New Treatment Option for Stopping Meth Abuse that is accompanied with Addiction Psychiatry Options.

Strength Over Speed Colorado

colorado meth project

the latest press release from the colorado meth project. read more about the organization and it's efforts at http://www.coloradomethproject.org/

Meth Project 2010

seth

image by hans op de beeck

Hearts gone astray
Deep in her when they go
I went away,
 just when you needed me so
You won't regret
I'll come back begging you
Won't you forget
Welcome love we once knew

i met him about 3 years ago as i finished up a long stint working as an advocate. i was co-facilitating a support group for poz people w/substance use disorders. somehow he stood apart from the rest. he was not the best looking nor the friendliest, but he seemed probably one of the most intelligent men i had encountered there and one of the most intricately entangled too.

his drug of choice had been meth. probably always meth. but that was coupled with a gambling obsession that fueled and encircled his addiction. he was a dealer at the the casinos in the foothills for years, but had lost his position(s) due to ramifications of heavy IV meth use. he had drifted back to the city to find work and was dealing cards again in underground parties to get by. as it usually goes, one party got busted and he was arrested. a tox-screen displayed evidence of meth use and treatment was ordered as part of his probation. this is when and where he first became known to me.

he had gone from making 70 grand a year dealing cards to 70 dollars a night waiting tables. in addition to his obvious ability to grasp concepts and themes in group, it was apparent that he was complicated and quite guarded in what he would bring forth. he seemed very private and more likely ambivalent about what was necessary and what he preferred. this is all so recognizable to most people with a substance use issue. there is a vast chasm between what we know we should do and what we are compelled to do. i drifted from that position after only a month or so of encountering him and charged through my life as is my way.

about 2 years later i encountered him again, this time in a different venue. he had finally finished his probation which had begun as 18 months and had dragged on for 3 years. he had quit injecting meth, had been working steadily, and gotten his hiv issues mostly under control. we discussed the idea of smoking cessation, but he was in precontemplation mostly. i was able to catch up with his journey a bit. he seemed much more open and at peace than i remembered, and i got a pretty good feeling about it all.

he stopped in once every few months and all seemed well. but there was a syphilis diagnosis and he had to come in for a series of shots over 3 weeks and the picture shifted somewhat. he no longer seemed as grounded. he started talking about changing his situation. he said he was tired of his restaurant job and was going to move to dallas to live with his best friend and her husband. he didn't have a job prospect, but really needed a change. that was on february 4th. one month later, he was removed from his apartment after injecting an extremely large amount of methamphetamine.

he died fairly instantly and it was not a well publicized story. i didn't find out until 2 weeks ago. there had been a very small service and it was reported to be quite sweet. his ex-partner had to identify the body and has been traumatized since, although this particular situation may bring some some necessary change to the latter's life that he hasn't been able to create on his own.

i have been a bit stunned and very sad. it reminds me again of the impotence i can feel when working with others. there will be no change until change is desired. yes someone may have to hit their bottom in order to find motivation to do something different, but i think it is definitely worth using intervention and treatment to keep that bottom from being as far down as it was for seth... that damn bitch tina seems to be working overtime, all the time, every which way and loose.

may peace be with you my friend, and with those of us left behind...

The Stonewall Huddle

              Recovery Support Comes To Denver Poz Health Care

              

more on being bi

"I have lost friends, some by death...others by sheer inability to cross the street."

— Virginia Woolf

there is something so humbling about a chemical imbalance. after all, if sober, even with medication, there are some waves of emotion that follow those brain chemical dumps that are unmistakably powerful. sometimes one feels quaky for no reason. sometimes one can't sleep, even when there is no apparent reason for it. and one learns that without self-medication, the challenges maneuvering these potential emotional minefields can be huge.

and the carousel of brain chemicals doesn't go away with sobriety or with medication. it becomes manageable- sometimes more than others- and continues to challenge. it's not being crazy, it's more being flooded with impulse. feelings, thoughts, ideas, questions, more questions, and very often a debilitating depression.

i took another class for my counseling certification on bi-polar disorder. it was bittersweet as most of the persons in the class had some very personal and often difficult experiences with bi-polar disorder among their families and friends. the class is titled "understanding and treating bi-polar disorder". of course i am not able to diagnose, but i am capable of recognizing it in many instances. treating chemically is not my purvue, but treating it in the context of substance use is something i deal with regularly. and something i have much personal experience around.

it's well documented that over 1/2 of people who have substance use issues have mental health issues as well. the largest pool of that number have bi-polar disorder. and it's said that 60 percent of people with bi-polar disorder have substance abuse/ alcohol abuse issues. one of the most amazing things to me is the general lack of dual diagnosis treatment options in lieu of these figures. it somehow seems neglectful.

some not-so-fun facts about this disorder are that only a fraction of those with bipolar ever receive treatment because of
1) associated stigma
2) its misdiagnosis
3) tendency to deny that anything is wrong
4) self-medicating
5) identifying it as a physical, behavioral, or psychological issue and NOT biochemical.
6) although is can profoundly affect relationships for families and friends, it taks an average of 10 years to seek treatment.
7) Bipolar disorder affects 1.5 % of the population worldwide regardless of race, gender ethnicity, or socioeconomic factors.

peace can be so elusive at times.

recovery is a process in which an individual actively pursues mental wellness in the context of a neurobiological disorder.

today's sound choice is lady gaga with beyonce doing "telephone"

meth minutes .... usa

meth minutes 2009

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thaw

Emptiness and just a memory


love is gone with nothing left for me


al those wasted feelings for something I no longer have


I never knew that love could hurt so bad


Winter melody, winter melody, winter melody


play for me, just for me,... Donna Summer

i received a call from a probation officer the other day with regards to someone i have been working with. a few months ago during a group session, there seemed to be a shift for several of the members and they went a little deeper into themselves and shared what was going on. there were quite a few tears, quite a lot of exposed feelings and some growth (i hope) ensued.

one of the members was visibly shaken by all this honesty and introspection. he was affected by the whole thing and stopped coming to group. the audacity of people feeling their feelings and expressing that was just like the midday sun burning his heart's eyes. he retreated back into the shade of his mind and changed his course.

unfortunately with probation, one is sentenced to complete tasks if one is to progress. so he is now looking for alternative ways to finish his requirements. he is looking to complete this without the witnessing by a group at all. This is possible, but it requires cash, as individual therapy is more costly than group sessions, for obvious reasons.

this particular individual has a history of frozen feelings and whacked anger issues, and i wonder if all this is simply part of a spectrum of events that are leading to his "thaw". he has been afraid to feel his feelings for quite some time and has made grand gestures and engaged in activities to avoid doing just that. now that he has no access to those things, and has stopped self-medicating, he finds himself closer to his own truth. and when tears and honesty confronted him, he panicked and ran, because that's what he's become accustomed to doing. but he has a wonderful opportunity to take a look at his life, notice the fear, and address it anyway.

we'll see what happens. but i know that witnessing lives change is one of the blessings in my career. change is hard, but just as in any good thaw, it can clean away so much dirt and debris and leave things in much better condition. but damn, in mid-winter, when things are frozen and dry and dead, it is almost impossible to envision an oasis like spring. i hope he can find enough faith and hope to make the journey.

i've been hoping to post today's sound choice for awhile now. i remember this song so well, and it used to pry open my heart with just one bridge. here is donna summer with "winter melody"



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something to soothe

RR_huddleflyer

the huddle has begun. it's drawn people - about 7 or so each meeting. it has been marketed about 3 weeks now. there are conversations happening and there has been a spectrum of use issues thus far. this is the purpose of this venture. a place within our clinic setting for lgbt patients to develop a sense of community within the divisive nature of their struggles. and people  are talking each meeting. but i have rarely known too many gay people to have difficulty talking when they feel somewhat safe. even if it is only to bitch. (although this is not how this hase rolled out thus far.)

the circle starts early next month. it is hoped that this will offer support and insight to folks who are struggling with inspiration and direction in their lives- substance use and abuse being one of the issues at the top of that list. it is thought that the journey with hiv (pre or post diagnosis) can be so engulfing that it can become difficult to pick oneself up, dust oneself off, and move forward. it is hoped that this process will offer some assistance with this piece of life. it's based on journaling and reconnecting with one's internal guide or creative force. it is believed that eveyone has an internal voice, and although they may have different volume settings, they are none-the-less valuable to each of us for our survival. this group is to be co-facilitated by a psych nurse so if an issue of a deeper nature arises, we should have immediate support available. and if no such happenstance occurs, we will have fun remembering our less mature and responsibility-burdened selves.

this seems to represent a shift in direction for our little universe. it feels a privilege to be witness this shift and participate in it. i am truly grateful for the opportunity and anticipate the direction that it takes me.

today's sound choice is soft and soothing for me. it is dashboard confessional with "stolen"




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hard work

one of my very dearest friends celebrated his birthday yesterday. i have plans to go to chicago next weekend  to see him and celebrate his journey. i haven't been to chicago for almost 2 years it's actually so long ago that it's hard to remember ever actually living there. but i did, and there are several folks there who still sweeten my cuppa tea. it's funny, cuz in many of the pics i see of him, he is always wearing shirts i gave him 5 or more years ago. it makes me laugh. so i got him several new shirts to add to the collection. maybe each time he wears them he feels a big hug from me.

i haven't taken a vacation in over 2 years. i have gone away for work, but not really just a getaway to lather up in fun and frolic. his condo is on north lake shore drive. the view is spectacular. every moment there, i will be aware that i am somewhere else. i am thinking this is some therapy i may need.

my friend turned 55 this year. eeeegaaad! how the hell did we find ourselves here. "i don't think we're in kansas anymore" hardly skims the surface. most of my friends are at the half century mark. whether we are more blissful or not i cannot honestly say, but i do believe we have gotten better. better at working a room, better at knowing our own hearts, better at helping a friend, better at the giving of comfort, and better at receiving both praise and criticism. whatever else can be said, 50 plus is hard work. worth doing and worth rejoicing.

this particular friend is part of a small circle of guys that dramatically changed my life back in the late 70's-early 80's. like a groundhog, they helped me learn to pop my head out of the ground and look around a bit. they reinforced in me the importance of giving to others and trying to live right-minded. strange words coming from a recovering addict i am sure, but definitely my truth. this trip will herald in my holiday season. i can feel the excitement starting to build. this is part of the fun, no?
i cracked open another installment of the "back to mine" cd collection. this one is from carl cox and it seems to have a home spun flavor i cannot help but love.a little house-y and a little jazz-y  it reminds me of what was once home.  many of the cuts reflect much of my own musical history. today's sound choice is captain john handy with "hard work"



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walking the labyrinth

i will be entering a new phase of my employment- group facitator. i have enjoyed this part of my responsibilities elsewhere, probably most because i feel somewhat like an educator. there is something that is fulfilling and satisfying about this.

there will be two groups starting, each with a different focus and in different locations. the first will be a life-skills type group and is to follow the curriculum of "the artist's way" without requiring the journaling or the artist's dates. it will be more about re-connecting with a previous time in our lives before we were inundated with our own negative voices and moving towards embracing some fearlessness. it should be fun, require minimal writing, but does require involvement and challenging one's self. this is to start the 1st week in december. the group's name is still evolving, but currently we are looking at "celebrating you"

as a sidenote, i utilized the artist's way as a journaling process when i was getting clean. it remains transformational in my mind, and when i have read the morning pages i wrote at that time, i can easily revist the emotional damage i was dealing with, and the frustration i harbored clangs loudly like a harbor bell, as does some of the delusional ideas i had hatched during my time at bat with meth. to read it now is to understand more personally how far my journey has brought me. and that insight is all due to the processes of julia cameron's "the artist's way".

the second group is to start next week. the name is "the stonewall huddle" and is more recovery support. it will be a weekend primer, taking place on friday afternoons at 3pm. it too, should be upbeat and offer support and perspective on life's questions and decisions, including tobacco, drug, and alcohol use. this is to be an lgbt group, not limitied to hiv positive persons. i hope to invite community members who are making healthy choices to come and share their insight. this is slightly sketchier as there is no set curriculum and will be much more spontaneous. for the 1st two months, there will be three weeks that there is no group, due to the holidays that land of friday's this year.

it is definitely a good time to remember some of the words i have written here as well as shared with my friends. the first would be to make room for good things to happen. this is one i truly have come to believe, but is also one that holds very real challenges for me. it is almost second nature to start imagining non-productive and limiting thoughts when there are unknowns. the upside here is that even though these thought patterns continue to occur, i have become more adept at recognizing this pattern and redirecting my brain. and when i think differently, my heart usually follows.

i feel excitement about this next step. i can't say i'm really confident, but i would guess that a healthy position. i will just trust in my intentions. i have seen with regularity how impactful the group process can be for individuals. i also believe that people respond as they are inspired, and that inspiration is nourishing. i simply hope these process will embody those beliefs.

almost completely out of context, today's sound choice is a cut from another "back to mine" cd- this one is from new order. i smile every time i hear it in my car, as it brings back memories and i still love the quirkiness. here is missy elliott with "i can't stand the rain" from her supa dupa fly album.

what a difference a day makes

he has told me on several occasions that he is sure he is an alcoholic. he has been to meetings before, but he doesn't feel able to go right now. he is on probation and gets regularly screened for substance . he passed a dirty ua and now has to jump through some extra hoops.

he cries as as he fiercely explains about the dental pain and the sist that is growing. and how great the pain and how expensive the bills . he has written proof of the financial pressures. he has a rejection letter from a former customer who has discontinued their business relationship. after all, of course, with all this pressure, who wouldn't drink? he certainly is justified.

inside, i know that what he is going through is torture. i can empathize with the unmanageability of it all. it can get that way. physical pain, especially dental, is an incredible paralyzer, and can create giant holes in a persons spiritual armor.

empathy is a great start, but how does one truly help another.  it is said that it makes no sense to crawl in a hole that someone has fallen in to help them get out. rather it is better to stay out of the hole to have better leverage and perspective when it's time to help. i surmise that this situation is no different.

so let's try starting at the basics. if you want to stay out of more legal trouble, you might consider abiding by the guidelines of your probation. that includes not drinking alcohol. even when you want to. even when you don't want to. next you might consider just how much you have done thus far. here you are, in a position to actually be taking care of your dental issues and addressing your health issues. this is quite a distance from where you have been. until recently, you have been in no condition to give your health a second thought in any way. and that neglect has probably exacerbated your current problems and that responsibility is tough to swallow. but is swallowing booze a better choice? thirdly, what is the outcome you want from all this drama in your life. do you want to ignore it more? do you want it to go away? are you thinking it will disappear like bewitched just scrunched and wiggled her nose? do you want to overcome it? if you can consider what outcome you desire, and start taking steps for that to happen, you are more likely to actually get there.

finally, you have confided that you used to be on psych meds. but it never really worked to your liking and you just decided to stop. what are the things that weren't working? how much of that was actually about you? could your reasons for drinking be linked to some of these reasons as much as the pressure you are facing with being sober? have you considered revisiting your mental health in this brave quest to take better care of your health?

i rarely know if i ask the right questions. even less do i know if i have been heard. inside i know that something i may say could spark an idea in someone else somewhere down the  road. or not.
it's a challenge to remain neutral when someone is in pain. there is a fine line between empathy and caretaking.

my style is to be truthful with people. this is a blessing and a curse. most people would prefer not to hear truth. also truth is subjective. the way i see things is not the way others see them. this is always a dance.
but i know i carry the belief that people can change. and that holding that light will sometimes help them see their way.

so i am definitely on a little esther phillips kick this week. i haven't listened to her since the mid 1970's. a version of today's sound choice was remade into a dance record about 1976. i remember asking the  dj at the broadway limited in chicago to play this record. he politely told me "we don't play that shit here"... it ain't shit in my mind. hava listen to esther phillips with "what a difference a day makes"

hiv and meth-dream on

Thugs and badmen
punks and lifers
locked up interns
pigs and snitches

Rest your weary heads, all is well

You won't be strip-searched, torn up tonight
you won't be cut up, bleeding tonight
you won't be strung out, cold, shaking to your bones
wishing you were anywhere else but right here
So dream on

in june, hrsa published a new document which breaks down quite a bit that is already known about hiv positive folks who use crystal meth. there has been quite a bit of press over the last five years over this particular intersection of crises and i have come to believe that this 5 page overview is thoughtful and concise. i have also come to believe that as a nation and a culture, americans are far far behind the eight ball in understanding substance abuse and in our infancy in dealing with it. just take a look at our prison system if you need some validation on this point.

here is my current favorite excerpt from the document. the thoughtful approach that can be financially supported by the ryan white program could perhaps be utilized to garner further understanding to apply to the rest of our citizens who struggle with meth addiction but without hiv. you can read the rest of the article after the jump

Provider Strategies
Treating HIV-positive meth users requires intensive collaboration among mental health specialists, dentists, pharmacists, social workers, primary care physicians, substance abuse counselors and, in some cases, correctional employees. “Treating patients requires a team. We have an electronic medical record where we share everything, and we have case conferences almost every week,” says Disney. “The case manager makes sure the patient is connected with resources and . . . following their plan; the pharmacist meets with the client and checks to make sure they’re sticking with an HIV medication regimen; the physician is tracking the lab numbers; I’m helping them deal with the deeper emotional issues, and the dentist is working to improve oral health,” Disney adds.

Part of an effective strategy includes dispelling the myth that meth is harder to treat than other drugs. According to Shoptaw, meth users’ rate of retention in treatment is virtually the same as that for other drugs (3 out of 5 people complete treatment).5 Although no specific guidelines exist to screen for meth, some providers use general substance abuse screening tools, a modified CAGE questionnaire or, in some cases, diagnostic testing with informed consent.9

Shoptaw advises providers to use the “5 A’s”: ask if the patient uses meth, assess if he or she is willing to quit meth, advise in a clear voice that it is a good idea to quit, assist the patient with finding intervention, and arrange for followup. Providers should also become familiar with co-occurring disorders and create a referral system with medical professionals in their area who treat those disorders.6

Cultural competency is vital to help providers under­stand not only the drug but also the user population and the reasons for use. Equally important is detection of underlying mental health problems. Inclusion of mental health specialists extends to emergency rooms, where it is important to identify whether patients’ mental health problems are meth induced.

Providers are seeing a specific type of memory impairment among meth-using clients. According to a longitudinal memory performance test conducted by colleagues of Shoptaw, word recall and word recognition among meth users is worse than among clients who do not use meth—even after 6 months of abstinence. No real difference for picture recall and picture recognition tests was found between meth users and other clients.32 Providers should therefore use pictures and write down instructions as well as explain information to patients.

In addition to addressing psychological changes, providers can help counter physical changes resulting from meth use by advising patients to hydrate and to avoid wearing hats so as to lower base body temperature and reduce the risk of malignant hyperthermia. Similarly, patients should be advised to consume protein to help repair muscle fibers and naturally produce and replace dopamine.2 To treat xerostomia, providers can recommend the use of artificial saliva products or sugar-free citrus candies to stimulate saliva production.33

today's sound choice is tongue-in-cheek definitely... christian falk featuring robyn "dream on"

something's gotta give

There is nothing like returning to a place that remains unchanged to find the ways in which you yourself have altered.
- Nelson Mandela

i had the pleasure of being shadowed at my job last week. it is not my favorite experience. a stranger following you, listening to your dialogues, and offering feedback and criticism to you as part of their job. we are grant-funded however, and the manager of the grant has their responsibilities, just as i have mine. and you never know what you have to learn.

it turned out to be a very pleasant experience. our clinic was cancelled that day as the attending was persuaded to have labor induced and gave birth to twins. so the person responsible for shadowing and i had lunch and talked about the program, and then she sat in on 3 individual sessions i had scheduled for that afternoon.

there is a movement underfoot in our state to examine and reshape the idea of substance abuse treatment and referral in the medical setting. i actually believe it's probably long overdue. the indulgences and over-indulgences of tobacco, drugs, and alcohol do have health implications and they tend to be serious. they also tend to be costly.

tomorrow i will be attending a conference put on by the grant program which is really a brainstorming session. they are expecting 150 persons and have some relevant speakers. i have been asked to join some others and moderate discussions at my table and to report to the larger group. i am fortunate enough to be bringing the HIV perspective to the conversation. and i shouldn't have to tell you how intrinsically linked HIV and substance use/abuse are.

our state traditionally has been ranked 48th in spending for substance treatment. this is not a fact that i am boasting about. it is merely a reading of the importance this issue has in Colorado. so in the sbirt screening process, referral to appropriate treatment modalities is paramount. but i fear they are limited, hard to find, and challenging to discern the appropriate fit. my hope is that tomorrow's dialogue will signal some change in this attitude and create some momentum that collaboration and systemic change needs to happen.

i mean, if we don't believe someone getting clean and sober is important, or that moderation is actually a virtue and saves lives, how likely is any individual to believe it either?

today's sound choice is the highly underated royal crown revue with "something's gotta give" - yes that's a rat pack remake... i certainly had my days of being a rockabilly/swing afficianado... i even learned how to do the lindy hop..

peace train

Everything one does in life, even love, occurs in an express train racing toward death. To smoke opium is to get out of the train while it is still moving. It is to concern oneself with something other than life or death.
Jean Cocteau

what a day this has been. i started with meeting with two people who are both struggling with alcohol use, but they reside on two completely different sides of the intellectual spectrum. the first person seems quite simple and has challenges recognizing that his behaviors have led directly to his life issues. but we will work on that. the second person seems very bright, but has had a multi-decade relationship with booze that has likely sucked much of the brightness and joie-de-vivre directly out of him like a kiss from lestat.

a quick introduction to a new person who still dabbles with meth (about 4-2day binges a month according to him). he did not initiate the introduction and appeared cautiously frozen in his tracks like an intuitive deer caught in a hunter's scope. he answered questions freely and honestly, but remained close to the bench that was seating him. pre-contemplation is the space on the wheel of change that he has landed for quite some time. no income, no employment, and no prospects for change (as well as several missing front teeth) indicate that he has lost sight of his own reflection.

the afternoon brought a revisit with someone who is working on quitting smoking. there is great confusion about a specific plan for stopping including a date as well as developing alternative behaviors or activities to replace the need for the relief that smoking a stogie brings. upon further clarification, it is revealed that the real task is to reconstruct the living situation as it glares as a much more important issue that tobacco cessation. decreasing the nicotine intake is taking place. but the total stoppage is doubtful at this point. adding pharma support at this time does not make good sense.

this is a sampling of a day. absolutely no resolution was found for any of these passengers. an impression of who these characters once were is more evident than is easier to discern than where they are headed.

all are passengers who are holding tickets for this journey... i can only hope they have boarded the train going in the direction they intended.

today's sound choice is cat steven's with "peace train"

tracks of my tears

thanks b2u for indulging my emotions this week. i am undergoing a culture shock and am doing my best to keep my head above water. but goodness knows i really needed a change and i believe the universe is looking out for me once again. i also find that some of my values may have been slipping back into a more selfish realm, definitely a side effect of fear and insecurity. i hope i am recognizing this in time and can make the necessary adjustments to get back to looking at the world with loving eyes. oh yeah, and a loving heart. i am to be conducting interviews over the next year and making referrals to treatment as well as developing a support mechanism for the clinic i will be working in. i am humbled and thrilled at the opportunity, but feel much more blessed that the team i am working with are already in my corner and have been actively working to bring me on board. in the referrals to treatment arena, the conversation i knew had to happen did just that. it is with reference to an experience that i have worked through, but perhaps not let go. ergo- resentment. and resentments really are poison. i know that the more i hold onto it, the more distorted my perception. honestly, i am working on this. forgiving an abuser has proven not to be a simple thing for me. in turn, however, it sets me up to re-enact that abuse, which is something i very much want no part. but no matter how much i try to cover up and disguise my past hurt, i am pretty sure you can still see the tracks of my tears.

today's sound choice is this season's idol frontrunner- adam lambert with "tracks of my tears"

don't stop till you get enough

To err is human, but when the eraser wears out ahead of the pencil, you're overdoing it”...josh jenkins

one thing i am learning (or re-learning) is that a person isn't done with their relationship with alcohol or drugs until they are done. i knew this about myself, but i am starting to understand on a deeper level that the same truths hold true for others.

i have been counseling people with use and abuse issues for a short while now, and as the time layers, so does my understanding of how deeply embedded the relationships with drugs and alcohol can be. it becomes transparent that some individuals are not at all comfortable with being in their own skin for very long without changing the way they feel. it doesn't take much for them to return to numbing out as a coping skill for their own lives.

of course, i recognize this. it doesn't seem foreign to me. it doesn't horrify me. quite the contrary actually. i understand it. why not? if i don't have to look at the unpleasant things in my life, why should i? i can't solve things, so why shine a light on them? now it all seems more cruel than kind.

and who knows? just because the very act of not using has offered me some huge relief from that hamster wheel of shame and guilt that i encircled myself with for years, doesn't automatically mean that the same is true for others. besides, i waited until i was damn good and ready (and had no other options) before i decided to make some behavior changes.

none-the-less it is a painful and delicate exercise as i accompany some of these individuals on their journey through self-discovery. trying to suspend my own values and judgement, see the "spirit" in another when they are struggling to live comfortably in their own skin, and witnessing another's self-sabotage at the same time has its challenges.

this past week, an individual came smelling of alcohol to our little facility. i had to perform a screening process and there was a fairly high level present. no choice laid before me, but to have him call for a ride, have that driver screened also, and send them both on their way. needless to say, it's heartbreaking to me that someone can't go without for the short period of a year without imbibing. but it's very common.

another individual has had several "hot" screenings for another substance over the last few months, and that person was discharged tonight for that very reason just as the other screening and sending home incident was happening with the other.

truth be told, i believe these folks are asking for help. they could easily just blow this whole probation away, and dive fully into a "using" lifestyle. but instead, they proceed with the process. such as coming to treatment with a blood level as high as i saw, indicating that they must feel comfortable in our midst. maybe they want to talk, but have forgotten how without a boost. it is a challenge for me to remain aloof.

you know, there were many times that i wanted to stop, but i didn't know how. and when i tried, i failed miserably. i didn't know how to stop. i couldn't face my life yet. i couldn't think of moving forward. forward was so full of fear.

in some circles they might say that i hadn't had enough yet. go figure....


today's sound choice is michael jackson with "don't stop till you get enough". and believe me, the concept of facial reconstruction being the subject of this song is not lost on me....

hope

beijing: smoky city of hopes

Dale Carnegie:
Most of the important things in the world have been accomplished by people who have kept on trying when there seemed to be no hope at all.

marc sent me a link to an article that i thought i would share today. i am specifically interested in abzymes. is this a new word? is this a new concept? my friend Michael sits on ATAC says they just discussed it and its a hoax. wikipedia says this:

is there hope?

the second thing i am interested in is the new studies that have come out about prep. this category includes but is not limited to microbicides. these topical agents that are applied with lubricants seem to hold much possibility for the changing of very very many lives.

i write a little about hope in conjunction with hiv because that is something so close to my own life. i have been personally affected by it in my own life as well as my professional life. but also, because it is one of the major health issues across the globe. it's not just a big deal in the u.s, but a much bigger crisis in africa, india, asia, and elsewhere on our small planet. i honestly think after 25 years, we can use a little hope.(or maybe more)

the trick for me some days is to remember hope. i know it well, but i forget it or lose site of it so easily. life can be overwhelming sometimes and i cannot even begin to handle it all well. it makes me cringe to misstep and even more toxic is my ego when faced with failure. that's a dangerous spot for a guy like me. i need to keep hope close. hope is the breeze on my face in the sun. i need the olympics perhaps even more than the world does. even tho i don't compete, i can feel connected, and i can always hope that an underdog can win.