Seattle’s Book-It Reparatory Theater has adapted a memoir about being a musician, heroin addict, and drug dealer during Seattle’s grunge era titled American Junkie. It’s an incredibly raw take on addiction, something that’s familiar to both the music industry and to Seattle, then and now.
We spoke with several people on addiction and recovery, and on solutions: Tom Hansen, the author of American Junkie; KEXP DJ Marco Collins — he championed Seattle grunge artists when he worked for Seattle’s 107.7 The End in the '90s and has struggled with cocaine use and alcohol; and Caleb Banta-Green, a researcher at the University of Washington’s Alcohol & Drug Abuse Institute and an affiliate associate professor in the School of Public Health. He started working on issues related to opioid addiction and HIV in Seattle in the mid-’90s.
Listen to the segment and read some of the highlights below. The show is running now through March 10th.
TOM HANSEN: The opening scene of the book and the opening scene of the play is when I'm sitting there in the bed, I'm shooting up in my hip. My hip is all screwed up. I haven't been able to walk for weeks, haven't been able to get out of bed for weeks. And I had been thinking about picking up the phone and calling for help because I wasn't so far gone in my denial that I didn't realize that I was in bad shape. I weighed about 100 pounds — or a little more — and I'm 6'1". You look at those pictures of those concentration camp people and that's what I looked like. But the thing that finally made me pick up the phone and call for help wasn't a conscious decision that "oh gee, this is bad. I better stop doing this." It wasn't that. I don't have an explanation for why that happened at that time. I thought about it every day for weeks that this has got to stop. I need to do something, I need to call for help, and I don't know why I finally did, except it must have been some deep, deep survival instinct kicked in.
MARCO COLLINS: Currently, I'm a year and five months sober. But I've struggled for two decades with addiction issues and it got really bad in the '90s because I kind of had walked away from half the job. I was the music director of a station and I was a DJ. So I would work all day long. And I quit being Music Director and they didn't reduce my pay. So, I was still making great money, only having to work four hours a night. And when you have that kind of time on your hands and you're an addict, it's just not a good scene at all. So things got out of control, really out of control in the late '90s and then I left [107.7] The End and took a job in L.A. One of the requirements in going to the new job was that I had to go to rehab first. And that was my first rehab experience and not the last by any means.
CALEB BANTA-GREEN: One of the things we know through research is that one of the biggest factors associated with substance use disorder or addiction is childhood trauma. The fancy words for it are "adverse childhood events." But the more bad stuff that's happened to you as a kid, the chance of you having addiction eventually skyrockets. On the front end, what it means is that if you know a person has a history of trauma, you know, really being mindful of that and doing your best to hook them up with sort of the right services and care early on in their life. It's difficult to navigate that on your own because you have issues around identity and "am I worth it." You have issues around mental health, anxiety, and depression. And then depending on where that trauma is happening — if it's in the context of family — you may not be seeing a healthy way to live. The challenge is once you start on that path of recovery and you start feeling normal again, then hopefully you can start getting some of those other services — social support, really good trauma-informed counseling, all these other things — because once you start feeling normal again, normal is also scary because now you've got to deal with life again.
MARCO COLLINS: The last year and a half have been hell. I joke about it but thank God I’ve got enough support around me that I understand that the first couple of years of sobriety are hellish because you are dealing with being you. Being comfortable in your own skin is not something I have ever been, ever. And when I used or drank, it was just a way to escape feeling like that. Just feeling uncomfortable. And I just kept taking it to the extreme because if I can feel this much more comfortable if I add more drugs and I go for longer, I can basically stay in that comfortable zone for a long time.
CALEB BANTA-GREEN: What happens when these drugs hit your brain: [If] you take methamphetamine, you're getting a massive hit of dopamine. You can't replicate that with pharmaceuticals. Opiates [give you a] massive hit of morphine or endorphins. We talk about endorphins — that word "endorphin" actually means endogenous morphine which means morphine that your body makes. We're predisposed to respond to these substances and they feel really good. There's a reason people use drugs because they feel really good and they help people escape. I think an analogy I kind of like is the idea of a rollercoaster. And the idea is, it's kind of like when you first get on a roller coaster and you've got that rush and it feels really good and going up and down and having these thrills and maybe have a little normal in there in between the peaks and valleys, but eventually you can't get off the damn rollercoaster. And so at the peak, you're no longer feeling great, you're just feeling less worse, and that's sort of the irony and horrible part of addiction is you start off using to feel good and you end up using to not feel bad.
CALEB BANTA-GREEN: I think the fundamental piece around stigma is that people think people want to be addicted and don't want help. They keep saying, "well, they're just failing treatment" or "they don’t want treatment," as opposed to, "no, I don’t want your treatment, I don't want your treatment with a capital T. That is a giant hassle that makes me go to counseling when I don't like talking to people." And so what we're trying to do is start building services that gave people what they want first and then get them to a stable place in their life that when they're ready they can start engaging with those things and that the counseling and social supports are offered and that they're made available and that they're supportive and that they're not preconditions to getting other types of treatment because there is not one path for everybody. . . I am fortunate to get to talk with people all across Washington state and it conflicts with how I was trained. I was trained really early on in my career about evidence-based treatments. And what are all the supports that you need within that context? And what I didn't really realize until I kept hearing the same thing and getting this confused look from audiences is that 99 percent of the general public thinks that detox and inpatient are treatment. And for many people, they are not treated and in fact, [its] the exact opposite of what they should get. There's a lot of work that can happen in the real world. Going to inpatient can be a lifesaver and can rescue folks, but usually not. Some people call it pajama recovery. It's like, that's great you're getting a break, I understand the need for that. That's an expensive way to get a breakthrough. And you're not necessarily learning and using tools in a real world that you have to go navigate.
CALEB BANTA-GREEN: I want to talk a bit about opiate addiction, whether it's heroin or fentanyl or prescription pain pills. Those all impact the endorphin system. And we need to understand the difference between being physically dependent on an opiate-like a chronic pain patient might be and the chaos of addiction. So what I think is important to understand around substance use disorder is it is three things. It's biology. It's changes in brain chemistry. It's thinking issues. It's a change in priorities in your life. It's cravings that are nonstop. It's a change in psychological makeup. . . So when it comes to opiate addiction a lot of the work we're doing locally is to say, you know what? On average, for most people, the best thing is actually long-acting opiate treatment medications. They are not the right thing for everybody. These are medications like methadone or buprenorphine and they're not the right thing for everybody. But they are the right thing for most people it seems. And the idea is that instead of injecting or smoking or snorting heroin multiple times a day you, take medication by mouth once a day and it gets you off of that rollercoaster. So you’re on a rollercoaster and you're above baseline you're feeling good, you're eventually on a roller coaster you're below baseline and feeling terrible you end up just trying to get back to normal. It's not a miracle cure-all and of itself. We're trying to get you back to normal get you back to steady state. And the thing about those medications is they're incredibly effective. What I think is important is that you can be on a medication like methadone or buprenorphine which is also known as suboxone and you are still physically dependent on an opioid. But you're out of the chaos and I want a person that's absent from chaos and harm. . . The amazing thing about those medications is that they support recovery. You can be in recovery and be on medications. Most people don't know that. Also really important given the number of deaths we're seeing all around the United States and in Seattle your chance of dying of an overdose drops by 40 to 80 percent every day you're on those medications. The only way we're going to nip this opiate epidemic this epidemic of deaths is we have to make medications readily available to people. And we also have to give people actual free will and choice that they may not want to do that or that if one thing isn't working they can try something else.
CALEB BANTA-GREEN: What we started doing two years ago, we now have over a half dozen programs in just two years in the Seattle area, is same-day access to treatment medications. And we actually set one of these programs up at the syringe exchange in Belltown [Seattle]. And that program is set up so that people could drop in, they can be seen by a nurse that same day, they could get started on medications that same day. There were no counseling requirements. In fact, they could still continue to use other illicit drugs and alcohol. That is the main kicker that kicks most people out of treatment. And the reason for that is the vast majority of people with opioid use disorder also use other drugs. They also use anti-anxiety medications benzodiazepines, they use methamphetamine, they use cocaine they use alcohol. They're using all of these things. So if you don't offer services to people who use multiple substances, you're missing 80 percent of the population. And that's exactly what we're missing right now. So we started offering those services within a couple of months. We people lining up two hours early for this new model of care while they wanted to get in. And we've had really good results and we've been expanding it around the city and we're working to expand it around the state.
Tom Hansen’s heroin addiction left him without functioning hands. Even today, he says, “it was a blessing in disguise for me that I couldn't play music anymore because it was very tied up with the drug thing. It forced me to move in a new direction.”
MARCO COLLINS: Throughout the years, throughout my treatments, people have said, you have to get out of the music industry completely because there is too much addiction, there are too many drugs, there's too much alcohol. It's all about the party. But I can't. I know nothing else. This is what I'm passionate about. This is what I believe in. And it wasn't until MusiCares stepped in to help me and they got me into a sober living with other musicians and actors in Los Angeles. I realized there's as much sobriety in the music industry as there is addiction because it has to be that way. Either you're in or you're out. But you can't ask music people to stop being involved with music. It's just not realistic. Even the DJ profession. God knows there's tons of cocaine, at least there was back in the day surrounding that job. And for me, it’s what I love, the drugs came later, the alcohol abuse came later. It was my passion for being involved in music that I'm not going to be able to ever really shake. So I had to plug in with a music community who were all sober.
ALL: Don’t give up.
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