INTRODUCTION

About Face: Essays on Recovery, Therapies, and Controversies of Addictions in Canada seeks to illuminate social justice and equity in Canada germane to addictions. This collection is meant to be accessible to a broad spectrum of the Canadian population, and by highlighting the stories of diverse people affected by addiction, we hope to increase public awareness, debate, and direction in the understanding and treatment of addiction.

Some contend that addiction is a disease, or a spiritual problem created by a lack of meaning and purpose in this twenty-first-century era of increased social disconnect and loneliness. One thing is for sure—people with addictions are our family members, co-workers, healthcare professionals, teachers, counsellors, and community leaders—people with addictions are present in every walk of life. Addictions bypass social class, ethnicity, sexual orientation, sex/gender, rural and urban locations, and the spectrum of physical and mental health. Addiction is not a phenomenon of the other but affects us all.

In our first section, entitled Substance Abuse, several essays relate the grip of alcohol and cigarette addictions, by far the most common drugs used by Canadians. The estimated costs of cigarette and alcohol harm to Canadians are in the billions. Among youth, while smoking and alcohol abuse has decreased in recent years, prescription-stimulant use is on the rise. In the twenty-first century, there is a marked increase in so-called party drugs, including ecstasy, cocaine, ketamine, crystal meth, Percocet, and other various opioids. However, their use is not limited to youth, but involves mothers and fathers, blue- and pink-collar workers, and university educated professionals. Do you think of these drugs and automatically picture rave culture with tribal beats and strobe lights? Think again. In many circles, these drugs have replaced the evening or weekend cocktail or beer.

The second section of this anthology explores, Digital Addictions: Sex, Video Games, Gambling, and Social Media. Growing numbers of Canadians not only excessively partake of alcohol, but also use the Internet to procure multiple sex partners while under the influence of drugs such as crystal meth. Legal ramifications of sexually compulsive behaviours are also discussed. Additionally, whether it be an addiction to dating or hook-up sites, Facebook, Instagram, video games, or online gambling, some Canadians spiral down a rabbit hole that is deleterious to their mental and physical health, social and familial relationships, and employment. Professionals who treat them, and who problematize the superficial characterizations of this new-millennium trend, complement this section.

The third section is Food Addiction, Body Dysmorphia, and Eating Disorders. Awareness of eating disorders was brought to public attention in the 1980s in a proliferation of movies, television shows, talk shows, documentaries, and books. Obesity and compulsive eating are an ongoing problem, emphasising the intricate interplay of mental and physical stressors in life. Moreover, in our millennium, men, women, and youth are exposed to unprecedented social-media messages to obtain the perfect body. Perfectionism is but one trait common to many of those affected with body dysmorphia. While increasing numbers of boys and men suffer from anorexia nervosa and bulimia, girls and women remain the majority. However, a significant number of Canadian boys and men display megarexia or bigorexia—the drive to become impossibly muscular and/or to have a lean musculature. Abuse of anabolic steroids, obsessive dieting, counting of calories, and embracing of so-called miracle foods, along with an overly regimented workout schedule, may lead to what some term the Adonis Complex. To conclude this section, therapists discuss the distinctions and overlap between body dysmorphia and those who suffer from substance abuse, delving into the question, Are eating disorders addictions?

Contemporary Discussion of Addictions in Canada: Steps Forward, contains provocative essays by people working in the field of addictions, including social workers, therapists, criminologists, psychologists, lawyers, a journalist, and a psychiatrist. The lives of imprisoned men and women, many of whom are Indigenous, are accentuated, and links made to inmates’ histories of childhood abuse and poverty. The need for increased government funding is a reoccurring theme. A final section, Service Providers, provides an overview of several agencies across Canada known for their innovative and holistic treatment of various addictions.

In brief, About Face: Essays on Recovery, Therapies, and Controversies of Addictions in Canada, aims to question:

Who suffers from addiction in Canada?

How can we better understand addiction in the 21st century, and its myriad new forms?

What are steps forward in the prevention and treatment of Canadians affected by addiction?

About Face: Essays on Recovery, Therapies, and Controversies of Addictions in Canada provides a timely platform for rigorous discussion and improved understanding of the contemporary evolution of addictions across our country.

Douglas Gosse

General Editor

SUBSTANCE ABUSE

A friend’s heart attack, two more friends dying of cancer, watching relatives carry around oxygen tanks, all of these would remind me that I shouldn’t smoke, and then I would light up.

When my grandmother was a young mother of six children, she went to the doctor due to stress. Her family doctor told her to go out and buy a pack of cigarettes, keep them at home, and whenever she was feeling anxiety, to smoke. Thus, prescribed by her doctor, my grandmother picked up and set down cigarettes for years. Fortunately, she was one of those individuals who could behave in this manner and not become an addict.

My mother was not so fortunate. She started as a young woman as well, and smoked until she was in her fifties. She had her own experience with a doctor when pregnant with her first child, myself. She asked her family physician if smoking was bad for the fetus. He asked how much she smoked and, upon hearing it was just under a pack a day, told her she had nothing to worry about. She thus continued to smoke through her pregnancies, with us in the car as children and in the house, and didn’t quit until we were adults living away from home. Though it was over twenty years ago, today at seventy-nine she still chews nicotine gum and, on occasion, when feeling stress, will go out and purchase nicotine patches.

I am my mother’s daughter.

I had my first cigarette around grade seven. Over visiting friends whose parents were out of town, I had one after being offered. Everyone else was and so, being the typical eleven-year-old girl, I didn’t want to feel different, and so I lit up. I coughed terribly, but felt such pride at doing something so adult that I went home that night and kissed my mother. Thus was my introduction to the fact that cigarettes smell.

In grade eight, after witnessing that many of my friends’ parents had given permission to their children to smoke, I asked my mom for permission. She was so upset with me that she lit up a cigarette to calm down. I gave her the expected teenage glare and the conversation was over.

What proceeded through my high-school years were instances of smoking at school, out at parties, and mom finding my cigarettes and taking them. By this point I had a part-time job and could easily replace them. Smoking was easy back then. Just as when I was a child and my mom used to send me to the store for cigarettes, no one asked for ID when I was in high school. You simply went in and asked and they were given to you. At school, there were no lessons on the evil of tobacco; instead, there were smoking areas on school property, and the teachers smoked in the staffroom. I remember smoking on the bus, smoking being allowed on airplanes and in restaurants, and smoking during a movie in a movie theatre.

In the later years of high school, I do remember thinking that I wouldn’t smoke when I turned twenty, but this auspicious birthday came and left with me still smoking. It was not until I was in university that smoking started to become ‘not in vogue.’ I quit for the first time in my third year of university. I remember the initial days feeling angry and upset, but didn’t recognise the wild mood swings I was having as withdrawal. I had experienced similar times in high school when I had to go away for a few weeks with my parents on family trips, but never associated these terrible angry moments with the cigarettes. I quit for over a year, until one night at a university party there was this guy whom I really liked. He was having a cigarette. I walked up to him and bummed one in order to strike up a conversation. At that point, I was working in a student pub, and given smoking was still allowed indoors and the customers and staff smoked, it was nothing to pick up the habit again. Back then, smoking was still considered a habit. I have to say, there was something so deliciously social about having a cigarette with another person. I still feel this way.

By the time I had my first job whether or not you could smoke at your desk at work was dependent on your employer. While many provided breaks and smoking rooms, more still provided ashtrays beside your typewriter. I was successful in the career I chose, but due to a series of events, ended up going to teacher’s college. I smoked all the way through teacher’s college though there were times I would abstain due to the fact that less and less of my friends seemed to be smoking. I also found it was interfering with my sports as digging for the ball in volleyball, or swimming fast in water polo became challenging. I seemed to have the muscle tone to be competitive, but would occasionally get winded. I also started to feel tingling in my hands and feet on occasion. This always occurred when I smoked and seemed to disappear when I did not. The social rewards of smoking, though, always outweighed these symptoms, and so I continued to light up. It was not really an issue as smoking was allowed at the university, just not inside anymore, and smoking still occurred inside bars and cars and restaurants and, while on teacher placement, on public-school property. We would step outside and smoke on the steps of the school.

It was within my first years of teaching that school boards began to demand that teachers and students leave school property to smoke. I remember the first warning from the board office that announced that if teachers did not leave school property they would be fined, and their principals would be fined three times the amount. Having your principal fined because of something you chose to do was enough to cause a mass exodus of vehicles every lunch hour from the school parking lot. Snowstorms, rainstorms, scheduled meeting with parents, nothing would deter us from our lunch-hour drives. I can remember bundling up and going out to my car, sweeping it off in blowing wind that cut my face and hurt my hands, driving off school property and up the road in zero visibility, just to get that one cigarette in me. Boy, could I suck that one cigarette back. It was such a pleasure! I always kept perfume in the car and would try to avoid everyone upon reentering the school, making a beeline to the sink to brush my teeth. I didn’t want anyone to smell it on me. With a sense of shame that I owned this addiction, I would cower over the sink and brush like crazy, making sure my clothes didn’t smell, and my hair was re-hairsprayed. This sense of shame was not enough to make me quit, though, as smoking was still considered acceptable in many social places, whether in a bar or at a ball diamond, at people’s homes, or in the car. The only place I felt shame was at work or when in a situation with nonsmokers. However, this shame was as intense as the desire to smoke. The desire to smoke, the addiction, overrode the shame on most occasions, but not always.

I remember one weekend being at a volleyball tournament with my students. By lunch, my normal cigarette time, I was dying for a smoke. I knew I could have one, but then the parents and students would smell it on me, so out of a sense of shame, I resisted. I was wound up tighter then a drum by the time the tournament ended. Even forming sentences when talking with parents seemed difficult. My nerves were drawn like violin strings and I was trying very hard not to shake. My eyes began to lose their ability to focus, and I clenched my hands to prevent the shakes from spreading to my arms. One cigarette would have solved the problem, but I could not allow myself to be seen as a smoker by these others. In similar situations, there were times I even cried upon finally having that first cigarette, such was the relief.

During the next twenty years, I quit numerous times. Sometimes it lasted only a few days, but during other times it lasted months, and on one occasion it lasted a year. It was always finding myself in a social situation with another smoker that caused me to fall off the wagon. By this time I knew I was an addict, and accepted the label. At this time, society had changed enough that the dangers of smoking were better known. Gone were the days of advertisements on the television, on billboards, and in magazines for different brands of cigarettes. In their place, we had health warnings, documentaries on cancer, and then later some pretty awful pictures on cigarette packages. Yet, despite all this new information, I continued to find myself smoking. A friend’s heart attack, two more friends dying of cancer, watching relatives carry around oxygen tanks, all of these would remind me that I shouldn’t smoke, and then I would light up.

Beside social situations, the other big catalyst for me was stress. A bad day at work, favouritism by a boss that hurt others, a dispute with a friend or partner—any of these could stimulate the need for a smoke. In fact, just being in a room with someone who smoked could prompt me to light up as well, despite how long I had quit. Of course, when others felt the same way as I did about a stressor and they smoked, then the urge was doubly strong. It was common to find myself sitting on a patio with a peer or a group of peers from work, discussing the situation with a beer and cigarette in hand. We were venting. We were seeking solace. We were releasing stress. Of course, once the meeting was over, I would have a cigarette or two in the car on the way home and then continue to smoke through the evening. The following morning, after brushing my teeth, the first thing I would do is have a cigarette.

After numerous years of smoking in my car and in my house, I decided to only smoke outside. The catalyst for this change was a new car and then a new house. I couldn’t stand the smell of old cigarette smoke on my clothes and didn’t want to spend hours cleaning yellow off the inside of the car windshield, off framed photos in the house, nor tackle cleaning the yellow stains that ran down the walls. It occurred to me more than once, since this residue was left on glass and walls, to question what must be left in my lungs. I would have a smoke as I thought about it. These visual facts were not enough to stop me from smoking. It could be a snowstorm or pouring rain, and yet outside I would go, cigarette in hand, to suck back the nicotine into my lungs.

My battle with cigarettes continues. I am an addict. I quit frequently and for months at a time. I have found if I want to stay off cigarettes I need to not drink alcohol or coffee, avoid heavy foods and large meals, avoid social situations with any friends who smoke or who like to talk about stressful things, and walk a lot. Basically, if I want to be a non-smoker, I must be a hermit. I have done so on many occasions, forgoing social invites and ostracizing myself from a social life. I can quit for five months in this manner until I find the smell of cigarette smoke on others so repulsive that it physically turns my stomach. And yet, with a beer or two in me while sitting with a friend who smokes, it is likely I fall of the wagon. The craving to have one is immense, even though the smell and taste disgust me. The smoke enters my lungs and after the initial revulsion, it is like I relax. My muscles relax, my nerves relax, my entire being slows down, and my mind finds peace.

When I am not smoking, after the initial five days of withdrawal that is present even with the nicotine patch, and despite the vivid dreams of cigarettes I frequently have at night, I find myself happier. I feel together and in control. I feel complete. I feel energized. When I find myself experiencing this intense happiness and completeness, I remind myself to remember these feelings and to never light up again. I always think I won’t; and then I do. All it takes is for me to find myself in a social situation, have a few beers, and be around a smoker. My friends who still smoke are only too happy to give me one when I ask. All it takes is one, and I am hooked again.

I am an addict. I am always hooked, always craving, always one decision away from having a smoke. I never wanted to be an addict. I never set out to be one. I feel shame frequently and try to hide it all the time. I sneak out the back door at work and look around to make sure there is no one I know before lighting up. While sucking the smoke into my lungs, I keep my eyes peeled for other people so I can hide. I continue to fight the addiction every day.

I have thought about going to Alcoholics Anonymous or Narcotics Anonymous to see if it will help. The problem is that what frequently happens at these meetings is that people share and then, at break, have a coffee and go out for a smoke. For addiction meetings, smoking is considered the lesser of two evils. Cigarette smoking, as much as it is considered disgusting by many today and recognized as an addiction, has a different history than other drugs. While it was never considered okay to watch porn on an airplane, in vogue to have a joint in the workplace, or socially acceptable to drink while watching a movie in a theatre, for a long time, smoking was socially acceptable and even encouraged. For this reason, there are no meetings for me, and I must continue to struggle on my own. Though a narcotic, when cigarettes are your evil vice and addiction, you are alone in coping. I had a friend who was an alcoholic who explained to me that he could never do drugs, as it would stimulate the need to drink. I had another friend who was in Narcotics Anonymous who explained he could never drink, as it would create the desire in him to do drugs. Smoking, though a narcotic, due to its social history of acceptance, is still allowed by these twelve-step programs. I have friends who have quit for twenty years who have started smoking again. It is still out there and accepted by segments of society. Cigarettes are still sold in corner stores with milk, bread, and deodorant.

I do not want to smoke. And yet, upon the smoke entering my lungs, I feel whole again. I am in recovery frequently, but I am always a smoker. Despite the negative attitude, given the permissiveness and acceptance that still exists in society, I suspect that I will always be a smoker. I know I am an addict. I know smoking has killed some of my friends and relatives. I try to abstain, but then I light up and feel shame. I occasionally cry. And then I will have a second one.

I know the essays in this book are to be those of people in recovery. I have not had a cigarette since July 2017, and yet I find myself wondering if we are ever really in recovery. Are we ever recovered? I also find myself wondering how many of those with alcohol, drug, porn, or sex addictions are also still smokers. Smoking has a unique place among addictions. It is still accepted in certain situations. How I wish the world were different when I was young, and how I wish the world were different now. Writing this was stressful; I think I’ll have a smoke.

I had seen what happened when you turned on people, and I saw your Jekyll-and-Hyde personality. I had seen you use people until there was nothing left.

Dear alcohol,

We can no longer be friends, ever. For many years, I thought you were my friend. I looked to you to comfort me in times of pain and sorrow, and I even hung around with you during the happy times. For many years, we seemed to have a good relationship, but as time passed, I sensed our relationship was going bad. People even warned me that I should hang out with you less. I became too dependent on you and needed you more and more. This was not a healthy relationship. You were always there, every day, to take the edge off. At first, you seemed to make every day a little better, and even spending a few minutes with you in the evenings was enough for me to forget about whatever was bothering me. You whispered to me even when I wanted to be alone with my thoughts. You assured me that no matter what I had going on, I could count on you to see me through the day. You made subtle suggestions that one more would make things just that much better. You kept my demons at bay.

The signs were there from the start, and I should have paid attention. I had seen what happened when you turned on people, and I saw your Jekyll-and-Hyde personality. I had seen you use people until there was nothing left. I had seen you ruin families, relationships, and lives, but you assured me that you were not the cause. You said, It was really the people themselves who were screwed up. They were the weak ones. You told me time and time again that I was not one of those people and we could be friends forever. You told me I was stronger than everybody else and what we had together was special and unique. I believed you. For years, I believed you. I convinced myself that our relationship was different and that I would never become one of those people. You boosted my confidence and made me feel special. You convinced me that any problem could be overcome just by having a drink. It seemed to work for a long time.

Then I started noticing the change. You became more demanding. You wanted to spend more and more time together. You became jealous of the time I spent with others. You wanted me exclusively to yourself. You whispered dark things to me. For years, you held the key that kept my demons locked away. Whenever they threatened to break free, you could push them back into that locked box in my mind. For years, you were the only gatekeeper that worked, and with you, I could keep them at bay. When I attempted to distance our friendship, you blackmailed me. You would let the darkness peek out, and then you would threaten to release it if I stayed away from you. You used your powers of persuasion to always reel me back in. We were living a lie together, right under the noses of the other people I loved. I became your prisoner instead of your friend. Despite my best attempts, I could not break free. I felt guilty about you, but felt helpless to do anything about it. I was afraid that my demons would finally come out and I would be left dirty, discarded, and alone.

In the days leading up to our breakup, you convinced me that nothing else mattered, only our friendship. You convinced me that I didn’t need anybody else but you. You made me push everybody away. You made me believe that if we couldn’t be together then life was not worth living. On this dark day, I saw no light.

Thankfully, something pulled me back from the brink and I asked for what I had been too afraid to ask for all my life—help. I discovered that there were people who loved me more than you. I found that in my darkest hour of despair, I was worthy and, if I were strong enough, I could face my demons. I reached out for a hand to hold and realized there were many hands that wanted to hold mine. I realized that maybe I could not do without you on my own, but I could with the help and love of others.

Since our breakup, I have learned a lot about you. I see that you were never a true friend and were only using me to get what you wanted—control. You wanted to control me like you control many others. My body, my mind, and my soul were only pawns that you toyed with. You made many promises, but kept very few. I now know that even though you made me feel special and strong, I was not unique, and you cheated on me with countless others. I was a fool for believing you could fix anything. All those evenings and weekends we spent together and the problems you said you were fixing were all there the next day. We never fixed anything together; we only made things worse. All those times you told me our friendship would take the edge off, we only ever masked the symptoms and never addressed any of the issues. All those mornings you stayed and offered me comfort from the night before was a lie. You just wanted to keep me on your leash so that I couldn’t stray from your firm grasp. All those bad decisions we made together seemed like fun at the time, but only served to hurt myself and others. Looking back, you always seemed to come out unscathed, and I was the one with the hurt, shame, sorrow, and guilt. You were never my true friend.

I think this breakup will be harder on me than you. I know you have many other friends and have a long list of young people that want to be your friend. I know you are still there and will make many attempts to rekindle our relationship. I know your appeal. I know how intoxicating you can be and how the sight and scent of you makes me susceptible to your charms. I know that I must be on my guard for fear of losing myself in you all over again. I still see you with my friends and family, and I see you playing the same tricks with some of them as you played on me.

I have faced my demons, and I have grown stronger without you. I have learned that love and life are far better friends than you ever were. I have learned that each precious moment in the day is worthwhile, and if I need you to be happy, then something else in my life is broken and needs fixing. My body and my mind are healthier since I left you, and my true inner spirit has taken your place.

So this is goodbye, forever.

My new, sober world was a scary one. My confidence left me. In a strange way, my motivation was gone, and I could no longer put in the marathons at the office without the promise of the beer-soaked reset button at the end.

Mine was a weekend alcoholism. The kind you can brush aside, as I did, for years by saying things like, It’s just a few drinks. It’s not like I do it every day. I work hard; I deserve it.

I grew up in England and later moved to Newfoundland. From a drinking culture perspective, you could say that’s the frying pan to the fire. Add my field of work—creative marketing—to the mix and you’ve just thrown on gasoline.

There are many drinks I can’t recall, but I remember my first one well enough. It should have served as a warning, but at fifteen I lacked the perspective I’ve earned today. I loved the way that cold, crisp, bubbly beer made me feel. I remember standing in the bathroom, the taste on my lips, the warm feeling in my stomach, thinking, Oh yes. I’m going to be doing much more of this. I sure did. Only much later did I learn that the disease worsens the younger you start.

We were at my Mum’s friend’s place when I had that first one. She was a journalist and, I would later discover, an alcoholic herself. Go on, she said, that way we alkies do, Let him have a pint. He’s old enough now. Mum was reluctant but such was the culture. Safer, I’m sure she thought, to be here when he tries it than not. (That friend of my Mum’s would later lose her driver’s license and career to the bottle.)

That wasn’t my first time being close to beer, or smelling its hoppy odour. My earliest memory of beer was sitting on Dad’s lap as a toddler, being entertained as he wrote my name in the thick white foam of his Guinness and showed me how it was miraculously still there at the bottom of the glass after he’d quaffed the thick black liquid below.

Nor was it the first time I was drunk. That came a little later, at a cousin’s house party. They’d let me off the leash that night. Introduced me to the joys of whiskey and coke, and made the mistake of telling me to help myself. I did, and, as it turns out, I most certainly didn’t. Mum stood over me tutting as I threw up from alcohol abuse for the first time, but far from the last.

As the years went by, my love of booze continued to develop. University made it easier than ever to overindulge. Fifty-pence-a-pint days at the Student Union. Vodka-Red Bull ‘Pitchers of Happiness’ (oh, the irony) at the local student bar. Endless cheap tins of the bubbly stuff to bring back and drink at home, sometimes with friends, but increasingly alone.

Five years sober and I still sometimes do that thing that addicts do. I question if I was really an addict at all. What if I overreacted to a few bad nights and a few bad choices and cut the booze I loved so much out of my life for no good reason? What if I’m missing out?

Then I pull out the little scrap of paper I keep in my satchel at all times, in the little Velcro pocket with a plastic comb I never use. The scrap of paper where I jotted down the words, Why you are an alcoholic:

Drinking alone. I started this as a teenager. I loved nothing more than being in my bedroom, knocking back beers and singing along to my blasting music. Sometimes with a friend, often not. It hardly seemed to matter. Check one.

Unable to stop at one or two. I remember coming home for Christmas after my first semester at uni and going to visit my next-door neighbour. He gave me a tall can of beer. I drank it. He didn’t offer me another, so I asked. My friend asked me, Do you ever have just one? I thought it was a silly question. At eighteen years old, I already regarded having one drink as a waste of time, a waste of an opportunity to get lit. If I knew I’d only be able to get my hands on one beer, I’d opt not to drink at all. Later, stopping at one case of beer would become a challenge. Check two.

Becoming very convincing. I don’t have a problem; I just had a rough day / I’m celebrating / I just played soccer / it’s Friday, etc. Check three.

Struggling through workday hangovers. Today, when my addict brain says, Hey, why don’t we have a beer? those are the days I think of. Head throbbing, body aching, stomach nauseous. Your soul itself begging you to just lie down, close your eyes and sleep. But you can’t. This is a get-through day, I’d have to keep telling myself. Just get through today. What a horrible way to live. Check four.

Can’t stop for a period of time. I remember telling my now-wife (then-girlfriend) that of course I could go a whole weekend without drinking. I think I even believed it myself. I lasted till about 7 p.m. on Friday night. Check five.

The clock hits five and you’re drinking immediately. Only on Fridays for the most part, but then I didn’t