Many people who struggle with drugs or alcohol fail to fully grasp the extent of their addiction until years after they have gotten clean and sober. But Michael Pond knew exactly what he was doing.

Pond took note when he missed days at work. He understood how severe his problem was when he was forced to leave the Penticton home he shared with his wife and three sons. Months were spent binge-drinking in roadside motels. Eventually, he ended up on a bus to Vancouver’s Downtown Eastside. Broke and homeless, he bounced between recovery homes in Surrey and neighbouring suburbs, finally landing in a cell at Fraser Regional Correctional Centre in Maple Ridge.

“I knew what was happening,” he told the Straight at a coffee shop in North Vancouver, roughly six years later. “I knew what was going on, all the time. There was always this sense of, ‘I know what’s coming; I know what this is.’ ”

Pond is a psychotherapist with more than three decades of experience, both in an institutional setting and in building a successful private practice. By the time his life began to fall apart in the mid-2000s, he had helped hundreds of addicts like him.

Pond’s inability to help himself is recounted with painful honesty in the second edition of Wasted: An Alcoholic Therapist’s Fight for Recovery in a Flawed Treatment System, coauthored by Pond and CBC News veteran Maureen Palmer. The two combine the objectivity of their respective fields to bring unique clarity to the crowded genre of addiction memoirs.

“As I carry my prize [a bottle of vodka] inside, I spy baby spiders crawling up the kitchen wall,” Pond writes. “As I move to swipe them away they disappear.”

Pond had been a drunk for years by that point in the book. But his medical training remained intact, allowing him to conduct “mental status exams” on himself.

Appearance and behavior: Patient is unshaved and appears underweight. He is gaunt with dark circles under his eyes. Psychomotor agitation, restless and agitated. Upper extremities tremulous.
Speech: Slurred and muffled.
Mood and Affect: Depressed, anxious, and fearful.
Thought content and process: Guilt, self-recrimination, shame. Suicidal ideation. Poor concentration.
Perceptions: Visual, tactile hallucinations.
Orientation: Disoriented to time.
Sleep: Poor.
Appetite: Poor.
Insight: Fair:
Judgement: Poor.
DSM-5 Diagnosis: Alcohol Use Disorder – Severe; Withdrawal Delirium.

On January 21, a documentary adaptation of Wasted is scheduled to appear on CBC’s The Nature of Things. (There's also an accompanying website featuring an interactive guide for people seeking help with an addiction.) While most of the book is spent on Pond’s darker days, the bulk of the episode focuses on the next steps in his journey.

“Everyone in Mike’s life told him to go to AA,” David Suzuki says as the documentary’s narrator. “But Mike kept failing the program. And he’s not alone. In fact, Alcoholics Anonymous doesn’t work for most people.” Only about one-third of addicts enrolled in AA remain sober after one year, Suzuki notes.

At the café, Pond acknowledged that western medicine categorizes addiction as a disease and health-care professionals generally insist they treat it like one. But, he continued, it’s his experience that doctors’ and therapists’ actions are often very different from their words.

With Palmer sitting alongside him, Pond recounted how for two years he saw an addictions specialist weekly and not once did that expert suggest a pharmaceutical solution to help with his addiction.

Going back further, to the time he spent in the Lower Mainland’s unregulated recovery homes, Pond recalled abuse and shame inflicted on him for the symptoms of his disease. He emphasized the counterintuitive logic of an instance when he was punished for taking Ativan, a drug that was prescribed for him specifically for symptoms related to alcohol withdrawal.

“With any other illness, you’d be hospitalized,” he said. “You would get compassionate care. But because it is addiction, you are kicked out the door.”

Palmer interjected: “The key to getting away from that psychosis is to sleep,” she said. “He needed his brain to heal. And I think there are so many alcoholics and drug addicts trying, in those first horrible couple of months, and if they had…some of these other drugs, it would be easier. Why do they have to white-knuckle it?”

The documentary reveals a world of treatment options that the majority of addictions therapists don’t understand and refuse to recommend.

Gabapentin and topiramate, for example, are anticonvulsants that act on the brain’s reward pathways in ways that could be useful in managing an addict’s cravings. There’s also a slow-release injectable form of naltrexone (better known by its brand name, Vivitrol), a synthetic drug used to blunt the addictive effects of alcohol and opioids such as heroin. Vivitrol is not approved for use in Canada, and in the film Pond and Palmer travel to the United States for a monthly injection.

Palmer said doctors remain reluctant to treat an addiction to one drug with a prescription for another. But she argued that there exists an overlooked mountain of evidence showing pharmaceuticals can complement traditional therapies like those deployed in Alcoholics Anonymous meetings.

“I’ve taken some flak,” she said, “about shilling for the pharmaceutical industry, like it will just be another way for these guys to make money. But we wouldn’t say that about heart medication or any other medication.”

Pond expressed greater impatience.

“People are dying,” he said. “People are dying that don’t have to.”