“Internet addiction” may soon spread like wildfire. All the elements favoring fad generation are in place: the profusion of alarming books, the breathless articles in magazines and newspapers, extensive TV exposure, ubiquitous blogs. the springing up of unproven treatment programs, the availability of millions of potential patients, and an exuberant trumpeting by newly minted “thought-leading” researchers and clinicians.

So far, DSM 5 has provided the only restraint. Exercising uncharacteristically wise decision making, it has chosen to rain on this parade by relegating Internet addiction to an obscure appendix rather than legitimizing it as an official psychiatric diagnosis. But Internet addiction seems to be picking up steam even without DSM 5 endorsement.

There is no doubt that most of us have become hooked on our electronic devices, and that some people are gravely harmed by what develops into an unhealthy and uncontrollable attachment to them. The question is how best to understand, define, and deal with this. What does the term “addiction” mean, and when is it a useful way of describing our passions and needs? We don’t consider ourselves addicted to our cars, TVs, refrigerators, or air conditioners. Is attachment to the Internet fundamentally different? If so, how and what do we do about it?

The definition of Internet addiction is closely related to the definition of drug addiction, so this is the best place to start if we are to gain understanding and avoid confusion. Three features define drug addiction:

1. Tolerance: needing more to get the same kick.
2. Withdrawal: feeling terrible when you try to stop
3. A pattern of compulsive use: continuing the substance even if the pleasure is largely gone and the cost is extremely high (e.g., terrible health, work, interpersonal, financial, and/or legal consequences).

 Drug addiction means being enslaved — not being able to stop using, despite the lousy cost/benefit ratio of no longer getting much pleasure from the drug while suffering much harm from it. This has to be clearly distinguished from the much more common pattern of recreational use (i.e., taking drugs because they are fun and accepting the harms because, at least in the short run, they seem worth it). Recreational use may lead to really stupid choices and dreadful outcomes, but it is not to be considered a mental disorder.

DSM 5 proposes to introduce a category of “behavioral addictions,” with gambling as the first member and Internet addiction standing next in line to become a possible second. Behavioral addictions could easily expand to eventually include passionate attachments to many other common activities. If we can be addicted to gambling and the Internet, why not also include addictions to shopping, exercise, sex, work, golf, sunbathing, model railroading, you name it? All passionate interests are at risk for redefinition as mental disorders.

The whole concept of behavioral addictions is highly controversial and has never heretofore been given any official status. There is a good reason for this. It is extremely difficult to distinguish the relatively few people who are really enslaved by shopping, sex, work, golf, or the Internet from the huge army of those who are attached to these as pleasurable recreation. It should not be counted as a mental disorder and be called an “addiction” just because you really love an activity, get a lot of pleasure from it, and spend a lot of time doing it. To be considered “addicted,” you should be compulsively stuck doing something that is no longer fun, feels out of control, serves no useful purpose, and is certainly not worth the pain, costs, and harms. The unfavorable cost/benefit ratio should be pretty lopsided before mental disorder is considered.

We all do dumb things that offer short-term pleasures but cause bad long-term consequences. It is not “addiction” whenever someone gets into trouble because of overspending, golfing too much, or having repeated sexual indiscretions. That’s our human nature, derived from many millions of years of evolutionary experience during a time when life was short, opportunities for pleasure rare, and the long term didn’t count for nearly as much as it does now. There is a risky slippery slope if we medicalize our pleasure-seeking, irresponsible selves. “Addiction” could easily become an Oprah-ready excuse for impulsive and irresponsible pleasure seeking (“I am really sorry I did it, but it is not my fault — my addiction made me do it!”).

This brings us to “Internet addiction.” Granted, lots of us are furtively checking emails in movie theaters and in the middle of the night, feel lost when temporarily separated from our electronic friends, and spend every spare minute surfing, texting, or playing games. But does this really qualify us as addicts? No, not usually, not unless our attachment is compulsive and without reward or utility; interferes with participation and success in real life; and causes significant distress or impairment. For most people, the tie to the Internet, however powerful and consuming, brings much more pleasure or productivity than pain and impairment. This is more love affair and/or tool using than enslavement and is not best considered the stuff of mental disorder. It would be silly to define as psychiatric illness behavior that has now become so much a necessary part of everyone’s daily life and work.

The best analogy is caffeine. Many millions of people can’t get through the day without their treasured cups of coffee. Starbucks built its franchise and skillfully sited its drug distribution centers on the proven premise that coffee is addicting. In preparing DSM-IV, we excluded caffeine as an addictive substance only because it doesn’t cause that much trouble for most of the people hooked on it. It seemed crazy to diagnose mental illness in all those people patiently waiting in line for their next hit. Most Internet users deserve equally benign neglect from psychiatric diagnosis. Ditto passionate shoppers, workaholics, sexual athletes, golfing fiends, and dedicated sun worshipers. If the activity works for them, it is not to be labeled addiction and is not a mental disorder.

But what about the small minority of Internet users who really are stuck in a pattern of joyless, compulsive, worthless, and self-destructive use — the 24/7 gamers, the shut-ins, the people trapped in virtual lives? The concept of addiction may indeed apply to many of them, and diagnosis and treatment may someday be proven to be useful, but not yet; it is still far too early to tell. We don’t know how to define Internet addiction in a way that will not also mislabel the many who are doing just fine being chained to their electronics. We also don’t know what proportion of excessive users are stuck on the Internet because they have a primary psychiatric problem that needs to be addressed first and may be missed if “Internet addiction” becomes an explain-all, masking their underlying problems.

So far, the research on “Internet addiction” is remarkably thin and not very informative. Don’t get too excited by pretty pictures showing the same parts of the brain lighting up during Internet use and drug use; they light up non-specifically for any highly valued activity and are not indicative of pathology. The history of psychiatry is filled with fad diagnoses that far overshoot their target, get wildly misapplied, and spawn new “treatments” that are often no more than expensive quackery. “Internet addiction” needs to be less a media darling and more a target of sober research.

South Korea is the most wired country in the world and has the biggest problem with excessive Internet use. The government is attempting to tackle this head-on with education, research, and intelligent public policy, none of which has required declaring “Internet addiction” a mental disorder. This is an excellent model for the rest of the world to follow. Deal with the problem of excessive Internet use as it exists in those who have it, without prematurely jumping to a label that may be misleading and is likely to unleash a set of harmful unintended consequences.

Despite all the media hype, it is way premature to conclude that the Internet is controlling our lives, ruining our brains, and driving us crazy. We are not all Internet addicts. Let’s stop this fad before it starts.

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I’m an alcoholic. That revelation isn’t new. But alcoholics, I’ve learned, are masters at considering themselves the exceptions—the special snowflakes who’ll find a path toward sobriety that doesn’t actually involve giving up booze.

At least I did.

A year ago, after 67 days of not drinking, of going to meetings and taking it one day at a time and introducing myself and raising my hand and taking people’s phone numbers, I slipped. And once I slipped, I started strategizing. I didn’t want to be an alcoholic. I also wanted to drink. And, like countless other people before me, I thought I’d find an easier way—or eight. These were a few of my attempts.

1. The “Sober in the States, Alcoholic Abroad” Strategy. A few months after my first meeting—day 67, to be exact—I went to Spain for a week of solo traveling. On my first night in San Sebastian, I discovered that glasses of red were one or two euros each—cheaper than coffee, cheaper than water! It’s part of the culture. It’s an experience, I thought, shifting on the cobblestoned street as I glanced up at a tiny café. It doesn’t really count. But it did, a realization made all the more evident when I came back to the States and—jet-lagged, exhausted, and still headache-y hungover—immediately hit a bar, not a meeting.

My goal was just to get through the holiday season without embarrassing myself.

2.  But I’d Only Order Beer. Post-vacation, this was my new compromise. After all, it was summer. There were barbeques and rooftop parties and all-day drinking sessions in the park. Beer had never gotten me as hammered as hard alcohol or wine, so it seemed like a safe choice. Until, of course, after pint four or five, when I’d be the first to suggest shots.

3. Finding a Semi-Sober Sister. Around that time, my friend Kelly was also trying to cut back. So we decided to help each other. We’d only have two drinks. Three if it was a weekend. And four if someone else was buying.

4. Making Up Cutesy Reminder Mantras. JOG, I’d whisper under my breath as I headed into a fancy cocktail bar. It was an acronym for Just Order Gin. It was already fall, and the sobriety of early summer was a distant memory. So were my early attempts at cutting back. Now, I decided that I’d order anything I wanted—as long as it had gin in it (a liquor I’d never liked). I knew from the meetings I had attended that this was a pretty ineffective strategy, but mine would be different. After all, other people didn’t have acronyms.

5. Self-Shaming. The thing about already having admitted you’re an alcoholic is that you aren’t waiting for that light bulb “this isn’t normal” moment. Even though I wasn’t going to AA anymore, I wasn’t in denial that I had a capital P Problem. I just didn’t want to deal with it. So instead, my goal was just to get through the holiday season without embarrassing myself. Before any party—where I’d notoriously drink too much and end up throwing up or passing out on the host’s bed—I’d go through photos from previous soirees. I’d make myself look at images of myself—hair mussed, lipstick a mess, eyes red and wild, with a drink in my hand. Don’t be that girl, I’d sternly remind myself. Alone, in front of my laptop, it was an easy resolution. But as soon as my wineglass was refilled, it was forgotten in favor of my old party resolution, which was to drink as much as absolutely, humanly possible.

6. Training for a Half Marathon. Quite honestly, this method was the most effective of my not-effective strategies. In the winter, I signed up for a running class that met at 7AM every Saturday morning. Not only would I not drink on Friday nights, but I also found surprising moments of clarity in the early AM cold. I liked feeling as if I were doing something positive for myself. And I began making friends who weren’t into late night bar hopping. But occasionally, I wouldn’t be able to resist temptation and would hit up an after-work happy hour on a Friday. I’d wake up sad and sick on Saturday mornings, knowing that I wasn’t in any condition to run—and I’d feel like a failure as I drifted back to sleep. Because if I couldn’t even make it to a workout, how could I ever take control of my drinking?

7. Pill popping. As winter slid into spring, I saw a psychiatrist with the goal of getting an Adderall prescription. I was overwhelmed. Work, freelance projects, running, and dating were all taking up too much time, and I found myself constantly panicked about being able to get everything done. When I confessed this to a friend, she recommended I try Adderall—and gave me the name of her own prescribing doctor. After a seven-minute consultation, I walked away with a prescription and immediately began taking them the way my friend recommended: As many as possible, whenever I was out. Adderall wasn’t coke, but it did remind me of it, a bit. I was buzzy, chatty, licked my lips a million times a minute and could be out all night and be productive at work the next morning—until I’d crash and turn into a crying, bitchy mess.

8. Lying. This is the one I’m most ashamed of, and what eventually led me back to AA in May of 2012, a year after my first meeting. The Adderall had pushed me over the edge, and friends—including a guy I’d just begun to date—were concerned. I’m actually taking a break from drinking, I told him one day, a couple of days before a Kentucky Derby Day party he was hosting. I’d gotten too drunk on a recent date that culminated in me crying on his shoulder in a cab. That sounds like a good idea, he said. Relief flickered in his eyes. On the day of the party, I filled a water bottle with vodka. I finished it within the first hour. Afterwards, I took perverse pleasure in waiting until his back was turned, then rushing to the makeshift bar where I’d refill with whatever clear alcohol I could find. I’d head to the bathroom and take Adderall. And then, when all the guests were gone, we had sex, but it was hard and fast and I didn’t remember any of it. Which, unfortunately, was all too familiar. I was back to where I’d been in the worst days of my drinking. I guess it was my bottom, but to me, it didn’t feel like that so much as the norm. And there it was: if I kept doing this, these things would keep happening. It was time to try the simple solution. Stop.

And for the past 80 days, I have. I want this time to stick. I hope it will. Sometimes, I get angry with myself that I didn’t just stay with it the first time. I wonder what it would be like if I had a year of sobriety, instead of being at the stage of counting days and collecting phone numbers just like I was last spring. But there’s also a relief in the certainty that while some people can just cut back, I’m not one of them. Plus, after so much time feeling so alone in my struggle to maintain sobriety, it’s a relief to be surrounded by other special snowflakes…who are, of course, just like me.

JL Scott is the pseudonym for a writer living in New York City.

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I often imagined I would fall down the stairs with my son in my arms when I was in a blackout. There were many ways to cause him injury but it was the stairs my brain kept going back to. And yet picturing that didn’t halt my drinking.

This is what I say to my friend, Gina, when she asks me about my rock bottom. I search her face for traces of shock—a twitch, a shutter-speed blink of an eye—but her face is still.

“It’s not that I made peace with it,” I say, suddenly self-conscious. Gina nods. “But I couldn’t stop. And nobody or nothing could stop me.” Gina nods. She nods and she nods because she’s an alcoholic just like me and she knows about not being able to stop.

I recalled this conversation recently, when I heard about Toni Medranoaccidentally killing her three-week old baby when she crushed him after drunkenly rolling over him. Eight months later, she set herself on fire and died. Medrano’s family suggested she killed herself after watching Nancy Grace’s histrionic blame-game on CNN, where Grace called for murder charges, acted out Medrano’s drinking and coined the term “Vodka mom” to possibly further dehumanize Medrano.

Upstairs, I was a good mom but downstairs I was a drunk.

I saw Medrano’s suicide as a non-surprising ending to a tragic event that began with the first sip of vodka on that November 21st, 2011. I imagined myself in her place and thought that the suicide wasn’t just because of Grace’s predictable idiocy, although it may have helped push her over the edge. I think that Medrano was standing at that edge, looking down for a long time—perhaps even before her son died. When I drank, I thought about suicide too. I thought it would be a way to prevent the tragedy I was sure I was courting. I was lucky nothing happened when I drank after my son was born. I was lucky I got sober, not dead. Lucky. Not better, smarter than Medrano or even more responsible. Just lucky.

I first got sober at 27 and relapsed when I was 31, after my son was born.

When I drank, I had a routine worked out. I would put the baby to sleep in his crib and wait until my husband would go to bed. Then I would go downstairs to the living room and watch movies on my laptop and drink in secret. My husband never caught me with a drink. He knew that I was at it again but he had no idea about the extent of it. I hid bottles in the closet, in the inside lining of my purse. I hid them behind the potted plants on the deck and behind the baby’s diaper drawer and in the stroller. I hid them in my shoes. I lied. I made sure I looked well put-together. I never asked for help. It’s true that sometimes, I thought I should probably kill myself to prevent something bad from happening but, again, planning a suicide would mean admitting that something was going to happen.

I knew, too, that my drinking would catch up with me. It would be only a matter of time before I got sloppy, before my brain got too fogged up by too much booze, before I threw routines out the window. As I drank, I kept looking at the stairs. They felt symbolic. Upstairs, I was a good mom but downstairs I was a drunk. I imagined myself in a blackout, climbing up, taking my son out of the crib. And carrying my son as I walked down those tall, polished-white, slippery oak stairs.

There is the famous story that New York Times writer David Carr tells in his memoir The Night of the Gun about driving to his dealer’s house (Kenny’s) with his baby daughters and leaving them in a car for hours as he did drugs. He wrote, “God had looked after the twins, and by proxy me, but I realized at that moment that I was in the midst of a transgression He could not easily forgive. I made a decision never to be that man again.”  This is the famous story but the part that I can relate to best is this short passage: “Sometime soon after that night at Kenny’s…I became convinced that something brutal and unspeakable was about to land on all of us, including the kids.” Carr entered treatment shortly afterwards.

Like Carr, I, too, was in the midst of a transgression watching those stairs. I could picture what could happen but I still couldn’t admit it. And the truth is, if anyone asked me if I needed help, I’d say, “I’m fine, there’s nothing wrong.” Yes, I realized I was in the midst of a transgression but no epiphany followed. There was no God to intervene; no clear-cut insight that would make me stop. I was unstoppable. The only hope I had left was that I might also be wrong about that.

See, foresight doesn’t always work. And even people trying to stop you are weaker than the addiction. Toni Medrano’s husband found her passed out on the couch on that fateful night and warned her about falling asleep with the baby next to her. Who knows what she said but she probably told him things were fine—that’s what I often said to my husband too. Everything is fine. (Help.) Everything is fine. Or maybe she even told him she wasn’t going to do it and she did it anyway. In the morning, her husband woke up to her yelling, “The baby is dead!”

I wrote a book about my experience as a drunk mom, which will be published in the spring. I wrote it for all kinds of reasons, the main one being so that I could try to understand how my love for my son was no match for addiction.  My husband, who read the manuscript recently, said he would have had my son removed from my care right in the beginning of my relapse, had he known. Had he looked inside of the lining of my purse, the potted plants on the deck? Behind the baby’s diaper drawer? The lining of the stroller canopy? The point is, he wouldn’t have known, he wouldn’t have stood a chance against my hiding. As for me, there was no way I would’ve confessed out loud to the screaming in my head.

I eventually got sober under rather mundane circumstances: I broke a toe, my husband asked me to move out, it was summer. There was no voice from the sky, no decisions. The hope came over me simply and suddenly, completely unprovoked as I limped toward the park with my son in the stroller one sunny morning. My husband will tell you I got sober because he threatened to kick me out. But really? It could’ve been the nice weather, it could’ve been the little toe. It was not my son in my stroller. He was just lucky. I was just lucky. We lived. The epiphanies came only after I got sober.

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“Today Show” host Kathie Lee Gifford is being slammed by addiction experts and fans for implying that the parents of drug addicts are failures as moms and dads and are ultimately at fault for their children’s drug and substance-abuse problems.

Gifford, 58, made the inflammatory statement in the September 2012 issue of “Family Circle” magazine, where she snorted: “I’m not a perfect mom, but my kids haven’t been arrested, in rehab or kicked out of school, so I must be doing something right!”

Since then, Kathie Lee has come under fire from offended fans, who barraged her Facebook page with comments such as the following:

“Well Kathy, here is a pic of my little brother who we lost at the age of 33 yrs old due to a DISEASE called DRUG ADDICTION … I find it funny we were both raised by the same woman called MOM … I am NOT an ADDICT and NEVER was … Poor parenting?? Gimme a break.”

“Shame on you Kathie Lee Gifford, shame on you. You are a thoughtless human being.”

“I’m glad you never had to face any of your babies drowning in a disease they could not be cured from. I lost my baby at the age of 32 to a heroin overdose in Sept 2010. I am a doctor and worked hard my entire life to give her the best.”

The gaffe-prone Gifford has also been criticized by addiction experts, who note that drug abuse and alcoholism are not the result of poor parenting, but rather, are brain diseases unrelated to the alleged moral failings of moms and dads.

“It really is exasperating that uneducated celebrities feel the need to pontificate about addiction as if they are experts,” says Ben Levenson, CEO of Origins Recovery Centers.

“It is shocking that someone like Kathie Lee would seemingly kick suffering parents when they are desperately trying to save their children’s lives. Enough misinformation already! Addiction is a disease which affects over 30 million Americans, approximately the same number of Americans suffering from diabetes. If bad parenting were causal of addiction, as Kathie Lee suggests, this number may be even higher.”

This stance was echoed by Dr. Frank Lawlis, director of psychology and neurological plasticity programs at Origins.

“It’s widely regarded among medical professionals that addiction is a disease of the brain specifically relating to the Accumbens Nucleus (the pleasure center), and it stems from the inability to properly metabolize dopamine,” says Lawlis.

“This imbalance promotes depression and these individuals, addicts, seek external stimuli like drugs or alcohol to feel normal. The brain’s neuro pathways in an addict cease to work normally, so the only way an addict can achieve happiness is from external stimulation.”

Kathie Lee, who has a son Cody, 22, and daughter Cassidy, 19, has been curiously quiet since the fallout began, but might want to be more careful with her comments next time.

After all, her husband, former NFL star Frank Gifford, 81, famously cheated on her in 1997 with a 46-year-old flight attendant, who interestingly, was older and less attractive than Kathie. Using Kathie Lee’s reasoning, it would be logical to conclude that her husband cheated because she was a terrible wife who was bad in bed.

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We’re a nation of addicts. Would you care to dispute it?

Recent studies confirm an alarming reality: As a country, when it comes to dealing with personal problems, we use an external fix. Whether it’s routine disruptions we face at work, the common crises at home, or our children trying to parse the maelstrom of media overload—the fact is that it’s increasingly rare that Americans turn to internal or interpersonal resources to establish equilibrium. Instead, our first impulse is to seek out a quick and external source, which becomes both the cause of our problems, and the solution.

The first place people look is the simple dopamine spike. Most people have reliable techniques to make themselves feel better—or, as I like to say, to give themselves a little “dopamine spike.” Dopamine, as you probably know, is the neurotransmitter triggered by “rewarding events.” These pleasurable moments may occur naturally, but they are also thedirect result of specific drugs, such as cocaine, methamphetamine or nicotine.

How is it that we’ve wrapped ourselves in the fuzzy dopamine blanket of substance misuse, prescription medication, compulsive eating, celebrity worship, compulsive shopping, internet addiction, video gaming, and compulsive sexual behavior?

While we may admire the American impulse to applaud hard work, innovation, and daring, the rewards of these labors aren’t immediate. We’re an impatient nation; we seek more immediate gratification. We’ve come to accept an approach of “why wait?”, so we grab ahold of whatever it takes to feel better, to keep feeling better, to make it through the day.

In our addicted culture, we go for the artificially-induced dopamine spike—and not just one, but one right after the next. Consider the following: Roughly one in ten Americans is currently an illicit drug user; nearly one quarter of American adults engage in binge drinking, many on a regular basis; and the majority of those with problem drug or alcohol use do not seek treatment for their problems.

Now, if we broaden the criteria that we use in thinking about addiction to include unhealthy coping mechanisms and other “ways-to-get-through-the-day”—we face staggering results. For one, most Americans have lost their ability to eat normally, with two-thirds of the nation’s adults meeting the definition of obese. As another example, approximately one out of every five American women is on an anti-depressant. I recently signed up with a new primary care physician. When she found out that I’m a psychologist, she asked me “Why is every kid in New York on Ritalin, and every adult taking Ambien?”

It’s an excellent question.

How is it that we’ve wrapped ourselves in the fuzzy dopamine blanket of substance misuse, prescription medication, compulsive eating, celebrity worship, compulsive shopping, internet addiction, video gaming, and compulsive sexual behavior?

Here’s one reason: these external fixes are readily available, and every addiction fuels somebody else’s craving—for cash. The alcohol industry takes in over $100 billion a year; Big Tobacco earns $35 billion. Gambling, pornography, prostitution, and texting all add fuel to our country’s dopamine fire.

The root issue is that direct, undiluted, authentic engagement with the world and others is a challenge, and the strategy of occasional mood alteration that many employ to “take the edge off” can slide into something more dangerous. Others end up in another kind of distorted dependence, finding that it’s easier to move your onscreen avatar through the world than to actually navigate it on your own. What about thetragic case of the Korean couple who found it easier to raise a “virtual” baby in a popular internet cafe than to take care of their child who died while they were busy online?

The couple’s three-month old starved to death. She was only fed between sessions of the game. According to police, these parents “indulged themselves in the online game raising a virtual character so as to escape from reality, which led to the death of their real baby. Here in Dopamine Nation, internet and video game addiction are real concerns.

Those of us who work in the addiction treatment community find our most critical task—helping clients find an authentic path to recovery—more challenging than ever. In part, this is due to a culture that seems engineered to foster dependence on artificially induced means to “feel OK.”

Turn on the TV, and the prevailing wisdom says there’s no reason to suffer discomfort. Moreover, we’re being instructed that continuous synthetic  “adjustment” is the norm – in other words, there’s a pill for whatever ails you: ADHD, shyness, erectile dysfunction, fibromyalgia—you name it. Of course, abuse of these drugs is soaring, from anxiety medications to pain pills. But the problem is more insidious.

We’re so addicted to food that we literally have to seek surgical intervention to staple our stomachs in order to control our weight. Technologies allow us to seemingly be everywhere at once, but we’re never quite “right here now.”

These same devices create a state of continuous partial attention. We’re so busy attending to our screens and keys, so dependent on the next little dopamine surge that comes in the form of a text, that we turn our eyes from the road and accidents are increasing in record numbers.

Speaking of cars, picture this. Your vehicle is acting up, so you take it to the service station. You know there’s something wrong because it just doesn’t run the way it used to. You explain the problem to the mechanic, and he lays out your options.

“OK,” he says. “You have a choice. You can put some goop in the engine every day. It’s expensive, you’ll have to do it forever, and it may make the problem worse. Plus, we’ll never know what’s wrong. Or, I can lift the hood and see what’s going on.”

Which option would you choose?

We’re all human, and we like to feel good. Dopamine is naturally generated from any number of physical and emotional sources. The accumulation of externally generated dopamine, however, creates a vicious cycle of relief- seeking that ultimately spirals out of control. For those who are lucky – or smart – it lands patients in our offices where we can finally begin to “lift up the hood”—and actively address the real problems.

The life of Everclear front man Art Alexakis may have resembled a Behind The Music special before he got famous, his greatest career successes occurred once he got sober. Alexakis dealt with an absentee father, the death of his brother to a heroin overdose and the suicide of his girlfriend—all before his 14th birthday. You kind of can’t blame the guy for turning to drugs to numb the pain. Smoking weed at age nine, he was shooting dope by 13 and eventually suffered a nearly fatal cocaine overdose at 22. After a few attempts at sobriety, he got fully clean in 1989 and has been sober ever since.

Since then, his band has sold nearly five million records, with 1997’s So Much For The Afterglow reaching double platinum and songs like Santa Monica and Everything to Everyone reaching No. 1 on the Billboard Modern Rock charts. Now, Everclear and several other ‘90s friendly bands including Sugar Ray and the Gin Blossoms have hit the road this summer for the Summerland Tour 2012.

In our exclusive interview, Alexakis talks about performing sober as a touring musician, how the heroin overdose of his brother inspired him to do more drugs and his wife’s reaction to seeing him on morphine at the hospital.

I shot up for the first time when I was 13 and that became my whole perception of self.

How’s the Summerland Tour been so far?

So far, so good. We’ve done really well in about 75 percent of the markets—some huge successes but no failures. As far as the performances go, everyone is on top of their game. No one is taking this for granted because it’s been so hard to tour for the last few years. You have to give people value for their money. With this tour, there’s five bands, four hours worth of performances and a lot of hits between us, all for 40 bucks. That’s what it takes these days.

You’ve been sober for 23 years now. How do you maneuver around performing in bars and clubs and places where alcohol is flowing?

It’s tricky because the alcohol isn’t just on stage but backstage as well. I’m an anomaly on this tour. There are only two or three sober people who are part of the entire tour and I’m the only sober performer. I just don’t pay attention to what other people do. You’ve got to want to be sober and not want to be part of that world.

There are definitely times where I’m not strong. I still think about drinking and I’ve been sober for 23 years. I’ve learned that when it gets bad, I’ll have a doughnut or something like that when I maybe shouldn’t. I’m a guy who allows himself to have vices—just not ones that will destroy my life.

It’s interesting you say that because a lot of people often think that there gets to be a point in sobriety where those cravings just disappear.

I haven’t met that guy or gal yet. I still get wake-up calls every now and then. Three or four years ago, we played a show with a guy that was big in the ‘80s and he said he had been sober for almost 20 years. He started having a couple beers every now and then and within two months, he was shooting dope and living with a stripper. You’re never out of the woods. I’m an addict and always have to ask myself what I’m doing that’s feeding my addiction.

I’ve always had a bad back but this past winter it turned into sciatica and was the worst pain I’ve ever had. It hurt too much to get on the MRI table and the doctors said, “We’ve got to medicate you, you’re not breaking your sobriety.” I didn’t want to do it, but I had two vertebrae that were smashed and they needed to see that. They gave me the smallest amount of morphine possible and I got on the table. My wife of nine years comes in and she’s never seen me using before. She goes, “I’ve never seen you like this. I’ve never seen you happy.” (Laughs). I was like, “That’s because I’m comfortable in my own skin now and you’ll never see me like this again.” (Laughs).

Were you ever worried about not being able to be in recovery anonymously during the peak of your fame?

There was some of that. There was a period where people would wait outside the door and ask for autographs or pictures. I don’t want to say no to people, but it just wasn’t the spot for that and I was uneasy about the safety of others at the meeting. But at the end of the day, it makes people happy and it’s just so easy to say yes.

You’ve said that you started smoking weed at age nine and shooting dope by 13. How do you score weed as a nine-year-old?

It was the ‘70s, dude! (Laughs). My brother died of a heroin overdose when I was 12. All my relatives except my aunt and my sister were smoking pot and I lived in a housing project in a rough neighborhood. It sounds incredibly crazy, but it wasn’t that hard. It might have been harder to get drugs in elementary school, but by junior high it wasn’t.

It seems like having your brother overdose on heroin would be the catalyst for most people to stop doing drugs. Why wasn’t it for you?

It’s gonna sound silly saying it now, but it was actually the catalyst for me to get into drugs seriously. I wanted to be like him because he was the only male role model I had at that point. How fucked up is that? But he loved me and cared about me. And there were other issues that were still being dealt with. My dad leaving us when I was six. Being sexually abused by a bunch of teenage guys in my neighborhood when I was eight. My girlfriend at that time committing suicide not too long after my brother’s overdose. All that shit adds up.

I shot up for the first time when I was 13 and that became my whole perception of self: I do drugs and I do more drugs than anyone else. If you do one hit of acid, I’m gonna do four. I didn’t even like doing drugs all that much. There was only one specific instance of getting high when I really liked it.

Recreational drugs called bath salts, which have gained popularity recently and have been in the news for their bizarre effects on users, have the potential for abuse and addiction, similar to that of cocaine.

 

Bath salts, which, despite their name, have no use in the tub, are different variations of the compound called cathinone, an alkaloid that comes from the khat plant. Currently, 42 U.S. states have laws banning many substituted cathinones. Mephedrone is one of the most common derivatives of cathinone and was listed federally in October 2011 on Schedule 1 of the Controlled Substances Act for one year, pending further study. Then on July 9, 2012, President Barack Obama signed a law placing bath salts containing mephedrone or the stimulant MDPV onto the controlled substances list.

 

The drugs can cause a laundry list of body and mind changes, including dizziness, delusions, paranoia, suicidal thoughts, seizures, nausea, vomiting and even death.

 

In the study, Malanga and his colleagues trained mice to spin a wheel to receive a reward. In this case, the reward was direct stimulation of a brain circuit involved in reward perception. The electrical stimulation came from electrodes implanted into the mice’s brains.

 

“These are tiny, tiny currents at the very tip of a tiny, tiny electrode, delivering the current to very specific and discrete brain circuits,” said Dr. C.J. Malanga, an associate professor of neurology, pediatrics and psychology at the University of North Carolina School of Medicine.

 

Called intracranial self-stimulation, the method has been used since the 1950s to look at whether drugs activate reward areas of the brain. The thinking goes that when the electrical stimulation is intense enough for the mice to perceive it as rewarding, these mice will work hard to spin the wheel and get more of that reward. “If you let them, an animal will work to deliver self-stimulation to the exclusion of everything else — it won’t eat, it won’t sleep,” Malanga told LiveScience. [10 Easy Paths to Self Destruction]

 

During the study, the researchers measured wheel-spinning effort before, during and after the implanted mice received various doses of either

mephedrone or cocaine.

 

“All drugs of abuse, regardless of how they act in the brain — heroin, morphine, cocaine amphetamine, alcohol, do the same thing to ICSS, they increase its rewarding value,” Malanga said. So for a lower electrical stimulation, one that wasn’t considered rewarding previously, the mice drugged with cocaine, say, would then be willing to spin the wheel.

 

It turned out that mephedrone had the same reward potency as cocaine, causing the mice to work for the reward at lower stimulations.

The study results, published online June 21 in the journal Behavioural Brain Research, suggest mephedrone and similar drugs have significant addiction potential, supporting the recent ban on the sale of bath salts in the United States, signed on July 9, Malanga said.

 

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For years, oxycodone reigned as the prescription drug of choice for dealers and abusers in Florida.

The painkiller was so widely prescribed in the Sunshine State that just two years ago, 90 of the top 100 oxycodone-buying physicians in the nation were from Florida.

But a major crackdown by law enforcement, a new prescription-drug-monitoring database, legislation and other factors have caused a significant reduction in the amount of oxycodone available in Florida.

And the streets are feeling it.

“Our street sources tell us that the crackdown on pain clinics has had a definite impact on the price and availability of oxycodone,” said Volusia County Sheriff’s Office spokesman Gary Davidson. “We’re still working about the same number of pill-related cases as in the past, although there has been a small uptick in morphine seizures.”

Central Florida law enforcers say oxycodone is hard to come by these days, and when abusers and dealers can find the drugs they need, the pills can get prohibitively expensive.

Authorities say Central Florida physicians are prescribing less oxycodone now than in the past, partly because they’re now being tracked by the Prescription Drug Monitoring Program. Some local pharmacists also are reluctant to fill prescriptions they think might be suspect.

That means abusers are turning to other drugs, such as the painkiller hydromorphone, investigators say.

And there are concerns across the country that heroin use could rise, and that overdoses could increase as abusers try drugs they aren’t familiar with.

In Seminole County, narcotics investigators say they are seeing more hydromorphone on the streets, but it’s not because that is the preferred drug.

“It is because it is cheaper and easier to acquire than oxycodone,” said Sheriff’s Office spokeswoman Heather Smith.

Law-enforcement officials in Orange County said they have encountered people with illegal hydromorphone during traffic stops, undercover buys and even when they’re assisting the Department of Children and Families during child-welfare checks, according to a review of local arrest reports.

On a recent afternoon in east Orange County, deputies say, James Franklin Frost walked into a Walgreens on East Colonial Drive, implied he had a gun and placed a note on the pharmacy counter demanding prescription drugs.

He got away with about 600 Dilaudid pills, a brand name forhydromorphone, before being spotted by deputies in a wooded area near the pharmacy.

In April, Kyle Elden Shiver of Orlando was arrested after, authorities said, he agreed to sell an undercover detective 86 Dilaudid pills for $1,376.

Agents with the Metropolitan Bureau of Investigation, the task force that investigates prescription-drug cases in Orange and Osceola counties, say an oxycodone pill today can cost about $30 on the street.

In comparison, a Dilaudid pill will run about $15.

MBI Director Larry Zwieg said if addicts can’t get their oxycodone, they’re most likely going to try another drug.

That observation was mirrored in a national study recently published in the New England Journal of Medicine that looked at the illicit use of OxyContin before and after the painkiller was reformulated to make it more difficult to crush — a deterrent to abuse.

Of those surveyed, 66percent said they switched to another opioid after OxyContin was reformulated in 2010, and the most common drug shift was to heroin.

There also was an increase in the number of people who chose hydromorphone and fentanyl, a painkiller more potent than morphine, as their primary drug.

The researchers wrote that their data showed the harder-to-crush OxyContin formula reduced abuse of that drug but caused abusers to find replacement drugs, including heroin.

Researcher Theodore J. Cicero, a professor at Washington University in St. Louis, said it’s logical that some oxycodone abusers would switch to heroin, as the painkiller is often crushed and snorted or injected.

“The worrisome thing about this switch with all these drugs is people who were accustomed to oxycodone … are suddenly now forced to use other drugs that they may not be familiar with,” Cicero said.

That change in drug use, Cicero said, could lead to accidental overdoses.

According to recent data from the Substance Abuse and Mental Health Services Administration, 81percent of people who stated using heroin from 2008 to 2010 had previously abused prescription drugs.

Heroin use still pales in comparison to prescription-drug abuse, said Berit Hallberg, deputy press secretary for the Office of National Drug Control Policy.

“The public-health and safety threat that heroin and the abuse of prescription painkillers pose to our nation is devastating,” Hallberg said. “While heroin use is still far less common than prescription-drug abuse, we must ensure that the federal government — in close coordination with state and local authorities — responds effectively and in a balanced way to any emerging trends.”

Though some of the patients in Cicero’s study reported a switch to heroin, Central Florida law enforcers say they aren’t seeing any significant shift to heroin as a preferred drug.

But that doesn’t mean abusers are giving up drugs.

“At the end of the day, you’ve got thousands or hundreds of thousands of people who are addicted to drugs,” said Florida Department of Law Enforcement Special Agent Danny Banks. “And when the drugs that they are addicted to become less available, they are going to need to find some other type of drug to fuel their addiction.”

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Life happens and you’re walking around like Queen of All Sober People expecting to be exempt from little things like job loss, illness, and divorce. And slowly it dawns on you that when they say things like “Life on life’s terms” and “We practice these principles in all our affairs” they’re talking to YOU. Not the guy sitting behind and slightly to your left.

How disappointing to find that getting clean not only doesn’t get you a parade, it often brings with it all kinds of wreckage that you were either too drunk or stoned to see before. Nothing takes you down 10 pegs like a sober look at what you’ve done with the last few years of your life—especially divorce, that many-headed hydra of pain, remorse, and guilt.

Karen Khaleghi, the founder and Director of Education for Creative Care Malibu, a rehabilitation center specializing in dual diagnoses, points out that “no one starts a marriage with the intention of divorcing—people are naturally optimistic.” Khaleghi, who has worked for over 20 years with families in recovery, adds that because of these high expectations, couples often feel like failures and experience a deep sense of loss if they do get divorced “and this applies doubly to those in recovery, especially when they’re facing a problematic relationship for the first time with a clear mind.” When a spouse enters treatment, Dr. Khaleghi notes, it isn’t uncommon for their partner to break off the relationship or file for divorce.

Early in sobriety, it occurred to me that my husband and I no longer spoke, made eye contact, or entered each other’s perimeter except to exchange grocery lists, cash, or speeches about how the other person was Falling Short.

She counsels sober people in troubled marriages to “connect the dots” and understand the link between their emotions and their behavior. “Holding onto anger and resentment,” she adds, “keeps you stuck and attached to your loss and anger.”

My friend, a fellow author named Amy Hatvany, struggled through years of legal wrangling during her divorce, all while trying to balance motherhood and recovery. And while she knew others in her home group had been divorced, she still felt isolated during the worst of it. Still, Amy tries to remember during heated disagreements to try, if at all possible, to stay kind, patient, and loving. And when that’s not possible, she uses this mantra:  “Bless him, heal me, bless him and heal me,” until she calms down.

Amy recalls one very snowy evening a few years back, after hearing weather bulletins warning people from driving on dangerous roads, she asked her ex to change their visitation plans in order to insure her kids’ safety. When he insisted on hitting the road anyway, kids in tow, Amy lost it. “I was fired up with self-righteous indignation and I let him have it from both barrels about imperiling the kids,” she recalls. “Before long, we were in a screaming match and the kids were crying in the back seat.” Once both parents realized the scene they were causing, they ended the call, the ex took the kids back to safety, and Amy called her sponsor.

“Recovery takes the fun out of getting angry,” Amy now reports. “You feel so guilty afterward; it’s not even worth it.” She and her ex are on better terms these days. And while they aren’t quite friends, they can talk about personal matters without as much heat and fighting. “One of the greatest gifts of recovery is learning to stay rational and stick to the facts,” she says. “I try not to give in to the hysteria of hurt feelings.”

Another friend who’s been sober for two years and is recently divorced with kids, tries to stay away from blame and recrimination in discussions with his ex but reports that it’s easier said than done. “In the beginning I lost my shit a lot,” he confesses. “When you first start getting divorced, there is a lot of anger recrimination and blaming, a lot of ‘Here’s how you contributed to the downfall of our relationship.’” The instances of yelling and blaming decrease over time, but he recalls a time when a disagreement over their eldest son’s visit caused a stir. He admits yelling and telling her things like “You never let me have my way!” and trying to make her feel guilty so he could get what he wanted. Here, the guidance of the program came in handy. “I’ve learned to stay on my side of the street and frame disagreements in terms of what I can control—myself—rather than trying to control her,” he says. When he finds himself getting heated, he tries to stay calm, breathe deeply and step away from the phone and computer so as not to text or email something he may regret. He pauses when he’s agitated and tries to stay focused on what’s best for his kids. “On many things,” he reports, “we now simply agree to disagree. We let each other have our own house rules, and keep our bickering back and forth to a minimum.”

Early in sobriety, it occurred to me that my husband and I no longer spoke, made eye contact, or entered each other’s perimeter except to exchange grocery lists, cash, or speeches about how the other person was Falling Short. When I shared this with my sponsor, she smiled beatifically and reemphasized that Big Changes (such as leaving one’s husband, or beating him with a big bat) were not suggested in the first year of sobriety. Little changes? I bargained. How about one very small polite boyfriend? Is that allowed? She nodded quietly, directing my attention back to our step work. I left there emptied of all hope. The thought of staying married for another year made me want to dive headlong into a vat of cool crisp white wine.

Instead, I kept repeating, “Just for today, I won’t drink, get a boyfriend, or tell my husband he sucks. Just for today, I’ll stay married and pretend I have good manners and am kind.” I read over and over the part of the Big Book where it promises we’ll eventually learn to “meet calamity with serenity.”

I don’t know how I got through that year, except by the grace of my home group, my sponsor, swearing, and candy. At year’s end, my husband and I separated and began the process of divorce and lived happily ever after and fulfilled all our dreams and each live in half a shared duplex and help each other with our organic vegetable garden. Not really. Actually we still fight all the time and sic lawyers on each other, but at least we have moments of civility and I haven’t called him a dick on over a year.

It’s about progress, not perfection, right?

One of the many aspirational parts of the Big Book suggests that we live out the principles of recovery “in all our affairs.” I don’t know about you, but all my affairs weren’t that principled before recovery. I was passionate (had a problem with anger), feisty (said mean things during fights), empowered (selfish), strong-willed (self-seeking), and ruined many relationships without as much as a twinge of conscience. So bringing principles of recovery like honesty, openness, and willingness into something as thorny as divorce felt like wearing shoes 10 sizes too big: I could make my way around but it was clumsy and hard to watch and involved lots of swearing and yelling.

To this day, my first instinct with my ex is to call names and yell, but now what I want even more is to avoid the emotional hangover (and the amends) that always follow such outbursts. I’d love it if he saw me as a paragon of recovery, but I’m told his opinion is none of my business. Sigh.

I’ve determined that though there will always be financial ruin, divorce, death, and taxes, you can meet those mo-fos head-on, my sisters and brothers. You can do it with style and panache, while wearing heels, and staying sober. You can even do it wearing sweats.

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Thirty-seven health care workers signed and submitted a petition to the Food and Drug Administration Wednesday, urging officials to change labels on prescription opioids, such as OxyContin, morphine or Vicodin, all part of an effort to curb prescription drug abuse.

“If the requested changes were adopted, drug companies would not be able to claim that the pain medications are safe and effective for long-term use by noncancer patients,” read a statement from Public Citizen, the nonprofit advocacy group spearheading the petition.

The petition follows a wave of reports of increased addiction to opioid pain drugs. Although pain management and addiction specialists agreed with the sentiment behind the petition, several doctors told ABC News it takes a step too far by limiting opioid access to noncancer patients with chronic pain.

“I believe this is not an appropriate way to address the disease of addiction,” said Pam Kedziera, the clinical director of Fox Chase Cancer Center’s pain program. “Pain is a significant problem in the United States, and those who suffer deserve treatment.”

The proposal suggests striking the word “moderate” from opioid labels to reserve it only for patients with severe pain; limiting the maximum daily dose to the equivalent of 100 milligrams of morphine; and limiting the maximum prescription duration to 90 days.

Dr. Joshua Prager, who directs the Center for Rehabilitation of Pain Syndromes at the University of California at Los Angeles, told ABC News he’s treated chronic pain patients for nearly 30 years and believes a regulation that would make it harder for doctors to treat these “legitimate patients” would be “extremely regressive.”

Prager’s patients have included people who’ve had a failed back surgery or severe osteoarthritis.

Other chronic pain patients could have shingles, multiple sclerosis or pain from a nerve injury.

“We’ve seen the pendulum go from it being extremely difficult for physicians to prescribe opioids to patients who didn’t have cancer… to where it was clearly being overprescribed,” Prager said. “What I would argue for is that there really has to be balance that doesn’t have the pendulum swing back too fast and too far beyond what is reasonable.”

Prager called the 90-day limit “draconian,” and Kedziera called it “unbelievable.” After all, the definition of chronic is that it is long-lasting, and Kedziera said she’s worried about arbitrarily taking chronic pain patients off medication just because time runs out.

Regardless of whether doctors said they believed the petition went too far, they agreed on the need to rethink opioid prescriptions based on firsthand knowledge and the data presented in the petition.

Opioids are the second-most-addictive drug, right behind tobacco, said Dr. Stephen Ross, who holds a slew of addiction and psychiatry titles at New York University hospitals and said he is in favor of the petition. He said about one-quarter of all patients who try heroine, an illegal opioid, become addicted.

Ross said about 75 percent of all opioid users get it from a friend or a parent’s medicine cabinet, and because doctors prescribe it, they think it’s safe. However, opioids can suppress breathing and become lethal.

However, even addiction specialists like Ross said they were worried about curbing opioid addiction at the expense of pain patients.