The Perils of Intellectual Thinking

Tuesday, June 1st, 2010

Recently, I was moved by Clinton McCracken’s brave essay in The Journal of the American Medical Association.

In the article, Dr. McCracken, a research scientist who specializes in addiction, reveals the tragic results of his own substance abuse.  For three years, he writes that he “intellectualized” his problem, convinced that his intelligence and training would allow him to maintain control over his drug use and prevent negative consequences. Sadly, the illusion was shattered last fall when his fiancée, a fellow scientist, died after injecting opioids that were likely contaminated.  After the police found a considerable amount of drugs in the home they shared, he was evicted, charged with a number of felonies, and lost his postdoctoral fellowship. He offers his story as a cautionary tale for anyone who believes they can outsmart addiction.

Dr. McCracken’s courageous piece hit me on a gut level, not only as a fellow researcher in the field of addiction, but also, as a person in long-term recovery who, on a regular basis, reminds herself not to approach her illness intellectually.

I entered treatment in my early twenties for a cocaine problem that prevented me from keeping a relationship, a job, or an apartment. I dropped out of school, moved eleven times in four years, and suffered a small stroke. Needing professional help, I entered an outpatient program and eventually got my life back on track. Over the next nine years, I went from community college to a bachelor’s degree to earning my doctorate.

Although recovery has allowed me to achieve goals I never imagined possible, I nearly gave it all up on three different occasions because, like Dr. McCracken, I fell into the trap of intellectualizing my feelings. This happened once during a particularly stressful period of my internship when, lonely and depressed, I took a shot of my roommate’s tequila.  A year later, I had a glass of wine on a flight to Europe, rationalizing that the rules of recovery didn’t apply thousands of feet above ground. Finally, the next year, while spending a weekend in California, I decided to take my former dealer out to show her how well I was doing. Sometime during our brunch, I somehow decided it would be a blast to freebase cocaine one more time. “I know so much more now,” I told myself. “I can handle this.”

Convinced that “the new Deni” could control her drinking and drug use, I didn’t realize that I was willing to risk losing everything I had worked so hard to accomplish.  Thankfully, and luckily, the coke I bought was never delivered. If it had been, I don’t think I would be here today.

Fifteen years later, whenever I get the urge to use, I try to keep it simple: You’ve got a great life and recovery has worked so well for you, so why change it?  No matter how far I’ve come, I will always have a chronic medical disorder that requires an ongoing commitment to maintain sobriety under any circumstances.

Dr. McCracken’s essay didn’t mention treatment, but I hope he’s getting the help he needs. He has paid a tremendous price for his substance abuse, but if I had the opportunity, I would tell him that all is not lost.  The public knows that people who use drugs can do stupid, foolish things.  But, what they don’t know—if we don’t show them—is that people in recovery can go on to do amazing things.  If he makes a sincere commitment to recovery, I have no doubt that he will revive his career and come back even stronger.

In sharing his story, he’s done a great service.  He helped me remember the importance of keeping recovery a priority in my life—for the perception of control is an illusion.

Deni Carise, Ph.D.
Chief Clinical Officer, Phoenix House
Adjunct Clinical Professor, University of Pennsylvania
Senior Scientist, Treatment Research Institute

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4 Comments

  • I recall people asking me, “How can an intelligent guy like you get strung-out on heroin. Well, my “intelligence” told me in 1959 that I should be careful with heroin because it’s addictive, so I took what I read about using heroin three days in a row would get one hooked, and kept my use to every three days. Then I used my “intelligence” to tell myself that I can use every day if I split a three-dollar bag into thirds. There were more “intelligent” decisions in my six-year habit that was broken-up periodically by a bust or taking the “21-day cure” at Manhattan General Hospital / Morris Bernstein Institute on Second Avenue and 18th Street, and a trip to the Public Health Hospital in Lexington, Kentucky. but my intelligence–my real intelligence– won-out when I joined the program that got started at Morris Bernstein Institute in late 1966 / early 1967, which came to be named Phoenix House.


  • I thank all three of you for sharing this story, because you never realize how significant the timing comes.


  • My son too, intellectualized his use. He was a Paramedic and an RN and he “knew” what he could do and could not do. He was “too smart” (and his IQ was indeed 150) to get into trouble using.

    On December 1st, 2002, we lost our beloved son to a crack/heroin OD. He accomplished amazing things, all the while being addicted. The one thing he couldn’t accomplish was the defeat of what I call The Addiction Monster.


  • I was touched by your words, Sheryl because I didn’t expect your son to have not survived. I myself have felt I’m living on borrowed time because I survived four overdoses–by the most uncanny luck of people reviving me, including a guy I only met once, from whom I copped some h and shot it in his apartment in Harlem. He injected salt into me, which revived me. One time I had the luck of doing it in a restaurant toilet whose door bottom was about eighteen inches off the floor–and through which the guy whose “works” I borrowed to shoot up, dragged me and put my head in a sink to run cold water over it, and slap me around. If I had my own works, that’d be it. You don’t need to hear all that, but I just felt like sharing it. I’m sorry for your loss.



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