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thank you for listening the human
experience is traversing the realms of
addiction and unbreaking your mind as we
welcome my guest Maya
Sullivan’s Maya it’s a pleasure welcome
to hxb thank you so much for having me
Maya you have to be one of the most
brave people I’ve I’ve read about
encountered I mean your story is quite
compelling why don’t you lay the
foundation for that for us and kind of
tell us about who you are and what
you’re doing please oh sure uh so
basically in my 20s I had a very severe
cocaine and heroin addiction I was
shooting up dozens of times a day I
ended up facing a 15 to life sentence
for selling coke and I was basically
miserable Wow
okay and and you’ve shifted that from
writing writing at least seven books and
I mean you write for Time magazine what
happened how did you go from you know
using these these substances and to
being addicted to them and to you know
where you are now
sure well just to get there we have to
go back a little bit before I became
addicted I was at Columbia College I had
been a straight-a student I was a very
driven person and that you know was sort
of from birth from the time I was really
really little I was always sort of
obsessive and that I think gave me both
the ability to succeed and the ability
to be horribly addicted when I be
came addicted and for me what the
addiction was mostly about was that I
couldn’t connect socially I was very
intellectual
I was very alienated I felt unlovable
and when I found drugs it was sort of
the first obsession that I was going on
and on about that other people actually
wanted to listen to and so that made me
very favorable towards drugs also when I
got to college I was sort of terrified
of the whole new social scene that I had
to once again deal with I had finally
made a few friends in high school
and so then College I’m thrown into this
whole thing and I was just terrified and
I discovered very rapidly that if I had
cocaine people wanted me around and I
didn’t need to worry about oh they hate
me they think I shouldn’t be here
because when you were bringing the coke
people are very happy to see you yeah I
mean that that sounds like quite the
situation I mean there’s there are
certain hallmarks of addiction and kind
of pattern recognitions where you can I
mean there’s there’s genetic traits and
personality disorders I mean what did
you what did you discover as while you
were writing this book as some of the
misconceptions that we have regarding
addiction a lot of people think that
there’s a single addictive personality
and that is one of the biggest myths
about addiction that’s this idea that if
you have sort of one kind of addictive
obsession you won’t be able to control
your use of any other substances and if
you’re addicted to gambling you’ll also
be addicted to food and sex and drugs
and all different types of drugs and
alcohol while it’s certainly the case
that addictions do tend to run together
it’s not the case that everybody with
addiction is susceptible to all
addictions the other myth about the
addictive personality is that all people
with addiction are liars are
compulsively antisocial are you know
just basically nasty horrible people and
in fact
the things that predispose people to
addiction can range incredibly widely so
if you’re a really anxious and nervous
person who is oversensitive and who
really is quite a caring person you
might be very high-risk but you also if
you’re on the other extreme of that if
you’re really bold and actually somewhat
callous you’re also at higher risk and
most people don’t have both of those
characteristics at least not at the same
time so and certainly not most people
with addiction so addiction is sort of
you know there’s there’s a sort of joke
addicts are like everybody else only
more so and that kind of captures the
fact that it is extremes that predispose
you but some of these extremes are
opposite to each other and the idea that
all people with addiction are compulsive
liars or are dishonest or are
fundamentally bad people is just false
are you saying that it’s not solely
based on physiology and it can be based
on other things well and this depends on
if you want to get into the mind-body
problem but the my point is really that
addiction is a complex multifactorial
thing and so genes do play into it
absolutely but so does the environment
and the environment plays into it in an
incredibly complex way over the course
of development so that things that
happen very early on can have an
outsized effect and even the way you
interpret your experience is important
in addiction because for example you
can’t be addicted to something if you
don’t know that the drug causes the
effect that you like hmmm let’s let’s
explore that further what do you mean by
that so like there are people who will
go into the hospital they will have
surgery they will be on opioids long
enough to develop physical dependence on
the drug and then they go home and they
basically go into withdrawal but since
they have no idea that they have
developed physical dependence on the
drug they don’t have any craving for it
since they don’t know what to crave and
they are actually in that instance they
are not a
they are simply physically independent
but in order to be addicted you have to
know that it’s the drug that solves your
problem interesting so it’s it’s more of
a mental psychological thing yeah
absolutely and when people talk about
you know the horrors of opioid
withdrawal the physical stuff really
isn’t that bad anybody who has had any
serious medical problem as well as an
opioid withdrawal experience can tell
you that most serious medical problems
are most are way worse I once had
hepatitis A and that was definitely way
worse than withdrawals but the the point
is that what really is horrible and
causes suffering and withdrawal is not
that physical things not the puking and
the sweating and the shaking I mean
those aren’t fun but it’s the mental
agony it’s the sense that you will never
ever have a sense of safety or comfort
or pleasure again and it’s like breaking
up with you know the love of your life
and that’s where the pain comes in um I
personally kicked heroin about six or
seven times it was I never relapse
during the withdrawal part when I was
sick and feeling lousy I always relapse
like a couple of weeks or months later
when I was like oh I’m fine I can do
this on weekends hmm interesting I mean
how do you how do you feel about the
role of policy and where legislation is
in regards to addiction and like how how
our society and the stigma of being
addicted being an addict I mean it’s
it’s absolutely ridiculous the way we
deal with this there is no science
whatsoever to our drug laws there is no
rational way you could make a case to
have marijuana illegal and tobacco legal
that is just not anything that can
actually be based on anything other than
racism and colonialism which is what it
is actually based on until we recognize
this we’re going to be struggling with
these really lousy absurd drug laws if
we want to say addiction is a medical
problem which I believe it is it is
absolutely absurd to think that
criminalization is going to help
and in fact addiction is actually
defined by the DSM psychiatry’s
diagnostic manual as compulsive behavior
despite negative consequences negative
consequences is another word for
punishment
so therefore if punishment were to fix
addiction addiction wouldn’t actually
exist so we’re really dumb in terms of
our drug policy yeah agreed
I mean it feels like the war on drugs
has been an abject failure if you look
at it from the stance of helping people
if you look at it from the stance of
enslaving the humanity well yeah the war
on drugs is a gleaming success yes I
mean it’s it’s a success at racism and
it’s a success at creating mass
incarceration and I suppose there’s some
employment involved with that like it is
absolutely not a success at controlling
demand at controlling supply or it
dealing with drug related harms in fact
it tends to make them worse so so Mya
let’s let’s get them at the root of this
I mean it I mean if if you’re just a
normal person I mean if there is such a
thing but if you’re just kind of
operating on you know a regular schedule
you have a nine-to-five job and yet you
use cocaine on the weekends I mean what
what’s wrong with that picture
I don’t think there’s anything wrong
with that picture unless you are harming
yourself or others addiction is not
using on weekends generally although you
you can have certain addictive patterns
where you binge and you know spend all
your money on coke every weekend and
then can’t pay the rent but if you are
in a situation where your drug use is
not causing harm to you is not messing
up your career is not messing up your
relationships you know is basically
pleasurable
that’s not addiction and to my mind that
isn’t anything the state should care
about I mean what in your opinion is is
an addict looking for I mean it seems
like people who are drug seeking and
look they’re they’re searching for a way
to escape this sort of pain this turn
internal soul pain that they have do you
agree with that yeah I think that
addiction is very often a search for
escape on there is
there are so many different ways you can
get into addiction but the vast majority
of them do involve some sort of self
medication
about two-thirds of people in addiction
and an even larger number for women have
severe childhood trauma and there’s
enormous ly high rates of sexual abuse
amongst women with addiction so you know
a lot of people are trying to
self-medicate that there are also
there’s also a really high prevalence of
mental illness pre-existing mental
illness among people with addictions so
the same genetics that predisposes you
to say depression can also predispose
you to addiction either because it makes
you more vulnerable to the drugs
themselves or because you want to feel
better so you start taking them so
you’re saying that having a mental
condition kind of amplifies your either
need your need for that that certain
drug that kind of alleviates those
symptoms yeah well I mean if you have
any type of mental illness or
personality disorder you know you’re
different from other people you’re
different from other people in different
ways depending on what your actual
problem is but the you know you know
that you stand out you don’t feel
comfortable you are not happy I mean
mental illnesses are defined by you know
causing significant impairment and
disability so who wants to feel awful
all the time um
yeah people are generally seeking ways
to you know feel okay and to connect
with other people and drugs often offer
a way into that for a lot of people I
mean one of the things I think is really
sad is that you know if you look at a
high school if you want to be in any
clique it’s hard but the drug users
pretty much accept anybody as long as
they take drugs and that’s a very
admirable thing in some sense but it is
sad that that is the group where that
acceptance is there yeah I mean we’re
probably gonna jump around in this
conversation but going back to genetics
I mean if you look at
sort of the studies on adoption and like
twin studies and twins reared apart I
mean what have you seen in your research
in regards to that as far as most of the
research on that is on alcoholism and
basically that shows that about half the
risk is accounted for by genetic factors
and it’s probably the same with other
drugs but the data is not you know
there’s just there’s not as many people
with addiction to the other drugs so
there’s not you know as much data on it
certainly not going back generations the
way there is with alcoholism but it is
absolutely the case that you know
genetic factors play into it and there’s
a huge range of genetic factors that can
have an influence for example there is a
gene that is common in Asia that makes
you quite uncomfortable when you drink
like your skin turns red and you feel
like warm and it’s not pleasant at all
and so those people with that gene are
like 10 times or some really high number
they’re really less at risk however in
Japan where that gene is quite prevalent
during the I guess 80s and 90s there was
this whole there developed this whole
really heavy drinking culture among
business people and what you saw then
was that even with the presence of this
gene the number of people with the gene
that developed alcoholism was like 3
times higher during that time period so
you know people’s choices and people’s
cultural pressures also play a big role
I mean where are you at with the whole
12-step you talk about the kind of the
concept of kind of hitting rock bottom
and I mean is that a false idea it’s a
very very very destructive myth the idea
that if you just make things bad enough
for people with addiction they’ll get
better has caused a lot of abuse a lot
of death a lot of psychological damage a
lot of making a lot of people’s lives
worse for a really long time in the name
of something that simply is not the case
if you look at when people recover
people are actually more likely to
recover if they still have a job if they
still have their family if they still
have resources I mean if you just think
about it logically who would you pick as
most likely to recover a doctor or a
homeless person yeah so true I mean have
you found that addicts move into other
forms of sort of addiction like a person
who is addicted to cocaine going into
kind of addiction towards sex yeah I
mean people can certainly do that it
just you know that happens to about half
of people with addiction they will
develop more than one but it’s you know
is it Universal no are there people who
can have addictions to say alcohol but
not marijuana absolutely are there
people who are addicted to cocaine but
not pot yes um so you know it’s not
always the case that everybody needs to
be totally abstinence forever obviously
that’s the safest route to take
but the this idea that you know you must
be perfectly abstinent from everything
if you’ve ever had an addiction to
anything just is unrealistic and also
incorrect yeah I mean um and we’re I
mean where is your research as far as
the harm reduction and the bringing I
mean what what is that we can do to kind
of help people who are struggling with
this sure so um as with helping anybody
else compassion love affection support
treating people with dignity and respect
all matter tremendously in addiction
what basically happens is that the
system that allows you to fall in love
with people or you know care for your
baby gets misdirected towards the drug
and so in order to help that system heal
relationships are critical and so what
people with addiction need they don’t
have any lack of pain what they are
missing is often hope and love and
support
and so tough-love is exactly the
opposite thing that they need now that’s
not to say that you should you know
tolerate an addicted family member
beating you up or stealing from you or
doing any kinds of nasty things it’s
just if you throw them out of the house
that will help you not them and it is by
the way perfectly acceptable to do that
to help you or your own family because
you can’t help anybody if you are being
abused so you know it is sometimes
necessary for people to cut people with
addiction out of their lives for that
reason um it just doesn’t work to save
their lives it may actually do the
opposite Wow
yeah you know I was reading I was
reading the story prior to this
interview about this this woman this
girl who was struggling with with heroin
usage and her parents found her needles
kicked her out of the house she ended up
becoming homeless I mean the story got
much much much worse and like what is I
mean what is your opinion about just
throwing someone into a kind of really
AB facility well it usually doesn’t work
um the thing with opioids in particular
is that the only treatment that we know
that reduces mortality and it reduces it
by 50 to 70 percent or more is
indefinite potentially lifelong
maintenance with either methadone or
buprenorphine which is better known as
suboxone so throwing somebody into an
abstinence rehab on will actually just
put them at risk of overdose that is way
more severe than when you started with
30 days after that you know a lot one of
the incredible things that has happened
in the last few years is Hazelden which
is the model for the 28-day rehab in
which you know is very strongly into 12
steps and complete abstinence from
everything they were finding that many
of their patients who had opioid
addictions unlike their alcohol patients
the opioid addiction patients would go
out and they’d be dead in a week and so
they now have decided that they will be
doing buprenorphine maintenance for some
of their patients the
because otherwise they die so it is
really important to know a that the best
treatment for opioid addiction is not
residential abstinence treatment and
it’s also important to know that
coercion is usually not the best way to
go
treatment in this country has suffered
an enormous amount because it basically
gets people that are forced to be there
if you are making cars and your
customers are forced to buy them you
don’t have to make very good cars if
your customers are forced to go into
treatment you can do absolutely awful
things to people which treatment
unfortunately sometimes does you know a
lot of treatment in the past and some
still to this day is based on the idea
that we will make you hit bottom we will
make you feel powerless we will attack
and humiliate and try to break your
personality into pieces you know who
would voluntarily choose that you know
the reason people with addiction avoid
treatment is not generally that they’re
having so much fun getting high it’s
that most treatment they know doesn’t
work and treats them awfully Wow
I mean it’s horrifying it seems like the
culture that we’ve established in
regards to you know the stigma behind
behind drug use and the criminalization
aspect of it is just it’s so completely
backwards it really is and what’s what’s
very odd about it is that you know the
12-step treatment providers have gone
around saying addiction is a disease but
the treatment is a self-help group that
teaches you prayer confession and
restitution and so people quite
logically react to that by saying you
don’t really think it’s a disease you
think it’s a sin and that’s not to say
that many many people don’t find help
from 12-step programs but it is to say
that they are not modern medicine hmm
interesting you know again it for the
research for this episode I was I saw
ended up seeing an a sign in Amsterdam
on the internet that said the cocaine
that
is being sold on the street has cut is
actually white heroin please be careful
and for tourists have died using this
and what an amazing approach you know if
we just kind of looked at this as a
health disorder rather than a criminal
disorder maybe we would make some some
progress but we absolutely would because
we’re throwing away money and people’s
lives right now
I mean why does anybody think that
putting someone in a cage is going to
fix any kind of psychological problem it
makes absolutely no sense the idea that
locking people up for possession would
be helpful for anything is ridiculous
the you know the idea of that is to make
it so stigmatized that people won’t do
the drugs but obviously that has failed
to work and it is ridiculous that we are
saying we must do we must distinguish I
as addiction but we criminalize it which
is the opposite thing like if it’s just
you know counterproductive I mean do you
find that most addicts want to get clean
and they’re just there there’s they’re
so compelled the the compulsion is so
high that I mean they just can’t well I
mean I think it’s complicated first of
all I would urge you to avoid the word
clean because that implies the people
who are still using are dirty and it’s
you know we just use this horribly
stigmatizing language though and I have
to catch myself I try to use people with
addiction as opposed to addict because
we don’t like in news coverage we don’t
say that person is a schizophrenic we
say that’s a person with schizophrenia
but we say that person is an addict so
anyway but yeah we just we do so many
things backwards and yes people with
addiction often are ambivalent about
quitting they feel you know again
imagine giving up the love of your life
imagine feeling like you know you’ve
been loved this way only this one time
and now you are giving that up like if
you heard a song that was your song or
if you you know saw like that person on
the street you would probably want to
talk to them you know it’s not
surprising that it is hard to
get over addiction but what I think I
think love is the best comparison to it
and yes like breaking up totally sucks
and some people actually do suffer
physical withdrawal in breaking up with
people you know it you know the
basically in the brain love is the
template that gets captured by addiction
but the good thing about that and the
thing that I think is important to
stress is that falling in love isn’t
breaking your brain falling in love is a
deep emotional form of learning that is
very hard to undo as anybody who’s ever
been dumped can tell you but the you
know but it’s not impossible and it’s
not brain damage it is simply a state of
maladaptive learning interesting I mean
is there a point and this is I mean this
is just kind of a rhetorical and for the
audience question is there a point where
you think it’s too late to help someone
no um I think that there may well be
people whose lives are so traumatic and
so compromised by a mental illness that
they may not be able to maintain
abstinence but there’s lots of things
you can do to help people in that state
first of all you can help them have a
home
second of all you can help them have
access to drugs that are safe and not
you know impure you can be kind to them
you know there are there are many many
different ways of dealing with people
but we just have to get rid of this idea
that the only acceptable State for a
human being with a with addiction is
like hat being absolutely drug free all
the time now that can and absolutely
does happen for some people but it is
just you know we we just have this idea
I mean it’s almost it’s like a form of
prejudice that if you have this
substance in your blood you are a bad
person yeah I mean you’ve you’ve done
some work on suicide as well
what’s your what’s your stance on that
well I mean what I
I think what you’re referring to I did
some articles about overdose and suicide
and one of the things that I think we
really really need better data on is
that we really don’t know on what
percentage of overdoses are actually
suicides or are these kind of weird like
the person doesn’t care if they live or
die and I think it’s really important to
know that because when we want to
prevent overdose we want to tell people
hey don’t mix alcohol with like heroin
and benzodiazepines because that’s a
really deadly combination but if
somebody doesn’t care they made or if
they’re actively suicidal they may be
like okay good there’s the recipe so
this doesn’t mean we don’t provide that
information but it also means that we
need to find out like you know how much
of this is despair and we need to try to
address that kind of despair man it
seems like 2016 has been a year of
celebrity deaths and a lot of these
celebrities are dying from overdoses
we’re finding out you know through tox
up toxicology reports we’re finding out
that they you know prince was on
fentanyl and you know others it what’s
your what’s your stance on this how I
mean how do you think these these a list
type people are being affected by
addiction well I mean I think that if
you look at addiction rates there are
clearly occupations that are especially
high risk and celebrities tend to be
really high risk as well as really
really poor people so what do those have
in common one of the things that they
have in common is that they have sort of
structure less time a lot of the time
but the other and I think more important
thing is that like when you have
everything that you want it can become
as meaningless as having nothing that
you want and so you know I also think
that celebrities are at high risk
because the drive and the compulsiveness
and the obsessiveness and the
persistence that allows you to get
through all the rejection and all the
hard work and all the stuff that you
have to deal with to get there is
exactly the kind of thing that people
do in terms of addiction and what is
what is your research show on using
iboga to treat heroin addiction you ask
things like that I mean I think that
clearly some people find those things
helpful I think that ibogaine there is
there have been some deaths associated
with it and it’s certainly the case that
a one-shot treatment is rarely going to
fix something as complex and long-lived
as addiction howard lotsof who
discovered that ibogaine relieves opioid
withdrawal told me this story once that
I’ve never forgotten and he said that
you know he gave it to a couple of his
friends who were also heroin addicts and
you know he got up and he was like wow
I’m not in withdrawal I don’t have to
get high I’m free yay and the others was
like we’re like wow I’m not a myth draw
let me go score so you know it’s like
you really have to understand you know
if people don’t have anything else in
their lives or if people’s like identity
is really wrapped up in you know being
an active drug user um you know unless
you come up with things that are going
to deal with that you know simply with
relieving the withdrawal or simply
having the insight that wow this is like
a huge problem for me which a lot of
people can get during the psychedelic
experiences and they can get insight
into trauma and all kinds of other
things but that insight alone is often
not enough if you don’t have support if
you don’t have you know something else
to live for it can be really really
difficult so I think you know again we
want to have as many tools as we
possibly can have to help people recover
and I think we definitely need more
research on all of that kind of stuff
but I think it’s equally dangerous to
call those things cures and to make to
over-promised because that’s the history
of addiction treatment it’s like people
are go around proclaiming this is a cure
and very quickly they find out that it
isn’t yeah that’s a safe perspective
I mean my what what is the single you
know first thing that perhaps someone
that is listening to our voices right
now can do that is struggling from for
from addiction and wants to not suffer
anymore um I always suggest that people
start with a complete psychiatric
evaluation by somebody who is not
affiliated with any rehab or any
addiction program at all
because so many people with addiction
have trauma and have other psychiatric
disorders it’s really good to know
what’s going on from the start so that
you can find the kind of help that’s
best for you so that I certainly
recommend I definitely also recommend if
you have an opioid addiction the safest
treatment options are methadone and
buprenorphine and don’t worry about oh
oh I’m replacing one addiction with
another that is absolutely not the case
because when you use methadone or
buprenorphine in an appropriate way when
you take it in a steady regular dose you
are not high you are not impaired you
can drive you can love your partner you
can take care of your kids you can do
everything that anybody else can do and
so you are not addicted you may still be
physically dependent but you know I’m
physically dependent on Prozac because
if I stopped taking Prozac I will
probably get depressed again does that
mean I’m addicted to Prozac no so I
think it’s really important to look at
maintenance medications in that light
and to not fall for the stigma that we
have associated with them I think we
really need to fight that I also think
that you know people with addiction
should read other stories of addiction
talk to other people with addiction
realize that there are many many
different paths and that if one doesn’t
work for you you can try another one
realize that even though you can’t feel
it right now there are almost certainly
people in your life that totally love
you and really care about you and are
not trying to control you or take away
your fun but they can
from their outside perspective that what
you’re doing isn’t working so those are
I think some of the key bits of advice I
would give is there a point that you
find with people who are suffering from
this disease that they are just kind of
Numb to everything well yeah that’s what
you want um you know um I think you know
when people are in that state that
they’re trying to achieve they’re really
tuned out from the world but you know if
you could stay like that it wouldn’t be
addiction it would be Nirvana right but
you can’t and you don’t and that doesn’t
work on this world so what you have to
do if somebody does seem really tuned
out is approach them at a different time
mm-hmm interesting I mean my I really
appreciate you know everything what
you’re doing you know dese – dese TIG
mitai zing this is I think so huge and
so important and really discussing this
as much as possible I think is is
crucial your story is is huge and I mean
I congratulations for you know kind of
beating this and and coming forward and
talking about it
thanks yeah no I mean it’s been really
an amazing journey and you know I it’s
funny because I you know get asked to
give advice at journalism schools and
stuff like this and I don’t want to say
well go shoot up for a few years you
know that would be a bad plan and I
certainly don’t recommend that but
because of having had the experience
that I have had unfortunate to that
experience maybe I have been able to
give a lot that I wouldn’t have
otherwise been able to do and I have
been able to understand situations that
I might not have otherwise been able to
do so so you know I guess you can make
lemonade right yeah so Maya where can
people find your work where can people
kind of get to your website give us that
oh sure so I am at just Maya a Z so it’s
ma I a s like Sam Z like zebra comm you
I also have a bi-monthly column at vice
and I write for a bunch of different
places and the book can be found it
you know Barnes and Noble Amazon
hopefully independent bookstores and
yeah
so those are a few ways thank you so
much Maya this is the human experience
we will see you guys next week
you