Can Addiction be "Cured"

Saifudin · May 28, 2009

"I find it interesting there is such resistance to the disease model of addiction despite the wealth of research to back it up."

Great post Jack and the web site referral is excellent.

We see how emotional the subject of addiction is. Even though we all understand what evidence based means and that there is an abundance of scientific data about addiction, still, emotions and subjective responses abound.

It took me a couple of years to get over my preconceived notions about addiction. I had to deal with my personal experiences of years working in the ER, personal attitudes and later spiritual beliefs. But, after working in the field, and importantly, learning evidenced base knowledge about addiction, my understanding and attitude has changed.

jackstem · May 28, 2009

So how do we change this "subjective, emotional" response? With education, of course. Unfortunately, very few nurses (or doctors) attend lectures about the disease, unless they work in the field or are recovering.

As peer advisor for Ohio's nurse anesthetists, I have a booth available at all association functions. We have a spring and fall meeting every year. Very few people stop by the booth, especially if I'm standing there. If I'm away from the booth, people will stop and look at some of the materials I have available. If I walk back toward the table, everyone leaves (and no...it's not my deodorant or aftershave!). It's as though they are afraid they might catch the addiction bug if they speak with me. Or even worse, someone might think they have a "problem". I also have an "open AIR (Anesthetists In Recovery) meeting for anyone to attend. Very few people attend the meeting (unless they are recovering and open about it). Wouldn't want anyone to think they might have a "problem".

I've teamed with a nurse attorney to present a series of workshops on addiction in nursing. We've had 5 workshops to date and only one person has attended. One. Despite numerous mailings and contacts with departments of nursing. If breast cancer affected 12 - 17% of the nursing workforce we'd have standing room only.

The only explanation is nurses don't believe this is a disease, and they don't think it will happen to them. Here is what the ANA has to say about substance abuse and addiction in nurses. This is reprinted with permission (the ANA developed this specifically for posting on web sites):

RESOLUTION before the ANA House of Delegates, Philadelphia, PA, June, 2002 (As submitted in its final form)
SUBJECT: Reaffirming the Profession's Response to the Problem of Addictions and Psychological Dysfunctions in Nursing
RELEVANT CORE ISSUE: Nursing shortage, workplace advocacy
INTRODUCED BY: K. Lynn Wieck, RN, PhD., President, Texas Nurses Association on behalf of the signatory organizations.
EXECUTIVE SUMMARY: A changing workplace, multi-state compacts, and decreased access to reimbursed treatment programs for the nurses with addiction or psychiatric disorders creates a heightened need to readdress the lack of universal alternative-to-discipline programs. To maintain standards of the profession and a sufficient workplace, ANA should advocate for comprehensive and consistent access to alternative-to-discipline programs for nurses with addictions or psychiatric disorder. This report addresses the preservation of the health and professional practice of nurses with addiction and/or psychiatric illness.
RECOMMENDATIONS:
WHEREAS, substance abuse, the number one preventable national health problem, occurs among registered nurses at rates at least similar to those reported in the general population; and,
WHEREAS, education promotes the early identification of, intervention with, and treatment of, persons, including registered nurses, who experience addiction and psychiatric disorders; and,
WHEREAS, treatment is effective in reducing drug use, deterioration of health, improved social and occupational function; and,
WHEREAS, nurse employment policies and procedures supportive of alternative-to-discipline programs result in improved employee job function and return and retention of nurses to the workforce; and,
WHEREAS, the American Nurse's Association Code of Ethics for Nurses mandates workplace advocacy and promotion of nurses' well-being; and,
WHEREAS, society's health needs require the preparation, support and retention of a healthy workforce; and,
WHEREAS, in ten states, nurses do not have access to programs that provide alternatives to discipline during recovery; and,
WHEREAS, the development of multi-state licensure compacts underscores the need for consistent availability of alternative-to-discipline programs across all jurisdictions;
THEREFORE BE IT RESOLVED that the American Nurse Association will:
Support efforts to educate the public and professional nurses on the prevalence of addiction and psychiatric disorders as diseases for which society and registered nurses are at risk.
Seek to preserve the current and future workforce by promoting awareness of impaired practice, its prevalence, management and implications for public safety and well-being.
Increase awareness of the health and patient safety risks associated with untreated addiction and psychiatric illness.
Promote member and affiliate actions that encourage the development and use of
alternatives to discipline for health professionals in those states where they currently do not exist.
Support expansion of peer assistance to include professional nursing students.
Support efforts by United American Nurses and the Commission on Workplace Advocacy to advocate for the retention of nurses who experience addiction and psychiatric disorders.

In the 7 years since this resolution was voted on and passed, the overall climate regarding impaired nurses has not improved. In some areas it has deteriorated. How can we expect the attitude regarding this disease in the general public to change if we can't deal with it compassionately and effectively in our own profession?

I thank God for my experiences as a recovering nurse anesthetist, because it enabled me to deal with the disease appropriately when my youngest daughter developed it. If I hadn't gone through this first, I have no doubt I would have "blown it" and she would be dead today.

Jack

Saifudin · May 29, 2009

Jack,

Compelling information. Once you get inside the science of addiction the perspective changes but getting others to that point, is as so poignantly stated a huge hurdle to get over.

All my direct addiction experience has been overseas in a Muslim country where the stigma of addiction and mental health disorders is great but, I see that the stigma of addiction or even the possible association with an addiction problem is great back in the States as well. Fear of disclosure or just inquiry is obviously a problem.

Thanks for the information and your continuous struggle to get the message out.

SoxfanRN · May 29, 2009

Jack, I agree that the data speaks for itself, and I agree with it. However, I think it is crucial for us to understand why people do not prescribe to that data. Here are some thoughts, ideas, and beliefs that I have witnessed myself.

Nurses and doctors, like all other people, think addiction is something that happens to other people. And who could blame them? Think about the image of "the addict" or "the alcoholic" that we have seen on TV, or that we have seen with our own eyes. Even in the midst of full-blown addiction, people do not want to belive that they appear like those images. The negative connotation of those images overwhelmes people into truly believing that they could not be a part of it, and they deny it.

I also think that the public-at-large believes in "Once an addict, always an addict." We discussed it in this forum. That attitude promotes hopelessness for recovery. Again, who would admit to addiction if they believe that they have no chance of recovery? So, if there is no cure, and people will always be an addict and have these problems, than their only hope is to believe that they are not an addict.

Let's forget about using to cope for now; Partying and having fun are part of our society. We are in the midst of a tolerance period. Drinking and partying are accepted and encouraged, especially in one's youth. Given the above societal forces, what person truly wants to be an outcast from the norm; especially since developmentally teens are governed by their peers? Besides that, recovery dictates abstinance; more than anything people with addiction want to be able to do what they want to do because they enjoy it and there are usually secondary gains associated with using (comfort, friendship, belonging, etc.). Recovery is in direct conflict with that.

So, I believe addiction is a chronic illness, but I can understand why people would choose not to believe this.

rholman · May 29, 2009

it's amazing how this thread has taken on a life of its own. i love the different perspectives, opinions and educational information.

the below paragraph, i copied from jack's post, hit the nail on the head, especially the statement highlighted in red. as i mentioned in one of my earlier post, i stay away from people, places and things at all cost. after 15 years clean, there are times, when out of the blue, i can smell crack cocaine, or i have drug dreams. the dreams can be so vivid and in my dream i am saying to myself, this can't be true. when i wakeup, i am soooo happy that it was just a dream. i am not sure what triggers it but obviously something does. they happen few and far between (years) but it is a reminder that i will always be susceptible.

unfortunately, not everyone who gets clean, stays clean and there are some who never get clean. it you think you are cured, go hang around some drugs and alcohol for a while, then let us know how that worked for you. i know it sounds harsh but sometimes it takes a few relapses to realize it doesn't just go away.

"a big problem for the recovering addict is it takes 1.5 - 2 years of abstinence for the brain to recover as much as possible. research is showing this recovery is incomplete, meaning the brain is always susceptible to cues, even decades after the last use of the substance. as a result, a person who isn't aware of this susceptibility is at increased risk of relapse, especially when they stop working their program of recovery. it also takes much less time for the brain to degenerate once the use of mood altering chemicals begins. any addict who has relapsed will tell you it seemed like it took very little time to return to the level their disease achieved when they achieved abstinence."

knowledge is power!

jackstem · May 29, 2009

Jack, I agree that the data speaks for itself, and I agree with it. However, I think it is crucial for us to understand why people do not prescribe to that data. Here are some thoughts, ideas, and beliefs that I have witnessed myself.
Nurses and doctors, like all other people, think addiction is something that happens to other people. And who could blame them? Think about the image of "the addict" or "the alcoholic" that we have seen on TV, or that we have seen with our own eyes. Even in the midst of full-blown addiction, people do not want to belive that they appear like those images. The negative connotation of those images overwhelmes people into truly believing that they could not be a part of it, and they deny it.

I agree with your assessment of why doctors and nurses react the way they do. I'm not willing to accept the rationalization that it's acceptable and should be overlooked. As far as the addict goes, pathological denial is part of the disease process. Unlike the psychological defense mechanism of denial, which protects us from overwhelming tragedy and allows us to continue to function until the situation has passed or until we can "digest" the events and develop healthier coping skills, pathological denial prevents the addict from seeing how ill they are and how crazy they have become in the context of obtaining and using their drug of choice. As the disease progresses and the use of their substance (or activity) escalates, the areas of the brain involved in memory, learning (similar but different things), decision making, and impulse control continue to deteriorate. These are the reasons dependent individuals fail to see the negative consequences of their actions and are incapable of learning from the negative consequences of their actions while intoxicated. PET scans and fMRIs clearly demonstrate the significant hypoactivity in the areas of the brain previously mentioned. Denial isn't a decision by the addicted person, it's a result of the brain alterations.

I also think that the public-at-large believes in "Once an addict, always an addict." We discussed it in this forum. That attitude promotes hopelessness for recovery. Again, who would admit to addiction if they believe that they have no chance of recovery? So, if there is no cure, and people will always be an addict and have these problems, than their only hope is to believe that they are not an addict.

Unfortunately, "once an addict, always an addict" is true, since there is no known "cure" at this time. However, the lack of a cure is also a part of other diseases. This doesn't mean that the disease process can't be arrested, and many times reversed. It doesn't mean long term remission is impossible. However, because of the stigma associated with this disease, those who ARE in recovery rarely speak out. So it makes sense that people think the disease is hopeless if we aren't aware of the millions of people who have found and sustained decades of recovery. All we see are the folks who don't find recovery.

Currently, the statement, "Once a diabetic, always a diabetic" is true. We don't see people going off the deep end with despair and continuing to ignore their symptoms. At least not all diabetics. We spend a great deal of time educating the diabetic on diet, exercise, and monitoring their glucose level in order to keep the side effects of the disease to a minimum. Does the diabetic have periods where their disease "flairs" and puts them in the hospital in order to get things in remission again? Sure. In fact, a large number of those folks are in the hospital because they stopped being diligent following their treatment program. We don't condemn these people as stupid, weak willed fools. We don't ostracize them when they "relapse". We don't find it OK to limit the number of times they may receive treatment. Why? Because we are trained health care "professionals". We understand the biology and pathophysiology of diabetes and are constantly educating those we care for (and their families) in order to help them live a relatively "normal" life.

The same analogy can be made for other chronic, progressive, potentially fatal diseases. The difference I see is the health care training programs aren't doing their job. Very few nursing or medical schools teach the DISEASE of addiction. They focus on the consequences and side effects of the disease...cirrhosis, HIV, hepatitis, sexually transmitted diseases, cardiovascular, pulmonary, GI, etc. As a result of this lack of knowledge, the health care "professionals" fail to understand the difference between serious substance abuse vs. the disease of chemical dependence. While the person with a significant substance abuse problem can suffer many of the same serious consequences as the addict (DUI, divorce, job loss, violence, criminal activity and death), these individuals are still capable of deciding to stop abusing their drug of choice. The addict, because of their substance abuse crossing the line into addiction, isn't capable of deciding to quit. The changes in their brain structure and chemistry have caused obsession with obtaining and stockpiling their drug of choice, and a compulsion to use that drug (alcohol is a drug so alcoholism is addiction) until it's gone. Ask any addict if they were able to "stretch" the amount of drug available until they knew they could obtain more. The answer will be no. I know for myself, I would "save up" my stockpile of sufenta to make it through a weekend. By Saturday evening it was gone. Once I started using it, I had to keep going until I ran out.

While I am more than willing to give the non-health care professional a pass on not understanding the disease concept, I'm not willing to do the same for the health care "professional". As nurses (and physicians as well), we don't have to actually have a disease to understand it and provide care to those who do have it. We don't have to have the disease to teach prevention techniques to those susceptible to developing the disease. The hallmark of a professional is they maintain their level of education and skills throughout their career. No one will ever learn everything in training that will last a career of 20, 30, or 40 years. If we don't learn something during training, we are supposed to keep up through our own initiative by reading journals and attending continuing education programs. To lack even the most basic understanding about a disease that is one of the major public health issues we face as a society is unprofessional and unethical. Look at the way those with addiction are (mis)managed. If we approached any other illness in this fashion there would be lawsuits, congressional investigations, and all sorts of demonstrations to get things changed. Why don't we have that going on now? Because any recovering individual knows as soon as their status is known, there will be hell to pay. Our lack of understanding allows us to discriminate against those with the stigmatized disease. Insufficient insurance coverage, inadequate treatment for too little time and little if any follow up is the norm for someone diagnosed with chemical dependence. We all know what happens when we don't administer the correct antibiotic in the right dose for the right amount of time...sepsis. What happens when we don't use evidence based treatments in the right "dose (inpatient) for the right amount of time (90 days appears to be the watershed for significant increase in long term recovery), with the right amount of follow up and reinforcement? Relapse.

Let's forget about using to cope for now; Partying and having fun are part of our society. We are in the midst of a tolerance period. Drinking and partying are accepted and encouraged, especially in one's youth. Given the above societal forces, what person truly wants to be an outcast from the norm; especially since developmentally teens are governed by their peers? Besides that, recovery dictates abstinance; more than anything people with addiction want to be able to do what they want to do because they enjoy it and there are usually secondary gains associated with using (comfort, friendship, belonging, etc.). Recovery is in direct conflict with that.

We agree on the societal acceptance of using mood altering substances for numerous reasons. It has been this way since recorded history has been available. Today, we use alcohol to celebrate turning 21 years of age, to celebrate weddings (and divorces too), many religions use it in their rituals, we use it with sporting events, funerals, to celebrate a promotion or a new job, moving into a new home, etc. I have no quarrel with the responsible use of alcohol. But does it gives us permission as health care professionals to rationalize the lack of understanding of the disease and our failure as patient advocates to change the way addicts and their disease is dealt with? I don't think so. As for the "Drinking and partying are accepted and encouraged, especially in one's youth. Given the above societal forces, what person truly wants to be an outcast from the norm; especially since developmentally teens are governed by their peers?" My response to that is exactly what my parents said to me...if Johnny jumps of the roof does that mean you should to?" Also, we're talking about the lack of understanding and acceptance of addiction as a disease by health care professionals, not teenagers.

We must also remember that 10 - 20% of the population is susceptible to developing addiction as a result of their genetic make-up and recreational use of mood altering substances, not to mention other conditions that increase the risk, such as other mental disorders (depression, bipolar disorder, etc.). If we don't understand the disease concept, conditions that increase the risk, and the early signs of the disease, we aren't able to recognize a problem and intervene at a time when treatment is likely to be more successful. We believe the myths that treatment doesn't work (it does at a similar rate of success for diabetes, hypertension and other chronic diseases...we just don't see the successes because they remain anonymous to avoid the stigma associated with the disease), that the addict has to want to get well (Addicts, by virtue of the disease interferfering with rational decision making about the use of mood altering chemicals aren't likely to make rational decisions in this regard) recovery rates are similar for those mandated to treatment as for those who "voluntarily" seek treatment. I know of very few addicts who really wanted to enter treatment initially), and they must hit some sort of mystical "bottom" before treatment will be effective (The real bottom for an addict is death. We have no effective treatments for that sort of bottom). Intervention is a technique use to create an artificial bottom when treatment is more likely to be successful. Addiction is the only disease I'm aware of where people have to become so ill they almost die before the medical profession will treat the disease. We treat addiction the exact opposite of the way we treat other chronic, progressive, potentially fatal diseases.

Diabetes - Early recognition and treatment with patient education about the disease and how to best keep it in remission.

Addiction = Ignore the early symptoms (maybe they'll go away) and only treat them when the disease has progressed to near death.

Illogical, definitely not evidence based, and most assuredly unprofessional and unethical. With the scientific information available as a result of significant research over the past 30 years it is indefensible to continue to mismanage this disease.

I just returned from an open house for a new peer based treatment facility in northern Kentucky. It's 100 beds And the majority of the manpower needed to run the facility is performed by the patients. It's motivationally based, peer mentoring form of treatment. The woman responsible for passing Casey's Law in Kentucky and getting this facility financed and built lost her son (Casey) to a heroin overdose. She took him to an emergency room twice to get help for her son. One ER sent him home with prescriptions for Ambien and Xanax (exactly the medication to prescribe for an admitted addict). The other sent him home because "he hasn't hit bottom yet. He hasn't lost enough to really want to get well." And, there was no law that allowed parents of a child over the age of 18 to intervene and have that child admitted for treatment against their will. He was dead a couple of weeks later.

This information is from an article on BNET, a business oriented web site sharing info to improve the way businesses function and improve the delivery of products or services: (http://findarticles.com/p/articles/mi_qa4084/is_200507/ai_n14826334/ Read the article. It was written by Casey Wethington's mother.

This law (Casey's Law) was inspired by the life and death of Casey Wethington, who died at the age of 23 from a heroin overdose. At that time, there was no law supporting the right of parents to intervene for a child over the age of 18. Now, because of Casey, parents, relatives, and/or friends can petition the court by law for treatment on behalf of someone who is shown to be substance abuse impaired. This involuntary treatment law is known as 'The Matthew Casey Wethington Act for Substance Abuse Intervention.
These are some things I have learned or have come to realize in hindsight. Involuntary treatment is often called into question because of the oft-used phrase, "he/she has to want to." Actually, studies show that involuntary treatment is just as successful if not more so than voluntary treatment. Addiction, not unlike cancer, is a progressive, life-threatening disease, and as with cancer, early diagnosis and treatment is key to the likelihood for. recovery. No one would say of a cancer patient, "he/she has to hit bottom," but these words are frequently used when speaking of an alcoholic or addict. After Casey's second overdose, an emergency room nurse looked at me and said, "Honey, he's still too young, he hasn't lost enough yet." The problem was that the only thing my son had left to lose was his life. Most of his material possessions had been sold for drugs; he had no wife or children, no job, and no home of his own. My reply was, "What if he doesn't live to be old?" I didn't know then how prophetic those words would be. A little over a month later, Casey died. I guess he had finally lost enough."

His mother is an amazingly inspired woman who refuses to take no for an answer. We talked for almost an hour today. To say she is inspiring seems so inadequate. I find it truly sad that a woman with no medical or science background comprehends this disease and how to deal with it better than health care professionals. I'm not saying all health care providers have to have an in-depth knowledge of the disease. But to lack even a basic understanding is unacceptable. There is no acceptable excuse for the way our profession deals (or refuses to deal) with this disease.

Jack

jackstem · May 29, 2009

Knowledge is power!

I heard someone say at a 12 Step meeting

You can lead a person to knowledge, but you cannot make them think.

Ignorance alone isn't necessarily a bad thing. Most of the time we aren't aware we don't know something. However, WILLFUL ignorance, choosing to not learn information that is necessary to perform a professional function safely and correctly is unprofessional and unethical.

I encourage everyone to read the story behind Casey's Law (The Matthew Casey Wethington Act for Substance Abuse Intervention) at this link. It highlights the absurdity in the way our society approaches this disease. Charlotte tells it better than I ever could.

Follow this link: The Matthew Casey Wethington Act for Substance Abuse Intervention

Jack

Long Term Care Columnist / Guide · May 29, 2009

it's amazing how this thread has taken on a life of its own. i love the different perspectives, opinions and educational information.
the below paragraph, i copied from jack's post, hit the nail on the head, especially the statement highlighted in red. as i mentioned in one of my earlier post, i stay away from people, places and things at all cost. after 15 years clean, there are times, when out of the blue, i can smell crack cocaine, or i have drug dreams. the dreams can be so vivid and in my dream i am saying to myself, this can't be true. when i wakeup, i am soooo happy that it was just a dream. i am not sure what triggers it but obviously something does. they happen few and far between (years) but it is a reminder that i will always be susceptible.
unfortunately, not everyone who gets clean, stays clean and there are some who never get clean. it you think you are cured, go hang around some drugs and alcohol for a while, then let us know how that worked for you. i know it sounds harsh but sometimes it takes a few relapses to realize it doesn't just go away.
"a big problem for the recovering addict is it takes 1.5 - 2 years of abstinence for the brain to recover as much as possible. research is showing this recovery is incomplete, meaning the brain is always susceptible to cues, even decades after the last use of the substance. as a result, a person who isn't aware of this susceptibility is at increased risk of relapse, especially when they stop working their program of recovery. it also takes much less time for the brain to degenerate once the use of mood altering chemicals begins. any addict who has relapsed will tell you it seemed like it took very little time to return to the level their disease achieved when they achieved abstinence."
knowledge is power!

i soooooo understand what you mean about the dreams.............once in a great while, i'll have one in which i either pick up or am handed an alcoholic drink, and toss it down as casually as if i'd never even stopped in the first place. then the remorse comes, and i spend the rest of the dream in self-recrimination: "you idiot!! how could you have done that?! now you have to start all over again", blah, blah, blah. and when i wake up, it's like "oh, my god, i didn't do it!! it was just a dream, oh, thank you lord!"

they say that the price of freedom is eternal vigilance.........and never is this more true than with alcoholics and addicts! getting and staying clean and sober frees us from bonds that we never knew existed when we were using, but we can never relax our guard. i'm firmly planted in the conviction that addiction is only managed, never cured; and for me, that's a good thing, for surely i'd want to 'test the waters' if i weren't thoroughly convinced that to do so would mean the end of the world as i've come to know it.

jackstem · May 29, 2009

I've had the occasional using dream too. Fortunately it's been awhile. But I can still recall placing the tourniquet around my arm, the anticipation of getting the flash of blood and then the warmth after injection. So real that I would wake up in a sweat looking at my arms to see if there were any injection marks! Tough to get back to sleep after one of those babies!

The disease is definitely lurking, just waiting for me to think things are just fine and one little "taste" wouldn't hurt. Yeah.....right. One is too many and a thousand is never enough!!

One day at a time....sometimes it can be one minute at a time.

Jack

Blackcat99 · May 29, 2009

I don't believe addiction can ever be cured. I am a food addict in recovery and I believe I will always be a food addict. I do not ever think that I will be cured. In the past, I would lose weight and think "Oh look.I'm cured. I've lost weight now and can eat whatever I want now." :sniff:Of course, I would regain all of my weight back and more. I have lost 120 pounds and have been abstinent for 3 years. Do I think I will ever be cured? Never. The big book makes it very clear to me that there is no cure.

jackstem · May 29, 2009

Thanks Blackcat99! You have one of the toughest addictions to deal with!

My daughter who is a recovering cocaine addict and recovering bulemic said it pretty well. The cocaine addiction was difficult to get through and into recovery. But she doesn't need cocaine to stay alive (although her brain believed that's exactly what was needed to stay alive!). But we all MUST eat to survive. Congratulations on your 3 years!

If you have a blog or website (or even want to use it in email), you can get a "sobriety counter" at this link:

http://www.odatonline.com/sobriety-counter

Jack

rholman · May 30, 2009

they say that the price of freedom is eternal vigilance.........and never is this more true than with alcoholics and addicts! getting and staying clean and sober frees us from bonds that we never knew existed when we were using, but we can never relax our guard. i'm firmly planted in the conviction that addiction is only managed, never cured; and for me, that's a good thing, for surely i'd want to 'test the waters' if i weren't thoroughly convinced that to do so would mean the end of the world as i've come to know it

one of the most important things that keep me grounded, is so basic and simple, but it's powerfull. i reflect back on the progression and consequences of my addiction. as they would say in na "play the entire tape". yes, it was fun in the very beginning but the remaining 75% of my run was horrific. i was a loser, dropped out of school, couldn't keep a job, physically run down, lying, stealing and inflicting severe emotional pain to myself and others. i did not like getting high anymore but couldn't stop, that alone convinces me, i am an addict. na saved my life.

since being in recovery, i have come a long way and accomplished more than i ever hoped to. however, i am still cleaning up the broken pieces. i was 42 before deciding to go back to school and get a career. when i first got clean, all i could do was stay clean and get any job to help support me and my daughter. there are times i can't help but beatup on myself about the time i wasted and lost. if nothing else keeps me clean, i think about all i have gained and how i don't want to give this up and lose anymore precious time.

with every fiber of my entire being, i am thoughly convinced i will never be cured. i know it will only take 1 time and i am off to the races again, only next time, i might not make it back to recovery. i am not willing to sacrifce my life for drugs anymore.

"my worst day clean, is better than any of my best days getting high"