Pubdate: Thu, 12 Oct 2006 Source: New York Times (NY) Copyright: 2006 The New York Times Company Contact: http://www.nytimes.com/ Details: http://www.mapinc.org/media/298 Author: Paul Scott Bookmark: http://www.mapinc.org/rehab.htm (Treatment) BODIES IN MOTION, CLEAN AND SOBER WHEN Todd Crandell competes in the Ironman World Championship in Hawaii this month, it will mark his 12th Ironman in seven years. The remarkable is no longer remarkable, of course. Tens of thousands of people have completed one. But Mr. Crandell's path to the starting line was unconventional. He first learned of the endurance showcase while smoking crack cocaine. Now sober, Mr. Crandell, 39, recalls how at 21 he watched television coverage of the triathlon (2.4-mile swim, 112-mile bicycle ride and 26.2-mile run) in awe while struggling with alcohol and cocaine addictions. In a memoir, "Racing For Recovery: From Addict to Ironman," he describes his path of self-destruction as marked by drug dealing, arrests and living out of a Buick filled with gin and Motley Crue posters. Today he runs Racing for Recovery, a five-year-old foundation based in Sylvania, Ohio, that encourages people battling dependency to exercise as a way to create much-needed structure in their lives. More than 2,000 people have run in 5-kilometer races organized by the foundation around the country. Strenuous exercise has not been a part of traditional recovery programs like Alcoholics Anonymous or the Betty Ford Center, which emphasize abstinence above all else. But a few treatment centers, and former addicts like Mr. Crandell, are coming to see the value of road running and other fitness regimens in building confidence and managing stress for those battling alcohol and drugs. Mr. Crandell said he and other addicts he knows embrace regular conditioning as a way to help them stay sober and to pursue goals. And for those who are competitive, preparing for a race not only eats up time and distracts them from temptations, it also can help them establish goals and make clean-living new friends. Odyssey House, a treatment program in New York City, shares that view. On Sept. 23, 1,000 walkers and runners, many of them ex-addicts, participated in a 5-kilometer race organized by the program. It also now has 15 residents preparing for next month's New York City Marathon. "We're turning people who were heroin addicts, cocaine addicts, crack addicts into marathon runners," said Peter Provet, the president of Odyssey House. "I really believe it's a model for other treatment centers." A new study seems to back up the idea that exercise can play a role in addiction recovery. Butler Hospital, affiliated with Brown University in Providence, R.I., recently completed a study that tracked 44 alcoholics and found that outpatient treatment and 12 weeks of aerobic conditioning increased the likelihood of their remaining sober. Research also has found that aerobic exercise improves symptoms of mild to moderate depression. Considering that depression is a risk factor for relapse for substance abusers, alleviating some of the disease's burden may help addicts stay sober. Dr. Provet, a clinical psychologist, calls physical activity "the perfect antidote to addiction." Ordinary hobbies don't suffice, he said. "Knitting is good, but knitting does not address the negative breakdown of the human spirit and human body. Running does." Odyssey House, with over 1,000 low-income patients in its nine centers, encourages clients to run. Activity counselors lead residents on group treks three to four times a week; athletic clothing and footwear are provided when needed. Nancy Waite-O'Brien, the vice president for clinical services at the Betty Ford Center in Rancho Mirage, Calif., said she thinks that helping addicts train for a race is a "terrific idea." But helping patients accomplish their training goals is not always feasible for short-stay centers like Betty Ford, she said. Patients tend to stay three to four weeks at the Betty Ford Center compared with state-financed centers like Odyssey House, where patients reside an average of nine months to a year. The Betty Ford Center does not reject the benefits of exercise; it has a gym and offers some personal training, which the able-bodied can take advantage of, Dr. Waite-O'Brien said. But, she said: "Sometimes people are physically sick when they arrive. What we're doing is mostly helping them get moving." The Butler Hospital study suggests that incorporating exercise into recovery programs may be beneficial. Richard A. Brown, Butler's director of addiction research, said their randomized controlled trial is in the final stages, but has already noted the impact that moderate exercise has had on previously sedentary alcoholics in outpatient treatment. The study used a control group, which was given only brief advice on the benefits of activity. The intervention group, though, received a weekly gym session, with instruction, on cardiovascular machines. The exercise group also attended discussions about overcoming barriers to activity, and were instructed to do two or three workouts on their own. Two months into the intervention, the group that participated in structured exercise sessions was two and a half times more likely to be abstinent from alcohol than those in the control group, according to preliminary results. Dr. Brown also reported that the more moderate exercise the alcoholics did, the higher the rates of their abstinence. "What we showed was when people are actively engaged in exercise they are doing better," Dr. Brown said. "The question is how to keep them engaged." After six months, Dr. Brown found, his charges ran into the same problem many of us do: their training dwindled. Jean Ferlesch, 54, who has been sober for two decades, wouldn't dream of giving up her running and weight lifting routine. She recalls how the toil of exercise helped her manage emotions wrought by her divorce that at one time would have caused her to drink. "I started going to the gym and I was so sad and so angry," she said. As she built up endurance, she imagined herself emotionally strong. "I ran through my pain." Being able to persevere was novel, said Ms. Ferlesch, a store designer living in Brooklyn. "Years ago when something hurt, I would do anything to get away from that feeling," she said. "It's a more sophisticated understanding of pain now. I can sit with it and go through it, be it physical or emotional." Other ex-addicts are drawn to competition for the exhilaration it offers. When Glen Caulkins, 53, of Dana Point, Calif., took up freestyle snowboarding four years after he kicked heroin, the intensity of his new sport felt familiar. Doing 60-foot aerial stunts was "the edge, and I was used to the edge," said Mr. Caulkins, the owner of Glenhaven Sober Living Homes, a drug-free residence in San Clemente, Calif. He went on to become a three-time national snowboarding champion. "It was a fix for about 10 years," said Mr. Caulkins, who now prefers inline skating and practicing yoga. Besides stimulation, Mr. Caulkins said, snowboarding gave him something far more mundane, a new social identity. "It gave me a whole group of friends who didn't know my past," he said. Exercise can also add structure to lives that once revolved around using. "When you're drinking four, five, six hours a day, that in itself is an activity," said Steve Vallender, 38, a recovering alcoholic and financial planner from Las Vegas who has set up a chapter of Racing for Recovery in his hometown. "I found myself with three, four hours of idle time every night and that's when I started working out." Ex-addicts looking to reinvent themselves commonly look to the sport of triathlon, said Alan Ley, the coaching education manager for USA Triathlon. "We've got a lot of people in triathlon training who are trying to change old habits, whether they be related to drugs, alcohol or living a poor lifestyle," he said. "It's sort of like trading a negative addiction for a positive one." Melissa Ellefson Huray, 33, a freelance writer and disc jockey in Duluth, Minn., sees her marathon training as a way to manage emotions, even if it can feel like a dependency. "I have a schedule and I do it six days a week," said Ms. Huray, who was walking on a treadmill at 8:30 p.m. as she took part in a telephone interview. "I don't like to deviate from my schedule," she said. "If I didn't run, I don't think I would drink, but I might be on anxiety drugs or drugs for depression." She added: "I have to be vigilant. I can never let my guard down with drinking or running." Training consistently offers recovering addicts a way to regularly finish tasks. "There's a mentality of, 'Oh, someday I'll do it,' that alcohol perpetuates," said Heidi Stone, 34, a mortgage broker and recovering alcoholic living in Brooklyn. But through weight lifting three times a week, she not only has arms strong enough to do a military push-up, but also a sense of accomplishment. And that, experts say, is crucial to an ex-addict's growth. "Whether it is a 5K or a marathon, the closure of accomplishment is powerful," Dr. Provet said. Racking up Ironman finishes is a way for Mr. Crandell to feel good but also to send a message to other addicts that they, too, can start over. He added: "There's more to life than saying 'I'm powerless over alcohol' and 'I've got to come to support-group meetings.' " - --- MAP posted-by: Beth Wehrman