Narcotic addicts and the potential of horticultural therapy

Calais, Maine: You may not have ever heard of it. Speaking frankly, it is a community of good natured people, drug addicts, and good natured drug addicts. The last category is absolutely that, as anyone who has had the displeasure of interacting with a drug fiend can understand.  It wasn’t always this way, but in the 1990s, this community and the surrounding county were beset by an onslaught of narcotic prescriptions (namely Oxycontin). The area became nationally and internationally known for its rates of addiction and overdose, which were (and are) remarkable.

I grew up in this area, and have returned to it. I know the pinch of poverty and the pain of a parent with a prescription pill addiction. I was lucky that my mother survived, but I know others are not as lucky. And I know that there are children who are watching their parents kill themselves as we speak.

That said, I believe that this is a trend we can reverse. There is indeed an abundance of good people here. Rather than approaching this as a problem to throw another pill at, however, we need to look at the cause of the addiction. What hole in each life is the pill trying to fill? One very important part of it is diet. A diet that does not sustain nor satisfy the body is not doing its primary function.

I decided to focus one of my research papers on the topic of food gardening therapy and its potential for providing a foundation for the community as well as the individual drug addict, specifically in Washington County.

 

Introduction

For over a decade, Maine has been recognized nationally (and internationally) for its high rate of prescription drug abuse, a trend that began in the 1990s with the introduction of Oxycontin. Nicknamed “Hillbilly heroin”, this potent pain-killing narcotic became rapidly sought after by those destitute and down on their luck for its euphoric effects. The poorest county in the state—Washington County—was the hardest hit, with the highest rates of recorded overdose in the state from 2005 to 2008, and the highest number of those seeking treatment for addiction.

Aside from struggling with high rates of drug abuse and unemployment, Washington County is also faced with the highest food insecurity in the state, leaving more households without consistent meals. The trend shows no sign of reversing with a 2010 report indicating that “Washington County’s poverty rate trended upward almost every year from 2000-2008.”

Is there a way to reconcile these problems simultaneously? Gardening (ornamental and vegetable) has been used for therapeutic purposes for many generations and in many cultures, and at times, it has been utilized for drug addiction therapy. If it is indeed effective, the creation of community gardens, greenhouses, or rehabilitation centers would serve to prevent drug addiction or relapse while contributing to the food supply of the area.

To examine the efficacy of gardening as a rehabilitative therapy, we’ll start by seeing what effect the act of gardening has on gardeners, as well as what effect drug addiction (particularly prescription narcotics) has on the addict. We’ll then have a look at the successes or failures of specific case studies and examples, including “The Narcotic Farm”, the federal prison for drug addicts.

The Therapeutic Value of Gardening

Gardening has long been associated with physical health benefits due to its incorporation of exercise and the end result of producing nutritious food. The psychological benefits of gardening are not as well researched, though nearly all gardeners agree on an improved feeling of well-being.

In the past century, social movements have emerged from the growing belief that interacting with ecology can have a positive effect on emotional and psychological health. In the 1990s, “ecotherapy” was coined as an umbrella term for this understanding. Since its widespread introduction, it has become more and more accepted, with related degrees now offered at leading institutions. The movement is rapidly becoming global, with England initiating a 30-year plan to bring half the population of the country within the vicinity of at least 1 of 12 newly planted community forests.

In prisons, horticultural therapy has been practiced for decades in an effort to relax and rehabilitate prisoners. In Horticulture as Therapy: Principles and Practice (1997), Simson and Strauss state that a 1990 telephone survey of 55 prisons reported that 51 had some kind of active horticulture-related program. The benefit gained from gardening goes beyond regular vocational therapy in its psychological effects due to its nurturing nature. “Taking care of plants cultivates the experience of being responsible for other lives.”

Ecotherapy supporter Craig Chalquist compiled an impressive list of studies reporting the benefits of horticulture therapy in his essay, A Look at the Ecotherapy Research Evidence (2009). He summarizes: “[Horticulture therapy] has proved effective for treating alcohol addiction and substance abuse,” as well as in “decreasing vulnerability to drug abuse in violent offenders” and “fostering emotional restoration.” He adds that it also has the capacity to reduce or ease trauma disorder.

The evidence for the positive potential of ecotherapy and gardening in particular is present in abundance, and the public response is gradually shifting to include an understanding of its psychological impact. However, how well does that actually translate to rehabilitation or relapse prevention in the drug user (and in particular, the narcotic abuser)? One notable example brings to the forefront the reality of the situation of addiction: The United States Narcotic Farm.

“Narco”: Its philosophy and failure

In 1935, following a boom in the use of heroin by teenagers after the First World War and the popularization of its use in the Harlem jazz scene, the United States opened its first prison for drug addicts, the United States Narcotic Farm (“Narco”). Intended to treat federal prisoners as well as those who willingly volunteered for rehabilitation, the institute pioneered a number of new treatments and conducted extensive research on drugs and related substances (including the first use of methadone).

The Narcotic Farm (2008) states that “[The Farm’s] goals were audacious: nothing less than the complete social rehabilitation of America’s drug addicts and the discovery of a permanent cure for drug addiction.” Chief in their philosophy for rehabilitation was integrating vocational therapy into the idyllic setting of 1,000 acres in rural Kentucky. “Fresh air and sunshine would reinvigorate addicts, farming would teach them the virtue of hard work, and their newfound work ethic would sustain their lifelong abstinence from drugs.”

Narco housed a massive agricultural operation, complete with livestock (cows and pigs, which were milk and/or butchered appropriately) and numerous kinds of crops (kale, corn, beans, tomatoes, etc), each of which were harvested and processed. Prisoners and volunteers worked side by side, often in the company of the children of the staff of the institution (who were housed onsite). All of the food was cooked and served in the prison, providing nutritional benefit and meaningful purpose to the efforts of the addicts.

Despite the ongoing success of the farm and constant abundant harvest, “by the early 1950s, it was obvious to everyone that farmwork didn’t cure drug addiction,” The Narcotic Farm reports. Most inmates were from the city and had no use for the skills they learned on the farm, and for many, the activities of farming came as something of a culture shock.

In 1968, when the institute transitioned from prison hospital to hospital (and the ensuing loss of workforce that could be compelled to run it), the farming aspect of the United States Narcotic Farm ceased.

Horticultural therapy was but one of many performed at Narco, where inmates could also choose to work in textile, woodcrafting, or automotive industries, to name a few. Arts and crafts and other leisure activities were heavily encouraged, and the institute had a performing arts stage that played host to some of the most legendary musicians of the mid-century. Group therapy and social events were held often in an effort to promote “talk therapy”.

Although clearly a massive, sprawling institutional prison, the interior design of Narco was aimed at providing a peaceful, humane environment that was favorable for recovering from drug addiction in. Day rooms were large and airy with big windows permitting views of the landscape, and the arched doorways were reminiscent of serene monasteries. The most modern understandings of the psychological effect of the environment were employed.

Even with all of these advantages, however, the truth uncovered by relapse rates belied the efficacy of the “Narco cure”. Far from its original goal of curing drug addiction, a 1962 study of 2,000 former inmates of Narco uncovered that 93% reported going back to drugs almost immediately after their release. Over the course of its existence, that rate hovered around 90%.

Drug addiction, it seems, had proved far more complicated than anyone could have predicted.

Narcotic Addiction: Understanding the Sickness

Most of the inmates and volunteers that came through Narco were suffering from heroin addiction, which bears a number of similarities to its narcotic brethren. Oxycontin has been one of the frequently abused prescription drugs in Maine, though other opiates are also on the list (Percocet, Vicodin, morphine, etc).

Recent reports from the National Institute on Drug Abuse indicate that prescription drug abuse has been on the rise dramatically in the past few decades. Deaths from overdose from prescription drugs have increased from 3,300 in 1999 to 12,000 in 2008 while those related to cocaine have decreased and those related to heroin have increased, but by only a few hundred.

In response to this escalation of abuse, new forms of Oxycontin capsules have been released that cannot be melted down and injected, which is, in turn, contributing to the introduction and increased usage of heroin in this area.

What is it that makes these narcotics so compelling? Like all opiates, they produce a feeling of euphoria. Injected heroin produces a rush of intense elation, while Oxycontin users experience a much longer lasting high that is amplified if the pills are crushed and snorted (or injected). All pain and often all sensation is numbed or blocked, allowing the imbiber to detach themselves from their physical forms. This release becomes highly addictive.

Considering the nature of narcotics, it becomes easier to see why the United States Narcotics Farm had such a discouraging relapse rate, despite its well-intentioned environment and cutting edge therapies. However, some of the therapies (including horticulture) seemingly hold real value in terms of treating substance abusers, as we examined earlier.

Does horticulture therapy have viable potential in Washington County for narcotic addicts? Are there area characteristics that may affect its success?

Local Potential of Horticulture Therapy for Narcotic Addicts

The consensus among many of the former doctors of the Narco is that the primary factors in the high relapse rate were the lack of follow-up after release and the reabsorption of the recovering addict back into their old community (and consequently, their old habit).

With the small population and large area of Washington County, families and communities tend to assume a tribe-like mentality, existing in pods that more or less float independently. Outsiders are regarded with curiosity and are generally unwelcomed (other than during tourist season). Once you become involved with the community, it is very difficult to interact with other parts without meeting the same folks. Because of that, drug abusers here face one of the biggest vulnerabilities for relapse—falling back into the same crowd and patterns after they kick the habit.

It is that same tendency of rural Mainers, however (staying close with their family and flocking together with their friends and relatives), that may make horticulture therapy more valid here. Maine has a long history of small-scale farming, with much of its early European history hallmarked by family-run agricultural operations, and in recent years, small, single-family farms have been multiplying all over the state as interest rises in fresh, local food. Reinforcing this trend along with the familial ties that many here have to farming and gardening is not a difficult proposition to consider, especially if the recovering addict feels that they are contributing positively to their community.

One of the primary failures that the Narco farm experienced was that many of its inmates were from the city, did not take well to farming, and did not continue to gain from the habits that they learned. This is clearly not the case for residents of Washington County, who typically work rugged, seasonal jobs, and have some land available to them (even if it’s simply their yard).

It is important to consider that Narco’s farm closed when it could not compel its inmates to work on the farm any longer (when they were no longer prisoners, but strictly volunteers). Unless drug offenders in Washington County were forcibly kept at an agricultural rehabilitation center where they could be compelled to work, it will likely not be sufficient to send recovering addicts home with a brochure and a suggestion. A follow-up program implemented to help encourage and enforce active therapy would be necessary for long term success.

In reality, there is no simple or surefire way to handle the epidemic facing Washington County and other parts of the nation. For Big Pharma, who introduced Oxycontin to the area initially, the answer is another drug: Suboxone, introduced in 2000 as an alternative to methadone. Sales of Suboxone have climbed from $137 million in 2006 to $1.4 billion in 2012.

For those of us who believe the answer is not another drug, we are planting our roots.

“If you want to treat an illness that has no easy cure, first of all, treat it with hope.”  — George Vaillant, former Narco psychiatrist

 

References:

Acheson, Ann W. Poverty in Maine 2010. http://mcspolicycenter.umaine.edu/files/2010/09/PovertyinMaine2010.pdf

Campbell, Nancy D., Olsen, JP and Walden, Luke. The Narcotic Farm. 2008. Abrams.

Center of Substance Abuse Research (2012). Suboxone Sales Estimated to Reach $1.4 Billion in 2012—More than Viagra or Adderall. http://www.cesar.umd.edu/cesar/cesarfax/vol21/21-49.pdf

Chalquist, Craig. A Look at the Ecotherapy Research Evidence. 2009.

Department of Health and Human Services (2008). Treatment Episode Data Sets: State     Admissions to Substance Abuse Treatment Services. http://wwwdasis.samhsa.gov/teds08/teds2k8sweb.pdf

National Institute on Drug Abuse (2011). Prescription Drug Abuse. http://www.drugabuse.gov/publications/topics-in-brief/prescription-drug-abuse

PBS. Opium Throughout History. 2008. http://www.pbs.org/wgbh/pages/frontline/shows/heroin/etc/history.html

Richardson, John. (2011 October 16). Washington County Named Ground Zero for Prescription Drug Abuse. Kennebec Journal.

Simson, Sharon and Straus, Martha. Horticulture as Therapy: Principles and Practice. 2003. CRC Press.  

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You don’t know Jill

Though I’ve said my identity before on this blog, and it’s true that you may know my name, it’s also true that you don’t know “me”. To be clear, I don’t know me. Who I am is on the path of who I will become, as it is with each of us. Que sera, sera, whatever will be, will be.

That said, I realize there is a very real human connection that exists outside of the clouded webs, perpetuated by instances of shared electrical patterns, or thought. As you read these words, we walk together down the same synaptic path, our identities merged in fleeting moments of time. This effect is even more profound when you remove the concept of time (and let’s never forget: time is a concept) from the equation, enabling the realization that when you read a dead author’s words, you read them with the minds of every brain that ever traced the same electrical route.

Energy is never destroyed, nor created, after all.

We may not know each other, you and I. But with our magical brains and eusocial hearts we share something special.

To you, who sees this now.

You have the ability to live a wonderful life of good health and fulfillment, thanks to the advancements your ancestors have made. You also have the ability to bugger it up completely, one way of which would be by ignoring common sense and indulging freely in what mass media conveys (to the exclusion of anything else).

You can be aware of how essential minerals and vitamins affect you, and why they are considered essential on a daily basis. If you live north of Virginia, and don’t take a vitamin D supplement, you are most likely Vitamin D deficient. Being outside on a 24 hour basis would not provide the amount of vitamin D our physiological makeups are accustomed to, originating closer to the equator, where we lived for a very long time. Vitamin D helps us heal, mentally and physically. It helps us sleep.

Potassium is critical to nerve function, muscle function, and breathing capacity, and the more sodium you consume, the more potassium you need. Every single day. Our modern diets have huge amounts of sodium with no countering potassium to help us maintain a PH balance, and this should be remedied. If you struggle with breathing, nerve spasms, muscle cramps, depression, or sleep apnea, it may simply be because you need more potassium. Happily, this is a very quick thing to remedy– consuming a salty lunch and the irritable, hot feeling that comes afterward can be immediately countered by having something with potassium in it (coffee — preferably decaf, to avoid caffeine, tea, orange juice, a banana, or go right to the source and mix some salt substitute like Nosalt with water and drink 1/4 tsp or so).

These small adjustments done in consideration of your marvelous human meat bag will make every day that much easier to live– and free you to become as fulfilled as you ought to be.

An ongoing study of mania

My husband is bipolar, and since I am not inclined to settle for simple labels of things, his incredibly complex mental state is a constant source of ripe material for me to attempt to grasp and comprehend. His logic (obtained from decades of rapid and constant thinking and rethinking) makes perfect sense, but it remains an ongoing challenge for me to see some angles of certain aspects (which are necessary for me to keep my patience and maintain growth). I “grok” each piece eventually, but I readily admit that sometimes it takes me a while. Though I consider myself intelligent at times, he always helps me keep myself humble in that regard.

Some pieces are significant enough that I know I will need to remember them (on frequent occasion) forever… I will share any valid realizations I can muster, for my own memory, and for any comfort they provide.
Lately, as we’ve been in the middle of a move (and our car just burnt to the ground), and we’ve been interacting with people constantly, his mania has been periodically present in full gear. This has prevented his sleep as he considers the consequences of each and every potential interaction with any person of significance. This cycle– partly attributable to his state of hyper-awareness (as a result of past trauma)– is something he cannot prevent, and it helps explain why social interaction fuels his mania indefinitely. Each person is a dot with a miasma of connections to other dots, especially in the realm of potential. In the past, he has had weeks of insomnia as a result of this, leading alternately to a nervous breakdown, kidney failure, and respiratory attacks.

In the past two years, we’ve been extensively discussing his symptoms, and his ability to verbalize his perspective has been improving immensely. This has, in turn, helped him understand his own condition– and, in some ways, to cope with it. He has made great progress in recovering parts of himself that he once thought lost (he couldn’t listen to music for years, but he is now discovering a musical ability), and I am delighted with each piece of his own puzzle that he finds and recognizes.

Awakening the right side of the brain

In developmental psychology, it is generally accepted that we each have left and right hemispheres within our brains that address specific functions of our bodies. The right brain is said to be dominant in spatial and facial recognition, and musical/visual affinity. The left brain is more rigid, preferring calculations, math, and logic. Our personal preference is most often based on our dominant hand, which causes the most activation and strengthening of the corresponding opposite hemisphere.

For example, I am right handed, and developed my left brain very strongly as a result. Throughout my life I have attempted to write and draw with my left hand, or to incorporate it into usage, but it was frustratingly difficult to remember to do so.

I became interested in specifically expanding the usage of my right brain as I learned more about neuroscience, and how the brain can actively grow through the learning of skills or knowledge. Learning juggling is said to physically increase the white matter of your brain—any such gain leads in turn to enhanced efficiency and capability in any other task correlated with the skill you learn. The right brain is said to be the home of “intuition”, or your ability to connect the dots (the dots being the specific objects or facts in your left brain), and I was definitely eager to see if I could improve that.

I took a drawing class—“Drawing with the Right Side of the Brain”—to see how easy and/or effective such a change could be. I have always been an artist, but I have always drawn with my right hand and left brain (resulting in stiff drawings from clipped memories).

After just a few classes, I began to notice shifts in my perception. Practicing this method of drawing was forcing me to specifically consider the spatial relationships between objects, rather than the objects themselves. As that became more and more fluid, I became able to draw accurately from life rather than from the filtered viewpoint of the left brain (which acts to sort and categorize all incoming information).

Other aspects of my life changed as well. I gained a greater appreciation of music, and have started writing songs (something I’ve never done before). I understand geometry and the sciences of spatial relationships much more (formerly one of my weakest subjects). My terrible memory for faces has started to improve—all in the past 6 months, since the drawing course started.

I started practicing writing with my left hand again, though it didn’t seem comfortable or fluid in any sense until I realized it made more sense to write in a mirrored fashion to enhance the flow of the wrist. Making that shift was surprisingly easy, and it has enabled a tremendous gain in speed and accuracy.

I thought I might get a boost out of tracing a mirrored alphabet, and set about finding one online. However, every single site that I looked at presented only worksheets on fixing mirrored writing. Parents were worried, seeing their children write in such a fashion, and they set about correcting what they perceived as flaws.

For many kids, being told that something is absolutely wrong will affect their perception of it for the rest of their life. Inserting a filter that confines spatial perception blocks the growth of the right brain and each attached function (musical, visual, facial affinity). Teaching a child to do both methods (or teaching anybody to do so) enhances their ability to make connections. The best example of this point may be Leonardo da Vinci, who could and did write effectively in both fashions.

Dedicated to the Maine NEWL of 2013

We came here as individuals,

noble and fierce in our own right.

Those first few days changed us

as we learned of leadership’s great might.

Hand to hand we considered our lives

broken apart by society’s divide.

Heart to heart a new chain was formed

Ready and able to withstand any storm.

Knowing the truth in that strength,

tempered by love and by rage,

Bar by bar we will tear down

that terrible oppressive cage.

So that each and every future woman

can stand up and say,

“I’m ready to face life.

Today is my day.”

–Lura Jackson, 06/03/13