I want to first make clear that David Kekacs, the person filing the report, is not and has never been a patient of mine. He lives in Connecticut and I live and practice in Wisconsin.
I am recovering from opiate dependence. I left my anesthesia practice in 2001 to increase my odds for surviving my addiction. Since that time I have spent a significant amount of my time in the treatment of addiction to narcotics. The work is very difficult; anyone who has lived with, worked with, or treated narcotic addicts is familiar with the self-centeredness, the sense of being 'special', the avoidance of responsiblity, and the deceit that become hallmarks of the personality of the using addict.
I have several award-winning web sites that are funded entirely by myself, that serve to educate recovering opiate addicts and provide a means for addicts to exchange useful information. On the web sites I have links to recordings that describe what I learned from dealing with my own addiction over 20 years. I am not one to mince words; I call things as I see them, something that has produced positive feedback from those who had the courage to open their minds to the changes required to get clean.
Mr. Kekacs angered me when he said in his first e-mail that the tapes were 'misleading'. Anyone who visits my sites knows where I stand on the treatment of addiction. I was particularly angered by his negative focus on the steps. This becomes very complicated, and you can read more on my web site about my philosophy... the steps saved MY life, but with opioid dependence the long-term success rate of the steps alone is quite low, particularly in young people. My belief (which is what is on the audio tapes) is that the best approach to treating addiction to narcotics is the new medication buprenorphine, BUT if a person wants to avoid buprenorphine, the only other approach that has shown success is residential, step-based treatment.
Mr. Kekacs has an attitude similar to the attitudes of most narcotic addicts-- that I want help, but I want MY kind of help. I have seen too many people die from that type of ignorance. There is an old phrase that applies well to the treatment of narcotic addiction: 'Insight maketh a bloody entrance.' I have learned over the years that I can either 'make nice' with addicts and have 'nice' appointments where they fail to improve... or I can call people on their behavior and attempt to shock them out of complacency. The words are crude, and were intended to drive an addict to take a look at himself. They were not written for 'public consumption.'
I ask that people who read the exchange read Mr. Kekacs comments-- at least the ones he chose to share. It would be nice if we could fix addiction through nice conversations, but as people who live with addicts know, it does not work that way. Residential treatment is more civilized, but I'm working through a $20 tape-- not a $50,000 stay in treatment!
One final comment. Twelve steps programs have their deficiencies, but at this point, there is nothing available that rivals their success rates-- EXCEPT taking a chronic medication, in the case of opioids (pain pills and heroin). My Kekacs has his links accusing AA of being 'propaganda'-- but every addict who fails treatment tends to blame the program, rather than do the hard work of changing one's self, in order to FIT recovery. While I regret the exact words that I used-- i.e. 'jack-ass'-- I am not sure what other word to use to describe the boorish behavior that characterizes active addiction. And perhaps some good will come of all of this. At least the exchange shows a typical example of the denial that characterizes addiction. I'll take a good look at my own actions... and I encourage Mr. Kekacs to do the same.
