The Wrath of Grapes (as well as dry goods)
My name is Billy, and I’m a recovering alcoholic and drug addict. I never wanted to be, and I swore would never be one. I grew up in a small New England town to poor working class Irish Catholics. By kindergarten, I knew that alcohol made people do and say bad things. As a devout Irish Catholic, we were asked to take an abstinence pledge to not drink until we were 21 years old. I was the first in line to promise God that I wouldn’t drink, probably ever! It lasted until I was 15. While I was babysitting my cousins, my aunt and uncle left a bottle of scotch and a pack of cigarettes on the table. I poured my first drink, and lit my first smoke. I loved it. I hardly felt the alcohol (high alcohol tolerance), and was not even dizzy from the nicotine; but an amazing connection was made.
Mine was not a happy childhood, which lasted 32 years. I was a confused, scared, guilty, and lonely boy who thought he was ugly, stupid, and unlovable. Suddenly, with alcohol courage, I felt like I had unlocked the magic that made me confident, brave, social, and finally able to claim my seat at the banquet of life. It was the ‘60s, and drug use was beginning to come into fashion; and being a fashionista, I was first on the block to feature the trend. I quickly started to make paired associations. Celebration drink; stressed-after-work drink; dance drink or drug; sleep drug; wake-up drug; restaurant drink; date drink; sex drink or drug; uncomfortable feelings drink or drug. For quite some time, chemicals were my friend, then my best friend, and then they became my only friend.
I began to find my life becoming one crisis after another. It never occurred to me that it was the drinking. My problems were my job, my boss, my wife, my friends, my town, and anything other than me. When people rarely began to question my drinking, I offered, “I’m Irish,” “I keep my job,” “you’d drink too if you…,” “ poor me, poor me, pour me another drink.” I was not about to end my connection with the magic potion that was responsible for giving me the ability to live in the world. What had begun as manageable drinking to lower inhibitions ended with me drinking cologne for its alcohol content when I needed a drink when none was available.
Sadly, I kept on using chemicals (and by chemicals, I mean alcohol and illegal drugs) until I was hospitalized for almost a year of my life. Therapy and joining the recovery community began to reveal to me how I suffered from post traumatic stress disorder (PTSD), but had drank and drugged myself right into a dual diagnosis of chemical dependency: late stage and chronic. I stopped using chemicals. Twenty-eight years later, I still have not had a drink or a drug, one day at a time.
My story is a common one. People with PTSD, depression, or anxiety disorders seek to change their mood to avoid their extreme feelings. Some actually get help early on from trained professionals. Unfortunately, most seek quick, less healthy ways to cope, such as food, obsessive relationships, sex, work, and gambling, just to name a few. Most people are exposed to alcohol and drugs at a very young age. Studies report that 93% of high school students have tried alcohol, and 60% have used used marijuana. The US Department of Health and Human Services in 2008 revealed that more than half of all Americans 12 or older currently drink (129 million), 23% binge drink(58.1 million), and 6.9% report heavy drinking. The same survey revealed that 22.2 million were classified as substance dependent or abusing. In addition, high risk factors dramatically increase potential of abuse. Families of substance use, the elderly, adolescents, college students, various ethnic groups, gays/lesbians, and psychiatric co-morbidity, are some of the various subgroups that have increased alcohol and drug abuse. Further still, 51.9% of men with PTSD reported substance abuse at some point in their lives.
There has not been a study showing the rates of addiction or substance abuse within the Disorders of Sexual Development (DSD) community. My primary anecdotal experiences and my educated guesses are about adult males with a DSD. Unfortunately, parents who come to me use their time to discuss their child, and seldom discuss how this has affected them directly. Nevertheless, my guess is that parents may also have higher rates of addiction and substance abuse.
I have never met anyone with a DSD who did not feel shame, isolation, and fear for much of their life. Also, I have never met someone with a DSD who didn’t fear exposure of their condition, profound fear of having others see their genitals, fear of rejection, worries about inadequacies, concerns about functionality, and an ever-present feeling of being damaged.
There are four areas of concern I have for this community in the area of substance abuse.
Emotional Medication
Most people have a drink or recreational drug to enhance good feelings and lower inhibitions. They have a glass of wine with a fine meal, a beer at a ball park, a Champagne toast, a cocktail before dinner or at a social event. That first drink is pleasant, and many stop when they begin to feel a loss of control. Many, however, have their first of the day and feel a decrease in negative emotions. Suddenly, they are relaxed, and all the troubles in their mind begin to drift away. Just as we make a connection between headache and aspirin, we make a connection between negative emotions and chemical substances. Over a short period of time, increased tolerance requires more chemicals to achieve the same desired effect. Now it’s two, maybe three drinks, and it maybe three or four days instead of just Saturday night. Early stages of abuse are often successful experiences, and are often accompanied by an overall sense of well-being. Depressed, anxious, and fearful people often feel like they have finally found the right people and the right place to overcome these past obstacles.
Social Integration and Sexual Activity
People with DSD often fear social interaction and sexual activity. Too often I fear that the slogan “better living through better chemistry” becomes a philosophy of life. If a few drinks allow someone to socialize, loosen up, or be more outgoing, what possible harm could come of that? Many drugs today heighten sexual arousal and lower inhibitions. If using marijuana, cocaine, ecstasy, GHB, crystal meth or others (what’s known as designer drugs) enable one to be sexual, what possible harm could come from that? I have met many men who have said they were unable emotionally to be sexual until they were introduced to alcohol or other substances.
Past/Present Pain Medication
I have always believed in behaviorism and paired associations. Touch a live wire, get a shock, so avoid wires. Many people with DSD have had pain medication. Again, for some, the feelings associated with pain medication are of discomfort, and following the decrease in pain, they quickly want to discontinue taking them. Some too, after an extended medication period, experience painful emotional withdrawal, and never wish to feel that way again. For others, however, pain medication can induce a quick decrease in uncomfortable emotional feelings and a huge sense of euphoria. My wife broke her ankle and came home with a cast. I had filled a prescription for pain. She was screaming in pain when I arrived. Very shortly after taking the pill, she began to stop screaming, and then stopped crying, and then seemed fine. She was then silly and giggly. I started to throw myself down stairs, knowing I needed some of that! I am concerned about associations people make to medications as they develop secondary gains from them.
After the Kids Go to Bed
Again, I want to reinforce that my experiences as a therapist with this community has primarily been with adult men, but I am a parent. I know the joys and amazing experiences that you have raising children. However, I also know, all too well, how exhausting, terrifying, and blood pressure raising it can also be. When my fifteen year old son, with no license and zero driving experience, took my car and drove with friends around Manhattan, I wanted to shoot heroin into my eyeball!
I have never met a parent of a child with a DSD who was not struggling with anxiety, guilt, and isolation. I am concerned with how they cope with their intense emotions when so many have said they have countless questions, and no one they can talk to about it. In my years of clinical practice, parents who have come to me with other life crises have frequently turned to alcohol or substances for relief, sleep, and to numb. I have no evidence that this group is any different.
This article was written to raise awareness. Substance abuse can have an onset from cradle to grave. Be aware of your use, and notice if it is increasing; or if negative events happen during or shortly after any substance use. A self test to help you assess your use can be found here (http://rethinkingdrinking.niaaa.nih.gov/ IsYourDrinkingPatternRisky/WhatsYourPattern.asp and the following five webpages on this site).
I would add some self-assessment questions specific for this group:
1. Do you use any substances just before, during, or shortly after going on a website to learn about DSDs?
2. Do you use any substances just before, during or shortly after meeting with others with a DSD?
3. Have you ever been physically or sexually assaulted while being under the influence?
4. Do you use any substance just before, during, or shortly after telling someone about your condition?
5. Do you use any substance just before, during, or shortly after being sexually active?
6. Have you ever had any unsafe sex practices while under the influence?
7. Do you use any substance just before, during, or shortly after having any health care professional contact?
8. Have you joined HEA yet? (sorry, I just had to ask that!)
If anyone would ever like to talk to me about their concerns, please call me at the HEA office at 212-382-3471, and know our conversation will be kept confidential.