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Thoughts on Japanese horror comic book writer Junji Ito's story The Enigma of Amigara Fault. A panel from the story. Check out the full version in dubbed format here. In The Enigma of Amigara Fault, a seismic event opens a seam in an ancient mountain. Embedded in the fault line are hundreds, perhaps even thousands, of human silhouettes. Inexplicably, people viewing the event on the news recognize their own outlines in these silhouettes, and they travel from great distances to view these mesmerizing openings in person. Some enter the mountain through these serendipitously shaped keyholes only to discover that the further in they go, the more contorted they must make themselves to continue on. In the end, those who succumb to the strange allure of the Fault are trapped deep inside the mountain, unable to move forward or backward; they have twisted themselves beyond all recognition. A while after reading the story for the first time, I learned to wonder: Were the outlines ever there at all? What did those who entered the mountain see and hear when they answered the Fault's call? What did all the others who weren't chosen experience? Ask anyone destined to become an addict about their first experience with their substance of choice and they will tell you that -- far from feeling weird, or out of it, or out of control, or embarrassed by their actions, or a hundred other reasonable responses -- they felt an overwhelming sense of rightness, of home. Addiction beckons with the lie of chemical completion, which, chased far enough, distorts the soul beyond all recognition, until the only thing that remains is the desire for the drug - the human addict a complex organism turned into a simple vehicle for the propagation of the chemical through space and time (much as viruses can commandeer the nervous systems of much more complex organisms to replicate themselves). The future becomes a blind pouch; we cannot look back to remember the past.

Because xylazine isn’t an opioid, overdose can’t be reversed with Narcan (naloxone), meaning that EMTs Gabapentin also gave me more relief from opioid withdrawal than any other medicine aside from opioids Most opioid addicts my age or older entered opioid addiction through these pills - they were sort of So, just as we’re taking away gabapentin, an approved substance that opioid addicts use to manage their We pushed people away from prescription opioids, and those people eventually ended up on heroin, then

sensitive) the receptors that these drugs bind to. Again, using opioids regularly exacerbates pain, a phenomenon known as opioid-induced hyperalgesia (if you're interested in the physiology of opioids, I wrote a walkthrough of mu opioid receptor dynamics here , which explains concepts like full / partial agonism, antagonism, and receptor affinity). get behind the wheel while on Ambien (a z-drug used as a sleeping medication, which acts at the same receptor

Florida known for being a rehab destination, and the strength of the young recovery there – especially of opioid If you’re an opioid addict, find a program that isn’t going to railroad you onto buprenorphine or methadone After you have experienced “happiness with a half-life,” as I call the misery of severe opioid addiction

A subscriber who is a fellow writer and who suffers from a mental illness that isn't addiction emailed me with kind words about my piece about famous people in recovery. She shared how my writing had impacted her with words brief and true, and I was gobsmacked. I am still "going through it," as they say, and her message made so much more than my day, and it inspired me to run to the Internet to share like a 17-year-old girl after her first kiss. “It's not catastrophes, murders, deaths, diseases, that age and kill us; it's the way people look and laugh, and run up the steps of omnibuses.” ―Virginia Woolf, Jacob's Room My ratchet little blog is just starting out, and I'm not sure that it will ever be anything more than a place to upload my crazy mind to the Internet to disturb generations to come. I have dreams, and I have at least a little talent shaped by some formal and a lot of informal education, but in the grand scheme of creative people, it is truly nothing. Even still, I got a message from a new subscriber today that meant more to me than I can possibly articulate here. My first thought when I read it wasn't "oh, thank God someone likes my stuff," or even "I'm so glad that what I wrote helped someone a little bit"; instead, it was "When was the last time that I took a break from my own goals and my own pain for long enough to write an email this kind and sincere to someone who I don't know for no (ostensibly practical) reason at all?" Her message was beautiful, and it made so much more than my day. Our world is so dark these days; the Internet in particular feels so much more hateful and accelerated than it used to. It's so easy to forget that our small acts of kindness, praise, and gratitude can do as much as supposedly "big" things to change this wildly entropic world that we inhabit (and perhaps even the warp-holed universes that we help create, too). Being a teacher has made me aware of how much more sensitive to the overall vibe of our country and our world young people are - post-pandemic Gen Z has the most alarming mental health statistics on record, which if you're a Millennial should freeze the blood in your veins - and putting these softer kinds of thoughts out there is helping them, too. We all create the interlocking worlds that we inhabit, moment to moment, atom by atom, in our personal lives, our professional ones, in our tiny, unobserved interactions with people who "don't matter." I'm picking a couple of people whose work I enjoy who I don't know and who I think probably don't receive heaps of praise and I'm sending them my own emails tonight. This post isn't part of my "planned programming," and I'm not sure how many people will end up reading it. But for anyone who does, I hope that you consider sending your own messages, too.

The way that I explain this is by saying that for me, taking opioids didn't feel like adding something

pressure regulator that is used to mitigate the Restless Legs Syndrome (RLS) and anxiety caused by opioid Because xylazine is not an opioid, Narcan [naloxone] is not effective in reversing xylazine overdose. amputations is very high in xylazine users relative to users of fentanyl, heroin, and other illicit opioids Use the resources below to find a 12-Step meeting and / or an opioid maintenance treatment provider. Zubsolv find a doctor (sublingual buprenorphine) SAMHSA Opioid Treatment Program Directory *Includes

When it came to opioids and benzos, I wasn’t floating down a raft on Da Nile. Part I with a description of my benzo addiction is because – even though I identify primarily as an opioid When it came to my opioid use, I retained some ability to plan, to ration, to exercise caution to ward

Is it a fiery pit, eternal separation from God's love, or perhaps just insight into the true nature of things? I have spoke with the tongue of angels I have held the hand of a devil It was warm in the night I was cold as a stone. - “I Still Haven't Found What I'm Looking For” by U2 Some Christians believe in the quintessential, fire-and-brimstone conception of Hell as a place of endless, gory, imaginative suffering. Because I was raised by parents who had attended Catholic universities, I grew up with a less flashy, more theologically sophisticated, but ultimately no less terrifying notion: Hell, I discovered, was simply a state of complete, permanent disconnection of the soul from God. Sometimes I think that Hell is a type of insight into the nature of things. There is a 2000-ish movie starring Ryan Gosling called The United States of Leland. In it, his character murders a developmentally disabled boy after noticing the sadness that fills the young man’s eyes while he interacts with a young woman; the implication is that the disabled young man desires this girl romantically, whereas she views him simply as someone to be aided and pitied. Despite the fact that the disabled young man recognizes this, he can neither articulate nor change it. There is a darkness to this world, Ryan Gosling’s protagonist realizes, and once you’re awakened to it, it becomes a part of you forever. Addiction opened my eyes to much that I wish I had never seen. The festering abscesses resulting from missed shots and dirty needles, some of which ate all the way down to the bone; the angry pink patches of skin caused by stimulant-induced “picking” with tweezers, razors, and knives; the robberies and beatings, sometimes senseless and sometimes chillingly calculated; the please-God-take-me-now wails of fellow patients in detox (or were they my own?). The funerals of a dozen electric, potential-filled twenty-somethings, their relatives weeping with wild abandon – giving themselves over to a keening that bears witness to the fact that their lives are irreversibly diminished. Then, of course, there is also the interminable, inexorable decay of those who somehow survived until nothing but diminished, glued-back-together-shells remained; reaching a point at which, frankly, it would’ve been much kinder to them and everyone who loved them if they were already gone. There is yet another level to this addictive blackness. Once you have injected a speedball and experienced that Dionysian splendor, nothing – and I mean nothing – can compare to that paradise. Not porn-star-orgy sex with your soulmate. Not your Grandma watching you thank her as you win an Oscar. Not even, perhaps, the birth of your first child. Nothing “normal” will ever measure up, and at that point, restoring yourself to spiritual health is as futile as trying to resurrect frostbitten flesh. My friend John D. (June 1985 - January 2021). I met John in inpatient treatment, during which his dry & pessimistic humor, his perspicacity regarding other people's characters, and his in-demand culinary skills distinguished him. Before his addiction derailed his life and he ended up serving time for an armed robbery conviction (for stealing from a drug dealer), John worked for a prestigious caterer in New York City. Shortly after we left treatment, infectious endocarditis from a reused needle damaged the valves of his heart, rendering him unable to work and restricting his lifespan to three to four additional years. I visited John several times at the nursing home where he was recuperating, only to discover that he had befriended and / or seduced most of the female staff; he never failed to pressure me to smuggle in contraband dip (chewing tobacco). Out of our cohort of eight patients who shared a bathroom with a single shower and toilet, at least five have passed away of OD's or suicides; in terms of the three who shared a bedroom with me at one point, I am the lone survivor. Rest in peace, John. I will miss your despite-yourself smile - as well as the safe, I-belong-to-someone feeling that came over me when you used to sling your arm around my shoulder - every single day until I can shed my earthly worries and join you somewhere better.

A bar in Harbin, Northern China, a frigid and stunning city. 1. Anyone who says that money isn’t everything is revealing that they have lived their life in bourgeois or “better” socioeconomic circumstances. Poverty is health-annihilating and soul-sapping. It keeps you in a constant state of flight or fight, jangled nerves wondering when the next crisis is going to wipe you out. Poverty has a potent, negative effect on IQ. With protracted poverty, the connections between nerves wither, particularly in the cerebral cortex, causing the nervous tissue to appear like trees in winter. This isn’t a subtle phenomenon when you’re the one experiencing it: Sustained poverty is literally stupefying. And sometimes you have to take the shittier job simply because that first paycheck arrives earlier. 2. Hunger hurts. Not hunger for a few hours, which is the only way that many in the developed Western world have ever experienced it. Longer-term hunger hollows out areas of the body that are meant to be filled with flesh and cushioned with fat. It becomes painful to sit or to rest in almost any position; you feel bone poking through where it shouldn’t be. 3. People without much to give are the most generous in the world – a cliché, I realize, but a valid one. Steinbeck hit the nail on the head in The Grapes of Wrath: “If you’re in trouble or hurt or need – go to the poor people. They’re the only ones that’ll help – the only ones.” 4. As the eighth-century theologian and writer Al’Shafi’i put it: “Health is a crown that the healthy wear on their heads, but only the sick can see it.” When you have compromised your health irreversibly, the depth of loss and regret are beyond description with mere words. The nature of addiction means that you will seldom be able to predict or control when you cross the point of no return and inflict permanent damage on yourself. Please, from the bottom of my heart to those of you for whom it is not too late, get help and stop now. Today. This moment. I have seen people finally ready for recovery – only to discover that their lifespan has been reduced to a few years due to cirrhosis or damage to their heart from endocarditis. 5. Addicts are the lumpenproletariat. We receive disdain, disgust, and all too frequently, distilled hatred. Some of this negativity is grounded in the crime and chaos that active addicts leave in their wakes, but the judgment that we receive is beyond any sane proportion. We are the punching bags of a sick society, punished because we represent the worst fears of many people who struggle to contain their urges and vices in an age of supreme decadence – as well as those who wallow in the misery of self-deprivation instead of finding spiritually and physically healthy ways to feed their souls. 6. Moments of heroism are rare but real. Human beings are capable of the most profound, unexpected, and beautiful self-sacrifice. In addition to the upstanding individuals who you would “expect” this behavior from, I have witnessed it from some of the “lowest” members of society. No matter how deep you have descended into addiction or depression, please find time for the pursuits that nourish your soul. Make art – even if it’s just by keeping a journal or coloring mandalas. Find a way to be of service. For me, there is something powerfully renewing and optimism-restoring about spending time with young people. If I didn’t have teaching in my life during many of the roughest points of my addiction and recovery, I doubt that I would’ve been able to reconcile my worldview with my continued existence.

Do we deserve the epidemic of addiction that's swallowing the U.S.? Dark thoughts for a dreary day. Beijing hood. I lived around the corner. There is a staggering darkness imbued in the manufacture and distribution of illegal drugs. Entire economies of violence and exploitation are built upon feeding the developed world the substances that it craves so that it can use them to escape a reality that it still finds inadequate somehow. The privileged West has exported so much of the profound yet quotidian suffering that has until very recently been a universal part of the human experience. Particularly in the United States, we live so well at the direct expense of others who are mostly invisible to us – whether it’s those who die as civilian casualties in wars to maintain our geopolitical hegemony or those who work in unsafe conditions for unlivable wages to make products available to us for cheaper than they have any right to be. In a way, drug addiction seems to be a karmic balancing act, a way in which these poor, devastated areas of the world export back some of the suffering inflicted upon them during the last few rounds of this globalized Monopoly game. After all, we’ve harmed their children; why shouldn’t they do the same to ours?

Part III begins mid-pandemic, during one of my worst ever bouts of opioid / benzo withdrawal, then flashes An old mnemonic for GABA-A receptor action follows: Ben wants it more often, but Barb likes it to last What wouldn't I do for opioids and benzos right now? It's the international clinic that I get most of my benzos and opioids from. He knows the dangers of taking this many benzos and opioids.