I also love medication. Because anyone who's taking something that is having success, we are not opposed to that. That is not, and I'm just summarizing what we're talking about here, so there's zero miscommunication amongst listeners.

I'm with you, yes. We want anyone to find the solution that works best. What we're articulating is that there are ways that people can get help that are more specialized, that are more specific, and that the help that some people get, not everyone, but many people get is this very, very broad brush that ends up not working for them. And that's what we're sort of fighting against.

We're fighting against this broad, non-specific brush that doesn't get the people the help they need. We are not opposed to anyone who has found something that works. And if you found something that doesn't work, we hope that you get the specialty and the special skills required in order to get you something that does. That was the very polite Canadian way of approaching this. I'm going to take a more specific, and yes, I'm going to push people a little harder,

and I think David will agree with me. We live in a culture where when something hurts, you pop a pill. And our children learn it from a very young age because that's why all those drugs exist. So for people who teased parents like me who were like, let's use ice for teething, yeah, there was a reason I didn't want to give my kids that kind of, of Western medicine, for example, when they were teething and people are going to be like, she's horrible to children. That's not true. But we are taught from a very young age that emotional or physical discomfort should be numbed. Here, have a cookie. People still do that shit to their kids.

Oh, you're sad, distracted away. I remember when I got divorced, I said to our family therapist. I was like, what do I do if he wants to, she said, you just tell him it's sad and you hold him. I was like, what? He doesn't get to write a letter. We don't. make a phone call. She said no, because sometimes it hurts and that's just life. And the resiliency to learn to have uncomfortable feelings and to know that you're okay anyway and not to stuff it with a cookie. When the solution that we are given is to take any pill in the absence of education, further resources, further support, understanding mental illness in a larger context, we are all robbing ourselves of the opportunity to progress.

as human beings. But the notion that we shut people up with a drug is not what any of us want. David's like, why didn't you give your kids a cookie when they missed their dad? No, I think there's probably a drug for that that you can take to, you know, be better about not taking drugs, right? You know what I mean? And my kids have said to me, why didn't you give us all that Western medicine? Why did you want us to suffer? I mean, no, I totally agree. And the thing that's that's so scary that I keep hearing about because that is just foist on us and kids know it. You know, my daughter's 15. So this scares me, although she insists that I've completely ruined drugs and alcohol for her forever.

You're a downer dad. Which is fine. I'm so happy about that. But no. So the idea, you know, like my daughter, I mean, she's in like AP everything. I mean, she's like the biggest nerd in the world, but she's like the cool kid. And so she's got all these friends and whatever. She's not the kind of person that's going to go out and like drink and smoke pot, right? But these very nerdy AP, you know, girls, if somebody comes up to them and they say like, hey, this is Xenics, your parents take it. It's from the pharmacy. It's not, you know, all this, whatever. Those are the kinds of kids that are the most likely to take it. And, and like so much of it is now counterfeit and full offense and all, and you don't get another chance with that.

Yeah. And I mean, we've talked a lot essentially about, you know, this much of the book, you know, the big chunky part. But, you know, the real kind of beauty, you know, of this book is when you do talk about, I don't want to say coming clean, but, you know, it's such a funny expression. You know, you found a medication that is typically prescribed for opioid addicts. And I believe for 10 years, no one knew you were on it. Is that right? There's more like 12, yeah.

12 years. Okay. you ended up writing about it for you wrote an op-ed in in the LA Times right it was my coming out party yeah tell us about your coming out party because I think especially because we did talk a little bit about shame and anonymity you know I'm not going to ask you this dumb question like why did you write this book but was there some sort of decision about wanting to sort of bring this out yeah I mean you know I I knew I mean you know the views that I have today are more evolved than they were 30 years ago but it's pretty much the same thing. I knew that I wasn't the exception to this junkie stereotype, you know. I mean,

back then, it was like a homeless Vietnam veterans or the, you know, murderous heroin addicts. I never met, you know, a stereotypical junkie. I just lived in such shame. I mean, I had so many, you know, more than a decade of relapses. And I felt like as the opioid, you know, I mean, I was on buprenorphine. I didn't tell my, I told her it was like a migraine medicine or something. But as the opioid crisis started to be, you know, a thing that was in newspapers, I saw so much misinformation. And I thought, like, you know, I'll start talking about this when it's more, you know, the stigma is less or whatever. And I just, I realized that like my silence was sabotaging what I was trying to accomplish. And if I'm not going to do it, how can I expect anybody else to talk about, you know, openly about their struggles?

And they're really, you know, I haven't read every single book about, um, drugs and addiction and mental health. But, you know, I was fairly certain that this story didn't exist or hadn't been, you know, put on paper. And I mean, I don't mean that in like, you know, well, I'm the guy to do it. But I just felt like that was really sad. And I was so afraid to tell my wife because, you know, no matter how you look at it, I deceived her for a very long time. And that's not okay. So I had this thought that like, I'm going to write this book. I mean, writing's always been my thing. Like I wrote a bunch of novels that I. I was too afraid to share with anybody before this.

I'm going to write this book. I'm going to give it to her and we'll talk about it. And that'll be that. You know, and that was kind of that. And she was, you know, I mean, I don't know why I was so shocked that she was so compassionate and understanding and, you know, really sensitive about it. We're still married. You know, so she was so accepting and I started, you know, sharing it with other people.

I mean, it wasn't like I was, you know, hey, this is, you know, all the, I mean, you know, three years ago, Everybody in the world that knows me believe that I was 24 years sober and the happiest guy in town. For I think more than half of that, you were not sober. I was still on the drugs. I mean, I'm on the medication now. I don't think that I'm nodding off and drilling. I don't know what. Anyway, yeah, I mean, my mom at different times, like I said, you know, either I was on heroin for like six months or a couple of years or like nothing, but, you know, it was 16 years. And like, that's longer. So the book started to, like I gave it to Andrea and I gave it to like a couple of other people and it was just one of those like, you should really do something with this. And, you know, so like I looked at, what do you call it? Andrea got me this book of literary agents. So I went through it and found, you know, I was like, I'm just going to find the like five dreamy agents. And when they tell me to go fuck myself like, this is over. And obviously, you know, that didn't happen. So the LA Times article was my agents said, you know, you got to get an article somewhere and then we'll, you know, go out and do this. So, you know, she might as well have said, like, you need to win the lottery in all 50 states on the same day. So, you know, so I wrote this article thinking like nobody's going to, you know,

I mean, I'm very, what do you call it? You know, like, I think I suck. So why would anybody care? Self deprecating. So, so LA Times took it and they're like, we're publishing it on Sunday. And my mom didn't know any of this. I think it was maybe, you know, 24 hours before the article came out. I was like, you've got to read this whole book right now. And she did. And, and, I mean, you know, the next day was the article. But after that, she came to meet me and I didn't know how she was going to respond. And I didn't, you know, like, I didn't have a book deal. Like, this wasn't going anywhere at that time. And she gave me this, like, really beautiful pen for book signings because that's how confident she is. And I'm like, what the hell am I going to do with this? But it was really surprisingly easy with everyone that, I mean, I shouldn't say that with everyone. Like, I, I certainly lost a few friends along the way. But the acceptance that I found is really extraordinary. And it's amazing the way that, um, that, that, that, you know, I find myself being received. I mean, I'm, I'm a very shy and insecure person. So it's like hard to even say this kind of stuff. Sure. Like, I mean,

just the idea that, that people are, I mean, I went to this, you know, thing last night, an event and like, people, you know, come up to me and they're like, you know, I never thought of it that way. Like, thank you so much. And I'm like, oh my God. Like, this is just crap to the, you. And I mean, it's in my head. With all the kind of like self-awareness you had and all the sort of information that you had, was there a time when you were like, I don't want to be on heroin? I don't like this. I don't like the lifestyle. I don't like the lying. Is there something else like a medication that I could try? I mean, the thing about it is, you know, I think everybody does the best they can with the choices they have at the time. Right. So my choices were heroin or

suicide. Okay. That answers that question. You were what we call suicidally depressed. Yeah. I mean, that's what it was. I was, I mean, you know, I was committed to either heroin's going to work or I'm going to die. And so, you know, what else could have worked? It's an interesting question because I know what might have worked. I'm just curious your path to not get there because that's a, that was something that happened too. Yeah. I mean, I, I hated the lifestyle from, you know, the first minute I went to buy heroin. I mean, it's miserable. But I noticed, you know, I didn't think about it at the time when I told my parents that

I was addicted to heroin, I was too ashamed to tell them why I was using it. And they were too scared and outrage to ask. And it seems like when drugs come up, people kind of lose their minds and they go, like, you've got to stop doing it. Like, there's no, nobody ever asks, why are you using this? And what are you getting out of it? Because that's the problem. And so your question is hard to ask because, or hard to answer because like my trajectory is shaped by the experiences that I had.

So that conversation never happened. It was just like, this has to stop. It's evil. I go to a rehab that tells me addiction is the problem. And I'm going, actually, depression is the problem. This is a symptom. Addiction is a medical, you know, physical medical condition. When I stop taking heroin, I'm going to get ill, right?

So the cure to that is definitely sobriety. I'm now sober and I'm not taking heroin. But mental health disorders, like, you know, if you're one of those turn the doorknob 77 times or your cat's going to die kinds of people, you can stop turning the doorknob, you're sober. Your compulsion to turn the doorknob hasn't changed. And you still think your cat's going to die. So in rehab, they're telling me, no, no, no, forget about it.

Like, that's crazy. You've got to just stop the behavior. That's the problem. And I knew that that wouldn't work, but they explained it so well to my mom in this non-scientific way. You know, I mean, they told her that like I was, I was, I'm an addict and a drug as a drug and all that kind of business. And like, she's got to, you know, get the Purell out of the house because I'm going to start chugging hand sanitizer if I'm desperate enough for a high. And I remember talking to her and just saying like, you know that that's not who I am. Like you were there the time

I got drunk. You know that I like, you know this. Like, um, and she's just going, you know, but what if you're wrong? At the time, I was like, what are you out of your mind? But now as a parents, I would do the same thing, like, without question, because I don't want my kid to die. David, it's really been a real pleasure to talk to you. I'll be honest, I was very nervous to talk to you because, you know, I do come from a very, you know, kind of died in the wool, you know, 12-step, you know, kind of structure. But we agree on more things than we don't, you know, and I really, I really, I commend you for sharing so openly and so beautifully about your experience with such honesty. And I hope that so many people will look at your book and this lens with more sincerity,

because I think it's an incredibly important part of the conversation no one wants to have in this country right now. Thank you for having me. I'm nervous talking to anybody. So, you know, I was certainly nervous, too. I mean, when you said at the beginning, like this brave and all of this bravery business, like, I see it the exact opposite. I mean, I hid this stuff. for more than two decades. You want me to call you a coward, David? Yeah, I mean, what I did couldn't have possibly been more cowardly.

I didn't say a word until I was ready. I held it all in. I mean, you know, so I hear that, and I'm just like, that's, you know, and I don't mean that in like some kind of humble brag way. Like, I really, I mean, look what happened. I didn't tell anybody. Like, that's, you know,

but I wrote this book with the hope that it would help people. And I really, you know, I don't care if you buy it. I just hope people read it. David, if you were to suggest, because obviously I've watched kind of every documentary that there is about the opioid crisis, you know, besides your book, do you have a top three or four other things that you suggest people either read or watch? Yes. I, the fire inside is a good movie. I mean, you know, I have kind of obscure taste. Maya Salivitz, I'm crazy about her on Broken Brain and she's got this new book on Doing Drugs.

I mean, she's great. Amy Dresner's book, My Fair Junkie. I mean, I'm not a girl. I'm not a sex addict. I am not a meth addict. Like, I can't relate to any of her stuff. And yet that's the most relatable, you know, drug memoir for me. And also, I mean, you know, like Jean-Paul Sard, nausea is there's no drugs in it. But that is right on the money. Yeah, that was a revelation when I read it. I was like, oh, someone else feels exactly what I'm feeling. Oh, look at that. I mean, yeah. But, and there's so much, you know, once you start going down that kind of existential rabbit hole, there's some plenty. Awesome. Thank you so much, David. Thank you. First of all, I don't speak for 12-step programs, you know, at all. No one does. We are, you know, we're just a bunch of fellows, just a bunch of people who hang out together. So I can't speak to his experience. I mean, I read his book, and he definitely, he spoke to some people who I don't love the way they represented 12-step programs or sobriety.

And, you know, that was his experience, and that's fine. Do I believe that, most, if not all of the people who use drugs and alcohol also have mental illness. Like, yeah. Meaning, I don't think it's, I don't think that, and I've read the big book many times, the notion is not that, you know, alcoholism or addiction exists as this like outside amorphous thing. It's a reaction to living. And, you know, what the big book says is it's not about drinking.

It's about being sober. The thing is not like, I love how I am when I drink, which of course, sometimes you are a more palatable version. The idea is whatever pain I'm living in sober, I don't want to live this way. So anything that takes me out of that is what feels like the cure. So 12-star programs don't work for everyone. That's true. And I can't speak to his stats. That's not my line of research.

And I plead ignorant on that. But what I will say is that we all. find what makes us feel better as humans. Some people have less angst. I envy those people. You know, since I'm as young as I can remember, I've been unbelievably pained by the fact that we're alive, that we're going to die, that attachment is suffering. Like, I had a very acute sense of that as a child. That's just been my existence. So I'm going to find whatever I can. Usually being bossy and managing other people's behavior makes me feel better. I need that sound bite.

That's my drug. My drug is nagging, managing, and controlling. All right. I think the podcast series, not only this podcast, but the entire series is over, we thank everyone who's listened to any of our episodes. That's not because I'm a healthy person that I seek to nag, manage, and control other people's behavior.

I know what it's like to eat my feelings. I eat my feelings. I don't want to feel what I'm feeling. feeling. So let's do this. Oh, I'm tired and that means I'm going to have to start thinking about my day because I'm going to lay down and not have video games to play. What do you think video game addicts are? What I mean is, you know, I'm a person who, like, yeah, I'm a person who has depression. I'm a person who suffers from anxiety and I don't just mean like, I'm anxious. I mean, like, my hands are almost always. It's been getting worse. Your hands are not food. Yeah, I'm a, I'm a person,

I hold that anxiety. So when I feel that way, I want something to make it better. And you know what? It's true. For me, a lot of that drug is not focusing on myself and focusing on you, whoever the you is. And if it's a romantic partner, all the better,

because then I can hold things over them. It doesn't sound healthy. That's because it's not. Because I'm a human. What really got me in his whole story was when he tells his parents and the reaction is, it has to stop versus, oh my God, this person that we love so much has been living in this.

What's going on? Painful and just, painful doesn't even capture it, just like this tortured existence for so long. Oh, I know so many people whose parents reacted that way when they found out they were cutting or they were bulimic that that was the response. What are you doing? It has to stop right now. And if I put more anger, energy, attention. on it versus oh my god my kid this person who i love so much is in crippling pain well there's no structure but honestly in our in our parents defenses and all those people and people who still

react that way we don't have any other framework to put it in and that's honestly like what i hope our show does even in a small way that's the framework hurt people hurt you know and when you are doing things that are hurting yours, it's because you're, like he said, it's what you're trying to cover up that's more interesting. Miam, let's do a quick, ask Miam anything. Ask Miam anything. Ask my Miam anything. Yeah. Don, no last name asks, what's the best alternative to antidepressants? CBD seems to work for my anxiety, but I haven't found much relief for my depression. Would T.HC work better? I mean, Don, first of all, I'm not a doctor. I can't answer that. legit. What I can say about THC is it makes most things better because it's reducing the amount

of focus you have on negativity, both physically and emotionally. That's not a cure for depression. I don't even know if I'd call it a treatment for depression. That's kind of like saying, you know, is chocolate a good mood enhancer? Yeah, it's a really good mood enhancer because it completely takes you out of all the feelings you're having and you focus on the sugar and the carb rush. CBD and THC can and are used in some cases in medicinal amounts. You will generally find those, quote, better for anxiety, but I'm a much, much bigger fan of simple things. I'm just, it sound like such a nerd. exercise. Finding an exercise that elevates your heart rate, even for 20 minutes a couple times a week,

it stimulates good chemicals that start training your brain to keep releasing them. Learning to meditate is absolutely proven and scientifically proven. Doing things like that are likely going to shift your depression. Also, like, I'm just going to say it, looking at what you eat and how. All the things that taste good in the moment generally give you some sort of crash, which for those of us who are prone to depression can really get complicated. So while CBD is important and, you know, chemically legitimate, especially for, you know, binding to certain receptors that do modulate pain, yeah, I can't really advocate THC as a treatment for really depression or anxiety. There's many, many other components that don't have. The side effects and the larger

impact that acquiring a pot addiction will get you. And I'm just going to say it now. I think it's important to remind people about this. The notion that pot's not addictive really bothers me because you know what is addictive, not feeling pain and not feeling shitty. So that's how you get pot addiction. Because once you have felt relief from feeling shitty, you're going to want that again. That's like the, that's the layperson's explanation to him. People are like, pot's not addicted. watch. Don, thank you for your question. Thanks, Don. And we wish you well.

If you want to ask Miami anything, you can do so at biolikbreakdown.com. That's a website, B-I-A-L-K, breakdown.com. Go there. There's a form. Scroll down the page. Type in your question or upload a video or audio recording, and you could be featured on the show. Thank you. You know, there's a lot of levity that we bring to this conversation about 12-step programs and about addiction. This is something we take very seriously, and we hope that everyone understands that. From our breakdown to the one we hope you never have. We'll see you next time.