A Misdiagnosis of Substance Abuse

 Six pages into his latest contribution to the literature of recovery, William Cope Moyers tells us that the "tried and true routes to recovery" failed him in his battle against a slip into opioid addiction. The venerable combination of meetings, the Twelve Steps of Alcoholics Anonymous (AA), and abstinence that has helped millions of people did not work for him.

It's the first indication of the painful story that Moyers tells in "Broken Open," a deeply troubling volume issued by Hazelden Publishing in September. As he describes a relapse that lasted more than three years and a Suboxone-based recovery, Moyers tries to redefine recovery, sobriety, and even the determination of a sobriety date.

His new definitions are an attempt to justify his continuing work as the face and voice of the Hazelden Betty Ford Foundation (HBFF) while in the throes of his addiction to opioids. In the middle of his relapse, he spoke about recovery from the pulpit of the National Cathedral in Washington, D.C. A year later in front of another throng at the base of the Washington Monument, he shared the platform with Stephen Tyler of Aerosmith, Joe Walsh of the Eagles, and Sheryl Crow, and he writes, felt "like a recovery rock star." 

Basking in what Moyers describes as "rolling waves of applause," he writes that he was able "to confidently share my passionate rhetoric in front of a huge crowd. . . but I wasn't whole." No, he certainly was not whole. He was in a continuous search for doctors and dentists from whom he could "score" more pills. 

Moyers describes his continuing search for providers who would prescribe opioids. He finally connected with an "addiction doc" named David Frenz whose website proclaims, "Don't Let Addiction Treatment Mess Up Your Life."

Although Frenz is board certified in addiction medicine, he is skeptical of AA and the Twelve Steps, describing them as "an off-the shelf treatment" and suggesting that there is among alcoholics "a high rate of spontaneous remission." 

Frenz tells Moyers that "AA was the wrong tool" for his addiction and recommended Suboxone. It worked instantly, Moyers writes. He quickly found that his "secret, frustrating and tangled struggle with opioids was suddenly over."

He realized that he had "an exciting new message to carry" and decided to try it out at the monthly "Awareness Hour" at the Betty Ford Center. He writes that he was "buoyed by the miraculous way Suboxone had returned me to my life" and would explain it all to an audience that would include senior leadership and trustees of the Hazelden Betty Ford Foundation. He was confident that this speech would be "memorable and would be talked about for years."

The speech was a disaster. HBFF officials and others felt blindsided by Moyers' revelation of his addiction and the solution he claims to have discovered.

Members of the audience began to realize that for three years, Moyers had been "preaching what I was not practicing. . . talking the talk without walking the walk."

Instead of telling his superiors about his use of pain pills and Suboxone at the time he was using or as he began the course of Suboxone, he made a grand and public gesture in this speech attempting to sweep away the unsavory details of the last few years.

Moyers and Hazelden Publishing made the same mistake in this book. Its details on the nature and extent of Moyers's relapse came as a shock to his immediate superior at Hazelden at the time (Nick Motu) and to the organization’s CEO (Mark Mishek). As they read the book, both executives and others at HBFF were surprised by the revelation of the lengthy slip and the fact that Moyers had never reported it to anyone at HBFF at the time. 

Moyers concedes that "admitting to everyone at Hazelden that I was addicted to painkillers . . . was too humiliating to even contemplate . . . and I might lose my job."

He's almost right. There is no doubt that if HBFF management had been alerted to the relapse, it would have suspended him and told him to return when he had been clean and sober for a year. 

If they knew of his relapse, HBFF clinicians and physicians would have told Moyers that the answer to his addiction was the organization's COR-12 program, a synergistic combination of the Twelve Steps and Suboxone instead of the sole reliance on Suboxone that Moyers learned from Frenz, the addiction doctor.

It is not often that a review of a book suggests that it should not have been published. But a patient who makes it to page six will learn that the "tried and true routes to recovery" they are learning in their treatment failed to help this addicted author. 

Lester Munson was a member of the Board of Trustees of the Hazelden Betty Ford Foundation from 2011 to 2022 and its chairman from 2019 to 2022. He is a recovering alcoholic with 41 years of sobriety. Now retired, he worked for 32 years as a writer and investigative reporter for Sports Illustrated and then ESPN.

https://www.realclearbooks.com/articles/2024/12/27/a_misdiagnosis_of_substance_abuse_1081098.html