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Brian had everything going for him. He grew up in a small town in Massachusetts. He did well in college, but that’s also when his challenges with addiction began. Alcohol and painkillers were his substances of choice. Normal behavior for a college student? That depends on the person’s emotional health, physiology and family background.
Brian’s family has a history of alcohol use disorder, so he may have had both a genetic and environmental predisposition to developing an alcohol use disorder himself. His peers also drank and used drugs, “but maybe not as much as I was,” he says. Then, at age 21, he was hospitalized with alcohol-induced pancreatitis—acute inflammation of the pancreas.
It was clear that his body couldn’t handle the amount of alcohol he was consuming, so he vowed to stop.
That vow didn’t “take,” however. He ended up seesawing between drugs and alcohol— at times replacing alcohol with a different substance to help him reduce the amount of alcohol in his system, or so he mistakenly thought.
After college, Brian moved to New York City and took a high-pressure job in finance.
He became adept at hiding his addiction to alcohol and painkillers from his colleagues, friends and family.
In November 2022, after more bouts of pancreatitis, he hit an all-time low. “I had a seizure. My partner called 911, and I ended up spending a couple of days in the Department of Emergency Medicine at NewYork-Presbyterian/Weill Cornell Medical Center. A few days later, I decided to go to rehab.”
Brian chose a 45-day inpatient program in Arizona. “I was drawn to the type of therapy offered there, called IFS, which stands for internal family systems.”
Although there are many evidence-based treatment approaches for addiction, IFS was particularly helpful to Brian and his loved ones.
And it worked. Brian has been sober for more than three years now.
Even before enrolling in rehab, Brian had started seeing Dr. Jonathan Avery, Vice Chair of Addiction Psychiatry, Stephen P. Tobin and Dr. Arnold M. Cooper Professor in Consultation-Liaison Psychiatry and Program Director of the Opioid Overdose Prevention Program at Weill Cornell Medicine. Dr. Avery was treating him for ADHD (attention-deficit/hyperactivity disorder). They also discussed his addiction issues.
In rehab, Brian received an additional diagnosis of OCD (obsessive-compulsive disorder)—a common anxiety disorder characterized by obsessive thoughts and repetitive behaviors.
Nonetheless, he has learned to lead a full life with these interconnected diagnoses, thanks to multiple sources of support.
He still checks in regularly with Dr. Avery, along with his personal psychotherapist. He also joined a post-rehab, 90-day intensive outpatient program, during which he’d meet with a group once or twice a week. Then, he “graduated” to group therapy. He’s also a member of Alcoholics Anonymous (AA), and his sponsor has been an invaluable source of support.
If that sounds like a lot, it is. These diverse programs may seem onerous, but Brian was determined to overcome addiction, and he has done just that through his commitment to a multimodal treatment approach.
Brian is living his best life, both personally and professionally. A life of generosity, inner richness and meaning.
He volunteers with SAFE: the Support, Advocacy and Family Education program for people with substance use issues and their families, which is based at Weill Cornell Medicine and overseen by Dr. Avery. Drs. Jenny Makovkina and Nicholas Romano—both Assistant Professors of Clinical Psychiatry—are co-directors of this innovative, highly effective program.
SAFE connects its participants with addiction psychiatrists and volunteers who share their own lived experience with individuals and families struggling with addiction.
As one such volunteer, Brian actually embraces his identity as a person with a substance use disorder. “I never assume that my addiction issues will be gone forever,” he said. That awareness keeps him diligent and committed to the process.
The support he provides through the program is anything but generic. For example, he affirms participants’ experiences with stigma: a lamentable set of attitudes that permeate the healthcare system and society at large, making substance use disorders even more difficult to overcome.
As a major voice against stigma, Dr. Avery offers a hopeful vision that’s rare in a world that vilifies addicts as weak, immoral and even criminal.
“Take my word for it,” he tells his patients. “You can do this.”
More people get there than you may think, Dr. Avery says. These successes go largely unreported. “Stigma blinds us to that hopeful view,” he notes, adding that many people with substance use issues recover on their own.
The SAFE program is living proof that overcoming addiction is not only possible; with the right support, it’s likely.
Dr. Avery aims to grow the SAFE program over the next couple of years. Along with the research he performs on stigma as a driver of addiction in our society, an expanded version of the program will chip away at both substance use disorders and the blame and shame that worsen them.
Rehab, recovery and volunteering have changed him a lot, Brian says. “I have much more clarity in the way I think, relate to others and make decisions. All of these positive experiences have allowed me to become closer to my friends, my partner and my family.”
Armed with a new set of priorities and attitudes, he has also changed careers. He started his own business as an executive and leadership coach, a role he defines as “part therapist.”
“I’ve learned from the best of them,” he says proudly.
Learn more about the SAFE program here, and consider getting involved as a participant or volunteer.
