Addiction Management Blog

A call for increased treatment and education for those behind bars

October 20th, 2013

I have written before about the criminal justice system and addiction, but it has been awhile and my thoughts continue to evolve on this topic. So, time for an update!

First, as a society we should be embarrassed by how many of our citizens are in jail/prison due to problems associated with untreated addiction. We have the highest incarceration rate of any country in the world with approximately 2.3 million behind bars. If we add those on probation and parole the number jumps to almost 7 million under correctional supervision! And I have not even mentioned the 70K juveniles we are grooming for later prison life. What is so troubling about these statistics is that they are primarily the result of mandatory sentencing laws put in place in the 1980s to enforce the war on drugs (which I have also written about).

US in Prison

Most now realize the war on drugs has been a miserable failure. Putting people behind bars when the drivers behind their crimes are addiction-related is costly and fails to address the underlying problem(s). We know that many will get out and that recidivism rates are quite high. One recent study indicated that more than 1 in 4 offenders return to prison within three years. And we know that when addiction goes untreated it most often returns, leading many who get out of prison right back in.

While I believe we need to evolve our drug sentencing laws, and there is evidence that things are changing for the better, this post is not about that. It is also not about the proliferation of drug courts that offer an alternative to jail/prison. Instead, I want to comment on what we can do for those who are behind bars right now (and will be in the future). In short, I think we should make use of their time in jail to prepare them to succeed in life once they get out. What do I mean by succeed? Here are a few outcomes I think we as a society should support:

  • Stay clean and sober, manage co-occurring disorders, and maintain physical health by working a comprehensive addiction management program (5 Actions!)
  • Use personal talents to benefit society (Action 5) (Dave’s Killer Bread is a good example)
  • Develop a spiritual life
  • Keep learning and growing as a person
  • Obey society’s laws
  • Seek out (or increase) appropriate help when times become stressful (as they do for all of us at times)

I am sure you can add to this list, but it is a good start. How do we accomplish such lofty goals? In short, we develop a technology-based intervention system that individualizes behavioral health treatment and education for a fraction of what it would cost to utilize humans (nothing against humans). The treatment component would be based on the 5 Actions I have outlined on this site, and the educational part of the system would be built by those who have a track record of delivering online education. Why this has not already been done actually surprises me!

The details of how to construct and implement such a system are beyond this post, but I do want to provide you some thoughts on why I believe doing this is more than possible.

  • Studies show fairly consistently that timing is critical for helping people with many problems, including addiction, depression, and other life issues. Those in prison have nothing but time, and are in a place where we can take advantage of a motivational window of opportunity.
  • Computers memory is superior to humans and can track far more information about a person’s life, and leverage points for change.
  • New treatment interventions can be quickly programmed into the system, where there is a much longer learning curve for humans.
  • Delivery of interventions can be more consistent (i.e. therapists stray from intervention protocols fine-tuned by researchers, often thinking they are doing good, but in the end have less than optimal results).
  • Online systems can track outcomes in real-time and make adjustments accordingly. Most treatment today does not include any formal outcome or evaluation of process, let alone changing therapy based on adaptive outcomes.
  • Relationship with a relational online system can last indefinitely, whereas human counselors are less consistent and change jobs frequently (i.e., the turnover rate in addiction treatment programs is higher than in fast food restaurants).
  • Online treatment is significantly less costly than human treatment.
  • Studies show people are more apt to disclose sensitive issues to a computer than a human – issues like:  sexual abuse, domestic violence, child abuse, shaming behaviors (cutting, eating disorders, sexual disorders) – all can be addressed in a user-friendly, less threatening environment than with humans in many cases.
  • An online intervention system can link and communicate more consistently with other important stakeholders in a person’s life, including: primary care physicians, specialty providers, medication providers, legal system, pharmacies, insurance providers, complementary and alternative care providers, mental health and addiction programs (if necessary), and employers. Computer system can keep track of all these relationships, the flow of information between them, and manage information privacy and disclosures.
  • Online systems are flexible and can consult with humans when necessary – so human’s time can be used most efficiently (i.e., expert humans are not replaceable, they are just in limited supply).
  • And perhaps most important, the system can be utilized to manage ongoing treatment and educational goals both in and outside of prison seamlessly, and help manage parole and probation responsibilities.

Would it be easy to develop and implement? No. I think it would require a lot of work on behalf of many stakeholder groups. But I believe it is what we need to do as a society if we care about our future and the future of our children.

I also made a couple of brief videos on how I would utilize the 5 Actions framework in an online system for those behind bars. Excuse the coffee breaks, it is early Sunday morning.


 

Theater as a force of creativity, inspiration, and healing

July 15th, 2013

I am big believer in balancing our efforts to intervene on the pathological side of the equation of life issues, with efforts to enhance individual strengths, talents, and creative life energy. When we solely focus on problems, like addiction, depression, and trauma, we often – quite surprisingly and opposite to what you may think – get more of the same. The reason has to do with how systems operate in life, and the fact that there is a big difference between interventions aimed at reducing and stopping addictive behavior, and taking action to creatively bring something cool into the world that gives your life meaning and purpose.

One of my favorite books on this topic is The path of least resistance: Learning to become the creative force in your own life by Robert Fritz. He says: “There is a profound difference between problem solving and creating. Problem solving is taking action to have something go away – the problem.  Creating is taking action to have something come into being – the creation.” He goes on in the book to explain how the actions are very different, and why spending time creating cool things may in fact lead to better outcomes than focusing on getting addiction to go away. Now I say all of this because I believe one of the most creative, inspiring and healing forces in life can be found in theater. Yes, you heard me correctly, theater!

Whether you watch theater, decide to get into acting, or engage in set design, lighting or some other aspect of the production, being involved in theater is a way for the soul to nourish creative desires. While I am fortunate to have the opportunity to experience amazing theater multiple times a year in New York City, I can honestly say that theater in my home town of Portland, Oregon rivals the best of what I have seen on Broadway. Some of the most amazing productions come from Portland Center Stage that recently put together the following video in honor of theater and all that it can provide us. Enjoy!

The College on Problems of Drug Dependence 2013 – my update

June 23rd, 2013

For the past half-dozen years, I have been attending The College on Problems of Drug Dependence, better known as CPDD. The conference has been in existence since 1929 and this year is celebrating 75 years! It is the longest running conference on drug addiction problems in the US and is attended by the brightest minds in the field from all over the world (it even has its own blog). This year it was held in San Diego and included poster sessions, oral presentations, and plenty of networking. Usually I go it alone, but this year decided to drag my family along to make up for the year I brought them to the same conference in Reno where, ironically, gambling, drinking and smoking permeated the hotel and conference (yuck!).

There was a lot of great stuff this year as usual, so I thought I would highlight just a few things that really caught my attention.

  • traumafiveAdverse childhood experiences predict later substance abuse and addiction. We have known for a long time that 80-90 percent of those who go down the path of addiction start their journey early in life – during teenage-age years – most often as an adaptive response to coping with one or more adverse childhood experiences. I have written about the ACE study on this site, but what is new are studies that continue to evolve these findings in more detail, and help us really understand just how complex, pervasive, and critical it is to evaluate and treat underlying traumas in those who struggle with addiction. Current stats on abuse and neglect are frightening, and sadly addiction is not the only outcome of these cases. The British Journal of Psychiatry recently published a paper linking childhood adversity to all classes of mental health disorders. At the conference Cathy Spatz Widom presented some of her work that has involved following 1,575 kids from childhood through adulthood. This amazing study included 908 substantiated cases of childhood abuse and neglect processed by the courts from 1967 through 1971, and then matched this group with a control group of 667 children with no official record of abuse/neglect. The results from interviews over multiple decades provides strong evidence that early life experiences make a difference in the trajectories of our lives. Bottom line for those who struggle with addiction: intervention must involve addressing unresolved issues from the past that perpetuate addictive behavior.
  • Legalization of marijuana. I have not written about this topic on this site before, largely because I continue to struggle with exactly how I feel about it. While it is now legal in two states (Colorado and Washington) many other states are moving to legalize recreational use as well. On many fronts I agree that legalization makes sense, as the drug war has been a miserable failure. At the same time, Nora Volkow, the Director of NIDA, in cannabisher keynote address pointed out that marijuana use among teens is at an all-time high, while research findings are absolutely clear about the dangers of THC in young developing brains. This year the public policy forum was dedicated to this topic, and two great speakers from the RAND Drug Policy Research Center – Beau Kilmer and Rosalie Pacula – provided a lot of food for thought. Beau reviewed his seven P’s and Rosalie addressed the four primary public health goals: 1) prevent youth access, 2) prevent drugged driving, 3) regulate product content and form (potency), and 4) minimize concurrent use with alcohol. The “how” of accomplishing these goals is beyond this post, but if you dig into the RAND site you will find a recent publication that provides all the details.
  • Abuse of prescription drugs. If the 80′s were about cocaine, the 90′s about meth, we are now deeply entrenched in a time where “the” object of addiction are prescription drugs. In the past decade there has been a five-fold increase in treatment admissions for abuse of opioids, and overdose deaths related to pills have tripled in the past two decades. In some states more people die of pill overdoses than motor vehicle accidents. It is a problem that has gained national attention by many government agencies (and non-government groups), and was a hot topic this year at CPDD. Much of the focus was on abuse-deterrent formulations, which studies have shown have reduced abuse and diversion. This is a good thing, but at the same time such formulations are not necessarily reducing the number of people who struggle with abuse/addiction – they are just pushing them in another direction to other more easily abusable products or illicit drugs (what we call the “balloon effect”). The key point goes back to my first bullet point. We need to invest far more resources into prevention and early intervention since this is really the origin of the problem for most who struggle.
  • psilocybinPsilocybin and quantum change. Of all the cool things I learned this year, the one that surprised me the most was a workshop focused on the treatment benefits of psilocybin, a hallucinogenic compound from mushrooms that operates mostly on 5-HT-2a/c serotonin receptors. The session, led by Roland Griffiths and Herb Kleber, reviewed studies where psilocybin produced some remarkable mystical experiences for participants that rated among the most important events in their life! Here is a video clip describing one of the studies. The hope for those who struggle with addiction is that psilocybin may be an accelerated way to induce spiritual experiences that result in profound and lasting behavioral changes. The compound, when used appropriately in controlled conditions, appears to be non-physically toxic and virtually non-addictive. While the early findings are intriguing, I am not so sure we will see it on the list of evidence-based practices any time soon.

If you want to read more about the conference, check out the CPDD Blog.

Lastly, I know many of you won’t believe this, but CPDD has workshops that go from 8pm until 10pm at night, even Sunday – on Father’s Day! My wife never believed me until she saw it for herself. This is a dedicated group of people! So, after one of these very long evenings, I ventured out into the evening and did a little picture taking. Here are two of my favorites:

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Hitting Rock Bottom: New docu-drama about addiction needs your help!

June 3rd, 2013

I don’t think I have ever done this before on a post, but here goes. I need your help.

Not long ago I was contacted by some folks who have been working hard on a show called Hitting Rock Bottom. It tells the real stories of people who have struggled with addiction, hit rock bottom, and found a way out. Unlike reality television that often turns tragic stories about addiction into entertainment, this show has a far more noble and broader reaching aim. The creater and Director, Corey Snyder, who has been in recovery for the past five years and also happens to be a very talented film maker, wants to instill hope (and action) in those who still struggle. He portrays challenges with addiction through docu-drama storytelling that utilizes actors to dramatize real stories. He and his team have already completed the first four episodes of season one which you can watch right now for free on the Hitting Rock Bottom homepage. Each episode is a few minutes, so watching them all will not take you that long.

HRBThe first season tells the story of Daryl Brown, a very likable young man who sets out in life with no idea of what is ahead for him. The show is more than engaging, and realistically captures the underlying risk factors that contribute to going down a path of addiction. It is real, scary, and unfortunately a story that plays out far too often.

Fortunately, the story of Daryl has a positive ending, but that is where I need your help!

The show is need of funding to finish filming the first season and complete the story of how Daryl overcomes addiction. It’s the best part of the story and has the potential to motivate many struggling souls to seek help. To complete the season, the crew are presently running a fund-raising campaign on Indiegogo. The goal is $57,500 which will cover all costs to finalize filming the remaining episodes. Even with these funds, many involved in this project are giving their time and energy to see this project to its successful completion. By contributing whatever you can, be assured that your donation will go towards a project that has the potential to transform how we understand, treat, and address addiction in this country. Also, there are only 13 days left in the campaign, so please contribute now. And be sure to check out some of the cool perks at various donation levels.

Thank you.

Ah-hah moments to move beyond addiction

May 11th, 2013

Not long after my wife and I were married, we decided to proactively increase our chances of staying together by enrolling in one of Dr. John Gottman’s weekend couples workshops in Seattle. At the time I was deeply immersed in my graduate studies in counseling and was excited to spend some time with the world-famous marriage guru. What I had not realized was that 1000 other people would be crammed into the Seattle Center taking the workshop as well, so my chances of a little one-on-one time were not so good. Fortunately, he circulated around while we all were doing exercises and I told my wife that if he ever came within 200 yards we should wave our hands wildly and grab his attention.

The moment came and sure enough my plan worked. He sat down and we began talking about some martial issue that escapes me now. During our conversation I began challenging him a bit about how people really change behavior, at which point he brought up focusing. Because I had told him I was nearing completion of my graduate program he assumed I would know all about focusing, but my deer-in-the-headlights response gave me away. I had to admit that never in any of my classes had the word focusing ever been mentioned. I was clueless and a bit embarrassed. He said it was the key to behavior change and I needed to know about it.

focusing_book_2007_medCoincidentally, the relative I mentioned a couple of blog posts ago who had given me a bunch of psychology books, had included the book  Focusing! Written in the 1970s by Eugene Gendlin, the book is based on about two decades of research analyzing what happens in therapy sessions that explain good outcomes. What Gendlin found is that it has little to do with the therapist or the specific type of therapy one gets, and far more to do with what happens inside the client. In essence, he discovered that positive outcomes occur when clients have “ah-hah” moments during sessions that awaken them to deeper truths about themselves and life. These moments occur when we (and clients) go inside and connect with what he calls a felt sense – a pre-verbal inner knowledge or awareness that comes from paying attention to an integrated and holistic aspect of our being that we can access at any time. If this sounds a little new-agey it really is not, it is just hard to describe something that cannot be easily put into words.

Have you ever lost your keys and banged your head against a wall trying to remember where you left them? No matter how hard you try nothing seems to work. So you go on to something else and then, in the middle of folding laundry, it hits you. You remember exactly where you left them! That moment of remembering is what Gendlin would call a felt-sense, an ah-hah moment that awakened you to an answer that previously was outside your awareness. While focusing can help you find your keys, it really has the power to change your life.

Focusing is the name Gendlin uses to describe the six-step process he developed for helping people – both and in out of therapy – have felt-sense experiences to solve a multitude of life problems, including addiction! If you have never heard about it, I really encourage you to check out the focusing website and read one of the many books written on the topic. What started as a little research project in Chicago in the 1950s has evolved into one of the greatest tools we have for overcoming addiction.

New book out today! Craving: Why we can’t seem to get enough

April 30th, 2013

cravingI am excited to announce that a new book is out today from my colleague, Dr. Omar Manejwala. He is the former Medical Director of Hazelden (one of the oldest and most respected treatment organizations in the world), and current Chief Medical Officer of Catasys, an innovative health management company focused on treating substance abuse problems. I was fortunate to receive an advanced copy of his new book, Craving: Why we can’t seem to get enough, so I have had the past month to review it thoroughly. If you struggle with addiction, or care about someone who does, then I strongly encourage you to get this book!  Why?

First, craving is a universal experience we all share and it also happens to be at the heart of addiction. In healthy doses, it is part of what makes us human. But when cravings become so intense that they lead to out-of-control behaviors, then they are not such a good thing. In fact, they cause significant pain and suffering. For those who have never experienced addiction, imagine holding your breath and then starting to think about air. How long before your desire to breath becomes an intense craving for air? How long until the craving for air becomes almost unbearable? You may think this example has little to do with addiction, but the regions of the brain that control your breathing, heartrate and other survival functions happen to be the same areas of the brain that get hijacked by addiction. By reading Dr. Manejwala’s new book, you will be treated to a very lucid and beneficial explanation of the science of craving. If you are afraid of brain science, have no fear, he makes it very accessible!

2013_0409_omar_manejwala_600x300Second, once you understand cravings more clearly, you will be in a far better position to do something about them. Perhaps what I like most about this book is that he provides an approach to deal with cravings that links back to the science of what we know about them. For example, part of the experience of craving is biological. Cravings are not just obsessive thoughts in your head, but are deeply rooted in physical and chemical changes that take place in the brain and body. Think back to our example about holding your breath. Is your need for air all in your head? Of course not. While we don’t require alcohol or drugs to survive like air, cravings have a similar intensity and feel because of what takes place physically in the body. So interventions focused on addressing the physical aspects of craving are critical. And at the same time, part of what makes cravings so painful is that once they start, they feel like they will never end until acted upon.

The best news of this book is that cravings can be overcome! Dr. Manejwala outlines a wonderful tool box of interventions that address both the physical aspects of craving, but also the painful obsessions that precede addictive behavior. You will learn about the benefits of self-help meetings, meditation, exercise, and being accountable to others. There are also some tools that you likely have not heard about, which is a testament to the comprehensive and holistic approach taken throughout the book.

Third, I really appreciate his view that “Courage is, in fact, the most essential quality of recovery, because without courage, none of the other needed practices are possible.” I couldn’t agree more! Dealing with addiction and all its complicating and co-occurring problems is not for the faint of heart. Those who engage in the process of overcoming addiction and are willing to face their most intense cravings, are among the best examples in our society of courage.

While I have a lot more to say about this book, Dr. Manejwala and I plan to discuss it over a video chat in the next week or so. Stay tuned for the broadcast and in the meantime, checkout the latest on the book on facebook and order your copy today.

Addiction & Homelessness, Part II

April 29th, 2013

books-stackIt was early summer and I was deep into my counseling internship at the behavioral health clinic. I was lucky enough to have a giant corner office with many windows overlooking downtown Portland – room enough to conduct both my individual sessions and run groups. It was so big that I decided to bring in two of my own bookcases to fill out the space. Lucky for me, a relative who happened to be a retired psychologist, had a ton of books to donate to my cause. I figured my clients would walk into the room and see all those counseling-related books and be less concerned that I was an intern. I just hoped they didn’t ask me whether I had read them all because then I would have to fess up.

I chose a late night to get the books into my office. The clinic had a hand-truck to make life easier, but it was still a lot of boxes to move. As I was unloading books from my car, a young man in his early thirties came strolling up and casually asked me for $25. While I have been asked for money many times, never has someone on the street asked me for $25! I was taken aback, but even more, just really curious. I told him I would consider his request if he explained to me exactly why he needed the money. Without knowing at all what I did for a living, he said, “I have been in drug treatment for the past month…a couple of days ago, was kicked out and have nowhere to go… I’m homeless and need the money to buy a bus ticket to San Francisco where my parents live.”

Made sense to me. “Why did you get kicked out of drug treatment?” I asked.

The question made him squirm. He looked down at the pavement and said nothing. I could sense he felt shame. Then in a soft voice he said flatly, “I was caught on my bed with another man.”

I replied non-judgmentally that it seemed like a dumb reason to get kicked out of treatment, and that I would help him. I gave him my business card from the clinic and said to come see me the next morning when I could access funds to help him. Because he had nowhere to sleep I pointed him in the direction of a nearby shelter. The next morning when I stumbled tiredly into the clinic, he was sitting in the lobby waiting for me. It was a busy day. I had two evaluations back-to-back and the first client was also in the waiting room. I had him come back to my office where we chatted briefly about the money. I said I would make some calls, fill out some paperwork, and we could reconvene in my office around 11am to finalize things. He thanked me for my efforts and said he would be back then.

But he never returned.

preventing-heroin-overdose

Around 3pm that afternoon I got a call from the county coroner. He had a body and the only item found on it was my business card. The man had overdosed just blocks from my office. My heart sank and my mind raced. What had gone wrong? How could this have happened? What had I missed?

I will never fully know the answers to these questions, but I suspect that he overestimated the amount of drug his body could handle after being clean for a number of weeks while in treatment. I don’t think he was suicidal, but perhaps I missed something. To this day I regret not taking more time to assess his risks for relapse and overdose, but I didn’t know then what I know now.

For me, homelessness will always have a face.

 

Addiction & Homelessness, Part I

April 24th, 2013

Young-person-homeless-hun-007In recent months my travels have taken me to Philadelphia and New York City (NYC), two of the most amazing cities in America. While I have enjoyed staying at comfortable hotels and dining on delicious food, it has been impossible to ignore the significant number of homeless people on the streets, begging for money and food. In fact, many have approached me and asked for help. As someone who has spent a career treating those who struggle with addiction, my stance has always been that giving money to the homeless essentially equates to giving them the means to engage in addiction – because of course they will use the money to buy alcohol or drugs! And this stance has been so easy to implement. All I have to do is walk on by, pretend not to notice, and feel good knowing that I am doing my part not to further addictive behaviors in the homeless.

But then I discovered Wayne Teasdale’s enlightening book, A Monk in the World: Cultivating a Spiritual Life, and my resolute stance on (not) giving to the homeless began to crumble. He put names and stories to the faceless and awakened me to how the homeless mirror many of my own insecurities. Very few who become homeless have chosen this lifestyle. Various risk factors conspire – much like addiction – to bring about the unfortunate state of homelessness. Behind every person wrapped in newspaper, sleeping on a park bench on a cold night, is a story.

In America approximately 500,000 individuals experience homelessness (100,000 are chronically homeless) on any given night. A report by SAMHSA indicates that more than a third had chronic substance abuse problems and many also suffer from mental illness. A study conducted in Philadelphia and NYC on the chronic homeless – my two recent destinations – revealed that most were male and over 90% Black. In January of this year, for the first time ever, NYC recorded over 50,000 individuals showing up at shelters, one in ten being children. Homelessness is a growing and omnipresent problem that I now see everywhere – now that I am actually seeing.

Homeless chart

So what to do about the homeless?

For the first time in my life I am now engaging the homeless. Instead of walking by and ignoring their pleas for help, I am stopping and doing my best to listen to their stories. This past weekend in NYC I met Nelson. He suffered from a vascular disorder that injures blood vessels called Hemangioma. He came to NYC a few years ago from a South American country in hopes that doctors could help him, and they did. As we chatted on the street, he pulled out a stack of family photos and told his story. He was incredibly grateful to be alive and reminded me that relationships are at the center of a good life. Our conversation also highlighted the incredible discrepancies between those – like myself – that invest significant amounts of time, energy, and money on materialistic things, and those that have nothing.

In addition to Nelson, there have been others recently whom I have engaged and listened to their stories. At the same time, I don’t stop for everyone. My relationship with the homeless is still evolving. I don’t mind giving money anymore. But what I have learned in the brief time that I have opened to this problem, is that money alone is not the answer. A permanent solution to homelessness will require a transformation in our society, a systems approach that understands how to intervene at the root of the problem.

For now, I will no longer ignore or be afraid of the homeless. I will embrace the vulnerabilities they mirror in myself, and take the time to listen to their stories.

Addiction and the Perennial Philosophy

April 13th, 2013

perennial_philosophy_coverWe have known for a long time that among the most powerful ways to overcome addiction is through spiritual interventions. The essence of such approaches is that addiction is a problem of the ego, of our lower self, of the body. By harnessing the powers and energy from our higher self, from the part of us that is unchangeable and connected to the source (God, Buddha,  Allah, Atman …your choice), we can overcome most anything in life. This philosophy is at the heart of twelve-step programs, but it really goes far beyond recovery. In fact, it is about our ultimate work on this earth – awakening to our true nature.

I will admit I have been slow to all of this. I was not raised religious and the rare times I made it to church were with friends on holidays primarily for the food. Even more, I was raised in a family that valued science, and awakening to our true nature was not something that fit well into randomized clinical trials. So it took many years of wandering before I stumbled upon the Perennial Philosophy, something that made a lot of sense to me.

Perhaps you too have heard about it, or maybe not. Although I am sure there is a more elegant way to describe it,  I understand it like this. If you ventured back in history and gathered up all the wisdom on how to live life from all the great mystics and enlightened beings from all the world’s religions and spiritual traditions, and then boiled down their essential message, they would all speak universal truths, which is the Perennial Philosophy. It is the commonality in all religions, it’s what links them all together no matter how different they may appear on the surface. For me, this is very much like the scientific method. We have a bunch of researchers, who over time, using a variety of techniques, study a phenomena from various perspectives and all arrive at the same conclusion, informing reality as we know it!  Of course science is not perfect because it is conducted by people who can make mistakes, but history has shown that it is pretty darn good at helping us understand the world.

UntetheredSoulMech-#1.inddSo for me, the Perennial Philosophy bridges the gap between science and spirit, and has been a game-changer in life. If awakening to our true nature is our primary purpose on this earth, then it sure simplifies a lot of things! My to-do list is now much, much smaller. And so many things that I believed to be critical to a good life, things that I had to have, now seem not so important. Less really is more! What exactly is the Perennial Philosophy? There are two ways you can discover the answer. You can use your lower self, your ego, and read all about it. A good place to start is Aldous Huxley’s well-known The Perennial Philosophy. Or you can read about it in many of Ken Wilbur’s books, or get a nice summary on Wikipedia. But in all honesty, this method is a bit like reading all about a cool place you want to visit. It will give you some background, the lay of the land, but in the end it is not the cool place, is it? To really experience and understand the cool place you read about, you have to visit the cool place!

If you really want to understand the Perennial Philosophy you have to experience it through your higher self, through contemplative practice. There is no other way. Meditation, in all its forms, is the primary vehicle for developing a contemplative life, although there are other ways. With practice, you will discover the self behind the self. The part of you that has always been there, that does not change with your thoughts and feelings, and is capable of pure awareness. If this all sounds a bit warm and fuzzy, check out the bestselling book The Untethered Soul. I will admit, it has been a very slow journey for me. Perhaps the most important thing I have learned thus far – if you never take trip, if you never go inside and really see what is there – you are missing out on something very cool, beyond cool, actually.

Vacation is over, a lot of new posts coming!

April 10th, 2013

I cannot believe it has been since October of last year that I have written a blog entry! Yes, I have been busy, but aren’t we all busy? I don’t think it is a very good excuse. Addiction continues to be among our most serious public health problems, and we need to do as much as we can to help those who suffer. This site has been my small contribution, but over the past few months I have felt an increasing desire to do more.

Since switching this site to a new host server in 2007, request for pages has grown from about 2000 per month to well over 60,000 (and growing). I find this incredible, and am grateful for all of you who visit! It also tells me that there is a real and growing need for help, and that despite there being thousands of addiction-related sites out there, most of them fall short of offering helpful solutions.

I don’t claim to have all the answers, but I have spent the past couple of decades working as a licensed professional counselor, researcher, graduate school teacher, consultant, and friend to those who suffer, and over the years have developed a very broad, comprehensive and unique way to think about addiction and treatment. Perhaps one of the most influencing factors on my present work is my doctoral degree in systems science. Most of my family and friends still ask what the heck I studied all those years, but systems science essentially is about the science of solving complex and challenging problems. And in my opinion, what better problem than addiction to  address through the lens of systems science!

So, what can you look forward to in the months to come?  I get so many requests to blog about newly published books, cool new shows on addiction, and even apps that can help those who struggle with addiction, my problem is finding the time to do it, but I promise you I will!  And, if you are not finding what you need on my site, please email me, as I am always open for suggestions on how to improve it.

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So what’s up with the stars!  I love photography and shot this a couple of weeks ago. Taking pictures reminds me of the importance of slowing down, focusing, and paying attention to what is right in front of me, in the present moment. Next time you are outside and the stars are shining, look up and take in the beauty of the sky. And thanks again for visiting the site, I promise, no more vacations.