The RUN­NER’S HIGH

Runner's World (UK) - - Addiction - by CALEB DANILOFF

Young per­haps, but it was Soviet- era Moscow, where my fa­ther was sta­tioned as a jour­nal­ist back in the 1980s. I wasn’t very good at drink­ing, though I cer­tainly tried hard. When I was 15, I was ar­rested three times for pub­lic drunk­en­ness, twice in one day. And when I moved back to US, a litany of drug and al­co­hol vi­o­la­tions got me kicked out of board­ing school – with the fi­nal in­ci­dent just hours be­fore my grad­u­a­tion cer­e­mony, where my fa­ther was the key­note speaker (nope, no daddy is­sues there). At col­lege, the morn­ing I was sched­uled to start a new job, I woke up be­hind the wheel, on a mo­tor­way in an­other state, fac­ing the wrong way. Sev­eral years later, drunk driv­ing and drug charges landed me in the crime log of the news­pa­per where I worked as a re­porter. And so it went.

Fast-for­ward 17 years and I’m catch­ing my breath near the 4,302m sum­mit of Colorado’s Pikes Peak, my race bib flut­ter­ing in the wind. Brac­ing my­self at the half­way mark of the gru­elling moun­tain marathon, tak­ing in the count­less jagged switch­backs I’d picked across, I couldn’t help but think about the dis­tance I’d put be­tween Then and Now. And about the irony that af­ter nine marathons and thou­sands of miles, this is how I now get high. Stand­ing on a vast rooftop shin­gled with moun­tain peaks, the thin air fizzing my brain, I was buzzing. And grate­ful. I largely have run­ning to thank for my trans­for­ma­tion. Af­ter years of face­plants ( lit­eral and fig­u­ra­tive) and a self-im­age cur­dled by guilt and self-loathing, a sim­ple pair of run­ning shoes had re­turned mo­men­tum, even joy, to my life and al­lowed me to evolve into a ca­pa­ble per­son – a gen­uine hu­man be­ing. And I wasn’t alone. About five years into my run­ning life – mostly soli­tary back-coun­try road work – I started to come across sto­ries about other trou­bled souls who had traded in chaos for run­ning shoes: a meth-head­turned-iron­man- com­peti­tor; a re­cov­er­ing crack ad­dict who once ran 350 miles in a week; an ex­con­vict al­co­holic who would tackle the equiv­a­lent of al­most six back-to-back marathons across the Gobi Desert. Later, I’d read about a treat­ment cen­tre in New York’s East Har­lem that trains rock-bot­tom peo­ple suf­fer­ing from ad­dic­tion to fin­ish the New York City Marathon; an­other in Canada that man­dates run­ning, com­plete with a nat­u­ral track area on the premises and an an­nual race named the ‘ Re­demp­tion Run’. And yet an­other – Re­cov­ery Run­ners in Glas­gow – that uses run­ning to help those strug­gling with sub­stance abuse and now or­gan­ises a se­ries of re­cov­ery race events over var­i­ous dis­tances. I wrote a re­cov­ery me­moir in that time, and when it was re­leased my in-box swelled with mes­sages: from other drunk­sturned-run­ners, sober marathon­ers, freshly quit opi­oid ad­dicts, the im­pris­oned, psy­chi­a­trists and drug coun­sel­lors. Other than some scep­ti­cal 12- step­pers ar­gu­ing that I had sub­sti­tuted one ad­dic­tion for an­other ( I de­cided not to go down the Al­co­holics Anony­mous route), all were firm be­liev­ers in the heal­ing power of the run. In some­thing as sim­ple as hit­ting the road, they, too, had felt a loos­en­ing of ad­dic­tive thoughts and a spark­ing of pos­i­tive changes in the brain and in the heart. But was there much to it be­yond our per­sonal sto­ries and a would-be ‘swap­ping of vices’?

RE-LAC­ING THE BRAIN

that ad­dic­tion is a neu­ro­log­i­cal dis­ease or dis­or­der rather than a moral fail­ing or ques­tion of willpower, sci­en­tists still aren’t sure why cer­tain peo­ple who ex­per­i­ment with drugs and al­co­hol be­come ad­dicted

The author, shown above in Moscow in 1984, was of­ten ine­bri­ated as a teen.

while oth­ers don’t. Many point to an im­bal­ance in dopamine (the feelgood brain chem­i­cal) and a dereg­u­la­tion of glu­ta­mate, the brain’s main ex­ci­ta­tory (those that fa­cil­i­tate) neu­ro­trans­mit­ter re­spon­si­ble for parts of our learn­ing and mem­ory.

En­vi­ron­ment, ge­net­ics and stress are be­lieved to play im­por­tant roles, too. But a grow­ing body of re­search sug­gests that aer­o­bic ex­er­cise such as run­ning can, in fact, re­bal­ance those neu­ro­trans­mit­ters, re­duce so­bri­ety- crush­ing crav­ings and even re­pair drug-dam­aged parts of the brain.

‘The stud­ies are show­ing that there’s def­i­nitely an ef­fect in the in­ter­ac­tion be­tween phys­i­cal ac­tiv­ity and the way that we re­spond to drugs,’ says Dr Nora Volkow, di­rec­tor of the Na­tional In­sti­tute on Drug Abuse in the US. ‘Some of the re­search has started to doc­u­ment the molec­u­lar mech­a­nisms re­spon­si­ble for th­ese in­ter­ac­tions. That’s in the very early stages, but we don’t need to wait for all of the ev­i­dence, to cross all the T’s and dot all the I’s, be­fore we can rec­om­mend it.’

Dr John Ratey has been preach­ing the lace-’em-up cure for years. The as­so­ci­ate clin­i­cal pro­fes­sor of psy­chi­a­try at Har­vard Med­i­cal School in Bos­ton says that even a lit­tle bit of run­ning can make a big dif­fer­ence. ‘ What hap­pens im­me­di­ately when you be­gin to run is you get a boost in dopamine, no­ra­drenaline and sero­tonin, just as if you were tak­ing a lit­tle bit of Prozac and a lit­tle bit of Ri­talin,’ he says.

Ratey, a long­time run­ner who logs about 15 miles per week, and a psy­chi­a­trist who has coun­selled plenty of peo­ple with ad­dic­tions, says quit­ting isn’t nec­es­sar­ily the hard part. It’s the main­te­nance of so­bri­ety, which is too of­ten un­der­mined by stress, anx­i­ety and de­pres­sion, things that are rife in the newly sober life.

‘Many of the great [ex­er­cise] stud­ies have been done on smok­ers be­cause nico­tine, which is re­ally our tough­est ad­dic­tion, acts in a sim­i­lar fash­ion to drugs of abuse by pump­ing up the dopamine sys­tem,’ says Ratey. ‘Smok­ing crav­ings are in­tense. One of the ways of deal­ing with them is to go for a run or a brisk 10-minute walk. Not only is that a pos­i­tive ac­tiv­ity, it changes the brain chem­istry so you are much less re­spon­sive to stres­sors. It just is a fact. It takes more to stress you out than it did be­fore run­ning.’

There is no short­age of clin­i­cal and pre­clin­i­cal re­search to sup­port Ratey’s views. Re­searchers at Van­der­bilt Univer­sity in Nashville, Ten­nessee, US, set a dozen heavy- us­ing cannabis smok­ers on tread­mills and, over two weeks, got them to run ten 30- minute ses­sions at 60-70 per cent of their max­i­mum heart rate. The re­sult? A more than 50 per cent de­crease in spark­ing up. An­other study, led by Dr Michael Ussher at the Univer­sity of London, showed that even as lit­tle as 10 min­utes of mod­er­ate ex­er­cise dulled the crav­ing for a drink among re­cently detoxed al­co­holics. Re­search at the Univer­sity of Colorado, US, even showed a pos­si­ble re­ver­sal of cog­ni­tive brain dam­age in re­cov­er­ing al­co­holics who ex­er­cised aer­o­bi­cally.

Th­ese are just a few of the nearly 100 stud­ies that as­so­ci­ate pro­fes­sor of psy­chi­a­try and neu­robe­havioural sci­ences Dr Wendy Lynch gath­ered into a com­pre­hen­sive ar­ti­cle ti­tled Ex­er­ciseasanov­el­treat­ment­for­dru­gad­dic­tion: a Neu­ro­bi­o­log­i­cal and Stage-de­pen­dent Hy­poth­e­sis , which was pub­lished in the jour­nal Neu­ro­science and Biobe­hav­ioral Reviews. Lynch ar­gues that, much like the de­vel­op­ment of con­di­tions such as AIDS or di­a­betes, ad­dic­tion takes hold in dis­tinct phases and al­ters dif­fer­ent parts of the brain ac­cord­ingly. At al­most all stages – ini­ti­a­tion of drug use, ad­dic­tion, with­drawal and re­lapse – ac­cord­ing to the stud­ies Lynch re­viewed, ex­er­cise had a pos­i­tive im­pact no mat­ter what sub­stance was be­ing abused.

‘In the early stages of ad­dic­tion, where dopamine is pri­mar­ily mo­ti­vat­ing the drug use, ex­er­cise

John Tavolacci, the founder of the Run for Your Life pro­gramme, leads a group run through Har­lem.

also ac­ti­vates dopamine re­lease,’ says Lynch. ‘So it could serve as an al­ter­na­tive to the drug re­ward and thereby pre­vent fu­ture drug use.’

‘ We’ve shown that even mod­est amounts of ex­er­cise can re­verse re­lapse vul­ner­a­bil­ity.’

YOUR BRAIN ON RUN­NING

re­leases plea­sure-jolt­ing dopamine when we en­gage in life-sus­tain­ing be­hav­iours such as eat­ing and sex. The good times are then en­coded in re­gions that con­trol mem­ory, new learn­ing, and mo­ti­va­tion, en­sur­ing that we con­tinue to en­gage in th­ese ac­tiv­i­ties.

In this sim­ple sys­tem, drugs and al­co­hol can act as grem­lins open­ing flood walls. Dopamine flows down the re­ward path­way, which we ex­pe­ri­ence as eu­pho­ria. Then, just as the re­ward-mo­ti­vated brain is pro­grammed to func­tion, it teaches us to re­peat the be­hav­ior. For the pre­dis­posed, the mind be­gins to burn with a new cen­tral con­cern: an­other drink, the next score. At the same time, we start pro­duc­ing less dopamine nat­u­rally to com­pen­sate for the tide of out­side stim­uli. That means peo­ple with ad­dic­tions need more drugs to achieve the same high, and even­tu­ally to sim­ply stave off the pain and an­guish of a dopamine dearth. Life be­comes strictly about main­te­nance.

When a chronic user de­cides to quit and shuts off that ex­ter­nal dopamine trig­ger, the brain is sud­denly bereft and per­ceives sur­vival to be at stake, just as if faced with a lack of food. With next to noth­ing go­ing on in the plea­sure-jolt­ing de­part­ment, the ad­dict’s mind and body re­ceive bright, des­per­ate flares of crav­ing. Throw in de­pres­sion, a bad day at work or a mem­ory trig­ger – some­thing as small as the beads of mois­ture run­ning down a bot­tle of beer – and you have a recipe for re­lapse. It’s dur­ing the early days of ab­sti­nence, Lynch says, that glu­ta­mate starts to rise and etch the di­rec­tions for crav­ing into the mind. A re­cov­er­ing ad­dict who ex­pe­ri­enced height­ened glu­ta­mate lev­els in with­drawal will see those beads rolling down the beer bot­tle and ex­pe­ri­ence pangs of crav­ing months, even years, af­ter their last sip.

In 2012, Lynch and her team found ev­i­dence in a pre­clin­i­cal trial that ex­er­cise may re­duce crav­ing by nor­mal­is­ing glu­ta­mate sig­nalling. She gave a group of lab­o­ra­tory rats ac­cess to high lev­els of co­caine, es­sen­tially ad­dict­ing them, then abruptly cut off the sup­ply for two weeks. Dur­ing that time, she gave one group a run­ning wheel two hours a day while an­other was left alone with just their lit­tle white knuck­les. Dur­ing the ab­sti­nence pe­riod, the run­ning rats pressed the empty drug-re­lease lever 35 per cent less than their coun­ter­parts. When small doses of the drug were rein­tro­duced, the run­ning rats pressed 45 per cent less. (Sim­i­lar re­sults were found in a sep­a­rate study con­ducted at the Univer­sity of Min­nesota at the same time.) In 2016, a sec­ond trial showed that when ex­er­cise was im­ple­mented within seven days af­ter sus­pend­ing drug use, crav­ings were dra­mat­i­cally re­duced.

‘We’ve shown that even a mod­est amount of ex­er­cise early in ab­sti­nence can re­verse changes in the brain and re­verse sub­se­quent re­lapse vul­ner­a­bil­ity,’ says Lynch. ‘Now, we’re try­ing to fig­ure out how ex­actly ex­er­cise is do­ing that.’

One el­e­ment, she says, may be an ex­er­cise-in­duced el­e­va­tion of brain­derived neu­rotropic fac­tor (BDNF), which helps make a protein nec­es­sary for brain cell com­mu­ni­ca­tion and mem­ory- en­cod­ing. Imag­ine this protein as the tele­phone lines be­tween brain cells and synapses. Drugs come in like light­ning, caus­ing worn and downed ca­bles. But sci­en­tists say a good, lungheav­ing sweat can ac­tu­ally re­pair some of the drug-in­duced neu­ro­log­i­cal dam­age. What’s more, BDNF might also en­cour­age the growth of new cells crit­i­cal to the brain’s abil­ity to learn as well as to re­pair synapses that can stave off de­pres­sion, both of which can con­trib­ute to suc­cess in re­cov­ery. One

Dr Wendy Lynch, an expert in ex­er­cise and ad­dic­tion, runs the Ri­vanna Trail in Vir­ginia, US.

study showed that run­ning de­grades trau­matic mem­o­ries among mice, thus po­ten­tially blunt­ing a prom­i­nent trig­ger for re­lapse.

BDNF may also in­crease lev­els of gamma-aminobu­tyric acid (GABA), the chief in­hibitory neu­ro­trans­mit­ter in the cen­tral ner­vous sys­tem. GABA makes us feel more tran­quil and gives us a sense of well-be­ing. With­out it, a per­son would con­stantly be on edge, anx­ious, un­able to re­lax – pre­cisely how an ad­dict of­ten feels and be­haves when gripped by crav­ings. In other words, GABA coun­ter­bal­ances the ex­ci­ta­tory role of glu­ta­mate, act­ing as the brain’s brakes, in a sense.

Ul­ti­mately, Lynch says, if sci­en­tists can pin­point when and how th­ese var­i­ous ex­er­cise-prompted changes are tak­ing place in the brain, they could then work out how to, lit­er­ally, pre­scribe phys­i­cal ac­tiv­ity – in pre­cise min­utes in­stead of mil­ligrams – and also at ex­actly the most ef­fec­tive points along the ad­dic­tion spec­trum. ‘ Ex­er­cise acts like a drug on the brain chem­i­cals,’ she says. ‘ But it’s a good type of drug that en­hances sys­tems that are in deficit. It re-reg­u­lates brain func­tions and can pre­vent re­lapse.’

FLIP­PING THE SWITCH

back in 1998, there was no dra­matic rock bot­tom. But just like the seem­ingly fate­ful con­stel­la­tion of fac­tors that had set me down a dark path, a num­ber of mishaps set me straight. I was ex­hausted. Con­trol­ling my be­hav­iour (min­imis­ing, ly­ing, de­ceiv­ing) had be­come a full-time job. And de­spite my avoid­ance of mir­rors (ex­cept with a rolled-up note be­tween my fin­gers), I’d caught too many harsh-lit glimpses of a guy who got rock-star wasted alone in his apart­ment, who brought home­less men back to his place for beers, whose wak­ing state was ei­ther guilt or stage fright, usu­ally both. I wanted to feel dif­fer­ent, some­thing, any­thing. So just shy of my 30th birth­day and with the pend­ing im­plo­sion of yet an­other ro­man­tic re­la­tion­ship, and this time with a young child in the mix, I grit­ted my teeth, dug in my fin­ger­nails, and re­solved to change course.

But with­out the gauze of booze and co­caine, my de­pres­sion, anx­i­ety and in­se­cu­ri­ties were prac­ti­cally blind­ing. Not sur­pris­ingly, I didn’t ex­actly part ways with my ad­dic­tive mind­set, my brain still trig­ger­ing any dopamine blast it could. I con­tin­ued to smoke heav­ily, gulped cof­fee, and ate like a pig, my hands and mouth a blur of ac­tiv­ity. At the cen­tre of my life gaped a bot­tle­shaped void that I packed with pizza, burg­ers and ice cream. Two years later, some­one snapped a photo of me on the beach. I was un­recog­nis­able – my nose and eyes were buried un­der a mound of pale dough, my belly drooped down to­ward the sand. I was sober, but not ex­actly the poster boy for re­cov­ery. ‘ The clas­sic treat­ment of ad­dic­tion is sim­ply the treat­ment of the drug the pa­tient is abus­ing and not ad­dress­ing other health is­sues such as smok­ing or overeat­ing,’ says Dr David Jones, a psy­chol­o­gist at Three Oaks Be­hav­ioral Health near Jack­son, Mis­sis­sippi, US. ‘ Peo­ple still main­tain that ad­dic­tive cy­cle on a daily ba­sis, that up-and- down cy­cle of “When do I get my next cig­a­rette or that next cho­co­late bar?” It keeps pa­tients in a state of hy­per-vig­i­lance.’ Jones, him­self re­cov­er­ing long-term from ad­dic­tions to al­co­hol and codeine, has been run­ning for 40 years, and the 10time marathoner is known to be­gin some group ther­apy ses­sions by tak­ing his pa­tients out for a few miles. Run­ning not only soft­ens some of the pains of so­bri­ety, he says, but it can in­ter­rupt those dis­placed ad­dic­tive be­hav­iors. ‘ What run­ning does is makes you pay more at­ten­tion to other is­sues as you’re start­ing to pro­duce your own lev­els of dopamine rather than depend­ing on those ex­ter­nal sources.’ While I can’t deny it was any­thing more than van­ity that first prompted me to break an hon­est sweat – in the pool, at first – I soon found my­self start­ing to sleep bet­ter and cut­ting back on the cho­co­late and dough­nuts. When I found my way

Daniloff, be­fore run­ning: drink­ing and smok­ing in a cheap mo­tel room in 1990.

onto a tread­mill, lit­tle by lit­tle, other things started to click. I even­tu­ally worked up the courage to run out­side, on a dirt road out­side of the small Ver­mont town, in the north­east of the US, where I’d been liv­ing.

Those first morn­ings were coal-black, predawn, when no one ex­cept the cows could see me. But the miles be­gan to steer me through so­bri­ety’s rough patches – ones I hadn’t yet faced – blunt­ing the de­pres­sion and panic just enough for me to start un­pack­ing the shame and guilt that still burned un­der my skin.

All of my apolo­gies would be drafted at six miles an hour as I picked across road­kill and ruts. The shin splints, sore mus­cles and seared lungs put me in a state of penance. The rare mo­ments that I did come upon an­other run­ner, even get­ting that sim­ple wave, with its silent un­der­stand­ing of work and re­ward, was enough to keep me go­ing. Af­ter years of draw­ing the cur­tains, I grad­u­ally be­gan to re­join the hu­man race.

There may have been a tran­si­tion of a dif­fer­ent sort tak­ing place, ac­cord­ing to Ratey. A key marker of re­cov­ery, he says, is the psy­cho­log­i­cal move be­tween the brain’s two re­ward sys­tems: the Re­ac­tive Re­ward Sys­tem, which op­er­ates from a more primal, in­stinc­tual, short­term po­si­tion, and the Re­flec­tive Re­ward Sys­tem, which is marked by the abil­ity to de­lay grat­i­fi­ca­tion, to make con­sid­ered de­ci­sions, and to think in the long term.

‘The Re­ac­tive is more an­i­mal­is­tic,’ says Ratey. ‘ It’s your crav­ing, you’re go­ing for it, you’re be­ing pushed from be­low. When you start run­ning, you build ad­di­tional brain con­nec­tions to help break the crav­ing and hold back the Re­ac­tive, to make it less po­tent. Re­flec­tive is more of a de­ci­sion be­hav­iour. You have goals and mo­ti­va­tion, an over­all wish, other ac­tiv­i­ties. You’re build­ing up the frontal cor­tex, which pro­motes new and won­der­ful learn­ing to help you achieve your goals.’

John Tavolacci, chief op­er­at­ing of­fi­cer at Odyssey House treat­ment cen­tres in New York City, is a long-term re­cov­er­ing ad­dict and 22-time marathoner who founded a pro­gramme called Run for Your Life, which has of­fered peo­ple run­ning and marathon train­ing since 2000. Tavolacci says he’s wit­nessed not only the crit­i­cal re­turn of self- es­teem, but out­right re­demp­tion. So far, 350 men re­cov­er­ing from ad­dic­tions un­der his watch have crossed the fin­ish line at the New York City Marathon – and then con­tin­ued mov­ing for­ward to­ward health­ier, pro­duc­tive lives.

‘ Odyssey House is the last stop on the re­cov­ery train,’ says Tavolacci. ‘ It’s not a lux­ury, pri­vate re­hab cen­tre. Th­ese are in­di­vid­u­als who may have been in prison, from low so­cioe­co­nomic back­grounds. There’s this his­tory of fail­ure, of every­one giv­ing up on them. The Run for Your Life pro­gramme is re­ally about show­ing the world you’re not use­less, not part of a so­ci­ety that every­one gave up on. This is an opportunity to prove every­one wrong.’ And re­demp­tion can lead to be­long­ing, both of which can trans­late to suc­cess in so­bri­ety.

‘ Peo­ple who have ad­dic­tions just want to fit in,’ says Tavolacci. ‘They’re mis­fits. Peo­ple re­lapse be­cause they don’t add any­thing to their life to make them feel like they be­long. They go to AA. They go to NA. But noth­ing else. What I find is peo­ple who go through the run­ning pro­gramme stay in treat­ment longer and the re­search says that with long-term treat­ment, the longer you stay in it, the more likely you are to suc­ceed.’ The im­por­tance of that sense of be­long­ing and con­nec­tion is some­thing that is also em­pha­sised at Re­cov­ery Run­ners in Glas­gow. The or­gan­i­sa­tion, which launched in 2012, ini­tially started as a pro­gramme for ad­dic­tion­ser­vice users to train for the Great Scot­tish Run. It ex­panded to cre­ate a plat­form for them to con­tinue run­ning and find a fo­cus out­side their strug­gles.

Dr David Jones, be­lieves in a holis­tic ap­proach to re­cov­ery and pre­scribes run­ning.

Re­cov­ery Run­ners now hold three train­ing ses­sions per week that, cru­cially, are open to the wider com­mu­nity as well as those with ad­dic­tions. They also en­cour­age re­cov­ered ad­dicts to vol­un­teer and work to­wards coach­ing qual­i­fi­ca­tion, keep­ing them in­volved in the group for the long haul and per­pet­u­at­ing those all-im­por­tant feel­ings of pur­pose and self-worth.

The group also re­cently launched its own se­ries of races – The Re­cov­ery 3K, 5K and 10K – to foster more con­nec­tions be­tween re­cov­er­ing run­ners and those out­side the group. ‘ We took the step to or­gan­ise our own races in the hope that we can bring to­gether our run­ners with the wider run­ning com­mu­nity, to help them make steps to re­turn­ing to main­stream ac­tiv­i­ties and im­prov­ing their so­cial net­works,’ says John Mil­li­gan, a se­nior ad­dic­tion worker for the South Glas­gow Com­mu­nity Ad­dic­tion Team who run the project.

In Ot­tawa, Canada, all able-bod­ied res­i­dents at the Har­vest House treat­ment cen­tre are re­quired to run five times a week as part of the re­cov­ery pro­gramme. In the win­ter, they shovel snow off the track on the grounds be­hind the main build­ing. In less in­clement weather, they can run on the nearby net­work of trails.

‘ When you talk about re­lapse, the abil­ity to recog­nise stress and man­age it through ex­er­cise and diet is so key to peo­ple stay­ing sober,’ says as­so­ci­ate pro­gramme di­rec­tor Gary Wand, him­self a run­ner and in long-term re­cov­ery from ad­dic­tion. ‘That’s the big trans­for­ma­tion I see. Peo­ple are recog­nis­ing that I’m go­ing to have more stress than the next guy be­cause of my back­ground, my his­tory with drug and all the other re­lated prob­lems, but what works for me is a re­ally good ex­er­cise pro­gramme. . . With run­ning and good nu­tri­tion, we’re see­ing peo­ple stay­ing sober longer.’

TWELVE STEPS VER­SUS TWELVE MIL­LION

that run­ning is in­her­ently a bet­ter ap­proach than oth­ers, such as Al­co­holics Anony­mous. But 18 years down the road, it’s played a lead­ing role in my life and, for what­ever rea­sons ( per­haps di­vine grace), I have never re­lapsed. When it comes to stay­ing clean and sober, I’m a be­liever that we all must forge our own paths. For some, per­haps for many, run­ning is just one of sev­eral tools. Plenty of my run­ner friends in re­cov­ery whom I ad­mire and re­spect swear by the 12-step ap­proach.

‘It’s like when we treat cancer, we don’t just give one chemo­ther­apy agent, we give mul­ti­ples,’ says Volkow, her­self a ded­i­cated run­ner. ‘Same with HIV: three an­tivi­ral reme­dies are given so the out­comes are much bet­ter. My per­spec­tive on ad­dic­tion is the same. Ad­dic­tion is a dan­ger­ous dis­ease. It can have dev­as­tat­ing con­se­quences, in­clud­ing death, and you treat it ag­gres­sively. Not every­body re­sponds to the same treat­ment ap­proach, so in that re­spect it’s no dif­fer­ent from any other med­i­cal dis­eases.’

To some ex­tent I can un­der­stand why peo­ple think I’ve merely traded one ad­dic­tion for an­other. But ul­ti­mately I find this per­spec­tive too nar­row. Un­like booz­ing, run­ning has never filled me with shame or re­gret, not once turned me into a mon­ster. I have never stolen, lied or cheated for run­ning. I don’t need more miles to get the same ef­fect. The trade that took place was so­bri­ety for ad­dic­tion, a dark cen­tral rhythm re­cast in light.

While not enough sci­en­tific stud­ies have been con­ducted on the ad­dic­tive qual­i­ties of ex­er­cise, I can see ways in which run­ning – or rather, not run­ning – has ef­fects that can echo with­drawal from drugs or al­co­hol. If I miss sev­eral days of run­ning, I might feel a lit­tle slug­gish, un­fo­cused, some­times ir­ri­ta­ble. I have some­times found my­self en­vi­ous when I see other run­ners, even if I’d laced up the day be­fore.

‘I would be cau­tious to say ‘ with­drawal,”’ says Volkow. ‘That term is one I use with very spe­cific con­no­ta­tions. But I can tell you that if I don’t ex­er­cise, I ac­tu­ally feel very un­com­fort­able. Run­ning gives me a great sense of well­be­ing and calms me down.’

Iron­i­cally, peo­ple re­cov­er­ing from ad­dic­tion may even have an advantage when it comes to en­durance sports, stem­ming from a per­son­al­ity that once chased drugs with bot­tom­less zeal. In fact, cer­tain ‘sur­vival’ skills de­vel­oped in ad­dic­tion – tol­er­ance for pain, sin­gle-minded fo­cus, in­ge­nu­ity born of des­per­a­tion, ease with iso­la­tion, a cold com­fort with hu­mil­i­a­tion – can be har­nessed on that 100-mile run or Iron­man triathlon.

I re­mem­ber one morn­ing back when I was still drink­ing, I showed up for a phys­i­cally de­mand­ing job, to help move sev­eral tons of hay, af­ter a rag­ing ben­der. It was win­ter in Ver­mont and the cold only made my head ache more. I had slept for only two drunken hours and made it to the job with what felt like bat­tery acid in my belly. I soiled my­self half­way through. But de­spite the ever-present shakes and ex­is­ten­tial crises spool­ing through my mind, I kept go­ing – partly be­cause go­ing home sick would be a shame­ful ad­mis­sion of a prob­lem and partly be­cause I knew I had a six-pack of beers wait­ing for me at the end. So to­day, to gird against giv­ing up in the late stages of a race, I’ll say to my­self, ‘ You haven’t even crapped your­self yet.’

And sure, we roll with the punches. We get knocked down and con­tinue to rise. ‘As ad­dicts, we’re sub­ject to be­ing eas­ily dev­as­tated, and those set­backs can kill,’ says Char­lie En­gle, author of Run­ning Man: a Me­moir (Scrib­ner Book Com­pany), which de­tails his jour­ney from crack ad­dict to en­durance ath­lete who once ran across the Sa­hara Desert. En­gle is an expert in the field of pain and, in his sober life, ris­ing up against ad­ver­sity (which for him in­cluded a stint in prison). It’s some­thing he’s learned through run­ning. ‘At least five times dur­ing an ul­tra, ev­ery­thing goes wrong,’ he says. ‘ But I’ve learned that no sin­gle event is the end of the world.’ It’s not that life or the run need be per­fect, he ex­plains, it’s how we adapt to the set­back – and that we con­tinue to run.

Volkow says that an in­tense drive, even com­pul­sive pat­terns, should not nec­es­sar­ily be viewed as ab­nor­mal in the con­text of achiev­ing ath­letic goals. ‘At the end of the day, there is a rea­son we have the ca­pac­ity to sus­tain ef­fort even when it’s painful,’ she says. ‘ Be­cause it pro­vides an advantage for sur­vival.’

Back in Colorado, as I be­gin zigzag­ging down from the sum­mit of Pikes Peak to­wards thicker, more oxy­gen-rich air, I think about my past, my own tough­ness, my brain chem­i­cals – hope­fully on the nor­mal spec­trum by now – and the life that run­ning has given me. Dur­ing my drink­ing and drug-tak­ing years, de­spite deep-seated in­se­cu­ri­ties, I fell un­der the spell of my own per­ceived grandeur. Now, I need to con­tin­u­ally re­in­force that I am no longer that de­gen­er­ate loser I once was. This con­flict in me still ex­ists – cor­rod­ing at my edges – at times drift­ing to the sur­face if I stay still for too long.

In this race, as all oth­ers, I will get passed. I’ll strug­gle against giv­ing up, with the lim­i­ta­tions of my body. I’ll as­sess my worth as an ath­lete, as a per­son. And that’s why I run. For a sober per­son – for any­body, in fact – the great­est gift run­ning can give is its abil­ity to ren­der us hu­man while si­mul­ta­ne­ously show­ing us the strength we have.

Run­ning down the edge of this moun­tain, I look around at the ter­rain and at other peo­ple, run­ners who slap me on the back as they dash by. This is where joy is found. This mo­ment. As long as I keep run­ning, I can re­main in this state – a state not only of mov­ing for­ward, but of be­ing.

Daniloff crosses the fin­ish in tri­umph at the Pikes Peak Marathon in 2013.

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