Jessica Bliss

There were 192 substance abuse treatment facilities in Tennessee with 12,544 clients being served on March 31, 2009, according to the National Survey of Substance Abuse Treatment Centers.

That is a 27.5 percent increase from 2002, when 9,838 people were in substance abuse treatment centers. In that time, the number of people being treated for a drug abuse problem more than doubled.

Of those being treated in March 2009, 58.7 percent were clients for drug abuse, 13.1 percent for alcohol abuse, and 28.1 percent for both alcohol and drug abuse.

Alcoholics Anonymous meetings are designed around sharing, but even in recovery Lance Roy went a year without talking. On his third anniversary of sobriety he said a few words, but only because it was expected.

So perhaps it was out of character to find him on an East Nashville stage describing violent convulsions that once consumed his body and could only be quelled by a 9 a.m. glass of Bacardi. But it was also very real to him.

As a recovering alcoholic, he found catharsis in telling his story to a room of friends and strangers. “It’s important to share your story,” says Roy, 41. “Just to let other people know they’re not alone.”

Roy’s story is one of thousands, but so often they are not told. Addiction comes with a social stigma attached, generally regarded in society as a shameful flaw. Addicts and alcoholics are left with fear of openly acknowledging their problem, worried about how it will reflect on their families, friends and themselves. They pay out-of-pocket rather than use company insurance, fearful of repercussions from an employer. They join recovery programs where anonymity is strictly observed.

But there are those committed to eliminating the stigma. Former first lady Betty Ford, who died in July at age 93, was one of the first. Brentwood-based Foundations Recovery Network is another. The organization, which runs treatment centers in Memphis and California, has ignited a grassroots movement called Heroes in Recovery.

Aimed at raising awareness of the recovery journeys that take place every day, it hopes to encourage more people to be open about their drug and alcohol problems and to inspire others to get needed help and support.

“People are dying every day — right now — because they can’t get help, they don’t know where to turn or they are afraid to,” says Lee Pepper, chief marketing officer for Foundations Recovery Network. “There’s a skepticism around addiction. People still view it and say, ‘Well, they made a choice. It’s a lifestyle.’ We have to overcome that by getting people to be able to become courageous and share their stories.”

Addiction as illness

Of the estimated 23.5 million people who needed treatment for a drug or alcohol problem in 2009, only about 2.6 million received help at substance abuse facilities, according to the U.S. Department of Health and Human Services’ National Survey on Drug Use and Health.

There has long been a debate about the roots of addiction, with some believing willpower can overcome the problem and others, like the American Society of Addiction Medicine, defining it as a chronic disease.

Increasingly, members of the medical community are recognizing substance abuse as an illness, much like type II diabetes and types of cardiovascular diseases and cancers.

In July, the New York Times reported that 10 medical institutions have established accredited residency programs in addiction medicine, where doctors study the relationship between addiction and brain chemistry. The goal, the article said, is to “establish addiction medicine as a standard specialty along the lines of pediatrics, oncology or dermatology.”

Despite the medical movement, it’s difficult for many to equate addiction — a disorder that affects brain chemistry — to a disease like cancer, which attacks the body in physical ways such as tumors and, in most cases, is not linked to a person’s actions.

“I don’t think there’s any question that there is evidence to support addiction as a brain disease,” says Dr. Chapman Sledge, chief medical officer at Cumberland Heights, a drug and alcohol treatment center located west of Nashville. “But the acceptance is still woefully limited. ... People project their own ability to moderate and control and abstain onto people with this disease: ‘I can drink two beers and go home, why can’t you?’ There’s a real lack of understanding.”

One example Sledge uses to illustrate the difficulty people have accepting addiction as a disease is the story of former Major League Baseball outfielder Darryl Strawberry. In 1998, the World Series-winning player was diagnosed with colon cancer and his fan base rallied around him as he underwent chemotherapy. But when he had a recurrence of cocaine dependency, he was ostracized.

The pattern continues today as famous figures like Lindsay Lohan struggle in reoccurring recovery efforts. Two celebrities, Amy Winehouse and Jani Lane (former lead singer of the rock band Warrant), recently died after long struggles with addiction.

“We don’t have an icon of recovery as a positive role model of recovery,” Sledge says. “A lot of celebrities are in and out of rehab, reinforcing the idea that treatment doesn’t work, and that is not helping the cause with the general public. People are reluctant to step forward and tell their story because of stigma, and because people don’t step forward and talk about their recovery, stigma persists.

“We don’t have a Betty Ford right now, and that hurts.”

Ford is a good example of what can come from sharing a personal story. Not long ago, breast cancer was considered a woman’s shameful secret. In 1976, Ford openly acknowledged the disease. In 1982, Susan G. Komen for the Cure was founded. Although it took time to build momentum, today the pink movement is monumental, just as the LIVESTRONG movement for testicular cancer and the RED movement for HIV/AIDS awareness.

Pepper sees the Heroes in Recovery movement as having similar potential.

“I envision a day when somebody who is suffering will come across Heroes in Recovery, and they will find a story that speaks to them and they will say, ‘I am going to call for help,’ ” Pepper says. “That’s what it’s about; to get people to not be afraid.”

Breaking the stigma

Alcoholics Anonymous also believes in the power of the story, but privacy remains its primary tenet. The organization abides by the maxim: “Whom you see here, what you hear here, when you leave here, let it stay here.”

In meetings, alcoholics assemble at churches, libraries and community centers. People are encouraged to share experiences, but no one person’s encounters dominate the hourlong meeting. Although some have no problem stating their first and last names, others embrace anonymity.

The intent always is to provide a safe place for honesty, so that if people in recovery run into each other in public they can do so without fear. That obscurity extends to the media. In general, people are allowed to share their own stories, but never another person’s.

“Anonymity is critical, especially for someone new in recovery, because they haven’t shared the honest truths about themselves,” says a Nashville man who attends AA, has been sober 24 years and, in keeping with AA’s tradition, asked not to be named. “They come in pretty shame-based and pretty beat down by the disease.”

Still, some actively involved in the program feel like they are being concealed, which is, in turn, reinforcing the stigma.

“Ninety percent of your AA meetings take place in a church basement,” Roy says. “It’s like we’re hidden. ... It reminds me of some kind of underground movement from the ’30s and ’40s. ‘We don’t want the government to know what we are doing, we
are meeting in the basement.’ ”

Foundations Recovery Network’s movement is not intended to upend the traditions of Alcoholics Anonymous or any other recovery program that adheres to privacy, Pepper says, but the organization does believe there is legitimacy in openly attaching a name and face to an experience.

“I would not encourage anybody to break their anonymity,” Pepper says. “But there are people who want to come forward, and we want to provide a platform to build.

“This is not going to be an appropriate platform for everybody. We totally respect and support AA for what they have done, but we have got to challenge the way society views people who have an addiction or have a mental health issue.”

A shared journey

On a stage in East Nashville, Roy faced his own challenge.

The former brewer, who spent years mastering the art of yeast harvesting and learning about the bittering powers of hops and extraction agents of malt, now spoke openly about his alcoholism.

There were nearly 120 people there that night. About half knew his story. Alone in front of the group, Roy shared his experience with both humor and humility.

“I drank to celebrate,” he read from a self-penned essay. “I drank to calm my nerves, to chase away the blues, to cope with the stress of running a brewery. I even drank because — damn it — I deserved to have a drink.

“It had become a cure-all for me, sort of a modern-day snake oil. Drinking had become good for what ailed me, and I took my medicine daily.”

He told about mistaking the downtown public library for a bar and ordering a Bacardi and Coke. He spoke about his DUI.  Then he pulled out his journal, reading handwritten entries from his first three months of recovery.

After the show, a man Roy didn’t know well approached him: “I could never picture you as a fall-down drunk,” he said.

The statement made an impact.

“I really liked hearing that,” Roy says, “because it meant I have come a decent long way.”

Reach Jessica Bliss at 615-259-8253 [email protected]


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