Friday, November 6, 2015

Chris Christie on Drug Addiction

Were you moved by Chris Christie’s soliloquy about drug addiction? Christie is a great communicator and he offered some emotion-laden words about drug addiction in New Hampshire the other day. The video, dutifully reproduced here, has gone viral. Millions of people have seen it. I trust that they have all been moved as much as you and I have.

Christie was arguing for drug treatment. He was arguing against those who believe that addicts should not be treated. Unfortunately, this is a straw man argument. Everyone is in favor of more treatment for people who abuse drugs. No one really believes that we can solve the problem by tossing drug addicts into jail.

Speeches that appeal to our emotions often induce us not to ask too many questions. If you do, you start sounding unsympathetic, lacking empathy. The more emotionally moving the speech the more likely we are to believe it; we let our feelings guide us and we take it on faith.

For those who like to come to the defense of feelings, I am suggesting that if you feel yourself being moved emotionally, you ought not to give in to the Siren Song, but should step back and think, hopefully rationally and objectively. No one can practice therapy or do any consulting if he believes whatever he is being told because it tugs at his heartstrings.

Anyway, Christie begins his argument with a story about his mother. His mother was a smoker; she tried everything but could not quit. Then she got lung cancer. He continues that no one at the time and no one today would suggest that she not be treated because she “deserved” to get lung cancer.

But, shouldn't we distinguish between people who get sick by consuming a legally available substance and those who get sick by consuming illegal drugs? The difference, not very subtle at that, lies in the fact that the one got sick by engaging in a legal economic transaction and doing something that was socially acceptable while the other got sick by engaging in a criminal act.

And perhaps we should add that people who smoke often function perfectly well in society. Nicotine is an antidepressant. It does not compromise your ability to do your job, to love your children or to be a good spouse. Alcohol is slightly different because in small quantities it can function as a social lubricant. In large quantities it can compromise your ability to function in society.

True enough, no one ever suggested that smokers not be treated for lung cancer or emphysema. But, the treatment available for smokers contains one important element. One reason why fewer people smoke today is that smokers have been shamed; they have been accused of costing the health care system too much and of poisoning other people; they have become social pariahs.

It is much easier to quit smoking when smoking makes you an outcast.  Christie suggests that his mother tried everything… every treatment that was available. Apparently, the treatments were not very good.

If he is suggesting that we ought not to think that people who smoke or smoked were responsible for their behavior, how do you expect people to overcome addictions when you are telling them that they are not responsible for what they are doing? You cannot get over an addiction by allowing someone to do something to you. You cannot get over it passively by undergoing brain surgery. The addict has to do most of the work and to be actively engaged in the treatment.

If you tell people that they are powerless to control their addiction you had best be able to show them how to use a higher power to overcome it.

Christie next suggested that we all believe that people who are addicted to heroin and alcohol have gotten what they deserve and that “we don’t want to treat them.”

I am not sure that it’s about what we do or do not want to do. After all, 12 Step programs exist across the country. They are open everywhere. You do not even have to pay to go. They are reasonably effective when participants attend meetings and follow the program. For those who do not, recovery is less likely.

The problem is that 12 Step programs are something that you can do for yourself. Regardless of whether anyone wants to treat you. I would add that while some physicians wholeheartedly support these programs, many merely pay them lip service. After all, AA meetings are free and that’s not good for business. Bad-mouthing AA does not help recovery.

Anyway, Christie became even more emotional talking about a law school friend of his, a man who had had it all. The man went to an Ivy League school, was the editor of the law review, was the first to get a job, married a woman doctor, made more money than his friends, had three wonderful daughters, had a great house, a nice car and was even good looking. He was in great physical condition.

And then one day he hurt his back and his physician gave him a prescription for Percocet, a narcotic. He became an addict and his life fell apart.

A year later, as Christie tells the story, he was addicted. His wife, the physician called Christie to tell him that her husband was an addict and that she had kicked him out of the house. Apparently, he would not listen to her and that meant that he deserved no sympathy from her. She wanted his old buddies to do an intervention and to get him to go to rehab. They did; he went; and he went and went. Over a ten year period he was constantly in and out of rehab.

In the meantime, his wife divorced him, he lost his law license, he lost his drivers’ license, he lost the right to see his children, he lost most of his savings and he lost the condo he bought to live in. The man ended his life in a cheap motel by downing a bottle of vodka with a bottle of Percocet pills.

To which Christie concludes: “He couldn’t get help and he’s dead.”

Now, step back and take a deep breath. We only have a sketch and risk drawing the wrong conclusions from having too little information, but some things we can assert with some certainty.

In the first place, the man did get treatment. He did get help. He was in and out of rehab for a decade. To say that he died because help was not available is absurd on its face. The problem is that the treatment was ineffective. Somehow or other those who believe that treatment is a panacea for addiction never ask themselves whether the treatments work. Apparently, they do not… with very great regularity.

Also, this man falls within the category of those who are addicted to prescription medication given by a licensed physician. One does not know how he kept getting prescriptions for a controlled substance, though one assumes that he bought it on the street. And one is obliged to remark that when your physician is your pusher you are less likely to accept his advice about how to get off the drugs that he gave you. Besides, isn’t a physician’s role to get you to take your medicine? After the first prescription, was the physician alert to the possibility of addiction? We do not know.

As unpleasant as it is to say, we must also ask what kind of support system the man had As Christie describes it, once his friend became addicted his wife tossed him out as though he were trash. Might she, a physician, have been more caring, sympathetic and supportive? Was she practicing what is called “tough love?” If so, it clearly did not work? What did the man do to lose the right to see his children? Did it help his recovery that he was treated like a complete pariah? When he bought a condo, whose idea was it to take that away from him too?

We do not know all of the details, but, frankly, this man had no support. And it is extremely difficult to conquer an addiction if you have been abandoned by everyone you love.

The man had nothing left. He was destroyed, and not just by the drugs. For my part I cannot avoid thinking that he was treated horrendously by his wife. When he would not listen to her, she threw him out of the house. Then, she divorced him, made it impossible for him to see his children, and must have been instrumental in taking away the condo. One suspects that he himself was responsible for whatever he did to lose his law license and his drivers’ license, but, in the end, he had nothing left to lose.

It’s nice enough to think of treatment as some pill that some physician gives you. But, consider another sense of the word “treatment.” How did other people treat him? Did they provide refuge? Did they provide a place where he could go to get a meal or to spend some (supervised) time with his children?

This man did not just kill himself because of drugs. He killed himself because his life was over. Social support systems count enormously for people who become addicted to drugs. When the addict loses all of them he is very unlikely to recover at all.

Christie believes that we do not give addicts the tools to recover. And yet, he was in rehab over and over again. Which tools was he lacking… except perhaps the support of a loving family.

As for Christie’s final point, namely that it could happen to everyone; it is simply untrue. Most people are not everyone. Telling them that it could have happened to anyone removes their responsibility and makes it more difficult for them to work their treatment.

Many people are given prescriptions to opioid substances. They do not all become addicts. When you say that it could have happened to anyone you are saying that the man was not responsible for his actions and that his family was not responsible for theirs.

Christie says that we should stop judging addicts. But, when this man’s wife threw him out of the house and took away everything that he loved, wasn’t this a type of judgment? Wasn’t she saying that he was hopeless and could never recover? Did she believe that his greater crime was not doing what she told him to do?

True enough, if no one judges you ill for being an addict you will have a problem. But, if no one offers you a refuge, a place where you can feel safe and optimistic about recovery, you will also have a problem.

The unfortunate part of Chris Christie’s heartfelt soliloquy is that so little of it makes any sense. 


JP said...

I suspect that the problem with law-guy addict here is that his entire career/lifestyle primed him for this fiasco. I also suspect that he entire edifice of his life was fragile. The practice of law often dissolves social support systems.

This seems pretty normal for so-called high powered law people.

His wife probably had no idea whatsoever how to deal with it. Quite possibly because solving the problem would require him to find a new profession.

I really need to start a blog on lawyer suicides to actually track the stupid things, including this type of slow-motion suicide.

A nice law guy, Tim Coleman, launched himself off of a building the other day in DC.

Anonymous said...

Addiction can be seen as a reenactment of a codependency relationship that does not meet one's authentic needs. So can therapy.

In as much as the causes of addiction are rooted in social mystery there is some truth to the idea that it could happen to anyone. There is a sample in society that becomes addicted and there is no deterministic model to describe why those people, and not others, become addicted. Thus addiction appears to be random and could happen to anyone. A person who has many conversations with or treats addicted persons might see a causal pattern however this is an expert judgment and not an empirical model. A person like Governor Christie probably regards the process as random and somewhat unexplained as to how one person becomes addicted and others avoid this condition.

Anonymous said...

I think it's unfair to lay so much blame on the friend's wife, since we have no idea what she was dealing with day-to-day with an addict husband spiraling downward. She had 3 kids, a career in medicine, and her sanity to protect.

Anonymous said...

Here is a blog describing work with 12 step programs:

And a post regarding efforts to overcome work aversion:

Stuart Schneiderman said...

In part, I agree with Anon 8:32... we do not know what the wife was dealing with. We only know the way Chris Christie presented it. And yet, it seems to me that tossing him out of the house and refusing to let him ever see his children under any circumstances is unduly harsh. And how was she protecting her sanity by taking the condo he was living in. One must ask what the role the courts were playing... but clearly, her hostility toward him, her willingness to toss him out with the trash contributed mightily to his decline. Shouldn't someone with a career in medicine have had some feeling for a man who was suffering from an addiction? I suspect that she put her career first and could not be otherwise bothered. We do not know it all but I suspect that if we did it would not look any better. She would probably look worse.

Ares Olympus said...

I agree its easier to suggest "we need to care more for addicts" than to know how to help them, or believe some new expensive program is going to do better than the voluntary programs like AA.

On the other hand, my brother did benefit by going through a 6 week "locked in" program for addicts, heroin and meth, which must be expensive. The first time got him clean, and it was being homeless in cold Minnesota winter that get him in, but it did not convinced he had a problem, and it took a single weekend visit to a friend to find out he had no self-control, and it might have helped that he let her his car, which she immediately crashed and totaled and lied about what happened, that it wasn't her fault. The second time he went in was a second cold winter, and he changed to idolize the counsellors and believed he had found his calling, and wanted to be one to help others escape the grips of drugs.

So drug addiction is destructive, and costly, and perhaps treatment is futile in many cases, and the best we can do is to find treatments that are cheaper than prison, which really is the ultimate waste of money for nonviolent people.

Meanwhile, perhaps as long as it was minorities and "losers" who were drug abusers, we could just blame it on them, but now that Whites are the leader, people like Christy can more easily push for compassionate approaches.

My brother would never talk about drug usage in the present, but he'd confess usage in the past. And I remember being shocked at one "meeting" with my dad included that my brother said sincerely that he felt the best when he was married and using the most drugs. Being married meant he had more disposable income, and in his mind his wife was only upset because he spent too much time with his "friends" which he didn't think was fair, just because she was a homebody. I don't know if she ever knew how much drugs he used. All that was clear to her is he always had excuses why he needed more money, and she was paying the majority of the bills on an only slightly higher income.

So the main "lesson" I learned from my brother is that addicts are "pathological liars", and they lie not just when they're in danger of being caught, but they'll lie just because its how their mind works. Their lies aren't even meant for anyone else, or to hurt others, but saying them outloud merely helps an addict believe them, as long as they can convince one person they are "trying their best", they can get the world off their back, and go back to what they need to feel better.

And all in all, we can accept its not the drugs that are the problem. Drugs are a coping mechanism that makes life bearable, while adding new problems, and alienating people who are trying to help you, so a downward spiral.

Real help obviously has to come in helping young people develop skills - in resisting peer pressure, in being assertive, and in recognizing their emotional states and finding better ways of coping, called "Emotional regulation".

I was looking again at Dialectical Behavior Therapy which was mentioned earlier in the year. It surely has some truths for all of us.
l Dialectical behavior therapy (DBT) is a therapy designed to help people change patterns of behavior that are not helpful, such as self-harm, suicidal thinking, and substance abuse.

I imagine is always easy to find some new idea that seems to work, and run with it, too far, too fast, and end up with incompetent implementation.

But anyway, I'm with Christy if he's saying we need to invest in people, and it costs time and money to do so, but it may cost more time and money to not invest in people, and pay later, especially in regards to criminality and imprisonment.

Anonymous said...

Stuart you may find this related article of interest. Apparently death rates are rising only for middle aged white Americans, and statistics indicate that poor people without college education are dying from suicide, drugs, and other problems in living:

Johnnie Smith said...

I have been struggling with addiction my entire life. It wasn't until they had an intervention and I saw while I was sober how my life has had a negative impact on the ones I loved, I was literally shocked into sobriety. I never again want to see my family crying because of the stupid things that I have done.

Johnnie Smith @ Ranch Creek Recovery