David Altshuler, M.S.
(305) 978-8917 | david@davidaltshuler.com

Parson D’Ascoynes: How do you find the wine?

Louis Mazzini: Admirable.

Parson D’Ascoynes: Cockburn ’79.

Louis Mazzini: Oh.

Parson D’Ascoynes: No finer year, in my view. My doctor though, is of a different opinion.

Louis Mazzini: And what does he favor?

Parson D’Ascoynes: Abstinence.

Abstinence indeed. Easy to articulate, harder to achieve. Alcohol, benzodiazepines, nicotine, gambling, anger, sex—addiction is defined as continuing behavior despite negative consequences. I’m going to start with a minor example and extrapolate to advice that may be more broadly beneficial.

Will this be the day that I follow through on the promise to myself and dispose of the Oreo cookies lurking in my pantry, cream-filled Sirens luring me toward the rocks of arterial sclerosis? Will February 22nd--seven weeks after traditional resolutions are made—be the day that I finally pull myself up by my bootstraps and toss those treats in the trash?

Surely, I am not addicted to those chocolate carb-magnets. Clearly, I could have a yummy orange for a snack or forgo dessert. I am a grown man; I have free will. I have run ultra-marathons for goodness, gracious sake. It’s not like I haven’t accomplished difficult, pointless tasks in my life—graduate school, hiking the Appalachian Trail, raising children, rooting for the Dolphins. I ran 50 miles on a hilly course, for goodness sake. My self-discipline has self-discipline.

Yet, somehow every day those desirable treats speak to me, and I answer their fragrant call.

To be fair, I do manage to walk past the mountain of Oreos dozens of times every day. Not before dinner I say to myself. Think about your blood pressure. And on days when I do eat Oreos, I only eat two or three. It’s not like I’m binging an entire box. My self-discipline may have self-discipline but, apparently, my excuses have excuses.

But you and I both know that the only way for me to stop eating Oreos is do dump the entire container. One time. All at once. I don’t have the fortitude to choose not to eat Oreos ten times out of ten. But I do have the ability to one time empty the lot of them in the trash.

Which is one of the many reasons that outdoor behavioral health can effect meaningful change for young people with substance use disorder or addictions that are more immediately harmful than those of black and white cookies. If Johnny has to choose repeatedly not to swallow a handful of benzos, he might make the right choice nine times out of ten: Xanax is disrupting my ability to perform in school; Xanax makes me feel foggy; Xanax is a bad plan. But the tenth time harms him and makes subsequent use more likely and even more troublesome.

As an adult in intensive outpatient treatment, he can make one decision: I’m going to check out of this facility and use. But in wilderness therapy, he has to make a series of several (poor) decisions: I’m going to check out of the program; I’m going to walk 12 miles through the snow; I’m going to find my way to the nearest town; I’m going to ask someone for money to make a phone call; I’m going to connect with a friend who is willing to lend me money; I’m going to take an Uber to the airport; I’m going to stay on someone’s couch; I’m going to use.

Each of these steps is difficult enough. The combination is more than most young adults can accomplish. Making one decision—enrolling in an outdoor program—takes tremendous courage. And staying clean can take on a momentum all its own. Overcoming the inertia of that first day without using is as admirable as it is worthwhile.

As a adult whose struggles have been with carbohydrates rather than chemicals that rewire the brain, I may not truly understand craving. Perhaps I don't have the standing to make comments. The necessity of substance use has been likened to the need for oxygen. I do know that the best way to stop is not to start. And I know that food issues are different from chemical addiction--you can live a long, healthy, productive life without ever taking another opioid, but it's hard to go more than a few days without food. Just the same, I am going to stand with those who have overcome their reliance on substances that are bad for them by putting those Oreos in the garbage and taking the bag out to the curb.

There. It's done.

Let me know of your accomplishments in this regard. Let's celebrate one another!

See you next week.



One thought on “Steps

  1. Michael Festinger

    Hi David, You’re on the right track. You’ve admitted a problem with those carbs. Now, if you need help not buying the next package of Oreos (or Haagen Dazs) give me a call and I’ll point you to professionals if necessary and personally share my experience. Support from people with common experience is very beneficial as are steps after that first one.
    Wilderness therapy or remote locations of treatment centers or anything that will give a person a chance to pause and help separate them from the first drug or drink are great as long as the environment is safe.

    Always good to read your thoughtful ideas my friend!

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