Friday, 14 February 2014

The Fast Food Wars and Exactly Who Is Responsible When We Eat Too Much

N.B.: The words "drug addiction" in this post will include the drug alcohol, as well as street drugs and those prescription drugs that people become addicted to.

     Some time ago, the insurance companies balked at paying for in-patient rehabs for people who were declared by professionals to be in need of treatment for their drug addiction. I viewed this as partly the fault of the rehabs themselves because everyone who was admitted got a twenty eight day program automatically. It was easier to convince staff that one needed an "extension" [a longer stay at the institution] than it was to convince staff that one was ready to be sprung before the scheduled time was up. It was not surprising when the H.M.O.s clamped down. In spite of the protests and tears generated by overly concerned paid professional helpers and profit-driven administrators, list of patients were gone through at treatment team meetings and a few folks were discharged early. Staff became devious skilled with their charting. Notes indicated that their people needed to stay the full twenty eight. Written signs of progress were no longer recorded. [N.B. I worked at a rehab. I saw this with my own eyes]. Staff by and large became concern trolls who were terrified at the prospects of anyone on their caseload being sent out into the cold, cruel world before readiness could be clinically established. There was no criteria for discharge. 

     In the time before there were rehabs and treatment facilities sprinkled all over America, the insurance companies did not want to pay for treatment for drunks, never mind those addicts who admitted to using street drugs. Politics happened and alcoholism was officially declared to be 'a disease' by the American Medical Association in 1956 so that physicians and treatment providers could be paid by the medical insurance companies. [see this: for one such view which also quotes the A.M.A. website in full. Also there, see footnote number 28]. Twelve step programs all over jumped on the disease bandwagon. 

     In 2013, The A.M.A. declared obesity to be a disease. [In 1998, the National Institutes of Health did so. [See this article for more:]. I have recently been 'treated' to a television commercial that staunchly maintained that obesity is indeed 'a disease.' My best guess informs me that this was done for similar reasons-- so that those providing treatment [including but not limited to surgical procedures such as lap bands, sleeves, and gastric bypasses] can be paid by the medical insurance companies.

     Frankly, I maintain with vigor that any sort of addiction or habituation is not in and of itself 'a disease.' I view all addictions as being conditions which may or may not have a disease process. This allows for a certain percentage of people who discover that they can indeed engage in their special hobby socially and safely at some time after their exposure to the addiction industry. Those people do exist, in spite of protestations otherwise. I suspect that usually by the time that someone comes to the attention of law enforcement personnel or medical personnel due to the effects of his or her special hobby-- be it over-eating, over-drinking, over-drugging, over-gambling, over-sexing, or any other overage-- it is most probably too late for that patient to moderate. That is only my opinion which means that I may be wrong.

     Addictions by their very nature have multiple and varying etiologies. Some folks started doing something too much because there is an obsessive side to their nature. Others report that their home lives were miserable or that they lacked the tools to effectively deal with some sort of major challenge presented to them so their special hobby raged out of control. There may be a genetic link to addictions in some people but we do not know that yet. [In an extremely general way, the younger someone is when a chronic condition develops, the more likely it is that a genetic component exists.] I've heard people identifying peer pressure, abuse, poverty, an un-diagnosed psych condition, grief, traumatic brain injury, a desire to fit in, genetics, and environment as various causes of their particular addiction. Any of these things may be causative, or they may be triggers [rather than causative] which pushed them beyond the point of social acceptability.

     When I was in my heyday of prolific partying, absolutely no one forced me to ingest any substance that I did not want to ingest. No one forced me to drink or use other drugs. I did that to myself. I did not wake up one day and declare to myself that I was going to strive to become addicted. I did enough of the stuff that I was doing to cause my body to warp out and I became physically addicted. At first, I was relieved to be deprived of the responsibility of what I had done to myself. I was told that I did not "do this" to myself. I was encouraged to believe that if my addiction did not happen as young as it did, it would have happened at any time that I started to drink or use socially later on in life. There was no way out of this being an addict. I was a victim of biology, or perhaps of a neurological process that demanded that I destroy myself through chemicals. I was slated to be trapped in addiction and that was the way of it. 

     I have a problem with that sort of excuse-making now. Anyone who used as much alcohol, pot, hash, pills, and other stuff as I did was bound to have problems. My using became just another problem on a long list of problems that I had. I suspect that had I not been in such a rush to alter my state of being with substances outside of myself, perhaps I would not have become an addict. I still think that if I had the gumption to directly address the problems that I was having as a young adult, perhaps my story would have had a different ending. But I didn't and my history is what it is.

     There was no return to social using for me. The moment I got my hands on as much as I wanted to drink or drug, I was off to the races. I tried to moderate my intake. I was not successful, period. 

     Most people are not addicted. The vast majority of people are not addicted to drugs, gambling, sex, food, or any other sort of physical thing or process. That is one thing that we do know. And just because I cannot safely do something, it does not follow that no one should do it. Thus, I am in favor of legalizing marijuana [especially since the drug cartels in Mexico stand to lose significant amounts of American cash if pot is legalized] and I am strongly against regulating what we eat via anti-obesity laws or fat taxes.

     During the times in my life that I have been overweight, I was the one who chose to eat more and exercise less if at all. No one forced me to consume massive quantities of food, period. There is not a commercial written that was capable of compelling me to go down to the local fast food shop and super-sizing everything that I ordered if I did not want to do so. I had to have the desire first. A commercial [maybe] might have struck a sympathetic chord in me which 'made me' crave something laden in salt, sugar, and fat. If I didn't have it in me to over-eat, no one or nothing could have forced me to do so. At the times in my life when I wanted to mess up my body via over-consumption of food, I did not care about the consequences.

     When someone like me is determined to give in to stuffing myself with something [alcohol, other drugs, or food], I don't think things like "I'll lose my health, my relationships, and life as I know it now if I do so." A fat tax will not stop me from consuming junk if I want to do that to myself. The law means nothing to me when I want to get f'd up. What stops me is me.

     Any changes that any of us make-- in order to be long-lasting changes-- are fueled with our desire to have something better or different or other than what we have now. We are not hapless victims of our environment. We are not incapable of taking care of ourselves. As adults, we have rights and responsibilities. When we do not take responsibility for our own lives, we become proficient in the language of victimology. To be sure, some of us had been victims of crimes committed against us. Part of recovery is to move beyond the state of victimhood into survivor mode and then into the state of thriving. Being stuck in the role of a victim limits us from experiencing the wonders of living. [Note: And we also become boring to others when we cannot successfully integrate and then move beyond the trauma.] When we refuse self-responsibility, we invite others to dictate to us how we ought to live. By necessity, that dictation is not self-affirming.

     By anecdotal evidence only, there were times when I wondered if treatment staff were collectively suffering from a group form of oppositional-defiant disorder. A mental health client wants a therapist of one gender and is automatically assigned a therapist of the other. An in-patient at the local hospital or addictions treatment center wants to go home and is pressured into entering a halfway house-- or a community residence if there is a 'serious behavioral health diagnosis'-- instead. Someone decides to return to school for pre-med. He or she wants to be a shrink. Oh no, you cannot handle that. Here's a job at a factory putting together urinary catheter bags. Fascinating stuff really. Take that job. You can start next week. I've seen things like this happen over and over again. I hope it's just my geographical location where helping professionals are like this but I don't think so.

     Now we have the increasing presence of a Spy Nation. First, build a huge facility to store all of the meta-data being collected on each one of us. Then carefully explain that it's really nothing. First, disarm as many citizens as possible. Then keep vast records on those who have guns. First, mess up the Internet. Then tell us that the censorship is really for our own good. First, make fast food the bogeyman. Then pass laws dictating what and how much we should eat. It didn't work during Prohibition. It's not going to work now.

     We live in a place that does not distinguish between hunger and over-eating. Here's a clue. I did not over-eat out of hunger. Most fat people also do not over-eat due to hunger or even due to concerns about when and where the next meal will come from. I did not come from an over-eating family. [I don't know what percentage of foodies do.] We are not so utterly powerless over our impulses that we are victimized by the advertisement budgets of the fast food restaurants in our neighborhood. No amount of laws or fat taxes is going to make a dent into the 'obesity epidemic' that we are facing in the United States. 

     If you want me to change, you have to give me some good reasons why I ought to change. You have to convince me to change. You have to get my attention. If your message is dull, I won't listen to you. If you take away my ability to order a large soft drink, I will find a way to drink as much of that soft drink if I want to. If you complain about the calories in a coffee-flavored drink with whipped cream available at a fast food chain but say nothing about the calories in a similar drink offered at the local upscale Starpukes, I will laugh at you and call you a hypocrite. Figuring that I should eat a diet chock-full of legumes, veggies, selected carbs, chicken and fish ignores the fact that I am allergic to fish and the fact that I have to eat beef three times a week in order to hold iron deficient anemia at bay. If you endeavor to tell me what to eat, I will ignore you and mock you. If you endeavor to tell me what to think, I will inform you that this is my life and not yours.



my three favorites among the stuff I read:

the rest:

and the worst of the bunch that I read, i.m.o.:

Thursday, 6 February 2014

Beating People Into "Recovery"

    I've been to many different meetings for people in recovery in many different places. The formats and the routines may be different. The message is the same: We can and do get healthier as we stop our self-destructive behaviors and/or addictions provided we are willing to do some work.

     The unfortunate reality observed in a subset of professional treatment providers and also in a subset of people who have an absolute belief in what has been been termed as "old-fashioned recovery" is the tendency to browbeat people into a mold. The perceived actions of what a vigorous recovery looks like to this outspoken minority is what is imposed upon the individuals newly abstinent. It is truly a small percentage of addictions counselors and a small percentage of the work-the-steps-immediately crowd of which I speak.

     When a counselor demands that a client profess belief in a higher power in a certain way, that is overstepping certain boundaries that should be in place. No one gets to dictate what form recovery will take for an individual. Yet, I have seen this happen more than once. A lack of belief in any gods, dogmas, or spirituality ought not be treated as a weakness to be re-mediated by a treatment plan. The counselor's beloved higher power and sincerely held belief system may not be appropriate to the client or the client may not be ready for it.

     When a visitor from out of town returns to a prior home group with stories of how much "better" recovery is where that visitor is living now, it is difficult to welcome the visitor back with open arms. The difficulty increases when that visitor takes a vigorous stand against drug courts. It gets worse when that visitor berates an anxiety-filled newcomer for not having a sponsor and not working the steps. 

     We know that voluntary treatment works. We know that people who are given the option of drug court over jail or prison time are motivated to choose drug court. We know that because of drug courts, folks do get funneled into the meetings and many of those folks stay even after they are no longer on paper. And some of those who don't stay come back after experimenting some more. [And a few die.]

sapphoq itching for a coffee says: If you believe that you are not 'god,' then how about taking a break from pretending to be the be all and end all of recovery. We used to say, "Bring the body and the mind will follow." We are similar enough to recognize each other as human beings and different enough to retain our individuality. So give yourself a break and resign from the divinity post. Remember that some of us may not be ready for your version of spirituality or it may not be appropriate for some of us. Have you no trust in the process?  Recovery and treatment plans ought not to be cookie-cutter in form and substance. Thank you.