The Weight of Air

by David Poses

  I started writing this book. When the first draft was finished, I began to open up. Slowly. Andrea and Daniel. A few friends here and there. I didn’t tell Mom until August 2019—the day before my first confessional op-ed was published in the Los Angeles Times. With few exceptions, everyone received my news with compassion. No judgment. They wanted to understand. And I launched a new career as a writer, activist, and advocate.

  Addiction isn’t an automatic result of exposure to opioids. Compulsive use is driven by the relief they provide. That’s the draw—painkillers kill pain. Opioids don’t know or care if you have a prescription or whether your pain is physical or emotional. They flood your brain with dopamine and serotonin and bind to your opiate receptors.

  No other type of substance has its own natural target or takes hold with such ferocity. Within weeks of active use, the normal hierarchy of needs shifts and neurotransmitters are rewired to seek out their next dose. Latent neural vulnerabilities include reduced connectivity between areas involving emotional regulation, stress response, and reward processing. These changes occur at a cellular level and don’t necessarily reverse when you stop using.

  Even after long periods of abstinence, significant dysfunctional activity has been observed in opioid addicts’ brains. If sobriety doesn’t get easier for an opioid addict over time, it might not be physiologically possible without medication.

  Sobriety focuses on abstinence, whereas recovery heals the wounds that led to drugs in the first place. It’s a process. And it doesn’t automatically start when you get sober. Why would it? Pain doesn’t end when you stop using painkillers. It gets worse.

  Chronic pain is defined as a distress that persists for up to three to six months or more. In this era of mental health awareness, beliefs persist that physical pain can’t be willed away, but psychological distress is optional. Upwards of 70 percent of depressed adults do not receive care. Shame prevents many from seeking help. Others lack resources or access.

  We know how opioids affect our neural pathways, yet conventional treatments emphasize addiction as the primary problem and insist that remission can be achieved only by replacing science and medicine with God and a support group.

  When addiction is equated with moral failure and opioids are lumped in with recreational drugs, we invalidate the real cause of our national health emergency. If it were simply about getting high, we’d cut risk, cost, and time and drink instead. Alcohol isn’t legal because it’s safer. Alcohol is safer because it’s legal. Legal is the difference between buying beer and knowing you’re not drinking grain alcohol and fermented wood, as was the case during Prohibition, when alcohol overdose fatalities surged.

  Drug laws are self-defeating and antithetical to public health and safety. Most overdose fatalities involve illegal drugs because potency is unknown and inconsistent. Another life is cut tragically short every nineteen minutes. In the hardest hit areas, as many as one in four kids has lost one or both parents. How can a national health emergency end when every harm-reducing, life-saving resource is stigmatized, criminalized, and restricted?

  The American Society of Addiction Medicine considers medication-assisted treatment and counseling the standard of care for opioid addiction. Though abstinence-based care (forced or voluntary) is now associated with increased risk of relapse and overdose death, buprenorphine is offered in only a third of rehabs, owing to the predominance of abstinence-based models. They maintain that any kind of medication (including antidepressants) invalidates your sobriety.

  It doesn’t matter to me that buprenorphine invalidates my sobriety. I never kept track of “clean time” because abstinence wasn’t my objective. I just wanted to feel okay in my own skin. I was too ashamed to let anyone know I was on it for more than a decade. Since I started opening up, many people have asked me when I’ll stop using it. In November 2020, I appeared on the CBS Doctors TV Show, and the host asked me that question. I responded with a question: If it were insulin, would anyone ask when I’d get off the life-saving medication because my diabetes was in check?

  Once a month, I drive to another state—an hour and a half each way—for a stigma-free experience filling my buprenorphine prescription. I pay out of pocket for the medication and doctor visit because my insurance provider doesn’t consider addiction a medical necessity. They (reluctantly) offer partial reimbursement for Dr. Aftergood’s fees.

  Today, writing is my full-time job. Andrea is an art therapist. We’ve been together for twenty-one years. Ruby is fifteen. Her brother, Samuel Herbert Hoppipolla Poses, is eleven.

  My family knows everything there is to know about me—including how I tracked down the framed print above my desk: a signed Kurt Vonnegut original, Peculiar Travel Suggestions Are Dancing Lessons from God, handwritten in purple ink.

  ________________________

  Thank you for reading The Weight of Air. As depression and addiction rates skyrocket, along with overdose fatalities, we are eager to spread the word about David’s story. Please help us save and improve lives by telling your friends. And we would be very grateful if you could post a rating and short review on the site where you purchased the book and on Goodreads. We look forward to your comments.

  acknowledgments

  If writing is a solitary act, this book is more like Lollapalooza (circa 1992): a multi-city, multi-stage festival, where, in any given moment, you’re profoundly grateful to be surrounded and supported by such capable talent and profoundly aware that, comparatively, you’re barely qualified to sell crappy homemade burritos in some off-site parking lot.

  From the first revision to the last, Ruby and Sam spoke only in the simple future tense (“when the book is published”). But if Andrea had reacted differently to the first draft, I would have deleted the file before anyone else knew it existed. I’m grateful beyond words for her acceptance of me and my story—and so profoundly sorry for the pain I caused.

  Tesla will never make enough Teslas for me to repay Carol Giacomo for turning on the light at the end of this tunnel.

  I never promised Amy Dresner a Tesla, but I owe her a hundred car washes for everything she’s done for me.

  To my friends and fellow writers, activists, and advocates—Michele Cannarella, Brandon del Pozo, Rob French, David Hollander, Jennifer Hornak, Josh Kaye, Aric Kupper, Ben Levenson, Jenn Lewis, Jeff McDaniel, Danielle Pak-McCarthy, Stephanie Papes-Strong, Jay Pearsall, David Richardson, Petra Schulz, Maia Szalavitz, and Carlyn Zwarenstein—thank you for your insight and support and for screaming louder than my insecurities.

  Thank you to Rob, Chessa, Jane, Greg, and everyone else who corroborated my memories and made them memorable in the first place—especially Mom and especially, especially Daniel, who is a much better older brother to me than I ever was to him.

  To Sandra Jonas: thank you for believing in my story and message and in me as a writer. I couldn’t have hoped to find a better partner for this book.

  Thank you to my publicists, Jennifer Buonantony and Demetria Johnson and Press Pass LA, my occasional literary agent, Heather Schroder, and my outstanding editors, Maia Danzinger, Emma Dries, and John Kenny, who taught me what I should have learned in the writing classes I never took.

  Endless thanks to Dr. David Aftergood for (among other things) helping me face and process the truth, and to Dr. Zevi Labins for optimizing my neural pathways with the right medication regimen.

  Change doesn’t happen until those who aren’t affected are as outraged as those who are. To anyone who struggles with mental health or addiction issues, or who cares about someone struggling or has lost someone, and to all the people and organizations working tirelessly to bring about positive change in policy, prevention, and treatment, thank you for your strength and courage. Every day, I’m humbled, heartened, and honored to fight alongside you.

  playlist

  Long before I knew how to talk about my feelings, I used music to communicate, so it isn’t surprising that music plays an important role in my story. Below are som
e of the songs that appear in The Weight of Air, along with a few others I added to round out the list. You can find the soundtrack on Apple Music.

  “Bodies”: Sex Pistols

  “I Am a Child”: Neil Young

  “So What”: Miles Davis

  “I Touch Myself”: Divinyls

  “Lightning Crashes”: Live

  “Rosanna”: Toto

  “Adagio for Strings”: Samuel Barber

  “Reason to Believe”: Bruce Springsteen

  “Hey”: Pixies

  “Negative Creep”: Nirvana

  “Exit Music (for a Film)”: Radiohead

  “Karma Police”: Radiohead

  “Bonus Track 1”: John Frusciante

  “Bonus Track 2”: John Frusciante

  “Ab’s Song”: Marshall Tucker Band

  “Love Is a Stranger”: Eurythmics

  “Natural Mystic”: Bob Marley

  “I Don’t Like the Drugs (but the Drugs Like Me)”: Marilyn Manson

  “Paranoid Android”: Radiohead

  “Forever Young”: Rod Stewart

  “Small Dark Movie”: Greg Brown

  “Rated X”: Miles Davis

  “Five-O”: James

  “Horses”: Be Good Tanyas

  “I Can’t Give You Anything but Love”: Django Reinhardt

  “Everloving”: Moby

  “Untitled #4 (Njósnavélin)”: Sigur Rós

  “The Wedding Toccata Theme”: Modeselektor

  “Idioteque”: Radiohead

  “The Past Recedes”: John Frusciante

  about the author

  DAVID POSES is a writer, speaker, and activist. After hiding his struggle with depression and opioids for twenty years, he started opening up and challenging conventional drug treatment prevention and policy. With candor, humor, and a unique perspective formed by science and lived experience, he advocates for a shift from punitive, self-defeating prohibition laws and logic to an approach based on evidence, compassion, and the harm reduction philosophy.

  David has been published by the Washington Post, Los Angeles Times, and New York Daily News and has appeared on national television programs, including The Doctors TV Show, and numerous radio shows and podcasts. He lives in New York with his wife and two kids and entirely too many guitars for such a mediocre player.

  Website: davidposes.com

  Facebook: @davidposes.author

  Twitter: @davidthekick

  Instagram: @david_thekick