There’s no shortage of information on the lifestyle and pressures of entrepreneurship, but it is not as often that people address the risks of addiction that can come with high-performing career pursuits. In honor of National Recovery Month (September), we sat down with retired professor and author Susan Bartz Herrick to discuss her latest book “Slow Dancing with the Devil.” The book dives into the facts around Substance Use Disorder (SUD) and the loss of her son Luke, an Ivy League graduate and successful entrepreneur.
Grit Daily: Start by telling us about your background and the background of your son who inspired your latest book.
Susan Herrick: I’m a retired professor. I taught at UNC-Fayetteville, St. Andrews University, and Methodist University. Early in my career, I was a Community Liaison Specialist at HCA Cumberland Psychiatric Hospital and Treatment Center, giving seminars on mental health disorders and addiction.
My son, Robert Luke Paschal, was born in 1991, the same year Purdue Pharma was in preparation for the opioid launch centered around targeting OxyContin to non-cancer patients with chronic pain. Little did my family know this distant correlation would one day steer the course of our lives into turbulent waters and eventual loss of life.
When someone hears about someone dying of an accidental overdose, the stigma cultural image that usually pops up is that of a strung-out, undisciplined party animal. No one expected that it was an Ivy League student with a documented high tolerance due to multiple surgeries who could not find reliable medical treatment and felt forced to go to the streets to find relief from unrelenting cravings.
When Luke was 14 years old, the medical profession passed out Oxycontin like Pez. They had bought into their lie that it was only 1% addictive. By the time Luke was 17, he had been prescribed narcotics four separate times: Pilonidal cyst surgery, wisdom teeth extraction, thumb surgery, and removal of a large sliver from his foot. Later in life, he would tell me that when the nurse gave him “that little white pill’ when he was 14, it made all his emotional pain go away. From that point on, it was on his radar.
In 2010, Luke was in a near-fatal car accident. The price we paid for his life was severe Substance Use Disorder – aka addiction. It took us nine months to figure out treatment options independently, as the medical community gave us little guidance. There are only 52 addiction medicine fellowships (addiction psychiatry is a separate discipline), which is minuscule compared to other subspecialties, such as the 235 accredited programs in sports medicine.
While most medical schools now offer some education about opioids, only about 15 of 180 American programs teach addiction, including alcohol, tobacco, and other drugs. – “It’s like trying to fight World War II with only the Coast Guard.” (NYT 2018)
Behind the hidden scars of the accident (27 broken bones, 11 hospitalizations, four major surgeries, and three painful procedures) was a person struggling with PTSD, a brain and neurology that simply was not on his side. Yet he got into an Ivy League School and started his own business.
Luke had an entrepreneurial spirit and went on to start a CBD oil company called Arrow Organics. He did this to give other chemically dependent people a safe way to deal with their pain. He also owned his own health and wellness business under the umbrella of the Shaklee Corporation. He had a Nutrition and Physical Training certificate from ASAM and was a TPI level 1 certified golf trainer.
Luke completed his associate degree at Santa Monica Community College and was currently enrolled in the BAAS online program at the University of Pennsylvania, where he maintained a 4.0 average while being a caddy at The Rivera Country Club. Unbeknownst to many, he had just been accepted into Harvard’s Extension School two weeks before he passed. His gift and passions were philosophy and political process. His goal was to become an attorney and help society understand the disease of addiction — stop the stigma — and create new laws and protocols for affordable recovery options.
Robert Luke Paschal, Courtesy of Susan Bartz Herrick
Grit Daily: Can you share some statistics about addiction and high-stress careers such as business and entrepreneurship?
SH: According to Dr. David J. Linden, a neurosciences professor at Johns Hopkins School of Medicine, the same qualities we seek in leaders are often the same personality traits found in addicts.
The psychological profile of a leader involves compulsive risk-taking, someone with a high degree of novelty-seeking behavior. Dr. Linden proposes that this behavior is because of a genetic mutation in how the brain responds to dopamine. Their brains may release less dopamine during pleasurable stimulation than others, which means to feel the same level of effects, they need to do riskier things, achieve “more success,” and maybe take a substance to help with the stimulation. Dr. Constance Scharff points out that both top executives and addicts usually experienced stress or trauma early on in their childhoods that left some sort of basic need unmet and inspired a deep-seated drive to succeed. Oftentimes, those with such a drive and need to succeed, if they do not reach certain goals within certain time limits, may feel as if they are failing themselves or others, which can have a devastating effect.
Addiction is a complex condition that’s broadly viewed as a compulsive engagement in rewarding stimuli. The results of a study performed at the University of San Francisco by researcher Michael A. Freeman suggested that almost half of entrepreneurs experienced at least one form of mental health condition during their lifetime. This research documented that when comparing startup founders to the general population, they could potentially be:
- Twice as likely to suffer from depression
- Six times more likely to suffer from ADHD
- Three times more likely to suffer from substance abuse
- Ten times more likely to suffer from bipolar disorder
- Twice as likely to have experienced a psychiatric hospitalization
- Twice as likely to have suicidal thoughts
Grit Daily: What are some common misconceptions when it comes to thinking about the addict “stereotype”?
SH: Here are the most common Myth Busters regarding Substance Use Disorder (SUD).
#1. Addicts Are All Junkies
It is quite common for people to hear the word “addict” and then immediately envision a homeless person living in squalor behind a Dumpster or in some abandoned building. Actually, many people are “functional addicts” with good jobs, homes, and cars, married and have children, and are even pillars of our communities. This stereotype is grossly detrimental to the cause of raising awareness about the disease of addiction, and it keeps many people under a heavy veil of denial about their addiction.
#2. Addiction Is a Moral Failing
In the early 20th century, some doctors believed that people with addictions were morally weak and needed to learn self-control—they lacked the willpower required for abstinence from drugs or alcohol. The tenets of AA in the 1930’s were based on this misguided belief system.
These days, most people think about addiction as a brain disease instead of something caused by poor character. Many people with SUD desperately try to cope with unresolved trauma, finding solace in drugs and alcohol. This leads us to the next most common stereotype on the list.
#3. Addiction Is a Choice
The choice model does not look at addiction from a biological point of view but from one’s thought processes. While it’s true that a person makes the initial decision to drink or use drugs, continued substance abuse causes changes in the brain that impair self-control. Science has confirmed that addiction is a chronic brain disease and has identified precursors to the disease of SUD.
- Genetic Vulnerabilities
- Environmental Influences
- Child Mistreatment
- Neurological Development
- Early onset puberty
- Stress Exposures and Physiological Reactivity
- Cognitive and Behavioral Phenotypes
- Psychopathology in many forms [e.g., posttraumatic stress disorder (PTSD), depression, anxiety, conduct disorder (CD), attention deficit hyperactivity disorder (ADHD), oppositional defiant disorder (ODD), antisocial personality disorder (ASPD)]
- Gender: Males more often exhibit antisocial personality and conduct disorders, while females often have higher rates of mood and anxiety disorders
#4. People Who Are Addicted to Heroin Can Still Drink
Many people misunderstand the nature of SUD and seem to think it’s the drug and not the disease. For example, the first time might have been for alcohol, but they return with an opioid addiction. The problem is not the substance itself. The problem lies within the brain. Therefore, someone with the disease of addiction cannot simply be rehabilitated from one substance and go on to use another one “successfully.” Introducing such chemicals into the brain triggers a chain reaction of cravings that lead to obsessions that ultimately lead to a compulsion to drink or use.
#5. Bad Influences Cause Addiction
Addicts just need to stop hanging around bad people who do bad things. That’s another common addiction stereotype. People want to blame their loved one’s friends or family for their drug problem. Again, addiction is a disease; therefore, no one can cause you to be an addict. On the other hand, when you get clean, you will have to change the people, places, and things with which you interact because these can derail your recovery.
#6. You Can Stop If You Really Want To
False. Back in the 1980’s Nancy Reagan’s “Just Say No!” campaign was thought to be the answer to solving the nation’s drug crisis. Science has since proven that by becoming addicted to a substance, the normal hardwiring of helpful brain processes works against you. Drugs or alcohol can hijack your brain’s pleasure/reward circuits and hook you into wanting more and more. Addiction can also send your emotional danger-sensing circuits into overdrive, making you feel anxious and stressed when you’re not using drugs or alcohol. At this stage, people often use drugs or alcohol to avoid feeling bad rather than for their pleasurable effects. The brain thinks it will die without the substance, causing horrific withdrawal symptoms.
#7. Some Drugs Are Better Than, or Not as Bad as, Others
When it comes to addiction, though, it really doesn’t matter what you use or how you use it. You have a disease for which there is treatment and help. Recovery is possible. The details don’t matter.
#8. Addicts Are Violent People
Some addicts are prone to violence when under the influence of drugs and alcohol. That can be a side effect of the substances and their influence on the individual’s brain chemistry. But not all addicts are violent.
#9. Addicts Have a Criminal History and Will Have Regular Contact with the Police
It’s true that addiction can lead to criminal activity. Many people who struggle with addiction also have legal issues or have had legal issues in the past. But that’s not always the case, especially for the functional addict, who generally never sees the inside of a jail cell. Not all addicts are criminals.
#10. SUD Typically Affects Teenagers and Young Adults
One of the common addiction stereotypes is that those with SUD are young people. There is now a growing trend of substance abuse and addiction among the Baby Boomer generation. Addiction is a non-discriminating disease. It affects people across gender, class, age, and ethnic lines.
#11. Some Fentanyl Pills Are Legal and, Therefore, Can Be Safe
There are two types of fentanyl: pharmaceutical fentanyl and illicitly manufactured fentanyl. Both are considered synthetic opioids. Pharmaceutical fentanyl is prescribed by doctors to treat severe pain, especially after surgery and for advanced-stage cancer. Fentanyl pharmaceutical products are currently available in the following dosage forms: oral transmucosal lozenges commonly referred to as fentanyl “lollipops” (Actiq®), effervescent buccal tablets (Fentora®), sublingual tablets (Abstral®), sublingual sprays (Subsys®), nasal sprays (Lazanda®), transdermal patches (Duragesic®), and injectable formulations.
However, most recent cases of fentanyl-related overdose are linked to illicitly manufactured fentanyl, which is distributed through illegal drug markets for its heroin-like effect. It is often added to other drugs because of its extreme potency, which makes drugs cheaper, more powerful, more addictive, and more dangerous. Only two milligrams can kill. That amount is equivalent to the tip of a small pencil.
#12. Fentanyl Is Only Mixed with Heroin, Cocaine, Crack, Methamphetamine, and Ketamine
The DEA Laboratory has found that, of the fentanyl-laced fake prescription pills analyzed in 2022, six out of ten now contain a potentially lethal dose of fentanyl. This is an increase from the DEA’s previous announcement in 2021 that four out of ten fentanyl-laced fake prescription pills were found to contain a potentially lethal dose. Those fake prescriptions include Xanax, Adderall, Klonopin, Oxycodone, Percocet, Norco, Tylenol 3, and even OTC Tylenol.
Author Susan Bartz Herrick & son, Robert Luke Paschal
Grit Daily: Your son had a successful career, but addiction does not discriminate and can affect anyone. What advice do you have for high-functioning individuals who do not face their struggles head-on, suffer in silence, or see it as the norm for that environment?
SH: Stigma is SUD’s greatest nemesis. It makes people believe those with SUD are weak with moral defects or are less ambitious and not as smart. That thinking causes denial that they may have a problem with substances. Like any chronic disease, if not treated properly, it will get worse. One would not ignore cancer or heart disease. Everyone is at risk. Being smart and ambitious does not inoculate you.
Grit Daily: What do you hope readers take away from your book?
SH: Ending Stigma is imperative for change. The goal is to shift attitudes and behaviors to remove the stigma surrounding this Chronic Illness of SUD. “SUD is a Chronic Illness, not a moral Defect.”
There must be a transformation in Addiction Treatment Science-based treatment using MAT/MOUD. We must educate and empower communities.
Accurate science-based information and resources must reach parents and the medical community. SUD can strike anyone and any family. It is a nondiscriminatory chronic illness that demands vast policy changes.
Grit Daily: As a first-time author, what were some of the business challenges you faced in finding a publisher and getting this story out there?
SH: The publishing world model has changed. Book publishing is now business-oriented – not to publish good books but to make money. This is like the trend in higher education – it’s about job training and not promoting a good book. McFarland Publishing is well-known in the academic publishing field. My old college roommate had a connection, and they were eager to publish my book. My book is not just a memoir but an instructive manuscript with nine pages of endnotes and a twelve-page biography.
Grit Daily: We were told there is development on a page-to-screen version of your memoir. How do you think crossing into entertainment can help to amplify the story and message?
SH: Movies that look and sound like us are not only entertaining and profitable; they can change social norms because these stories humanize, destigmatize, and make us empathize. The stories that film tells and the immersive way they tell them have always had the capacity to foster our sympathetic and empathetic tendencies, help us grow emotionally, and connect more with others. Whether you watch a documentary about human suffering thousands of miles away or a narrative that reveals the less-than-evident truths about your own life, watching a film can be emotional, which is a good thing.
“Luke,” the movie title of the book “Slow Dancing with the Devil,” will bring a face to the real tragedy of SUD to the public in a true and honest way. Goethe once said the purpose of Theatre was to Entertain, Edify, and Enlighten. This book does all three and hopefully will evoke change.
Grit Daily: Anything else you’d like to add?
SH: The Opioid Crisis is growing. There has been a 25,000 % increase in overdose deaths over the past 23 years: four thousand in 1999 to over one million in 2023. Three hundred people a day are dying. The present War on Drugs strategy is obviously unsuccessful. Change must occur before you or a loved one becomes one of the millions who lose their lives to this under-treated and stigmatized disease.
CNN reported that only 1% of the billions spent on fighting the opioid crisis is spent on research and development. Creative minds need to take over where politicians and pharmaceutical companies have failed.
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