Maia Szalavitz Quotes

good decisions aren't always made for healthy reasons.

Our brains are embodied - much of the problem with the debate over addiction and psychiatry more generally is a refusal to accept this and our ongoing need to see "physical," "neurological," and "psychological" as completely distinct.

Drug warriors' staunch opposition to needle exchanges to prevent the spread of HIV in addicts delayed the programs' widespread introduction in most states for years. A federal ban on funding for these programs wasn't lifted until 2009. Contrast this with what happened in the U.K. At the peak of the AIDS epidemic in the mid-1990s, the HIV infection rate in IV drug users in the U.K. was about 1%. In New York City, the American epicenter, that figure was 50%. The British had introduced widespread needle exchange in 1986. That country had no heterosexual AIDS epidemic.

Being bold and adventurous and being sad and cautious seem like opposite personality types. However, these two paths to addiction are actually not mutually exclusive. The third way involves having both kinds of traits, where people alternatively fear and desire novelty and behavior swings from being impulsive and rash to being compulsive, fear driven, and stuck in rigid patterns. This is where some of the contradictions that have long confounded the study of addiction come into play - namely, some aspects seem precisely planned out, while others are obviously related to lack of restraint. My own story spirals around this paradoxical situation: I was driven enough to excel academically and fundamentally scared of change and of other people - yet I was also reckless enough to sell cocaine and shoot heroin.

There is a safe, nontoxic drug called naloxone that can instantly reverse opioid overdose and prevent most of these deaths. But the drug war interferes with saving overdose victims in two ways: first, because witnesses to overdose fear prosecution, they often don't call for help until it's too late. Second, because the drug war supports the belief that making naloxone available over-the-counter or with opioid prescriptions would encourage drug use, the antidote is available only through harm reduction programs like needle exchanges or in some state programs aimed at drug users.

Because of the war on drugs, pain patients are treated with skepticism and pain doctors live in fear of being prosecuted for overprescribing. The end result is that addicts still get their opioids without much trouble, while genuine patients often can't find treatment. Those who do must typically be tracked in a database and must schedule frequent, expensive doctor visits for surveillance like urine testing.

There is often a struggle, and sometimes, even more interestingly, a collusion between the powers of pathology and creation. - OLIVER SACKS

I felt utterly stripped of safety and love. And so, what tormented me most as I shook through August of 1988 wasn't the nausea and chills but the recurring fear that I'd never have lasting comfort or joy again.