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PostPosted: Fri Sep 13, 2013 1:00 pm 
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I read this this morning and thought it was encouraging.. finally someone who gets it. It's a rare thing.

Lamar Odom In a Fight For His Life

I am often asked during media appearances something to the effect of, “Dr Heath, why do people do drugs?”
The response I often wish to give goes something like this, “Because drugs work really well.”
Of course, I never actually reply in such a way. I usually dress the response up a little bit for public consumption, but the basic content of the response is accurate. People engage in drug use because they are in a lot of pain and drugs in some way mitigate that pain. Hence the reason it is so hard to watch from afar what appears to be happening to Lamar Odom.

It has been well chronicled in recent weeks what a nice person Odom is. I would share my own anecdotes, but they would simply be repetitive at this juncture as my experiences with him have been equally pleasant. Perhaps that is why the general lack of humanity around his struggles makes me even angrier.
A couple of weeks back, as Odom went through a Taco Bell drive-through his car was encircled by paparazzi snapping pictures. One dude kept cackling out the question, “Lamar, are you addicted to crack?”

When you step back from this scene for a minute it really does tell us a lot about our culture, and the results are bizarrely grotesque. Here is a grown man who by all reports is in crisis surrounded by other grown men taking pictures of him and asking him intensely private questions. If you’re like me, it might be hard to decide who needs more help in this situation, but I digress.
Maybe it’s the fact I’m around addiction everyday and have worked with people struggling with addiction for over a decade, but I am always shocked at the general lack of knowledge and understanding around this process when a case like Odom’s is thrust into the public eye. I have heard and read people making character judgments, citing a lack of discipline, blaming income level, etc. The list of “causes” never seems to end.

In truth, addiction does not discriminate. Moreover, the one variable I have discovered over the years that is almost always present prior to the start of an addictive process is none of what was listed above. Instead, it is psychological trauma. When an individual has encountered a trauma that exceeds his or her coping resources, that is often when he or she begins abusing substances. The reasoning is simple: drugs make the pain go away. It would actually be a decent short-term way to cope if drugs didn’t have such horrible long-term consequences.

Noting that abuse often starts when coping mechanisms are exhausted, it might be easy to make the inference that people should just create more or better resources to cope. On the surface that sounds like a good plan, but the problem is that particular events are all but certain to exhaust the coping resources of even the most well adjusted people.

Take for example the loss of a parent at a young age. Young people often understandably do not have the resources to adequately deal with the death of a primary caregiver. The same can be said about children who live with parents who are addicts themselves and the stress that causes the family. As a final example, an adult losing a child can be the kind of trauma that no one is truly prepared to deal with.

The aforementioned traumas are just a few examples of life events that can completely deplete one’s ability to cope. They also just so happen to be traumas that Odom has personally experienced. His mother died of colon cancer when he was 12 years of age. His father, according to multiple accounts, struggled with heroin addiction when Odom was a boy. Finally, Odom lost his 6.5-month-old son Jayden to Sudden Infant Death Syndrome (SIDS) in 2006. Just one of these traumas is enough to profoundly impact someone and make them vulnerable to addiction. Keep in mind that these are just the traumas Odom has experienced that we are aware of; there most certainly could have been others. Furthermore, we know that addiction has a strong genetic component and given the fact that Odom’s father struggled with drug addiction, this only increases his risk.
Inevitably, someone will say something like, “Well, he decided to try that drug for the first time and that was a choice.” While this is indeed true, it shows a remarkable lack of sophistication for the process of addiction and a lack of understanding of psychological trauma (not to mention a lack of empathy).

For Odom to heal, kicking the addiction is just half of the battle. Part of this process is indeed physiological. Cocaine, which it has been widely reported is the drug that Odom is struggling with, is an indirect agonist. In short, this means the drug blocks the reuptake of the neurotransmitter dopamine causing a short period of euphoria when it is initially consumed. Each time the drug is ingested, that feeling of euphoria decreases a little and eventually the drug is needed just to help the person reach a baseline or “normal” mood rendering the person virtually dependent on the substance to function.

The more difficult part of the struggle for many people after they have been physiologically stabilized is working through past psychological traumas. Addiction has an amazing ability to coerce people into doing things against their better judgment. Often the ways in which people dealt with trauma in the past was to ignore or avoid it. Processing the trauma, looking it straight in the eye, can initially be a terrifying experience. However, it’s a crucial part of the healing process that can open up reservoirs of strength and resilience the person was initially unaware existed.

There is no doubt Odom has a long road ahead, but it is absolutely not an impossible one. It would appear from all accounts the situation is becoming increasingly dire. The unfortunate reality of addiction is that it runs a chronic and fatal course if not treated (and even after good, sustained treatment the threat of relapse is ever present). In short, if Odom doesn’t get help, he will die.
There are millions in the world struggling with addiction everyday. Odom just happens to be going through it with the spotlight of a sick culture on him. This adds another layer of complication to getting and staying clean. Whatever the outcome, hopefully the leaches of reality television and tabloid journalism can relent at least long enough to give him a fighting chance.

Read more at ... AduFLGf.99

PostPosted: Fri Sep 13, 2013 1:53 pm 
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Thank you for this Tiny. I have been following his story on the news lately. Great reading!
Karen xoxo

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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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