MIDDLE CLASS ADDICTS

For Lynn Wilson, it was the moment men entered her home with weapons.

For Candice, it was the realization that her soul was dying because music,
something that always moved her, became meaningless.

For Rob Schindel, it was the night God spoke, ordering him to go forth and
kill.

And for Rick Griffiths, it was the time he had one leg swung over a bridge
rail in Nanaimo.

Revelations happen rarely, but these instances--when the path of drug
addiction revealed its ultimate destination--were just that. If they hadn't
sparked decisions to stop using drugs when they did, these people might be
dead.

Vowing to get the monkey off your back, however, is one thing; prying it
loose and keeping it off is another. So much so that some view hard-core
drug addicts as hopelessly hooked and dismiss detox, treatment, and recovery
services as a waste of money. Yet these people are but four of millions of
Canadians who were once abusers of alcohol, pot, cocaine, crack, heroin,
barbiturates, tobacco, methadone, and other drugs. Somehow, someway, they
quit.

Say the words drug addict these days and the usual image conjured is of a
homeless person shooting up in Vancouver's safe-injection site. Yet there is
no one path to addiction. In Vancouver, 95 percent of addicts live outside
the Downtown Eastside. Although the international focus on North America's
first safe-injection facility is undeniably deserved, what often gets
overlooked is the paucity of treatment and recovery programs for
middle-class people grappling with addiction.

Wilson, for instance, grew up in Toronto in an "average" family, and she
does not blame her parents or her upbringing for her addiction. At the age
of 12, she took her first drink of alcohol and felt an immediate attraction.
Through her teens, she turned to pot and cocaine, and by 21 she was "chasing
the dragon" (smoking heroin), and soon after began injecting. Both Candice
and Rob Schindel were also born to middle-income families, yet they tripped
up and fell about as far as one can. Griffiths was brought up in Nanaimo by
a working single mother.

"I was as addicted as you can get; I was a slave to drugs," says Wilson, 39,
now a mother and an artist.

"Death was very close," says Candice. "My next step was the street. I was
hanging out with pretty dangerous people and I was disposable to them."

Today Candice, 31, describes her life as "domestic and calm". Married, she
has a dog, cats, a hamster, and a job helping young people kick drugs.

Not long ago, Schindel was headed for a career in crime. Into alcohol, glue,
acetone, shoe polish, PCP (angel dust), and other drugs, his life consisted
of "jumping off buildings, surfing cars on the highway, and smashing beer
bottles over people's heads".

Now, the 28-year-old Vancouver welder says, "I have nice stuff, a $20,000
car, a great job, and a loving relationship."

Griffiths used alcohol, lithium, Valium, and other benzodiazepines as well
as heroin from his teens until his 30s. Attempts at recovery failed so often
that he eventually teetered on the edge of the aforementioned bridge on
Vancouver Island.

"Some guy saved my life: he honked the horn and said, 'Jump, you fuckin'
junkie.' And it pissed me off so much I stormed off the bridge."

Today, at age 47, Griffiths is an alcohol-and-drug counsellor in the
Downtown Eastside who also counsels middle-class folks from his Vancouver
home in the evenings.

IF PEOPLE HAVE the foundations for a conventional, drug-free life--family,
education, and a decent standard of living--what leads them so far off
track?

"For me, it was a combination of things plus an addictive personality,"
Wilson says. "It was anarchy and rebelling: taking heroin was the ultimate
antiestablishment thing you could do."

Wilson, determined to be a "functioning" addict, went to work every day over
the years in art galleries, framing shops, and an animation studio, and she
attended college at night. But her desire for heroin rapidly progressed to
the point where she was spending all her money on drugs. By the time she was
30, she says, "I realized I was a full-blown heroin and methadone addict. I
was horrified." When armed men broke into her home and threatened her during
their search for a drug dealer she knew, Wilson realized she'd had enough.

Rob Schindel grew up in Coquitlam in an upper-middle-class suburban family.
Diagnosed with a psychotic personality disorder as an older teen, he says he
couldn't cope with reality and turned to drugs as a way to "fill the void".
Next, he was hanging out with bikers and hard-core punk rockers and
occasionally getting treated for his mental illness. When he walked out of a
health-care facility one day and heard voices telling him to murder certain
people, it scared him so much he walked back in.

Candice, too, was brought up with mainstream values, yet she dropped out of
college in Vancouver to pursue a drug career. Her motivation was simple: the
"pure joy" of heroin and the influence of certain friends.

"I hate to say it, but when you hang around with dogs, you get fleas," she
says.

Griffiths started using alcohol heavily in his early teens because, he says,
"thousands of inputs into my subconscious for years said drugs and alcohol
are good--good for coping, good for no worries, and good for pleasure. The
main reason people use drugs is because it is very, very pleasurable."

As the body builds up tolerance, however, that intense pleasure evaporates
and the addict needs more and more just to feel normal. Soon, procuring and
using something expensive and illegal becomes an all-consuming obsession.
And that is when many addicts want off.

Help in getting off drugs can range from taking another drug to
psychotherapy to group support to skills training to behavioural therapy.
There are more than 200 registered addiction services in the province.
Although all have their place, the greatest need is for detox and
residential treatment services.

Even with such services, however, many people with drug problems are caught
in a no man's land of being too rich to qualify for government assistance
but not rich enough to afford a private treatment facility such as Nanaimo's
Edgewood or Bowen Island's The Orchard, where two-month stays cost $10,000
and $20,500 respectively.

Government-contracted residential treatment centres are far cheaper, but
people not on welfare or without a generous employer pay $40 a day. The
Vancouver Coastal Health Authority pays the full fee for those earning less
than $1,100 a month, and it provides part of the fee for those earning up to
$1,600. Anyone who makes $1,601 or more per month--in other words, the
majority of people--pays the full shot. A two-month stay, not an uncommon
length of treatment time, in a residential centre costs about $2,400. And
even if you have money, waiting lists are the norm; Vancouver lost 10
medical detox beds in the past year.

"We have absolutely appallingly inadequate detox and treatment facilities,"
says Dr. Susan Burgess, an addictions specialist working in the Downtown
Eastside.

"Right now in the DTES we've created quite a comfortable harm-reduction
environment. But anybody who wants to escape has huge barriers. The moment
of wanting to get to detox should be the moment detox is available. All
those options, those recovery options, long-term-treatment options, et
cetera, should be so inviting and so much better than what people are coming
from that they have a chance to succeed."

Also often ignored in talk about addictions are questions about the
effectiveness of programs that do exist. For decades, B.C.'s addiction
services have been dominated by one model: the 12-step method created 68
years ago by a New York stockbroker and an Ohio doctor who both defined
themselves as "hopeless" drunks. Alcoholics Anonymous and the other "A"
groups uphold abstinence as the only way.

"We have created...basically a system for males and alcohol," says Dan
Reist, president of the Kaiser Foundation, a Vancouver-based incorporated
charitable organization that coordinates and disseminates addiction
information.

"We've tried to tweak it and modify it in a way to accommodate women, other
drugs, etcetera, and I'm not sure that has been very effective. The whole
model is problematic for women, women with children, youth, aboriginals,
Indo-Canadians, and on and on....We put everybody through a cookie cutter."

Although many people swear by 12-step groups, they aren't for everyone.

Stanton Peele is a senior fellow at the Drug Policy Alliance--a nonprofit
U.S. organization working to end the "war on drugs"--an adjunct professor of
social work at New York University, and author of Truth About Addiction and
Recovery (Simon & Schuster, 1991). In an interview from his home in North
Arlington, New Jersey, he says that analyses of available alcohol-treatment
methods found 12-step methods inferior to several other treatments and even
to no treatment at all.

"We have to have a wider range of choices," Peele says. "People will always
take drugs, smoke, drink too much. What do you do with those who say, 'I
can't quit. Can't I just help my life some?' Right now, our answer is 'No'.
That's not treatment; that's moralism."

Despite big strides toward harm reduction in B.C., the abstinence ethic
rules.

For example, an exclusionary policy in Vancouver schools increases the
chances that troubled kids will get deeper into drugs, according to Mark
Haden, an addictions specialist with VCHA. Children in school either caught
with drugs or inebriated are immediately kicked out. When they go to a new
school, the quickest way to make it with their peers--given they've just
been stamped on the forehead as a problem--is to use drugs.

"We've actually increased the likelihood this child will present with
problem behaviour," Haden says. "That child will actually have increased
social problems...based on our 'We need to make all of our population
abstinent' attitude."

The Kaiser Foundation's Reist has been working in the field for 15 years. He
says people tell him the system is worse than ever, but he's heard that
before and says services have never been well-established or
well-coordinated. Unlike Australia and many European countries, Reist says,
Canada has no official drug policy at the national or provincial levels.

B.C. governments have never known what to do with addiction services,
bouncing them from one ministry to the next. Under the NDP, they were part
of the Ministry for Children and Families. The Liberals moved them to the
Ministry of Health Services, which devolved delivery of services to the five
regional health authorities. Addiction prevention, however, moved to the
Ministry of Health Planning, while gambling-addiction services moved to the
Ministry of Public Safety and Solicitor-General. What was one now is three.

"I'd characterize the system as extremely fragmented and fragile," Reist
says. "We're at a particularly vulnerable time right now with another change
and so many things happening at the same time."

But this change may not be a bad one. Haden says addiction services belong
with the regional health authorities because they deal with the addicts.
VCHA is redesigning addictions services so that five core
services--withdrawal support, needle exchange, opiate replacement
(methadone), prevention, and counselling--will be available in community
health centres. Nonetheless, Haden says, inadequate funding creates
inadequate services.

"Our society has not dealt with this as a priority issue. So as we start to
shift public thinking, I think more money will come into addictions."

A SHIFT IN public thinking may be in order. One in 10 people--more than 3.3
million Canadians--struggle with addiction. The emotional toll of all this
misery is incalculable. The economic costs aren't. According to a 1992 study
by the Canadian Centre on Substance Abuse, drug abuse cost Canadians almost
$18.5 billion dollars at the start of that decade in health care, social
welfare, criminal justice, and lost productivity.

Although treating addicts costs money, not treating them is like flushing
dollars down the drain. In the U.S., one heroin user on the street costs
society US$43,000, while putting that user on a one-year methadone
maintenance program costs $2,400, according to a 1991 study by the U.S.
National Institute of Drug Abuse.

Findings like these may slowly be shifting attitudes about addiction. Once,
users were seen as social deviants who didn't have the moral fortitude to
resist temptation. Then came the disease model, which viewed addicts as
genetically flawed and, once exposed to a drug, stuck for life. Long-term
therapy and lifelong abstinence were their only hope. But this attitude only
goes so far, as Simon Fraser University biological psychologist Barry
Beyerstein points out. In his 1995 essay titled Paradoxical Beliefs About
Badness, Sickness, and Addiction, he writes: "If addicts are sick rather
than bad, why would a decent society heap insult upon injury by punishing
those who merely suffer a disease called addiction?" His answer is that
although we profess support for the disease theory, we continue to believe
that addicts are sinful people.

As for the addiction gene, Beyerstein says nothing would make him happier
than to corner the culprit. But there's no such thing, he maintains.
Instead, there's a gene for producing a system in the brain that doesn't
respond well to stress.

"That can make the fool's paradise of oblivion by drugs more reinforcing for
some people than others," he says. "It's not a gene for addiction; it's a
gene for how we view the world and how we respond to it."

Addiction is now seen as a "bio/psycho/social" disorder. That means it has
something to do with who you are, how you think and act in the world, and
the environment you're in--a classic public-health problem. And what happens
when we don't treat it as a health problem?

"By default, we treat it as an enforcement problem," the VCHA's Haden says.
"If we don't offer people voluntary and inexpensive and effective programs,
we wind up offering them involuntary, ineffective, and costly
programs--specifically, courts, judges, jails, and police."

And this misplaced use of resources happens in the drug capital of Canada.
Wilson, who left Toronto for Vancouver in hopes of a "geographical cure" for
her drug habit, says that move "was like putting a kid in a candy store".

Nichola Hall is chair of the Vancouver support group From Grief to Action
and the mother of two sons once addicted to heroin and now both hooked on
methadone.

"Hard drugs are available outside every high school. They're easier to dial
up in Vancouver than a pizza," Hall says. "And they're cheap. Those factors
make addiction ripe for an epidemic."

ALTHOUGH THERE is no doubt that B.C. needs more and better addiction
services, not everyone who quits drugs does so through formal treatment.
Sometimes the best treatment is no treatment at all. In fact, according to
Beyerstein and Peele, most people with addiction problems recover on their
own, a process some call "growing up" but that is known in academic circles
as "maturing out". Griffiths is one such self-recovered person.

When he decided to quit, professionals directed him to AA, NA (Narcotics
Anonymous), or other 12-step meetings. Frightened by what he calls the
"cultlike" aspect of those programs, he refused to go. He also objected to
the 12-step tenet that the drug is more powerful than the drug addict.

"I was really afraid to admit I was powerless," he says. "I thought 'No';
what you have to do is fight. You can't surrender. My instinct was that I
could solve this; I can do this if someone would just help me with some
information."

Griffiths experimented with several ideas, including Rational Recovery, a
thinking skill developed by American social worker and author Jack Trimpey.
RR urges addicts to take responsibility for their addiction, then search and
destroy the drug-loving voice within them. Griffiths came up with his own
cognitive weapons: cooking cabbage, and Muhammad Ali. He associated drugs
with the smell of cooking cabbage--something that makes him gag--and gave
his drug cravings the identity of the quick-witted, quick-footed boxer
Muhammad Ali.

"I'm kicking the hell out of him every time he speaks, and telling him to
shut up. It was crude but it worked."

Griffiths now considers himself "recovered, not recovering".

SFU's Beyerstein says there are more self-recovered people like Griffiths
than those who go through traditional therapy. He calls that fact "a dirty
little secret that AA doesn't want you to hear about".

"What the evidence shows is that if you don't die in a street fight or fall
down the stairs or get HIV from a tainted needle or hepatitis C or die from
starvation or malnutrition or tuberculosis because you're living in scuzzy
quarters or die from an overdose, chances are if you survived to 35 or 40,
you'll probably quit on your own, without the aid of any therapist."

True as that is, many cannot go it alone nor dodge the perils of a
drug-ruled life. Wilson, Schindel, and Candice all credit various support
groups, family members, and treatment programs for their recovery. Yet
coming clean took years and involved many failed attempts. Candice tried
detoxing 10 times before succeeding.

"I was so ashamed that I couldn't do it," she says, her voice breaking. "I
felt so fortunate that I had family that would work with me and support me
and not give up on me."

She finally kicked her addiction with the help of a four-month stay in a
residential treatment centre and five years of Narcotics Anonymous meetings.

Wilson tried methadone, a synthetic opiate that blocks the euphoric effect
of heroin and its withdrawal symptoms but is highly addictive itself.

"I thought methadone would stop the chaos in my life," she says. "It didn't.
I continued using just about everything."

After four years on methadone, Wilson wanted off, but, she says, medical
staff wouldn't let her come clean quick enough. So Wilson weaned herself,
all the while attending NA meetings, something she continued doing for
years. The night before her last dose she wrote about her struggle in her
journal, and in the morning poured the last bit down the drain.

"And that was it," she says. "I detoxed in class. I just sat there,
sweating, freezing, and getting up and going to the bathroom all the time."

Schindel says his recovery is due to support from mental-health workers,
family, friends, and ex-addicts. What helps keep him going now are
opportunities to share what he's learned with young people trying to kick
drugs.

"I take them out, have them over--show them my life, not tell them things,
because action speaks louder than words."

And, lastly, there is Jerry, a 37-year-old Vancouverite who, by all rights,
should not be alive to tell his tale. His story, like those of many former
addicts, points to the resiliency of the human spirit but also to the need
not to give up on drug users, no matter how far they fall.

Brutally abused as a child--physically, emotionally, and sexually--Jerry
dropped out of school in Grade 8, got into alcohol, cocaine, heroin, and
other drugs, lived in various Downtown Eastside hovels, ate out of
Dumpsters, spent two years in a Texas penitentiary for drug-smuggling, and
almost died when he developed gangrene in his neck back in Vancouver.

"My identity was so shame-based," he says. "I felt to my core that if you
really knew who I was you would run for your life in horror. I was lower
than dirt. It took me a long time just to get up to a place where I felt
equal to dirt....Welfare was a step up."

Today, renovating his West Side Vancouver home, where he lives with his wife
and young son, Jerry works at three jobs and is a full-time student at UBC.
Soon he will apply to medical school, and if he becomes a doctor, he intends
to work with addicts. In between the past and the present were years of
treatment, both through residential centres and group support. For three
years, he attended an NA meeting every day.

Addiction, Jerry says, is more than a sickness or disease. It is a culture
so strong that helping hands can take someone who wants out only so far.
Wanting isn't enough.

"I run across people all the time who want to be clean," he says. "But they
have to do more than want--they have to be willing to do whatever it takes."

The will is the way, Jerry says. Yet clearly, not everyone has his will of
iron, forged in hell fire. The rule of individuality dictates the need for a
range of treatments, everything from 12-step programs to supports for
sobriety to talk therapy to learning how to hang onto a job to learning how
to nurture a relationship.

Kicking drugs is a process, not an event, a process that--as Lynn, Candice,
Rob, Rick, and Jerry know--can make the difference between life and death.

Addiction And Rehabilitation Information

THE KAISER FOUNDATION The source for B.C. addictions information. Includes a
discussion forum plus news reports, fact sheets, studies, economic analyses,
information on alternative therapies, and a comprehensive directory of
addiction services in the province.

www.kaiserfoundation.ca/desktopdefault.asp?TabID=3&SectionID=1&CatID=1

THE REDBOOK ONLINE On-line guide to community, social, and government
services in the Lower Mainland.

www2.vpl.vancouver.bc.ca/dbs/redbook/htmlpgs/home.html

CANADIAN CENTRE ON SUBSTANCE ABUSE National centre for addiction
information. Includes information on the nature, extent, and effects of
substances and has a directory of treatment facilities across the country.
Good stats. Great links.

www.ccsa.ca/

THE ALCOHOL-DRUG EDUCATION SERVICE Educational material and training for
school-based addiction prevention for various grade levels.

www.ades.bc.ca/

VANCOUVER COASTAL HEALTH AUTHORITY ALCOHOL AND DRUG REFERRAL SERVICE Contact
numbers for information on treatment referrals, education, prevention, and
regulation.

Within the Lower Mainland, 604-660-9382

Toll-free elsewhere within B.C., 1-800-663-1441

CANADIAN FOUNDATION FOR DRUG POLICY Canada's Web site on drug-policy news,
essays, reports, facts, and reasons for reform.

www.cfdp.ca/

If you're up to it, enter the addiction debate: there are spirited arguments
and fascinating reading. And if you're looking for an unconventional way to
come clean, some of this information may help:

RATIONAL RECOVERY An idea, not a group, started by American Jack Trimpey in
response to 12-step programs. Try the step-by-step on-line recovery method
called Addictive Voice Recognition Technique. Sells books and videos.

www.rational.org/

SMART RECOVERY Another U.S.-based self-help recovery program. SMART is an
acronym for Self-Management and Recovery Training. Offers a free Internet
listserve discussion group.

www.smartrecovery.org/

STANTON PEELE Arguably the leading thinker in addictions studies. He has a
lot to say but is worth listening to.

www.peele.net/