Admittedly, I'm not in the most self-possessed frame of mind right now, having just finished with a two day crack cocaine bender a mere eight hours ago. This is perhaps not the ideal time for an accurate assessment of how drugs and alcohol have affected my life. Nevertheless, I think it's important to jot down a few notes while I'm sufficiently frightened, before the insidious amnesia of addiction causes me to minimize exactly what I'm up against. To be specific: I think I'm going to die if I don't stop this. During this last binge I experienced severe heart palpitations, chest pains, disorientation, extreme paranoia, uncontrollable shaking and profuse sweating. Moreover, I drove while having these symptoms, making excursions into the worst parts of town during all hours of the night, going from pawnshop to dealer and back again. When I ran out of things to pawn, I then lent my dealer the use of my car while he deposited me at a crack house for the next six hours. Finally when I was so exhausted that I could no longer use anymore, I returned home to my parents under whose roof I have the ignominious distinction of still living at the age of 34. Yet, in spite of all this — all of these perilous acrobatics above the abyss — the insidious craving for more is creeping up on me yet again.

I've been trying to abstain from one substance or another ever since I was 20 years old when I had my first admission to rehab. In the 14 ensuing years I've been institutionalized several times, have lost most of my friends, lost my health, have forfeited any hope for intimate romantic relationships, lost tens of thousands of dollars and, most recently, have been thrown out of my PhD program. I don't think I'm indulging in hysterics when I say that the next thing to go will probably be my life.

Something has to change. I have to change. I'm uncertain exactly course of action to take just yet; I only know that, for the moment at least, I feel fearful enough that some kind of action will be forthcoming. I think a good first step would be to reconnect with my sponsor and discuss with him whether or not I want to continue with the 12 steps of AA. Should I decide not to continue with 12 step based recovery programs, I can seek out a mental health professional for some kind of empirically supported therapy. My medication regimen can be altered as well. Lastly, I can attempt to forge relationships with other recovering addicts and alcoholics and develop a support group — perhaps through this website.

As a final thought, I am reminded that sobriety is not so much an event as a process. Like other chronic diseases, managing addiction requires continuous effort on my part. That means cultivating an attitude of willingness. If I'm to have any chance at all at maintaining a sober lifestyle, I must be just as willing tomorrow as I am right now. As such, I hope I don't soon forget what I've just been through.