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Trigger warning:
Contains frank discussion of substance abuse, treatment, and recovery.



Shake someone’s hand and recite that introduction, “Hi, my name is Mark and I’m an alcoholic” at an AA meeting, and that years ago you used to drink vodka every morning to stop the shakes,
praying you wouldn’t vomit, and you’ll receive a warm blanket of support, understanding, and acceptance.

Do it at your next job interview or when you meet your fiancés parents—well, not so much.

September is national recovery month, which exists “to promote and support new evidence-based treatment and recovery practices, the emergence of a strong and proud recovery community, and the dedication of service providers and community members across the nation who make recovery in all its forms possible.”

I’m here to talk about addiction and recovery, including some writer specific pitfalls, and how we can make recovery more accessible. I write this coming from 30 years of sobriety, a Master’s Degree in counseling, and 25 years working in behavioral health, much of that in substance abuse treatment. (Disclaimer—doesn’t mean what I say can’t be called out as bullshit.)

One step to destigmatize addiction would be to increase empathy for what it means to be an addict. (I use addict and alcoholic mostly interchangeable, because I think the concept that an
alcoholic is not as bad as an addict is actually a core stigma—for an alcoholic is an addict.)

There is a proven genetic predisposition for alcoholism. That does not mean that all addicts are born with ‘bad genes’ but many start with DNA that makes them process substances differently
from the start. No matter what the nurture, it’s their body’s nature to scream, kick, and cry for more, whereas the next person may naturally say Hell no, I’ve had enough.

None of us can be faulted for the DNA bestowed upon us.

And there is always something beyond an addicts’ control, if not genetics, that leads to the disease of addiction. Social determinates of health that suck people into the black hole of seeking
refuge in substances, and nearly any living soul who was born into that situation wouldn’t be able to escape.

I was the perfect victim. I grew up watching a family where drinking was synonymous with fun. Holidays were extra drinking. A long line of alcoholic men. Add that I was a sad, lonely and
scared little boy, by the time I had my first drink, age 12, it was love at first sip. When the feeling hit, my soul shuddered with delight and my inner voice whispered “My God! so this is what life can be like? I want this. I need this.”

Right away I knew. It felt like I finally fixed what was wrong with me. I was on a mission. By age 18, I was drinking every day and had used every single drug I’d even seen. (and I’d seen them all). By age 20, I was drinking every morning. By 23, my internal organs were swollen and bleeding, and I didn’t want to live any longer.

This process where the first use of substances leads to abuse and then to dependence can be found in the DSM— the bible of diagnosis (For a clinical but helpful explanation of a substance use disorder diagnosis, click here)

As drinking and drugging becomes a preoccupation and higher importance in our lives, it inevitably begins to impair life functioning, yet an addict will continue to use despite these consequences. Failed attempts to quit or limit use follows, and tolerance becomes super human. The same amount that used to get us high now just makes us feel normal.

Cravings get more powerful. It feels like each living cell in your body has a mind of its own, figuring out ways to drink and drug to stop suffering from the painful affliction. The relief from suffering is a high in itself.

While all this may seem extreme, it’s a good time to note: these symptoms do not need to happen to everybody. Everybody doesn’t hit rock bottom, but everyone in recovery has found some bottom that leads to them seeking help. And while society may treat addiction as just a failure of ethics and morals, creating undue burden and blame, we are indeed still responsible for our recovery.

Buried somewhere deep in every addict’s heart there is the daunting truth that they need to change, that their dependence on a substance is out of control and they can’t quit on their own. I can’t express how terrifying it is to ask for help. It’s shock of shame to an already suffering spirit and threatens the one and only thing that comforts us.

Asking an addict to live without drinking or drugging is asking a fish to exist outside the sea, for the desire to use substances equals the life force itself. It feels necessary for survival the way a
drowning man aims to breath. An addict’s mind is hijacked to deny itself of its problems. Years of rationalizing the act of destroying ourselves in order to keep drinking and drugging does not go away lightly.

For myself, this meant the worse my drinking became, the more grandiose notions I had to concoct to deceive myself that I was in control, believing myself the master versus the puppet. I became the unreliable narrator of my own condition, effectively telling others; “Why will you say that I am mad?” (to quote Poe) “The cocaine/vodka/crystal meth has only sharpened my senses, not dulled them.” (to paraphrase Poe)

Even in the process of starting some form of treatment or therapy, an addict’s brain will respond to the threat with more insidious whispers inside our brain — you know you love drinking and
drugging and you can’t live without it. It’s the only thing that gives you comfort. The only thing that makes you happy. So go ahead and fool everybody else. Make them think you’ll change, but in the end, it’s me and you, like always.

It’s cunning, the voice of addiction, and this is the battle we face when trying to champion the cause of recovery. Euphoric recall and an innate biological urge overrides the mountain of
evidence that each time you pick up a drug disaster awaits. I crawled my way into detox half a dozen times but relapsed soon after, one time stopping at the liquor store on the way home. It
took three weeks of residential treatment followed by months of outpatient therapy (of which I’m still a fan) and a lot of lifestyle changes.

But the miracles happen. They do. I experienced it, and I’ve witnessed it. While you are reading this, someone just celebrated a year sober. Their parents, who had been rehearsing how they would respond to their child’s death (I’m sorry Mrs. Matthews but we found a body) are in tears of joy. The future is wide open. All of this after they’ve gone through a hell as ferocious as you’ll read in any horror novel out this year.


Professional levels of care go from outpatient therapy; seeing a therapist 1-2 times a week, to intensive outpatient programs, which are typically group counseling 3-4 times a week, to detox
and residential programs, where you stay overnight. Detox is often medically necessary, because quitting alcohol if you are drinking daily can be life threatening without a taper such as Librium or Ativan. And there are very few humans alive who can withstand the painful detox of opioids (heroin, oxycodone, vicodin) without the comfort of medications such as suboxone.

And medication assisted treatment continues past detox, where there are now medications such as Naltrexone proven to reduce cravings for certain substances.

Community support groups are evolving, where AA was once the only game in town, treatment centers are now becoming more expansive, including groups like Buddhist Recovery Network and Rational Recovery.

But just getting it out of your system is hardly recovery, for the monkey may be off your back, but the circus has not left town. Recovery is what helps you find an emotional center, for if the shit builds up, the damn is more likely to break. I’ve always found that living in reality 100% of the time is what makes recovery hard. It requires patience and persistence. Patience to ride out uncomfortable feelings or situations. And persistence because if you ride out the hurricane, there’s something amazing waiting. Rainbows after the deluge have a unique kind of beauty. If I could speak to my former self, or those currently suffering, I would offer assurance of how staying sober can eventually become a natural state, the same way getting high used to be the default. Cravings still happen—my mouth still waters over gin and juice and my spine feels an electric jolt when I see someone snort cocaine on film, but it washes over me and passes. Way less flood, much more rainbow.


I do think there is something about creatives and empaths that make them more likely to succumb to addiction, and maybe moreso with horror writers. My take is horror writers have the
finest hearts around, for they are in touch with how fragile the human spirit can be when faced with the terrors of this world. I suspect writers feel things deeply, across the spectrum, and often
have their own trauma they are working out through their fiction. Certainly, there is a desire for uninhibited self-expression as we dive into the darkness. These are the ingredients for the kind of person who may need the solace or spice that a drink or drug may provide.

There is certainly a plethora of alcoholic writers as role models. We’ve romanticized the idea of artists imploding for their art. The mad, creative genius, full of passion, knocking out magnificent works, writing drunk, then editing sober. You know the trope. I wanted to be Jack Kerouac growing up, howling in the alleyways with drunken passion.

I can still admire his passion—On the Road is still my favorite book. And I don’t begrudge anybody their drug or drink (I’ll buy you a drink at Stokercon). I also don’t regret my own years of drinking and drugging, for it had such sights to show me, but I’ve since come to realize, never meet your heroes by becoming them, or parts of them, since you may realize how sad, cold and
alone they really feel.

Writers may fear that getting sober will make them less creative. I certainly did fear as much, and that getting sober was ‘selling out to the man’ and I’d lose my edge.

What I learned instead is there is something uniquely edgy about being clean and getting into recovery. When I was using, I was becoming a damn cliché. A trite, miserable, gross blob, living every day the same, only a little bit worse. But recovery brought me so many glorious highs, literally from different ends of the earth, from British Columbia to China, to starting a family, running a dozen marathons, and once in a while, writing something worth reading.

This is the joy of recovery to celebrate. The adventurous spirit remains, as does the creative spirit. I am just was weird as I ever was. I still think stoned thoughts. And there is not enough
time in the day for all the things I want to do. And recovering means the chance to do them, for addicts sure are not lazy, hell no. It takes way more effort to go through a week of getting high and getting by than it is to work a paying job.

Recovery brings loved ones back from the dead. It returns children to parents and parents to their children. It’s beautiful and miraculous. I’ve seen the sparkle in the eye, the glow of the spirit
flowering inside, versus the despair and despondency that had taken root. I’ve seen kids of all ages visit treatment centers to visit their mom or dad, and the trepidation in their feet, the fear they try to hide but can’t, and the joy when their parent is given back to them, by degrees, over the months and years that follow.

So Happy Recovery Month! Raise a glass to freedom, and treat it like the miracle it is.

Mark Matthews is a graduate of the University of Michigan and a licensed professional counselor who has worked in behavioral health for over 25 years. He is the author of On the Lips of Children, All Smoke Rises, and Milk-Blood, as well as the editor of Lullabies for Suffering, Garden of Fiends, and Orphans of Bliss. In June of 2021, he was nominated for a Shirley Jackson Award. His newest work, The Hobgoblin of Little Minds, was published in January, 2021. Reach him at WickedRunPress@gmail.com

LINK: https://webcampus.med.drexel.edu/nida/module_2/content/5_0_AbuseOrDependence.htm

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