David Poses, Author of ‘Weight of Air’, Talks About Addiction and the Medication That Helps Addicts Cope

By Peter Page Peter Page has been verified by Muck Rack's editorial team
Published on May 27, 2021

David Poses describes himself as “a nice, upper-middle-class, clinically depressed Jewish kid from Westchester” when, at age 16, he snorted heroin for the first time. Long years later, as a recovering addict who has been in and out of rehab repeatedly, he recalls the first impression heroin made on him. “As the bitter, coagulated mix of dope and snot dripped down the back of my throat, my body started to relax,” he wrote in a Los Angeles Times op-ed. “I felt light and warm and safe. My anger and fear and sadness and shame disappeared. Everything was all right —for the first time in my life.

Addiction in the suburbs has been around longer, and is more common, than people uninvolved with drug culture realize, but the age when, and place where, Poses began using are actually the least unusual aspect of his addiction, the double life he led to hide his heroin use, or his recovery. Poses credits the success he’s had kicking heroin to intensive therapy and buprenorphine, a medication approved by the FDA in 2002 to treat Opioid Use Disorder. Nearly 20 years later, the buprenorphine is little known to the public and far less available from doctors than the opioid medications that have largely fueled the addiction crisis that has claimed tens of thousands of lives each year for many years.

The people and institutions that are supposed to help people end their addictions have been slow to accept buprenorphine, if not actively resistant. Rehab centers have a mindset that addiction can be reversed by determined individuals. Poses, who writes and speaks about addiction and buprenorphine, has written a new book, The Weight of Air, that is part autobiography, part a critique of the rehab industry, and an exploration of why relapses are the norm for addicts who come out of rehab centers. We asked him about his struggle with addiction and how he and other addicts could be more effectively helped.

You don’t fit the image of the stereotypical addict. How do you explain the origins of your addiction? And what does your story tell us about addiction?

Depression was my gateway to heroin. I started using at 16 but it had been on my radar since fifth grade, when a cop came to my school for a drug prevention assembly. He said heroin was “the worst drug;” a pain killer so strong that you no longer had feelings—as if that was undesirable. Depression hadn’t entered my lexicon – I thought I was broken. The idea of heroin gave me hope. I couldn’t be farther from the stereotype, but I’m definitely not the exception. The stereotype is. When addiction is equated with moral failure and all illicit substances are lumped together as “recreational,” we forget the reason people have been using painkillers longer than written language: they kill pain—physical and emotional. Drugs are a coping mechanism. If the stereotype was remotely true, we wouldn’t be so surprised every time we learn a friend or relative is struggling with addiction.

You were in and out of rehab programs, including some that are quite well regarded. Why didn’t residential rehab cure your addiction? And why do people who have been through rehab relapse so frequently?

Addiction is a complex medical condition. The predominant treatment model—faith and abstinence— insists remission can only be achieved through some configuration of tough love and eschewing science and medicine for God and prayer. If we were talking about any other medical condition, would it be surprising that I wasn’t cured? When experts without medical credentials try to cure medical conditions with magical thinking, it’s called “quack medicine.” Faith and abstinence treatment are proven to increase risk of overdose, death and relapse, and methadone and buprenorphine are proven to save and improve lives but, for a variety of bullshit reasons, medically assisted treatment is a lot less accessible than faith and abstinence. How can a national health emergency end when the antidote is stigmatized, criminalized and restricted?

You don’t fit the image of the stereotypical addict. How do you explain the origins of your addiction? And what does your story tell us about addiction?

Depression was my gateway to heroin. I started using at 16 but it had been on my radar since fifth grade, when a cop came to my school for a drug prevention assembly. He said heroin was “the worst drug;” a pain killer so strong that you no longer had feelings—as if that was undesirable. Depression hadn’t entered my lexicon – I thought I was broken. The idea of heroin gave me hope. I couldn’t be farther from the stereotype, but I’m definitely not the exception. The stereotype is. When addiction is equated with moral failure and all illicit substances are lumped together as “recreational,” we forget the reason people have been using painkillers longer than written language: they kill pain—physical and emotional. Drugs are a coping mechanism. If the stereotype was remotely true, we wouldn’t be so surprised every time we learn a friend or relative is struggling with addiction.

You were in and out of rehab programs, including some that are quite well regarded. Why didn’t residential rehab cure your addiction? And why do people who have been through rehab relapse so frequently?

Addiction is a complex medical condition. The predominant treatment model—faith and abstinence— insists remission can only be achieved through some configuration of tough love and eschewing science and medicine for God and prayer. If we were talking about any other medical condition, would it be surprising that I wasn’t cured? When experts without medical credentials try to cure medical conditions with magical thinking, it’s called “quack medicine.” Faith and abstinence treatment are proven to increase risk of overdose, death and relapse, and methadone and buprenorphine are proven to save and improve lives but, for a variety of bullshit reasons, medically assisted treatment is a lot less accessible than faith and abstinence. How can a national health emergency end when the antidote is stigmatized, criminalized and restricted?

Tell us about your struggle against addiction once you discovered Buprenorphine.

It would be a gross understatement to say buprenorphine saved my life. Buprenorphine gave me my life. It raised my emotional pain threshold above basement level without the constant distraction of trying to find and hide heroin or avoid thinking about it. For the first time, I was able to focus on recovery; healing the wounds that led to heroin in the first place.

You’ve noted that every physician in the US can lawfully prescribe opiates but only a tiny percentage of physicians is allowed to Buprenorphine. Why is that?

That actually changed recently but it’s not as big a deal as the headlines made it seem. Every DEA-licensed physician can prescribe Buprenorphine to up to 10 or 30 patients, but that doesn’t mean every physician wants to or knows how to treat addiction. Would you ask a dentist to treat a foot injury?

In your opinion and experience, just how disconnected from science and data is the rehab approach to addiction treatment that rejects the use of Buprenorphine?

It’s as disconnected as the way we treated bubonic plague in the Middle Ages and Covid.

It seems you have found a new path in life as an advocate for a new approach to addiction treatment. Do you believe your addiction is truly in your past?

I hope I am and I have infinitely more and better tools to insulate myself but my addiction is a symptom of depression, which is a degenerative, biological condition. It’d be irresponsible to say or think I’m past it.

By Peter Page Peter Page has been verified by Muck Rack's editorial team
Journalist verified by Muck Rack verified

Peter Page is the Contributions Editor at Grit Daily. Formerly at Entrepreneur.com, he began his journalism career as a newspaper reporter long before print journalism had even heard of the internet, much less realized it would demolish the industry. The years he worked a police reporter are a big influence on his world view to this day. Page has some degree of expertise in environmental policy, the energy economy, ecosystem dynamics, the anthropology of urban gangs, the workings of civil and criminal courts, politics, the machinations of government, and the art of crystallizing thought in writing.

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