A way from addiction

Paige is an alcoholic in recovery. While she has since graduated from the University, she was in the special circumstance of being in college and recovery simultaneously. LSA sophomore Jake joined Paige in his own recovery efforts as an alcoholic on campus last year through the Collegiate Recovery Program.

Jennifer Cervi, school of social work graduate student, helped start CRP with Mary Jo Desprez, the University’s alcohol and other drug policy and prevention administrator, in the fall of 2011 as a part of her master’s in social work internship. Previously, there was a campus organization called Students for Recovery, which was then incorporated into CRP.

Cervi is working with the members to spread awareness of the group on campus.

“I would like no student to not know that it’s available to them,” said Cervi, who modeled the program after a similar group at Texas Tech University. “I would like the stigma around recovery to be changed on this campus.”

Jake knew about CRP before he came to the University and thought it would help make the school a good fit.

“I walk around campus and feel like I’m so different than everybody else, and I have to focus on these things that people at 19, 20 (and) 21 years old just aren’t thinking about,” Jake said. “The coolest part for me is being able to see other people in the program around campus and having that established connection with them. Having people to talk to about the same issues that you’re experiencing on campus because they know what it’s like.”

I met Paige and Jake on separate occasions, but in the same quiet room shrouded with wood panels and soundproof windows. A long wooden table ran between us. The room felt safe, a choice I considered when picking the location. Paige and I spoke in March, when she was an LSA senior getting ready to leave. Jake and I talked this summer while he was in Ann Arbor after finishing his first year of courses.

Though two people going through their own college experience could be widely dissimilar, their stories both share a theme: Paige and Jake are both in recovery from alcoholism and addiction.

And they’re not alone in their addiction, but are more of an anomaly for seeking recovery. According to the National Institute on Alcohol Abuse and Alcoholism, 19 percent of college students are either abusive or dependent on alcohol. And of that 19 percent, only 5 percent seek treatment.

“When you’re in college, the penalties for heavy use are not great because if you wake up and you’re too hung over to attend class, you can get away with it or if you screw up on an exam you can get away with it,” Psychology Prof. Robert Zucker, director of the University’s Addiction Research Center, said. “But if you show up at work and you’re acting this way, you immediately have a problem. Those are the kinds of external factors which lead one to decrease use.”

Zucker — who oversees the center’s both social and scientific research regarding addiction — said research is still being conducted to determine whether or not effects from addiction are permanent.

“We know the brain is undergoing major developmental changes between the ages of about 12 and 25,” Zucker said. “So if one is drinking very heavily or has other drug involvement, if that leaves some kind of permanent residual damages that does not repair itself afterwards, we don’t have the answer to that yet. It’s a very important question”

For students, it will be a very important answer.

I turned to Paige and Jake to put a voice to the data that taunts us in the news: “drinking amongst students increases,” “binge drinking reaches new high,” “university presidents call for lower drinking age.” I knew that Paige and Jake struggled with addiction when I met them, but the specifics I couldn’t have imagined. So I asked them for their stories.

“Can we start at the beginning?” I asked Paige as she sat down. Both Paige and Jake started their stories by going back to high school.

In late March, Paige missed our first interview due to her “nine-month sobriety anniversary.” But there was no celebration because, as Paige noted, that would be similar to a graduation, and there’s no graduation from their program.

“We can’t even have one drink and never again will be able to have a drink,” Paige said. “As alcoholics, we don’t know moderation and never will. I will never want just one drink, and I keep having to remind myself that.”

The pace and character of Paige’s storytelling was a story in itself: She would slow down and look at her hands as she spoke about times when the drinking caused harm, or in moments where there is black and she doesn’t remember. At other times — times where she was proud of what she has overcome or accepting of the events — she spoke to me as though she was a teacher of survival.

Paige is an alcoholic in recovery. However, her drinking tendencies didn’t fit the stereotypical definition of an “alcoholic” — she never drank alone, she didn’t start drinking when she woke up and her schoolwork didn’t plummet. But, she did drink to a blackout state almost every night.

She came to college not having experienced alcohol — told to stay away from it in high school as both an athlete and someone with a family history of addictive tendencies. And she did.

When Paige started at the University, she was told by her mom to rush a sorority as a means of making friends. During her time in the sorority, she frequently encountered alcohol and decided to start drinking.

“I’m slightly awkward and quiet,” Paige said. “So then I discovered alcohol and that was the “magic elixir” we call it, as something that made me someone different, which I didn’t realize then.”

Unlike Paige, Jake’s addiction started earlier in his life. When he started at the University in winter 2012 he was already in recovery. Jake first had issues with drugs and alcohol when he was in high school.

“I started having issues with drugs around 16 years old,” Jake said. “That escalated pretty fast through my sophomore, junior (and) senior years of high school, and I’d say after my junior year things were pretty hectic. Things with my parents were very rocky, and I couldn’t stop using.”

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But why Paige and Jake? Why were they susceptible to becoming addicted to drugs and alcohol early in life? Paige figured genetics had to do with it, Jake said circumstance. I sought to learn the science behind addiction from Psychology Prof. Terry Robinson, who teaches a course on the subject and conducts research that explores addiction and the effects drugs have on the brain.

According to Robinson, addiction is rooted in a primitive brain system humans have developed for survival called the dopamine-reward system. It’s responsible for impulses like human attraction to items like bananas and other food to help them survive.

Robinson said some of the leading research on the causes of addiction involves an over-activation, or hypersensitivity, of the dopamine-reward system in the brain that is due to repeated drug use. Dopamine is a neurotransmitter, which is a small molecule released from nerve cells in the brain into spaces between nerve cell endings called synapses, carrying signals to other nerve cells.

“What we think is going on in addiction is because these drugs produce a surge in dopamine, and they produce an unusually large surge compared to natural rewards, … they render all of the stimuli associated with drugs with pathological motivational value so that then they become excessively wanted,” Robinson said. “… They have this property to tap into this dopamine system that’s there just to mediate natural rewards.”

In other words, when someone uses a drug, its properties cause the brain to release more dopamine than it normally does and the user feels compelled to use them again — they end up wanting drugs more than they want the things that help them survive.

However, there is a popular misconception about dopamine — that it encourages “liking.” Robinson says this idea is false.

“The role of dopamine in reward is to mediate the wanting, the desire for it. And in the brain the wanting and liking are separable,” Robinson said. “And, in fact, people will report the drugs aren’t so great anymore in terms of the pleasure they get, but they still want it more and more and more.”

With repeated drug use, the brain changes in ways that are proposed to be similar to learning. As the brain changes and the dopamine system becomes “sensitized,” the effects of the drugs increase.

“You can sort of think of (sensitization) as the inverse of tolerance,” Robinson said. “Usually when you think about being repeatedly exposed to drugs you get less and less drug effect, that’s tolerance. And that’s true, tolerance develops to some drug effects, but other drug effects show sensitization — that is they get bigger and bigger, suggesting that the neural systems that mediate these drug effects that sensitize are also becoming hyper-sensitive if you will.”

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As she spoke, Paige recalled how her drinking escalated. She remembers when she had her first blackout — where she was and the less-than-pleasant conditions in an unknown place when she woke up. She sees the times when she tried to control her drinking by limiting her consumption to only one type of alcohol and she knows when she reached the point where nearly every drinking occasion meant blacking out.

“In Greek life, you just assume blacking out was normal and drinking a lot was normal,” Paige said. “It’s kind of interesting to look back because it’s like, ‘What was I thinking?’”

While at school, Paige would compare her drinking habits to her friends and believed she was not addicted to alcohol because they were drinking more than her.

“People tried to confront me about it and I would just be like ‘No, I don’t have a problem, I’m just drinking like everyone else does,’” Paige said.

Jake, continued to drink while watching his relationship with his parents deteriorate.

“Early in my senior year of high school, I had a major blow up with them, and I left home,” Jake said. “Then about two days later I said to my mom, ‘I think I need to go to treatment.’ That was December 2 of 2010, and that was the first time I entered treatment.”

After he ended treatment in April, he relapsed in June. He said he started to build resentment towards peers who didn’t have to worry about sobriety.

When he started using drugs and alcohol again, his parents offered an ultimatum: He couldn’t attend school at the University in the fall if he continued using.

“I didn’t care, and I kept using,” Jake said.

Because he continued using, he went to treatment again, this time at a wilderness program in North Carolina.

“It was enjoyable in a sense, but at the same time it kind of got me centered and realize what I needed to do,” Jake said.

Jake then came to Ann Arbor and spent his first semester at Washtenaw Community College before enrolling at the University for the winter semester.

In Ann Arbor, Jake lived in two different three-quarter houses — houses for people transitioning from treatment back to “normal” life.

After his first semester at the University was over, Jake briefly encountered drugs again — a relapse that put his life at risk.

“About three weeks after the semester ended, I took this deep sigh of relief (feeling) like I got through the school year clean and sober,” Jake said. “I had about 11 months sober and then I kind of forgot what I was doing and forgot that recovery and staying sober is a 24/7, 365-type deal, and I went back out and used.”

He drove to Detroit to buy drugs and woke up after overdosing surrounded in vomit with a bruised face.

“That was a very scary time because it seemed like a good idea, and for that to seem like a good idea seems ludicrous to anybody but an alcoholic and an addict,” Jake said. “The amount I used should kill any human being. A lot of people were shocked that I didn’t die.”

Paige reached her breaking point last summer when she left a party in nearby Saline and crashed her car.

But she doesn’t remember this.

She can’t tell me how her car crashed and at the time she didn’t know where she was. The details of that night have been relayed back to her from her mother, and she only can repeat what she’s been told.

The next day after the incident, though she resisted, Paige’s mom took her to an Alcoholics Anonymous meeting.

“She took me to a meeting, and she actually was crying to her friends which I’ve really never seen her do,” Paige said. “I’ve never seen her vulnerable in public ever, and she just couldn’t help it. And this woman came up and said, ‘welcome to the family.’”

Both Paige and Jake used different types of treatment for their recovery. Prof. Zucker said finding the right treatment for each person is important.

“There are a variety of different kinds of interventions … and those are all effective if one continues with them,” Zucker said. “They may not be one’s particular cup of tea (and it) doesn’t seem to fit, but if one sees that one of these resolutions is not working, one needs to look for something else because there are other options available. When one is significantly addicted, self-help often does not work.”

After going back and forth between drug use and treatment, Jake said that his most recent time using drugs caused a major change in his mindset and that has made him recommitted to stay clean and sober.

“That was a huge realization for me,” Jake said. “I came to a point where I, for the first time in my life, really felt like I was dedicated to staying sober. You really have to give all of yourself to that end if you want to accomplish it.”

Environment, however, can also serve as a gateway to recovery. Last year, both Paige and Jake participated in CRP, and both said it’s a significant contributor to their recovery success.

Paige, nine months sober in April when I spoke with her, was the vice president of CRP. She joined after being introduced to it by her AA sponsor.

“I know that if I didn’t have this community, if I just tried to stay sober by myself, it wouldn’t have worked,” Paige said.

Desprez said the University combats dangerous drinking and drug use in a variety of ways.

“We know a couple things, that one thing won’t work so you have to do a series of interventions” with evidence-based strategies, Desprez said.

Zucker added that because college offers a more “at-risk” environment for drinking, universities offer different options to combat drinking issues, with some programs working better than others.

“If you look at the data, there’s a tremendous amount of variation with some schools still very clearly being party schools, where it’s likely also that the alumni and the administration don’t take a heavy stance about controlling it,” Zucker said. “Then there’s schools who take it more seriously, who have alternative activities on football nights that don’t involve drinking or arrange transportation and generally raise awareness of the risk that’s associated with this.”

The student life survey, which is compiled from a random sample of students at the University every two years, shows that every year since 2005 — a year when binge drinking at the University hit its all-time high of 53.2 percent — it has decreased.

One effort to decease drinking at the University is the “Stay in the Blue” harm-prevention campaign started in the fall of 2006.

“(The Stay in the Blue campaign) helps people attach a (blood alcohol content) level to a level of low risk,” Desprez said.

Marsha Benz, health educator for alcohol and other drugs, was one of the primary people involved with initiating the campaign. Last spring, she said a big factor in making the campaign successful was including students in the process.

This year’s data, which was released with the 2011 student life survey results, shows the binge drinking prevalence number is the lowest it has been in over 10 years, at 44.7 percent. The lowest percentage previously reported was 45 percent in 1999.

Like Paige, Jake seldom mentioned being scared while using drugs. The only time Jake explicitly referred to his experiences as being scary was when he traveled to Detroit and overdosed. He said usually he wasn’t scared about using drugs.

“The two favorable options were to finally realize I can finally live a life clean or to not have to be in that misery anymore,” Jake said. “So it didn’t seem so bad in the moment to use those drugs and alcohol and think ‘Well, maybe if I wasn’t here anymore, it’d be better than being miserable.’ But you realize after the haze clears, that that’s a crazy thought and that you shouldn’t think like that, but in the moment you’re not really afraid of it. At least I wasn’t.”

To say it was easy to listen to the things they’ve already gone through in their still-young lives would be a lie. Paige and Jake, both sober and clean now, kept saying they were lucky — lucky to have the resources to already be in recovery — and that was the most hopeful outlook I could find for the problem of underage addiction and addiction in general.