Addict (drugaddict) wrote,

Michael Gimbel: I am clean 36 years last week. It is a day by day process and I am very glad to hear

Michael Gimbel: I am clean 36 years last week. It is a day by day process and I am very glad to hear she is doing so well. You should be proud of her and yourself for being strong and supportive

Jacqueline Duda didn't realize how challenging it can be to get treatment for drug addiction until her own daughter needed help. In  today's Health section, Duda describes the unsuccessful journey taken by her and her family to save Nicole Duda's life. She will be joined by Michael Gimbel, an addiction specialist and the former director of substance abuse education and prevention at Baltimore's Sheppard Pratt Health System. They will be online Tuesday, Oct. 7 at noon ET to discuss Duda's story and the importance of expanding the options for treating addiction.


Brookeville, Md.: Very sorry for your family, addiction is a horrible disease. My wife became addicted to prescription drugs in the late 80's. Ten years later it would cost me my job, career, a home, a car and almost a family. This all happened before she finally realized she needed treatment. When that day finally dawned it was in and out of rehab/detox more times than I could count, most of which were paid for out of my retirement funds I had to cash in. I'd guess we've spent well over $100,000 out of pocket for her treatment. Fact -- An addict will not get better until THEY want to get better. For some that never happens. The process I mention above is just to pacify the family in many cases, but not until they want to get clean and work the program, will you see any real progress. My wife finally had this awakening about 18 months ago just after she'd almost overdosed on methadone. It's not easy getting or being clean. She's heavy duty into NA, goes to as many meetings as she can squeeze in. She is still on a drug that costs over $5 a pill, four to five a day that kills her craving -- fortunately that is picked up by her insurance which she just got. At 58 I still have no health insurance, I can't afford it and my employer doesn't offer it. Its a nightmare getting it approved every month, its so expensive. So I am cautiously optimistic about our future. For the first time in 20 years my wife is happy, productive and clean but the collateral damage from her addiction is everywhere. God bless your family.

Michael Gimbel: I am clean 36 years last week. It is a day by day process and I am very glad to hear she is doing so well. You should be proud of her and yourself for being strong and supportive.


Alexandria, Va.: I understand that the economic bailout bill included passage of a new law that would require parity or equal coverage for mental health and addiction services , usually very limited under most insurance policies. This would seem to be very good news for those with insurance! Even with the most generous insurance coverage, treatment for opiate addiction (inpatient 30 day, 90 day extended care and another six months of transitional living with multiple detox treatments for relapses) is beyond the reach of most. Any idea whether long term residential treatment might be a benefit under this new law (to take effect in 2010)?

Michael Gimbel: Yes, it does contain a parity bill. Not sure what it covers. I think the main part of the bill states that if you have coverage for mental health and addictions, it must be treated the same as any other medical problem. It doens't mean that all insurance carriers must provide addiction and mental health coverage. Please check with you insurance carrier to see what they already cover and if that will increase with the new bill.


Washington, DC: Even with insurance, finding treatment can be difficult. Our insurance puts addiction services under mental health and will only cover out-patient services. My brother has been in and out of the emergency room and run up huge medical bills due to his alcoholism. Despite doctors insisting he needs long-term treatment, we cannot find a way for treatment to be deemed "medically necessary." We are close to giving up hope. Where can we turn for assistance?

Michael Gimbel: Beleive it or not, the economic bail out bill that just got passed this week contained a "parity" bill for addictions and mental health. This means your insurance must treat addictions and mental health the same as medical problems. It doesn't mean that all insurance carriers must carry addiction and mental health coverage but for those that do, they now must supply it the same as if it were a physical problem. Also sometimes there just insn't a in patient program so you need to set up a treatment plan that keeps the addict busy and in some type of treatment or education as many hours a day as possible. They should go to 12 step meetings, in tensive out patient or out patient can help as well.


Brooklyn, NY: Can you discuss intervention?

Michael Gimbel: An intervention is like a staged meeting in which all the friends, relatives and important people in the addicts life, will get together alone and discuss how to confront the addict by using an ultimatime such as " if you don't stop using and get treatment we can no longer be friends" or "you can no longer see your daughter or keep your job". Once the group has practiced, you than bring in the addict and confront them with your feelings. It can have a very powerful effect and hopefully send them into treatment. It doesn't always work the first time, and it may need to happen a few times. You need to have a good therapist lead the intervention and have a treatment program ready to take them in.


Poway ,Calif.: 1-Did Nicole have a coexisting psychiatric disorder? If so was treatment attempted? Could it have been the underlying cause of her tragic death?

2-What is your opinion about methadone maintenance under medical supervision in a federal and state-regulated Narcotic Treatment Program? Could it have helped Nicole?

Jacqueline Duda: Hi (#6), Jackie here, Nicole's mom. This is to Poway, Calif. We suspected that Nicole was also suffering from depression (it runs in my family). Or perhaps bi-polar disorder (when Nicole was "up" she was outrageously hilarious, always laughing and joking around and making us all laugh with her, but when it rained or was gloomy outside, or she faced difficulty in math class or in dealing with a friend, she would plumment way "down" and get very depressed)...we can't ascertain that with any medical evidence because it was never officially diagnosed by any of the treatment professionals. With their overworked caseloads, their main goal in helping Nicole to survive was trying to get her through the drug cravings and address those issues first. Co-occuring disorders with mental illness and addiction or alcoholism often go hand in hand. There are studies out there trying to investigate how to treat co-occurring disorders.


Washington, D.C.: I am so sorry for your loss. Ultimately, your daughter did get into a 30-day treatment program, but did not go into a halfway house afterward. From what I've been told about drug addiction (which is admittedly limited), that time directly after an intense rehab is critical in overcoming addiction, since the addict must learn to re-enter the outside world without needing drugs. Can you share more as to why your daughter didn't go to the halfway house and perhaps any steps you took to convince her to go?

Michael Gimbel: Hello. thanks for emailing. Jackie can answer the part about Nicole, but in general you are correct. It is best to give a person in recovery a step by step integration back into society. A half way house or a sober living situation is the best, if it is available. It helps them to slowly get back into society without all the old pressures and friends that used alcohol and drugs. Like treatment programs, there are not enough of these half way houses or sober living situations. Mike


Centreville, Va.: My 21-year-old son died of a heroin overdose three weeks ago. His 16-year-old brother found his body in his bedroom a day and a half later with the needle still in his arm. We don't have the toxicology report back yet, but your story is so similar to my own. Does the pain ever lessen?

Jacqueline Duda: Hello Centreville, Va. I am so sorry for your loss, when I talk to other parents like us, tears constantly well up in my eyes. Today is 2 years to the day that my husband and I were wandering around like complete "zombies" the morning after the police came to tell us that Nicole had been found dead in her apartment. One never gets over the loss of a child that you gave birth to, nurtured, fed, applauded every achievement for, and then to witness their battle with a horrific addiction, to watch them fight to rejoin their families, it literally rips your heart out. All I can offer is that every day is a different journey. Don't expect too much of yourself, and allow yourself to really grieve, and to feel what it's like. What helps me also, is to remember who Nicole really was (and still "is" in my heart and will forever be). She was a joy, a great friend, a loving daughter who enjoyed making us laugh, her teachers, her friends. She held a deep compassion in her soul and a wisdom beyond her young years, and even suggested once during the course of her treatment, that she and I write a book - her telling what addiction really feels like, and my telling how parents can gain information and understanding about the disease and ultimately help and support their children through recovery. I look at what I'm trying to do as not only honoring her memory, but as an extension of her willingness to help others. Please feel free to allow yourself the time to grieve, and disregard time limits. There is no time limit involved in the grief process. Again, my heart goes out to you, and to your son (which had to be horrific to find his brother that way), and your entire family. You're in my thoughts. Let's all work together to make whatever small differences that we can in the treatment system.


Baltimore, Md.: We are grandparents who presently have a 22-year-old grandson in a drug and alcohol rehab center for the second time. We want to help him in any way we can but don't know how we should go about this. We can not go to visit him but we can communicate by mail, yet we are hesitant to say too much when we write especially since he does not respond to our letters. What advice have you for us.

Michael Gimbel: Hello, thanks for emailing. It is important for family and good ( clean ) friends to support anyone in treatment and or recovery. If the program allows you to communicate make sure it is positive and supportive of their recovery. Do not talk about any old behaviors or things they did to others or you. Keep it upbeat and say how proud you are of their getting clean and sober. Give them hope. Don't let them talk about drugs, old stuff or how horrible the food is in the program. Many times they are looking for a way out and will find any little thing to justify leaving. The most important thing is that they stay in treatment and get involved in a good after care program as well as a 12 step support. Thanks for caring. Mike


Waldorf, Md.: I put my daughter in rehab in June in Atlanta, GA. She has been clean since then but I am terrified to let her come back to MD. She is not on any medications, and I don't want to have to go through this again. She is a college graduate with everything going for her but she associates with the wrong people. How can I keep her clean ans stop worrying about her?

Michael Gimbel: Thanks for the email. Sometimes its best that the person in recovery stay where they are and start a new life. The only thing back here in Md might be old friends, who she doesn't need to see. So you may encourage her to stay where she is and stay in treatment or a 12 step program. she needs to stay in a program. If she does come back she must be in a program or 12 step.

thanks and good luck


Falls Church, Va.: I thought your article was harder on yourselves and not as hard on the "system" as you should be. Our child has had drug problems since he was 15 and there has been a pretty consistent attitude among courts and law enforcement that parents are clueless and part of the problem, not part of the solution. And don't get me started on for-profit methadone maintenance companies or doctors who prescribe the withdrawal drugs.

Michael Gimbel: Amen on all you said. I have been fighting against private for profits for years. Its like legal drug dealing and they don't care about the person. The system is horrible and always will as long as we have politicians who get re elected by police unions and play on the fear of the public. the only real long term solution is treatment and education, not more prisons and police.



Fairfax County, Va.: I'm college educated, white, 27, clean criminal record, great family - and I'm addicted to narcotics. After seven years in the DC/Baltimore party scene I haven't used in over two years. I identify with Nicole -- she could have been me. >No one is at fault for someone becoming an addict. Nicole didn't choose to be an addict, she chose to get high. The parents aren't to blame. Addiction is a force of nature, much like a hurricane. If Nicole had health insurance would she be alive today? Put another way - if universal health care existed, if we mandated that health insurance fully cover addiction treatment, how many Nicoles' could we save?

Michael Gimbel: I want to congratulate you on staying clean these past years. I have 36 years of being clean. It does get easier. I hope you are involved with a program or go to 12 step meetings. If not, you might think about it. It helps to have support especially on those tuff days, when you think about using. Don't... get help instead.

good luck and god speed. mike


West Lafayette, Ind.: Jacqueline -- were there any warning signs of your daughter's addiction?

Jacqueline Duda: To # 29, (and #9 too, I think) this might help answer, regarding warning signs, things we would have done differently, etc. There were warning signs, in hindsight, but at the time, we didn't reconize them. The Christmas Eve dinner we had the year before Nicole died, we noticed a rash on her hands and on her chin. We asked her about it, and she explained it away saying that she was suffering from allergies (much like I do, I break out often from environmental allergies outdoors). Seemed logical, we asked her if she was going to see a doctor and she replied she would as soon as her health care insurance would come through at work. In reality, rashes are common with opiate addiction, some of the oppiates make them itch and scratch a lot. Then there was the new "style" of shoe wearing - Timberland hiking boots without the laces. Puzzling, at first, and then, as we were going through the treatment processes with her, Nicole explained that addicts often run around without shoe laces because they use the laces to tie off their arms to inject.
As far as what we would have done differently. First, would have taken Nicole to Harborview Hospital in Baltimore. I learned, after she died, that they do admit anyone for detox, at least 3 days. My advice, find a hospital in your area that will admit addicts for medically supervised detox. Would have bought us some time. Then I would have went to the TRI website (Treatment Research Institute) and located an addiction specialist medical doctor (rare, but they are out there). And taken Nicole to him/her to gain more information and professional advice as to where to go next and how to get into treatment faster. Hindsight is always 20/20, and yes, I do beat myself up nearly every day over new things I've been able to learn since. We need a comprehensive guide, co-written and published by addiction professionals and families, that will describe where to go for detox, for example, and list addiction treatment doctors. A guide like this should be easily found in every emergency room in the country.


Arlington, Va.: I am so so sorry for your loss. We too are dealing with the nightmare of opiate addiction and realize that it will be a long hard road. As parents of a young adult addict (in residential treatment) my husband and I still struggle with the idea of letting the addict suffer consequences -- the stakes are so high, prison... death. Each family situation is different, but how many times do we intervene and pay for rehab? It seems that though imperfect, rehab is the best we have but we also have to preserve what is left of our family and finances -- a heartbreaking choice.

Michael Gimbel: Thank for sharing your story. This is why we say its a family illnes. Everyone suffers. I am in recovery 36 years and my parents used to say they wanted me dead, but when i finally came home they thanked god. There is alot of feelings and guilt associated with this. Please don't blame yourself, its not your fault, but it is your responsiblity now to take and keep taking action.... Tuff love means letting them hate you even though you are doing the right thing. A addict only wants to use over and over again. They are not thinking when they are using. so keeping them clean and in treatment is the most important thing you can do. Support his recovery and the program and get involved in any family program and or 12 step support group. It does help.

good luck, Mike


Houston, TX: Your story brought tears to my eyes. Myself and my two brothers have all fought addiction, with various levels of success. I don't know what I would have done without a corporate insurance policy to support my rehabilitation, and my children to act as an anchor during my recovery. What can be done to change the prevailing concept of prosecution as the best treatment for the drug and alcohol problem in our country? Knowledge and prevention are really the only measure that can help people; prosecution simply deepens the despair that the addict feels, and removes their chances to succeed in a post substance abuse life.

Michael Gimbel: Congratulations on your recovery. I have 36 years of being clean and I too was lucky to find a free program in 1972. The government has turned the drug problem into a political hot potatoe and most of them get elected by saying they are going to be tuff on crime. To them that means more police and prisons and to us we understand that if you don't get to the root cause of addiction, all crime will continue. But they don't care because their goal is to get elected and make people beleive they are safer. Its a game that's been played for years. MOst of the money to fight drugs in this country goes to enforcement program and the least goes to treatment, which has shown the best success. So its an up hill battle to convince the government to do the right thing. The public supports treatment but they need to demand it... locally, state and nationally. good luck to you.


DC 20005: While this sad story focuses on drugs, there are others our there just as dangerous and with a less "accepting" perception, that is sexual addition which has a more negative connotation. The public is more "forgiving" if a person has a drug problem than a sexual addition. I know, unfortunately from a family experience. What's your view? How can or can this be overcome?

Michael Gimbel: Thanks for your email. I agree that we have begun to indentify more illnesses that are part of a bigger problem of obsessive compulsive behavior. Eating, drugs, sex, working, excercise etc... They all will continue untill the person experiences some type of pain from their behaviors. It is hard to convince a person they have a problem when they have no consequences to their behavior. They are in denial and we all see it more clearly then they do. You need to take the same steps for any addiction and comp. behavior. Treatment, therapy, 12 step and good relapse prevention programs are the best options. Good luck.


Bethesda: I am struck by what incredibly good parents both Jacqueline and Joseph Duda are. Nicole's tragic passing does not diminish that. Our close family friends struggled with the mental illness and addictions of their son for ten years only to lose him to an accidental overdose at the age of 22. My heart goes out to you all. I hope this question isn't too personal, but how is your family coping now with Nicole's loss? How have your younger children dealt with Nicole's addictions and her passing?

Jacqueline Duda: Bethesda: Every parent, I believe, is a good parent. We all try to do whatever we think is best to love and support our children. There are days I agonize over what more I could have done (my logic center says we did all we could, my heart says differently), and that will always be with me, just as Nicole's memory is always with me, every second, every minute, every hour of every passing day. Love is the ultimate glue that holds everyone together, and Nicole was one of the most loving people around. And strong. She tried, but lost, her battle. Our younger children miss their incedibly funny sister who doted on the younger girls and loved "palling" around and joking with her brother. I tell them that Nicole always stays within our hearts, and we must always live every day trying to help, understand, and exhibit compassion toward everyone on this earth. By keeping love alive, and remembering Nicole's vibrancy and depth, we are able to hold on to each other and appreciate the things Nicole so loved - the beach, the sunshine, the creative arts of dance, and always, the healing power of laughter. The youngest girls do not truly understand the addiction, we are working with them in age appropriate levels of understanding. Their youth shields them in a way, and they frequently laugh and giggle over remembering silly things their sister did. Our son, Joe, is now 18 and in college. He seeks his catharsis through projects like the DVD that was shown in excerpts online, and studying and reporting on topics like the cocaine vaccine development, the brain's limbic system for biology class, and all the scientific discoveries related to mental health and addiction. He and I work together on researching addiction and enlightening the public (and, his professors at college). We are all sad, and we all miss Nicole terribly, and we each try to work out our own personal ways of keeping her alive in our hearts. She will always be a part of us.


Washington: To Mike Gimbel: what do you think of the practice in the Netherlands of treating heroin addicts with heroin itself to help them avoid withdrawal during the recovery phase?

Michael Gimbel: Thanks for the email. I have never been a big fan of either using methadone or heroin to help get people off of narcotics. With the new medications of suboxin and bupenorphing, we have found them to help with withdraw and with the cravings and are less harmful and addictive themselves. These medications are available from doctors and with a good support network of therapy and 12 step, might be the real answer we have been looking for. I was on methadone and it was terrible. I think giving heroin out will only do the same. You need to change behavior and that doesn't happen when you give an addict an addictive drug. Thanks and good luck


Alexandria, Va.: Is buphenephrine (Suboxone) used long term? Treatment professionals at Hazelden (where our daughter received inpatient treatment) were very much opposed to using it. Can you discuss how or if this approach to treatment threatens rehab programs who use the 12-step approach?

Michael Gimbel: Good question. I am in recovery for 36 years and from the old school. But I do support bup and have found it to be very successful short and long term. I think most residential long term programs have had such a bad experience with methadone that they try and keep the abstanance concept alive by not supporting bup. The same goes for 12 step, however they are getting better at accepting bup. The government didn't help its own cause by allowing doctors to prescribe bup without counseling. I don't agree with that. You need bup, therapy, 12 step and support all working together for it to be effective. Many programs need to learn about bup and its benefits and limitations as well. Its a long process but I beleive if the early indicators of bup hold true, more programs will accept it.


DC: How early is too early to take action? My 15-year-old nephew drinks, smokes cigarettes and marijuana, and abuses prescription drugs. He's also bi-polar but doesn't always take his meds. He's in an alternative school and has received a ton of suspensions/expulsions. His parents don't really seem to care about all the substance abuse, telling him that all they want is for him to turn 16 and then he can do what he wants. They live in MI. Any advice?

Michael Gimbel: You need to get outside support and help. Can you tell someone about what is going on? Its almost child neglect and abuse when they are not willing to get him help. Tell a teacher, minister, or some other adult who can step in and help. If that doens't work you can call social services and speak to a social worker about reporting child neglect. They will keep it confidential and will pay a visit to the home. You are doing the right thing, but it may get harder. Stick with it, it will be worth it.


Washington DC: This was such a timely article and discussion. My boyfriend had been clean for six months. Last week he started desperately struggling with cravings, and yesterday went out and used. I have never been in a situation with an addict and I don't know what my next step, in conjunction with his family, should be. Thanks for any advice you can offer to someone who is new to dealing with addiction.

Michael Gimbel: GET HIM BACK INTO TREATMENT... That is the most important thing right now. Many people will slip and start to use again, but its important to get them right back on the road to recovery. This may be going back to treatment or going back to 12 step meetings. He needs to know that he made a mistake but its ok and to get himself back on track. Don't let it go any longer and insist on him going back. Make sure that everyone is also on the same page with this advice. He must get back into treatment...


Arlington, Va.: I'm a white, middle-aged, non-drug-using female who found Jacqueline Duda's story immensely sad: Ms. Duda, my heart goes out to you and your family, and I applaud your efforts to help others in your grief. But I also found the story's publication deeply troubling. What was the message here -- that there is something particularly dreadful when a middle-class white suburban girl can't get the help she needs? Of course her story is appalling, heartbreaking: but no more so (perhaps less so, because there were some family resources) than that of countless poor, urban, often African-American, addicts of all ages and both sexes who struggle with these realities every day. Yet their stories are not considered news. If the real intended story here wasn't the apparent subtext -- "how could such a horrible thing happen to a nice white middle-class family?" -- can someone please explain to me what it was? Thanks.

Michael Gimbel: Thanks for the email. I have been in the field for 30 years and in recovery 36 years. The bottom line is that addiction does not discriminate. It happens to anyone, at anytime, regardless of any race, color etc... This story could have been about anyone and by the number of letters, it is happening to many people across the country. We need help for all. Every city, county, state needs to do more to help all people.

good luck


Silver Spring, Md.: My niece, whose home is in MD, is currently in a drug addiction facility in Atlanta, GA for a 90 day treatment program. How, in any small or large way, can I be helpful to her and her family -- who are all devastated by her situation. Thank you!

Michael Gimbel: Please be supportive of her recovery and how the family is going through this together. Offer your help, but don't be judgemental or bring up past experiences. Keep things positive and be encouraging that the future will be better. Let them know you love them and will be there for them. Its nice that you care.



Fredericskburg, Va.: I have found support groups for family members struggling with a loved one's addiction to be extremely limited (at least in this area). I've had no success in locating ones that focus on families who've actually lost their loved ones due to addiction. I lost my husband four years ago and attended a very good bereavement support group. While it was helpful, I still felt very constrained in discussing the details of his addiction that eventually lead to his death. Are there any groups out there to help family members like us?

Jacqueline Duda: I'm not aware of any. I am so sorry for your loss. It is difficult to deal with the bereavement, on top of everything you've been through with the addiction of a family member. I will ask some of the experts I know, to see if there is such a thing out there. I've been looking for something very similar myself.



New Orleans, La.: How has Nicole's death impacted your other children? Do you think they will be less likely to try illicit drugs? Do you find yourselves being stricter with them? Do they know how she died?

Jacqueline Duda: Some of my answer to this can be found in the one I just posted. I am somewhat terrified that because addiction is partly, a genetic disease, that my younger children could also be susceptible, even knowing what their sister suffered. It's so easy for kids to be at a party or out on their own once they get an apartment, to be offered to try something - alchohol, or drugs. These substances are literally everywhere. And often, some kids try them, and can walk away, others, with the right genetics and chemical responses in their brains, as many addiction doctors will say, they have the right key to unlock the door, will become hopelessly addicted. I find myself making my way through parenthood much the same, with a level of trust and understanding, and hope that addiction will not touch our family again. As for being stricter, after having "walked the walked," I find myself being even more involved with the parents of my children's friends so we can each keep out a watchful eye for each other. That's not to say it's a cure all - there is no parent guide on all this unfortunately. It's just day by day, I'm willing to learn more, and respond with awareness. I find myself even being softer, in some ways, opening up new avenues to just sit, relax, and chat, and respond to one another. Our second oldest, Joey, knows how his sister died. The younger girls, ages 7 and 11, (they were 5 and 9 at the time Nicole died), aren't as aware of the details. Our 11 year old knows it was somehow related to drugs and our youngest just knows that her sister was suffering from a disease that couldn't stop her from dying. We've given them information that they could handle, at their ages, and will discuss more with them as they grow and get older. It's okay, young children sometimes can't figure out all the details, it's too much for them. If they specifically ask me something, I tell them what they want to know, at a level that they can understand. It was easier with Joey, since he was 16 when Nicole died, and more aware of her addiction and search for treatment.



Reston, Va. : Please remember that addiction is a family disease and that not just the addict needs treatment. Family members are sometimes sicker than the user. Speaking for myself, I was as sick as the addict. I read the article in Post and I wanted to wanted to know about Jacqueline and her recovery from her illness -- the family disease. Too often the focus is on the addict and not the surrounding support system that is actually enabling the disease. It's the big dirty secret. For every one addict in treatment there needs to be five family members getting their own help. That is just my experience.

Jacqueline Duda: I agree....and my hope is that the treatment doctors will involve all of us as supportive tools that addiction professionals can use, as part of the solution as one poster put it, that we can learn as much as we can about this disease, and how we can best support someone we love through it.


Baltimore, Md.: You mentioned the importance of having the addict get into a half-way house but will the rehab center help them do what is necessary to get into one? I feel it is important for the addict to also get a job in order to assume responsibility for helping pay for some of the costs that will be accrued. I'm sure that jobs will not be easy for any of the program participants to obtain. Thank you.

Michael Gimbel: The biggest problem is that there aren't many half way houses anymore. Too expensive and too many regulations. Instead people have opened up what is now known as "recovery house". These are homes that are rented by several recovering addicts and they have one house manager. These are just places to live, not treatment centers. They all go to 12 step meetings and treatment outside the house. These homes can open in any community and are protected by the ADA disabilities act. When run properly, they are very helpful and affective.


Chevy Chase: What can we do to help you and to advocate for better services for people who are trying to recover?

Jacqueline Duda: There are sites out there - Join Together ( is one, that reports on policy and legislative issues regarding addiction and alcoholism. You can sign up on the website to receive information, article, and updates. I've been able to easily email and call my legislative branches here in Maryland via the email alerts I get from Join Together, regarding issues like the mental health and addiction parity bill, and other topics. Legislators and those who make the laws and provide the funding are what can help our overwhelmed counselors and addiction professionals to gain to much needed manpower, centers and facilities that are needed. One voice is small, but many voices together, can be strong.


Wickenburg, Ariz.: Sorry to hear about your loss, heroin takes so many lives. I'm sorry it had to impact your family like that. My question is for Mr. Gimbel, and it's about the dangers of marijuana. Lots of people say it isn't addictive, but is that really true? It seems addictive to me and people who smoke marijuana still cough -- does it damage the lungs? I don't understand why people say that drugs like alcohol and marijuana aren't dangerous for our bodies. Can you shed some light on this please? Thank you.

Michael Gimbel: You are correct in saying that many people are not telling the whole story about today's "pot". It is much stronger than the pot of even 5 years ago. It is now grown with other chemicals and enhancers making it much more dangerous. We have had kids hallucinate on today's pot. It is addictive and can cause cancer and other mental health problems. The biggest problem is that the "baby boomers" want it to be legal and will find any reason to justify new laws making it available to people who are ill . While there may be some medical use for pot, the research is not conclusive or final, but it has not stopped legislators from legalizing it. I see more damage from today's pot than ever before and hope people stop and really see what is going on with pot before they continue to leglize it.


Alcoholism: My husband is drinking more and more. He knows he is, but "isn't hurting anyone" so doesn't want to stop. My complaints sound like the stereotypical nag wife -- he sleeps too much, lays around the house when he is up and is very moody. I've been thinking of Al-anon, but I'm not sure what it will do for me, other than fulfill the "misery loves company." What can I do? Can I talk to his doctor?

Michael Gimbel: Yes, you can and should tell his doctor. Sometimes a medical expert can help to tell him the dangers and gethim to see how its effecting his liver and other parts of his body. You can also talk with a minister or counselor yourself to get some good direction.


Baltimore, Md.: Is there any way to help someone who doesn't want help? My college roommate and her husband, both now middle-aged, are dependent on prescription anti-depressants and illegal drugs. I care deeply for them both and only found out about their problem when I stayed with them for a few days. Now she talks about it with me but denies there is a problem. She rarely even gets dressed. He sometimes works, otherwise they live on disability pay he gets for a condition that also gets him pain pills. The illegal drugs range from marijuana, which they smoke every half-hour or so, to cocaine or speed for her when she needs to do something and booze for him. He went to rehab and got clean once but then went home to her and fell back into his old habits. They are wonderful, generous people in so many ways.

Michael Gimbel: i need to leave, please email me at and i will answer


DC: Do you have views about the drinking age in this country?

Michael Gimbel: yes, keep it at 21 or raise it to 25. The brain doesn't develop untill the age of 25. Most of these kids are not old enough to drink as much as they are. Some may be responsible, but most are not.


Poway, Calif.: Mr. Gimbel: Buprenorphine is of limited benefit because it doesn't work in the majority of addicts with high opioid requirements.

Michael Gimbel: I found that is does. i will look into that more.

thanks for the info.


Chevy Chase, Md.: Sorry for your tragic loss. As a mother of two preteen daughters, when is it appropriate to talk to them about the dangers of drugs? Thank you.

Jacqueline Duda: I think it's never to early to start talking to kids about drugs and alcohol, but the challenge is being age appropriate. Preteens are just entering into all the middle school stuff, where they can be exposed to drug and alcohol use of course. Be involved with their teachers (I love email in this respect), people in the community, and when it is appropriate to bring it up with each individual child. It will vary by child, by area, everything. Let your girls know they can come to ask you about these things, that nothing is off limits to talk about when it comes to drugs. Keep the channels of communication open. And my best wishes to you and your daughters. It's not easy, and there are no easy answers to any of this.

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