Summer House

ORLANDO, Fla. — When Bryan stopped taking drugs six months ago, he got through the worst of his heroin withdrawal in a week. It was Xanax that tortured him for a full month.

He longed for the "benzos," slang for benzodiazepines, the class of drugs that includes Xanax, to take the edge off his skittishness, sleeplessness and anxiety.

Although Bryan used a variety of drugs for about 12 years, the Orlando man found Xanax one of the hardest to let go.

"Once you get fixated on downers like that, you don’t stop easily," said Bryan, 29, who asked not to be identified by last name to protect his business. "Especially if you’re a high-strung individual, it just gives you an extremely relaxing feeling. It’s slows down your thought process; you take everything in stride."

Xanax is a prescription medication used to treat anxiety. But it also is a highly abused, easily addictive tranquilizer and the focus of a fraudulent prescription drug charge against Gov. Jeb Bush’s 24-year-old daughter, Noelle.

If convicted, officials said, Noelle Bush likely would be given probation as a first-time offender.

She will not be required to appear in court personally until after formal criminal charges are filed, a process that generally takes four to six weeks, Leon County Assistant State Attorney Owen McCaul said.

Xanax and other prescription drugs are becoming increasingly popular with younger people, according to the National Institute on Drug Abuse. A government survey in 2000 found that about 5 million Americans have abused Xanax or a similar anti-anxiety drug at some point.

" It ’s basically the modern-day version of a Quaalude,  the mother’s little helper," said Lui Delgado, a certified addictions professional and executive director of Quest Counseling Centre in Altamonte Springs. " It ’s very common with young people, and it ’s very easy to find."

Xanax is the brand name for alprazolam, a drug developed at least 20 years ago as an alternative to Valium, a widely prescribed sedative that was considered too easily addictive.

But both drugs can create powerful addictions, and some say Xanax is worse than Valium.

"Xanax, in particular, is abused because it has a fairly quick uptake into the system, and many people get a buzz from it, " said Dr. Herndon Harding, medical director of Florida Hospital ’s Center for Behavioral Health.

Xanax works by depressing the central nervous system, enhancing the effects of a chemical in the brain that slows down the firing of neurons and reduces brain activity.

Bryan said taking Xanax felt like having a few drinks, minus the dizziness. He could get 100 pills for about $200, but the drug sells for up to $5 a pill on the street.

Most prescriptions call for no more than 2 mg of Xanax total a day. Because he had built up a tolerance, Bryan needed about 10 mg to get the desired effect.

Since the 1960s, many addicts have reported that even a single dose of ibogaine, a hallucinogenic alkaloid extracted from the root of an African shrub, helps them kick their habit by reducing their cravings for drugs. And there is hard evidence to back these claims, as well. Ibogaine was first introduced as a potential treatment for opiate addiction by Howard Lotsof, who took the drug in 1962 looking for a psychedelic experience, and awoke 30 hours later with no cravings and no withdrawal symptoms, despite being a heavy heroin user at the time. Lotsof was able to develop and follow an ibogaine maintenance program, which he then followed for three years while remaining opiate free. In 1986, Lotsof opened a company by the name of NDA International to advocate for the use and research of ibogaine and its active constituents as anti-addictive compounds.

Since ibogaine aides in the cessation of addiction, it started to be used to deal with opiates and other substance addictions. Ibogaine has only been introduced to Western scientific medicine but has documented use by the Bwiti tribe in Central Africa for centuries. At lower doses ibogaine has the ability to increase energy and mental alertness and appears to decrease the desire for food and drink. Higher doses (20+ mg/kg) of ibogaine have a larger psychoactive property, and is used ritualistically in initiation rites for its potent hallucinogenic properties.
 

Barbara E. Judd, CSW did a study on ibogaine and stated that the most difficult aspects of treatment are getting the patient to enter treatment.  She notes that the three major obstacles are the fear of detoxification lack of insight, and the inability of patients to control their urges to use drugs. It was in these three areas where she felt the benefits of ibogaine treatment far outweighed those of traditional methods. Judd further states that psychological fear of pain and withdrawal prevents many addicts from even attempting detox. Addicts feared having to deal with the emotions that lead them to use in the first place. Judd adds that when patients learn the benefits of ibogaine they are more willing to try it.
 

Like all forms of detox, ibogaine is not without risks and side effects. At therapeutic doses, ibogaine has an active window of 24 to 48 hours, is often physically and mentally exhausting and produces ataxia for as long as twelve hours. Nausea that may lead to vomiting is not uncommon throughout the experience. These side effects reduce the attractiveness of ibogaine as a recreational drug at therapeutic doses, however, at lower doses ibogaine is known to have stimulant effects. It is still a controversial and experimental drug and there are some cases of fatal cardiac arrhythmias.
 

There are two types of ibogaine treatment. The first type of treatment is oriented toward addiction, most commonly heroin dependence, and typically involves dosages in the range of 15 to 25 mg/ kg .5-8 The second type of treatment, also know as “initiatory," involves a dosage on the order of 8 to 12 mg/kg, or about half of the dose used for addiction and is used for spiritual insight and facilitating psychotherapy.  In addition to reducing craving, ibogaine often promotes a sense of wellbeing that can last from weeks to months. As the studies into the nature of ibogaine progress, scientists have discovered that ibogaine’s anti-additive properties are actually two-fold. First, when the substance is consumed, the body produces a chemical called noribogaine. Noribogaine blocks the brain’s receptors that control cravings. Noribogaine also increases dopamine and serotonin levels, which elevate feelings of wellbeing.

So while ibogaine is not a substitute for drugs, and is not addictive, ibogaine is a chemical dependence disruption and a chance for patients to get a head start on recovery. Ibogaine enables the patient to focus on the underlying causes of addiction without going through the intense withdrawal symptoms that accompany most types of detoxification. And, even if there are some remaining symptoms after ibogaine detox they are more tolerable than other detox approaches. Studies show that ibogaine has the ability to drastically attenuate drug withdrawal in all patients and, in 90 percent of treated patients during one case study, to interrupt the patient’s craving to continue drug use for periods of time ranging from as short as two days to as long as two and a half years from a single treatment.

Miami Herald — Most everybody in this neighborhood coffee haunt has been hooked on something. The high school dropout with beauty-pageant looks has been fending off a heroin habit for two decades. The former football player says he is clean now after years of popping pain pills. Santa Claus succumbed to alcohol.

Nineteen of the fallen are here tonight for therapy and healing, for a second — or a third or fourth — chance, hoping to reclaim a piece of their lives. They form a circle in the pebble garden behind KoffeeOkee, which is owned by Harold and Dawn Jonas, former users who now help others kick drug and alcohol habits and answer the question: What now?

A resort on the Atlantic in Palm Beach County, Delray Beach has another, less obvious civic profile: Florida’s sobriety capital. Like Hazelden in Minnesota and Utah’s Cirque Lodge and the communities that surround them, it is a place to dry out, clean up. Its recovery community is spirited and multilayered, a dense mesh of dozens of treatment facilities, counseling centers and residential housing that gives addicts a wide-reaching chance for recovery and permanent lifestyle change.

This is where people start over. And sometimes stay.

”You want to be here if you are struggling with an addiction,” says Anna O’Connell, 43, who has been in and out of detox for crack cocaine, heroin and alcohol over the past 20 years and attends therapy sessions at KoffeeOkee. “This is the closest thing to family; this is where you feel safe.”

Treatment for addictions that the medical community now accepts as chronic diseases ranges from private $10,000-a-month treatment centers to free coffee, counseling and karaoke at java houses such as this one, which hosts formal therapy sessions twice a week and informal gatherings even more often.

MANY, FROM ALL OVER

The size of South Florida’s recovery community is difficult to estimate because only one layer — facilities with residential treatment beds — is licensed by the state. Delray Beach alone offers more than 1,200 beds in transitional houses — a second layer — according to the South County Recovery Residence Association in Delray, which monitors halfway residences.

Every week in Delray, about 5,000 addicts attend 12-step meetings that stretch from 7 a.m. to 11 p.m. At Crossroads Club, a squat stucco complex off Lake Ida Road, about 700 people walk through the doors every day to attend 120 meetings aimed at a swath of needs, from treatment for cocaine addiction to obsessive cluttering, says Susan Miller, executive director, a recovering alcoholic.

Addicts arrive from as far away as Oregon and Rhode Island and from as nearby as South Beach. They face daunting odds: Relapse rates range from 40 to 90 percent, depending on the client’s dedication and will power, sustained treatment, and follow-up care, according to the National Institute on Drug Abuse.

”My parents sent me here to try to turn my life around,” Rani Canosa, 21, a pretty, petite college dropout offers one Monday night at KoffeeOkee. “Alcohol made me feel good. I would be really, really happy, then really, really sad, then just miserable.”

Canosa, from a Baltimore suburb, started drinking seriously as an 18-year-old freshman in college. Soon she could consume a 12-pack of beer and a half-bottle of vodka in a two-hour stretch.

She had tried treatment centers in Maryland and Pennsylvania but returned home only to relapse once she was back among friends and familiar haunts.

Canosa has been in Delray Beach since Aug. 29, out of treatment at the Wellness Resource Center in nearby Boca Raton since Feb. 5. She lives in a halfway house and works as a barista at KoffeeOkee.

”The truth is, if I was home, I would be drunk or looking to get drunk,” she says softly, never making eye contact. “I actually want to be here.”

COLLECTIVE STRUGGLE

But what distinguishes this vibrant recovery community from similar places elsewhere, is a growing sober social infrastructure, an informal network of places for people to mingle without the colossal temptations of drugs and alcohol.

”Delray Beach is a microcosm of the various layers of the recovery process,” says Howard Lerner, clinical director of the Addiction Treatment Program at South Miami Hospital. “Those struggling belong to a fraternity.”

Here, even in the midst of fighting for sobriety, addicts can go dancing at popular clubs that hold sober nights, sing karaoke at a sober coffee house, listen to live music at a sober juke joint, call in to recovery radio shows, roar into the sunset with a sober motorcycle club and pray at a Bible study just for them.

”The struggle with an addiction can be forever,” says Harold Jonas, a mental health counselor. “So all we really want is for people to be healthy and to laugh and have hope and be part of the world, not just the recovery community.”

The collective sobriety struggle here is no longer anonymous. Recovering addicts live among ”normies” and often work on Atlantic Avenue, the city’s glittering ribbon of sidewalk cafes and boutiques and galleries.

”When you are on this journey, it’s incredibly important to feel like you are not alone, to see and be around people just like you,” says nattily-dressed Jonah Yolman, now 22 months on the clean side of a wicked crack-cocaine addiction.

Yolman, 29, sitting in a Starbucks on Atlantic Avenue, quietly acknowledges two people ordering coffee who are in one of the dozens of 12-step anonymous programs. He talks casually about the familiar identifying signs of people in recovery: the relentless smoking and coffee drinking, the trails of cigarette butts and empty coffee cups and candy wrappers. And the most obvious sign: people tightly clutching books with dark covers, their 12-step guides.

”We are everywhere, living and working in this city,” says Yolman, a counselor at a local treatment facility who promotes two sober nights at area clubs. He and a partner are also launching a similar sober club night in August at a South Beach club (sobernightlife.com).

“People come here and enjoy the weather, the beaches, low-key atmosphere and try to start over.”

NATIONAL REPUTATION

In some ways, Delray’s recovery community draws its inspiration from a small, rural town in Minnesota that over the years became a magnet for recovering addicts, from marquee rock stars like Eric Clapton to the anonymous souls who came looking for peace and order.

Since 1949, addicts have famously flocked to Hazelden, which started as a farmhouse retreat in Center City for men working their way through programs based on the 12-step principles.

Over the years, teams of doctors, counselors and chaplains developed a holistic approach to rehab now emulated worldwide.

More than three decades ago, Delray’s first sober houses opened for people making the transition from residential care to independent living. The houses — a yellow clapboard with a sweeping porch on one street, a peach bungalow with a white-picket fence on another — are sprinkled within neighborhoods, around public squares, near churches.

Rents range from $125 to $175 weekly for a room and access to kitchens and family areas. Most landlords require random drug tests, and some perform bed checks or monitor whether their clients have reported to work.

Two years ago, Crossroads Centre in Antigua, a drug-treatment program founded by Eric Clapton, opened in the city. And in February, Lecreshia Hall, a Boca Raton psychiatrist, started Hallway of Life Recovery Center, a faith-based, 28-bed transitional facility for women, on a quiet residential street near downtown.

”When I did the research to find the best place to open, Delray Beach kept coming up,” says Hall, who leads Bible study on Tuesdays. “The idea of our center is to teach our clients how they can use the Bible to help in recovery.”

But Delray Beach’s national reputation as a recovery community has been unsettling for some residents.

”We don’t mind taking care of the people living here, but we don’t particularly like people coming from all over the country or the world to recover,” says City Manager David Harden. “But it’s a fact of life, and so we have tried to be supportive of the community.”

Harden says Delray Beach gives money each year to the Drug Abuse Foundation of Palm Beach County, the county’s oldest chemical-dependency treatment and prevention center. The Commission also sold city property to Crossroads Club several years ago, allowing the center to expand.

Over the years, residents have complained to city officials about the lack of security and control at some sober houses. Owners need only a landlord permit to run them, a reality that makes strict regulation difficult.

Jonas, who heads the South County association and runs the coffee shop, says problems stem mostly from unscrupulous landlords who hope to turn quick profits at the expense of fragile tenants and the surrounding neighborhood.

”You got some of these operators who don’t manage the property or the tenants, then they put the people out and leave them homeless,” Jonas says. “There are some operators we would all be better off without.”

FINDING SOLACE

Jonas came to Florida 20 years ago full of reasons to give up. But with the help of his father, who put him in a West Palm Beach treatment center, he cleaned up and stayed put.

A slight guy with a thick mustache and a thicker Philadelphia accent, Jonas sits in the lounge of his coffee shop one afternoon rattling off his story with sobriety’s detachment and confidence.

Pot by 13. Then acid and speed and cocaine. Graduation to alcohol. Bottomed out in the injection world of cocaine and heroin.

Jonas entered rehab in 1987. He married Dawn, a recovering cocaine addict (they met in a 12-step group), and went back to school, earning an online master’s degree in counseling psychology from Antioch University and a doctorate in addiction studies from International University in St. Kitts.

”You come out of a situation like that broken and with very little to hold on to,” Jonas says. ‘You come out of treatment and you say, `Now what?’ ”

So Jonas and his wife — who recently celebrated her 22nd clean year — began working to answer this huge question, working to help define what life after treatment really means.

In 2000, they launched sober.com, a Web clearinghouse for 30,000 recovery programs nationwide. And for 10 years, he operated a recovery residence in Delray Beach. She runs a home for women in recovery.

Two years ago, they opened KoffeeOkee, in many ways ground zero for the recovery community. Inside is a cozy mix of velvet wingback chairs and bistro tables and a small cafe offering every coffee, tea and juice imaginable but absolutely no alcohol. The walls are covered with bulletin boards offering testimonials, treatment and housing ads, and calendars outlining the month’s sober activities.

A piano sits in the corner with a dried white rose on top, a delicate memorial to Valerie, a drug counselor who died a year ago.

Of an overdose.

InfoPackets.com — Major recovery organizations have been using the Internet to help individuals recovering from drug and alcohol addiction. An increasing number of support groups are springing up all over the web with one goal: to provide online, 24/7 assistance to people recovering from some form of substance abuse.

According to the U.S. Department of Health and Human Services, almost 2 million people this year will find themselves entering some kind of rehabilitation for abuse of various drugs or alcohol. In the past 70 years or so, these alcoholics and addicts would have left various rehabilitation institutions to then begin a lifetime of meetings in church basements with fellow addicts or alcoholics, there to find the support and encouragement to continue their life clean and sober.

Typically, the online venues focus on the 12-step recovery approach — the recovery program outlined by Bill Wilson and Bob Smith, founders of Alcoholics Anonymous. It’s a popular program and, it seems, there is now a 12-step program tied to every possible substance abuse or behavior, including Nicotine Anonymous. Instead of holding daily or weekly meetings however, more and more of these 12-step groups are turning their attention to providing online chat, web forum, and list server-based recovery groups. The Internet is being used to connect similarly afflicted individuals and groups from all over the world. Over the world wide web, recovery meetings are no longer of an hour’s duration in a church basement, groups now meet for 24 hours a day with members checking in and out at will or as needed.

Alcoholics Anonymous the oldest of the recovery groups, now offers meetings using email list servers, VoIP, and chat. AA provides online meetings in 33 different countries and hosts them in more than 10 different languages!

Narcotics Anonymous has more than 20 internationally accessible email meetings and Cocaine Anonymous offers 6 internationally accessible email meetings.

Of course, for every benefit of online meetings, there are also some risks. The use of chat protocols, for example, opens up a portal to the user’s PC that may expose them to risk of being hacked. Email-based list servers also pose the problem of how to remain anonymous when the entire virtual room can see your email address.

There are also hazards from various unscrupulous recovery organizations that prey on individuals in early recovery or their families. Over the Internet, they seem like legitimate organizations, but they are not always. As with most Internet-based activities, various fraud, email harvesting, and identity theft schemes abound. But even in those cases, Internet-based solutions emerge. One organization, All Addictions Anonymous Watch, for example, focuses on keeping a watchful eye on some of the less scrupulous efforts to exploit recovering individuals.

Exploiting Internet technology may prove to be a great boon to people trying to shake addictions. It has truly become Addiction Recovery 2.0. Nonetheless, family members and recovering individuals would be wise to stick to the best known recovery organizations (e.g AA, NA, CA) and, if they choose to participate online, they should get a Yahoo!, Gmail, or Hotmail mailbox using a pseudonym to keep themselves truly anonymous.

Times Union — Tatum O’Neal, the Oscar-winning actress, took a plea deal last week stemming from her June 1 arrest while supposedly trying to score some crack cocaine on the Lower East Side of Manhattan. She was initially charged with possession of a controlled substance and faced a year in prison if convicted. The court allowed her to plead out to a disorderly conduct charge and ordered her to attend two half-day drug treatment sessions. If she follows the court’s orders, the cocaine possession charges will be dismissed.

O’Neal has been open about her history of heroin addiction as outlined in her memoir, "A Paper Life." When she was arrested by undercover officers, they searched her and found two bags of cocaine along with an unused crack pipe. She had initially told police she was doing research for an acting role. Then she changed her story and told them that the death of her 16-year-old dog nearly triggered her into relapse.

Some say O’Neal was treated with a slap on the wrist. Others say she did not deserve to do any jail time because of her addiction. This raises a critical question that we as a society need to address. Should we treat drug addiction as a criminal matter, or as a medical problem?

For most people, treatment is a much more effective approach than imprisonment for successfully breaking their addictions, yet our prisons are full of individuals whose only crime is their drug addiction.

According to Justice Department statistics, the United States has more prisoners than any country in the world, 2.5 million and rising. In 2006, the Justice Department recorded the largest increase since 2000 in the number of people in prisons and jails. Criminal justice experts attribute the exploding prison population to harsh sentencing laws and record numbers of drug law violators entering the system, many of whom have substance abuse problems.

Nonviolent drug offenders like Tatum O’Neal should be given an opportunity to receive treatment, not jail time, for their drug use. This would be a more effective (not to mention much more affordable) solution for both the individual and the community. Prosecutors in many states, most notably New York, have leeway to recommend a defendant to treatment instead of incarceration. More than likely, however, they will not do it. This is because it would not be considered a victory for them. The system does not reward prosecutors for doing the compassionate thing.

O’Neal can be an example for millions of young people. One can only hope that her experiences with addiction and the realities of the drug war will encourage her to join the movement to reform U.S. drug policy. If she decides to take up the cause of treatment, she could help change laws across the country. After all, if treatment instead of jail is good enough for her as she struggles with her addiction, surely it is good enough for the thousands of others just like her who struggle with their own substance abuse problems.

Like depression, addiction affects tens of millions of Americans. How best to treat it is a serious a question we need to explore. Rich or poor, young or old, addiction has no boundaries. But the drug war does. Our long war on drugs has stifled the open debate society should be having about the nature of addiction and how best to deal with it. It is time to treat addiction for what it is — a medical problem, not a criminal one.

BALTIMORE, Maryland (CNN) — "Heroin, cocaine, alcohol…whatever was on the table, I wanted it," recalls Baltimore native Tyrone Lewis, who struggled with drug addiction for most of his life.

His addictions made it impossible for him to hold a job very long. For a time, he was homeless.

"After a while you just feel … alone," says Lewis. "That made me want to give up. "

But that all changed when he met Galen Sampson, a five-star chef who offered Lewis the chance to join Chefs in the Making, a culinary training program that offers jobs and education to people who’ve been homeless, incarcerated or have struggled with addiction. For Lewis, it was the chance of a lifetime.

"He was offering me a free education," Lewis says. "What he was doing gave me hope."

For many years, hope has been in short supply in parts of Baltimore. While some areas have been revitalized, much of the city is plagued by crime, poverty and drugs. According to the Census Bureau, nearly 23 percent of residents live below the poverty line and the city has an estimated 60,000 addicts.

As a chef at one of Baltimore’s elite hotels, Sampson often saw his employees struggling with these problems in their own families. When he met his wife, Bridget, a writer who ran literacy programs in the city, he got involved with her work and wanted to do more.

"I was a chef; that’s what I was good at," Sampson recalls. "How could I apply what I did to help?"

Sampson had always dreamed of having his own restaurant. So in 2005, he and Bridget decided to create a socially responsible business that could address some of Baltimore’s problems. They decided that part of their restaurant would be a training program, and Chefs in the Making was born. 

In many respects, Chefs in the Making is run like any other culinary school. Apprentices take classes four hours a week and the rest of the time, they work at The Dogwood, Sampson’s restaurant, which also includes a deli and catering business. Students not only earn a living and learn a trade, but they also build a job history.

The program has partnered with other programs to give apprentices additional support; there’s even a counselor on staff who meets with them every couple of weeks. For Tyrone Lewis, the restaurant itself is a refuge.

"Here there are no secrets," Lewis says. "Most of us just know we are people who are trying to get our lives back together. " 

Sampson admits this unorthodox approach had its skeptics.

"A lot of people think we’re crazy. We’ve pretty much put everything that we have into this project," he says.

But for Sampson, it’s well worth the risk.

"To see what our apprentices have been able to do here has been very rewarding. I think we’re setting the foundation for something good," he says.

In 2008, Chefs in the Making intends to provide training/jobs to more than 30 people. Apprentices make up about 25 percent of the restaurant staff and Lewis’ own situation suggests what potential the program has to change lives.

"Ten years from now, I see myself owning a home, maybe owning my own business," he says.

It’s a future that he wouldn’t have dreamed was possible before meeting Sampson.

"A lot of people say they want to help," says Lewis. "Galen actually makes a difference."