Wednesday, November 12, 2008

Tough Words To Say....

Our society makes it really hard to admit, but the excuses? Come on. A judge in disciplinary proceedings for being intoxicated on the bench explains,
during the alleged drunken appearances, he was taking the painkiller Vicodin for back and knee injuries from a car accident; an anti-inflammatory medicine; Ambien for sleep apnea; and medication for diabetes and high blood pressure.
Let's get one thing straight. You don't take Ambien (or any other sleep medication) for sleep apnea. You take it to help you sleep if you are having trouble with a CPAP or BiPAP machine, the actual treatment for sleep apnea. After you take it you go to sleep. You do not take Ambien and then go to work unless you are either intending to go to sleep on the bench or you are an addict.
He admitted that he went on the bench on two occasions after taking Vicodin and consuming alcohol.

On Dec. 6, 2006, he took three or four Vicodins before a 9 a.m. session in Bridgewater, and at lunch that day had two to three glasses of Chardonnay.
When you're gulping down a triple or quadruple dose of Vicodin, with a substantial alcohol chaser, you're either being extremely foolish and reckless in the treatment of your physical pain or you've moved well hinto the territory of addiction.
Sasso said he knew he should not take his daily Vicodin dosage all at once but added that he generally needs a large dose because he is 6'3" and weighs 290 pounds.
More likely, because if you take three or four times your prescribed dose you build up a tolerance. If you are taking prescribed pain relievers and they're not helping, here's what you do: You go back to your doctor and say, "These aren't helping at the dose you prescribed. What do you recommend?"

Similarly, if you find yourself taking Ambien and not falling asleep, you go back to your doctor and say "These aren't helping me sleep. Can we try something else?" If you take Abmien and intentionally stay awake, it's unlikely that you're taking it for any purpose other than its intoxicating effects (which, as Patrick Kennedy (and the officer who investigated his accident) can tell you, are a lot like alcohol intoxication).

Let's draw a line here between addiction and dependence. If you take certain medications for a long enough period of time, including opiates, you develop a physical dependence on those medications. You may also develop a tolerance that requires an adjustment of your dose or a change of medication, and may be dependent to the point that you will suffer withdrawal if you suddenly stop taking your medications. That's not addiction. Where you transition from dependence to addiction is when your medications stop improving your ability to lead a normal life, and your focus shifts to clock-watching or drug-seeking. There's also a syndrome called pseudoaddiction, where somebody who is receiving inadequate pain relief may demonstrate obsessive or drug-seeking behaviors that resemble those of an addict, but those symptoms resolve when their pain is adequately treated. But if you're buying shoeboxes of drugs from your maid (in addition to taking the drugs you get from your doctor), or gulping down huge doses of opiate medication with alcohol, it's safe to assume that you're an addict.

The AA/NA model for addiction dictates that the very first step in recovery is admitting your powerlessness over your drug of choice. I'm fortunate enough not to have a history of addiction, but I can say this: When the Rush Limbaughs, Patrick Kennedys, and even lesser known people like Judge Sasso avoid making that direct, honest concession - when they insist that their addictions are somehow more elevated because they claim to have physical pain, or are somehow more pure because they're abusing prescription pharmaceuticals - they're lying to themselves and to anybody who listens to them.

It would be really nice to hear one of these high profile addicts discard all of the excuses and finger pointing and simply admit, even if prefaced with an explanation of how they became addicted, "I did it because I am an addict." (e.g., "Although I didn't seek out this disease, and had no experience with addiction before I received opiate medication for a back injury, I stole drugs from my charity because I am an addict.")

Addendum: To be clear, I believe that if high profile addicts are honest about their addiction, they will help diminish the stigma of addiction. While we sometimes pretend otherwise, addiction strikes at all levels of our society and, while the rich and powerful are often better able to cover for their addiction or avoid street drugs, nobody is immune.


  1. Criminy! This gives a new spin on the whole "sleeping judge" thing.

    Thanks for a thoughtful post, Aaron. I think you are totally right about how it would be helpful for high profile folks to admit their addiction. If it truly is an issue of the brain (and I don't know a ton about it, but from what I've read, I think it is), then there should be no shame in the addiction itself. It's a medical condition. Similarly, it'd be helpful for high profile folks to be open about mental illnesses as well. Might open some minds....

  2. None of which changes the fact that if he was mixing vicodin and alcohol before taking the bench, he needs to be removed.

    Not prosecuted criminally, not harassed, not stigmatized, but he does not need to be on the bench making ruling of law, much less sitting in judgement on others.


  3. That from the guy who mixes his drinks so strong, he raises eyebrows at a party held in a frat house? ;-)

    No question, if he's intoxicated he shouldn't be taking the bench, or driving that train, or.... well, I might give him a pass on "sittin' downtown in a railway station" as long as he behaves himself.


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